Research indicates the essentiality of dignity as a vital component for quality of life, reconfirming the emphasis on dignity preservation in the international code of nursing ethics. Applying Noblit and Hare’s meta-ethnography, the aim of the study was to develop a theory model by synthesizing 10 qualitative articles from various cultural contexts, exploring nurse and allied healthcare professional perception/practice concerning dignity-preserving dementia care. “Advocating the person’s autonomy and integrity,” which involves “having compassion for the person,” “confirming the person’s worthiness and (...) sense of self,” and “creating a humane and purposeful environment,” was identified as a primary foundation for dignity-preserving dementia care. “Balancing individual choices among persons no longer able to make sound decisions, against the duty of making choices on behalf of the person,” which involves “persuasion” and/or “mild restraint,” was considered a crucial aspect in certain situations. “Sheltering human worth—remembering those who forget” was identified as a comprehensive motive and core value within dignity-preserving dementia care. (shrink)

Background:Dignity experience in the daily lives of people living with dementia is influenced by their relational interactions with others. However, literature reviews show that knowledge concerning crucial interactional qualities, preserving their sense of dignity, is limited.Aim:The aim of this study was to explore and describe crucial qualities of relational interactions preserving dignity experience among people with dementia, while interacting with family, social network, and healthcare professionals.Methodology:The study was founded upon Gadamer’s philosophical hermeneutics, and an exploratory design employing qualitative research interviews (...) was conducted.Participants and research context:A total of 11 individuals diagnosed with mild to moderate dementia, living in their own homes, were recruited from two Hospital Memory Clinics in Norway.Ethical considerations:In recruiting persons with dementia as study participants, sensitivity toward their life history, autonomy, integrity, relationships, and dignity is essential. These standards, and the ethical principles of moral sensitivity to their vulnerability, doing no harm, showing justice, and respecting their personal utility, guided our research.Results:Three main interactional qualities preserving the participants’ dignity experience were found: Experiencing love and confirmation; experiencing social inclusion and fellowship; experiencing humane warmth and understanding within a caring culture, while being met as an equal human being. A total of 10 sub-qualities were identified within these 3 main qualities.Discussion and final considerations:Dignity experience among the participants was preserved when certain interactional qualities were present in their interactions with family, social network, and healthcare professionals. While supporting some of the findings of previous studies, this study adds new knowledge on the subject. Knowledge of relational interactions toward preserving dignity experience should be a fundamental part of future dementia care practice. Based on the results of this study, an empirical–theoretical model was developed for this purpose. (shrink)

The aim of this study was to describe the experiences of undergoing a presymptomatic genetic test for the hereditary and fatal Huntington’s disease, using a case study approach. The study was based on 18 interviews with a young woman and her husband from the decision to undergo the test, to receiving the results and trying to adapt to them, which were analysed using a life history approach. The findings show that the process of undergoing a presymptomatic test involves several closely (...) connected ethical and medical questions, such as the reason for the test, the consequences of the test results and how health-care services can be developed to support people in this situation. (shrink)

Using an analysis of child care books and parenting Web sites, this article asks if second-wave feminism’s vision of gender-neutral child rearing has been incorporated into contemporary advice on child rearing. The data suggest that while feminist understandings of gender have made significant inroads into popular advice, especially with regard to the social construction of gender, something akin to “a stalled revolution” has taken place. Children’s gender nonconformity is still viewed as problematic because it is linked implicitly and explicitly to (...) homosexuality. (shrink)

Many women professionals traverse settings beyond the office in their work, but research on women professionals rarely follows them out of the office. Using a large, archived data set of focus groups with sales professionals, the authors ask how work in out-of-the-office settings affects women’s careers. The authors distinguish between two types of settings. In “heterosocial” settings, interaction rules are traditionally and normatively gendered; women and men are understood by others as heterosexually linked pairs, women become targets of gossip, and (...) some women report sexual advances and sexual harassment. In “homosocial” settings such as golf courses and strip clubs, women’s disadvantage takes the form of exclusion. (shrink)

My dissertation is an exploration of two theories of political judgment that are inspired by Kant's Critique of Judgment. Both Hannah Arendt and Jean Francois Lyotard appropriate different versions of Kantian reflective judgment as a model for making political decisions because it allows for differences in thought and action, and does not reduce politics to a fabrication guided by a universal conception. This dissertation examines the viability of both theories of judgment, and assesses the relation between political judgment, politics, and (...) history. ;I begin by briefly summarizing the Critique of Judgment, and examining the factors of Kant's universal moral philosophy that are rejected by Arendt and Lyotard, in order to better understand the aspects that they appropriate for political judgment. I then explore Arendt's theory of political judgment based upon judgments of beauty. Through her theory of judgment, Arendt seeks to maintain the balance between valuing plurality, but at the same time, allowing the spectators to come to a political judgment based upon the good of the whole community. The relation between her theory of judgment and the philosophy of history is also discussed in light of her criticisms of instrumental reasoning. Next, I investigate Lyotard's theory of judgment that is based upon Kant's judgments of the sublime. Lyotard focuses upon the incommensurability of phrase genres that are manifested in his analysis of the differend . The differend concerns a wrong that cannot currently be expressed and is signaled by the feeling of the sublime. The link between the feeling of the sublime and history is explored, as well as the implications of Lyotard's theory of judgment upon his politics. Finally, I conclude with a discussion of five major differences between Arendt's and Lyotard's theories of judgment, focusing upon the temporality of judgment, the influence of the holocaust on their respective political theories, the difference between the beautiful and the sublime governing judgment, Lyotard's interpretation of Arendt's thought, and the connection between their theories of judgment and political action. Although their political strategies are important, the success of both of their theories of judgment are provisional because neither can settle the issues surrounding political agency and action that have arisen in the debate between modern and postmodern theories of politics. (shrink)

In den letzten Jahren neu aufgefundene und publizierte Briefe, Gedichte und private Notizen von Marilyn Monroe verändern das Bild ihrer Biographie, ihrer psychischen Entwicklung und ihrer Analysen. Unter Berücksichtigung dieser Informationen kann Marilyn Monroes Analyse bei Ralph Greenson auf der einen Seite als eine intensive Idealisierung und eine tiefe Vertrauensbeziehung zu ihrem Analytiker interpretiert werden. Auf der anderen Seite wird klar, in welchem Ausmaß der Behandlungsprozess Schritt für Schritt entgleiste und zu vielfältigem Agieren aller beteiligten Personen in Marilyn Monroes Umfeld (...) führte. Monroe hatte sich entschieden, Unbeabsichtigt zerstörte Greenson einen Übertragungsprozess, der hoffnungsvoll begonnen hatte. Nach Monroes Tod entwickelte Greenson sein Konzept eines unverzichtbaren Arbeitsbündnisses zwischen Patient und Analytiker, das allen Psychoanalytikern gut bekannt ist. Aus heutiger Sicht stellt sich dieses Arbeitsbündnis als ein abgespaltener Teil eines ichpsychologischen Übertragungsbegriffs dar. (shrink)

To offer engaging neurorehabilitation training to neurologic patients, motor tasks are often visualized in virtual reality. Recently introduced head-mounted displays allow to realistically mimic the body of the user from a first-person perspective in a highly immersive VR environment. In this immersive environment, users may embody avatars with different body characteristics. Importantly, body characteristics impact how people perform actions. Therefore, alternating body perceptions using immersive VR may be a powerful tool to promote motor activity in neurologic patients. However, the ability (...) of the brain to adapt motor commands based on a perceived modified reality has not yet been fully explored. To fill this gap, we “tricked the brain” using immersive VR and investigated if multisensory feedback modulating the physical properties of an embodied avatar influences motor brain networks and control. Ten healthy participants were immersed in a virtual environment using an HMD, where they saw an avatar from first-person perspective. We slowly transformed the surface of the avatar from human to stone. We enforced this visual change by repetitively touching the real arm of the participant and the arm of the avatar with a hammer, while progressively replacing the sound of the hammer against skin with stone hitting sound via loudspeaker. We applied single-pulse transcranial magnetic simulation to evaluate changes in motor cortical excitability associated with the illusion. Further, to investigate if the “stone illusion” affected motor control, participants performed a reaching task with the human and stone avatar. Questionnaires assessed the subjectively reported strength of embodiment and illusion. Our results show that participants experienced the “stone arm illusion.” Particularly, they rated their arm as heavier, colder, stiffer, and more insensitive when immersed with the stone than human avatar, without the illusion affecting their experienced feeling of body ownership. Further, the reported illusion strength was associated with enhanced motor cortical excitability and faster movement initiations, indicating that participants may have physically mirrored and compensated for the embodied body characteristics of the stone avatar. Together, immersive VR has the potential to influence motor brain networks by subtly modifying the perception of reality, opening new perspectives for the motor recovery of patients. (shrink)

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

In this article, the authors examine accounts of heterosexuality in media for children. The authors analyze all the G-rated films grossing $100 million dollars or more between 1990 and 2005 and find two main accounts of heterosexuality. First, heterosexuality is constructed through hetero-romantic love relationships as exceptional, powerful, magical, and transformative. Second, heterosexuality outside of relationships is constructed through portrayals of men gazing desirously at women's bodies. Both of these findings have implications for our understanding of heteronormativity. The first is (...) seemingly at odds with theories that claim that heterosexuality's mundane, assumed, everyday ordinariness lends heteronormativity its power. In fact, the authors suggest heterosexual exceptionalism may extend the pervasiveness of heterosexuality and serve as a means of inviting investment in it. The second offers ways to begin to think about how heteronormativity is gendered and racialized. (shrink)

Life history theory suggests that in risky and uncertain environments the optimal reproductive strategy is to reproduce early in order to maximize the probability of leaving any descendants at all. The fact that early menarche facilitates early reproduction provides an adaptationist rationale for our first two hypotheses: that women who experience more risky and uncertain environments early in life would have (1) earlier menarche and (2) earlier first births than women who experience less stress at an early age. Attachment theory (...) and research provide the rationale for our second two hypotheses: that the subjective early experience of risky and uncertain environments (insecurity) is (3) part of an evolved mechanism for entraining alternative reproductive strategies contingent on environmental risk and uncertainty and (4) reflected in expected lifespan. Evidence from our pilot study of 100 women attending antenatal clinics at a large metropolitan hospital is consistent with all four hypotheses: Women reporting more troubled family relations early in life had earlier menarche, earlier first birth, were more likely to identify with insecure adult attachment styles, and expected shorter lifespans. Multivariate analyses show that early stress directly affected age at menarche and first birth, affected adult attachment in interaction with expected lifespan, but had no effect on expected lifespan, where its original effect was taken over by interactions between age at menarche and adult attachment as well as age at first birth and adult attachment. We discuss our results in terms of the need to combine evolutionary and developmental perspectives and the relation between early stress in general and father absence in particular. (shrink)

Returning genomic research results to family members raises complex questions. Genomic research on life-limiting conditions such as cancer, and research involving storage and reanalysis of data and specimens long into the future, makes these questions pressing. This author group, funded by an NIH grant, published consensus recommendations presenting a framework. This follow-up paper offers concrete guidance and tools for implementation. The group collected and analyzed relevant documents and guidance, including tools from the Clinical Sequencing Exploratory Research Consortium. The authors then (...) negotiated a consensus toolkit of processes and documents. That toolkit offers sample consent and notification documents plus decision flow-charts to address return of results to family of living and deceased participants, in adult and pediatric research. Core concerns are eliciting participant preferences on sharing results with family and on choice of a representative to make decisions about sharing after participant death. (shrink)

Decaying wood, while an abundant and stable resource, presents considerable nutritional challenges due to its structural rigidity, chemical recalcitrance, and low nitrogen content. Despite these challenges, certain insect lineages have successfully evolved saproxylophagy (consuming and deriving sustenance from decaying wood), impacting nutrient recycling in ecosystems and carbon sequestration dynamics. This study explores the uneven phylogenetic distribution of saproxylophagy across insects and delves into the evolutionary origins of this trait in disparate insect orders. Employing a comprehensive analysis of gut microbiome data, (...) from both saproxylophagous insects and their non‐saproxylophagous relatives, including new data from unexplored wood‐feeding insects, this Hypothesis paper discusses the broader phylogenetic context and potential adaptations necessary for this dietary specialization. The study proposes the “Detritivore‐First Hypothesis,” suggesting an evolutionary pathway to saproxylophagy through detritivory, and highlights the critical role of symbiotic gut microbiomes in the digestion of decaying wood. (shrink)

BackgroundOne of the next frontiers in HIV research is focused on finding a cure. A new priority includes people with HIV (PWH) with non-AIDS terminal illnesses who are willing to donate their bodies at the end-of-life (EOL) to advance the search towards an HIV cure. We endeavored to understand perceptions of this research and to identify ethical and practical considerations relevant to implementing it.MethodsWe conducted 20 in-depth interviews and 3 virtual focus groups among four types of key stakeholders in the (...) United States (PWH, biomedical HIV cure researchers, HIV clinicians, and bioethicists) to obtain triangulated viewpoints because little was known about the ethics of this topic. Each group was queried as to ethical considerations, safeguards, and protections for conducting HIV cure-related research at the EOL to ensure this research remains acceptable.ResultsAll four key stakeholder groups generally supported HIV cure-related research conducted at the EOL because of the history of altruism within the PWH community and the potential for substantial scientific knowledge to be gained. Our informants expressed that: (1) Strong stakeholder and community involvement are integral to the ethical and effective implementation, as well as the social acceptability of this research; (2) PWH approaching the EOL should not inherently be considered a vulnerable class and their autonomy must be respected when choosing to participate in HIV cure-related research at the EOL; (3) Greater diversity among study participants, as well as multi-disciplinary research teams, is necessitated by HIV cure-related research at the EOL; (4) The sensitive nature of this research warrants robust oversight to ensure a favorable risk/benefit balance and to minimize the possibility of therapeutic misconception or undue influence; and (5) Research protocols should remain flexible to accommodate participants’ comfort and needs at the EOL.ConclusionBecause of the ethical issues presented by HIV cure-related research at the EOL, robust ethical safeguards are of utmost importance. The proposed ethical and practical considerations presented herein is a first step in determining the best way to maximize this research’s impact and social value. More much inquiry will need to be directed towards understanding context-specific and cultural considerations for implementing EOL HIV cure research in diverse settings. (shrink)

Frames, i.e., recursive attribute-value structures, are a general format for the decomposition of lexical concepts. Attributes assign unique values to objects and thus describe functional relations. Concepts can be classified into four groups: sortal, individual, relational and functional concepts. The classification is reflected by different grammatical roles of the corresponding nouns. The paper aims at a cognitively adequate decomposition, particularly, of sortal concepts by means of frames. Using typed feature structures, an explicit formalism for the characterization of cognitive frames is (...) developed. The frame model can be extended to account for typicality effects. Applying the paradigm of object-related neural synchronization, furthermore, a biologically motivated model for the cortical implementation of frames is developed. Cortically distributed synchronization patterns may be regarded as the fingerprints of concepts. (shrink)

Data are lacking with regard to participants' perspectives on return of genetic research results to relatives, including after the participant's death. This paper reports descriptive results from 3,630 survey respondents: 464 participants in a pancreatic cancer biobank, 1,439 family registry participants, and 1,727 healthy individuals. Our findings indicate that most participants would feel obligated to share their results with blood relatives while alive and would want results to be shared with relatives after their death.

Autonomy of people on the autism-spectrum has only been very rarely conceptually explored. Autism spectrum is commonly considered a hetereogenous disorder, and typically described as a behaviorally-defined neurodevelopmental disorder associated with the presence of social-communication deficits and restricted and repetitive behaviors. Autism research mainly focuses on the behavior of autistic people and ways to teach them skills that are in line with social norms. Interventions such as therapies are being justified with the assumption that autists lack the capacity to be (...) self-reflective and to be “author of their lives”. We question this assumption, as some empirical research shows that autists are aware of their strengths and are critical about social norms, we take this as a starting point to reconsider the beliefs about autistic people’s capacities. As a theoretical framework, we draw on Berlin’s idea of positive and negative liberty as he clearly distinguishes between one’s own developed preferences and the simple absence of interference. By drawing on the concept of positive liberty, we illustrate that a lot of autists are aware of their own needs, and usually do not deny their own needs, values and interests. This makes them less prone than non-autistic people to adapt their preferences to external influences, which might be seen as sticking to an authentic way of living. Our analysis shows that many autists are hindered to be autonomous due to unjustified interference, unreflected assumptions about their self-determination, or by paternalistic actions. These observations contribute to a better understanding when help and interference are justified and a more differentiated understanding of autonomy of autistic people. (shrink)

In a recent paper in this journal, Carter and Peterson raise two distinctly epistemological puzzles that arise for anyone aspiring to defend the precautionary principle. The first puzzle trades on an application of epistemic contextualism to the precautionary principle; the second puzzle concerns the compatibility of the precautionary principle with the de minimis rule. In this note, I argue that neither puzzle should worry defenders of the precautionary principle. The first puzzle can be shown to be an instance of the (...) familiar but conceptually harmless challenge of adjudicating between relevant interests to reach assessments of threats when applying the precautionary principle. The second puzzle can be shown to rely on a subtle but crucial misrepresentation of the relevant probabilities at play when applying the precautionary principle. (shrink)

We explored the possibility of a general brightness bias: brighter pictures are evaluated more positively, while darker pictures are evaluated more negatively. In Study 1 we found that positive pictures are brighter than negative pictures in two affective picture databases (the IAPS and the GAPED). Study 2 revealed that because researchers select affective pictures on the extremity of their affective rating without controlling for brightness differences, pictures used in positive conditions of experiments were on average brighter than those used in (...) negative conditions. Going beyond correlational support for our hypothesis, Studies 3 and 4 showed that brighter versions of neutral pictures were evaluated more positively than darker versions of the same picture. Study 5 revealed that people categorised positive words more quickly than negative words after a bright picture prime, and vice versa for negative pictures. Together, these studies provide strong support for the hypotheses that picture brightness influences evaluations. (shrink)

In this paper I propose a teleological account of epistemic reasons. In recent years, the main challenge for any such account has been to explicate a sense in which epistemic reasons depend on the value of epistemic properties. I argue that while epistemic reasons do not directly depend on the value of epistemic properties, they depend on a different class of reasons which are value based in a direct sense, namely reasons to form beliefs about certain propositions or subject matters. (...) In short, S has an epistemic reason to believe that p if and only if S is such that if S has reason to form a belief about p, then S ought to believe that p. I then propose a teleological explanation of this relationship. It is also shown how the proposal can avoid various subsidiary objections commonly thought to riddle the teleological account. (shrink)

Standard epistemology takes it for granted that there is a special kind of value: epistemic value. This claim does not seem to sit well with act utilitarianism, however, since it holds that only welfare is of real value. I first develop a particularly utilitarian sense of “epistemic value”, according to which it is closely analogous to the nature of financial value. I then demonstrate the promise this approach has for two current puzzles in the intersection of epistemology and value theory: (...) first, the problem of why knowledge is better than mere true belief, and second, the relation between epistemic justification and responsibility. (shrink)

Volume 19, Issue 5, May 2019, Page 43-45.

In feminist media studies, the growing body of research on media production has indicated that journalism remains divided along gender lines. The purpose of this study is to address the lack of relevant multi-method research on gender inequality in journalism. To assess the structural position of women in the journalistic workforce, the authors conducted a large-scale survey of journalists in Belgium. The survey results were explored in more depth by conducting qualitative interviews with 19 female journalists. The analysis confirms the (...) existence of all traditional barriers that women journalists experience. The added value of this study is that it enumerates several additional difficulties, and offers insight into the strategies that the respondents use to deal with gender-related career obstacles. These strategies were associated with the degree of flexibility in the newsroom for journalists with children, the choice to work part-time or freelance, and the use of new communication technologies. (shrink)

The Last Gift is an observational HIV cure-related research study conducted with people with HIV at the end of life (EOL) at the University of California San Diego. Participants agree to voluntarily donate blood and other biospecimens while living and their bodies for a rapid research autopsy postmortem to better understand HIV reservoir dynamics throughout the entire body. The Last Gift study was initiated in 2017. Since then, 30 volunteers were enrolled who are either (1) terminally ill with a concomitant (...) condition and have a prognosis of 6 months or less or (2) chronically ill with multiple comorbidities and nearing the EOL.Multiple ethical and logistical challenges have been revealed during this time; here, we share our lessons learnt and ethical analysis. Issues relevant to healthcare research include surrogate informed consent, personal and professional boundaries, challenges posed conducting research in a pandemic, and clinician burnout and emotional support. Issues more specific to EOL and postmortem research include dual roles of clinical care and research teams, communication between research personnel and clinical teams, legally required versus rapid research autopsy, identification of next of kin/loved ones and issues of inclusion. Issues specific to the Last Gift include logistics of body donation and rapid research autopsy, and disposition of the body as a study benefit.We recommend EOL research teams to have clear provisions around surrogate informed consent, rotate personnel to maintain boundaries, limit direct contact with staff associated with clinical care and have a clear plan for legally required versus research autopsies, among other recommendations. (shrink)

Inquiry is an aim-directed activity, and as such governed by instrumental normativity. If you have reason to figure out a question, you have reason to take means to figuring it out. Beliefs are governed by epistemic normativity. On a certain pervasive understanding, this means that you are permitted – maybe required – to believe what you have sufficient evidence for. The norms of inquiry and epistemic norms both govern us as agents in pursuit of knowledge and understanding, and, on the (...) surface, they do so in harmony. Recently, however, Jane Friedman (2020) has pointed out that they are in tension with each other. In this paper, I aim to resolve this tension by showing that reasons for acts of inquiry – zetetic reasons – and epistemic reasons for belief can both be understood as flowing from the same general normative principle: the transmission principle for instrumental reasons. The resulting account is a version of epistemic instrumentalism that offers an attractive unity between zetetic and epistemic normativity. (shrink)

For at least three decades, philosophers have argued that general causation and causal explanation are contrastive in nature. When we seek a causal explanation of some particular event, we are usually interested in knowing why that event happened rather than some other specified event. And general causal claims, which state that certain event types cause certain other event types, seem to make sense only if appropriate contrasts to the types of events acting as cause and effect are specified. In recent (...) years, philosophers have extended the contrastive theory of causation to encompass singular causation as well. In this article, I argue that this extension of the theory was a mistake. Although general causation and causal explanation may well be contrastive in nature, singular causation is not. (shrink)

The theory of belief, according to which believing that p essentially involves having as an aim or purpose to believe that p truly, has recently been criticised on the grounds that the putative aim of belief does not interact with the wider aims of believers in the ways we should expect of genuine aims. I argue that this objection to the aim theory fails. When we consider a wider range of deliberative contexts concerning beliefs, it becomes obvious that the aim (...) of belief can interact with and be weighed against the wider aims of agents in the ways required for it to be a genuine aim. (shrink)

Does transparency in doxastic deliberation entail a constitutive norm of correctness governing belief, as Shah and Velleman argue? No, because this presupposes an implausibly strong relation between normative judgements and motivation from such judgements, ignores our interest in truth, and cannot explain why we pay different attention to how much justification we have for our beliefs in different contexts. An alternative account of transparency is available: transparency can be explained by the aim one necessarily adopts in deliberating about whether to (...) believe that p. To show this, I reconsider the role of the concept of belief in doxastic deliberation, and I defuse 'the teleologian's dilemma'. (shrink)

A popular account of epistemic justification holds that justification, in essence, aims at truth. An influential objection against this account points out that it is committed to holding that only true beliefs could be justified, which most epistemologists regard as sufficient reason to reject the account. In this paper I defend the view that epistemic justification aims at truth, not by denying that it is committed to epistemic justification being factive, but by showing that, when we focus on the relevant (...) sense of ‘justification’, it isn’t in fact possible for a belief to be at once justified and false. To this end, I consider and reject three popular intuitions speaking in favor of the possibility of justified false beliefs, and show that a factive account of epistemic justification is less detrimental to our normal belief forming practices than often supposed. (shrink)