The clinical vignette remains the standard means by which medical ethics are taught to students in the healthcare professions. Although written or verbal vignettes are useful as a pedagogic tool for teaching ethics and introducing students to real cases, they are limited, since students must imagine the clinical scenario. Medical ethics are almost universally taught during the early years of training, when students are unfamiliar with the clinical reality in which ethics issues arise. Film vignettes fill in that imaginative leap. (...) By providing vivid details with images, film vignettes offer rich and textured details of cases, including the patient’s perspective and the clinical reality. Film vignettes provide a detailed ethnography that allows for a more complete discussion of the ethical issues. Film can serve as an additional tool for teaching medical ethics to members of the healthcare professions. (shrink)

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that (...) poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy. (shrink)

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that (...) poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy. (shrink)

A family reconstitution study of the Krummhörn population (Ostfriesland, Germany, 1720–1874) reveals that infant mortality and children’s probabilities of marrying or emigrating unmarried are affected by the number of living same-sexed sibs in farmers’ families but not in the families of landless laborers. We interpret these results in terms of a “local resource competition” model in which resource-holding families are obliged to manipulate the reproductive future of their offspring. In contrast, families that lack resources have no need to manipulate their (...) offspring and are more likely to benefit from allowing their offspring to capitalize on whatever opportunities to reproduce present themselves. (shrink)

Self-deception may be the result of social manipulation and conflict management of social in-groups. Although self-deception certainly has offensive and defensive aspects, a full evolutionary understanding of this phenomenon is not possible until strategies of other parties are included into a model of self-perception and self-representation.

In this article we try to give a philosophically reflected introductory overview of the current theoretical developments in the field of evolutionary aesthetics. Our aim is not completeness. Rather, we try to depict some of the central assumptions and explanatory tools frequently used in evolutionary accounts of human aesthetical preferences and address a number of currently debated, open research questions.

Based on historical data pertaining to the Krummhörn population (eighteenth and nineteenth centuries, Germany), we compared reproductive histories of mothers according to whether the maternal grandmother (MGM) or the paternal grandmother (PGM) or neither of them was resident in the parents’ parish at the time of the mother’s first birth. In contrast to effects of PGMs, we discovered conditional differences in the MGM’s effects between landless people and wealthier, commercial farmers. Our data indicate that the presence of the MGM only (...) lowers the woman’s age at marriage (AAM) and her age at the birth of her first child (AFB) in the case of landless families. However, among commercial farmers, who can generally be characterized by a lower AAM and AFB, we found opposite tendencies for the MGM’s effect leading to a relatively small delay in AAM and AFB. Moreover, we also analyzed differences in the completed fertility (i.e., children ever born: CEB). Results indicate that landless families in general do have fewer CEB compared with commercial farmers except for those families in which the MGM has been present. Emphasizing that the adaptiveness of investment decisions should depend on the interaction of genetic, lineage-specific (intrinsic) and ecologically imposed (extrinsic) constraints, we conclude that kin strategies consequently address different fitness components under different conditions. (shrink)

The wealthy elite males of nineteenth-century Krummhörn (Ostfriesland, Germany) achieved an above-average reproductive success. Membership in the elite class was determined from a list of the 300 richest men in the Ostfriesland district compiled by authorities in 1812. The main components establishing the link between cultural success and reproductive success aredifferences in the number of offspring owing to differences both in time spent in fecund marriage (mating success) and in rate of reproduction;differences in the probabilities of one’s adult offspring marrying (...) locally vs. emigrating unmarried owing to differential ability to allocate resources that enhance the “social placement” of adult offspring; anddifferences in the probability of total reproductive failure (lineage extinction).Contrary to what might be expected, infant survivorship was lowest amongst the richest families. We conclude that to a great extent females’ reproductive decisions contribute to the greater reproductive success of the elite males. (shrink)

Kenneth Kipnis (2006) presents a normative defense of strict confidentiality, but it follows from an empirical claim that allowing breach would result in all parties being worse off, including, par...

Life history theory predicts that exposure to high mortality in early childhood leads to faster and riskier reproductive strategies. Individuals who grew up in a high mortality regime will not overly wait until they find a suitable partner and form a stable union because premature death would prevent them from reproducing. Cox proportional hazard models were used to determine whether women who experienced sibling death during early childhood (0–5 years) reproduced earlier and were at an increased risk of giving birth (...) to an illegitimate child, with illegitimacy serving as a proxy for risky sexual behavior. Furthermore, we investigate whether giving birth out of wedlock is influenced by individual mortality experience or by more promiscuous sexual behavior that is clustered in certain families. Models are fitted on pedigree data from the eighteenth- and nineteenth-century Krummhörn population in Germany. The results show a relationship between sibling death in early childhood and the risk of reproducing out of wedlock, and reproductive timing. The risk of giving birth out of wedlock is linked to individual mortality experience rather than to family-level effects. In contrast, adjustments in connubial reproductive timing are influenced more by family-level effects than by individual mortality experience. (shrink)

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. (...) The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary. (shrink)

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. (...) The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary. (shrink)

Commentary on Angelo E. Volandes & Michael K. Paasche-Orlow, Health Literacy, Health Inequality and a Just Healthcare System.

Evolutionary Aesthetics emerges today as a young and lively field of studies whose main aim is to rethink the traditional questions of philosophical Aesthetics in the light of biological theories, in particular in the light of Darwin's evolutionary theory by means of natural selection. The aim of this issue is to introduce Evolutionary Aesthetics into the Italian philosophical debate. Contributions collected cover almost entirely the lively, multifaceted spectrum of the discipline: 1) the high-debated question of the adaptive value of aesthetic (...) sense, artistic practices and art fruition (Stephen Davies, Zach Norwood, Joseph Carroll); 2) the evolutionary explanation of human sexual preferences and production of artefacts (Hannes Rusch & Eckart Voland); 3) the possibility for a Darwinian non-reductionist definition of art as a culturally differentiated behavior (Kathryn Coe; Nancy E. Aiken; Roberta Dreon); 4) a comparative analysis of aesthetic experience from a cognitive viewpoint (Gianluca Consoli) and from a morphological one (Salvatore Tedesco); 5) the influence of Darwinian perspective beyond the English boundaries, with particular reference to the Italian scientific community in the Nineteenth century (Elena Canadelli) and to the tradition of Gestaltpsychologie (Michele Gardini); 6) a naturalistic approach to aesthetic experience and medial experience (Antonino Pennisi & Francesco Parisi). (shrink)

Despite drives’ importance for Nietzsche’s explanation of individuals’ values, controversies persist over how to interpret Nietzsche’s attribution of normative capacities to the drives themselves. On one reading, drives evaluate their aims and recognize the normative authority of other drives’ aims. On another, drives’ normative properties reduce to nonnormative, causal properties. Neither approach is satisfying. The former commits Nietzsche to the homuncular fallacy by granting drives complex cognitive capacities. The latter reading either commits Nietzsche to the naturalistic fallacy, having him derive (...) normative conclusions from descriptive premises, or eliminates normativity from his thought altogether. In response to this impasse, this article advances a Leibniz-informed interpretation of Nietzsche’s drive psychology. By construing the normative and efficient causal orders as parallel modes of explanation distinguished by one’s perspective, a Leibniz-informed reading captures the benefits of extant interpretations while avoiding their drawbacks. (shrink)

The term “lean in” was popularized by Sheryl Sandberg, Facebook COO, via her #1 Best Seller encouraging women to defy their fears and dare to be leaders in their fields. She received criticism because although admitting to external barriers contributing to the gender gap in leadership, the scope of her book focused on the internal shortcomings of women. She asserted that women are hindered by barriers that exist within themselves, and provided practical tips, backed by research, to equip women with (...) strategies to proactively progress in the workplace instead of shying away. Sandberg is not the first to raise concern about gender inequality. Other women in history like Susan B. Anthony and Maggie Lena Walker also challenged lopsided gender roles through their words and actions. Using the critical biography methodology, this paper explores these women’s experiences, philosophies and contributions, reflects on Sandberg’s insight, and develops a framework, based on the theory of planned behavior as well as the ethical principles of utilitarianism and corporate social responsibility, that links internal factors, organizational external factors, and societal external factors to intentions to lean in and leaning in behavior. Thus, via critical biography, this paper examines both internal and external factors, showing how they are linked, and how they may impact leaning in intentions and behavior. The paper also discusses how leaning in may influence both individual and gender mobility for women, and ultimately, increased gender equality. (shrink)

The sports world has historically rejected the practice of tanking. I argue that this attitude is unwarranted. To do so, I introduce a concept called strategic suboptimal play (SSP), which is the practice of incurring the risk of a short-term competitive disadvantage to increase the chances of gaining a longer-term competitive advantage. Tanking is just an instance of SSP employed in higher-order games, i.e. games that are at least partially played by other games, like tournaments or seasons. Since SSP is (...) integral to every sport, there are currently no easy grounds for rejecting it outright. As such, the same is true of tanking. I will explore some possible reasons why tanking is wrongly thought objectionable, as well as some objections to and implications of my argument for competitive sports more broadly. (shrink)

Over the past decade, sexual rumor spreading, slut-shaming, and homophobic labeling have become central examples of bullying among young women. This article examines the role these practices— what adults increasingly call “bullying” and what girls often call “drama”— play in girls’ gendering processes. Through interviews with 54 class and racially diverse late adolescent girls, I explore the content and functions of “sexual drama.” All participants had experiences with this kind of conflict, and nearly a third had been the subject of (...) other girls’ rumors about their own sexual actions and/or orientations. Their accounts indicate that sexual drama offers girls a socially acceptable site for making claims to, and sense of, gendered sexuality in adolescence. While they reproduce inequality through these practices, sexual drama is also a resource for girls—one that is made useful through the institutional constraints of their high schools, which reinforce traditional gender norms and limit sexuality information. (shrink)

La estructura convivencial: La convivencia como problema, por V. M. González-Haba Guisado. Diálogos verdaderos y diálogos falsos, por G. D. Pire.--El hecho religioso: La libertad religiosa, fundamento de la convivencia política, por P. Lucas Verdu. La religión como sistema establecido, por F. Pérez Gutiérrez. La función del escritor, por J. Maritain.--La realidad socio-económica: Sociología del cooperativismo agrario, por A. Fernández Oubiña. La alienación internacional, por C. Herreros de las Cuevas. Salario y plusvalía, por M. Rico Lara.--Las tensiones sociales: Reflexiones sobre (...) democracia y opinión, por C. Movilla Alvarez. Participación social y personalidad, por J. Ubalde Merino. El derecho natural como técnica de racionalización, por M. M. Zorrilla Ruiz. (shrink)

This article discusses the pros and cons of the creation of a separate Ukrainian standard of the Russian language. Owing to the centralist and elitist history of the Russian standard language, the high variant of Russian that is used in Ukraine does not significantly differ from that of Russia, if at all. Low varieties, by contrast, are quite heterogeneous. The standardization of “Ukrainian Russian” would thus be very problematic at all stages: the selection of norms and their codification, the implementation (...) and elaboration of the new norms. All these steps would not only require considerable funding; in the long run, it would also undermine the status of Ukrainian as Ukraine’s sole state language. (shrink)

After examining the problem that gratuitous suffering poses for Nietzsche's notion of life affirmation, I mount a skeptical response to this problem on Nietzsche's behalf. I then consider an orthogonal objection to Nietzschean life affirmation, which argues that the need to justify life is symptomatic of life denial and show how strengthening the skeptical defense sidesteps this worry. Nietzsche's skepticism about our all‐too‐human, epistemic position thus aids his project of life affirmation in two ways. First, it suggests that we are (...) unable to determine reliably whether a given instance of suffering is, in fact, gratuitous. Second, it provides a corrective to the moralistic need to redeem life, showing that all attempts to justify life as a whole are epistemically fraught. Before concluding, I examine Nietzsche's reasons for advancing such an epistemological argument and suggest how we might approach life affirmation in nonrational terms. (shrink)

An historical survey of Thomas Kuhn's 1962 The Structure of Scientific Revolutions, charting the development of this influential work throughout Kuhn's career and exploring the continuing impact of Kuhn on the philosophy of science.

In the United States, patients have a clear right to determine what is done to them by doctors. Starting in the early 20th century, multiple court cases paved the way for our current understanding...

Издание предназначено для философов, теологов и всех тех, кого интересуют фундаментальные проблемы метафизики и надконфессионального умозрительного богословия.

In this paper, we criticize what we dub the “pruning view” of self-constitution, championed widely by philosophers, mainly though not exclusively in the Kantian tradition, and instead defend an alternative view inspired by psychoanalysis. We argue that normative assessment comes much too early on the pruning view, so early that it interferes with achieving deeper self-understanding that can produce lasting change. On the proposal we advocate, self-constitution must begin with a non-moralizing attempt to truly understand why one has undesirable and (...) unwanted propensities. We call this the “understanding first” principle. Only after deeper self-understanding has been achieved are attempts to liberate oneself from unwanted elements likely to succeed. (shrink)