ZusammenfassungDie Diskussionen um Sterbehilfe und Patientenverfügung sowie der Ruf nach einer Stärkung der Palliativmedizin nehmen viel Platz in der deutschen Presselandschaft ein. Da Zeitungen einerseits Meinungen und Wissen der Bevölkerung abbilden, andererseits auch zu deren Meinungsbildung und Information beitragen, wurde eine Analyse der Darstellung der Sterbehilfedebatte und der Palliativmedizin durchgeführt. Als empirisches Material dienten 433 Artikel aus den Jahren 2006 und 2007, die mithilfe einer Suche nach den Schlagworten „Palliativmedizin“, „Hospiz“, „Sterbebegleitung“, „Patientenverfügung“, „Patientenautonomie“ und „Sterbehilfe“ in den Print-Archiven verschiedener deutscher (...) Zeitungen identifiziert wurden. Diese Artikel wurden einer qualitativen Inhaltsanalyse unterzogen. Mit Würde, Selbstbestimmung, Unterversorgung und Unsicherheit zeigten sich vier Hauptargumente innerhalb der Sterbehilfedebatte. Würde wird dabei als Argument sowohl für wie gegen aktive Sterbehilfe benutzt. Eine Unsicherheit zeigt sich in der Terminologie der Sterbehilfe. Das Bild der Palliativmedizin ist gekennzeichnet von der Hoffnung, dass sie eine Alternative zur Sterbehilfe bieten kann, sofern sie weiter ausgebaut und besser finanziert wird. Die Ergebnisse bestätigen die in verschiedenen Studien aufgezeigte Bedeutung der Begriffe Würde und Selbstbestimmung für die Einstellung der Bevölkerung zu Sterbehilfe, Suizidbeihilfe und Patientenverfügungen. Das Potential und die noch zu gering ausgebauten Strukturen der Palliativmedizin werden zunehmend erkannt. Demgegenüber erschwert das mangelnde Wissen um die Sterbehilfe-Terminologie und die rechtlichen Grundlagen der Therapiebegrenzung und Patientenverfügungen eine Diskussion um die Sterbehilfe auch auf fachlicher Ebene. (shrink)

Die Diskussionen um Sterbehilfe und Patientenverfügung sowie der Ruf nach einer Stärkung der Palliativmedizin nehmen viel Platz in der deutschen Presselandschaft ein. Da Zeitungen einerseits Meinungen und Wissen der Bevölkerung abbilden, andererseits auch zu deren Meinungsbildung und Information beitragen, wurde eine Analyse der Darstellung der Sterbehilfedebatte und der Palliativmedizin durchgeführt. Als empirisches Material dienten 433 Artikel aus den Jahren 2006 und 2007, die mithilfe einer Suche nach den Schlagworten „Palliativmedizin“, „Hospiz“, „Sterbebegleitung“, „Patientenverfügung“, „Patientenautonomie“ und „Sterbehilfe“ in den Print-Archiven verschiedener deutscher (...) Zeitungen identifiziert wurden. Diese Artikel wurden einer qualitativen Inhaltsanalyse unterzogen. Mit Würde, Selbstbestimmung, Unterversorgung und Unsicherheit zeigten sich vier Hauptargumente innerhalb der Sterbehilfedebatte. Würde wird dabei als Argument sowohl für wie gegen aktive Sterbehilfe benutzt. Eine Unsicherheit zeigt sich in der Terminologie der Sterbehilfe. Das Bild der Palliativmedizin ist gekennzeichnet von der Hoffnung, dass sie eine Alternative zur Sterbehilfe bieten kann, sofern sie weiter ausgebaut und besser finanziert wird. Die Ergebnisse bestätigen die in verschiedenen Studien aufgezeigte Bedeutung der Begriffe Würde und Selbstbestimmung für die Einstellung der Bevölkerung zu Sterbehilfe, Suizidbeihilfe und Patientenverfügungen. Das Potential und die noch zu gering ausgebauten Strukturen der Palliativmedizin werden zunehmend erkannt. Demgegenüber erschwert das mangelnde Wissen um die Sterbehilfe-Terminologie und die rechtlichen Grundlagen der Therapiebegrenzung und Patientenverfügungen eine Diskussion um die Sterbehilfe auch auf fachlicher Ebene. (shrink)

This content analysis examines the ways that genocide is included in the high school world history content standards of eleven states with legislative mandates requiring genocide education, as well as if the content standards in those states differ from those of states without mandated genocide education. The null curriculum theorizes that the content that is not taught may be as important as what is taught; this lens allows for a nuanced analysis of the ways that genocide is included and excluded (...) in state standards. The findings suggest that states with legislative mandates requiring genocide education do not necessarily have high school world history content standards that require genocide education. The content standards in states with legislative mandates often omit acts of genocide, refrain from using the term “genocide,” and frame genocides as less important than the Holocaust, perpetuating the null curriculum of genocides. (shrink)

Recent studies have provided evidence of associations between neurochemistry and reading (dis)ability (Pugh et al., 2014). Based on a long history of studies indicating that fluent reading entails the automatic convergence of the written and spoken forms of language and our recently proposed Neural Noise Hypothesis (Hancock et al., 2017), we hypothesized that individual differences in cross-modal integration would mediate, at least partially, the relationship between neurochemical concentrations and reading. Cross-modal integration was measured in 231 children using a two-alternative forced (...) choice cross-modal matching task with three language conditions (letters, words, and pseudowords) and two levels of difficulty within each language condition. Neurometabolite concentrations of Choline (Cho), Glutamate (Glu), gamma-Aminobutyric (GABA), and N- acetyl-aspartate (NAA) were then measured in a subset of this sample (n = 70) with Magnetic Resonance Spectroscopy (MRS). A structural equation mediation model revealed that the effect of cross-modal word matching mediated the relationship between increased Glu (which has been proposed to be an index of neural noise) and poorer reading ability. In addition, the effect of cross-modal word matching fully mediated a relationship between increased Cho and poorer reading ability. Multilevel mixed effects models confirmed that lower Cho predicted faster cross-modal matching reaction time, specifically in the hard word condition. These Cho... (shrink)

This article is concerned with ethical issues that have to be considered when under taking qualitative research. Some of the issues - such as informed consent, the dignity and privacy of the research subjects, voluntary participation and protection from harm - are the same as in other types of research and have their basis in moral and ethical principles. Qualitative research, however, generates specific ethical problems because of the close relationship that researchers form with participants. Qualitative research with patients is (...) especially difficult because of their vulnerability and lack of power in the clinical situation. Therefore the potential conflict between the dual role of the nurse - the professional and the research roles - has to be solved. Researchers also learn how to cope with the tension of subjective and objective elements of the research. Nurses who attempt qualitative research have to consider a variety of complex ethical issues, which are addressed in this paper. (shrink)

These questions lie at the heart of contemporary feminist theory, and in this collection they are addressed by a group of distinguished international scholars ...

L’article fournit un exemple concret des possibilités qu’ouvre l’exploration des données numérisées, et notamment de la Toile, en matière de morphologie dérivationnelle. Il y a une soixantaine d’années, en se fondant sur un exemple unique (silvio-pelliqueste), Edouard Pichon avançait l’hypothèse qu’en contexte vélaire, le suffixe –esque pouvait, par un phénomène de dissimilation préventive, se voir remplacé par la finale –este. Depuis, aucun argument n’était venu étayer cette hypothèse, sinon peut-être des remarques hésitantes de Zwanenburg (1975) et de Björkman (1984) sur (...) la difficulté de trouver des dérivés en –esque après vélaire. Les données réunies confirment que l’adjonction de –esque à une base dont la dernière syllabe comporte une vélaire engendre des tensions dissimi-latives. Lorsque le contexte s’y prête, ces tensions se manifestent tantôt par l’effacement de certaines vélaires finales, tantôt par le maintien inattendu d’une voyelle finale précédée d’une vélaire. Elles se manifestent aussi, comme l’avaient entrevu nos prédécesseurs, par une moindre productivité de cette suffixation après les radicaux en vélaire. Dans l’établissement de ces résultats, l’utilisation d’un outil permettant de récupérer automatiquement sur la Toile des néologismes en fonction de leur terminaison, s’est révélée déterminante. Les recherches automatisées ont joué aussi un rôle capital quand il s’est agi de trouver des dérivés en ‑este et de montrer que ce suffixe n’était utilisé productivement qu’après vélaire, conformément à la conjecture de Pichon. (shrink)

Pragmatic clinical trials (PCTs) serve an important function in the modern research landscape: studying interventions in an environment that reflects real-world conditions, rather than the relative...

This paper examines the importance of reconciliation in post-conflict state-building. We argue that while the economic and political aspects are vital components of the state-building tool-kit, states can hardly be reconstructed without the support of the society. Individuals and communities are central to the re-establishment of peace and democracy. We will conduct a case study analysis focusing on Bosnia and Herzegovina (hereinafter Bosnia). After more than 10 years of international supervision, Bosnia remains fragmented by ethnic tension, and continues to need (...) the guidance of the United Nation’s Office of the High Representative and European Union Special Representative. The Dayton Accord provided little direction for how to proceed with reconciliation beyond a state-centered peace-agreement and constitution. This study suggests that the peacebuilding process that has taken place in Bosnia over the past decade has been unable to foster reconciliation and re-create social trust, two necessary elements for ensuring lasting peace in the aftermath of conflict. (shrink)

De Marco et al 1 argue that the standard account of medical ‘invasiveness’ (as ‘incision’ or ‘insertion’) fails to capture three aspects of its existing use, namely that invasiveness can come in degrees, often depends on features of alternative medical interventions and can be non-physical. They propose a new schematic account that suggests that medical interventions can possess ‘basic invasiveness’ (which can come in degrees and of which they suggest at least two types: physical and mental), and ‘threshold invasiveness’ which (...) can depend on the alternatives a specific intervention is being compared with. While we agree that the standard account of invasiveness fails to capture existing use and are supportive of their aim, here we express scepticism about the practical utility of De Marco et al ’s revised account. Our scepticism concerns the application of De Marco et al’s revised account in the narrow context of clinician–patient communication and deliberation about medical interventions within clinical practice, which we see as a crucial context for its use. While De Marco et al do not specify the contexts in which their revised account could be used, we assume from their discussion of treatment interventions (e.g. non-invasive prenatal testing, ventilation) and their comparison to ‘more or less invasive’ options, that at least one of the purposes in mind for …. (shrink)

In the research integrity literature, funding plays two different roles: it is thought to elevate questionable research practices (QRPs) due to perverse incentives, and it is a potential actor to incentivize research integrity standards. Recent studies, asking funders, have emphasized the importance of the latter. However, the perspective of active researchers on the impact of competitive research funding on science has not been explored yet. Here, I address this issue by conducting a series of group sessions with researchers in two (...) different countries with different degrees of competition for funding, from three scientific fields (medical sciences, natural sciences, humanities), and in two different career stages (permanent versus temporary employment). Researchers across all groups experienced that competition for funding shapes science, with many unintended negative consequences. Intriguingly, these consequences had little to do with the type of QRPs typically being presented in the research integrity literature. Instead, the researchers pointed out that funding could result in predictable, fashionable, short-sighted, and overpromising science. This was seen as highly problematic: scientists experienced that the ‘projectification’ of science makes it more and more difficult to do any science of real importance: plunging into the unknown or addressing big issues that need a long-term horizon to mature. They also problematized unintended negative effects from collaboration and strategizing. I suggest it may be time to move away from a focus on QRPs in connection with funding, and rather address the real problems. Such a shift may then call for entirely different types of policy actions. (shrink)

Compared to evidence-based public health, evidence-based medicine is a more familiar phrase. Evidence-based medicine has become increasingly popular in the past decade, due in large part to the emergence of computerized database search technology and advanced statistical tools which allow researchers to quickly identify and summarize vast amounts of scientific information.Today, the concept of evidence-based public health is gaining momentum and has grown in popularity. However, the term “evidence-based” lacks clarification and is subject to a variety of interpretations. The evidence (...) that supports evidence-based medicine or public health may include individual experience, anecdotal information, the content of a single scientific article, or the results of a sophisticated systematic review of scientific literature. The imprecise language used to describe evidence leads to confusion over what types of evidence are most appropriate in answering different types of questions. (shrink)

Carpendale & Lewis (C&L) stress the importance of social interaction for social understanding, but focus on the adult-child relationship. In the present commentary, we discuss the development of social understanding within early peer relationships. We argue that peer interaction stretches the limits of early social understanding, thereby providing both unique challenges and unique opportunities for constructing an understanding of others' minds.

Climate change is more than a discrete issue demanding political attention and response. A changing climate permeates political life as material processes of planetary change reverberate in our bodies, affecting subterranean processes of attention and evoking bodily responses at and below the threshold of awareness. By way of example, I explore the register of bodily feeling to raise the possibility that proliferating anomalies in atmospheric, oceanic, and seismic activities are entering into subliminal experiences of time and confounding embodied expectations of (...) how the future is likely to flow from the past. The essay concludes with a preliminary discussion of how micropolitical strategies to amplify visceral experiences of climatic changes might valuably contribute to larger programs for climate action. (shrink)

Classic statements of research ethics advise against permitting physician-investigators to obtain consent for research participation from patients with whom they have preexisting treatment relationships. Reluctance about “dual-role” consent reflects the view that distinct normative commitments govern physician–patient and investigator–participant relationships, and that blurring the research–care boundary could lead to ethical transgressions. However, several features of contemporary research demand reconsideration of the ethics of dual-role consent. Here, we examine three arguments advanced against dual-role consent: that it creates role conflict for the (...) physician-investigator; that it can compromise the voluntariness of the patient-participant’s consent; and that it promotes therapeutic misconceptions. Although these concerns have merit in some circumstances, they are not dispositive in all cases. Rather, their force—and the ethical acceptability of dual-role consent—varies with features of the particular study. As research participation more closely approximates usual care, it becomes increasingly acceptable, or even preferable, for physicians to seek consent for research from their own patients. It is time for a more nuanced approach to dual-role consent. (shrink)

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors that are crucial for the reproductive success of animals living in groups. The Perception-Action Model, (...) together with an understanding of how representations change with experience, can explain the major empirical effects in the literature. It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations. Key Words: altruism; cognitive empathy ; comparative; emotion; emotional contagion; empathy ; evolution; human; perception-action; perspective taking. (shrink)

Growing interest in embedded research approaches—where research is incorporated into clinical care—has spurred numerous studies to generate knowledge relevant to the real-world needs of patients and other stakeholders. However, it also has presented ethical challenges. An emerging challenge is how to understand the nature and extent of investigators’ obligations to patient-subjects. Prior scholarship on investigator duties has generally been grounded upon the premise that research and clinical care are distinct activities, bearing distinct duties. Yet this premise—and its corresponding implications—are challenged (...) when research and clinical care are deliberately integrated. After presenting three case studies from recent pragmatic clinical trials, we identify six differences between explanatory trials and embedded research that limit the application of existing scholarship for ascertaining investigator duties. We suggest that these limitations indicate a need to account for the implications of usual care and to move beyond a narrow focus on the investigator-subject dyad, one that better reflects the team- and institution-based nature of contemporary health systems. (shrink)

O cérebro ocupa um lugar central na epistemologia de Schopenhauer. Ele remete à visão empírica das faculdades de conhecimento e é o responsável pela realização da representação intuitiva da realidade material e empírica do mundo através das formas puras de tempo e espaço e a aplicação da lei a priori de causalidade, esta que é o fundamento e a possibilidade da representação intuitiva. Se o cérebro é a visão empírica das faculdades de conhecimento, por sua vez, é somente através dele (...) e para ele que existe esta realidade empírica. A realidade empírica é, para Schopenhauer, sempre ideal, pois dependente do cérebro que conhece; e por tal, possui uma existência real, porém relativa, sempre como uma representação que remete às formas a priori do sujeito que conhece. Este artigo expõe o lugar do cérebro na epistemologia de Schopenhauer e o seu papel enquanto uma concepção chave para compreender a idealidade transcendental da realidade empírica e o estatuto de realidade da representação intuitiva. (shrink)

Many meta-ethicists are alethists: they claim that practical considerations can constitute normative reasons for action, but not for belief. But the alethist owes us an account of the relevant difference between action and belief, which thereby explains this normative difference. Here, I argue that two salient strategies for discharging this burden fail. According to the first strategy, the relevant difference between action and belief is that truth is the constitutive standard of correctness for belief, but not for action, while according (...) to the second strategy, it is that practical considerations can constitute motivating reasons for action, but not for belief. But the former claim only shifts the alethist's explanatory burden, and the latter claim is wrong—we can believe for practical reasons. Until the alethist can offer a better account, then, I argue that we should accept that there are practical reasons for belief. (shrink)

Ethics and Educational Technology explores the creation and implementation of learning technologies through an applied ethical lens. The success of digital tools and platforms in today's multifaceted learning and performance contexts is dependent not only on effective design and pedagogical principles but, further, on an awareness of these technologies' interactions with and implications for users and social systems. This first-of-its-kind book provides an evidence-based, process-oriented model for ethics in technology-driven instructional design and development, one that necessitates intentional reflective practice, a (...) critical and theoretically informed interrogation of technology, and a participatory, emancipatory approach to technology design and applications. Rich with real-world ethics examples and design cases, supported by reflection questions and applied activities, and attentive to ethical codes among preeminent educational technology organizations, this is an ideal resource for students, faculty, researchers, and professionals across educational technology, instructional design, learning sciences, learning engineering, organizational training, and other disciplines. (shrink)

Unconsented pelvic exams under anesthesia are assaults cloaked in defense of healthcare education. Preemptive linguistic qualifiers “presumed” or “implied” attempt to justify such violations with flippancy toward their oxymoronic implications: to suggest a priori that consent can be assumed undermines its otherwise standalone social, ethical, and medico-legal reverence. In this paper I conceptualize “medical sexual assault” and argue that presumed consent for intimate exams exemplifies its definition. By bluntly describing pelvic exams as “penetration,” this work aims to reify the intimate (...) reality of the clinical label “pelvic exam” and to call attention to cisheteronormative and androcentric assumptions involved in its practice. Additionally, this scholarship seeks to create a foundation toward broader work in conceptualizing clinical rape culture. Given recent national survey data indicating a surprising frequency of unconsented intimate exams, detailed language as to their problematics is necessary for ongoing legal and ethical efforts. Explicit consent for intimate exams must be the standard of care for conscious and unconscious patients. (shrink)

Forsyth (J Pers Soc Psychol 39(1): 175-184, 1980) argued that ethical ideology includes the two orthogonal dimensions of relativism and idealism. Relativists determine morality by looking at the complexities of the situation rather than relying on universal moral rules, while idealists believe that positive consequences can always be obtained without harming others. This study examined the role of ethical ideology as a moderator between justice and constructive and deviant reactions to injustice. Students with work experience (N = 200) completed Bennett (...) and Robinson's (J Appl Psychol 85(3): 349-360, 2000) measure of Workplace Deviance, Gill's (Reactions to injustice: Development and validation of a measure. Unpublished doctoral dissertation, University of Western Ontario, 2005) Reactions to Injustice measure, and the Ethics Position Questionnaire (Forsyth, 1980), and provided ratings of justice in their own workplace. Hierarchical regressions revealed a significant main effect of idealism on deviance and constructive behaviors, and three-way interactions between idealism, relativism, and some types of justice. These findings suggest that ethical ideology plays a significant role in predicting responses to injustice. (shrink)

Matthew Kieran has recently argued that those he calls ‘appreciative snobs’ go wrong by valuing appreciative objects primarily because of their ability to raise the snob’s social status, what I call social contagion snobbery. In this paper, I argue that there are at least two other ways that snobbery commonly manifests itself in appreciative contexts, what I call attitudinal snobbery and contextual snobbery. As it turns out, all three snobs—Kieran’s social-contagion snob, the attitudinal snob, and the contextual snob—represent distinct ways (...) that appreciative judgments can go wrong because of how socio-hierarchical elements figure into the snob’s appreciative judgments. (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

Peut-on prédire si un projet sera jugé socialement acceptable par ses principales parties prenantes? Dans un contexte où l’acceptabilité sociale en est venue à être considérée comme une condition à la réalisation de tout grand projet, cette question s’avère centrale pour tout développeur de projet, de même que pour les investisseurs qui les soutiennent. C’est dans cette perspective qu’a été développé l’Indice du risque social dans les projets miniers, une initiative soutenue par l’Autorité des marchés financiers à laquelle a travaillé (...) une équipe interdisciplinaire de chercheurs. Au-delà de jeter un éclairage sur la pertinence d’aller de l’avant ou non avec un projet, cet outil prédictif peut surtout permettre de moduler ledit projet, de concert avec ses parties prenantes, pour le rendre davantage acceptable à leurs yeux. Nous souhaitons ici rendre compte des possibilités offertes par cet indice en l’appliquant à deux projets miniers récemment discutés au Québec, soit le projet de mine aurifère développé par Osisko dans la municipalité de Malartic, en Abitibi-Témiscamingue, et celui de Mine Arnaud, à Sept-Îles, qui vise cette fois l’exploitation de l’apatite. Cet exercice nous permet de réaffirmer la pertinence de l’outil que constitue l’Indice, mais également de relever les limites qui lui sont inhérentes. (shrink)