The year 2020 has yielded twin crises in the United States: a global pandemic and a public reckoning with racism brought about by a series of publicized instances of police violence toward Black men and women. Current data indicate that nationally, Black Americans are three times more likely than White Americans to contract Covid-19, a pattern that underscores the more general phenomenon of health disparity among Black and White Americans. Once exposed, Black Americans are twice as likely to die of (...) the virus. Unsurprisingly, Black Americans report higher levels of fear of Covid-19 than their White peers, but they also report higher levels of hesitancy toward a Covid-19 vaccine. This paper explores why this apparent discrepancy exists. It also provides practical recommendations for how government and public health leaders might address vaccine hesitancy in the context of the twin crises of 2020. (shrink)

In the original publication, the sentence “Most notable and famous are the Tuskegee syphilis experiments that occurred from 1932–1972, in which Black men in Macon County, AL were infected with syphilis under the guise of free health care.” under the section “Drivers of Mistrust of Motives” was published incorrectly. The correct one is “Most notable and famous are the Tuskegee syphilis experiments that occurred from 1932–1972, in which Black men in Macon County, AL many of whom had latent syphilis, were (...) misled into believing that they would receive free health care in exchange for their participation. (shrink)

Autism spectrum disorder affects an estimated 1 in 54 children aged 8 years in the United States. For many of these children, there are concomitant eating and/or behavioral challenges that can make managing their nutritional health challenging. This commentary responds to a particularly challenging case in which a pediatric patient with ASD presented to the local hospital’s emergency department with severe weight loss and malnutrition.

Ms. Johnson’s case highlights a number of the ethical challenges that can arise when treating anorexia nervosa, including uncertainty about a patient’s decisional capacity, the limitations of treat...

This article discusses the new reproductive technology of egg freezing in the context of existing literature on gender, medicalization, and infertility. What is unique about this technology is its use by women who are not currently infertile but who may anticipate a future diagnosis. This circumstance gives rise to a new ontological category of “anticipated infertility.” The author draws on participant observation and a qualitative analysis of scientific, mainstream, and marketing literature to identify and compare the representation of two different (...) candidates for egg freezing: women with cancer and healthy young women. Although both populations experience anticipated infertility, their dichotomous portrayals as appropriate candidates are demonstrative of gender norms linking women to motherhood. Egg freezing is a concise illustration of how the medicalization of women’s bodies and bodily processes masks a host of cultural anxieties about aging, illness, reproduction, and risk. (shrink)

Michael A. Petersa and Fazal Rizvib aBeijing Normal University, Beijing, PR China; bMelbourne University, Melbourne, Australia Our minds are still racing back and forth, longing for a return to ‘no...

Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include (...) a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sensemaking processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed. (shrink)

This letter addresses the editorial decision to publish the article, “Research on group differences in intelligence: A defense of free inquiry” (Cofnas, 2020). Our letter points out several critical problems with Cofnas's article, which we believe should have either disqualified the manuscript upon submission or been addressed during the review process and resulted in substantial revisions.

Development and targeting efforts by academic organizations to effectively promote research integrity can be enhanced if they are able to collect reliable data to benchmark baseline conditions, to assess areas needing improvement, and to subsequently assess the impact of specific initiatives. To date, no standardized and validated tool has existed to serve this need. A web- and mail-based survey was administered in the second half of 2009 to 2,837 randomly selected biomedical and social science faculty and postdoctoral fellows at 40 (...) academic health centers in top-tier research universities in the United States. Measures included the Survey of Organizational Research Climate (SORC) as well as measures of perceptions of organizational justice. Exploratory and confirmatory factor analyses yielded seven subscales of organizational research climate, all of which demonstrated acceptable internal consistency (Cronbach’s α ranging from 0.81 to 0.87) and adequate test–retest reliability (Pearson r ranging from 0.72 to 0.83). A broad range of correlations between the seven subscales and five measures of organizational justice (unadjusted regression coefficients ranging from 0.13 to 0.95) document both construct and discriminant validity of the instrument. The SORC demonstrates good internal (alpha) and external reliability (test–retest) as well as both construct and discriminant validity. (shrink)

Physicians anecdotally report inquiring about incarcerated patients’ crimes and their length of sentence, which has potential implications for the quality of care these patients receive. However, there is minimal research on how a physician’s awareness of their patient’s crimes/length of sentence impacts physician behaviours and attitudes. We performed regression modelling on a 27-question survey to analyse physician attitudes and behaviours towards incarcerated patients. We found that, although most physicians did not usually try to learn of their patients’ crimes, they often (...) became aware of them. We observed associations between awareness of a patient’s crime and poor physician disposition towards their patients and between physicians’ poor dispositions and lower reported quality of care. These associations suggest that awareness of a patient’s crime may reduce quality of care by negatively impacting physicians’ dispositions towards their patients. Future quantitative and qualitative studies, for example, involving physician interviews and direct patient outcome assessments, are needed to confirm these findings and further uncover and address hurdles incarcerated patients face in seeking medical care. (shrink)

Research about the Olympic Games has primarily focused on preparing athletes for competition. Less attention has been paid to the post-Olympic-phase and athlete well-being during this time. This study explored Australian Olympic athletes’ experiences following the conclusion of the 2016 Rio Olympic Games, including the factors that may have contributed to or challenged their well-being during this time. Eighteen athletes participated in semi-structured interviews and thematic analysis revealed that when Olympic performance appraisal met prior expectations, when athletes planned for a (...) return to work or study, and when support from a variety of sources was readily available, this positively influenced athletes’ well-being during the POP. When these factors were not in place, more challenging post-Games experiences were present, and well-being was compromised. The findings contribute to the broader literature on elite athlete well-being and at an applied level, may be used to inform targeted programs that focus on supporting athletes after an Olympic campaign. (shrink)

Previous studies have shown a robust bias to express the goal path over the source path when describing events. Motivated by linguistic theory, this study manipulated the causal structure of events and measured the extent to which adults and 3.5- to 4-year-old English-speaking children included the goal and source in their descriptions. We found that both children's and adults’ encoding of the source increased for events in which the source caused the motion of the figure compared to nearly identical events (...) in which the source played no such causal role. However, a goal bias persisted overall for both causal and noncausal motion events. These findings suggest that although the goal bias in language is highly robust, properties of the source influence its likelihood of being encoded in language, thus shedding light on how properties of an event can influence the mapping of event components into language. (shrink)

In this issue, we present two symposia on recent, influential books which have already sparked important research in philosophy and psychology. A common characteristic of these two very different b...

Against the backdrop of cultural and political ideals, this article highlights both the significance of mental health nursing in meeting population needs and the regulatory barriers that may be impeding its ability to adequately do so. Specifically, we consider how ambiguous notions of ‘proficiency’ in nurse education—prescribed by the regulator—impact the development of future mental health nurses and their mental health nursing identity. A key tension in mental health practice is the ethical‐legal challenges posed by sanctioned powers to restrict patients' (...) freedom at the same time as the desire (and obligation) to promote patients' self‐determined recovery. The genericism of the UK's Future Nurse Standards do little to prepare mental health nurses to navigate the tensions that ensue. This has consequences for nurses and patients alike, as both risk experiencing the distress and dissonance that attends giving or receiving poor care. We argue that more needs to be done to enable mental health nurses to define and articulate the nuances of the profession as part of becoming critical, thoughtful and confident practitioners. Educators can contribute to this mission by aligning curriculum, pedagogy and assessment to create meaningful opportunities for mental health nursing students to engage with the complexities of mental health nursing practice. Without this, the credibility of the profession will continue to be questioned; its future uncertain. (shrink)

Storytelling, art and craft can be considered aesthetic expressions of identities. Kalahari identities are not fixed, but fluid. Research with present-day Kalahari People regarding their artistic expression and places where it has been, and is still, practised highlights that these expressions are informed by spirituality. This article explores this idea via two Kalahari case studies: Water Stories recorded in the Upington, Kakamas area, as well as research on a specific rock engraving site at Biesje Poort near Kakamas. The importance of (...) the Kalahari People’s spiritual beliefs as reflected in these case studies and its significance regarding their identities and influence on social change and/or community development projects is discussed. The article thus highlights ways in which spirituality can be considered in relation to social change projects that are characterised by partnerships between local community, non-government and tertiary education representatives and researchers and that highlight storytelling as an integral part of people’s spirituality. (shrink)

Previous studies have shown a robust bias to express the goal path over the source path when describing events (“the bird flew into the pitcher,” rather than “… out of the bucket into the pitcher”). Motivated by linguistic theory, this study manipulated the causal structure of events (specifically, making the source cause the motion of the figure) and measured the extent to which adults and 3.5‐ to 4‐year‐old English‐speaking children included the goal and source in their descriptions. We found that (...) both children's and adults’ encoding of the source increased for events in which the source caused the motion of the figure compared to nearly identical events in which the source played no such causal role. However, a goal bias persisted overall for both causal and noncausal motion events. These findings suggest that although the goal bias in language is highly robust, properties of the source (such as causal agency) influence its likelihood of being encoded in language, thus shedding light on how properties of an event can influence the mapping of event components into language. (shrink)

Background Design thinking is a tool for generating and exploring ideas from multiple stakeholders. We used DT principles to introduce students to the ethical implications of organ transplantation. Students applied DT principles to propose solutions to maximise social justice in liver transplant allocation. Methods A 150 min interactive workshop was integrated into the longitudinal ethics curriculum. Following a group didactic on challenges of organ donation in the USA supplemented by patient stories, teams of students considered alternative solutions to optimise fairness (...) of organ distribution and ethical implications of changing the current model. Facilitators led students through DT steps of empathy, defining the team’s point of view, ideating on potential solutions, prototyping a specific idea and testing the idea through oral presentation, with questions and answers by peers and faculty. The curriculum was evaluated with presurveys and postsurveys including quantitative and open-ended items. Results 100 first year medical students participated. Before the session, 75.3% of students had no practical experience with DT. Following participation, students reported an increased understanding of the current liver transplant allocation system and an increased appreciation of shortcomings of the current organ allocation system. After the session, 73.8% of students felt that DT could be used to approach complex health system problems. Discussion Students participating in a DT workshop displayed improved knowledge and attitudes toward organ transplantation and DT. In this pilot study, DT showed promise as a student-led approach emphasising collaboration and creativity in ethics curricula in medical education. (shrink)

In this paper, I identify a form of epistemic insensitivity that occurs when someone fails to make proper use of the epistemic tools at their disposal in order to bring their beliefs in line with epistemically relevant evidence that is available to them. I call this kind of insensitivity agential insensitivity because it stems from the epistemic behavior of an individual agent. Agential insensitivity can manifest as a failure to either attend to relevant and available evidence, or appropriately interpret evidence (...) that is attended to. The concept of agential insensitivity allows us to conceptualize the kind of not-knowing involved in forms of ignorance that are cultivated and maintained by individual agents, especially when this ignorance is enabled or encouraged by social structures. I use the skepticism about racial disparities in policing practices that is displayed by many white Americans as a lens for exploring this connection. Understanding agential insensitivity thus provides insight into both social and epistemic phenomena. (shrink)

This grounded study investigated the negotiation of authorship by faculty members, graduate student mentors, and their undergraduate protégés in undergraduate research experiences at a private research university in the northeastern United States. Semi-structured interviews using complementary scripts were conducted separately with 42 participants over a 3 year period to probe their knowledge and understanding of responsible authorship and publication practices and learn how faculty and students entered into authorship decision-making intended to lead to the publication of peer-reviewed technical papers. Herein (...) the theoretical model for the negotiation of authorship developed through the analysis of these interviews is reported. The model identifies critical causal and intervening conditions responsible for the coping strategies faculty and students employ, which, in our study, appear to often produce unfortunate consequences for all involved. The undergraduate student researchers and their graduate student mentors interviewed in this study exhibited a limited understanding of authorship and the requirements for authorship in their research groups. The power differential between faculty and students, the students’ limited epistemic development, the busy-ness of the faculty, and the faculty’s failure to prioritize authorship have been identified as key factors inhibiting both undergraduate and graduate students from developing a deeper understanding of responsible authorship and publication practices. Implications for graduate education and undergraduate research are discussed, and strategies for helping all students to develop a deeper understanding of authorship are identified. (shrink)

In several recent publications, Professor Adolf Grünbaum has inveighed against the conventionalism of writers like Einstein, Poincaré, Quine and especially Duhem. Specifically, Grünbaum has assailed the view that a single hypothesis can never be conclusively falsified. Grünbaum claims that the conventionalists’ insistence on the immunity of hypotheses from falsification is neither logically valid nor scientifically sound. Directing the weight of his argument against Duhem, Grünbaum launches a two-pronged attack. He insists, first, that conclusive falsifying experiments are possible, suggesting that Duhem's (...) denial of such experiments is a logical non-sequitur. He then proceeds to show that, more than being merely possible, crucial falsifying experiments have occurred in physics. I do not intend to make a logical point against Grünbaum's critique so much as an historical and exegetical one. Put briefly, I believe that he has misconstrued Duhem's views on falsifiability and that the logical blunder which he discusses should not be ascribed to Duhem, but rather to those who have made Duhem's conventionalism into the doctrine which Grünbaum attacks. Whether there are any writers who accept the view he imputes to Duhem, or whether he is exploiting “straw-men” to give weight to an otherwise trivial argument is an open question. For now, I simply want to suggest that his salvos are wrongly directed against Duhem. (shrink)

A fundamental goal of research in neuroscience is to uncover the causal structure of the brain. This focus on causation makes sense, because causal information can provide explanations of brain function and identify reliable targets with which to understand cognitive function and prevent or change neurological conditions and psychiatric disorders. In this research, one of the most frequently used causal concepts is ‘mechanism’ — this is seen in the literature and language of the field, in grant and funding inquiries that (...) specify what research is supported, and in journal guidelines on which contributions are considered for publication. In these contexts, mechanisms are commonly tied to expressions of the main aims of the field and cited as the ‘fundamental’, ‘foundational’ and/or ‘basic’ unit for understanding the brain. Despite its common usage and perceived importance, mechanism is used in different ways that are rarely distinguished. Given that this concept is defined in different ways throughout the field — and that there is often no clarification of which definition is intended — there remains a marked ambiguity about the fundamental goals, orientation and principles of the field. Here we provide an overview of causation and mechanism from the perspectives of neuroscience and philosophy of science, in order to address these challenges. (shrink)

The role of emotions in mental life is the subject of longstanding controversy, spanning the history of ethics, moral psychology, and educational theory. This paper defends an account of love’s cognitive power. My starting point is Plato’s dialogue, the Symposium, in which we find the surprising claim that love aims at engendering moral virtue. I argue that this understanding affords love a crucial place in educational curricula, as engaging the emotions can motivate both cognitive achievement and moral development. I first (...) outline the state of the challenge between dominant rival theories regarding emotions in learning. Next, I demonstrate how Platonic virtue ethics offers the most tenable prospect for an education of reason and emotion. Third, I sketch three practical ways educators might constructively engage emotions in the classroom. I conclude that love’s virtue is its peerless power to motivate the creative and lateral thinking which leads to moral development. (shrink)

Causal selection has to do with the distinction we make between background conditions and “the” true cause or causes of some outcome of interest. A longstanding consensus in philosophy views causal selection as lacking any objective rationale and as guided, instead, by arbitrary, pragmatic, and non-scientific considerations. I argue against this position in the context of causal selection for disease traits. In this domain, causes are selected on the basis of the type of causal control they exhibit over a disease (...) of interest. My analysis clarifies the principled rationale that guides this selection and how it involves both pragmatic and objective considerations, which have been overlooked in the extant literature. (shrink)

The work of the French philosopher Jean-Luc Nancy shares with the thinkers of the ‘theological turn in phenomenology’ the programmatic desire to place the ‘theological’, in the broad sense of rethinking the religious traditions in our secular time, back on the agenda of critical thought. Like those advocating a theological turn in phenomenology, Nancy’s deconstructive approach to philosophical analysis aims to develop a new sensibility for the other, for transcendence, conceptualized as the non-apparent in the realm of appearing phenomena. This (...) is why Nancy launches a project looking for the ‘unthought’ and unexpected within the Christian traditions, called deconstruction of Christianity. However, the deconstructive approach to the non-apparent differs fundamentally from that of the thinkers of the turn (1) in its being non-apologetic and non-restorative with regard to religion, because it starts from a problematization of the—typically modern, that is romantic—desire to defend and protect what would be ‘lost’ and possibly to restore this, (2) in its focus on the complex difference-at-work (différance) between religion and secularism, a difference that can be termed entanglement and complicity between these two, (3) in its hypothesis that this entanglement is essentially one between (the meaning and experience of, the rituality around) presence and absence in modern culture, (4) in its conviction that the philosophy and history of culture must join, support, complete and maybe even turn around phenomenology when dealing with the difficult task of determining what exactly would be ‘left’ of the ‘theological’ in our time. In this article, both positions are compared and confronted further, leading to an account of Nancy’s re-readings of the Christian legacy (its theology, doctrine, art, rituals etc.), and ending in a more detailed, exemplary inquiry into the tension between distance and proximity, characteristic of the Christian God. (shrink)

Communication and Conflict Management Training for Clinical Bioethics Committees Content Type Journal Article Pages 341-349 DOI 10.1007/s10730-009-9116-7 Authors Lauren M. Edelstein, Johns Hopkins Medicine’s Howard County General Hospital 5755 Cedar Lane Columbia MD 21044 USA Evan G. DeRenzo, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Elizabeth Waetzig, Change Matrix Inc. 485 Maylin St. Pasadena CA 91105 USA Craig Zelizer, Georgetown University Department of Government 3240 Prospect St. Washington, D.C. NW 20057 USA Nneka (...) O. Mokwunye, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume 21, Number 4. (shrink)

Poor Eliza -- Pax Americana : the case of Show boat -- National brands, national body : Imitation of life -- Uncle Sam needs a wife : citizenship and denegation -- Remembering love, forgetting everything else : Now, voyager -- "It's not the tragedies that kill us, it's the messes" : femininity, formalism, and Dorothy Parker -- The compulsion to repeat femininity : Landscape for a good woman and The life and loves of a she-devil.

Social scientists appeal to various “structures” in their explanations including public policies, economic systems, and social hierarchies. Significant debate surrounds the explanatory relevance of these factors for various outcomes such as health, behavioral, and economic patterns. This paper provides a causal account of social structural explanation that is motivated by Haslanger (2016). This account suggests that social structure can be explanatory in virtue of operating as a causal constraint, which is a causal factor with unique characteristics. A novel causal framework (...) is provided for understanding these explanations–this framework addresses puzzles regarding the mysterious causal influence of social structure, how to understand its relation to individual choice, and what makes it the main explanatory (and causally responsible) factor for various outcomes. (shrink)

This book draws on the hermeneutics of Hans-Georg Gadamer to inform a feminist perspective of social identities. Lauren Swayne Barthold moves beyond answers that either defend the objective nature of identities or dismiss their significance altogether. Building on the work of both hermeneutic and non-hermeneutic feminist theorists of identity, she asserts the relevance of concepts like horizon, coherence, dialogue, play, application, and festival for developing a theory of identity. This volume argues that as intersubjective interpretations, social identities are vital (...) ways of fostering meaning and connection with others. Barthold also demonstrates how a hermeneutic approach to social identities can provide critiques of and resistance to identity-based oppression. (shrink)

Recent philosophical work has explored the distinction between causal and non-causal forms of explanation. In this literature, topological explanation is viewed as a clear example of the non-causal variety–it is claimed that topology lacks temporal information, which is necessary for causal structure. This paper explores the distinction between topological and causal forms of explanation and argues that this distinction is not as clear cut as the literature suggests. One reason for this is that some explanations involve both topological and causal (...) information. In these “borderline” cases scientists explain some outcome by appealing to the causal topology of the system of interest. These cases help clarify a type of topological explanation that is genuinely causal, but that differs from standard topological and interventionist accounts of explanation. (shrink)

This article examines the multiple realizability thesis within a causal framework. The beginnings of this framework are found in Elliott Sober’s “Multiple Realizability Argument against Reduction,”...

In several recent publications, Professor Adolf Grünbaum has inveighed against the conventionalism of writers like Einstein, Poincaré, Quine and especially Duhem. Specifically, Grünbaum has assailed the view that a single hypothesis can never be conclusively falsified. Grünbaum claims that the conventionalists’ insistence on the immunity of hypotheses from falsification is neither logically valid nor scientifically sound. Directing the weight of his argument against Duhem, Grünbaum launches a two-pronged attack. He insists, first, that conclusive falsifying experiments are possible, suggesting that Duhem's (...) denial of such experiments is a logical non-sequitur. He then proceeds to show that, more than being merely possible, crucial falsifying experiments have occurred in physics. I do not intend to make a logical point against Grünbaum's critique so much as an historical and exegetical one. Put briefly, I believe that he has misconstrued Duhem's views on falsifiability and that the logical blunder which he discusses should not be ascribed to Duhem, but rather to those who have made Duhem's conventionalism into the doctrine which Grünbaum attacks. Whether there are any writers who accept the view he imputes to Duhem, or whether he is exploiting “straw-men” to give weight to an otherwise trivial argument is an open question. For now, I simply want to suggest that his salvos are wrongly directed against Duhem. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Care of the terminal patient:Are we on the same page?Lauren WancataIn surgical training a “service” or care team consists of sick patients admitted to the hospital and the medical team caring for the patient. Each service consists of an attending physician, a chief resident, a senior resident and junior residents structured as a hierarchy. The chief was gone for the week. As a senior trainee I would be (...) the acting chief—a role I had assumed many times before this month. To prepare for the week of his absence, I read through each patient’s chart, and the chief and I discussed each patient—diagnosis, procedures, and plans.One was a 41–year–old male with cancer—he was young, but a patient like him was not uncommon at my institution. He originally came in through the emergency department with abdominal pain and difficulty with urination. His admitting medical team started the work–up for his symptoms—blood tests, a CAT scan, and consults to other physician services with specialized knowledge. He eventually underwent endoscopy with biopsies of his stomach and placement of stents into his ureter and kidney for his urinary issues. With return of the biopsies, he had a diagnosis—cancer. He required additional procedures, including the placement of stents into his bile ducts, as they, like his ureter, had become affected by the cancer. The next step was staging the cancer to determine his treatment options. Our surgical service was consulted for a diagnostic laparoscopy with washing—we would take a look inside his abdomen with a camera and obtain a fluid sample to be sent to the pathologist for review, the standard of care for this type of cancer. When the camera was placed nodules were seen—a sample of the nodules and the fluid were sent to a pathologist and determined to be positive for cancer: metastatic disease, stage IV. A special feeding tube was placed into his small intestine to aid in nutritional support, as he had already lost a significant amount of weight, and improving his nutrition would be imperative for any further treatments. Following this operation, oversight of his day–to–day care was taken on by our surgical service, and he had been under our care for a period of time before I rotated onto the service for the month.What was the plan for his care in the hospital, and what was his–long–term plan? His cancer could not be surgically removed due to the extent of its spread within his body. He had recently undergone another CAT scan due to an elevation in his white blood cell count (this elevation was a sign of possible infection) and a thoracentesis, a procedure to remove some of the fluid that was collecting around his lungs. Nephrologists (kidney specialist) had been consulted due to his declining kidney function. Throughout the days, his tube feeds, his source of nutrition, would often be turned off due to bloating and feeling full.Each morning, I rounded with our team, and we would see how he was doing. We would discuss how his night went, and make a plan for the day. He was a man of few words, but his wife was always at his bedside, to support him, listen to updates and keep tract of his progress. She had worked at the hospital and had seen a wide range of patients. She would ask about his kidney function, his tube feeds, and his labs. But, she never asked about his prognosis. I would leave his room each day with the unnerving feeling that the patient, family members and care team were not on the same page. Yes, we all wanted him to get better and to leave the hospital. [End Page 28] But, was he really going to get better? What defined better? Did the patient and his family really know the extent of his disease and his prognosis?Towards the end of my week as chief, I started to ask if they had any other questions. It had been a few weeks since his operation. Was there anything that they wanted to discuss or ask me about? At the... (shrink)