The language of “participant-driven research,” “crowdsourcing” and “citizen science” is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists....

As in other countries, the traditional doctor-patient relationship in the Japanese healthcare system has often been characterised as being of a paternalistic nature. However, in recent years there has been a gradual shift towards a more participatory-patient model in Japan. With advances in technology, the possibility to use digital technologies to improve patient interactions is growing and is in line with changing attitudes in the medical profession and society within Japan and elsewhere. The implementation of an online patient engagement platform (...) is being considered by the Myotonic Dystrophy Registry of Japan. The aim of this exploratory study was to understand patients’ views and attitudes to using digital tools in patient registries and engagement with medical research in Japan, prior to implementation of the digital platform. We conducted an exploratory, cross-sectional, self-completed questionnaire with a sample of myotonic dystrophy patients attending an Open Day at Osaka University, Japan. Patients were eligible for inclusion if they were 18 years or older, and were diagnosed with MD. A total of 68 patients and family members attended the Open Day and were invited to participate in the survey. Of those, 59 % submitted a completed questionnaire. The survey showed that the majority of patients felt that they were not receiving the information they wanted from their clinicians, which included recent medical research findings and opportunities to participate in clinical trials, and 88 % of patients indicated they would be willing to engage with digital technologies to receive relevant medical information. Patients also expressed an interest in having control over when and how they received this information, as well as being informed of how their data is used and shared with other researchers. Overall, the findings from this study suggest that there is scope to develop a digital platform to engage with patients so that they can receive information about medical care and research opportunities. While this study group is a small, self-selecting population, who suffer from a particular condition, the results suggest that there are interested populations within Japan that would appreciate enhanced communication and interaction with healthcare teams. (shrink)

BackgroundInnovations in technology have contributed to rapid changes in the way that modern biomedical research is carried out. Researchers are increasingly required to endorse adaptive and flexible approaches to accommodate these innovations and comply with ethical, legal and regulatory requirements. This paper explores how Dynamic Consent may provide solutions to address challenges encountered when researchers invite individuals to participate in research and follow them up over time in a continuously changing environment.MethodsAn interdisciplinary workshop jointly organised by the University of Oxford (...) and the COST Action CHIP ME gathered clinicians, researchers, ethicists, lawyers, research participants and patient representatives to discuss experiences of using Dynamic Consent, and how such use may facilitate the conduct of specific research tasks. The data collected during the workshop were analysed using a content analysis approach.ResultsDynamic Consent can provide practical, sustainable and future-proof solutions to challenges related to participant recruitment, the attainment of informed consent, participant retention and consent management, and may bring economic efficiencies.ConclusionsDynamic Consent offers opportunities for ongoing communication between researchers and research participants that can positively impact research. Dynamic Consent supports inter-sector, cross-border approaches and large scale data-sharing. Whilst it is relatively easy to set up and maintain, its implementation will require that researchers re-consider their relationship with research participants and adopt new procedures. (shrink)

Dynamic Consent is both a model and a specific web-based tool that enables clear, granular communication and recording of participant consent choices over time. The DC model enables individuals to know and to decide how personal research information is being used and provides a way in which to exercise legal rights provided in privacy and data protection law. The DC tool is flexible and responsive, enabling legal and ethical requirements in research data sharing to be met and for online health (...) information to be maintained. DC has been used in rare diseases and genomics, to enable people to control and express their preferences regarding their own data. However, DC has never been explored in relationship to historical collections of bioscientific and genetic heritage or to contexts involving Aboriginal and Torres Strait Islander people.In response to the growing interest by First Peoples throughout Australia in genetic and genomic research, and the increasing number of invitations from researchers to participate in community health and wellbeing projects, this article examines the legal and ethical attributes and challenges of DC in these contexts. It also explores opportunities for including First Peoples' cultural perspectives, governance, and leadership as a method for defining DC on cultural terms that engage best practice research and data analysis as well as respect for meaningful and longitudinal individual and family participation. (shrink)

The language of “participant-driven research,” “crowdsourcing” and “citizen science” is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists. Originally, these labels were invoked by volunteer research efforts propelled by amateurs outside of traditional research institutions and aimed at appealing to those looking for more “democratic,” “patient-centric,” or “lay” alternatives to the professional science establishment. As mainstream translational biomedical research requires increasingly larger participant pools, however, corporate, academic and governmental research programs (...) are embracing this populist rhetoric to encourage wider public participation. We examine the ethical and social implications of this recruitment strategy. We begin by surveying examples of “citizen science” outside of biomedicine, as paradigmatic of the aspirations this democratizing rhetoric was originally meant to embody. Next, we discuss the ways these aspirations become articulated in the biomedical context, with a view to drawing out the multiple and potentially conflicting meanings of “public engagement” when citizens are also the subjects of the science. We then illustrate two uses of public engagement rhetoric to gain public support for national biomedical research efforts: its post-hoc use in the “care.data” project of the National Health Service in England, and its proactive uses in the “Precision Medicine Initiative” of the United States White House. These examples will serve as the basis for a normative analysis, discussing the potential ethical and social ramifications of this rhetoric. We pay particular attention to the implications of government strategies that cultivate the idea that members of the public have a civic duty to participate in government-sponsored research initiatives. We argue that such initiatives should draw from policy frameworks that support normative analysis of the role of citizenry. And, we conclude it is imperative to make visible and clear the full spectrum of meanings of “citizen science,” the contexts in which it is used, and its demands with respect to participation, engagement, and governance. (shrink)

Children who experience well-being are engaging more confidently and positively with their caregiver and peers, which helps them to profit more from available learning opportunities and support current and later life outcomes. The goodness-of-fit theory suggests that children’s well-being might be a result of the interplay between their temperament and the environment. However, there is a lack of studies that examined the association between children’s temperament and well-being in early childhood education and care, and whether this association is affected by (...) ECEC process quality. Using a multilevel random coefficient approach, this study examines the association between toddlers’ temperament and well-being in Norwegian ECEC and investigates whether process quality moderates this association. Results reveal an association between temperament and well-being. Staff-child conflict moderates the association between shyness and well-being, and between activity and well-being. Moreover, high emotional behavioral support moderates the association between activity and well-being. Extra attention should be paid by the staff to these children’s needs. (shrink)

What tensions arise between philosophy of religion and theology? What strengths and weaknesses of analytical methods emerge in relation to strongly confessional philosophical theologies, or to Continental philosophies? Faith and Philosophical Analysis evaluates how well philosophy of religion serves in understanding religious faith. Figures who rarely share the space of the same book - leading exponents of analytic philosophy of religion and those who question its legacy - are drawn together in this book, with their disagreements harnessed to positive effect. (...) Figures such as Richard Swinburne and Basil Mitchell reflect on their life-long projects from a perspective which has not previously been seen in print. A wide range of approaches found in contemporary philosophy of religion are explored, including: reformed epistemology, 'traditional' metaphysical theory building, feminist methodologies, Wittgensteinian approaches, and American pragmatism. Considering the trends in philosophy of religion as they are interacting across continents, looking particularly at philosophical influences in North America, Britain, and Continental Europe, this book will appeal to students, scholars and general readers with an interest in philosophy of religion, theology, or analytical philosophy. (shrink)

During the past four decades the governance of environmental problems – the definition of issues and their political and practical resolution – has evolved to include a wider range of stakeholders in more extensive open discussions. In the introduction to this issue of Environmental Values on ‘Environment, Policy and Participation’, we outline some features of these recent developments in participatory environmental governance, indicate some key questions that arise, and give an overview of the collection of papers in this special issue.

_Feminist Interpretations of Thomas Hobbes _features the work of feminist scholars who are centrally engaged with Hobbes’s ideas and texts and who view Hobbes as an important touchstone in modern political thought. Bringing together scholars from the disciplines of philosophy, history, political theory, and English literature who embrace diverse theoretical and philosophical approaches and a range of feminist perspectives, this interdisciplinary collection aims to appeal to an audience of Hobbes scholars and nonspecialists alike. As a theorist whose trademark is a (...) compelling argument for absolute sovereignty, Hobbes may seem initially to have little to offer twenty-first-century feminist thought. Yet, as the contributors to this collection demonstrate, Hobbesian political thought provides fertile ground for feminist inquiry. Indeed, in engaging Hobbes, feminist theory engages with what is perhaps the clearest and most influential articulation of the foundational concepts and ideas associated with modernity: freedom, equality, human nature, authority, consent, coercion, political obligation, and citizenship. Aside from the editors, the contributors are Joanne Boucher, Karen Detlefsen, Karen Green, Wendy Gunther-Canada, Jane S. Jaquette, S. A. Lloyd, Su Fang Ng, Carole Pateman, Gordon Schochet, Quentin Skinner, and Susanne Sreedhar. (shrink)

De-Signing Design: Cartographies of Theory and Practice throws new light on the terrain between theory and practice in transdisciplinary discourses of design and art. The collection brings together a selection of essays on spatiality, difference, cultural aesthetics, and identity in the expanded field of place-making and being.

In lieu of an abstract, here is a brief excerpt of the content:Medical Tourism:Crossing Borders to Access Health CareHarriet Hutson Gray (bio) and Susan Cartier Poland (bio)Traveling abroad for one's health has a long history for the upper social classes who sought spas, mineral baths, innovative therapies, and the fair climate of the Mediterranean as destinations to improve their health. The newest trend in the first decade of the twenty-first century has the middle class traveling from developed countries to those (...) with emerging economies to avoid treatment delays, prohibitive costs for life-saving procedures, or simply high costs for elective surgery. Others leave to have access to assisted suicide in countries that have legalized it: Belgium, The Netherlands, and Switzerland. This new era of globalization in health care has arrived without the benefit of international standards, government oversight, or ethical and legal review.Howard Staab, a self-employed carpenter from North Carolina, flew to India for his medically necessary heart surgery, scheduled a side trip to the Taj Mahal, and returned home to work in North Carolina. He spent a total of less than $10,000, instead of the $200,000 required from the local hospital (I, Milstein and Smith 2006).At first blush, the outsourcing of medical care to India seems to be a particular solution for a particular problem. However, the particularity of Mr. Staab is not unique. His experience is emblematic of those patients in the United States with a medical need for major and elective procedures, but who also must bear the total cost of these procedures. These middle-class, under-insured Americans go abroad.In tandem with increasingly aggressive marketing campaigns, American hospitals and companies have begun to leverage their connections in Asia to grow the medical tourism business into a major economic force. What are the consequences of this?Several authors point to the effect on the host country's population, particularly the poor, to be pushed farther down the queue to receive adequate, affordable care. Resources are applied to the foreign trade instead of building the local [End Page 193] medical infrastructure. Another potential problem is the obligation of the home-country physician to provide follow-up care. What are the legal ramifications when the procedure was illegal to begin with? Are there opportunities for redress for medical errors?These factors may be converging into a "perfect storm" for health care in the U.S., in which the potential participation of the major insurance companies in promoting offshore care will be the tipping point in the precarious structure that represents the economic currents in health care. Third-party administrators and self-funded employers may be on the cutting edge in 2009 by providing incentives to employees to travel overseas for care.I. Economic ConsiderationsConnell, John. Medical Tourism: Sea, Sun, Sand and... Surgery. Tourism Management 27: 1093–1100, 2006.As evidence of the interest of traditional tour operators in this newer twist on the industry, the author explores medical tourism as an element of the growth of world tourism. In promoting medical tourism, he urges consideration of such issues as the privatization of health care, the foundational role of technology, and uneven access to health resources.Dunn, Philip. Medical Tourism Takes Flight. H and HN: Hospitals and Health Networks: 40–44, November 2007.Writing for U.S. health care executives, Dunn emphasizes that the reality of medical tourism competes with the local medical center for patients and their insurance dollars in a significant way. He examines the possibility that U.S. insurance plans soon may offer to pay for what is currently a cash only business and that the economic impact to the local medical center could be significant or even devastating.Frontiers of Health Services Management [Selected Articles] 24 (2), Winter 2007.In "Managing Healthcare Services in the Global Marketplace" (pp. 3–18), Bruce J. Fried and Dean M. Harris consider legal, ethical, and financial implications of the international workforce. In "Globalization of Health Care" (pp. 19–30), Lynn Schroth and Ruthy Khawahja point out that the transfer of comprehensive management expertise and intellectual property from U.S. medical centers to international sites is driving the success of collaboration between U.S. and foreign health care centers. In "Is... (shrink)

This essay responds to Donna J. Haraway's (2016) provocation to ‘stay with the trouble’ of learning to live well with nonhumans as kin, through practice-based approaches to learning to care for nonhuman others. The cases examine the promotion of care for trees through mobile game apps for forest conservation, and kinship relations with city farm animals in Kentish Town, London. The cases are analysed with a view to how they articulate care practices as a means of making kin. Two concepts (...) are proposed, ‘learning from’ and ‘facing’ the Other, which are thickened through discussions of how caring takes place in each case in relation to a particular category of nonhuman other: animated tree and urban farm animal. Thus while attendant to situations of care involving a specific nonhuman subject, the cases also broker thinking on learning from and facing (the) other kinds of trees and animals, and the interspecies dynamics of which they are a part. The intersectional implications of the practice sites and participants are elaborated, to complexify and affirm situated but also reflexive approaches to caring. In doing this, the authors attend to their own positionalities, seeking to diversify Western-based ecofeminist engagements with caring, while asking what their research can do for the nonhuman other. They formulate and apply a collaborative methodological approach to the case studies, developed through cultivating attentiveness to the nonhuman subject of research. The authors consider in particular how attentiveness to the nonhuman other can facilitate practices of knowing that further a non-anthropocentric and non-innocent ethic of caring. By further interconnecting situations of caring for nonhuman animals and plants, the authors advocate for practices of care that antagonise how species boundaries are drawn and explore the implications for learning to care for nonhumans as kin. (shrink)

Modal counterpart theory identifies a thing’s possibly being F with its having a counterpart that is F at another possible world; temporal counterpart theory, the stage view, according to which people and other ordinary objects are instantaneous stages, identifies a thing’s having been F or going to be F, with its having a counterpart that is F at another time. Both counterpart theories invite what has been called ‘the argument from concern’ (Rosen, G. 1990. “Modal Fictionalism.” Mind 99 (395): 327–54). (...) Why should I be concerned about my counterparts at other possible worlds or other times? I care about how things might have gone for me—not how they go for other people at other possible worlds; I care about my prospects—not the way go for other people at other times. Jiri Benovsky has argued that while modal counterpart theory can be defended against this style of argument, temporal counterpart theory cannot (Benovsky, J. 2015. “Alethic Modalities, Temporal Modalities, and Representation.” Kriterion: Journal of Philosophy 29: 18–34). I argue that temporal counterpart theory, like modal counterpart theory, resists the argument from concern. (shrink)

Modal counterpart theory identifies a thing’s possibly being F with its having a counterpart that is F at another possible world; temporal counterpart theory identifies a thing’s having been F or going to be F, with its having a counterpart that is F at another time. Benovsky, J. 2015. “Alethic Modalities, Temporal Modalities, and Representation.” Kriterion: Journal of Philosophy 29: 18–34 in this journal endorses modal counterpart theory but holds that temporal counterpart theory is untenable because it does not license (...) the ascription of the intuitively correct temporal properties to ordinary objects, and hence that we should understand ordinary objects, including persons, as transtemporal ‘worms’. I argue that the worm theory is problematic when it comes to accounting for what matters in survival and that temporal counterpart theory provides a plausible account of personal persistence. (shrink)

We explore men’s negotiation of emotional expression within larger social discourses around masculinity. Drawing on the phenomenon of men’s crying within the competitive sports context, we demonstrate that although the prevailing image of men’s emotion is one of constricted expression and experience, inexpressivity is representative neither of typical nor ideal masculinity in contemporary dominant culture. We first review the literature on prevailing cultural beliefs about normative male emotional expression, then focus on literature specific to men’s tears. Turning to a discussion (...) of masculinity and sports participation, we offer possible explanations for why counter normative emotional expressions may be particularly prevalent and public in the context of men’s competitive sports, despite wider cultural discourses that appear to discourage men’s openly expressive behavior. (shrink)

This chapter contains sections titled: Introduction: The Design Argument The Design Argument in Antiquity Christian Authors Hume's Onslaught William Paley's Natural Theology The Bridgewater Treatises Intelligent Design: A Political Movement Eyes to See No “There” There Blood and Tears Gambling to Non‐existence Natural Selection Natural Selection and Design Postscript: Counterpoint Notes References.

In lieu of an abstract, here is a brief excerpt of the content:Elegia i.3 PROPERTIUS Translated by Steven J.Willett Just as she lay when Theseus’ keel was sliding seaward, the Cnossian maid languid on the desolate shore; just as Cepheus’ daughter reclined in her first slumber, Andromeda, now freed from jagged rocks; just as the Thracian bacchant, weary from incessant dancing, slumps on the grassy bank of the Apidanus; even so Cynthia seemed to breathe a soft repose, her head pillowed (...) on open unruly hands, when I came dragging footsteps wobbly with too much wine, the boys waving burnt-out torches in the late night. Against her I tried, not all my senses utterly derelict, to advance gently on the compliant couch; and, though seized by a double ardor—each was commanding me, love here and wine there, both implacable gods— to assault her by slipping my arm lightly beneath her body and with a hand advanced take kisses and arms, yet I lacked the courage to shatter my mistress’ repose, fearing the brawls whose savagery I’d tasted; so I remained standing there motionless with rapt eyes, like Argus at the strange sight of Io’s horns. And now I was untying the garlands from my forehead and placing them, Cynthia, around your temples; and now I was finding it pleasant to smooth your fallen tresses; then I was giving you stolen apples in hollow palms; but I was lavishing all these gifts on ungrateful sleep, gifts that often tumbled from your sloping lap; and every time you heaved a sigh stirring fitfully, arion 28.2 fall 2020 98 elegia 1.3 I froze, foolishly credulous of an empty sign, fearful that some dream was bringing you strange terrors, or some man was forcing you reluctantly to be his: until the moon drifting across the opposite windows, the meddling moon whose eyes incline to linger, drew her closely-lidded eyes open under its delicate beams. Then, her elbow propped on the soft couch, she asked: “Has another’s rejection finally brought you back to my bed, chucked out with the doors slammed in your face? Where have you squandered the long hours of my night, languid, alas for me, as the stars are waning? Oh, I pray that you may endure, you beast, such nights as you are always making poor me to suffer! Just now I was cheating sleep with purple yarn at the loom, and then, exhausted, with song on Orpheus’ lyre; and sometimes, quite desolate, I softly complained to myself of the long waits your outside loves often cost me. Till sleep with gentle wings brushed me down to oblivion. That was the last concern of all my tears.”... (shrink)

v. 1. Nicomachean ethics. Politics. The Athenian Constitution. Rhetoric. On Poetics.--v. 2. Logic.--v. 3. Physics. Metaphysics. On the soul. Short physical treaties.--v. 4. On the heavens. On generation and corruption. Meteorology. Biological treatises.

It's an achievement of the last couple of decades that people who work in linguistic semantics and people who work in the philosophy of language have arrived at a friendly, de facto agreement as to their respective job descriptions. The terms of this agreement are that the semanticists do the work and the philosophers do the worrying. The semanticists try to construct actual theories of meaning (or truth theories, or model theories, or whatever) for one or another kind of expression (...) in one or another natural language; for example, they try to figure out how the temperature could be rising compatibly with the substitutivity of identicals. The philosophers, by contrast, keep an eye on the large, foundational issues, such as: what's the relation between sense and denotation; what's the relation between thought and language; whether translation is determinate; and whether life is like a fountain. Every now and then the philosophers and the semanticists are supposed to get together and compare notes on their respective progress. Or lack thereof. (shrink)

This article aims to explore the complex issue of the emotive effect of Christian songs. It is based mainly on a literature survey, using sources both from Christian hymnology and musicology. It also uses illustrative examples from three informal surveys in congregations on the reasons particular songs are favourites. The point is made that exploring this issue scientifically is very complex as there are so many variables in people’s appreciation of songs. Some of these elements are discussed, such as the (...) effect of the external setting in which people experience a song, factors important in the appreciation of a text, such as poetic quality and knowledge of the author’s background. Other factors are the emotive quality and level of difficulty of a tune and in what time this style was popular. Then there are the internal factors, such as the link of a song with group identity and special memories. Some of the survey results corroborate the pointers in the literature for what makes certain songs particularly emotionally appealing. Some of these were a preference for musical styles popular in one’s youth, the importance of relationships with significant others for forming favourites and the important element of memory in the emotional impact of songs. Concluding pointers for worship include motivating for different styles of music in worship and carefully finding those songs in each new musical genre, which have the potential for sustaining today’s youth into the future.Contribution: This article makes a contribution in what is a complex and often emotionally charged issue in congregations: Worship styles and musical preferences. It argues for the importance of using different musical styles and bringing the generations together. (shrink)

The foreskin in small boys causes much anxiety in our society. It develops during the second half of gestation, and in premature infants may appear relatively deficient. By term, however, it has grown and protruded to well beyond the glans penis. The inner layer of the foreskin is densely adherent to the surface of the glans and cannot be retracted until it is fully separated, which occurs during the first few years of life. Prior to that time the distal opening (...) of the foreskin is narrow, but because of its adherence there is no significant pocket under the skin to allow accumulation of urine or debris. Later in childhood, after the foreskin is fully separated, urine and dirt can accumulate between the foreskin and the glans, leading to infection and inflammation . With recurrent balanitis, and/or tearing of the delicate foreskin, phimosis or scarring may constrict the distal foreskin.Circumcision has a long history in ancient societies of the Middle East, and is likely to have arisen as an early public health measure for preventing recurrent balanitis, caused by sand accumulating under the foreskin. Circumcision is a major part of the ritual for such religions as Judaism, Christianity, and Islam, and it is probably no accident that all of these arose in the Middle East. By contrast, in religions arising outside the arid Middle East , there is no ritual circumcision. In aboriginal society in Australia, circumcision is practised also.The importance of preventing recurrent balanitis and secondary phimosis in arid, sandy regions was confirmed by the Australian army medical corps in two world wars. During both wars, Australian soldiers were stationed in North Africa and the Middle East, and the incidence of recurrent balanitis caused by sand under the foreskin reached “epidemic” proportions, leading to large numbers …. (shrink)

A plural referring expression (‘the Fs’ or ‘Tom, Dick and Harriet’) may be used to refer either distributively, saying something which applies to each of the Fs individually, or collectively, to the Fs taken as a single totality. Predicate Logic has to analyse both uses in terms of singular reference, treating them quite differently in so doing; but we think of such an expression as functioning in basically the same way in both kinds of use. This understanding can be (...) vindicated if we recognise that what a plural referring expression picks out is not either an aggregate simpliciter or a set, but a plurality– an aggregate taken relative to a principle for individuating its constituents; this admits of being seen either as many things or as one. In any given case, it is the nature of what is being said about the plurality which tells us whether the reference to it is to be taken as distributive, collective, or a combination of the two. Talk about pluralities is extensional. Augmenting Predicate Logic to accommodate the distinctive inference‐pattern associated with distributive plural reference is simple – and arguably necessary, to cope with cases in which distributive and collective reference are essentially combined (e.g., attributions of concerted action). (shrink)

American health care reformers face a number of ethical issues, including familiar debates over the merits of a single-payer system and publicly provided universal health insurance. No matter how these debates are resolved, a further ethical question must be addressed. Both universal coverage and a single-payer system are compatible with permitting some patients to pay more for faster, better, or more health care choices. Should the United States continue to have a two-tier health care system in which wealth grants some (...) patients access to medical services that others with the same needs cannot obtain? Critical evaluation of both principled objections to inequalities and practical objections to anticipated social and medical consequences of a two-tier health care system are needed. (shrink)

This essay describes and commends the treatment of tears and weeping in Augustine’s Confessions. It shows that Augustine depicts these acts as communicative of a particular judgment about the way things are; and that he understands these acts as a species of confession appropriate to the human condition. To become, or attempt to become, the kind of person who does not weep is to distance oneself from God; Augustine therefore commends weeping to Christians as a mode of establishing intimacy with (...) God. (shrink)

A Dutch 'folk theorem' holds that 'from exchange it comes to tears'. This seems to contradict the basic idea found in economics that exchange and trade can make both sides better off. We show that the 'folk theorem' has a better theoretical foundation than sometimes thought, as it is vindicated by the equilibrium of an exchange game with two-sided asymmetric information. We, then, explain the practical value of such 'folk wisdom' in the real world by showing why players might be (...) unlikely to learn such an equilibrium strategy. (shrink)

Uitvoerige historische speurtocht naar de betrekkingen van Erasmus met zijn Hollandse humanistische vrienden en zijn invloed op hun leven en werken.

In the introduction to his recent book outlining a "deep rhetoric" that can affirm rhetoric's "philosophical foundations," James Crosswhite celebrates a remark made by the late Henry Johnstone, the founding and long-time editor of Philosophy and Rhetoric. Johnstone, claims Crosswhite, "once suggested that rhetoric was an attempt to be 'philosophy without tears'". The passage to which Crosswhite refers appears in Johnstone's foreword to the book Rhetoric and Philosophy, a collection of essays edited by Richard Cherwitz. There, in a bungled bid (...) to praise rhetoric's "increased interest in philosophy during the past few decades," Johnstone attributes the "belief that [rhetoric] is 'philosophy without tears'"... (shrink)

Provides comprehensive, yet concise coverage of the broad field of bioethics, dealing with the scientific, medical, social, religious, political and international concerns.

A combination of social forces has thrown marriage into question in westernised societies at the end of the millennium. This uncertainty creates space for new ways of thinking about marriage. In this context, we examine the idea of marriage as friendship. We trace its genealogy in the work of Mary Wollstonecraft, John Stuart Mill and Harriet Taylor and then subject it to critical scrutiny using some of Michel de Montaigne’s ideas. We ask how applicable the ideal of higher friendship (...) is to marriage and what might be gained and lost by a synthesis of marriage and friendship. Grounding the discussion in historical sources is valuable because the topic is so little explored in the contemporary philosophical literature. This approach also allows any enduring value in these historical texts to be elicited. (shrink)

Parents respond to the death of a child in very different ways. Some parents may be violent or angry, some sad and tearful, some quiet and withdrawn, and some frankly delusional. We present a case in which a father’s reaction to his daughter’s death is a desire to protect his wife from the stressful information. The wife is in the second trimester of a high-risk pregnancy and so is particularly fragile. We asked pediatricians and bioethicists to discuss the ways in (...) which they might respond to the father’s understandable but troubling request. -/- The death of a young child is one of the most stressful events that can happen to parents. The stress of such a loss is compounded if the parents are in a foreign country, far from home, and without a network of family and friends to provide social support. The stress may be more difficult to deal with if the parents have acute health problems of their own. In this month’s “Ethics Rounds,” we present a case in which a father whose daughter died requested that the doctors delay telling his wife. His reason: She is pregnant, in the second trimester, and on bed rest because of preterm labor. He does not want to add to her stress. We asked both pediatricians and bioethicists to respond to this request. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Prayer for the BabyKatherine J. GoldWe didn’t talk much about religion in medical school. Rightly so, it seemed to me at the time. I didn’t know how or why it would fit in to my patient care other than respecting patients who used their faith as a coping strategy. I was not at all religious and didn’t like the thought of talking about such things with patients. And (...) in my clinical experiences, it rarely came up.When I got to my last year of school, I signed up to work for a month with an obstetrician–gynecologist in her outpatient clinic. I don’t recall how I met her but remember she was respected for her outpatient teaching so it seemed like it would be a good experience to work with her. (I’ll refer to her by a fictional name here.)“Call me Maria,” she told new patients, enveloping them in a warm, supportive style. They did, and I adjusted to her caring approach, shadowing her as we saw patients during pregnancy, those with abnormal uterine bleeding, patients with pelvic pain, others needing pelvic surgeries. It was an odd experience for me, six months pregnant myself, to be seeing other patients during their own pregnancies.One day, about a week in to my rotation, a couple came in together for an appointment two weeks after an early miscarriage. I watched Dr. Copeland (as a student I just couldn’t call my attending by her first name) give them a hug and we sat down. She asked how they were doing and they shared their story, tears flowing as the mother recounted her emotions over the last week and support from their friends. I had the impression that they attended the same church as Dr. Copeland from their conversation. At the end of the visit everyone stood up.“Shall we pray?” Dr. Copeland asked, and they all took hands. I edged back, away from their small circle, uncertain what to do. I had never seen prayer in medical practice and certainly not initiated by the doctor. Not being religious myself, I felt uncomfortable. I didn’t know the protocol. This was not a setting where I knew what to do. So I leaned [End Page 200] quietly against the wall, trying to be unobtrusive, feeling my baby kicking while I watched. All of them bowed their heads and Dr. Copeland said a brief prayer. I watched the mother as her shoulders relaxed. They said “amen” and squeezed hands and hugged one last time. I thought about that interaction for weeks afterwards. I was uncomfortable, but clearly the patients were not. If there were a role for religion in medicine, I reflected, this might be a place for it. It had been accepted by the family without hesitation, so somehow Dr. Copeland knew it would be alright. It had been used in a healing way.There were several other visits where Dr. Copeland prayed with patients. Sometimes she seemed to know them from her church; at other times, I wasn’t sure. But there never seemed to be a misstep—patients never seemed surprised or awkward with her approach. Did they choose her because of shared beliefs? Did she have a reputation of using faith in her practice and patients selected her for this reason? I wasn’t sure. But it was always the same. They would bow their heads and pray. I would stand back a little uncertainly, but the patients were always grateful and appreciative, thanking Maria by her first name as they left.As I spent more time with her, I looked for other ways that faith might impact Dr. Copeland’s practice and asked questions when I thought there might be relevance. I knew from others that she was opposed to abortion, though I never heard her talk about it openly and I was unsure how this might be manifest in her practice. I watched her prescribe birth control (I knew some religious physicians who did not). I watched her send a patient with a second trimester fetal death to the hospital to be induced for delivery. I wondered if someone... (shrink)