Apresentam-se os resultados clínicos principais de uma primeira investigação efectuada a familiares de doentes sob tratamento paliativo no domicílio da área de Lisboa, com o instrumento de medida da satisfação SERVQUAL Modificado. Dos 58 familiares/doentes que responderam ao questionário apenas uma minona estava insatisfeita (uma classe de 5 indivíduos mostra-se francamente insatisfeita), uma classe de 15 estava moderadamente satisfeita, havendo 38 individuos fortemente satisfeitos com a qualidade e prontidäo dos serviços prestados. Porém urna percentagem elevada de doentes, segundo a opinião (...) retrospectiva dos cuidadores, faleceu com sintomatologia agravada, nomeadamente dores (60%), obstipação (67%) e depressão/ansiedade (43%). Discute-se a consistência e validade do questionáno SERVQUAL Modificado, contextualizam-se os resultados no que é o standard da prática da MCP e integram-se na promoção da dignidade humana no fim da vida. We present the main clinical findings of research on palliative home care, carried out among relatives of patients in the Lisbon area. An adapted version of SERVQUAL was used. Of a total of 58 carers surveyed only a small number (5) was unsatisfied 15 were only moderately satisfied. 38 family carers were strongly satisfied with the services. Yet, a high percentage of patients, as viewed in retrospect by their relatives died with some aggravated symptoms: 60% with more pain, 67% constipation, and 43% anxiety/depression. We discuss the consistency and validity of this adapted SERVQUAL tool and the main results are contextualized beanng in mind the standard practice of palliative medicine and the pursuit of human dignity in death. (shrink)

Apresentamos um resumo do desenvolvimento e do contexto institucional do Projecto Humanização dos Cuidados Paliativos em Contexto Domiciliário, aprovado e financiado pela Fundação Calouste Gulbenkian. Utilizam-se largamente os próprios documentos que o justificaram e os relatórios oficiais para dar uma imagem vivida, realista e técnica das dificuldades da profissionalização e reforma dos Cuidados Paliativos, mesmo quando integrada em acções de formação num serviço de um Centro de Tratamento Compreensivo do Cancro. We put forward a synopsis of the development and institutional (...) context of the Project Humanização dos Cuidados Paliativos em Contexto Domiciliário, approved and financed by the Calouste Gulbenkian Foundation. The groundwork documents are widely used as well as official reports so as to convey a lively, realistic and technical image arising from professionalizing and reforming Palliative Medicine even when it is based on in-service training programmes in an Comprehensive Cancer Center. (shrink)

Une géodésie spatio-temporelle pervertie résulte des notions de règles et d’horloges variables, qui sont prises pour avoir leur longueur et leur rythme affectés par le champ gravitationnel. D’autre part ce que nous pourrions appeler une géodésie concrète repose sur les notions de règles et d’horloges invariables de mesure d’unité. En fait, il s’agit d’une hypothèse de base de la relativité générale. Les règles et les horloges variables conduisent à une géodésie pervertie dans le sens où un espace-temps courbe pourrait être (...) vu comme provenant du départ de l’espace-temps Minkowskien comme un effet du champ gravitationnel sur le rythme d’horloges et la longueur des règles. Dans le cas d’une géodésie concrète, nous avons « directement » un espace-temps courbe dont la courbure peut être déterminée en utilisant des règles et des horloges de mesure d’unité (invariables). Dans cet article, nous défendrons la plausibilité que le point de vue d’Einstein sur la géométrie par rapport à la relativité générale est imprégné par une géodésie pervertie. (shrink)

Cet article est une étude sur la lysis, la « libération » dionysiaque. On commence avec la suggestion que dans la description de la mania telestike dans le Phèdre 244d-245a, le meilleur candidat parmi les pratiques cultuelles dionysiaques à l’opération de soustraction résultante de la rhétorique socratique c’est la transe ménadique. Les références ménadiques accompagnent également les témoins sur Dionysos Lysios à Corinthe, Sicyone et Thèbes, mais ici les sources nous invitent à élargir l’horizon des pratiques cultuelles dionysiaques pour regarder (...) les cultes à mystère en l’honneur du dieu, notamment aux renseignements des lamelles d’or trouvées dans des sépultures des initiés. Puis, on entreprend de proposer une lecture exclusivement dionysiaque de la lamelle de Pélinna. Cette lecture prend appui sur: une analyse du texte de la lamelle ; une critique des interprétations qui mettent la lysis en rapport avec l’expiation du crime des Titans ; un examen du rôle de Perséphone ; la signification de lysis dans l’OF 350 Bernabé ; l’articulation des célèbres passages de la République où il est question des initiations avec les dynamiques de la punition différée dans les représentations grecques anciennes de la justice divine. Puis, l’article suggère que la lysis dionysiaque porte sur une délivrance non seulement après la mort, mais aussi pendant la vie des initiés. En conclusion, l’étude revient au Phèdre 245a pour mettre en contraste les transes ménadique et mystique. (shrink)

En la gran producció filosòfica d’Eusebi Colomer, s’hi poden distingir tres grans centres d’interès particularment destacats. En primer lloc, la seva dedicació a l’estudi del pensament de Ramon Llull i de Nicolau de Cusa. La seva tesi doctoral va mostrar les influències lul·lianes en l’obra de Nicolau de Cusa a partir de les anotacions autògrafes en què el jove Nicolau es feia ressò de les coses que més li interessaven de Llull. El segon gran centre d’interès el (...) van constituir, naturalment, els grans corrents de la filosofia alemanya moderna i contemporània. Des dels anys d’estudiant s’havia familiaritzat particularment amb l’idealisme, la fenomenologia i la filosofia de l’existència. Finalment, el seu tercer centre d’interès va ser el diàleg filosòfico-teològic. Colomer lamentava profundament el divorci produït entre la filosofia i la teologia. Adaptant una coneguda formulació de Kant, pensava que la teologia sense filosofia és cega, però que la filosofia sense teologia és buida. Format en la tradició metafísica espiritualista i defensor de l’humanisme cristià, Colomer es trobava, però, a les antípodes de qualsevol sectarisme o dogmatisme. La seva formació, el seu tarannà i, segurament, els seus enormes coneixements de la història de la filosofia, li havien conferit una gran capacitat per al diàleg. Ell no veia el diàleg com un recurs o com una tàctica, sinó com un element constitutiu de l’ésser humà. \n. (shrink)

Trata-se aqui da resenha do livro _Pieter Bruegel: le tableau ou la sphère infinie – pour une reforme théologico-politique de l’entendement_, de Laurent Bove, publicado em 2019. O livro explorando, de um ponto de vista espinosista, o tema da “segunda natureza”, o qual, anunciado _en passant_ em _La stratégie du conatus: affirmation et résistance chez Spinoza_, de 1996, ganhou centralidade em suas monografias publicadas na última década: _Vauvenargues ou le séditieux_, de 2010, e_ Albert Camus, de la transfiguration_, de 2014. (...) A leitura de Bove busca reconstituir o significado da obra de Pieter Bruegel, o Velho (1525/1530-1569), pintor flamengo cujo legado pertence à Bélgica e aos Países Baixos, a partir de três eixos fundamentais: histórico, artístico e filosófico. A partir de uma problematização da imagem da "esfera infinita", tal como empregada na obra de Nicolau de Cusa, Bove confere um lugar para a pintura de Bruegel enquanto arte filosófica. (shrink)

ABSTRACT:Psychedelic substances have great promise for the treatment of many conditions, and they are the subject of intensive research. As with other medical treatments, both research and clinical use of psychedelics depend on our ability to ensure informed consent by patients and research participants. However, some have argued that informed consent for psychedelic use may be impossible, because psychedelic experiences can be transformative in the sense articulated by L. A. Paul (2014). For Paul, transformative experiences involve either the acquisition of (...) knowledge that cannot be obtained in any other way or changes in the self. Either of these characteristics may appear to undermine informed consent. This article argues, however, that there is limited evidence that psychedelic experiences are transformative in Paul's sense, and that they may not differ in their transformative features from other common medical experiences for which informed consent is clearly possible. Further, even if psychedelic experiences can be transformative, informed consent is still possible. Because psychedelic experiences are importantly different in several respects from other medical experiences, this article closes with recommendations for how these differences should be reflected in informed consent processes. (shrink)

In _Civilization and Its Discontents_, Freud made abundantly clear what he thought about the biblical injunction, first articulated in Leviticus 19:18 and then elaborated in Christian teachings, to love one's neighbor as oneself. "Let us adopt a naive attitude towards it," he proposed, "as though we were hearing it for the first time; we shall be unable then to suppress a feeling of surprise and bewilderment." After the horrors of World War II, the Holocaust, Stalinism, and Yugoslavia, Leviticus 19:18 seems (...) even less conceivable—but all the more urgent now—than Freud imagined. In _The Neighbor_, three of the most significant intellectuals working in psychoanalysis and critical theory collaborate to show how this problem of neighbor-love opens questions that are fundamental to ethical inquiry and that suggest a new theological configuration of political theory. Their three extended essays explore today's central historical problem: the persistence of the theological in the political. In "Towards a Political Theology of the Neighbor," Kenneth Reinhard supplements Carl Schmitt's political theology of the enemy and friend with a political theology of the neighbor based in psychoanalysis. In "Miracles Happen," Eric L. Santner extends the book's exploration of neighbor-love through a bracing reassessment of Benjamin and Rosenzweig. And in an impassioned plea for ethical violence, Slavoj Žižek's "Neighbors and Other Monsters" reconsiders the idea of excess to rehabilitate a positive sense of the inhuman and challenge the influence of Levinas on contemporary ethical thought. A rich and suggestive account of the interplay between love and hate, self and other, personal and political, _The Neighbor_ will prove to be a touchstone across the humanities and a crucial text for understanding the persistence of political theology in secular modernity. (shrink)

Background Inadequate knowledge among health care providers (HCPs) and parents of affected children limits the understanding and utility of secondary genetic findings (SFs) in under-represented populations in genomics research. SFs arise from deep DNA sequencing done for research or diagnostic purposes and may burden patients and their families despite their potential health importance. This study aims to evaluate the perspective of both groups regarding SFs and their choices in the return of results from genetic testing in the context of orofacial (...) clefts.Methods Using an online survey, we evaluated the experiences of 252 HCPs and 197 parents across participating cleft clinics in Ghana and Nigeria toward the return of SFs across several domains.Results Only 1.6% of the HCPs felt they had an expert understanding of when and how to incorporate genomic medicine into practice, while 50.0% agreed that all SFs should be returned to patients. About 95.4% of parents were willing to receive all the information from genetic testing (including SFs), while the majority cited physicians as their primary information source (64%).Conclusions Overall, parents and providers were aware that genetic testing could help in the clinical management of diseases. However, they cited a lack of knowledge about genomic medicine, uncertain clinical utility, and lack of available learning resources as barriers. The knowledge gained from this study will assist with developing guidelines and policies to guide providers on the return of SFs in sub-Saharan Africa and across the continent. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Beyond Ratzinger's Republic:Communio's Postliberal TurnSam Zeno Conedera S.J. and Vincent L. Strand S.J.Is the political future of the West a postliberal one? For the past decade, numerous prominent thinkers in America and Europe have been debating this question. Matters that not long ago were merely of historical interest, such as Pope Gelasius I's understanding of the relation between sacral authority and royal power, Thomas Aquinas's thought on monarchy and (...) Robert Bellarmine's theory of the pope's indirect authority in temporal matters are now increasingly studied for their potential answers to contemporary political questions. This development, which would have been nearly unimaginable just a decade earlier, unsurprisingly has been led by Catholics. We say "unsurprisingly" in view of the long pre-modern tradition of Catholic political thought, as well as the Church's long struggle against liberalism during the nineteenth and early twentieth centuries. Some of the current postliberal writers explicitly connect themselves to both of these aspects by using the term "integralist" to describe their position.1 [End Page 889]This "new integralism" represents a radical departure from the mainstream of Catholic political discourse of the last half century, which has largely sought rapprochement with Western liberalism. A group of writers, led by John Courtney Murray, George Weigel, Michael Novak, and Robert George, have held that the American constitutional order is rooted in the natural law tradition, and therefore is basically friendly to Catholic political thought. The Church's role in American life, they say, is upholding the natural law as a public moral philosophy, while embracing the non-establishment clause of the First Amendment as a matter of principle, in accordance with the teachings of the Second Vatican Council. This "Whig Thomism," which for decades represented the predominant outlook of conservative American Catholics, must now face the challenge of a different sort of Thomism represented by the integralists.2While the engagement between Whig Thomists and integralists has received most of the attention from scholars and journalists alike, another postliberal option has emerged in recent years. Its source is a group of Catholic thinkers associated with the Communio theological movement. Their political vision, which has no single name or label, has a complex and subtle relationship with the thought of earlier Communio writers, most of whom shared the Whig Thomist desire for reconciliation with Western liberalism. [End Page 890] The appearance of a Communio postliberalism therefore represents a significant development within this intellectual tradition. The most important representative of the earlier Communio perspective on political questions is Joseph Ratzinger / Pope Benedict XVI, who has recently been lauded as the "most important Catholic thinker of the twentieth century" on matters at the intersection of theology and politics.3In an article titled "Ratzinger's Republic" that appeared in these pages in 2020, we identified a significant tension in his thought about the Church's contribution to political life.4 Exploring Ratzinger's writings on natural law, we demonstrated that two currents are present. In accord with his fundamental theological commitments about nature and grace and about faith and reason, Ratzinger often questioned the effectiveness of arguments from natural law. He claimed that, since reason is historically conditioned, and therefore in the current order marked by sin, reason needs grace and faith to function properly. Yet, on other occasions, Ratzinger strongly endorsed arguments from natural law, highlighting its role as the foundation of a just democratic political order. We traced this ambivalence about natural law back to a dilemma at the heart of Ratzinger's political thought. On the one hand, in accord with his thinking about the relations of nature and grace and faith and reason, Ratzinger argued that the state needs the Church to supply moral values that the state cannot furnish on its own. On the other hand, he believed it belongs to the very nature of the Church to be separate from the state, and he endorsed nonconfessional, religiously pluralistic states.5 In light of these two commitments, Ratzinger argued that the contribution Christians are to make to the state is to supply moral values that were discerned under the influence of grace and divine revelation but... (shrink)

Local food systems can have economic and social benefits by providing income for producers and improving community connections. Ongoing global climate change and the acute COVID-19 pandemic crisis have shown the importance of building equity and resilience in local food systems. We interviewed ten stakeholders from organizations and institutions in a U.S. midwestern city exploring views on past, current, and future conditions to address the following two objectives: 1) Assess how local food system equity and resilience were impacted by the (...) COVID-19 pandemic, and 2) Examine how policy and behavior changes could support greater equity and resilience within urban local food systems. We used the Community Capitals Framework to organize interviewees’ responses for qualitative analyses of equity and resilience. Four types of community capital were emphasized by stakeholders: cultural and social, natural, and political capital. Participants stated that the local food system in this city is small; more weaknesses in food access, land access, and governance were described than were strengths in both pre- and post-pandemic conditions. Stakeholder responses also reflected lack of equity and resilience in the local food system, which was most pronounced for cultural and social, natural and political capitals. However, local producers’ resilience during the pandemic, which we categorized as human capital, was a notable strength. An improved future food system could incorporate changes in infrastructure (e.g., food processing), markets (e.g., values-based markets) and cultural values (e.g., valuing local food through connections between local producers and consumers). These insights could inform policy and enhance community initiatives and behavior changes to build more equitable and resilient local food systems in urban areas throughout the U.S. Midwest. (shrink)

Virtue signaling serves to express moral and ethical values publicly, showcasing commitment to social and sustainable ideals. This research, conducted with non-WEIRD samples to mitigate the prevalent WEIRD bias (i.e., the tendency to solely rely on samples from Western, educated, industrialized, rich, and democratic societies), examines whether the scarcely studied virtue-signaling construct mediates the influence of consumers’ attachment anxiety (vs. avoidance) on their green purchase behavior and prosocial responses. Drawing on attachment theory and the emerging virtue-signaling literature, the current work (...) reports the results from three studies (_N_ total = 898) in which consumers’ attachment patterns were not only measured, as in most prior related research, but also manipulated. Study 1 confirmed the unique ability of measured attachment anxiety, but not attachment avoidance, to predict consumers’ green purchase behavior and prosocial tendencies, with virtue signaling mediating these links. Study 2 manipulated participants’ attachment patterns, finding further support for the mediating role of virtue signaling between attachment anxiety (vs. avoidance) and these dependent variables. Study 3 provided a more nuanced account for our virtue-signaling conceptualization by documenting that self-oriented, but not other-oriented, virtue signaling mediated the link between attachment anxiety and both our key outcomes in public contexts. From a managerial viewpoint, these findings indicate that anxiously attached consumers constitute a potentially lucrative segment for companies seeking to expand their market share of sustainable and ethically produced products. (shrink)

This study examines the outcomes of a four-year faculty learning community (FLC) that aimed to transform departmental ethics curriculum by supporting Earth Sciences faculty members as they ethically inquired into their teaching of ethics and refined existing courses in alignment with an Integrated Community-Engaged Learning and Ethical Reflection (ICELER) framework. We present ethnographic case studies that unpack processes through which three faculty members transformed undergraduate courses. We assembled case studies by triangulating interview data, course artifacts, and faculty reflections. We examine (...) how faculty (1) built awareness around teaching ethics, (2) took responsibility for and made judgments about teaching ethics, (3) experimented by designing and implementing ICELER-inspired courses, and (4) interrogated the outcomes of their ethics teaching, utilizing findings to enhance awareness and revise courses. The paper closes by introducing a model detailing how instructors inquire into ethics teaching and how model components might inspire future educational practice and research. (shrink)

https://revistes.uab.cat/enrahonar/article/view/v61-fidora.

On reviewing the literature regarding acceptance and trust in human-robot interaction (HRI), there are a number of open questions that needed to be addressed in order to establish effective collaborations between humans and robots in real-world applications. In particular, we identified four principal open areas that should be investigated to create guidelines for the successful deployment of robots in the wild. These areas are focused on: (1) the robot’s abilities and limitations; in particular when it makes errors with different severity (...) of consequences, (2) individual differences, (3) the dynamics of human-robot trust, and (4) the interaction between humans and robots over time. In this paper, we present two very similar studies, one with a virtual robot with human-like abilities, and one with a Care-O-bot 4 robot. In the first study, we create an immersive narrative using an interactive storyboard to collect responses of 154 participants. In the second study, 6 participants had repeated interactions over three weeks with a physical robot. We summarise and discuss the findings of our investigations of the effects of robots’ errors on people’s trust in robots for designing mechanisms that allow robots to recover from a breach of trust. In particular, we observed that robots’ errors had greater impact on people’s trust in the robot when the errors were made at the beginning of the interaction and had severe consequences. Our results also provided insights on how these errors vary according to the individuals’ personalities, expectations and previous experiences. (shrink)

J. L. Schellenberg has constructed major arguments for atheism based on divine hiddenness in two separate works. This paper reviews these arguments and highlights how they are grounded in reflections on perfect divine love. However, Schellenberg also defends what he calls the ‘subject mode’ of religious scepticism. I argue that if one accepts Schellenberg's scepticism, then the foundation of his divine-hiddenness arguments is undermined by calling into question some of his conclusions regarding perfect divine love. In other words, if his (...) scepticism is correct, then Schellenberg's case for atheism cannot stand. Finally, I demonstrate how my argument avoids the many defences that Schellenberg has employed thus far in defending these particular atheistic arguments. (shrink)

Peace is a hallmark of human societies. However, certain ant species engage in long-term intergroup resource sharing, which is remarkably similar to peace among human groups. We discuss how individual and group payoff distributions are affected by kinship, dispersal, and age structure; the challenges of diagnosing peace; and the benefits of comparing convergent complex behaviours in disparate taxa.

Shows the relevance of Schiller’s thought for contemporary philosophy, particularly aesthetics, ethics, and politics. This book seeks to draw attention to Friedrich Schiller (1759–1805) as a philosophical thinker in his own right. For too long, his philosophical contribution has been neglected in favor of his much-deserved reputation as a political playwright. The essays in this collection make two arguments. First, Schiller presents a robust philosophical program that can be favorably compared to those of his age, including Rousseau, Kant, Schelling, and (...) Hegel, and he proves to be their equal in his thinking on morality, aesthetics, and politics. Second, Schiller can also guide us in our more contemporary philosophical concerns and approaches, such as phenomenology, hermeneutics, aesthetics, and politics. Here, Schiller instructs us in our engagement with figures such as Walter Benjamin, Michel Foucault, Jacques Rancière, Roberto Esposito, and others. María del Rosario Acosta López is Associate Professor of Philosophy at DePaul University. She has published several books, including La tragedia como conjuro: el problema de lo sublime en Friedrich Schiller. Jeffrey L. Powell is Professor of Philosophy at Marshall University and the editor of Heidegger and Language. (shrink)

Reporting peers’ counterproductive work behaviors (CWBs) is important for maintaining an ethical organization, but is a significant and potentially risky action. In Bandura’s Theory of Moral Thought and Action (Bandura, 1991) he states that such acts require significant moral agency, which is generated when an individual possesses adequate moral self-regulatory capacities to address the issue and is in a context that activates and reinforces those capacities. Guided by this theory, we assess moral potency (i.e., moral courage, moral efficacy, and moral (...) ownership) as key capacities predicting peer reporting intentions and assess three contextual factors influencing the generation and effects of moral potency: whether a potential informant (1) works for an ethical leader, (2) is embedded in a psychologically safe climate promoting interpersonal risk-taking, and (3) operates in a more normal or extreme context. We assess the proposed model across three field studies entailing both normal and extreme (i.e., firefighting units) contexts. Results show that ethical leaders raise employees’ moral potency, promoting greater willingness to report their peers’ CWBs. In normal work contexts, psychological safety positively moderated both the relationship between ethical leadership and moral potency and between moral potency and peer reporting intentions. However, psychological safety had the opposite effects in more extreme work contexts. Whereas psychological safety strengthens the positive association between moral potency and peer reporting intentions in normal work contexts, in contexts where individuals are more frequently exposed to extreme events, psychological safety weakens this relationship, thus highlighting the unforeseen downsides of psychological safety in extreme contexts. (shrink)

In this perspectives article, we maintain that the current local to global sustainable development predicaments we face are the result of humanity's impact on the Earth System (ES)—that is to say, on the very systemic fabric of the ES (i.e., its functioning and configuration), combined with an insufficiently coherent application of sustainable development policy to address and resolve this systemic problem. In response to what is an urgent crisis, we propose four foundational guiding principles, which we contend provide an overarching (...) framing that, if implemented, would offer an approach to steer global sustainable development policy in a manner that would be to the benefit of the ES and the securing of a flourishing future for all. Our principles are applicable at the levels from a local business ecosystem, national‐regional networks, to global policy. (shrink)

Zaman, düşünce tarihinde üzerinde çokça tartışılmış ve muhtelif tanımlamaları yapılmış bir kavramdır. Bu makale de zamanın tanımlamasından ziyade onun üzerinde özellikle an kavramı merkezli bir düşünce etkinliği ortaya konulmaya çalışılmıştır. Bilhassa zaman ve an kavramları arasındaki farka değinilmiştir. Zamanın hareketin olduğu yerde var olduğunu, anın ise hem hareketin hem de durağanlığın olduğu her yerde karşımıza çıktığını belirterek zamanın akışkan hayatı ölçülebilir kılma çabasında var oluşuyla, anın ise bu akışkanlığın her safhasında var olduğuna temas edilmiştir. Aynı zamanda anın varoluş ile mütemadiyen (...) yan yana olduğu, algılanışının ise bireylerin tecrübeleriyle zuhur ettiği görüşü ortaya konulmuştur. An’ın insan tecrübesiyle anlam kazanması ve insanın anı nasıl değerlendirmesi gerektiği hususunda konu, kanaatimizce Asr Suresi ve Hz. Peygamberin (s.a.v) buyruğu ile temellendirilmiştir. Bahsi geçen konu, çeşitli filozofların görüşleri ile de desteklenmiştir. Daha sonra makalemizde modern düşüncenin insanı anı kaliteli yaşamaktan ziyade daha iyi gelecek vaadiyle kaygı ve huzursuzluğa sevk ettiğini ifade ettik. Makalemizin sonunda ise İslam’ın bu modern düşüncenin aksine insana akışkanlık içerisinde yaşarken anın kendisine sunduğu akışkanlığın her bir aşamasını en güzel şekilde değerlendirmesini emrettiği ve onu değerli bir maden gibi tavında işlemesi gerektiği mesajıyla sonuçlandırdık. (shrink)

Background Machine learning (ML) is utilized increasingly in health care, and can pose harms to patients, clinicians, health systems, and the public. In response, regulators have proposed an approach that would shift more responsibility to ML developers for mitigating potential harms. To be effective, this approach requires ML developers to recognize, accept, and act on responsibility for mitigating harms. However, little is known regarding the perspectives of developers themselves regarding their obligations to mitigate harms.Methods We conducted 40 semi-structured interviews with (...) developers of ML predictive analytics applications for health care in the United States.Results Participants varied widely in their perspectives on personal responsibility and included examples of both moral engagement and disengagement, albeit in a variety of forms. While most (70%) of participants made a statement indicative of moral engagement, most of these statements reflected an awareness of moral issues, while only a subset of these included additional elements of engagement such as recognizing responsibility, alignment with personal values, addressing conflicts of interests, and opportunities for action. Further, we identified eight distinct categories of moral disengagement reflecting efforts to minimize potential harms or deflect personal responsibility for preventing or mitigating harms.Conclusions These findings suggest possible facilitators and barriers to the development of ethical ML that could act by encouraging moral engagement or discouraging moral disengagement. Regulatory approaches that depend on the ability of ML developers to recognize, accept, and act on responsibility for mitigating harms might have limited success without education and guidance for ML developers about the extent of their responsibilities and how to implement them. (shrink)

I offer an interpretation of Wittgenstein's claim that Russell's theory of judgment fails to show that it's not possible to judge nonsense.

Following from sweeping law reforms across the global health landscape, there is a need to prepare the next generation to advance global health law to ensure justice for a healthier world. Educational programs across disciplines have increasingly incorporated the field of global health law, with new courses examining the law and policy frameworks that apply to the new set of public health threats, non-state actors, and regulatory instruments that structure global health. Such interdisciplinary training must be expanded throughout the world (...) to prepare future practitioners to strengthen global health law — ensuring a foundation for global health in legal studies and law and global health studies. Meeting this imperative for global health law teaching — establishing academic courses and textbooks on global legal responses to shared health threats — will be necessary to support students to address the global health challenges of the future. (shrink)

A deluge of state “anti-equity” legislative bills seek to reverse prevailing trends in diversity, equity, and inclusion; withdraw protections of LGBTQ+ communities; and deny access to gender-based care for trans minors and adults. While the political and constitutional fate of these acts is undetermined, profound impacts on patients and their providers are already affecting the delivery of health care and public health services.

This paper challenges historically preconceived notions surrounding a minor’s ability to make medical decisions, arguing that federal health law should be reformed to allow minors with capacity as young as age 12 to consent to their own Centers for Diseases Control and Prevention (CDC)-approved COVID-19 vaccinations. This proposal aligns with and expands upon current exceptions to limitations on adolescent decision-making. This analysis reviews the historic and current anti-vaccination sentiment, examines legal precedence and rationale, outlines supporting ethical arguments regarding adolescent decision-making, (...) and offers rebuttals to anticipated ethical counterarguments. (shrink)

This publication features the stories and experiences of pharmacy professionals who identify as members of historically underrepresented groups. This collection of personal essays presents significant events in the lives of those in the pharmacy community whose experiences have been shaped by their race, ethnicity, gender or gender presentation, sexual orientation, ability, language, mental health, or other factors. The perspectives from the narratives highlight the importance of diversity, equity, and inclusion in the healthcare sector. The authors of the narratives also reflect (...) on their experience to consider what they wish would have happened in the experience, to offer advice for others that may be faced with similar situations. Access to these stories will deepen the collective understanding among pharmacy colleagues, patients, and society of the experiences that individuals from historically underrepresented groups within pharmacy have experienced. (shrink)

Features of threatening cues and the associated context influence the perceived imminence of threat and the defensive responses evoked. To provide additional knowledge about how the directionality of a threat (i.e. directed-towards or away from the viewer) might impact defensive responses in humans, participants were shown pictures of a man carrying a gun (threat) or nonlethal object (neutral) directed-away from or towards the participant. Cardiac and electrodermal responses were collected. Compared to neutral images, threatening images depicting a gun directed-towards the (...) participant induced sustained bradycardia and an increased electrodermal response, interpreted as immobility under attack. This defensive immobility reaction is evoked by high perceived threat and inescapable situations and indicates intense action preparation. Pictures of guns directed-away from the participant induced shorter bradycardia and no significant modulation of the electrodermal response compared to neutral pictures, which might be consistent with the perception of a less threatening situation. The results show that the directionality of threat stimuli is a key factor that prompts different patterns of defensive responses. (shrink)

Background Current requirements for ethical research in Canada, specifically the standard of active or signed parental consent, can leave Indigenous children and youth with inequitable access to research opportunities or health screening. Our objective was to examine the literature to identify culturally safe research consent processes that respect the rights of Indigenous children, the rights and responsibilities of parents or caregivers, and community protocols. Methods We followed PRISMA guidelines and Arksey and O’Malley’s approach for charting and synthesizing evidence. We searched (...) MEDLINE, PsycINFO, ERIC, CINAHL, Google Scholar, Web of Science, Informit Indigenous Collection, Bibliography of Native North Americans, and Sociological Abstracts. We included peer-reviewed primary and theoretical research articles written in English from January 1, 2000, to March 31, 2022, examining Indigenous approaches for obtaining informed consent from parents, families, children, or youth. Eligible records were uploaded to Covidence for title and abstract screening. We appraised the findings using a Two-Eyed Seeing approach. These findings were inductively coded using NVivo 12 and analyzed thematically. Results We identified 2,984 records and 11 eligible studies were included after screening. Three key recommendations emerged: addressing tensions in the ethics of consent, embracing wise practices, and using relational approaches to consent. Tensions in consent concerned Research Ethics Board consent requirements that fall short of protecting Indigenous children and communities when culturally incongruent. Wise practices included allowing parents and children to consent together, land-based consenting, and involving communities in decision-making. Using relational approaches to consent embodied community engagement and relationship building while acknowledging consent for Indigenous children cannot be obtained in isolation from family and community. Conclusions Very few studies discussed obtaining child consent in Indigenous communities. While Indigenous communities are not a monolith, the literature identified a need for community-driven, decolonized consent processes prioritizing Indigenous values and protocols. Further research is needed to examine nuances of Indigenized consent processes and determine how to operationalize them, enabling culturally appropriate, equitable access to research and services for all Indigenous children. (shrink)

Mark McCreary has argued that I cannot consistently advance both the hiddenness argument and certain arguments for religious scepticism found in my book The Wisdom to Doubt . This reaction was expected, and in WD I explained its shortsightedness in that context. First, I noted how in Part III of WD , where theism is addressed, my principal aim is not to prove atheism but to show theists that they are not immune from the scepticism defended in Parts I and (...) II. To the success of this aim, McCreary's arguments are not so much as relevant, for a thoroughgoing scepticism embracing even the hiddenness argument is quite compatible with its success. But I also explained how someone convinced that the hiddenness argument does prove atheism escapes the grip of religious scepticism because of that argument's reliance on apparent conceptual truths. McCreary's critique obscures this point but does not defuse it. (shrink)

Both practitioners and scholars are increasingly interested in the idea of the human-centered organization. This term first appeared in the late 1950s and has gained attention in the last ten years. Awareness of the need for human-centeredness grew during the COVID-19 pandemic, in which many organizational leaders were compelled to focus on employee health, safety, and well-being. In this paper, we review and synthesize the rather fragmented scholarly and practitioner literature on human-centered organization (HCO) to develop an integrated definition and (...) framework. The 26 sources reviewed in depth indicate that the HCO construct is primarily utilized in two ways. First, human-centered design scholars and practitioners conceive of HCOs as employing human-centered design practices. The second discourse involves the humanistic management and culture literature, which conceives of HCOs as embodying humanistic values and cultures. After reviewing these separate discourses, we synthesize them in an integrated definition as well as framework of HCO. The framework starts from humanistic values such as dignity, well-being, and justice, which are pivotal in creating organizational practices characterized by a common good purpose, positive human experiences on the job, team structures to coordinate work, and participatory tools and approaches. (shrink)

In transplant medicine, the use of normothermic regional perfusion (NRP) in donation after circulatory determination of death raises ethical difficulties. NRP is objectionable because it restores the donor's circulation, thus invalidating a death declaration based on the permanent cessation of circulation. NRP's defenders respond with arguments that are tortuous and factually inaccurate and depend on introducing extraneous concepts into the law. However, results comparable to NRP's—more and higher‐quality organs and more efficient allocation—can be achieved by removing organs from deceased donors (...) and using normothermic machine perfusion (NMP) to support the organs outside the body, without jeopardizing confidence in transplantation's legal and ethical foundations. Given the controversy that NRP generates and the convoluted justifications made for it, we recommend a prudential approach we call “ethical parsimony,” which holds that, in the choice between competing means of achieving a result, the ethically simpler one is to be preferred. This approach makes clear that policy‐makers should favor NMP over NRP. (shrink)