Upon entering the examination room, Caitlyn encounters a woman sitting alone and in distress. Caitlyn introduces herself as the hospital ethicist and tells the woman, Mrs. Dennis, that her aim is to help her reach a decision about whether to perform an autopsy on her recently deceased husband. Mrs. Dennis begins the encounter by telling the ethicist that she has to decide quickly, but that she is very torn about what to do. Mrs. Dennis adds, “My sons disagree about the (...) autopsy.” As a standardized patient, a specialized actor, the woman playing Mrs. Dennis has already delivered the same opening lines several times to different learners practicing their clinical ethics consultation skills. An SP encounter is a simulated patient encounter used for educational purposes that requires the standardization of verbal and behavioral responses. In the encounter, the simulator, or “patient,” uses a scripted medical history to enable the learner to employ a certain skill, say, the ability to perform a neurological exam. The use of standardized patients in the evaluation of clinical skills has become a staple in medical education. To tackle the challenge of teaching clinical ethics consultation skills, we have incorporated SP encounters into the curriculum of the Bioethics Program of The Union Graduate College and the Icahn School of Medicine at Mount Sinai. SP encounters are incorporated into one of our onsite classes, the Onsite Clinical Ethics Practicum, and they are part of the capstone examination, which all of our graduates must complete successfully. The inclusion of simulated encounters into the curriculum is one way in which we equip our students with the core competencies specified by the American Society for Bioethics and Humanities Task Force for clinical ethicists. (shrink)

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

This study, the third in a series of three, draws on a broader Norwegian research project exploring the phenomenon of support for young persons with mental health issues. The aim was to explore and explicate the sense of “nourishing communion”, as a somewhat neglected aspect of support. Fourteen Norwegian young adults, aged 18-25, were interviewed about their experiences of support. Data was analyzed using van Manen’s hermeneutic-phenomenological approach to open up possible meanings of how nourishing communion is concretely lived. Analysis (...) was supplemented by in-depth reflexive dialogues between the first and second author, which fostered a nourishing communion akin to the processes and dimensions of our phenomenon of interest. Findings highlight five intertwined existential themes: a) trusting the other to hold vulnerability safely; b) flourishing in mutual participation; c) acceptance in a felt togetherness; d) feeling found and received; and e) feeling an attuned resonance. The notion of “nourishing communion” as a significant but neglected element of support challenges current practice, suggesting the need for a different approach to collaboration with young persons and their networks. From the perspectives both of individual professional engagement and of policy making, there is a need for further exploration of how young persons might be supported to create and maintain a broader range of nourishing relationships. (shrink)

Very little research has attempted to describe normal human variation in female genitalia, and no studies have compared the visual images that women might use in constructing their ideas of average and acceptable genital morphology to see if there are any systematic differences. The objective of the present work was to determine if visual depictions of the vulva differed according to their source so as to alert medical professionals and their patients to how these depictions might capture variation and thus (...) influence perceptions of ‘normality’. A comparative analysis was conducted by measuring (a) published visual materials from human anatomy textbooks in a university library, (b) feminist publications (print and online) depicting vulval morphology and (c) online pornography, focusing on the most visited and freely accessible sites in the UK. Post hoc tests showed that labial protuberance was significantly less (p<0.001, equivalent to approximately 7 mm) in images from online pornography compared to feminist publications. All five measures taken of vulval features were significantly correlated (p<0.001) in the online pornography sample, indicating a less varied range of differences in organ proportions than the other sources where not all measures were correlated. Women and health professionals should be aware that specific sources of imagery may depict different types of genital morphology and may not accurately reflect true variation in the population, and consultations for genital surgeries should include discussion about the actual and perceived range of variation in female genital morphology. (shrink)

" C'est Luther qui m'a accompagné dans mes recherches, écrit Heidegger en 1923, et mon modèle était Aristote. " Ce livre propose de lire Être et Temps, élaboré entre 1922 et 1926, à la lumière de ces deux sources fondamentales, en exhumant les strates du texte qui renvoient au laboratoire du premier Heidegger, particulièrement à la transformation du corpus aristotélicien opérée dans les cours de Fribourg et de Marbourg. Car, si cette opération de destruction critique de l'ontologie d'Aristote comme " (...) sagesse de ce monde " est essentiellement guidée par la théologie de la croix de Luther, elle permet, en retour, d'aristotéliser les théologoumènes luthériens afin de conceptualiser, phénoménologiquement, les expériences humaines fondamentales du Nouveau Testament. Cette analyse exégétique des conditions opératoires d'Etre et Temps entend ouvrir la possibilité d'interpréter le premier Heidegger dans le sens d'une phénoménologie radicale du vivant humain sous l'horizon d'une interprétation de l'être comme temps : il apparaît ainsi que la problématique décisive de l'ouvrage inachevé de 1927 tient à la mutabilité du Dasein, capable de saisir son excellence propre dans la performance même de son philosopher. (shrink)

This paper challenges T. S. Gendler's notion of aliefs, a novel kind of mental state which she introduces to explain a wide variety of belief-discordant behaviors. In particular, I argue that many of the cases which she uses to motivate such a mental state can be fully explained by accounts that make use only of commonplace attitudes such as beliefs and desires.

It has recently been argued that hope is polysemous in that it sometimes refers to hoping and other times to being hopeful. That it has these two distinct senses is reflected in the observation that a person can hope for an outcome without being hopeful that it will occur. Below, I offer a new argument for this distinction. My strategy is to show that accepting this distinction yields a rich account of two distinct ways in which hope can be lost, (...) ways that map onto the two senses of hope: A person can lose hope either by ceasing to hope for an outcome (hopelessness) or by ceasing to be hopeful that it will obtain (despair). Thinking about these negative attitudes in these two ways, I contend, is explanatorily rich and fruitfully reveals how they differ in phenomenology, behavioral differences, and the ways in which a person can escape them. (shrink)

Physicians have an ethical responsibility to their patients to offer the best available medical care. This responsibility conflicts with their role as gatekeepers of the limited health care resources available for all patients collectively. It is ethically untenable to expect doctors to face this trade-off during each patient encounter; the physician cannot be expected to compromise the wellbeing of the patient in the office in favour of anonymous patients elsewhere. Hence, as in other domains of public policy where individual and (...) collective interests conflict, some form of collective solution is required. Collective solutions may take the form of placing explicit resource constraints on resources available to physicians, or clinical practice guidelines that recognise cost-effective care as acceptable. Such solutions will be politically and ethically sustainable only if patients as citizens of the larger population accept the need for rationing of limited resources in health care. (shrink)

The answer to philosophical questions will often depend on the position one takes regarding the fact-value problem. It is, therefore, not surprising that, in the tradition of western philosophy, the past 200 years or so record an animated discussion of it. In the present collection the debate is continued by representatives of various "schools" in contemporary western thought. A number of philosophers from non-western cultures, too, enter into it. The contributions do not all reflect on the same theme, nor do (...) they use the same approach. Essays written by philosophers sympathetic to the analytical tradition are followed by reflections on the part of those inspired by phe nomenology. A third group of contributions is by non-western thinkers, who are more likely to approach the problem in terms of culture. Their engage ment with the issue clearly shows, among other things, that it is almost exclusively in the western tradition that the fact-value distinction is often understood as an outright dichotomy. The occasion for the publication of this collection is Dr. Cornelis Anthonie van Peursen's retirement as Professor of Philosophy. This year he leaves the Free University, Amsterdam; until 1982 he was professor at the University of Leyden as well. In the Netherlands and beyond he has become known for his concern with constructive comparison of diverging philosophical trends and the cross-cultural fertilization of thought. Characteristic of his career are his efforts to render the results of academic philosophizing understand able to a broader audience. (shrink)

Given the possibilities of synthetic biology, weapons of mass destruction and global climate change, humans may achieve the capacity globally to alter life. This crisis calls for an ethics that furnishes effective motives to take global action necessary for survival. We propose a research program for understanding why ethical principles change across time and culture. We also propose provisional motives and methods for reaching global consensus on engineering field ethics. Current interdisciplinary research in ethics, psychology, neuroscience and evolutionary theory grounds (...) these proposals. Experimental ethics, the application of scientific principles to ethical studies, provides a model for developing policies to advance solutions. A growing literature proposes evolutionary explanations for moral development. Connecting these approaches necessitates an experimental or scientific ethics that deliberately examines theories of morality for reliability. To illustrate how such an approach works, we cover three areas. The first section analyzes cross-cultural ethical systems in light of evolutionary theory. While such research is in its early stages, its assumptions entail consequences for engineering education. The second section discusses Howard University and University of Puerto Rico/Mayagüez (UPRM) courses that bring ethicists together with scientists and engineers to unite ethical theory and practice. We include a syllabus for engineering and STEM (Science, Technology, Engineering and Mathematics) ethics courses and a checklist model for translating educational theory and practice into community action. The model is based on aviation, medicine and engineering practice. The third and concluding section illustrates Howard University and UPRM efforts to translate engineering educational theory into community action. Multidisciplinary teams of engineering students and instructors take their expertise from the classroom to global communities to examine further the ethicality of prospective technologies and the decision-making processes that lead to them. (shrink)

Today's modern car is an assemblage of mechanical and digital components, of metal panels that comprise its structure and silicon chips that run its functions. Communication and information studies scholars have interrogated the problematic aspects of the programs that run those functions, revealing serious issues surrounding privacy and security, worker surveillance, and racial, gendered, and class-based bias. This article contributes to that work by taking a step back and asking about the issues inherent not in the software running on these (...) chips, but on the microchips themselves. Using the lens of “chipification”—the process by which a device is rendered capable of reading and processing data through the embedding of microchips—this article explores how the integration of microchips also involves processes that are often borne from, replicate, or create troubling power dynamics of their own. It takes light-duty passenger vehicles as a case study into how chipification is radically reshaping such processes as resource allocation, labor flows, and cultural practices around car manufacture, use, repair, and modification. By naming the process of chipification, this article allows researchers to identify and analyze the ways that integrating data processing capabilities into everyday devices is not a frictionless practice, but rather one that implicates a variety of power dynamics within these massive industries. (shrink)

During the coronavirus pandemic, communities have faced shortages of important healthcare resources such as COVID-19 vaccines, medical staff, ICU beds and ventilators. Public health officials in the U.S. have had to make decisions about two major issues: which infected patients should be treated first (triage), and which people who are at risk of infection should be inoculated first (vaccine distribution). Following Beauchamp and Childress’s principlism, adopted guidelines have tended to value both whole lives (survival to discharge) and life-years (survival for (...) years past discharge). This process of collective moral reasoning has revealed our common commitment to both Kantian and utilitarian principles. For Kant, respecting people’s rights entails that we ought to value whole lives equally. Therefore we ought to allocate resources so as to maximise the number of patients who survive to discharge. By contrast, the principle of utility has us maximise life-years so that people can satisfy more of their considered preferences. Although people are treated impartially in the utilitarian calculus, it does not recognise their equal worth. Subjecting Kantian ethics and utilitarianism to the process of reflective equilibrium lends support to the idea that we need a pluralistic approach that would accommodate our moral intuitions regarding both the equal value of whole lives and the additive value of life-years. (shrink)

The requirement of gauge invariance for the Schwinger-DeWitt equations, interpreted as a manifestly covariant quantum theory for the evolution of a system in spacetime, implies the existence of a five-dimensional pre-Maxwell field on the manifold of spacetime and “proper time” τ. The Maxwell theory is contained in this theory; integration of the field equations over τ restores the Maxwell equations with the usual interpretation of the sources. Following Schwinger's techniques, we study the Green's functions for the five-dimensional hyperbolic field equations (...) for both signatures ± [corresponding to O(4, 1) or O(3, 2) symmetry of the field equations] of the proper time derivative. The classification of the Green's functions follows that of the four-dimensional theory for “massive” fields, for which the “mass” squared may be positive or negative, respectively. The Green's functions for the five-dimensional field are then given by the Fourier transform over the “mass” parameter. We derive the Green's functions corresponding to the principal part ΔP and the homogeneous function Δ 1 ; all of the Green's functions can be expressed in terms of these, as for the usual field equations with definite mass. In the O(3, 2) case, the principal part function has support for x2⩾τ2, corresponding to spacelike propagation, as well as along the light cone x2=0 (for τ=0). There can be no transmission ofinformation in spacelike directions, with this propagator, since the Maxwell field, obtained by integration over τ, does not contain this component of the support. Measurements are characterized by such an integration. The spacelike field therefore can dynamically establish spacelike correlations. (shrink)

Since 1995, students, researchers, and professionals have turned to The Craft of Research for clear and helpful guidance on how to conduct research and report it effectively. Now, master teachers Wayne C. Booth, Gregory G. Colomb, and Joseph M. Williams have completely revised and updated their classic handbook. The new edition will continue to help thousands of students and writers plan, carry out, and report on research to produce effective term papers, dissertations, articles, or books -- in any field, at (...) any level. (shrink)

Le XI.ème Congrès International de Philosophie Médiévale de la Société Internationale pour l’Étude de la Philosophie Médiévale (S.I.E.P.M..) s’est déroulé à Porto (Portugal), du 26 au 30 août 2002, sous le thème général: Intellect et Imagination dans la Philosophie Médiévale. A partir des héritages platonicien, aristotélicien, stoïcien, ou néo-platonicien (dans leurs variantes grecques, latines, arabes, juives), la conceptualisation et la problématisation de l’imagination et de l’intellect, ou même des facultés de l’âme en général, apparaissaient comme une ouverture possible pour aborder (...) les principaux points de la pensée médiévale. Les Actes du congrès montrent que « imagination » et « intellect » sont porteurs d’une richesse philosophique extraordinaire dans l’économie de la philosophie médiévale et de la constitution de ses spécificités historiques. Dans sa signification la plus large, la théorisation de ces deux facultés de l’âme permet de dédoubler le débat en au moins six grands domaines: — la relation avec le sensible, où la fantaisie/l’imagination joue le rôle de médiation dans la perception du monde et dans la constitution de la connaissance ; — la réflexion sur l’acte de connaître et la découverte de soi en tant que sujet de pensée ; — la position dans la nature, dans le cosmos, et dans le temps de celui qui pense et qui connaît par les sens externes, internes et par l’intellect ; — la recherche d’un fondement pour la connaissance et l’action, par la possibilité du dépassement de la distante proximité du transcendant, de l’absolu, de la vérité et du bien ; — la réalisation de la félicité en tant qu’objectif ultime, de même que la découverte d’une tendance au dépassement actif ou mystique de toutes les limites naturelles et des facultés de l’âme ; — la constitution de théories de l’image, sensible ou intellectuelle, et de ses fonctions. Les 3 volumes d’Actes incluent les 16 leçons plénières et 112 communications, ainsi que les index correspondants (manuscrits ; noms anciens et médiévaux ; noms modernes ; auteurs). Le volume IV des Actes, contenant 39 communications et des index, est publié par la revue " Mediaevalia. Textos e Estudos ", du Gabinete de Filosofia Medieval de l’Universidade do Porto (volume 23, de 2004). Ouvrage publié avec l’appui de l’Universidade do Porto, de la Faculdade de Letras da U.P., du Departamento de Filosofia - F.L.U.P. et de la Fundação para a Ciência e a Tecnologia (Portugal). (shrink)

If T has only countably many complete types, yet has a type of infinite multiplicity then there is a c.c.c. forcing notion Q such that, in any Q-generic extension of the universe, there are non-isomorphic models M 1 and M 2 of T that can be forced isomorphic by a c.c.c. forcing. We give examples showing that the hypothesis on the number of complete types is necessary and what happens if `c.c.c.' is replaced by other cardinal-preserving adjectives. We also give (...) an example showing that membership in a pseudo-elementary class can be altered by very simple cardinal-preserving forcings. (shrink)

This volume sheds light on still unexplored issues and raises new questions in the main areas addressed by the philosophy of science. Bringing together selected papers from three main events, the book presents the most advanced scientific results in the field and suggests innovative lines for further investigation. It explores how discussions on several notions of the philosophy of science can help different scientific disciplines in learning from each other. Finally, it focuses on the relationship between Cambridge and Vienna in (...) twentieth century philosophy of science. The areas examined in the book are: formal methods, the philosophy of the natural and life sciences, the cultural and social sciences, the physical sciences, and the history of the philosophy of science. (shrink)

M. C. Dillon was widely regarded as a world-leading Merleau-Ponty scholar. His book Merleau-Ponty’s Ontology is recognized as a classic text that revolutionized the philosophical conversation about the great French phenomenologist. Dillon followed that book with two others: Semiological Reductionism, a critique of early-1990s linguistic reductionism, and Beyond Romance, a richly developed theory of love. At the time of his death, Dillon had nearly completed two further books to which he was passionately committed. The first one offers a highly original (...) interpretation of Nietzsche’s ontology of becoming. The second offers a detailed ethical theory based on Merleau-Ponty’s account of carnal intersubjectivity. The Ontology of Becoming and the Ethics of Particularity collects these two manuscripts written by a distinguished philosopher at the peak of his powers—manuscripts that, taken together, offer a distinctive and powerful view of human life and ethical relations. (shrink)

In their environment, plants are continuously submitted to natural stimuli such as wind, rain, temperature changes, wounding, etc. These signals induce a cascade of events which lead to metabolic and morphogenetic responses. In this paper the different steps are described and discussed starting from the reception of the signal by a plant organ to the final morphogenetic response. In our laboratory two plants are studied: Bryonia dioica for which rubbing the internode results in reduced elongation and enhanced radial expansion and (...) Bidens pilosa for which the response occurs at distance, hence pricking the cotyledon of a plantlet induces the growth inhibition of both the hypocotyl and the axillary bud of the pricked cotyledon. Reception of the signal and transmission of the message. In Bryonia the signal is received by epidermal cells while in Bidens they are the cells adjacent to the midrib of the cotyledon which receive the mechanical signal. In both plants the message is transmitted via a wave of electric depolarization. This latter is composed of an action potential associated with a slow wave whose transmission rates are respectively 1cm s−1 and 1 mm s−1. Recent results have shown the involvement of Ca2+ in the triggering of the slow wave and the role of the H+ pump during the slow wave. Transient and fast biochemical responses. An entry of extraceilular Ca2+ into the cells and a transient increase in IP3 occur within seconds following the mechanical stimulus. At the same time, the membrane becomes more fluid, correlated with qualitative changes in phospholipids. The rapid increase in the concentration of peroxidated lipids may be correlated with ethylene biosynthesis which is stimulated after rubbing. Other parameters such as cytoplasmic pH, relative water content, hydric potential, membrane potential and modifications of K+, Mg2+-ATPase and Ca2+-ATPase activities, play a key role in the early responses induced by the traumatisms. Irreversible-biochemical responses. The mechanical stimulus performed on a Bryonia internode induces an acceleration of: i) enzymatic activities related to the lignification, ii) esterification of phenolic acids in the cell wall. Consequently the lignification process is accelerated. Storage of the information. After being received by the target cells the information can be stored during several days before being expressed. At the level of cotyledonary bud, the first message, previously stored, can be expressed or not by a second treatment. Bidens thus behaves as if it was able to “store” and to “retrieve” morphogenetic messages, using a sort of rudimentary memory. The nuclei of the bud cells of the pricked cotyledon show that these cells, initially in G2 phase, divide and then remain in the G1 phase. In Bryonia, calli derived from young stimulated internodes, keep thigmomorphogenetic characteristics during several weeks. In the last part of this paper the particularity of our plant model which permits a study of the transmission and storage of the message, is underlined. The links between the different steps induced by the stimulus are discussed. Special attention is devoted to second messengers and to the amplification of the message. (shrink)

0$^{\sharp}$ can be invisibly class generic.

Originally published in 1988, M.C. Dillon's classic study of Merleau-Ponty is now available in a revised second edition containing a new preface and a new chapter on "Truth in Art." Dillon's thesis is that Merleau-Ponty has developed the first genuine alternative to ontological dualism seen in Western philosophy. From his early work on the philosophical significance of the human body to his later ontology of flesh, Merleau-Ponty shows that the perennial problems growing out of dualistic conceptions of mind and body, (...) subject and object, immanence and transcendence can be resolved within the framework of a new way of thinking based on the exemplar of the worldly embodiment of thought. (shrink)