Sentence comprehension involves maintaining and continuously integrating linguistic information and, thus, makes demands on working memory. Past research has demonstrated that semantic WM, but not phonological WM, is critical for integrating word meanings across some distance and resolving semantic interference in sentence comprehension. Here, we examined the relation between phonological and semantic WM and the comprehension of center-embedded relative clause sentences, often argued to make heavy demands on WM. Additionally, we examined the relation between phonological and semantic WM and the (...) comprehension of transitive and dative active and passive sentences, which may also draw on WM resources depending on the number of propositions that must be maintained and the difficulty of processing passive clauses. In a large sample of individuals with aphasia, we assessed whether comprehension performance on more complex vs. simpler active-passive or embedded relative clause sentences would be predicted by semantic but not phonological WM when controlling for single word comprehension. For performance on the active-passive comprehension task, we found that semantic WM, but not phonological WM, predicted comprehension of dative sentences when controlling for comprehension of transitive sentences. We also found that phonological WM, but not semantic WM, predicted mean comprehension for reversible active-passive sentences when controlling for trials with lexical distractors. On the relative clause comprehension task, consistent with prior results, we found that semantic WM, but not phonological WM, predicted comprehension of object relative clause sentences and relative clause sentences with a passive construction. However, both phonological WM and semantic WM predicted mean comprehension across all relative clause types for reversible trials when controlling for trials with lexical distractors. While we found evidence of semantic WM’s role in comprehension, we also observed unpredicted relations between phonological WM and comprehension in some conditions. Post-hoc analyses provided preliminary evidence that phonological WM maintains a backup phonological representation of the sentence that may be accessed when sentence comprehension processing is less efficient. Future work should investigate possible roles that phonological WM may play across sentence types. (shrink)

continent. 1.4 (2011): 279—285. Concerning its Transitive Nature, the Conversion of Native Americans of Spanish Colonial California, Indoctrinated Catholicism, & the Creation There’s no direct archaeological evidence that Jesus ever existed. 1 I memorized the Act of Contrition. I don’t remember it now, except the beginning: Forgive me Father for I have sinned . . . This was in preparation for the Sacrament of Holy Reconciliation, where in a confessional I confessed my sins to Father Scott, who looked like Jesus, (...) at least in Western cultural representations of Jesus since the middle ages, and if Jesus put on a few pounds. Father Scott was long-haired, redheaded, bearded, chubby, and tall. When he left church with the procession of altar servers and Eucharistic ministers, yelling, “Sing a Good Song Unto the Lord,” he smiled, hands folded, and he gazed over his parishioners, and bounced along. For four months every year he lived among the Crow Nation in Montana, where towards the end of his tenure at Our Lady of Refuge, they adopted him as an honorary member of their tribe. * This is the prayer we chanted, holding hands, every night before dinner: Bless us oh Lord, for these our gifts, which we are about to receive, our bounty through Christ, our Lord, Amen. Then we all said, God bless the cook! When we were with my grandparents, Grandpa said, God bless Chicky, and Holly, and Harvey, and Boots—all the dead dogs. * My sister tells me that she sits next to a handsome man on a flight across the country. After chitchat, she withdraws her book. She’s reading Kevin Sampsell’s A Common Pornography . After a few moments, the handsome man also reads from his book—his leather-bound Bible. Sister thinks, Oh, Jesus—too bad. She falls asleep. Later, settled in Nashville, she opens her volume and out falls a Jesus-covered card that reads, You can still find God and Salvation! Because that handsome God-fearing young man saw that word— pornography . * I suppose Father Jim’s dark hair, beard, and glasses made me think doctoral-ly of him. He called while I was in the midst of a breakup, after I’d twice attempted suicide, and my mother was desperate for help. She somehow found and phoned him. And Jim, now years out of Our Lady of Refuge’s parish, twenty years since my baptism, years even since he’d left the priesthood and the Catholic faith, still made the effort to bring me back into the fold. He said, “Have you seen a priest?” I did not respond, as I was more shocked to hear his voice than anything, so I said, “How are you, Father Jim? Sorry, I guess I shouldn’t call you ‘Father.’” And I said, “Why did you leave the priesthood? Do you have a girlfriend?” He said that I should call him just “Jim.” He said, “Do you need someone to talk to?” I said, “Not really.” He said, “Call your mother; she’s worried about you.” That was the last time I talked to Father Jim. * Mother let me know just how disappointed Jesus was. I cried and cried, and said I was sorry. Into my hands she placed my missal, ordered forty Rosaries. She said next Saturday I would go to confession. I hated confession. Who wouldn’t? * I realize, of course, that this page is a kind of confessional. * The Kumeyaay, Ipai, Tipai, Chumash, Esselen, Rumsen—all Native Americans of Alta California—shared similarities in their religions. Southern Californian tribes made use of Datura, or jimpson weed, a hallucinogen, for religious rituals. In the creation, God made brother sky and sister earth. Brother and sister mated, and sister gave birth to all things on Earth, including people, but it was difficult to distinguish people from all other aspects of Earth because everything was alive: granite and obsidian, the Pacific and its waves, the San Diego and Los Angeles Rivers. Wiyot—a hero—was very powerful, born from lightning, the son of the Creator and a virgin. When Wiyot thought that human women’s legs were more beautiful than Frog’s, Frog became jealous and poisoned Wiyot. The dying Wiyot went to all the people’s villages, and he distributed his power among them. He said, “When I die, I should be cremated.” The people built the fire and funeral pyre. When the fire was ready, and the people about to place Wiyot’s body upon it, Coyote came and snatched away Wiyot’s heart. * My friend Nick told me once how he ate some jimpson weed and that he hallucinated for three days. His family took a road trip and, while driving over the Sierra Nevada mountains, he kept seeing dinosaurs roaming the open meadows and charging down snowy slopes. So it’s no wonder that Native Americans who ingested this plant would have developed religion. * Walking Castroville’s streets after school I got into fights but mostly watched other boys scrabbling on the asphalt. I went to Burger King for Whoppers. Me and my friends cussed. Antonio admonished me when I said, “damn,” while strutting a sidewalk alongside the church. He said, “Jaime”—pronounced Hi-May, which was what all the Mexicans called me—“you’re crazy, eh. Don’t cuss at the church.” He meant while at church, as in, within its vicinity. I said, “We’re not in church.” Once we’d crossed the street, Tony said, “Damn dude, you’re fuckin crazy!” * Blessed Father Fray Junípero Serra raised the Eucharistic goblet to his lips, and candlelight danced on the blood’s tiny waves. Incense clouded the church so completely that some of the Pame natives grew nauseous. So, too, felt Blessed Father Fray Junípero Serra later that night, as he bent over a ceramic bowl and vomited blood, not only the Lord’s, but his own, for poison had laced the sacred vessel into which he poured the sacrament. The physician tending to the sick prelate urged him to take the remedy he’d prepared. But Blessed Father Fray Junípero Serra refused, said that he would pray, for he had never taken any medicine in his life, and he never would. * The Chumash of El Valle de Los Osos called themselves the Stishni, separating themselves from Chumash of other regions, those varying tribes of the central California coast that spoke mutually unintelligible dialects of their Hokan language. This made learning their languages impossible for the Spanish friars, to say nothing of translating the Doctrina. Thus the priests baptized few natives, despite the help that the tribes offered the fledgling settlements in the form of meat and acorn meal, which the Spaniards found repugnant. Some from these cultures, feeling threatened by the newcomers, shot flaming arrows into the thatched roofs of the mission structures. And why wouldn’t they feel threatened when priests chastised them for performing, for example, their Coyote Dance, wherein a man donning a coyote-skin-and-skull costume dances while a singer sings his tale, which laments the human feces strewn imaginatively about the Earth? Coyote, meantime, tries to get an onlooker to lick his genitals, and finally engages in public sexual intercourse with a female tribe member or two, then ends the dance by defecating. Though the Franciscans called such forbidden acts devilry , the Chumash maintained their Datura cult religion, along with the enforced Christianity. For the Chumash, the Earth was made of two enormous snakes that caused earthquakes when they slithered past one another—a vast reptilian tectonics. In the 20th century, long after Blessed Father Fray Junípero Serra and his cohorts had died, when asked by an anthropologist about religious contradictions, conflating the Datura and Christian cults, a Chumash man replied, incredulous: “But these are two different religions.” * When Portolá ordered that if by March 19th, the feast day of St. Joseph, the San Antonio had not arrived in San Diego Bay to relieve them, the Sacred Expedition to Nueva California would be abandoned, Blessed Father Fray Junípero Serra prayed a novena for San José’s intercession. And lo, a lookout sighted the San Antonio ’s sails—what seemed to the priest a miracle—that very Saint’s feast day. Europeans would stay in California, and Blessed Father Fray Junípero Serra would continue to reap a great harvest of souls for the Lord. By the end of mission secularization in 1836—sixty-six years after the San Antonio rescued the Spaniards—Native American populations in California had declined by seventy-three percent. * When Peter the Aleut would not renounce his Eastern Orthodox faith the padre of San Francisco had a toe severed from each foot with each refusal, totaling ten. The native Ohlones employed in this gruesome task—their obsidian chiseled knives tearing through skin and grinding bone—continued as per their orders, and cut off also each of Peter’s fingers (equals a total of twenty refusals). They quartered the martyr, spilled his bowels, as if from bear attack, attack by a bear in the shape of a Catholic. * Blessed Father Fray Junípero Serra absolutely believed that the slow rate of conversion for the native people was due to the influence of the Devil, who had been outraged by the coming of the Catholics to California, this region that he had long held in his dominion. * In his reception speech for the Nobel Prize for Literature, John Steinbeck said, “Man himself has become our greatest hazard and our only hope. So that today, St. John the Apostle may well be paraphrased: In the end is the Word, and the Word is Man—and the Word is with Men.” * In 1602, when Sebastián Vizcaíno and his friars sang mass on Catalina Island, as many as a hundred Pimungans witnessed the rite, asking by signs what it was about. According to Vizcaíno’s records, the Californians marveled not a little at the idea of Heaven and at the image of Jesus crucified. * Vizcaíno was brought to a prairie on Santa Catalina Island where the Pimungans worshipped their sun god. Upon the prairie they had placed an icon, a headless figure with horns protruding from the body, a figure that Vizcaíno predictably described as a demon. The Pimungans urged Vizcaíno not to approach the image of their deity, but he ignored them. He placed his crucifix against the wooden figurine and prayed the Our Father. Vizcaíno told the natives that his prayer was from Heaven, and that their god was the Devil. Vizcaíno held out his crucifix, encouraging the Pimungans to touch it and receive Jesus. He pointed at the sky and indicated Heaven. The Pimungans worshipped a sun deity, so they were impressed with this white man and his description of his god, for their gods seemed to be one and the same. It’s no wonder then that Vizcaíno’s diary reports the natives being pleased with this exchange. “Surely,” the diary says, “they will be converted to our Holy Faith.” * The Miwok women wailed and scratched at their faces when their men consorted with Sir Francis Drake and the other Englishmen who had landed on California’s coast in the summer of 1579. “The blood streaming downe along their brests, besides despoiling the upper parts of their bodies of those single coverings . . .they would with furie cast themselves upon the ground . . . on hard stones, knobby hillocks, stocks of wood, and pricking bushes.” Drake and his men fell themselves to their knees in prayer, their eyes Heavenward, so that the natives might see they prayed to God and they too might worship God then their eyes that had been so blinded by the deceiver might be opened. * Father Fray Antonio de la Ascención—Carmelite friar in Vizcaíno’s party—writes that the Indians of California can “easily and with very little labor be taught our Holy Catholic faith, and that they would receive it well and lovingly.” He calls for two hundred older and honorable soldiers to ensure brotherhood during the conquest, so that peace and love—the best tools to pacify pagans—should reign. The religious, the friar says, should likewise be wise and loving to easily quell animosities between Spaniards and the heathen, and therefore avoid war. The Spaniards should bring with them trinkets—beads, mirrors, knives—to distribute amongst the gentiles, so that they might come to love the Christians, and see “that they are coming to their lands to give them that of which they bring, and not to take away the Indians’ possessions, and may understand that they are seeking the good of their souls.” No women are to accompany the conquest, says Father Fray Antonio, “to avoid offenses to God.” * In 1955 Wallace Stevens admitted himself to St. Francis Hospital in Hartford, Connecticut. There, it’s rumored he converted to Catholicism before dying of stomach cancer, exclaiming to his priest after the baptism, “Now I am in the fold.” Stevens’s late-career poems seem less cynical, more in awe of being and death (read “Metaphor as Degeneration” from The Auroras of Autumn ). He could have chosen from at least three secular hospitals in Hartford at the time. * I was reading Stevens’s Collected Poems when I joined eHarmony and listed that as my “currently reading” book among the “more than twelve” books a year that I would read. I fell in love with my wife when she said, “Are you sending your work out to literary journals?” Prior to this, the first girl I talked to on the phone, when I explained my doctoral exams, said, “So, you’re like, reading Stephen King and stuff?” When I said not exactly she responded defensively: “He must be doing something right, since he makes all that money.” * Mom walked me, my brother, and sister, through the Stations of the Cross. We did this on Ash Wednesdays, or whenever she thought we needed extra God after church. It might’ve happened before church, though that’s unlikely because we were always late. Anyway, it’s easiest to walk the Stations of the Cross when there’s no one else around. To walk the actual Stations means one goes to Jerusalem and walks the Via Dolorosa to the Church of the Holy Sepulchre. So the Stations elsewhere—usually paintings, or low-relief sculptures upon church walls—serve as a kind of virtual Dolorosa. Mom held our hands and started from the rear of Our Lady of Refuge: the First Station. Mom said we should say a prayer at each Station and to think of all the pain Jesus went through so that we could go to Heaven. It was hard to keep thinking about that one thing for so long. My mind went to that Saturday’s little league game, to the donut and chocolate milk (our after-church reward from Castroville Bakery), and as I grew older I thought about girls. When you’re thirteen you can’t not think about the girl’s butt in the pew in front of yours as she kneels and stands to pray throughout mass. * It grew increasingly juvenile to lie awake at night daring myself to utter a simple sentence. Even if I said I didn’t believe in God, wouldn’t He know the truth? He was omniscient, like a narrator. Even the idea of Him as a him ceased making sense. Not only did this come with a budding realization of my paternalistic culture, but due to the simple question of why? If God was everything, everywhere, all knowing, then why would he be a man? There’s that question: If God is a man then God must have a penis, and if so, what for? * The Catholic Church incorporates some modern scientific research into its dogma concerning the formation of the Universe, Solar System, and Earth, as well as evolution. According to Catholic doctrine, in approximately the fifth millennia BCE, humans began to worship the one true God. Those humans were Adam and Eve, though the Church says humans had been around for thousands of years prior to Adam and Eve. The Church claims to be infallible. Every time the Church changes its doctrine it remains infallible. * One Catholic writer, Tom Meagher, writes that “Modernism[—]the idea that we come to our beliefs individually through emotional or personal experiences[—]has crept into our Catholic schools.” * Catholics believe that evil spirits, given power through Original Sin, can imbue ordinary inanimate objects of everyday use. Thus, such objects should be blessed in order to induce in them the desire to serve the good. Such objects are not limited to, but include, “new ships and boats, railways and trains, bridges, fountains, wells, cornmills, limekilns, smelting furnaces, telegrams, steam engines, and machines for providing electricity.” * In The Sound of Music Julie Andrews and Christopher Plummer sing together: “Nothing comes from nothing, nothing ever could...” * To explain competing theories on the very early universe, and pre-verse would be another book. What was the inflaton? Did (mem)branes collide, initiating the Big Bang, as opposed to Lemaître’s primordial atom, a singularity? Without a unified theory there’s gravity hanging out there, fucking everything up. We cannot make sense of the mechanics of the Planck Epoch—0-10-34 seconds into the Universe’s creation—named for Max Planck, who stumbled into the discovery of quantum mechanics in the early twentieth century. * My students often ask if I believe in God, since I espouse evolution, the Big Bang, Science, reject a strictly biblical or creationist theory of the Universe. I tell them that yes, I believe in God, though not the God that they imagine one must believe in. * When questioned regarding the rumor that, before his death, founder of quantum mechanics Max Planck had converted to Catholicism, he replied that he did not believe “in a personal God, let alone a Christian God.” * Physicist and Catholic priest George Lemaître, who formulated the theory and wrote the 1946 book The Primeval Atom Hypothesis , was made a household name by then-detractor Fred Hoyle, who pejoratively referred to the idea as a “Big Bang.” * Suicide is a mortal sin. To end one’s own life one must have despair, which is to lose hope, which is to lose faith, and to disbelieve in God. * Archaeology has uncovered graffiti in all of California’s missions—Indian pictographs inscribed into the adobe, covered with layers of whitewash. Native deities and depictions of cultural practices show that tribespeople never fully gave up their native traditions even after baptism and coming to the missions. There was something inside Native Californians that would never die. (shrink)

A growing body of scholarship argues that by disentangling gestation from the body, artificial wombs will alter the relationship between men, women, and fetuses such that reproduction is effectively ‘degendered’. Scholars have claimed that this purported ‘degendering’ of gestation will subsequently create greater equity between men and women. I argue that, contrary to the assumptions made in this literature, it is law, not biology, that acts as a primary barrier to the ‘degendering’ of gestation. With reference to contemporary case law (...) involving disputes over frozen embryos, I demonstrate that though reproductive technologies have already made it possible for gendered progenitors to have an ‘equal’ say in gestation, law mires the possibilities of these technologies in traditional stories of gendered parenthood. Looking to the way binary assumptions about gender limit the self-determination of trans men and nonbinary and genderqueer people who are gestational parents, I argue the ‘degendering’ of gestation will come not with artificial wombs but with the end of limited legal paradigms for gendered gestational parenthood. (shrink)

Taken at face value, pet cloning may seem at best a frivolous practice, costly both to the cloned pet's health and its owner's pocket. At worst, its critics say, it is misguided and unhealthy—a way of exploiting grief to the detriment of the animal, its owner, and perhaps even animal welfare in general. But if the great pains we are willing to take to clone Fido raise the status of companion animals in the public eye, then the practice might be (...) defensible. (shrink)

: Taken at face value, pet cloning may seem at best a frivolous practice, costly both to the cloned pet's health and its owner's pocket. At worst, its critics say, it is misguided and unhealthy—a way of exploiting grief to the detriment of the animal, its owner, and perhaps even animal welfare in general. But if the great pains we are willing to take to clone Fido raise the status of companion animals in the public eye, then the practice might (...) be defensible. (shrink)

Articulating the public's widespread unease about animal biotechnology has not been easy, and the first attempts have not been able to provide an effective tool for navigating the moral permissibility of this research. Because these moral intuitions have been difficult to cash out, they have been belittled as representing nothing more than fear or confusion. But there are sound philosophical reasons supporting the public's opposition to animal biotechnology and these arguments justify a default position of resistance I call the Presumption (...) of Restraint. The Presumption of Restraint constitutes a justificatory process that sets out the criteria for permitting or rejecting individual biotechnology projects. This Presumption of Restraint can be overridden by compelling arguments that speak to a project's moral and scientific merit. This strategy creates a middle-of-the-road stance that can embrace particular projects, while rejecting others. The Presumption of Restraint can also serve as a model for assessing moral permissibility in other areas of technological innovation. (shrink)

Long used as a tool for medical compliance and adhering to treatment plans, behavior contracts have made their way into the in-patient healthcare setting as a way to manage the “difficult” patient and family. The use of this tool is even being adopted by healthcare ethics consultants (HECs) in US hospitals as part of their work in navigating conflict at the bedside. Anecdotal evidence of their increasing popularity among clinical ethicists, for example, can be found at professional bioethics meetings and (...) conversations and idea-sharing among practitioners on HEC social media. While there are a handful of papers gesturing toward a bioethical critique of behavior contracts of various types, the use of behavior contracts in the context of interpersonal conflict has not been vetted by bioethicists to determine their ethical legitimacy or efficacy. In this paper, we highlight a set of ethical concerns that we believe must be addressed before continuing or widespread implementation of behavior contracts to manage the “difficult” patient or family. (shrink)

Clinical ethics consultations are sometimes deemed complete at the moment when the consultants make a recommendation. In CECs that involve actual ethical conflict, this view of a consult's endpoint runs the risk of overemphasizing the conflict's resolution at the expense of the consult's process, which can have deleterious effects on the various parties in the conflict. This overly narrow focus on reaching a decision or recommendation in consults that involve profound moral disagreement can result in two types of adverse, lingering (...) sequelae: moral distress or negative moral emotions. The problem, succinctly named, is that such consults have insufficient “closure” for patients, families, and providers. To promote closure, and avoid the ills of moral distress and the moral emotions, I argue that CECs need to prioritize assisted conversation between the different stakeholders in these conflicts, what is often referred to as “bioethics mediation.”. (shrink)

Many contemporary philosophers consider justice to be the crucial normative concept of ethics and political philosophy. This view goes back to J. S. MillÏs Utilitarianism (ch. 5), and to J. RawlsÏ A Theory of Justice. In this paper, I challenge this view. As I take it, justice is not the core of our normative convictions for many normative convictions do not concern questions of justice. I aim to show that our idea of justice has a very specific content and function.

Vor dem Hintergrund der aktuellen Frage nach einer angemessenen Einladungspolitik für akademische Veranstaltungen wird zunächst betont, dass das Recht auf freie Meinungsäußerung zum absoluten Kern jeder liberalen politischen Ordnung gehört. Seine Wahrnehmung unterliegt jedoch zugleich klaren Bedingungen und weist Legitimitätsgrenzen auf. Im vorliegenden Artikel werden fünf solche Bedingungen genereller Art formuliert, nämlich ein a) Moralitätskriterium, b) ein Reziprozitätskriterium, c) ein Legalitätskriterium, d) ein republikanisches Gemeinwohlkriterium und e) ein Relevanzkriterium. Es folgen weitere sechs Kriterien für die Limitierung des wissenschaftstypischen Gebrauchs von (...) Meinungsfreiheit: f) das Sozialisationskriterium, g) das Expertisekriterium, h) das Einschlägigkeitskriterium, i) das Methodenkriterium, j) das Qualitätskriterium und k) das Objektivitätskriterium. Illiberale Positionen werden sodann als solche definiert, die das Prinzip des Vorrangs der Grundfreiheiten nicht anerkennen. Schließlich stelle ich Überlegungen zum Toleranzbegriff mit dem Ergebnis an, dass gegenüber illiberalen Positionen Toleranz in der Regel nicht angemessen ist. (shrink)

J. Baird Callicott has proposed two second-order principles which he believes can be used to settle conflicts between his land ethic and traditional human morality. The first of these proposes that ethical obligations arising from “more venerable and intimate” communities should take precedence over those arising from “more recently emerged and impersonal” communities, while the second proposes that “stronger” interests should take precedence over “weaker” ones. Callicott’s first second-order principle fails to specify unambiguously which communities’ obligations should take precedence because (...) he has failed to provide a clear description of how we are to identify and compare communities. In order for his second second-order principle to be useful, a good deal more work needs to be done to spell out what is meant by describing certain interests as “stronger” than others, particularly with respect to holistic entities. While the project of fleshing out a description of the strengths of interests for holistic entities may present an interesting and fruitful challenge, the prospects for providing a description of community identification of the sort that Callicott requires are much dimmer. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Too Expensive to Treat? Finitude, Tragedy, and the Neonatal ICU by Charles C. CamosyAutumn Alcott RidenourReview of Too Expensive to Treat? Finitude, Tragedy, and the Neonatal ICU CHARLES C. CAMOSY Grand Rapids, MI: Eerdmans, 2010. 208 pp. $18.00In Too Expensive to Treat? Charles Camosy makes an important contribution to bioethics and Christian ethics by making the case for the need to consider social factors when treating imperiled newborns. (...) Arguing for both the full moral status of newborns and Roman Catholic social teaching’s emphasis on the just allocation of resources, Camosy calls the medical community, bioethicists, and [End Page 209] Christian ethicists to account for current practices that disproportionately favor exorbitant costs for imperiled infants over other even more basic medical needs within the US health care system. Written before the adoption of the Affordable Care Act under the Obama administration, Camosy’s argument has only increased in significance given the national need to prioritize resources in view of the government’s expansion of health care coverage.Born within twenty-two to twenty-four weeks of gestation and weighing between 500 and 850 grams, some imperiled infants absorb hundreds of thousands of dollars in short-term care that may extend into millions of dollars given long-term costs (146, 171–93). Recognizing the tragic reality in which “we have virtually unlimited health care needs” coupled with “limited health care resources,” Camosy contends that current Medicaid funds that privilege the NICU (neonatal intensive care unit) should be reevaluated (1–3). In an effort to temper the “autonomous,” patient-driven principle with “justice,” Camosy poses a challenging philosophical, theological, and practical proposal for what he identifies as the “gray area” of the NICU.Maintaining a twofold commitment to human dignity that values the moral worth of the infant, on the one hand, and the common good that privileges a preferential option for the poor, on the other, Camosy develops his argument in four major steps. First, he validates the moral status of newborn infants and rejects social quality of life models that dismiss their intrinsic status as “persons.” Second, he dismisses arguments that emphasize personal dignity at the expense of considering the social quality of life, pointing out that such arguments disregard Catholic social teaching’s emphasis on the link between relational anthropology and human personhood (100). Third, he contends that “weak” social quality of life models that privilege the patient or individual over social considerations do not take seriously either Catholic social teaching’s emphasis on the common good or the potentially overwhelming economic and practical burdens they might place on families and society as a whole. Finally, Camosy presents a constructive proposal for limiting NICU resources that seeks to counter a culture of overtreatment that idolizes technology and is at the mercy of an unrestrained free market (162). Emphasizing the need for a just allocation of resources, he supports withholding and withdrawing life-sustaining treatment in some cases, thus foreseeing the possible death of some infants. Although he does not accept the direct killing of these infants, he does maintain that Catholic social teaching would allow for the withdrawal of life-sustaining treatment based on certain criteria.Camosy raises a host of important considerations relevant to decisions about imperiled infants. Yet a few questions remain. First, from a Christian point of view, does he not fall into a kind of soft utilitarianism, even though he himself desires to avoid the pitfalls of utilitarianism? Second, how might Camosy envision Christian practices that care for “exposed” infants left without life-sustaining treatment? Finally, what about the difficult emotions that accompany [End Page 210] the death of an infant or child? Do certain kinds of grief complicate our rationing choices that appear to pit the old against the young? While perhaps unanswerable, these questions merit further discussion.Autumn Alcott RidenourMerrimack CollegeCopyright © 2015 Society of Christian Ethics... (shrink)

Between 15 and 60% of patients are considered ?difficult? by their treating physicians. Patient psychiatric pathology is the conventional explanation for why patients are deemed ?difficult.? But the prevalence of the problem suggests the possibility of a less pathological cause. I argue that the phenomenon can be better explained as a response to problematic interactions related to health care delivery. If there are grounds to reconceive the ?difficult? patient as reacting to the perception of ill treatment, then there is an (...) ethical obligation to address this perception of harm. Resolution of such conflicts currently lies with the provider and patient. But the ethical stakes place these conflicts into the province of the ethics consult service. As the resource for addressing ethical dilemmas, there is a moral mandate to offer assistance in the resolution of these ethically charged conflicts that is no less pressing than the more familiar terrain of clinical ethics consultation. (shrink)

Responding to Max Weber’s modern diagnosis of nature, science, and medicine as disenchanted, this article aims to reenvision nature and medicine with a sense of enchantment drawing from the Christian themes of creation, Christology, suffering, and redemption. By reenvisioning nature as enchanted with these theological themes, the vocation of medicine might be revitalized in terms of suffering presence, healing care, and works of mercy toward the neighbor in need.

Health care providers (HCPs) are routinely placed into morally challenging situations that have the potential to cause moral distress. This is especially true for HCPs working in the military, whether they are on deployment outside their typical contexts of practice such as in disaster relief (e.g., Haiti and the Ebola missions in West Africa), or in more typically military settings such as peace keeping or armed conflicts (e.g., Afghanistan, Syria). Moral distress refers to “painful feelings and/or psychological disequilibrium” (Nilsson, Sjöberg, (...) Kallenberg, & Larsson, 2011, p. 50) that occur when an individual is aware of a morally appropriate action in a moral dilemma but obstruction prevents them from carrying it out, or when in a situation where they must choose between upholding equally treasured but conflicting moral values. Similarly, moral distress can occur when faced with a ‘tragic choice’ where all available courses of action require something of moral significance to be given up, such as surgical triage in a mass casualty event (Hunt, Sinding, & Schwartz, 2012). In the literature, moral distress has been connected to negative psychological effects and even stress related mental health issues including compassion fatigue, burnout, and post-traumatic stress disorder (Owen & Wanzer, 2014; Gustafsson, Eriksson, Strandberg, & Norberg, 2010; Litz, et al., 2009). (shrink)

This paper offers an introduction to the philosophy and science of embodied learning, conceived as both the stabilizing and expansionary process that sustains order and novelty within learners’ worlds enacted through observing and describing. Embodied learning acknowledges stability and change as the purposeful conjoined characteristics that sustain learners. It is, in many respects, a composite theory that represents work from various disciplines. This ‘naturalized epistemology’ conceives a world of fact inevitably imbued with the values that our own structural histories guarantee (...) us observers, whether acknowledged or not within our reflective awareness. These values, however, are not simple sets of preferences, for they are constituted in our individual learning histories that, for good or bad, influence the course of future learning. This conservational element of our condition is only half the story, however. The more radical aspect resides in the expansionary capacity of embodied observers to change, to enact worlds that are not pre‐given but, rather, brought forth by learners as observers and describers. Furthermore, embodied learning seeks a grounding for understanding in the often‐unexplored epistemological terrain between positivist absolutism or its mirrored polar opposite, postmodern nihilism. Its epistemological stance derives from its ontology, which is grounded in the profound obviousness that ‘everything said is said by someone’. (shrink)

Medical students pose as physicians during clinical training. This article presents three cases where students justify misrepresenting their status for different reasons: self-concern for career, necessity for clinical training, and belief that the truth could cause undue psychological stress in the patient. The author suggests that serious consequences of this practice should be constantly reviewed in a critical light.

As groups around the country begin to craft standards for clinical ethics consultations, one focus of that work is the proper procedure for conducting ethics consults. From a recent empirical look into the workings of ethics consult services (ECSs), one worrisome finding is that some ECSs rely on a committee vote when making a recommendation. This article examines the practice of voting and its moral standing as a procedural strategy for arriving at a clinical ethics recommendation. I focus here on (...) the type of clinical ethics conflicts that are most likely to lead an ECS to vote, namely, conflicts involving ethical uncertainty—or, in the Greek, aporia. I argue that in cases of aporia, voting on an ethics conflict is not a morally justifiable procedure. Then on the same grounds that I use to show that voting is ethically problematic, I raise broader concerns about the common practice of making recommendations by other procedures. In contrast to the standard approach of adjudicating between moral claims, I argue that ECSs can best resolve aporetic conflict through the process of clinical ethics mediation. (shrink)

Clinicians at quaternary centers see part of their mission as providing hope when others cannot. They tend to see sicker patients with more complex disease processes. Part of this mission is offering longshot treatment modalities that are unlikely to achieve their stated goal, but conceivably could. When patients embark on such a treatment plan, it may fail. Often treatment toward an initial goal continues beyond the point at which such a goal is feasible. We explore the progression of care from (...) longshot to fantasy using two pediatric cases. This progression may be differentiated into four distinct stages of care related to the potential of achieving the initial goals of care. Physicians are often ill prepared for the progression of treatments from a longshot hope to an unfeasible and, therefore, typically unjustified intervention. We present a structured approach to guide clinicians at referral institutions where these situations may be common. The transition of care from “longshot” to “fantasy” is an inherent part of quaternary care for the sickest of patients that has been underexplored. Physicians are often poorly equipped to approach that transition. We advocate this approach to the shift from longshot to fantasy with the belief that such a structured method will have multiple benefits, including: reduced suffering for the patient; decreased emotional burden on patient and family; decreased provider moral distress; increased likelihood of seeking high quality palliative care earlier; and provision of honest and straightforward information to patients and their families. (shrink)

Internationally, there is an on-going dialogue about how to professionalize ethics consultation services . Despite these efforts, one aspect of ECS-competence that has received scant attention is the liability of failing to adequately capture all of the relevant moral considerations in an ethics conflict. This failure carries a high price for the least powerful stakeholders in the dispute. When an ECS does not possess a sophisticated dexterity at translating what stakeholders say in a conflict into ethical concepts or principles, it (...) runs the risk of naming one side's claims as morally legitimate and decrying the other's as merely self-serving. The result of this failure is that one side in a dispute is granted significantly more moral weight and authority than the other. The remedy to this problem is that ECSs learn how to expand the diagnostic moral lens they employ in clinical ethics conflicts. (shrink)

Proficient listening has been viewed as a critical skill in HEC (healthcare ethics consultation) from the inception of the practice, and it is included in the field’s set of core competencies that practitioners need to master to become a certified healthcare ethics consultant (HEC-C). Despite its centrality to the work of HEC, practitioners and trainees receive little or no formal training in the craft of listening, and there are few available resources that ethics consultants and trainees can access to enhance (...) their listening skills. This dearth of training in the skill of listening belies the enormous challenge of listening proficiently. Although many clinical ethics researchers refer to the need for “active listening” in HEC, the term is employed without description or instruction. In this article, I argue that a more helpful depiction of the requisite skill is conveyed by the term “diagnostic listening.” After describing the strategy of diagnostic listening, I introduce a novel technique for honing the listening skills needed for HEC: the ADEPT Model. The ADEPT Model is a tool that can begin to fill the training gap for this important skill. (shrink)

A brief poll of my scientific colleagues confirmed that, to a person, they regard addiction as a disease, whereas most non-science acquaintances consider it to be a failure of willpower. Reconciliation of these polarized views seems difficult and rather than finding a middle path, such as suggested by Foddy and Savulescu. I am an entrenched supporter of the view that addiction can be a disease. I first should declare my position as a card-carrying biologist, holding the view that behavior emanates (...) from the brain and, accordingly, that behavior and emotions result from brain function. This brain function also produces addiction and related behaviors, whereas Foddy and Savulescu seem to credit humans with a greater capacity to choose than biological evidence suggests. The second problem relates to definitions of disease: I argue that there are at least three ways addiction might be considered a disease. 1.? ? ? Addiction is a disease because it results in pathology. For example, hypertension is a disease. Hypertension per se does not cause dysfunction, but leads to pathologically definable conditions such as stroke and myocardial infarction. Smoking, like hypertension, can result in pathologies such as emphysema and cancer. The problem is not smoking per se, or even addiction to nicotine, rather it is the consequent diseases caused by tobacco. Nevertheless, if hypertension is a disease, so is smoking. The question of “choosing‘ to persist with smoking has no bearing on whether it is disease. Whether a person chooses to care for their hypertension or ignore it does not alter the fact that they have hypertension; it is still a disease and it will still harm them. Whether addiction affects the capacity to choose is not relevant because it does not alter the fact that smoking causes pathology and hence is a disease. 2.? ? ? Foddy and Savulescu argue that addiction leaves no tell-tale pathology to set it aside from. (shrink)

While Simone de Beauvoir's inaugural reflection in The Coming of Age depicting the aging experience as one of social marginalization and lament seemingly endures, a surprising source for offering hope to aging persons may be found in the theology of Karl Barth in congruence with W. H. Vanstone. This essay reconsiders the meaning of aging within a Christological interpretation that not only values the various life stages along with intergenerational relationships but also offers meaning for the embodiment of active and (...) passive agency during the aging stage of life. (shrink)

The American Journal of Bioethics, Volume 12, Issue 8, Page 10-11, August 2012.

This paper offers an introduction to the philosophy and science of embodied learning, conceived as both the stabilizing and expansionary process that sustains order and novelty within learners’ worlds enacted through observing and describing. Embodied learning acknowledges stability and change as the purposeful conjoined characteristics that sustain learners. It is, in many respects, a composite theory that represents work from various disciplines. This ‘naturalized epistemology’ ( ) conceives a world of fact inevitably imbued with the values that our own structural (...) histories guarantee us observers, whether acknowledged or not within our reflective awareness. These values, however, are not simple sets of preferences, for they are constituted in our individual learning histories that, for good or bad, influence the course of future learning. This conservational element of our condition is only half the story, however. The more radical aspect resides in the expansionary capacity of embodied observers to change, to enact worlds that are not pre‐given ( ) but, rather, brought forth by learners as observers and describers. Furthermore, embodied learning seeks a grounding for understanding in the often‐unexplored epistemological terrain between positivist absolutism or its mirrored polar opposite, postmodern nihilism. Its epistemological stance derives from its ontology, which is grounded in the profound obviousness that ‘everything said is said by someone’ (, p. 27). (shrink)

In their systematic review of the work of the ASBH Core Competencies Update Task Force, Anita Tarzian and ASBH Core Competencies Update Task Force (2013) write, “The ethics facilitation approach do...

Mediators utilize a wide range of skills in the process of facilitating dialogue and resolving conflicts. Among the most useful techniques for clinical ethics consultants (CECs)—and surely the least discussed—are those employed in acrimonious, hostile conversations between stakeholders. In the context of clinical ethics disputes or other bedside conflicts, good mediation skills can reverse the negative interactions that have prevented the creation of workable treatment plans or ethical consensus. This essay lays out the central framework mediators use in distinguishing positions (...) from interests and describes a set of strategies for managing contentious ethics consultations or working with “difficult” patients, families, or patient-careprovider interactions. (shrink)

This book offers a unique synthesis of past and current work on the structure, meaning, and use of negation and negative expressions, a topic that has engaged thinkers from Aristotle and the Buddha to Freud and Chomsky. Horn's masterful study melds a review of scholarship in philosophy, psychology, and linguistics with original research, providing a full picture of negation in natural language and thought; this new edition adds a comprehensive preface and bibliography, surveying research since the book's original publication.

Articulating the public's widespread unease about animal biotechnology has not been easy, and the first attempts have not been able to provide an effective tool for navigating the moral permissibility of this research. Because these moral intuitions have been difficult to cash out, they have been belittled as representing nothing more than fear or confusion. But there are sound philosophical reasons supporting the public's opposition to animal biotechnology and these arguments justify a default position of resistance I call the Presumption (...) of Restraint . The Presumption of Restraint constitutes a justificatory process that sets out the criteria for permitting or rejecting individual biotechnology projects. This Presumption of Restraint can be overridden by compelling arguments that speak to a project's moral and scientific merit. This strategy creates a middle-of-the-road stance that can embrace particular projects, while rejecting others. The Presumption of Restraint can also serve as a model for assessing moral permissibility in other areas of technological innovation. (shrink)

Much evidence suggests that semantic characteristics of a message (e.g., the extent to which the message evokes thoughts of spatial or motor properties) and social characteristics of a speaking situation (e.g., whether there is a listener who can see the speaker) both influence how much speakers gesture. However, the Gesture as Simulated Action (GSA) framework (Hostetter & Alibali, ) predicts that these effects should not be independent but should interact such that the effect of visibility is lessened when a message (...) evokes strong thoughts of action. This study tested this claim by comparing the gesture rates produced by speakers as they described 24 nouns that vary in how strongly they evoke thoughts of action. Further, half of the words were described with visibility between speaker and listener blocked. The results demonstrated a significant interaction as predicted by the GSA framework. (shrink)

Since the late nineteenth century, studies of mysticism have presented us with two contrasting conclusions. The first is that mystics all over the world report basically the same experience, and the second is that there are great differences among the reports, and possibly among the experiences. On the positive side there are such works as Huxley's The Perennial Philosophy , with its claim that all mystics say that all beings are manifestations of a Divine Ground, that men learn of this (...) by direct intuition, that men have two natures, one phenomenal and one eternal, and that identification with his eternal nature is the purpose of man. Walter Stace supports this view, in a modified way, with his observation that, while each mystic seems to advance a peculiar explanation of his experience, their statements collectively exhibit strong similarities. Mystics commonly report a consciousness of unity, carrying with it feelings of objectivity, blessedness, and holiness. They describe their experience in paradoxical language, and say that ultimately it is ineffable. These twentieth-century observations are repetitions of those of William James, so that this basic point has become a cliché, and, as R. C. Zaehner says, ‘We have been told ad nauseum that mysticism is the highest expression of religion and that it appears in all ages and in all places in a more or less identical form, often in a religious milieu that would seem to be the reverse of propitious.’. (shrink)

There were several worrisome results in the long-awaited studies on clinical ethics consultation by Fox et al, but one of the most sobering was the self-assessments made by ECSs (Ethics Consult Ser...

The Quality Attestation Presidential Task Force's recent proposal for “quality attestation” (QA) of clinical ethics consultants was advanced on the premise that, “[g]iven the importance of clinical ethics consultation, the people doing it should be asked to show that they do it well.” To this end, the task force attempted to develop “a standardized system for proactively assessing the knowledge, skills, and practice of clinical ethicists.” But can this proposed method deliver? If the proposed QA process is flawed, it will (...) label clinical ethicists as qualified to do clinical ethics consultations (CECs) when they are not. The result will be the creation of a new, likely intractable, problem of CEC “false positives:” consultants who have passed QA without actually possessing the requisite knowledge and skills to perform CECs.To avoid the risk of false positives, the QAPTF needs to conduct a rigorous analysis of the skills that the QA process will be positioned to judge and those that are simply beyond the scope of its current metrics. Rather than “attesting” to overall CEC “quality,” QA needs to be precise about the skill inventory it can confirm yet honest about the skills it has no basis to assess. I will argue here that QA has strong prospects for accurately assessing consultants’ competence in ethical analysis but very weak prospects for determining competence in two other skills listed as essential by the QAPTF: value‐neutrality and conflict resolution. (shrink)

Speakers often use gesture to demonstrate how to perform actions—for example, they might show how to open the top of a jar by making a twisting motion above the jar. Yet it is unclear whether listeners learn as much from seeing such gestures as they learn from seeing actions that physically change the position of objects (i.e., actually opening the jar). Here, we examined participants' implicit and explicit understanding about a series of movements that demonstrated how to move a set (...) of objects. The movements were either shown with actions that physically relocated each object or with gestures that represented the relocation without touching the objects. Further, the end location that was indicated for each object covaried with whether the object was grasped with one or two hands. We found that memory for the end location of each object was better after seeing the physical relocation of the objects, that is, after seeing action, than after seeing gesture, regardless of whether speech was absent (Experiment 1) or present (Experiment 2). However, gesture and action built similar implicit understanding of how a particular handgrasp corresponded with a particular end location. Although gestures miss the benefit of showing the end state of objects that have been acted upon, the data show that gestures are as good as action in building knowledge of how to perform an action. (shrink)

ABSTRACTThe concept of ‘vulnerability’ is well established within the realm of research ethics and most ethical guidelines include a section on ‘vulnerable populations’. However, the term ‘vulnerability’, used within a human research context, has received a lot of negative publicity recently and has been described as being simultaneously ‘too broad’ and ‘too narrow’.1 The aim of the paper is to explore the concept of research vulnerability by using a detailed case study – that of mineworkers in post‐apartheid South Africa. In (...) particular, the usefulness of Kipnis’s taxonomy of research vulnerability will be examined.2In recent years the volume of clinical research on human subjects in South Africa has increased significantly. The HIV and TB pandemics have contributed to this increase. These epidemics have impacted negatively on the mining industry; and mining companies have become increasingly interested in research initiatives that address these problems. This case study explores the potential research vulnerability of mineworkers in the context of the South African mining industry and examines measures that can reduce this vulnerability. (shrink)

The concept of ‘vulnerability’ is well established within the realm of research ethics and most ethical guidelines include a section on ‘vulnerable populations’. However, the term ‘vulnerability’, used within a human research context, has received a lot of negative publicity recently and has been described as being simultaneously ‘too broad’ and ‘too narrow’.1 The aim of the paper is to explore the concept of research vulnerability by using a detailed case study – that of mineworkers in post‐apartheid South Africa. In (...) particular, the usefulness of Kipnis’s taxonomy of research vulnerability will be examined.2In recent years the volume of clinical research on human subjects in South Africa has increased significantly. The HIV and TB pandemics have contributed to this increase. These epidemics have impacted negatively on the mining industry; and mining companies have become increasingly interested in research initiatives that address these problems. This case study explores the potential research vulnerability of mineworkers in the context of the South African mining industry and examines measures that can reduce this vulnerability. (shrink)

Trenton Merricks has recently argued that substance dualist accounts of embodiment and humanness do not cohere well with the Incarnation. He has also claimed that physicalism about human persons avoids this problem, which should lead Christians to be physicalists. In this paper, I argue that there are plausible dualist accounts of embodiment and humanness that avoid his objections. Furthermore, I argue that physicalism is inconsistent with the Incarnation.

Over the past forty years, economists associated with the University of Chicago have won more than one-third of the Nobel prizes awarded in their discipline and have been major influences on American public policy. Building Chicago Economics presents the first collective attempt by social science historians to chart the rise and development of the Chicago School during the decades that followed the Second World War. Drawing on new research in published and archival sources, contributors examine the people, institutions and ideas (...) that established the foundations for the success of Chicago economics and thereby positioned it as a powerful and controversial force in American political and intellectual life. (shrink)