Name der Zeitschrift: SATS Jahrgang: 18 Heft: 1 Seiten: 55-77.

The aim of this paper is to show that there is a reciprocal dependency relationship between social cognition and social ontology. It is argued that, on the one hand, the existence conditions of socially meaningful objects and of social groups are about subjects’ social cognitive processes and interactive patterns and, on the other hand, social cognitive processes and interactive patterns are modulated by socially meaningful objects and social groups. I proceed from a historically informed distinction between social ontologies – between (...) what might be called constructivist and emergentist theories of social reality. I then distinguish three theories of social cognition, theory-theory, simulation theory, and interaction theory, and argue that the first distinction and the latter map onto each other. Finally I argue that the reciprocal dependency between social ontology and social cognition can be justifiably though of as causal in Di Paolo et. al.’s sense of “downward” or “circular” causation. It is concluded that the dependency between social ontology and social cognition pertain to both a methodological and a phenomenal level. First, research on social ontology depends on research on social cognition; and, secondly, social phenomena, involving socially meaningful objects and groups, influence social cognitive processes and interaction, which in turn influence social phenomena. (shrink)

In this paper, I consider points of intersection between the Aristotelian and the Galenic notions of ‘ power of the seed’ and some of the key issues and key concepts developed within the power -structuralism paradigm and try to understand whether, and to what extent, the conceptual lens provided by the power -structuralism hypothesis may help us to shed fresh light on aspects of both the Aristotelian and the Galenic theory of the seed, which are still unclear or highly controversial, (...) like the role played by the female in the generative process; to better understand how much the Aristotelian and the Galenic theories of the seed have in common and, on the other hand, to what extent and in what regard they differ when it comes to considering the metaphysics of powers, which both theories are grounded upon. Specifically, I explore how far Marmodoro's theory of ‘ power -structuralism ontology’ can help us to make better sense of this metaphysics. I suggest that this theory helps us to recognize, below the s. (shrink)

This volume is a detailed study of the concept of the nutritive capacity of the soul and its actual manifestation in living bodies in Aristotle and Aristotelianism. Aristotle’s innovative analysis of the nutritive faculty has laid the intellectual foundation for the increasing appreciation of nutrition as a prerequisite for the maintenance of life and health that can be observed in the history of Greek thought. According to Aristotle, apart from nutrition, the nutritive part of the soul is also responsible for (...) or interacts with many other bodily functions or mechanisms, such as digestion, growth, reproduction, sleep, and the innate heat. After Aristotle, these concepts were used and further developed by a great number of Peripatetic philosophers, commentators on Aristotle and Arabic thinkers until early modern times. This volume is the first of its kind to provide an in-depth survey of the development of this rather philosophical concept from Aristotle to early modern thinkers. It is of key interest to scholars working on classical, medieval and early modern psycho-physiological accounts of living things, historians and philosophers of science, biologists with interests in the history of science, and, generally, students of the history of philosophy and science. (shrink)

The spread and publicity given to questionable practices in the corporate world during the last two decades has fostered an increasing interest about the importance of ethical work for organizations, practitioners, scholars and, last but not least, the wider public. Relying on the Social Identity Approach, we suggest that the effects of different ethical climates on employee behaviors are driven by affective identification with the organization and, in parallel, by cognitive moral (dis)engagement. We compared the effects of two particular ethical (...) climates derived from the literature: An ethical organizational climate of self-interest, and an ethical organizational climate of friendship. Three hundred seventy-six workers completed measures of Ethical Climate, Organizational Identification, Moral Disengagement, Organizational Citizenship Behaviors, and Counterproductive Work Behaviors. Structural equation modelling confirmed that the two ethical climates considered were independently related to organizational identification and moral disengagement. These, in turn, mediated the effects of ethical climates on Organizational Citizenship Behaviors and Counterproductive Work Behaviors. We discuss results in light of the social identity approach, and present some practical implications of our findings. (shrink)

This is a contribution to the controversy which of individual or collective intentionality is more fundamental. I call it the fundamentality-question. In a first step, I argue that it is really two questions. One is about sense and one about reference. The first is: Can one grasp or understand the concept individual intentionality and, correspondingly, individuality, on the one hand, without grasping or understanding the concept collective intentionality and, correspondingly, collectivity, on the other? The second is: Can the concept individual (...) intentionality and corresponding concept of individuality, on the one hand, refer to something without the concept of collective intentionality and corresponding concept of collectivity referring to something, on the other? Simplifying somewhat, this elaborated fundamentality-question admits of nine answers. In a second step, I pursue a tentative answer to the elaborated fundamentality-question. Given a disambiguation of individuality and, correspondingly, individual intentionality, the answer is the combination of claims that individuality and individual intentionality in one sense is fundamental in reference-dependence but that collectivity and collective intentionality is fundamental in reference-dependence in the other sense of individuality, while collectivity and collective intentionality is in both cases fundamental in sense-dependence. (shrink)

The prepositional ‘in’ and possessive pronouns, e.g., ‘my’ and ‘mine,’ in the context of attributions of mental states, such as “in my mind” or “in your mind,” threaten to confuse attempts to account for knowledge of other minds. This paper distinguishes proper from improper uses of such expressions. I will argue that proper use of the prepositional ‘in’ and possessive pronouns in the context of mental state attributions presupposes capacities to properly track and attribute what are really, in a sense (...) to be specified, intersubjectively articulated and inferentially interrelated normative statuses. What we call “mental states” or “minds,” in as far as primarily cognitive states such as beliefs are concerned, are intersubjectively constituted. As opposed to being inner and private, something we must learn to intersubjectively discover, minds and mental states are intersubjectively articulated and we learn to attribute them as inner and private. A scorekeeping-model is used to illustrate how the privacy of mind presupposes intersubjectivity. Using that model, I argue that the traditional problem of knowing other minds can be re-framed as a problem of learning how to pursue intersubjective practices of acknowledging, attributing and undertaking mental states. (shrink)

In this paper I explore how early modern Italian Aristotelians understood Aristotle’s De memoria by focusing on three key-points of Aristotle’s theory of memory and recollection: the localization of memory in the perceptual part of the soul; the characterisation of phantasia and its association with the notions of koinē aisthēsis and prōton aisthētikon; the definition of recollection as “a kind of syllogism” and its account as an activity that implies the faculty of deliberating and is therefore restricted to humans. My (...) aim is to show the interactions as well as the tensions between natural philosophical and medical theories in reading and interpreting Aristotle’s Parva naturalia in the Italian milieu. (shrink)

Mental episodes are typically associated with subjective ownership and first-person authority. My belief that an apple is red is had by me; it is mine and I’m in a privileged position to know it. Your experience of red is had by you; it is yours and you are in a privileged position to know it. The two assumptions are that mental events are had by individuals to whom they occur, and that owners are in a privileged epistemic position to fallibly (...) report their own. This paper asks how to understand ownership and first-person authority. It argues that the two assumptions should not be accepted by default. A normative pragmatism is specified, on which mental episodes are not owned, but owed to practices of reason articulation. Finally, a positive account of ownership and first-person authority is considered. (shrink)

A 120 anni dalla sua nascita, la filosofia politica di Popper continua a stimolare sia gli studiosi che per primi ne divulgarono le opere sia coloro che s'interrogano sull’attualità del suo insegnamento. Il mondo nel quale Popper ha concepito le sue opere era segnato dallo scontro ideologico, quello di oggi è attraversato da conflitti di natura diversa, riconducibili alle tensioni nelle società multiculturali. Se scegliere i valori della società aperta pare un obiettivo inderogabile, rimangono aperte le sfide della sua traduzione (...) in una realtà sociale complessa. Sfide che Armando editore è, ancora una volta, in linea con la sua storia, pronto a raccogliere e tradurre in studi e ricerche. (shrink)

Forms of collective leadership, such as Distributed Leadership, have become increasingly important. The need for measurement of the variables involved in the delegation processes, represents a new challenge for organizations that want to ensure high-level working. The present research aimed to validate the Italian version of the Distributed Leadership Agency (DLA) and verify its applicability in different contexts. The study involved all the employees of an Italian public Hospital, which were selected to complete a survey on organizational perceptions. The sample (...) comprised 704 employees (doctors, nurses, clerks, staff workers, healthcare assistants, consultants, management). Multiple Confirmatory Factor Analyses (Maximum Likelihood) have been computed to explore the factorial structure of the DLA, along with associations with other work outcomes. Results clarified that the Italian DLA respects the tri-factorial structure of the construct, suggested by Yukl (2002), with good fit indexes and reliability; moreover, in line with the literature, DLA was strongly related to satisfaction, commitment, and trust. Results contribute to underline the robustness of the construct of distributed leadership agency in different cultural sectors, and provide a useful tool to be adopted in the Italian context. (shrink)

In this paper, we discuss Armstrong’s account of attachment-based claims to natural resources, the kind of rights that follow from attachment-based claims, and the limits we should impose on such claims. We hope to clarify how and why attachment matters in the discourse on resource rights by presenting three challenges to Armstrong’s theory. First, we question the normative basis for certain attachment claims, by trying to distinguish more clearly between different kinds of attachment and other kinds of claims. Second, we (...) highlight the need to supplement Armstrong’s account with a theory of how to weigh different attachment claims so as to establish the normative standing that different kinds of attachment claims should have. Third, we propose that sustainability must be a necessary requirement for making attachment claims to natural resources legitimate. Based on these three challenges and the solutions we propose, we argue that attachment claims are on the one hand narrower than Armstrong suggests, while on the other hand they can justify more far-reaching rights to control than Armstrong initially considers, because of the particular weight that certain attachment claims have. (shrink)

This research aims to examine access to medical treatment during the COVID-19 pandemic for people living with disabilities. During the COVID-19 pandemic, the practical and ethical problems of allocating limited medical resources such as intensive care unit beds and ventilators became critical. Although different countries have proposed different guidelines to manage this emergency, these proposed criteria do not sufficiently consider people living with disabilities. People living with disabilities are therefore at a higher risk of exclusion from medical treatments as physicians (...) tend to assume they have poor quality of life, whereas access to medical treatment should be based on several parameters, including clinical data and prognosis. However, the COVID-19 pandemic shifts the medical paradigm from person-centred medicine to community-centred medicine, challenging the main ethical theories. We reviewed the main guidelines and recommendations for resources allocation and examined their position toward persons with disabilities. Based on our findings, we propose criteria for not discriminating against people with disabilities in allocating resources. The shift from person-centred to community-centred medicine offers opportunities but also risks sacrificing the most vulnerable people. The principle of reasonable accommodation must always be considered to guarantee the rights of persons with disabilities. (shrink)

Organizational identification has increasingly attracted scholarly attention as a key factor in understanding organizational processes and in fostering efficient human resource management. Available evidence shows that organizational ethical climate crucially predicts OI, a key determinant of both employees’ attitudes and behaviors. In the present paper, we examined the relationship between two specific ethical climates, distributed leadership, and employees’ attitudes and behaviors, incorporating OI as a core underlying mechanism driving these relationships. Three hundred and forty-two employees filled out questionnaires to examine (...) ethical climate, DL, OI, and a series of measures concerning attitudes and behaviors toward the organization. Structural equation modeling confirmed that a perception of an ethical climate of friendship fostered OI, which elicited higher commitment, perceived trust and recommendation, and lower turnover intention. Perception of DL further contributed to increasing OI. Our findings suggest that HR practices should carefully consider employee perceptions of a collectivistic ethical climate, together with perceptions of DL, as key determinants of positive organizational outcomes. We discuss results in light of the social identity approach and present practical implications for HR management. (shrink)

¿Por qué democracia? Referencia a los derechos humanos y a la ciudadanía. Why democracy? Reference to human rights and citizenship. Bozo de Carmona, Ana Julia Libertad de expresión y "libertad cómica". Free speech and "comical liberty".Calvo González, José La justicia según J. Finnis. Justice according to John Finnis. Hocevar G., Mayda G. El lenguaje sagrado y su escritura. The sacred language and its writing. Lizaola, Julieta Del carácter coactivo de la μετηνεστασζ en Tucídides. On cornening to compelling nature of Thucydides' (...) μετηνεστασζ. Meabe, Joaquín E. Apuntes para una filosofía crítica de la historia regional. Notes for a critical philosophy concern to the regional history. Mora García, José Pascual Competencia política partidista en los textos de Simón Bolívar . The defender political competition in the Simon Bolivar’s writings . Ortiz Palanques, Marco Fundamentación socio-jurídica de los procesos normativos. Social and juridical reasoning about the normatives changes. Pavó Acosta, Rolando Filosofía y psicopatología en Karl Jaspers: los entramados de la existencia. Philosophy and psychopathology in Karl Jaspers: the studworks of the existence. Portuondo Pajón, Gladys L. La doctrina platónica del alma en la «república». The platonic doctrine of the soul in the «republic» dialogue. Suzzarini, Andrés Una aproximación a la concepción romana del derecho. An estimate study to the roman concept of law. Terán Pimentel, Milagros Interdisciplinares Lo dionisíaco y lo apolíneo en Don Juan Tenorio. The dionysiac and the apolline in Don Juan Tenorio. Pérez Lo Presti, Alirio. (shrink)

The implementation of online technologies to promote wellbeing is increasingly becoming a worldwide priority. This study includes secondary analyses of data and examined drop-out rates in an online guided self-help intervention for patients with anorexia nervosa. Specifically, rates of drop-out at end of treatment (i.e. six-week assessment), as well as intervention adherence (minimum of four of six online guided sessions) and differences between completers and drop-outs were examined. Motivation to change and associated patient variables were assessed as predictors of drop-out (...) using structural equation modelling. Ninety-nine patients were randomised to the intervention arm of the trial. Data were available for 82 individuals, 67 of whom completed the six-week assessment and attended a minimum of four online sessions. No significant differences were found between completers and drop-outs at baseline. At the end of the first week of participation, drop-outs from the six-week assessment or the intervention reported less satisfaction with their work with the mentor delivering online guidance. Greater confidence in own ability to change and higher controlled motivation (willingness to change due to pressure from others) predicted lower drop-out rates from the six-week assessment. Stronger alliance with the therapist at the treatment centre and lower psychological distress were associated with greater autonomous motivation (self-directed motivation) and importance and ability to change. Data demonstrate that a novel online guided self-help intervention for patients with anorexia nervosa is feasible. Early satisfaction with the program and external pressure to change have a protective role against drop-out rates. (shrink)

The possibility of autonomous artificially intelligent systems has awaken a well-known worry in the scientific community as well as in popular imaginary: the possibility that beings which have gained autonomous intelligence either turn against their creators or at least make the moral and ethical superiority of creators with respect to the created questionable. The present paper argues that such worries are wrong-headed. Specifically, if AAIs raise a worry about what human ways of life it a worry for a certain human (...) way of thinking about what it is to be human. What is threatened is a way of thinking about what it is to be human, not human ways of life or human value. (shrink)

La fascinante vida intelectual y espiritual de Gastón Soublette Asmussen lo ha vuelto un renombrado filósofo en Chile, quien fue galardonado recientemente con el Premio Nacional de Humanidades y Ciencias Sociales año 2023. Hoy, con sus 97 años, este musicólogo, esteta y experto en filosofía oriental y teología cristiana es uno de los referentes más importantes en el acontecer intelectual chileno. En esta entrevista se exploraron las diversas facetas de su vida, desde el inicio de su actividad docente y académica, (...) hasta las motivaciones existenciales que lo llevaron a explorar los temas de su investigación –como la cultura tradicional indígena, el folclore, la música, la teología y las espiritualidades orientales–. Con más de una docena de libros publicados, Soublette ha dejado una profunda huella en centenares de alumnos y alumnas. En esta ocasión, Soublette compartió sus experiencias y aprendizajes a lo largo de los años, y destacó la importancia de la cultura tradicional indígena y su valor para la sociedad contemporánea. Nos explicó cómo estas culturas ancestrales pueden ofrecer una visión profunda y significativa de la existencia humana, alentando un mayor respeto por la naturaleza y una conexión más profunda con nuestra diversidad espiritual humana. El papel de la espiritualidad ocupó un lugar destacado en la conversación, y Soublette resaltó la importancia de preservar estas expresiones espirituales como una forma de mantener viva la identidad y la historia de un pueblo. Además, señaló cómo la búsqueda espiritual puede ser una herramienta poderosa para la transformación personal y el despertar de saberes, más allá del academicismo dominante. En cuanto a la filosofía oriental, Soublette compartió su profundo conocimiento sobre estas tradiciones. Habló sobre conceptos como el zen, el taoísmo y el budismo, y cómo pueden brindar una perspectiva única sobre la existencia humana y el propósito de la vida. En resumen, la entrevista con Gastón Soublette fue un viaje fascinante a través de su vida y su amplio conocimiento sobre filosofía oriental, cultura tradicional indígena, folclore, música, teología cristiana y espiritualidades orientales. Sus palabras ofrecieron una valiosa perspectiva sobre la importancia de estas disciplinas y cómo pueden enriquecer nuestras vidas, fomentando una conexión más profunda con nosotros mismos, los demás y el mundo que nos rodea. (shrink)

Este artículo reseña: Byung-Chul, HAN, Infocracia, la digitalización y la crisis de la democracia., Editorial Taurus, Santiago de Chile, 2022. 91 pp.

What do we do when we say ‘We’? This paper pursues a response from analytic pragmatism. The guiding idea of analytic pragmatism is to look to what one must implicitly know how do to be able to use expressions to say something, including how to make that implicit know-how explicit. Accordingly, the question we are tasked to answer is what one must know how to do to say ‘We’ – that is, what practical know-how saying ‘We’ requires and can be (...) employed to make explicit. The concept normative ascent is introduced in developing an answer. On this approach, the know-how in question turns out to be a distinctively normative capacity. Both being and saying ‘We’ turns out to involve being able to do and say something normative. (shrink)

The aim of this paper is to show that there is a reciprocal dependency relationship between social cognition and social ontology. It is argued that, on the one hand, the existence conditions of socially meaningful objects and of social groups are about subjects’ social cognitive processes and interactive patterns and, on the other hand, social cognitive processes and interactive patterns are modulated by socially meaningful objects and social groups. I proceed from a historically informed distinction between social ontologies – between (...) what might be called constructivist and emergentist theories of social reality. I then distinguish three theories of social cognition, theory-theory, simulation theory, and interaction theory, and argue that the first distinction and the latter map onto each other. Finally I argue that the reciprocal dependency between social ontology and social cognition can be justifiably though of as causal in Di Paolo et. al.’s (2010) sense of “downward” or “circular” causation. It is concluded that the dependency between social ontology and social cognition pertain to both a methodological and a phenomenal level. First, research on social ontology depends on research on social cognition; and, secondly, social phenomena, involving socially meaningful objects and groups, influence social cognitive processes and interaction, which in turn influence social phenomena. (shrink)

The paper argues that contexts of interaction are structured in a way that coordinates part actions into normatively guided joint action without agents having common knowledge or mutual beliefs about intentions, beliefs, or commitments to part actions. The argument shows earlier analyses of joint action to be fundamentally flawed because they have not taken contextual influences on joint action properly into account. Specific completion of earlier analyses is proposed. It is concluded that attention to features distributed in context of interaction (...) that signal expected part actions is sufficient for a set of part actions to qualify as a joint action. (shrink)

Different types of consent are used to obtain human biospecimens for future research. This variation has resulted in confusion regarding what research is permitted, inadvertent constraints on future research, and research proceeding without consent. The National Institutes of Health Clinical Center's Department of Bioethics held a workshop to consider the ethical acceptability of addressing these concerns by using broad consent for future research on stored biospecimens. Multiple bioethics scholars, who have written on these issues, discussed the reasons for consent, the (...) range of consent strategies, and gaps in our understanding, and concluded with a proposal for broad initial consent coupled with oversight and, when feasible, ongoing provision of information to donors. This article describes areas of agreement and areas that need more research and dialogue. Given recent proposed changes to the Common Rule, and new guidance regarding storing and sharing data and samples, this is an important and tim.. (shrink)

En el presente trabajo nos proponemos reflexionar acerca de las posibilidades, límites y desafíos que se presentan en la práctica docente cuando jóvenes de sectores subalternos emprenden la tarea de escribir sus propias historias. Estas reflexiones surgen a partir de una experiencia pedagógica desarrollada en el marco del Programa Pueblos Originarios y Escuelas Rurales de la UNCuyo. Consideramos que la fragmentación y la discontinuidad es un rasgo de la memoria colectiva de los sectores subalternos, sin embargo, en ocasiones encuentra espacios (...) para expresarse y tensionar la historia oficial. En esa dirección, en esta ocasión, decidimos convertir nuestros espacios curriculares en ámbitos de reflexión personal y colectiva donde los y las subalternos (parafraseando a la filósofa india Gayatri Spivak) “pudieron hablar”, para luego plasmar sus historias en fanzines. (shrink)

Un vínculo necesario entre estética y socialización explica la profundidad sensible que debe construir todo cambio de paradigma y toda re-socialización. La democracia no funciona sin una apropiación individual y colectiva del sentir y de la producción de sentir. Es a partir entonces del trabajo artístico y de la instrospección y exteriorización de la dimensión sensible, que toda transformación puede ser aplicada. Se recorren parcialmente los pensamientos de Alain Badiou y Bernard Stiegler. A required link between aesthetic and socialization explains (...) the sensitive depth that all paradigm and re-socialization must build. Democracy does not work without an individual and collective ownership of feeling and feeling's production. It is from the artwork and the introspection and externalization of the sensitive dimension, that any transformation can be applied. The article covers partially the thoughts of Alain Badiou and Bernard Stiegler. (shrink)

El propósito del trabajo es rescatar la importancia de los casos en el modelo de la ponderación alexyano, la cual, a mi entender, quedó opacada por su preocupación por el desarrollo de la ponderación como forma de argumento. Esto permitirá compararlo con la versión que desarrolla Moreso a través de los casos paradigmáticos y mostrar que ésta guarda con el modelo de Alexy más parecidos de fami- lia que diferencias. Se concluye que ni el modelo de Alexy está tan abocado (...) al particularismo como a veces se asume, ni el de Moreso es tan definicional como pretende. (shrink)

Este informe se enmarca en el proyecto que desde hace dos años venimos desarrollando dentro del Departamento de Investigación de la Universidad Siglo 21, en Córdoba, Argentina. Hemos abordado a través de metodología cualitativa las representaciones que los jóvenes ingresantes a la Universidad tienen acerca de la misma y del estudio universitario. En el presente reporte exponemos una serie de ejes que, de acuerdo a nuestro análisis de los discursos relevados, dan cuenta de valoraciones emergentes al momento de evaluar la (...) universidad pública en relación a la privada y viceversa. Nuestra intención es comprender y describir cuáles son las nociones entramadas en el análisis que los ingresantes realizan de una y otra institución, las cuales se ponen en juego al momento de optar y evaluar aquéllas. (shrink)

Centramos la atención en la noción de "función utópica" del pensamiento de Arturo Andrés Roig. El problema se aborda partiendo del vínculo que se establece entre la función utópica y la condición humana. Apelamos al análisis de algunos textos de Ernst Bloch para mostrar los argumentos que esgrime en relación con el tratamiento de la utopía. A partir de la consideración de la función utópica como un ejercicio crítico mostramos que esta función implica un modo de habitar el hombre en (...) el mundo. En otras palabras, trazamos un itinerario que lleva el propósito de esclarecer uno de los ejes que atraviesa la obra de Arturo Andrés Roig: la dimensión antropológica. We focus our attention on the concept "utopian function" of thought by Arturo Andrés Roig. This question starts with the link between "utopian function" and "human condition". We appeal to the analysis of some texts of Ernst Bloch in order to show the arguments he presents in relation to the treatment of utopia. From the consideration of utopian function as a critical exercise, we seek to show that this function involves a way of inhabiting the human being in the world. In other words, we draw up an itinerary which has the purpose of clarifying one axis that runs through the work of Arturo Andrés Roig: the anthropological dimension. (shrink)

RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)