Objective: Contemporary ethical accounts of the patient-provider relationship emphasise respect for patient autonomy and shared decision making. We sought to examine the relative influence of involvement in decisions, confidence and trust in providers, and treatment with respect and dignity on patients’ evaluations of their hospital care.Design: Cross-sectional survey.Setting: Fifty one hospitals in Massachusetts.Participants: Stratified random sample of adults discharged from a medical, surgical, or maternity hospitalisation between January and March, 1998. Twelve thousand six hundred and eighty survey recipients responded.Main outcome (...) measure: Respondent would definitely be willing to recommend the hospital to family and friends.Results: In a logistic regression analysis, treatment with respect and dignity 3.4, 99% confidence interval 2.8 to 4.2) and confidence and trust in providers were more strongly associated with willingness to recommend than having enough involvement in decisions . Courtesy and availability of staff , continuity and transition , attention to physical comfort , and coordination of care were also significantly associated with willingness to recommend.Conclusions: Confidence and trust in providers and treatment with respect and dignity are more closely associated with patients’ overall evaluations of their hospitals than adequate involvement in decisions. These findings challenge a narrow emphasis on patient autonomy and shared decision making, while arguing for increased attention to trust and respect in ethical models of health care. (shrink)

López-Escobar, E. G. K. Introduction.--Kueker, D. W. Back-and-forth arguments and infinitary logics.--Green, J. Consistency properties for finite quantifier languages.--Cunningham, E. Chain models.--Gregory, J. On a finiteness condition for infinitary languages.

A recent commentary defends 1) the concept of 'brain arrest' to explain what brain death is, and 2) the concept that death occurs at 2–5 minutes after absent circulation. I suggest that both these claims are flawed. Brain arrest is said to threaten life, and lead to death by causing a secondary respiratory then cardiac arrest. It is further claimed that ventilation only interrupts this way that brain arrest leads to death. These statements imply that brain arrest is not death (...) itself. Brain death is a devastating state that leads to death when intensive care, which replaces some of the brain's vital functions such as breathing, is withdrawn and circulation stops resulting in irreversible loss of integration of the organism. Circulatory death is said to occur at 2–5 minutes after absent circulation because, in the context of DCD, the intent is to not attempt reversal of the absent circulation. No defense of this weak construal of irreversible loss of circulation is given. This means that paents in identical physiologic states are dead (in the DCD context) or alive (in the resuscitation context); the current state of death (at 2–5 minutes) is contingent on a future event (whether there will be resuscitation) suggesting backward causation; and the commonly used meaning of irreversible as 'not capable of being reversed' is abandoned. The literature supporting the claim that autoresuscitation does not occur in the context of no cardiopulmonary resuscitation is shown to be very limited. Several cases of autoresuscitation are summarized, suggesting that the claim that these cases are not applicable to the current debate may be premature. I suggest that brain dead and DCD donors are not dead; whether organs can be harvested before death from these patients whose prognosis is death should be debated urgently. (shrink)

This is the first book to undertake an applied postmedia and philosophical approach to the work of Felix Guattari. It provides a way to understand philosophically issues in contemporary technology, social life and consumer culture in Asia.

The Carol J. Adams Reader gathers together Adams's foundational and recent articles in the fields of critical studies, animal studies, media studies, vegan studies, ecofeminism and feminism, as well as relevant interviews and conversations in which Adams identifies key concepts and new developments in her decades-long work. This volume, a companion to The Sexual Politics of Meat (Bloomsbury Revelations), offers insight into a variety of urgent issues for our contemporary world: Why do batterers harm animals? What is the relationship (...) between genocide and attitudes toward other animals? How do activism and theory feed each other? How do race, gender, and species categories interact in strengthening oppressive attitudes? In clear language, Adams identifies the often hidden aspects of cultural presumptions. The essays and conversations found here capture the decades-long energy and vision that continue to shape new ways of thinking about and responding to oppression. (shrink)

When should we listen to our guts and when should we ignore them? What makes disgust and other related emotions morally relevant in some situations but not others? In this paper, I argue that emotions are morally relevant only when they are backed up by reasons and arguments.

On the surface, developing a social psychology of science seems compelling as a way to understand how individual social cognition – in aggregate – contributes towards individual and group behavior within scientific communities (Kitcher, 2002). However, in cases where the functional input-output profile of psychological processes cannot be mapped directly onto the observed behavior of working scientists, it becomes clear that the relationship between psychological claims and normative philosophy of science should be refined. For example, a robust body of social (...) psychological research demonstrates implicit gender bias in the evaluation of others (e.g., Steinpreis, Anders, & Ritzke, 1999). Many expected implicit bias to be a major cause of women’s underrepresentation in math intensive fields of science; however, quantitative sociological research of hiring and manuscript and grant evaluation has discovered no gender disparity in outcomes (Ceci & Williams, 2011). Why might this be so? This paper will discuss methodological challenges that go beyond classic problems of external validity in extrapolating psychological effects and explanations to scientific communities. These problems include more complex external validity issues raised by the introduction of multi-process models of cognition (e.g., implicit versus explicit social cognition) as well as the reflexive role that folk and experimental theories of social psychology play in guiding the behavior of scientists at the individual and community level. (shrink)

Classic statements of research ethics advise against permitting physician-investigators to obtain consent for research participation from patients with whom they have preexisting treatment relationships. Reluctance about “dual-role” consent reflects the view that distinct normative commitments govern physician–patient and investigator–participant relationships, and that blurring the research–care boundary could lead to ethical transgressions. However, several features of contemporary research demand reconsideration of the ethics of dual-role consent. Here, we examine three arguments advanced against dual-role consent: that it creates role conflict for the (...) physician-investigator; that it can compromise the voluntariness of the patient-participant’s consent; and that it promotes therapeutic misconceptions. Although these concerns have merit in some circumstances, they are not dispositive in all cases. Rather, their force—and the ethical acceptability of dual-role consent—varies with features of the particular study. As research participation more closely approximates usual care, it becomes increasingly acceptable, or even preferable, for physicians to seek consent for research from their own patients. It is time for a more nuanced approach to dual-role consent. (shrink)

New Tenth Anniversary edition of this classic text with a new preface by the author, compares myths about meat-eating with myths about manliness, and seeks to ...

Here presented are three singular, philosophical perspectives on the Delhi student protests which took place in 2019 and 2020, before the coronavirus pandemic. The writers hail from India, England...

Introduction : first things : two black and blue thoughts -- Author's note I. a sewing needle inside a plastic and rubber suction cup sitting on a watch spring, or, an object for seeing nothing -- Elegy of milk, in black and blue : the bruising of La Chambre claire -- "A" is for Alice, for amnesia, for anamnesis: a fairy tale (almost blue) called La Jetée -- Happiness with a long piece of black leader : Chris Marker's sans soleil (...) -- Author's note II. She wrote me -- "Summer was inside the marble": Alain Resnais and Magurite Duras's Hiroshima mon amour. (shrink)

Some patients who have been diagnosed as “dead by neurologic criteria” continue to exhibit certain brain functions, most commonly, neuroendocrine functions. This preservation of neurologic function after the diagnosis of “brain death” or “brainstem death” is an ongoing source of controversy and concern in the medical, bioethics, and legal literatures. Most obviously, if some brain function persists, then it is not the case that all functions of the entire brain have ceased and hence, declaring such a patient to be “dead” (...) would be a false positive, in any nation with so-called “whole brain death” laws. Furthermore, and perhaps more concerning, the preservation of any brain function necessarily entails the preservation of some amount of brain perfusion, thereby raising the concern as to whether additional areas of neural tissue may remain viable, including areas in the brainstem. These and other considerations cast significant doubt on the reliability of diagnosing either “brain death” or “brainstem death.”. (shrink)

The World Brain Death Project clarified many aspects of the diagnosis of brain death/death by neurologic criteria. Clearer descriptions than previously published were presented concerning the etiology, prerequisites, minimum clinical criteria, apnea testing targets, and indications for ancillary testing. Nevertheless, there remained many epistemic and metaphysical assertions that were either false, ad hoc, or confused. Epistemically, the project was not successful in explaining away remaining brain functions, complex reflexes as “spinal,” the risk and lack of utility of the apnea test, (...) the ignored and often present confounders of central endocrine dysfunction and high-cervical-spinal-cord injury, the limitations of ancillary tests, or the cases of reversibility of some findings of brain death/death by neurologic criteria. Metaphysically, the World Brain Death Project variously suggested different concepts of death that were not supported with argument. Concepts offered included simply restating the criterion of brain death/death by neurologic criteria; personhood, without recognizing it is a higher-brain concept; and emergent functions of the organism as a whole, without specifying what these might be, if not biologic anti-entropic integration that actually remains after brain death/death by neurologic criteria. The World Brain Death Project only offered confused metaphysical discussion, and gave no reason why the state they described as brain death/death by neurologic criteria should be considered death itself. The main epistemic and metaphysical problems with brain death/death by neurologic criteria remain untouched by the World Brain Death Project. (shrink)

Pateman challenges the way contemporary society functions by questioning the standard interpretation of an idea that is deeply embedded in American and British political thought: that our rights and freedoms derive from the social contract explicated by Locke, Hobbes, and Rousseau and interpreted in the United States by the Founding Fathers. The author shows how we are told only half the story of the original contract that establishes modern patriarchy. The sexual contract is ignored and thus men's patriarchal right over (...) women is also glossed over. No attention is paid to the problems that arise when women are excluded from the original contract but incorporated into the new contractual order. One of the main targets of the book is those who try to turn contractarian theory to progressive use, and a major thesis of the book is that this is not possible. Thus those feminists who have looked to a more "proper" contract- one between genuinely equal partners, or one entered into without any coercion- are misleading themselves. In the author's words, "In contract theory universal freedom is always a hypothesis, a story, a political fiction. Contract always generates political right in the forms of domination and subordination." Thus the book is also aimed at mainstream political theorists, and socialist and other critics of contract theory. The author offers a sweeping challenge to conventional understandings- of both left and right- of actual contracts in everyday life: the marriage contract, the employment contract, the prostitution contract, and the new surrogate mother contract. By bringing a feminist perspective to bear on the contradictions and paradoxes surrounding women and contract, and the relation between the sexes, she is able to shed new light on fundamental political problems of freedom and subordination. (shrink)

Medical ethics assumes a clear boundary between clinical research and clinical medicine: one produces knowledge for the benefit of future patients, while the other provides optimal care to individuals right now. It also assumes that the two cannot be integrated without sacrificing the needs of the current patient to those of future patients. But integration could allow us to provide better care to everyone, now and in the future.

Pt. I. The road to mechanism : ancient Greece to the scientific revolution. Body and soul at war : Plato -- Body and nature : Aristotle and the Stoics -- The resurrection of the body : Christianity -- From astrology to the cult of dissection : the Renaissance -- The body-machine : Descartes -- The road not followed : Spinoza -- pt. II. The limits of mechanism : contemporary problems and solutions. The legacy of mechanism : the fragmenting and disappearing (...) body -- Recovering the body : yoga -- Recovering the body : alternative medicine. (shrink)

This paper examines the affective disorders plaguing many young people and the problem of attention-deficit hyperactivity disorder in particular. It aims to define the limits of the critique of British educationalist Sir Ken Robinson in terms of his philosophy of ‘creativity’ through a consideration of the ideas of French philosopher Bernard Stiegler, especially the notions of ‘industrial temporal objects’ and stupidity. It makes the case for adopting elements of each distinct research paradigm as a prolegomena to forging a social critique (...) of capitalist-dominated, market-led educational institutions. The former, it will be seen, identifies some of the problems facing teachers in terms of the use and application of technology, the false divide between arts and the humanities, but falls short of explaining the root of the structural and psychic malaise in neo-liberal regimes regarding classroom breakdown in general. The latter, despite the apocalyptic tone of some his pronouncements provides an update and radicalization of Deleuze’s societies of control thesis in terms of what Stiegler designates ‘uncontrollable societies’. Stiegler, it will be seen, presents a critique of technology that is all the more pressing in an age in which the loss of expectation in the lives of young people can lead to a corresponding fall off or destruction in ‘deep attention’. I want to test the hyperbole of Stiegler’s assertion that young people today suffer from a ‘colossal’ attention deficit disorder of unprecedented scale and magnitude. (shrink)

We are living in and beyond two massive changes in the world, both of which must be addressed by education, the caretaker of memory. First is the geological era of the Anthropocene—a crisis...

A new translation by Martin Hammond of Xenophon's Memorabilia and Apology of Socrates, with introduction and notes by Carol Atack, in the Oxford World's Classics series. -/- ISBN: 9780198856092 -/- 'Who would you say knows himself?' -/- In 399 BCE Socrates was tried in Athens on charges of irreligion and corruption of the young, convicted, and sentenced to death. Like Plato, an almost exact contemporary, in his youth Xenophon (c. 430-c. 354 BCE) was one of the circle of mainly (...) upper-class young Athenians attracted to Socrates' teaching. His Memorabilia is both a passionate defence of Socrates against those charges, and a kaleidoscopic picture of the man he knew, painted in a series of mini-dialogues and shorter vignettes, with a varied and deftly characterized cast—entitled and ambitious young men, atheists and hedonists, artists and artisans, Socrates' own stroppy teenage son Lamprocles, the glamorous courtesan Theodote. Topics given Socrates' characteristic questioning treatment include education, law, justice, government, political and military leadership, democracy and tyranny, friendship, care of the body and the soul, and concepts of the divine. Xenophon sees Socrates as above all a supreme moral educator, coaxing and challenging his associates to make themselves better people, not least by the example of how he lived his own life. Self-knowledge, leading to a reasoned self-control, was for Socrates the essential first step on the path to virtue, and some found it uncomfortable. The Apology is a moving account of Socrates' behaviour and bearing in his last days, immediately before, during, and after his trial. (shrink)

My intention is to consider Bernard Stiegler’s concept of ‘journeys of knowledge’. Open Humanities Press, 2020) and to explore how one might rethink the knowledge-creating potentialities of information itself. This has become all the more apparent in the time of lockdowns, physical distancing during the pandemic but the primary purpose of the paper is to look at the distinction between knowledge/information and the role of the teacher in using technology pharmacologically to safeguard the savoirs and to stem the proletarianization of (...) knowledge or stupidity as such. The point is that the pandemic is bringing home the question of the role of the teacher, the role of the school and the necessity of the co-production and co-creation of knowledge. It seems essential to understand the concept of ‘journeys of knowledge’ in the time of the pandemic as students are left at home without a journey to voyage upon. As such, there is a lack of futurally-bound collective protentions, an absence of any vision projection into the future. What is there in the concept of ‘journeys of knowledge’ that demonstrates how to use the Internet in bifurcatory ways, to produce what Stiegler calls negentropic knowledge or new forms of knowledge, or what I want to designate as experiments with truth-telling. What does it mean to produce negentropic knowledge without the teacher to guide, curate and care? With the above in mind, and by writing out of the wound of thinking, it is by rethinking the concept of curation in a different way that it is hoped one can contribute to educational research to produce unheard-of bifurcations of knowledge, to invoke Deleuze’s sense of the incomprehensible and Stiegler’s sense of the impossible, the improbable and the incalculable in educational concerns, to pave a path out of the aporia of the present—a present which is without decision and epoch. (shrink)

Impermanence is one of the most fundamental truths of our lives and one of the most uncomfortable realities for kids. This sweet story of changing seasons, ripping your favorite piece of clothing, and even growing up helps kids understand that even though we eventually have to say goodbye to everything, because everything changes there is a world of possibilities for the future.

This book elaborates on the distinction between societal innovation and social innovation. It provides eight case studies to illustrate the scope, process, outcome, and impact of societal innovation and social innovation. In addition, the book proposes a model for interested parties to maximize their contribution for the common social good in a systematic and effective way. Case studies are used to illustrate concepts for readers to grasp the real essence of the relatively abstract notions of societal innovation and social innovation. (...) In doing so, the book shows how small efforts can bring big benefits for the under privileged and to society as a whole. This book serves as a helpful resource for government officials, social innovation practitioners, social entrepreneurs, Non Profit Organizations, as well as students who would like to contribute to the common social good. (shrink)

Deeply rooted structures of racism, ableism, misogyny, ageism, and transphobia hurt great numbers of people, exposing them to intolerance, economic exclusion, and physical harm around the globe. Billions of land animals suffer and die annually in concentrated feeding operations and slaughterhouses. Our planet and all who live here are in perilous straights as the climate changes. In the face of such grievous problems, people who want to find positive ways to respond often grapple with difficult questions about how to make (...) a difference. Effective Altruism has arisen as an attempt to help answer these questions, encouraging people to give as much money as they can in the most effective ways to address human and animal suffering. But the Effective Altruists’ answers support some of the very social structures that cause suffering, undermining its efforts to “do the most good.” The Good It Promises, The Harm It Does is the first book-length critique of Effective Altruism. It brings together a diverse group of activists and scholars to explore Effective Altruism’s failure to meaningfully address forms of human and animal suffering. (shrink)

At first glance a Russian anarchist’s revolutionary address to the youth of his day made in the late 19th century and the address to youth made by a contemporary French philosopher may appear to have little in common as their context and era are ostensibly very different. How would Petr Kropotkin’s address be understood in our time? Are Kropotkin’s concerns the same as those raised by Bernard Stiegler? Could Kropotkin speak of universal concerns, a sense of elevation and sublimation not (...) governed, undermined or circumvented by digital relations, calculation or algorithmic determination? I find a mutual concern with the coming into maturity of youth, but, I am concerned that as we are passing through an epochal and revolutionary transformation driven by digital and cognitive capitalism and in our toxic and crisis-ridden milieu, Kropotkin’s rhetoric would inevitably fall on deaf ears? Is his rhetoric on revolution anachronistic? How would his rhetoric be crafted for a youth seemingly indifferent to the plight of fellow brethren? Is it conceivable that the humanist-inflected prospects of youth so vaunted by Kropotkin have now been devastated by the inhuman and nihilistic tendencies of the so-called miscreant, ‘blank generation’ as described by Stiegler? True, while it is difficult to calibrate the vision of youth affirmed in Kropotkin with the fear of youth in Stiegler, and, despite differences in episteme, tradition and political orientation, both thinkers I think are concerned with the trials and tribulations of youth and both hold out the prospect of the not-yet of youth, of the coming into being of the maturity of youth, of Aufklärung. It is this shared focus I wish to examine further. (shrink)

The shift away from paternalistic decision-making and toward patient-centered, shared decision-making has stemmed from the recognition that in order to practice medicine ethically, health care professionals must take seriously the values and preferences of their patients. At the same time, there is growing recognition that minor and seemingly irrelevant features of how choices are presented can substantially influence the decisions people make. Behavioral economists have identified striking ways in which trivial differences in the presentation of options can powerfully and predictably (...) affect people's choices. Choice-affecting features of the decision environment that do not restrict the range of choices or significantly alter the incentives have come to be known as “nudges.” Although some have criticized conscious efforts to influence choice, we believe that clinical nudges may often be morally justified. The most straightforward justification for nudge interventions is that they help people bypass their cognitive limitations—for example, the tendency to choose the first option presented even when that option is not the best for them—thereby allowing people to make choices that best align with their rational preferences or deeply held values. However, we argue that this justification is problematic. We argue that, if physicians wish to use nudges to shape their patients’ choices, the justification for doing so must appeal to an ethical and professional standard, not to patients’ preferences. We demonstrate how a standard with which clinicians and bioethicists already are quite familiar—the best-interest standard—offers a robust justification for the use of nudges. (shrink)