The debate about medical futility is no longer in its infancy. Scholarly literature on this seemingly intractable problem is voluminous. The list of widely publicized cases in which physicians have wanted to discontinue life-sustaining medical treatment that families demand has grown to include not just Helga Wanglie, but also Baby Rena, Baby L, Jane Doe, Joseph Finelli, Baby K, and Teresa Hamilton. A futility case has now been decided at the appellate court level.Commentators have generated three kinds of proposals (...) for resolving these conflicts. One group contends that the problem can be solved within the physician-patient-family relationship. While some in this group view professional authority broadly enough to warrant unilateral judgments by physicians that interventions desired by the patient or family should not be provided, others contend that physician authority does not extend that far, and that any resolution must be constrained by informed consent requirements. (shrink)

The debate about medical futility is no longer in its infancy. Scholarly literature on this seemingly intractable problem is voluminous. The list of widely publicized cases in which physicians have wanted to discontinue life-sustaining medical treatment that families demand has grown to include not just Helga Wanglie, but also Baby Rena, Baby L, Jane Doe, Joseph Finelli, Baby K, and Teresa Hamilton. A futility case has now been decided at the appellate court level.Commentators have generated three kinds of proposals (...) for resolving these conflicts. One group contends that the problem can be solved within the physician-patient-family relationship. While some in this group view professional authority broadly enough to warrant unilateral judgments by physicians that interventions desired by the patient or family should not be provided, others contend that physician authority does not extend that far, and that any resolution must be constrained by informed consent requirements. (shrink)

Affective variables have been shown to impact working memory and cognitive control. Theoretical arguments suggest that the functional impact of emotion on cognition might be mediated through shifting action dispositions related to changes in motivational orientation. The current study examined the effects of positive and negative affect on performance via direct manipulation of motivational state in tasks with high demands on cognitive control. Experiment 1 examined the effects of monetary reward on task-switching performance, while Experiment 2 examined the effects of (...) both rewards and punishments on working memory, using primary (liquid) reinforcers. In both experiments, dissociable trial-by-trial and contextual (block-related) enhancements of cognitive control during task performance were observed in relationship to motivational incentive value. Performance enhancements were equivalent in the reward and punishment conditions, but were differentially impacted by individual difference measures of trait reward and punishment sensitivity. Together, the results suggest both common and specific mechanisms by which approach and avoidance motivational states influence cognitive control, via activation of reward and punishment processing systems. (shrink)

23 pages, no figure. Proceedings of "Philosophical Aspects of Modern Cosmology" held in Granada, Spain, 22-23 Sept. 2011. Studies in History and Philosophy of Modern Physics ; doi:10.1016/j.shpsb.2013.02.002.

Abstract:This article posits Feminist Science and Technology Studies (FSTS) as a vital tool for bridging postcolonial and decolonial thought. First, FSTS forms a bridge by providing tools for reading epistemic imperialism and scientific racism as shared conditions of possibility for disparate colonizations. Second, by foregrounding the necessary links between epistemic and material violence, FSTS helps undo the theory/praxis binary that sometimes undergirds their analytic opposition. The authors argue that the careful study of science as a set of ideas, practices, and (...) attendant institutions is vital in order to better recognize and intervene in shifting modes of colonial conquest and governance. (shrink)

Does history really matter? As a historian, and more importantly as a teacher of history, I have become convinced of the need to raise this question in my introductory classes. Too often this fundamental query is left for upper-division “theory” courses, or never broached at all. At a certain point historians, like most of us I imagine, stop asking why we do what we do and just get on with doing it. But with history, the question of why we engage (...) in it or whether it is worthwhile at all is absolutely vital. (shrink)

Name der Zeitschrift: Neue Zeitschrift für Systematische Theologie und Religionsphilosophie Jahrgang: 58 Heft: 3 Seiten: 285-308.

Research teams have made considerable progress in treating absolute uterine factor infertility through uterus transplantation, though studies have differed on the choice of either deceased or living donors. While researchers continue to analyze the medical feasibility of both approaches, little attention has been paid to the ethics of using deceased versus living donors as well as the protections that must be in place for each. Both types of uterus donation also pose unique regulatory challenges, including how to allocate donated organs; (...) whether the donor / donor's family has any rights to the uterus and resulting child; how to manage contact between the donor / donor's family, recipient, and resulting child; and how to track outcomes moving forward. (shrink)

Environmental problems often outstrip the abilities of any single scientist to understand, much less address them. As a result, collaborations within, across, and beyond the environmental sciences are an increasingly important part of the environmental science landscape. Here, we explore an insufficiently recognized and particularly challenging barrier to collaborative environmental science: value pluralism, the presence of non-trivial differences in the values that collaborators bring to bear on project decisions. We argue that resolving the obstacles posed by value pluralism to collaborative (...) environmental science requires detecting and coordinating the underlying problematic value differences. We identify five ways that a team might coordinate their problematic value differences and argue that, whichever mode is adopted, it ought to be governed by participatory virtues, pragmatic resolve, and moral concern. Relying on our experiences with the Toolbox Dialogue Initiative, as well as with other dialogical approaches that support team inquiry, we defend the claim that philosophical dialogue among collaborators can go a long way towards helping teams of environmental scientists and fellow travelers detect their problematic value differences. Where dialogical approaches fare less well is in helping teams coordinate these differences. We close by describing several principles for augmenting philosophical dialogue with other methods, and we list several of these methods in an appendix with brief descriptions and links for further learning. Overall, the article makes three main contributions to the research collaboration and values in science literatures: It deepens our understanding of problematic value pluralism in team science; It provides actionable guidance and methods for improving values-oriented philosophical dialogue interventions; and It demonstrates one way of doing engaged philosophy. (shrink)

Volume 19, Issue 11, November 2019, Page 37-39.

Extending literature on health information to entertainment television, we analyze the prostate cancer narrative presented in the police drama, NYPD Blue. We explain how the physician-patient interaction depicted on the show followed (and sometimes did not follow) the medical dialogue model. Findings reveal that the producers of this show advocate a more dialogic model of medical interaction. Portrayals of incompetent, ineffective physicians are contrasted with the superior, effective efforts of other physicians. The audience learns that a non-dialogic approach characterizes “bad (...) doctors,” while the dialogic method typifies “good doctors.” Likewise, medical professionals can use such texts to enhance physician-patient interaction. (shrink)

ABSTRACTThis study aimed to investigate the emotional impact of sarcasm. Previous research in this area has mainly required participants to answer questions based on written materials, and results have been mixed. With the aim of instead examining the emotional impact of sarcasm when used in a more conversational setting, the current study utilized animated video clips as stimuli. In each clip, one individual answered general knowledge questions while the other provided feedback that could be delivered either literally or sarcastically, and (...) either complimented or criticized the question answerer’s performance. Participants rated the feedback based on the anticipated emotional impact on the recipient, how the speaker intended the recipient to feel, and whether the speaker intended to be humorous. Results overall supported the Tinge Hypothesis, showing that sarcastic criticism was rated as less negative than literal criticism, and sarcastic compliments were rated as... (shrink)

Christopher Southgate's work raises questions about God, evolution, and suffering. In this article, I begin by contributing an alternative to Southgate's “only way” argument and by offering a third option in speculations about the nature of nonhuman animals in heaven. The second half of the article starts with Southgate's approach of evolutionary theodicy as “an adventure in theology” and proposes a new path branching off his work. “Compassionate theodicy” is a reworking of the method and audience of traditional theodicy in (...) the hope that it might become something that could offer theological resources to those who suffer. (shrink)

Max Weber, the grandfather of organizational theory, recognized the close association between health care organizations and law. When he introduced the concept of a legallaw-saturated,rational bureaucracies, healthcare organizations have highly formalized rules and procedures. They pay a great deal of attention to legal criteria in decisionmaking, and some have entire departments devoted to legal risk management.

This essay review of Margaret Atwood's Payback centers on the observation that the book does not dwell on the unnatural face of interest and finance. In this era of financialization, debt has been thoroughly uncoupled from the concept of payback. The least valuable debt is the one that is promptly repaid. It is this aspect of debt—the interest, not the principal—that has attracted the richest tradition of social condemnation. As stable forms of production and exchange were replaced by international arbitrage, (...) the link between debt and sorcery became evident to observers around the world. More profoundly, Atwood's widely shared commonsense impression that consumer debt is a measure of self-indulgence does not hold up empirically. It turns out that our unprecedented levels of household indebtedness were overwhelmingly a function of nondiscretionary spending. Even as Americans owed one hundred percent of GDP in individual debt in 2008, the real Faustian bargain was not a “enjoy now, pay later” scheme for “glitzy, short-term junk.” The truth is much scarier, and points toward a different set of cultural and theological references than the ones Atwood investigates. The dividing line between solvency and insolvency, it turns out, is not consumption but reproduction: the most certain route to financial disaster is having a child. (shrink)

In this paper, we consider ethical issues related to the treatment of posttraumatic stress disorder (PTSD) in combat zones, via exposure therapy. Exposure-oriented interventions are the most well-researched behavioral treatments for PTSD, and rigorous studies across contexts, populations, and research groups provide robust evidence that exposure therapy for PTSD is effective and can be widely disseminated. Clinical procedures for Prolonged Exposure therapy, a manualized exposure-oriented protocol for PTSD, are reviewed, and we illustrate the potential benefits, as well as the potential (...) difficulties, associated with providing this treatment in combat zones. Several ethical considerations are identified: (1) Assuming successful treatment, is it ethical to send individuals with a known risk of developing PTSD back into combat? (2) If treatment is unsuccessful in theater (perhaps due to the confounding factor of ongoing danger), could that impact treatment effectiveness for soldiers who attempt therapy again post-deployment? (3) If the military finds combat-zone treatment effective and useful in maintaining an efficient work force, will treatment become mandatory for those diagnosed with PTSD? (4) What unintended consequences might be associated with large-scale dissemination of exposure therapy in or near combat, outside of mental health care infrastructures? (5) How would genetic variations known to be associated with PTSD risk influence decisions regarding who receives treatment or returns to combat? We conclude with a review of the personal and societal costs associated with not providing evidence-based PTSD treatments wherever possible. (shrink)

Treatment of military-related posttraumatic stress disorder is a major public health care concern. Since 2001 over 2.5 million troops have been deployed to Iraq or Afghanistan, many of whom have experienced direct combat and sustained threat. Estimates of PTSD rates related to these wars range from 8% to over 20%, or 192,000 to 480,000 individuals. Already, nearly 250,000 service members of Operations Enduring Freedom, Iraqi Freedom, and New Dawn have sought VA health care services for PTSD. This recent increased need (...) for mental health services comes in addition to the ongoing needs of Vietnam-era and other veterans who continue to suffer from PTSD. PTSD is related to high co-morbidities of other mental health difficulties, poorer physical health status, and increased medical care utilization. Such high demand for services is an important contributor to the large cost associated with combat-related PTSD. Accordingly, promoting successful, cost-effective treatment strategies for PTSD is a chief public health care priority. (shrink)

In this study, Bethany Somma argues for a dichotomous interpretation of human desire developed by late ancient Greek and medieval Islamic philosophers in response to an ambiguity in Aristotle’s account of desire.

Do cultural models facilitate particular ways of perceiving interactions in nature? We explore variability in folkecological principles of reasoning about interspecies interactions. In two studies, Indigenous Panamanian Ngöbe and U.S. participants interpreted an illustrated, wordless nonfiction book about the hunting relationship between a coyote and badger. Across both studies, the majority of Ngöbe interpreted the hunting relationship as cooperative and the majority of U.S. participants as competitive. Study 2 showed that this pattern may reflect different beliefs about, and perhaps different (...) awareness of, plausible interspecies interactions. Further probes suggest that these models of ecological interaction correlate with recognition of social agency in nonhuman animals. We interpret our results in terms of cultural models of nature and nonhuman agency. (shrink)

Human connection is universally important, particularly in the context of serious illness and at the end of life. The presence of close family and friends has many benefits when death is close. Hospital visitation restrictions during the Coronavirus pandemic therefore warrant careful consideration to ensure equity, proportionality, and the minimization of harm. The Australian and New Zealand Society for Palliative Medicine COVID-19 Special Interest Group utilized the relevant ethical and public health principles, together with the existing disease outbreak literature and (...) evolving COVID-19 knowledge, to generate a practical framework of visiting restrictions for inpatients receiving palliative and end-of-life care. Expert advice from an Infectious Diseases physician ensured relevance to community transmission dynamics. Three graded levels of visitor restrictions for inpatient settings are proposed, defining an appropriate level of minimum access. These depend upon the level of community transmission of COVID-19, the demand on health services, the potential COVID-19 status of the patient and visitors, and the imminence of the patient’s death. This framework represents a cohesive, considered, proportionate, and ethically robust approach to improve equity and consistency for inpatients receiving palliative care during the COVID-19 pandemic and may serve as a template for future disease outbreaks. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hyper-Abjects:Finitude, “Sustainability,” and the Maternal Body in the AnthropoceneBethany DoaneThe concept of the Anthropocene prioritizes a new paradigmatic scale that seems to outweigh that of “the political”: imagining deep time or the death of the human species as a result of climate change tends to negate the (relatively speaking) smaller-scale concerns of race, class, gender, or capitalism. While feminist critique is often circumscribed by this political scale, and thus (...) may seem to be dwarfed or rendered obsolete by the geological, deep-time scale of the Anthropocene, examining issues of feminist concern from this geological perspective has profound implications for thinking not only of gender politics but also of how to construct something like the political at all in this new era. Suggesting a new and normative global politics is, of course, beyond the scope of this article, but perhaps we might begin to conceive of a political schema that would function more appropriately in light of this grander scale. At the very least we may begin to think the borders or limits of the species as it has existed in the modern era in a way that neither environmentalism nor posthumanism has yet been able to sufficiently tackle.The Anthropocene marks the epoch in which human activities have caused global environmental changes that will leave their mark in the geological strata of the earth itself.1 While the specific moments of its onset are contested, its beginnings are generally associated with the industrial age; Crutzen and Stoermer mark its onset at roughly 1800 with the beginnings [End Page 251] of the industrial revolution. (Timothy Morton pinpoints it more specifically with the invention of the steam engine in 1794.) The changes made in this era of geological, technological, and climate convergence have accelerated in the last seventy years or so in what scientists call the Great Acceleration, which began around 1940 and quickened anthropogenic impact with events like the testing/dropping of atomic bombs, the homogenization of biodiversity, mass extinctions as a result of human activity, and various types of drilling and mining.2 In the era broadly conceived as modernity, the steady march of “progress” that has so shaped the paradigm of the period has been made possible only through its own abjections: those phenomena that mark the era as limited, limiting, and unsustainable. In other words, the “birth of the modern world” was made possible only through devastating acts of violence: institutionalized inequalities like slavery, oppression, colonization, and war. These acts of violence translate as cannibalization at the global scale: the exploitation of most members of the species and the consumption of their resources for the benefit and luxury of the few. While these forms of violence have been criticized and confronted by political and theoretical movements since at least the middle of the twentieth century, thinking of them in terms of the Anthropocene and deep time allows us to consider their consequences in a new light. Our present awareness of the Anthropocene makes visible phenomena like climate, global warming, earth, and the “anthropos” that present us with the very real eventuality of species finitude. Species finitude calls into question not just the practices of modernity that have brought about the Anthropocene (the exploitation of the many for the benefit of the few), but the entire paradigm of global thinking that is invested in progress, growth, and even in any environmentalism that calls for stewardship of the earth. The notion of care for an entity like “nature” or “the environment” only reinforces the separation between the human and its milieu, a separation that is impossible to maintain in light of the absolute inextricability that the Anthropocene brings to light.At the heart of this essay are two theoretical concepts: Julia Kristeva’s abjection, and Timothy Morton’s hyperobjects, both of which stand for a sort of insufficiency or impossibility of discourse (politics, the Symbolic, etc.) in managing some Real object or phenomenon. Kristeva’s abject is generally thought of as functioning at two levels or scales: the personal, in which an individual must cast off the abject of the maternal body in order to become a proper subject; and the social or... (shrink)

Anthropology of Consciousness, EarlyView.

A request that an ethics committee or consultant analyze the ethical issues in a case, delineate ethical options, or make a recommendation need not automatically but often does elicit legal information. In a recent book in which ethics consultants described cases on which they had worked, almost all cited a legal case or statute that had shaped the consultation process. During a period of just a few months, case consultation done under the auspices of one university hospital ethics committee involved (...) interpretation of statutes on living wills, durable powers of attorney, competency, confidentiality, guardianship, AIDS testing, and disability. At another hospital, 30% of ethics consultations were thought to involve legal issues. Attorneys at a third hospital estimated that virtually every case involves legal issues. The notion that ethics consultation is an “amalgam” of medicine, ethics, interpersonal skills, and law is gaining currency. Ethics consultation has become a channel through which law enters the clinical setting. (shrink)