BackgroundPatient skepticism concerning medical innovations can have major consequences for current public health and may threaten future progress, which greatly relies on clinical research.The primary objective of this study is to determine the variables associated with patient acceptation or refusal to participate in clinical research. Specifically, we sought to evaluate if distrust in pharmaceutical companies and associated psychosocial factors could represent a recruitment bias in clinical trials and thus threaten the applicability of their results.MethodsThis prospective, multicenter survey consisted in the (...) administration of a self-questionnaire to patients during a pulmonology consultation. The 1025 questionnaires distributed collected demographics, socio-professional and basic health literacy characteristics. Patients were asked to rank their level of trust for pharmaceutical companies and indicate their willingness to participate in different categories of research.Logistic regression was used to determine factors contributing to “trust” versus “distrust” group membership and willingness to participate in each category of research.ResultsOne thousand patients completed the survey, corresponding to a response rate of 97.5%. Data from 838 patients were analyzed in this study.48.3% of respondents declared that they trusted pharmaceutical companies, while 35.5% declared distrust. Being female, inactive in the employment market, and not-knowing the name of one’s disease are factors related to declared distrust. Distrust-group membership is associated with unwillingness to participate in certain categories of trials such as pre-marketing and industry-sponsored trials.ConclusionDistrust in pharmaceutical companies is associated with a specific patient profile and with refusal to participate in certain subcategories of trials. This potential recruitment bias may explain the under-representation of certain categories of patients such as women in pre-marketing drug trials. (shrink)

Does strolling through an art museum, admiring the old masters, improve us morally and spiritually? Would government subsidies of "high art" (such as big-city opera houses) be better spent on local community art projects? In What Good are the Arts? John Carey--one of Britain's most respected literary critics--offers a delightfully skeptical look at the nature of art. In particular, he cuts through the cant surrounding the fine arts, debunking claims that the arts make us better people or that judgements (...) about art are anything more than personal opinion. Indeed, Carey argues that there are no absolute values in the arts and that we cannot call other people's aesthetic choices "mistaken" or "incorrect," however much we dislike them. Along the way, Carey reveals the flaws in the aesthetic theories of everyone from Emanuel Kant to Arthur C. Danto, and he skewers the claims of "high-art advocates" such as Jeannette Winterson. But Carey does argue strongly for the value of art as an activity and for the superiority of one art in particular: literature. Literature, he contends, is the only art capable of reasoning, and the only art that can criticize. Language is the medium that we use to convey ideas, and the usual ingredients of other arts--objects, noises, light effects--cannot replicate this function. Literature has the ability to inspire the mind and the heart towards practical ends far better than any work of conceptual art. Here then is a lively and stimulating invitation to debate the value of art, a provocative book that will pique the interest of anyone who loves painting, music, or literature. (shrink)

This article explores the ethical challenges of providing Medical Assistance in Dying (MAID) in a paediatric setting. More specifically, we focus on the theoretical questions that came to light when we were asked to develop a policy for responding to MAID requests at our tertiary paediatric institution. We illuminate a central point of conceptual confusion about the nature of MAID that emerges at the level of practice, and explore the various entailments for clinicians and patients that would flow from different (...) understandings. Finally, we consider the ethical challenges of building policy on what is still an extremely controversial social practice. While MAID is currently available to capable patients in Canada who are 18 years or older—a small but important subsection of the population our hospital serves—we write our policy with an eye to the near future when capable young people may gain access to MAID. We propose that an opportunity exists for MAID-providing institutions to reduce social stigma surrounding this practice, but not without potentially serious consequences for practitioners and institutions themselves. Thus, this paper is intended as a road map through the still-emerging legal and ethical landscape of paediatric MAID. We offer a view of the roads taken and considered along the way, and our justifications for travelling the paths we chose. By providing a record of our in-progress thinking, we hope to stimulate wider discussion about the issues and questions encountered in this work. (shrink)

Non-Invasive Prenatal Testing is a technology which provides information about fetal genetic characteristics very early in pregnancy by examining fetal DNA obtained from a sample of maternal blood. NIPT is a morally complex technology that has advanced quickly to market with a strong push from industry developers, leaving many areas of uncertainty still to be resolved, and creating a strong need for health policy that reflects women’s social and ethical values. We approach the need for ethical policy-making by studying the (...) use of NIPT and emerging policy in the province of Ontario, Canada. Using an adapted version of constructivist grounded theory, we conducted interviews with 38 women who have had personal experiences with NIPT. We used an iterative process of data collection and analysis and a staged coding strategy to conduct a descriptive analysis of ethics issues identified implicitly and explicitly by women who have been affected by this technology. The findings of this paper focus on current ethical issues for women seeking NIPT, including place in the prenatal pathway, health care provider counselling about the test, industry influence on the diffusion of NIPT, consequences of availability of test results. Other issues gain relevance in the context of future policy decisions regarding NIPT, including funding of NIPT and principles that may govern the expansion of the scope of NIPT. These findings are not an exhaustive list of all the potential ethical issues related to NIPT, but rather a representation of the issues which concern women who have personal experience with this test. Women who have had personal experience with NIPT have concerns and priorities which sometimes contrast dramatically with the theoretical ethics literature. These findings suggest the importance of engaging patients in ethical deliberation about morally complex technologies, and point to the need for more deliberative patient engagement work in this area. (shrink)

Nineteenth-century optical toys that showcase illusions of motion such as the phenakistoscope, zoetrope, and praxinoscope, have enjoyed active “afterlives” in the twentieth and twenty-first centuries. Contemporary incarnations of the zoetrope are frequently found in the realms of fine art and advertising, and they are often much larger than their nineteenth-century counterparts. This article argues that modern-day optical toys are able to conjure feelings of wonder and spectacle equivalent to their nineteenth-century antecedents because of their adjustment in scale. Exploring a range (...) of contemporary philosophical toys found in arts, entertainment, and advertising contexts, the article discusses various technical adjustments made to successfully “scale up” optical toys, including the replacement of hand-spun mechanisms with larger sources of motion and the use of various means such as architectural features and stroboscopic lights to replace traditional shutter mechanisms such as the zoetrope’s dark slots. Critical consideration of scale as a central feature of these installations reconfigures the relationship between audience and device. Large-scale adaptations of optical toys revise the traditional conception of the user, who is able to tactilely manipulate and interact with the apparatus, instead positing a viewer who has less control over the illusion’s operation and is instead a captive audience surrounded by the animation. It is primarily through their adaptation of scale that contemporary zoetropes successfully elicit wonder as scientific spectacles from their audiences today. (shrink)

In their summary and critique, Gamble, Gamble, and Pruski mischaracterise both the central arguments and the primary objectives of our original paper. Our paper does not provide an ethical justification for paediatric Medical Assistance in Dying by comparing it with other end of life care options. In fact, it does not offer arguments about the permissibility of MAID for capable young people at all. Instead, our paper focuses on the ethical questions that emerged as we worked to develop a policy (...) for responding to MAID requests at our tertiary paediatric institution. Following the Supreme Court of Canada’s recent decriminalisation of MAID, our hospital needed to answer immediate on-the-ground questions such as: ‘What are we going to do if an 18-year-old patient in our care requested MAID today, as is now their legal right? How should we protect their privacy? What is the best way to ensure patients are informed when making these decisions?’ On these important questions, Gamble, Gamble, and Pruskiare silent. (shrink)

Epistemic Modality Epistemic modality is the kind of necessity and possibility that is determined by epistemic constraints. A modal claim is a claim about how things could be or must be given some constraints, such as the rules of logic, moral obligations, or the laws of nature. A modal … Continue reading Epistemic Modality →.

Communication is an important component in the construction of workplace identities, including leader and group identities. Micro-level analysis of everyday workplace discourse provides valuable insights into the way leadership is constructed and how workplace culture is created, maintained, and changed. In this context, leaders and managers are inevitably significant and influential participants, with a crucial impact on workplace culture. Drawing on audio and video data collected in 12 meetings of an IT department, the analysis demonstrates ways in which two leaders, (...) who succeed each other in the role of Director, reinforce and shape the culture of the workplace in which they operate. While both leaders claim teamwork as an important cultural value for their teams, their respective instantiations of teamwork are rather different. To explore the leaders' effect on the culture of their department, this investigation of leadership change examines ways in which the leaders manage regular workplace meetings and how they contribute to workplace humour. The analysis provides detailed evidence of the ways in which a change in leadership style can create the conditions for a change in the culture of a community of practice. (shrink)

There are clear associations between the overall quantity of input children are exposed to and their vocabulary acquisition. However, by uncovering specific features of the input that matter, we can better understand the mechanisms involved in vocabulary learning. We examine whether exposure to wh-questions, a challenging quality of the communicative input, is associated with toddlers' vocabulary and later verbal reasoning skills in a sample of low-income, African-American fathers and their 24-month-old children. Dyads were videotaped in free play sessions at home. (...) Videotapes were transcribed and reliably coded for sheer quantity of fathers' input as well as the number of wh-questions fathers produce. Children's productive vocabulary was measured at 24 months using the McArthur Bates Communicative Development Inventory MCDI, and children's verbal reasoning skills were measured 1 year later using the Bayley Scales of Infant Development. Results indicate that the overall quantity of father talk did not relate to children's vocabulary or reasoning skills. However, fathers' use of wh-questions related to both vocabulary and reasoning outcomes. Children's responses to wh-questions were more frequent and more syntactically complex, measured using the mean length of utterance, than their responses to other questions. Thus, posing wh-questions to 2-year-olds is a challenging type of input, which elicits a verbal response from the child that likely helps build vocabulary and foster verbal reasoning abilities. (shrink)

Only human beings have a rich conceptual repertoire with concepts like tort, entropy, Abelian group, mannerism, icon and deconstruction. How have humans constructed these concepts? And once they have been constructed by adults, how do children acquire them? While primarily focusing on the second question, in The Origin of Concepts , Susan Carey shows that the answers to both overlap substantially. Carey begins by characterizing the innate starting point for conceptual development, namely systems of core cognition. Representations of (...) core cognition are the output of dedicated input analyzers, as with perceptual representations, but these core representations differ from perceptual representations in having more abstract contents and richer functional roles. Carey argues that the key to understanding cognitive development lies in recognizing conceptual discontinuities in which new representational systems emerge that have more expressive power than core cognition and are also incommensurate with core cognition and other earlier representational systems. Finally, Carey fleshes out Quinian bootstrapping, a learning mechanism that has been repeatedly sketched in the literature on the history and philosophy of science. She demonstrates that Quinian bootstrapping is a major mechanism in the construction of new representational resources over the course of childrens cognitive development. Carey shows how developmental cognitive science resolves aspects of long-standing philosophical debates about the existence, nature, content, and format of innate knowledge. She also shows that understanding the processes of conceptual development in children illuminates the historical process by which concepts are constructed, and transforms the way we think about philosophical problems about the nature of concepts and the relations between language and thought. (shrink)

A review of the literature on corporate governance serves to demonstrate the applicability of many governance solutions to the university setting. Based on a review of university scandals, most of which are recent but some of which took place decades ago, it is possible to categorize them as follows: sex scandals, drugs, cheating, hazing, admissions and diplomas, on-the-job consumption, athletics, and murder. Several examples are provided in the paper, along with their impact on various stakeholders. The paper then discusses a (...) variety of solutions designed to either preempt the activities potentially leading to scandal, to deter them or to punish perpetrators. Some of these involve structural changes, institutional policies and procedures, fines, terminations, and sanctions. The paper emphasizes the proactive safeguards which govern and monitor to make sure that universities do not suffer on the back end and that their reputations do not suffer into the future. (shrink)

Understanding female sexuality and mate choice is central to evolutionary scenarios of human social systems. Studies of female sexuality conducted by sex researchers in the United States since 1938 indicate that human females in general are concerned with their sexual well-being and are capable of sexual response parallel to that of males. Across cultures in general and in western societies in particular, females engage in extramarital affairs regularly, regardless of punishment by males or social disapproval. Families are usually concerned with (...) marriage arrangements only insofar as those arrangements are economically or politically advantageous, but females most often have a voice in arranged marriages. Extended families also concentrate on a couple’s future reproduction rather than on sexual exclusivity. Although marriage for females is often compromised by male or family reproductive interests (which may not in fact differ from female interests), females appear to exercise their sexuality with more freedom than has previously been suggested. Notions of human females as pawns in the male reproductive game, or as traders of sex for male services, should be dispelled. (shrink)

Intellectual interest in epistemic bubbles and echo chambers has grown exponentially over the past two decades. This is largely because many assume, in light of recent events, that these phenomena are morally, socially, politically, and epistemically problematic. But are we justified in simply assuming that epistemic bubbles and echo chambers are inherently epistemically problematic? Perhaps surprisingly, numerous philosophers have recently argued that epistemic bubbles and echo chambers are not intrinsically epistemically problematic. Nevertheless, I argue, this trend is mistaken. Epistemic bubbles (...) and echo chambers are all intrinsically epistemically problematic, such that we should try to escape them, if we find ourselves in them. Crucially, there are two senses in which we might identify epistemic bubbles and echo chambers as being intrinsically epistemically problematic, as opposed to “good.” After distinguishing between these senses, I demonstrate that, even if there is a sense in which epistemic bubbles can in principle be “good,” all epistemic bubbles are epistemically problematic in the sense that is ultimately relevant to the question of whether we ought to stay in epistemic bubbles or to try to get out of them. (shrink)

Epistemic Modality Epistemic modality is the kind of necessity and possibility that is determined by epistemic constraints. A modal claim is a claim about how things could be or must be given some constraints, such as the rules of logic, moral obligations, or the laws of nature. A modal … Continue reading Epistemic Modality →.

Kant's Critique of Judgement analyses our experience of the beautiful and the sublime in relation to nature, morality, and theology. Meredith's classic translation is here lightly revised and supplemented with a bilingual glossary. The edition also includes the important First Introduction.

Humour is a prevalent feature in any form of human interaction, regardless of language modality. This article explores in detail how humour is negotiated in conversations among deafblind Australians who are fluent users of tactile Australian Sign Language. Without access to the visual or auditory cues that are normally associated with humour, there is a risk that deafblind interactants will misconstrue humorous utterances as serious, or be unsure whether their conversation partner has got the joke. In this article, we explore (...) how humorous utterances unfold in tactile signed interactions. Drawing on Conversation Analytic principles, we outline the ad hoc and more conventionalised signals deafblind signers use to signal amusement. Looking at humour in these conversations contributes to a greater understanding of how humour is conveyed across language modalities and further support for humour’s centrality to interactional solidarity. (shrink)

Philosophical counseling can be understood as the facilitation of personal narratives in which an individual’s moral frameworks are clarified and re-prioritized. Drawing on Charles Taylor’s notion of narrative, hyper-goods and moral frameworks, and applying them to a case study, this article shows the different roles family can play in the formation of a personal narrative.

Edgar Morin proposed that knowledge construction is best enacted via a complex and circular approach between both the part and the whole, while never enacting a strictly reductionistic or strictly holistic approach. It is the ability to connect and unite the parts within the whole via a dynamic circular process between the parts and whole that frees us from fragmented knowledge and helps us to bridge the gap between our seemingly disparate-competing nursing paradigms. This article examines the benefits of utilizing (...) Morin's complexity theory, the dialogical, and circular processes in creating a liberating structural framework or paradigm for nursing education. (shrink)

For the past 5 years I have been photographing and interviewing men who play games based on contemporary conflicts. The games attempt to re-create scenarios that the US military is engaged in around the world like the "Hunt for Osama Bin Laden" that took place three years ago on a campground in Northern, Virginia. On a sociological level, the work speaks about the way that trauma and conflict penetrate a culture sheltered from the horrors of war. Many of the scenarios (...) are created and inspired from news reports and images and the stages where the games are played are often a poor imitation of the original scenes from photographs. The book will bring together the series of 24 photographs with essays discussing and analyzing the influence of the media, particularly photographs and video, on the culture at large and how conflict is "discussed" in the visual realm. (shrink)

This research examined how and why group membership diminishes the attribution of mind to individuals. We found that mind attribution was inversely related to the size of the group to which an individual belonged . Mind attribution was affected by group membership rather than the total number of entities perceived at once . Moreover, mind attribution to an individual varied with the perception that the individual was a group member. Participants attributed more mind to an individual that appeared distinct or (...) distant from other group members than to an individual that was perceived to be similar or proximal to a cohesive group . This effect occurred for both human and nonhuman targets, and was driven by the perception of the target as an entitative group member rather than by the knowledge that the target was an entitative group member. (shrink)

Fifteenth century Scotland relied upon matrimonial diplomacy to create ties with mainland Europe and further solidify their alliances with the French and Burgundian courts. Studies of matrimonial diplomacy often solely focus on the political lead-up to the marital alliances, rather on the fates of the individual women who were thrust into foreign courts to sink or swim. Focusing on six key examples of Scottish royal women of the fifteenth century in comparison with the feminine ideals of Christine de Pizan’s The (...) Treasure of the City of the Ladies and the popular memory of St. Margaret, this paper attempts to address how the Scottish royal women of the fifteenth century worked within societal expectations to solidify their powerbase and create a role for themselves at court. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 25.2 (2001) 350-353 [Access article in PDF] Book Review The Ways of Naysaying: No, Not, Nothing, and Nonbeing, The Ways of Naysaying: No, Not, Nothing, and Nonbeing, by Eva T. H. Brann; xviii & 249 pp. Lanham, Md.: Rowman & Littlefield Publishers, 2001, $35.00. This, the third of Eva Brann's trilogy on imagination, time, and naysaying respectively, is described by one of her colleagues as her (...) "cradle-to-grave book" (p. xvi). The word "naysaying" plays felicitously on the sound of the English word "nay" and the cognate Indo-European root "ne," which gives Brann a convenient starting-point for discerning what various forms of naysaying have in common. Note that this is saying rather than thinking, being, or doing, although the relations among these acts are a recurring concern in her discussion. Unlike some "postmoderns," Brann does not regard language as a self-contained arena with no reference outside of itself. Rather, for her, language is a convenient medium for thinking about what is extralinguistic, whether in the mind or elsewhere.Nor does she think that a word must necessarily have some underlying unity beneath its various meanings. In fact, heeding Wittgenstein's warning, she admits that "it is a pathologically bad craving to want a word to have one ultimate meaning, worse to look for one meaning over many words, and worst to assume that such a meaning may apply to a something beyond the realm of language." Nevertheless, she suggests, "this craving to look for one truth behind many appearances may be simply irradicable, being nothing less than the philosophical impulse" (p. xiv).Where does her "philosophical impulse" focus, on texts or on things? She explicitly tells us that texts are indispensable (at least for her) to get very far with the things themselves (p. 2). And so, in the course of her investigation, she attends to Parmenides, Plato, Aristotle, Anselm, Kant, Fichte, Hegel, Bergson, Frege, Meinong, Russell, Whitehead, Dewey, Heidegger, and Wittgenstein, among others. Nonetheless, she begins by noticing a sort of willful denial that is pre-linguistic and "speechless" (the contrariness of an infant), and she ends with the nothingness that is void of all language and everything else. These two topics, expressed by the words "No" (Chapter One) and "Nothing" (Chapter Six) respectively, "frame" her inquiry (p. 42). Along the way she always has an eye to what lies behind or beyond language, in the world or in the mind, with a chapter each for "Not," "Nonexistence," "Nonbeing," and "Negativity." She [End Page 350] says that Chapter Four, concerning "Nonbeing," is the center and philosophic focus of her study. Brann's chapters thus represent the six big divisions for organizing her observations. Indeed, for Brann, the plurality of naysayings "seems to fall naturally" into her sixfold division (p. xiv).Thoughtfully pondering this structure takes the reader a long way toward understanding the work (in both senses of "work": the thought itself and the text which records that thought). The chapter divisions progress from the willful, through the logical, the imaginative, the philosophic, and the dialectical, to end, as we noted, in the absolute Nothing, the "antagonist of Being." For instance, the distinction between the first two--the willful and the logical--is the distinction between the personal (denial) and the impersonal (negation). In considering willful denial, Brann understands the will to be a "willingness, inclination, readiness"--usually "determinate," "focused and active" (p. 7). Likewise, negation also has a personal origin: "Negation arises from the human desire and ability to make distinctions; it is (most likely) grounded in the opposition and polarities that belong to beings (of which the first... is surely that of thinking itself to its object, be it ideal or real)" (p. 29f.). Thus, although logical negation seems to originate in the personal subject there is something quite detachable and impersonal about logical formulations, so that Heraclitus "bids people hear his truth 'not listening to me but to the logos,' the cosmic collecting and distinguishing power" (p. 128). So the logos that begins for us as "reason manifested in... (shrink)

_Wittgenstein, Mind and Meaning_ offers a provocative re-reading of Wittgenstein's later writings on language and mind, and explores the tensions between Wittgenstein's ideas and contemporary cognitivist conceptions of the mental. This book addresses both Wittgenstein's later works as well as contemporary issues in philosophy of mind. It provides fresh insight into the later Wittgenstein and raises vital questions about the foundations of cognitivism and its wider implications for psychology and cognitive science.

Doig, Meredith The promise from new Victorian Premier, Daniel Andrews, to make Victoria the 'education state' is welcome and timely.