Humanización de los servicios de salud en Iberoamérica: una revisión sistemática de la literatura Humanização dos serviços de saúde na Ibero-América: uma revisão sistemática da literatura Humanization is an ethical imperative that contributes to safeguarding human dignity in harmony with bioethical principles and deontological regulations that govern health care practices. The present study aims to explore the advances in the humanization of Ibero-American health care in the last ten years through a systematic review. Results show that such advances point to (...) understanding the phenomenon based on theoretical approaches, a growing interest in the subject in recent years, and the creation of policies, programs and strategies that should be strengthened from a comprehensive view of the human being. Para citar este artículo / To reference this article / Para citar este artigo Carlosama DM, Villota NG, Benavides VK, Villalobos-Galvis FH, Hernández EL, Matabanchoy SM. Humanización de los servicios de salud en Iberoamérica: una revisión sistemática de la literatura. Pers Bioet. 2019;23:245-262. DOI: https://doi.org/10.5294/pebi.2019.23.2.6 Recibido: 21/06/2019 Aceptado: 04/09/2019. (shrink)

In the last few years repeated scandals have rocked their worlds of many industries. Stories which have hit the headlines recently have included news of * Deliberate cheating by car makers to evade emissions tests * LIBOR and FX manipulation by bankers * Falsification of drug testing results plus allegations of bribery and corruption in major pharmaceutical corporations * Unlawful tapping of phones of the famous by newspapers * Cover-ups over high death rates in hospitals. While it is not always (...) obvious what has gone wrong, there is no disguising the widespread impact on many stakeholders, and the catastrophic loss of trust and sense of betrayal that results. Matt Nixon has had a privileged insider seat in several of the organizations which came to suffer major crises, crises which inspired deep emotional responses. (shrink)

Since educators are always looking for ways to improve their practice, and since empirical science is now accepted in our worldview as the final arbiter of truth, it is no surprise they have been lured toward cognitive neuroscience in hopes that discovering how the brain learns will provide a nutshell explanation for student learning in general. I argue that identifying the person with the brain is scientism (not science), that the brain is not the person, and that it is the (...) person who learns. In fact the brain only responds to the learning of embodied experience within the extra-neural network of intersubjective communications. Learning is a dynamic, cultural activity, not a neural program. Brain-based learning is unnecessary for educators and may be dangerous in that a culturally narrow ontology is taken for granted, thus restricting our creativity and imagination, and narrowing the human community. (shrink)

Time’s arrow is necessary for progress from a past that has already happened to a future that is only potential until creatively determined in the present. But time’s arrow is unnecessary in Einstein’s so-called block universe, so there is no creative unfolding in an actual present. How can there be an actual present when there is no universal moment of simultaneity? Events in various places will have different presents according to the position, velocity, and nature of the perceiver. Standing against (...) this view is traditional common sense since we normally experience time’s arrow as reality and the present as our place in the stream of consciousness, but we err to imagine we are living in the actual present. The present of our daily experience is actually a specious present, according to E. Robert Kelly (later popularized by William James), or duration, according to Henri Bergson, an habitus, as elucidated by Kerby (1991), or, simply, the psychological present (Adams, 2010) – all terms indicating that our experienced present so consists of the past overlapping into the future that any potential for acting from the creative moment is crowded out. Yet, for philosophers of process from Herakleitos onward, it is the philosophies of change or process that treat time’s arrow and the creative fire of the actual present as realities. In this essay, I examine the most well known but possibly least understood process cosmology of Alfred North Whitehead to seek out this elusive but actual present. In doing so, I will also ask if process philosophy is itself an example of the creative imagination and if this relates to doing science. I conclude Whitehead's process philosophy falls short of allowing for the actual creative spontaneity of a dynamic (eternal) present. (shrink)

This paper focuses, not on the existing conditions of institutional association, but on hoped-for conditions that would have to be met for professional relationships within higher education to aspire to what Aristotle referred to as ?virtuous friendship?. Such relationships, it is argued, constitute the social content of hope in that they look to new perspectives on institutional renewal and professional regeneration. They provide a context of mutuality and reciprocity within which individuals can begin to realise, through the acquisition of ?functional (...) capabilities?, their particular capacities. The question then arises as to the conditions necessary for generating and sustaining such relationships within the increasingly differentiated and stratified institutional settings of the higher education sector and across an academic workforce that has become fractionalised and atomised around increasingly complex divisions of academic labour. It is that question which this paper seeks to address. ?Civil society is fragile, and it needs to be extended? (Hall, 1995, p. 27). (shrink)

[This is an edited and improved version of "You Are Not Your Brain: Against 'Teaching to the Brain'" previously published in *Review of Higher Education and Self-Learning* 5(15), Summer 2012.] Since educators are always looking for ways to improve their practice, and since empirical science is now accepted in our worldview as the final arbiter of truth, it is no surprise they have been lured toward cognitive neuroscience in hopes that discovering how the brain learns will provide a nutshell explanation (...) for student learning in general. I argue that identifying the person with the brain is scientism (not science), that the brain is not the person, and that it is the person who learns. In fact the brain only responds to the learning of embodied experience within the extra-neural network of intersubjective communications. Learning is a dynamic, cultural activity, not a neural program. Brain-based learning is unnecessary for educators and may be dangerous in that a culturally narrow ontology is taken for granted, thus restricting our creativity and imagination, and narrowing the human community. (shrink)

In this condensed survey, I look to recent perspectives on evolution suggesting that cultural change likely alters the genome. Since theories of development are nested within assumptions about evolution (evo-devo), I next review some oft-cited developmental theories and other psychological theories of the 20th century to see if any match the emerging perspectives in evolutionary theory. I seek theories based neither in nature (genetics) nor nurture (the environment) but in the creative play of human communication responding to necessity. This survey (...) finally looks to more recent work to do with the appearance of independent self-consciousness in the individual following empathic group awareness. The result of such self-created group awareness and symbolic communication is seen to be cultural consciousness, unique to humanity, from which individual consciousness and personhood derive. I conclude by noting the general implications for these approaches in our schools, politics, and in ultimate ontological questions. (shrink)

Many philosophers have been attracted to the idea of using the logical form of a true sentence as a guide to the metaphysical grounds of the fact stated by that sentence. This paper looks at a particular instance of that idea: the widely accepted principle that disjunctions are grounded in their true disjuncts. I will argue that an unrestricted version of this principle has several problematic consequences and that it’s not obvious how the principle might be restricted in order to (...) avoid them. My suggestion is that, instead of trying to restrict the principle, we should distinguish between metaphysical and conceptual grounds and take the principle to apply exclusively to the latter. This suggestion, if correct, carries over to other prominent attempts at using logical form as a guide to ground. (shrink)

Ecological-enactive approaches to cognition aim to explain cognition in terms of the dynamic coupling between agent and environment. Accordingly, cognition of one’s immediate environment (which is sometimes labeled “basic” cognition) depends on enaction and the picking up of affordances. However, ecological-enactive views supposedly fail to account for what is sometimes called “higher” cognition, i.e., cognition about potentially absent targets, which therefore can only be explained by postulating representational content. This challenge levelled against ecological-enactive approaches highlights a putative explanatory gap between (...) basic and higher cognition. In this paper, we examine scientific cognition—a paradigmatic case of higher cognition—and argue that it shares fundamental features with basic cognition, for enaction and affordance selection are central to the scientific enterprise. Our argument focuses on modeling, and on how models promote scientific understanding. We base our argument on a non-representational account of scientific understanding and on the material engagement theory, for models are hereby conceived as material objects designed for scientific engagements. Having done so, we conclude that the explanatory gap is significantly less threatening to the ecological-enactive approach than it might appear. (shrink)

There are two intuitions about time. The first is that there's something special about the present that objectively differentiates it from the past and the future. Call this intuition Specialness. The second is that the time at which we happen to live is just one among many other times, all of which are ‘on a par’ when it comes to their forming part of reality. Call this other intuition Egalitarianism. Tradition has it that the so-called ‘A-theories of time’ fare well (...) at addressing the first intuition, but rather badly when it comes to the second. The goal of this article is to offer advice to A-theorists about how to reconcile their view with Egalitarianism. (shrink)

Humanity’s self-ordained mandate to subdue and dominate nature is part of the cognitive foundation of the modern world—a perspective that remains deeply ingrained in science and technology. Marine biology has not been immune to this anthropocentric bias. But this needs to change, and the gaps between basic scientific disciplines and the global conservation imperatives of our time need to be bridged. In the face of a looming ecological and climate crisis, marine biologists must upgrade their values and professional standards and (...) help foster the radical transformation needed to avert a climate and ecological breakdown. To prevent some of the damage, they must cross the imaginary line that separates science from science-based activism and consciously pursue the health and durability of human and natural communities. To this end, they can (1) develop compelling narratives that engage human society, with emphasis on care for the wild living world; (2) move beyond marine conservation on paper and avoid self-serving complaisance; (3) advocate constructive changes in market and human behaviour, not only by documenting damage but also by clarifying how the extraction, production and consumption system can be steered away from practices that harm nature; (4) push for systemic change in politics through individual and collective efforts, supporting environmental activism and those who demand biosphere-saving policies; and (5) endorse a more ecocentric and holistic world vision, relinquishing contempt for spiritual wisdom and liaising with (or at least not dismissing) spiritual traditions that encourage equality, self-restraint and environmental sustainability. (shrink)

Solving the meta-problem of consciousness requires, among other things, explaining why we are so reluctant to endorse various forms of illusionism about the phenomenal. I will try to tackle this task in two steps. The first consists in clarifying how the concept of consciousness precludes the possibility of any distinction between 'appearance' and 'reality'. The second consists in spelling out our reasons for recognizing the existence of something that satisfies that concept.

We emerge into everythingness. The senses mingle incestuously. Nothing is distinct or differentiated. Everything is no-thing. How is it we come to be as distinct entities? Let me personalize: In what manner did I become an "I"? Is the motive force behind this much-maligned, much-altered, much-abused body my soul? my genes? me?

[This is a commentary article on Michel Bitbol's TA: "The Tangled Dialectic of Body and Consciousness: A Metaphysical Counterpart of Radical Neurophenomenology".] -/- A summary of the major metaphysical positions reveals them to be variable enough that they do not deny experience to the researcher. Further, Merleau-Ponty’s intra-ontology and related terms are fleshed out.

In this paper it is argued that a proper understanding of the justification of perceptual beliefs leaves open the possibility that normal humans, unaided by microscopes, could genuinely know, by direct observation, of the existence of a theoretical entity like an electron. A particular theory of justification called perceptual responsibilism is presented. If successful, this kind of view would undercut one line of argument that has been given (for example, by Bas van Fraassen) in support of scientific anti-realism. Various objections (...) to the idea that electrons can be directly observed are also considered. (shrink)

Book Review of 'Ethics and AIDS in Africa: The Challenge to Our Thinking' By Anton A. van Niekerk and Loretta M. Kopelman (Eds).

Assuming a radical stance on embodied cognition, according to which the information ac- quired through basic cognitive processes is not contentful (Hutto and Myin, 2013), and as- suming that perception is a source of rationally grounded knowledge (Pritchard, 2012), a pluralistic account of perceptual knowledge is developed. The paper explains: (i) how the varieties of perceptual knowledge fall under the same broader category; (ii) how they are subject to the same kind of normative constraints; (iii) why there could not be (...) a conflict between the different varieties of perceptual knowledge; and (iv) why the traditional episte- mological inquiry is inclined to overestimate the role of propositional perceptual knowledge. (shrink)

This handbook is currently in development, with individual articles publishing online in advance of print publication. At this time, we cannot add information about unpublished articles in this handbook, however the table of contents will continue to grow as additional articles pass through the review process and are added to the site. Please note that the online publication date for this handbook is the date that the first article in the title was published online.

In the paper, after clarifying terms such as ‘identity’, ‘self’ and ‘personhood’, I propose an empirical account of identity based on the notion of “whole phenotype”. This move allows one to claim the persistence of the individuals before and after their being affected by dementia. Furthermore, I show how this account permits us to address significant questions related to demented individuals’ loss of the capacity of moral decisions.

Emotions and personhood are important notions within the field of mental health care. How they are related is less evident. This book provides a framework for understanding the important and complex relationship between our emotional wellbeing and our sense of self, drawing on psychopathology, philosophy, and phenomenology.

How can we better understand and treat those suffering from schizophrenia and manic-depressive illnesses? This important new book takes us into the world of those suffering from such disorders. Using self descriptions, its emphasis is not on how mental health professionals view sufferers, but on how the patients themselves experience their disorder. A new volume in the International Perspectives in Philosophy and Psychiatry series, this book will be of great interest to all those working with sufferers from such disorders - (...) helping them to better understand their mental lives, and providing important insights into how best to treat them. (shrink)

ABSTRACT Despite Institutional Review Board concerns about psychological harm arising from research participation, evidence from trauma-questionnaire research suggests that participation is typically well-tolerated by participants. Yet, it is unclear how participant experiences of in-lab trauma simulations align with IRB ethical guidelines. Thus, we compared reactions to a trauma film paradigm with reactions to a positive film task or cognitive tasks. Overall, relative to other conditions, the trauma film was well-tolerated by participants: they generally reported low-to-moderate negative emotions, moderate benefits, and (...) that participation was not worse than everyday stressors. Our results have implications for the research community in designing trauma-based research. (shrink)

The first essay is one of the most influential papers ever written on Lonergan; it and the second one inquire into the notion of the a priori. The third essay presents a detailed analysis of Kantian intuitionism and contrasts it with the 'knowledge as structure' position of Lonergan's critical realism. In this essay intuitionism is generalized, to allow Sala to address representatives of neoscholasticism as well. The argument with neoscholasticism continues in the fourth essay.

Much of the recent philosophical debate on causation and causal explanation in the biological and biomedical sciences has focused on the notion of mechanism. Mechanisms, their nature and epistemic roles have been tackled by a range of so-called neo-mechanistic theories, and widely discussed. Without denying the merits of this approach, our paper aims to show how lately it has failed to give proper credit to processes, which are central to the field, especially of contemporary molecular biology. Processes can be summed (...) up in the notion of ‘pathway’, which is far from being just equivalent to that of ‘mechanism’ and has a profound epistemological and explanatory relevance. It is argued that an adequate consideration of pathways impels some rethinking of scientific explanation in molecular biology, namely its functional and contextual features. A number of examples are given to suggest that the focus of philosophical attention in this disciplinary field should shift from the notion of mechanism to the notion of pathway. (shrink)

This paper defends the view that one's own mental states are metaphysically privileged vis-à-vis the mental states of others, even if only subjectively so. This is an instance of a more general view called Subjectivism, according to which reality is only subjectively the way it is. After characterizing Subjectivism in analogy to two relatively familiar views in the metaphysics of modality and time, I compare the Subjectivist View of the Mental with Egocentric Presentism, a version of Subjectivism recently advocated by (...) Caspar Hare. I argue that the Subjectivist View of the Mental goes a considerable way towards solving certain long-standing philosophical puzzles having to do with the unity of consciousness, the contents of self-awareness and the intransmissibility of experiential knowledge through testimony. (shrink)

The theologians of the late German Enlightenment saw in Kant's Critique of Pure Reason a new rational defence of their Christian faith. In fact, Kant's critical theory of meaning and moral law totally subverted the spirit of that faith. This challenging new study examines the contribution made by the Critique of Pure Reason to this change of meaning. George di Giovanni stresses the revolutionary character of Kant's critical thought but also reveals how this thought was being held hostage to unwarranted (...) metaphysical assumptions that caused much confusion and rendered the First Critique vulnerable to being reabsorbed into modes of thought typical of Enlightenment popular philosophy. Amongst the striking features of this book are nuanced interpretations of Jacobi and Reinhold, a lucid exposition of Fichte's early thought, and a rare, detailed account of Enlightenment popular philosophy. (shrink)

Two problems related to the biological identity of living beings are faced: the who-problem (which are the biological properties making that living being unique and different from the others?); the persistence-problem (what does it take for a living being to persist from a time to another?). They are discussed inside a molecular biology framework, which shows how epigenetics can be a good ground to provide plausible answers. That is, we propose an empirical solution to the who-problem and to the persistence-problem (...) on the basis of the new perspectives opened by a molecular understanding of epigenetic processes. In particular, concerning the former, we argue that any living being is the result of the epigenetic processes that have regulated the expression of its genome; concerning the latter, we defend the idea that the criterion for the persistence of its identity is to be indicated in the continuity of those epigenetic processes. We also counteract possible objections, in particular (1) whether our approach has something to say at a metaphysical level; (2) how it could account for the passage from the two phenotypes of the parental gametes to the single phenotype of the zygote; (3) how it could account for the identity of derivatives of one living being that continue to live disjoined from that original living being; (4) how it could account for higher mental functions. (shrink)

Role models can be highly influential in conveying ethical standards. This study investigates the influence various categories of role models have had on a population of over 1,600 undergraduate students in Texas, Oregon and Michigan. Those identifying clergy, boy scout leaders, friends and college advisors as role models exhibited less willingness to adopt questionable ethical behavior in negotation situations. Journalist and spouse role models tended to cause students to be more accepting of questionable behavior. Individuals with strong end-result and social (...) contract ethical philosophies, as well as males and those who served in the military exhibited strong tendencies toward less than ethical behavior. Individuals with strong rule ethical philosophy, high levels of religiousity, and those with a cooperative attitude in negotiations tended to adopt higher ethical standards in negotiations. (shrink)

This paper examines the effectiveness of the use of executive compensation linked to Corporate Social Responsibility (CSR) goals across US firms. Empirical analysis of a cross-industry sample of 746 listed companies for the period 2002–2013 showed that the use of CSR-linked compensation contracts for Named Executive Officers (NEOs) promotes CSR performance. More specifically, we found that linking NEOs’ compensation to CSR goals produces positive effects in the 3rd year after adoption. As firms accumulate experience and learn how to use the (...) system over the following eight periods, CSR performance increases monotonically. Furthermore, experience accumulated over time affects the different specifications of CSR performance asymmetrically, by reducing both environmental and social CSR concerns and increasing only environmental CSR strengths. Interestingly, we also found that the simultaneous use of other CSR-focused governance systems moderates the effect of a firm’s accumulated experience in using CSR-linked executive compensation on CSR performance: the existence of a CSR committee at the board level and the public release of a CSR report are likely to have a positive moderating effect, while the purchase of a CSR audit has no moderating effect. (shrink)