What is it like to live with the label “Disability?” NIB editorial staff and narrative symposium editors, Jeffery Bishop and Naomi Sunderland developed a call for stories, which was sent to several list serves, shared with the 1000 Voices Project community and posted on Narrative Inquiry in Bioethics ’ website. The request for personal stories from people who identify with the label “disabled” asked them to: consider how the label “disability” interacts with other aspects of their life in (...) health care settings; does the term “disability” reflect their actual embodied experiences of impairment or does it fail to do justice to their particular experience of impairment; describe the kind of experiences that are possible because of the impairment(s); discuss how the label has affected their “authentic voice”; and many other concepts about what effects the label has on their lives. These authors share deeply personal experiences that will help readers understand their world, challenges, and joys. Thirteen stories are found in the print version of the journal and an additional five supplemental stories are published online only through Project MUSE. The stories are complemented by four commentary articles by Elizabeth R. Schiltz; Lorna Hallahan; Nicole Matthews, Kathleen Ellem, and Lesley Chenoweth; and Jeffery Bishop, Rachelle Barina, and Devan Stahl. These scholars come from the disciplines of law, social work, media studies, medicine, and bioethics from Australia and the United States. Together, the symposium’s storytellers and commentators offer striking and informative insights into the everydayness of living with disabilities. (shrink)

The stories in this issue of Narrative Inquiry in Bioethics demonstrate two important things. First these stories explore the space between bodily impairment and the social structures that both enable and constrain the flourishing of those who are differently embodied. The authors of these narratives resist the dominant biomedical interpretation of their impairments, but also demonstrate their dependency upon others—social, medical, or familial others. Second, in writing these narratives, the authors are also engaged in an act of identity formation, which (...) sometimes challenge and sometimes embrace the label of disability. By telling their stories in the middle of the action of their lives— in media res, taking up or resisting the label of disability—they also demonstrate the way in which lives can be lived open to new possibilities and interpretations. (shrink)

Honor walks are ceremonies that purportedly honor organ donors as they make their final journey from the ICU to the OR. In this paper, we draw on Ronald Grimes’ work in ritual studies to examine honor walks as ceremonial rituals that display medico-technological power in a symbolic social drama (Grimes, 1982). We argue that while honor walks claim to honor organ donors, ceremonies cannot primarily honor donors, but can only honor donation itself. Honor walks promote the quasi-religious idea of donation (...) as a “good death,” and mask the ambiguity and discomfort inherent in organ donation to promote greater acceptance by the medical community. While some goods may be achieved through honor walks, particularly for donor families, it is still important to examine the negative work done by this practice. (shrink)

Jeffery Aubin,Julio Cesar Dias Chaves,Steve Johnston,Louis Painchaud,Anne Pasquier,Paul-Hubert Poirier,Jennifer Wees,Eric Crégheur.

Upshot: Albeit mostly supportive of our work, the commentaries we received highlighted a few points that deserve additional explanation, with regard to the notion of learning in our model, the relationship between our model and the brain, as well as the notion of anticipation. This open discussion emphasizes the need for toy computer models, to fuel theoretical discussion and prevent business-as-usual from getting in the way of new ideas.

Human trafficking is associated with a variety of adverse health and mental health consequences, which should be accurately addressed and documented in electronic health records.

Since the terrorist attacks of September 11, 2001, the concept of 'evil' has enjoyed renewed popularity in both international political rhetoric and scholarly writing. World leaders, politicians, and intellectuals have increasingly turned to 'evil' to describe the very worst humanitarian atrocities that continue to mark international affairs. However, precisely what 'evil' actually entails is not well understood. Little consensus exists as to what 'evil' is, how it is manifested in the international sphere, and what we ought to do about it. (...) With this in mind, this work seeks to ascertain precisely what is meant by 'evil' when it is used to describe actors and events in international politics. Focusing on the history of evil in western secular and religious thought, it reintroduces a classical understanding of evil as the means according to which we seek to understand otherwise meaningless human suffering. (shrink)

Introduction Currently, The nature and scope of Clinical Ethics Protocols in Madrid are not well understood.Objectives The main objective is to describe the features of ‘guideline/recommendation’ type CEPs that have been or are being developed by existing Clinical Ethics Committees in Madrid. Secondary objectives include characterisation of those CECs that have been the most prolific in reference to CEP creation and implementation and identification of any trends in future CEP development.Methods We collected CEPs produced and in process by CECs accredited (...) in the public hospitals in Madrid, Spain, from 1996 to 2008.Results CECs developed 30 CEPs, with 10 more in process. The most common topic is refusal of treatment . If CEPs addressing terminal illness, Do-Not-Resuscitate orders and advance directives are placed into a separate ‘ethical problems at the end of life’ category, this CEP subject emerges as the most common . There is a relationship between the age of the CEC and the development of CEPs . CECs now seem to be more likely to engage in CEP development.Conclusions The CECs in Madrid, Spain, have developed a significant number of CEPs and there is a trend towards continued development. The most frequent topics are ethical problems at the end of life and refusal of treatment by the patient. (shrink)

Social contract theory has been criticized as a “theory in search of application.” We argue that incorporating the nano- or individual level of analysis into social contract inquiry will yield more descriptive theory. We draw upon the psychological contract perspective to address two critiques of social contract theory: its rigid macro orientation and inattention to the process of contract formation. We demonstrate how a psychological contract approach offers practical insight into the impact of social contracting on day-today human interaction.

People who defend “pragmatic encroachment” about knowledge generally advocate two ideas: you can rationally act according to what you know; knowledge is harder to achieve when more is at stake. In their chapter in this volume, Charity Anderson and John Hawthorne argue that these two ideas may not fit together so well. This chapter extends Anderson and Hawthorne’s argument. By applying some standard decision theory, we can calculate a precise quantity of “how much is at stake” that does fit together (...) with knowledge and action. While this calculated quantity matches intuitions about how much is at stake in certain standard cases, in others it does not.Keywords. (shrink)

Introduction Patients require an accurate knowledge about placebos and their possible effects to ensure consent for placebo-controlled clinical trials is adequately informed. However, few previous studies have explored patients’ baseline levels of understanding and knowledge about placebos. The present online survey aimed to assess knowledge about placebos among patients with a history of back pain. Design A 15-item questionnaire was constructed to measure knowledge about placebos. Additional questions assessed sociodemographic characteristics, duration and severity of back pain, and previous experience of (...) receiving placebos. Setting Participants recruited from community settings completed the study online. Results 210 participants completed the questionnaire. 86.7% had back pain in the past 6 months, 44.3% currently had back pain. 4.3% had received a placebo intervention as part of a clinical trial and 68.1% had previously read or heard information about placebos. Overall knowledge of placebos was high, with participants on average answering 12.07 of 15 questions about placebos correctly. However, few participants correctly answered questions about the nocebo effect and the impact of the colour of a placebo pill. Conclusions The findings identified key gaps in knowledge about placebos. The lack of understanding of the nocebo effect in particular has implications for the informed consent of trial participants. Research ethics committees and investigators should prioritise amending informed consent procedures to incorporate the fact that participants in the placebo arm might experience adverse side effects. (shrink)

One of the unique insights provided by the growing number of fully sequenced genomes is the pervasiveness of gene duplication and gene loss. Indeed, several metrics now suggest that rates of gene birth and death per gene are only 10–40% lower than nucleotide substitutions per site, and that per nucleotide, the consequent lineage‐specific expansion and contraction of gene families may play at least as large a role in adaptation as changes in orthologous sequences. While gene family evolution is pervasive, it (...) may be especially important in our own evolution since it appears that the “revolving door” of gene duplication and loss has undergone multiple accelerations in the lineage leading to humans. In this paper, we review current understanding of gene family evolution including: methods for inferring copy number change, evidence for adaptive expansion and adaptive contraction of gene families, the origins of new families and deaths of previously established ones, and finally we conclude with a perspective on challenges and promising directions for future research. (shrink)

The American Journal of Bioethics, Volume 11, Issue 11, Page 42-43, November 2011.

The aim of this study was to evaluate the neuromuscular response to an agility and repeated sprint ability test according to the level of competition in futsal players. A total of 33 players from two elite teams and one amateur team participated in the study. The participants completed an agility t-test, a 30 m-speed test, and a RSA test. A countermovement jump test and a tensiomyography test of the rectus femoris and biceps femoris of both legs were carried out before (...) and after the tests. RSA test revealed better sprint times in elite players compared to amateurs in the seven bouts, as well as in the 30 m sprint and in the agility test. In conclusion, elite players showed greater performance in the RSA test, in the 30 m tests and in the agility test compared to amateur players. The contractile properties were not a key factor in the RSA performance of the futsal players. (shrink)

This is the first volume compiling English translations of Leibniz's journal articles on natural philosophy, presenting a selection of 26 articles, only three of which have appeared before in English translation. It also includes in full Leibniz's public controversies with De Catelan, Papin, and Hartsoeker. The articles include work in optics, on the fracture strength of materials, and on motion in a resisting medium, and Leibniz's pioneering applications of his calculus to these issues by construing them as mini-max and inverse (...) tangent problems. Other topics covered by the articles include: criticisms of the Cartesian estimate of motive force and Leibniz's proposal of a different way of estimating force to replace it; a proposed theory of celestial motions and gravitation, and derivation of the inverse square law; challenge problems concerning the isochronous curve and the catenary; a sample of work on gaming theory; and Leibniz's critique of atomism. (shrink)

Social contract theory has been criticized as a “theory in search of application.” We argue that incorporating the nano, or individual, level of analysis into social contract inquiry will yield more descriptive theory. We draw upon the psychological contract perspective to address two critiques of social contract theory: its rigid macro-orientation and inattention to the process of contract formation. We demonstrate how a psychological contract approach offers practical insight into the impact of social contracting on day-to-day human interaction. We then (...) articulate several potentially testable propositions that emerge from this nano-level perspective. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Mimetic SacredGirard and Bataille Transcending DesireJeffery D. McNeil (bio)René Girard's (1923–2015) mimetic theory and Georges Bataille's (1897–1962) theory of the sacred both describe an unwitting pull to violence fueled by an aspect of desire. This violence cannot be denied but may be channeled through ritual, resulting in social cohesion or utter catastrophe. Their theories also illustrate the contagious flow of affective violence between individuals, quickly infecting the whole. (...) Girard describes a violent contagion that threatens physical annihilation, while Bataille's more vital contagion illustrates the dissolution of self into other. Both come to the same result—collective cohesion. However, for all the similarities, the essential mechanisms "end up with profoundly different visions of the dynamics sustaining the social bond and, indeed, of society's whole affective economy."1 For Girard, the operative community requires distinct individuals specific in their identities. A lack of distinctions between individuals—a state he calls undifferentiation—leads to a struggle for identity, conflict, and violence. Unity comes from the catharsis of collectively thwarting violence before conflict can destroy the community. For Bataille, unity comes from collectively communicating through ritual. A [End Page 103] primal urge to slip out of the hierarchical mastery of discontinuous being and join with the other in a step closer to continuous being unites through mutual affect generated through shared experience. Girard asserts that cohesion occurs by maintaining separation, while Bataille describes cohesion generated in its destruction.Despite their similar concerns and many agreements, Girard and Bataille have rarely been compared. Among those few studies, Tiina Arppe argues that the divergence in both thinkers' theories can be found in their sources, namely, Emile Durkheim's theory of the sacred and Alexandre Kojève's reading of Hegel.2 Antony D. Traylor argues in answering the question of the purpose of sacrifice that Bataille's understanding may add to or replace Girard's scapegoat mechanism.3 Traylor dissects both theories focusing on Girard's critique of metaphysical desire and Bataille's notion of sovereignty. Nidesh Lawtoo mobilizes both thinkers and others to unmask the mimetic forces entwined in ego creation.4 First, similar to Arppe, I argue that apparent contradictions between Girard and Bataille arise from critical influences of each thinker and offer an analysis paving the way, like Traylor, toward compatibility. However, I focus on the influence (or denial) of Sigmund Freud and Marcel Mauss—whom I argue are the most crucial influences for untangling these theories. By examining Girard's interpretation of Freud's theory of cultural origin and Bataille's use of Mauss's notion of the gift and potlatch, I trace a short anthropological genealogy of the sacred that proves critical to both theories.5 In that regard, I eschew wrestling with metaphysical concerns and instead take an anthropological approach to the sacred that moves beyond compatibility. Second, we perform a synthetization, illuminating a shared mimetic force lurking within both theories and how Bataille offers an expansion to Girard's already acute observations—for which Lawtoo's notions of the mimetic unconscious and mimetic communication are essential.My primary source for Girard's theory is Violence and the Sacred, with secondary support from The Scapegoat and Things Hidden since the Foundation of the World. For Bataille, I consult Erotism: Death and Sensuality and two essays: "The Notion of Expenditure" (and its later development in The Accursed Share) and "Definition of Heterology." I also use a small but significant excerpt from Theory of Religion concerning sacrifice and the festival. Secondary literature is introduced as needed. [End Page 104]PSYCHOANALYTIC ANTHROPOLOGYGirard and Bataille found varying degrees of influence in Freud. A short detour through the relationship between subject and desire and the violent origins of the sacred will set the stage for a deeper comparison. While Girard does not explicitly admit using the father of psychoanalysis as a starting point,6 he acknowledges the influence and relegates it under his own, claiming that Freud's theory "has been replaced by another explanation, at once very close to and very far removed from the Freudian viewpoint."7 Lawtoo illustrates essential similarities to be "Girard's emphasis on desire as the essence of... (shrink)

Although consumers are increasingly engaged with ethical factors when forming opinions about products and making purchase decisions, recent studies have highlighted significant differences between consumers' intentions to consume ethically, and their actual purchase behaviour. This article contributes to an understanding of this 'Ethical Purchasing Gap' through a review of existing literature, and the inductive analysis of focus group discussions. A model is suggested which includes exogenous variables such as moral maturity and age which have been well covered in the literature, (...) together with further impeding factors identified from the focus group discussions. For some consumers, inertia in purchasing behaviour was such that the decision-making process was devoid of ethical considerations. Several consumers manifested their ethical views through post-purchase dissonance and retrospective feelings of guilt. Others displayed a reluctance to consume ethically due to personal constraints, a perceived negative impact on image or quality, or an outright negation of responsibility. Those who expressed a desire to consume ethically often seemed deterred by cynicism, which caused them to question the impact they, as an individual, could achieve. These findings enhance the understanding of ethical consumption decisions and provide a platform for future research in this area. (shrink)

This article analyzes Wittgenstein’s position on the grammatical incorrigibility of psychological self-ascriptions and shows how introspective statements can be of use to philosophers. In Wittgenstein On Rules and Private Language, Kripke notes Wittgenstein’s puzzling ambivalence toward introspection. On the one hand Wittgenstein repudiates introspection and on the other he uses it in his own philosophical investigations. To resolve the paradox, this paper distinguishes between introspective methodology in psychological and philosophical investigations. Wittgenstein’s arguments against introspection are specifically directed at introspective methodology (...) in psychology. He argues that the use of introspection to discover “inner causes” commits one to a conception of “direct inner awareness”. On that conception, psychological self-ascriptions are considered highly reliable due to the superiority of the subjective vantage point in ascertaining one’s own mental contents. As an alternative, Wittgenstein maintains that this reliability stems from the grammar of the ascription. The paper places Wittgenstein’s alternative conception of incorrigibility into the context of his argument against the use of introspection in psychology. (shrink)

This article analyzes Wittgenstein’s position on the grammatical incorrigibility of psychological self-ascriptions and shows how introspective statements can be of use to philosophers. In Wittgenstein On Rules and Private Language, Kripke notes Wittgenstein’s puzzling ambivalence toward introspection. On the one hand Wittgenstein repudiates introspection and on the other he uses it in his own philosophical investigations. To resolve the paradox, this paper distinguishes between introspective methodology in psychological and philosophical investigations. Wittgenstein’s arguments against introspection are specifically directed at introspective methodology (...) in psychology. He argues that the use of introspection to discover “inner causes” commits one to a conception of “direct inner awareness”. On that conception, psychological self-ascriptions are considered highly reliable due to the superiority of the subjective vantage point in ascertaining one’s own mental contents. As an alternative, Wittgenstein maintains that this reliability stems from the grammar of the ascription. The paper places Wittgenstein’s alternative conception of incorrigibility into the context of his argument against the use of introspection in psychology. (shrink)

One common justification for the pursuit of profit by business firms within a market economy is that profit is not an end in itself but a means to more efficiently produce and allocate resources. Profit, in short, is a mechanism that serves the market’s purpose of producing Pareto superior outcomes for society. This discussion examines whether such a justification, if correct, requires business managers to remain attentive to how their firm’s operation impacts the market’s purpose. In particular, it is argued (...) that the value of efficiency, despite views to the contrary, cannot be fully separated from the planning and intentions of business managers as long as those managers direct their firms in an ethically responsible fashion. This position is inspired by, and serves as a supportive clarification of Joseph Heath’s so-called “market failures approach” to business ethics. (shrink)

The fact that Gilbert Ryle and J.L. Austin seem to disagree about the ordinary use of words such as ‘voluntary’, ‘involuntary’, ‘voluntarily’, and ‘involuntarily’ has been taken to cast doubt on the methods of ordinary language philosophy. As Benson Mates puts the worry, ‘if agreement about usage cannot be reached within so restricted a sample as the class of Oxford Professors of Philosophy, what are the prospects when the sample is enlarged?’ (Mates, Inquiry 1:161–171, 1958, p. 165). In this chapter, (...) we evaluate Mates’s criticism alongside Ryle’s and Austin’s specific claims about the ordinary use of these words, assessing these claims against actual examples of ordinary use drawn from the British National Corpus (BNC). Our evaluation consists in applying a combination of methods: first aggregating judgments about a large set of samples drawn from the corpus, and then using a clustering algorithm to uncover connections between different types of use. In applying these methods, we show where and to what extent Ryle’s and Austin’s accounts of the use of the target terms are accurate as well as where they miss important aspects of ordinary use, and we demonstrate the usefulness of this new combination of methods. At the heart of our approach is a commitment to the idea that systematically looking at actual uses of expressions is an essential component of any approach to ordinary language philosophy. (shrink)

ABSTRACT:Does effective moral judgment in business ethics rely upon the identification of a suitable set of moral principles? We address this question by examining a number of criticisms of the role that principles can play in moral judgment. Critics claim that reliance on principles requires moral agents to abstract themselves from actual circumstances, relationships and personal commitments in answering moral questions. This is said to enforce an artificial uniformity in moral judgment. We challenge these critics by developing an account of (...) principle-based moral judgment that has been widely discussed by contemporary Kantian scholars. In so doing we respond to some basic problems raised by so-called “moral particularists” who voice theoretical objections to the role of principles as well as to contemporary business ethicists who have criticized principle-based moral judgment along similar lines. We conclude with some future areas of research. (shrink)