Most jurisdictions require that a mental capacity assessment be conducted using a functional model whose definition includes several abilities. In England and Wales and in increasing number of countries, the law requires a person be able to understand, to retain, to use or weigh relevant information and to communicate one’s decision. But interpreting and applying broad and vague criteria, such as the ability ‘to use or weigh’ to a diverse range of presentations is challenging. By examining actual court judgements of (...) capacity, we previously developed a descriptive typology of justifications used in the application of the Mental Capacity Act criteria. We here critically optimise this typology by showing how clear definitions—and thus boundaries—between the criteria can be achieved if the ‘understanding’ criterion is used narrowly and the multiple rationales that fall under the ability to ‘use or weigh’ are specifically enumerated in practice. Such a typology-aided practice, in theory, could make functional capacity assessments more transparent, accountable, reliable and valid. It may also help to create targeted supports for decision making by the vulnerable. We also discuss how the typology could evolve legally and scientifically, and how it lays the groundwork for clinical research on the abilities enumerated by the MCA. No data are available. This paper does not report any original data. (shrink)

Book reviewed in this article: Long Term Care: Principles, Programs and Policies. By Rosalie A. Kane and Robert L. Kane. Long Term Health Care: providing a Spectrum of Services to the Aged. By Philip W. Brickner, Anthony J. Lechich, Roberta Lipsman, and Linda K. scharer.

Book reviewed in this article: Long Term Care: Principles, Programs and Policies. By Rosalie A. Kane and Robert L. Kane. Long Term Health Care: providing a Spectrum of Services to the Aged. By Philip W. Brickner, Anthony J. Lechich, Roberta Lipsman, and Linda K. scharer.

Special moral, regulatory, and scientific questions surround the inclusion of children in health-related research. These questions arise from a fundamental moral tension between the obligation to expose children to research participation to ensure that they share in the benefits that arise from it and the obligation to protect them from the harms associated with their inappropriate involvement in research. This tension is felt in the development of moral and regulatory frameworks for the protection of child research subjects and in the (...) implementation and interpretation of these frameworks by institutional review boards. (shrink)

Ronit Stahl and Ezekiel Emanuel have recently issued a stark challenge to conscience protections in medical law and ethics. Their argument is flawed, however. They misrepresent the nature and relevance of conscientious protection in the military, misinterpret the scope of consent tendered by modern medical professionals, and offer no reason to think either that conscientious objection harms patient well-being or that such harm should solely determine the permissibility of conscientious objection. Moreover, and most fundamentally, Stahl and Emanuel do not recognize (...) that conscience protections promote moral integrity, a basic aspect of human well-being that justifies protective action. (shrink)

Many important decisions depend on unknown states of the world. Society is increasingly relying on statistical predictive models to make decisions in these cases. While predictive models are useful, previous research has documented that (a) individual decision makers distrust models and (b) people’s predictions are often worse than those of models. These findings indicate a lack of awareness of how to evaluate predictions generally. This includes concepts like the loss function used to aggregate errors or whether error is training error (...) or generalisation error. To address this gap, we present three studies testing how lay people visually evaluate the predictive accuracy of models. We found that (a) participant judgements of prediction errors were more similar to absolute error than squared error (Study 1), (b) we did not detect a difference in participant reactions to training error versus generalisation error (Study 2), and (c) participants rated complex models as more accurate when comparing two models, but rated simple models as more accurate when shown single models in isolation (Study 3). When communicating about models, researchers should be aware that the public’s visual evaluation of models may disagree with their method of measuring errors and that many may fail to recognise overfitting. (shrink)

Research using mHealth apps has the potential to positively impact health care management and outcomes. However, choosing an appropriate mHealth app may be challenging for the health researcher. The author team used existing evaluation tools, checklists, and guidelines to assess selected mHealth apps to identify strengths, challenges, and potential gaps within existing evaluation tools. They identified specific evaluation tool components, questions, and items most effective in examining app content, usability, and features, including literacy demand and cultural appropriateness; technical information; practical (...) aspects of app functionality; and evolving capabilities of mobile medical apps. Challenges included the subjective nature of the results, time required to complete the evaluation, lack of emphasis on evidence‐based content, and inadequate tool flexibility. Health researchers considering the integration of mobile apps into research will benefit from evaluation tools that assess both evidence‐based content and the ability of the mobile app to securely integrate with other digital technologies involved in patient care. Next steps will include the involvement of health care providers and professionals, including nurses a wide range of expertise, to develop an mHealth evaluation tool that focuses on identifying quality, evidence‐based mobile apps into patient outcomes research. (shrink)

This paper analyzes and discusses related passages of Euripides’ „Electra“ and Aristophanes’ „Wasps“ in order to suggest a date for the performance of the „Electra“. Particularly interesting are: Ar. „Wasps“ 615 and Eur. „Electra“ 985; „Wasps“ 1490, 1492, 1530 and „Electra“ 860-861, which seem to reveal more complex dynamics of dependence in the Aristophanic attempt to mock the language excessively hyperbolic of Euripides. In my opinion these puns and innuendos may endorse the dating of Euripides’ „Electra“ at the Great Dionysia (...) of 423 b. C. one year before the performance of Aristophanes’ „Wasps“. (shrink)

Background:The concept of conscientious objection is well described; however, because of its nature, little is known about real experiences of nursing professionals who apply objections in their practice. Extended roles in nursing indicate that clinical and value-based dilemmas are becoming increasingly common. In addition, the migration trends of the nursing workforce have increased the need for the mutual understanding of culturally based assumptions on aspects of health care delivery.Aim:To present (a) the arguments for and against conscientious objection in nursing practice, (...) (b) a description of current regulations and practice regarding conscientious objection in nursing in Poland and the United Kingdom, and (c) to offer a balanced view regarding the application of conscientious objection in clinical nursing practice.Design:Discussion paper.Ethical considerations:Ethical guidelines has been followed at each stage of this study.Findings:Strong arguments exist both for and against conscientious objection in nursing which are underpinned by empirical research from across Europe. Arguments against conscientious objection relate less to it as a concept, but rather in regard to organisational aspects of its application and different mechanisms which could be introduced in order to reach the balance between professional and patient’s rights.Discussion and conclusion:Debate regarding conscientious objection is vivid, and there is consensus that the right to objection among nurses is an important, acknowledged part of nursing practice. Regulation in the United Kingdom is limited to reproductive health, while in Poland, there are no specific procedures to which nurses can apply an objection. The same obligations of those who express conscientious objection apply in both countries, including the requirement to share information with a line manager, the patient, documentation of the objection and necessity to indicate the possibility of receiving care from other nurses. Using Poland and the United Kingdom as case study countries, this article offers a balanced view regarding the application of conscientious objection in clinical nursing practice. (shrink)

Despite the fact that the requirement to obtain informed consent for medical procedures is deeply enshrined in both U.S. moral and legal doctrine, empirical studies and anecdotal accounts show that women's rights to informed consent and refusal of treatment are routinely undermined and ignored during childbirth. For example, citing the most recent Listening to Mothers survey, Marianne Nieuwenhuijze and Lisa Kane Low state that "a significant number of women said they felt pressure from a caregiver to agree to having (...) an intervention that they did not want during birth". Specifically, Nieuwenhuijze and Low cite that "19% of women who did not have epidural analgesia felt... (shrink)

This chapter talks about the first season of the TV series Veronica Mars. Additionally, the chapter explores the significance of Veronica Mars's photography. Veronica has found her life irrevocably altered in multiple ways. Her best friend, Lilly Kane, was murdered, her father, Keith Mars, lost his job as sheriff as the result of an apparently bungled investigation into Lilly's death, and Veronica lost her social status and former friends. Subsequently her mother, Lianne Mars, left home, apparently unable to deal (...) with the stress of it all. In addition to all this misfortune, Veronica, had attended a party at which she was drugged and then raped. She states in a voiceover, that she is a marshmallow, ironically though. But at the end of the season she has broken through to a new self‐understanding, which is illustrated in the final scene. (shrink)

This is an extremely lucid analysis of free will, the relativity of values, and the relationship between them, based on the “dignity of the individual … because one is the ultimate originator of one’s own ends”. It is an analysis which avoids “mystery at all costs … [and] … appeals to mysterious forms of agency”. Kane’s theory neither requires nor rules out mind/body dualism, the appeal to noumenal selves, or other nonoccurrent causes.

"On the ... issue of our pluralistic age -- whether we can continue to believe in absolute value -- Robert Kane has written the most helpful discussion I know.

oise Baylis, 1234 Le Marchant Street, Halifax, Nova Scotia, Canada B3H 3P7. Tel.: (902)-494–2873; Fax: (902)-494-2924; Email: francoise.baylis{at}dal.ca ' + u + '@' + d + ' '//--> . Abstract Recently, there has been a growing interest in public health and public health ethics. Much of this interest has been tied to efforts to draw up national and international plans to deal with a global pandemic. It is common for these plans to state the importance of drawing upon a well-developed (...) ethics framework and we argue that this framework should reflect the values and insights of feminist relational theory. More specifically, we argue that pandemic planning must be squarely situated in the larger realm of public health and that an ethics framework for public health will be one that recognizes the need to pay particular attention to the vulnerability of subpopulations lacking in social and economic power. We propose an ethics framework for public health that builds on the notions of relational personhood (including relational autonomy and social justice) and relational solidarity. In this way, we aim for a public health ethics that, as appropriate, promotes the public interest and the common good. CiteULike Connotea Del.icio.us What's this? (shrink)

When Ron Giere introduced perspectivism into philosophy of science, he provided a perspectivist analysis of both scientific instruments and scientific theorizing. Today, there is a burgeoning literature that extends Giere’s analysis of theorizing, with many philosophers examining the perspectivist approach to aspects of theorizing such as models, laws, explanations, and so on. However, relatively little attention has been paid to Giere’s analysis of instruments. In this article, I hope to fill this gap. I argue that the perspectivist analysis of instruments (...) should be rejected. First, I give a general account of the kind of instrumentation relevant to instrumental perspectivism, drawing on Cartwright’s notion of nomological machines, which forms the basis of my criticism of Giere’s argument for instrumental perspectivism. Next, I present the case against instrumental perspectivism. I argue that instrumental perspectivism is dependent on theoretical perspectivism in a way that robs it of philosophical significance, and that it introduces new puzzles while adding little to our understanding of instruments. (shrink)

This article brings together and compares my own artistic practice of drawing/painting and the eighteenth-century novel Tristram Shandy. In both cases, there is a free play of lines, textual or graphic, which sets ‘all things out of rule’. A whole typology of lines is woven throughout Sterne’s text and reappears, alter-inscribed, in the artworks. The article presents an account of these lines: rectilinear, hylomorphic, fractal and nomadic, as well as the line of incision. Each is explored as a specific mode (...) of line with differing effects. To follow these lines is to enter a world of material expressivity, to be exposed to an ontology of becoming and change, of flows and transformations, that overturns the traditional ontology of being and stable identity. Sterne’s use of wild digression, doodles and graphisms, establishes certain proximity between writing and drawing. Both may be seen as types of ‘figured metaphysics’ and as ways of bringing something new into the world. The article concludes with some philosophical observations on the strange event of drawing a line, with reference to the work of Heidegger and Deleuze and Guattari. (shrink)

This article divides into two roughly equal parts, both of which aim to address the act rather than the art of drawing. The second part focuses on a theoretical discussion of drawing. The first bears on a number of themes including the role of drawing in colonial history, drawing and data collection, and drawing and memory. It begins by describing an episode that unfolded as an encounter between two worlds, and two ages—an episode whose meaning and effects are still controversial (...) today. (shrink)

Examines the subtle link between the moral vision and ethical behavior that distinguishes Mamet's theatre and film.

Adorning the Country with Ruins -- The Western Baroque Landscape -- The Irish Tours -- Designing Picturesque Ireland -- Epilogue: Studies in a Point of View.

How can we register the participation of a range of elements, extending beyond the human subject, in the production of HIV events? In the context of proposals around biomedical prevention, there is a growing awareness of the need to find ways of responding to complexity, as everywhere new combinations of treatment, behavior, drugs, norms, meanings and devices are coming into encounter with one another, or are set to come into encounter with one another, with a range of unpredictable effects. In (...) this paper I consider the operation of various framing devices that attribute responsibility and causation with regard to HIV events. I propose that we need to sharpen our analytic focus on what these devices do, their performativity—that is, their full range of worldly implications and effects. My primary examples are the criminal law and the randomized control trial. I argue that these institutions operate as framing devices: They attribute responsibility for HIV events and externalize other elements and effects in the process. Drawing on recent work in science and technology studies as well as queer theory, I set out an analytic frame that marks out a new role for HIV social research. Attentiveness to the performative effects of these devices is crucial, I suggest, if we want better to address the global HIV epidemic. (shrink)

Modernity has challenged the ancient ideal of a universal quest for wisdom, and today's world of conflicting cultures and values has raised further doubts regarding the possibility of objective ethical standards. Robert Kane refocuses the debate on the philosophical quest for wisdom, and argues that ethical principles about right action and the good life can be seen to emerge from that very quest itself. His book contends that the search for wisdom involves a persistent striving to overcome narrowness of (...) vision that comes from the inevitable limitations of finite points of view. When applied to questions of value and the good life, this striving has ethical implications about the way we should treat ourselves and others. This study argues for the merits of this central thesis against alternative theories in contemporary normative ethics, and discusses its practical applications for social ethics, political philosophy, law and moral education. (shrink)

There are many different interpretations of what the family should be – its desired member composition, its primary purpose, and its cultural significance – and many different examples of what families actually look like across the globe. I examine the most paradigmatic conceptions of the family that are based upon the supposed primary purpose that the family serves for its members and for the state. I then suggest that we ought to reconceptualize how we understand and define the family in (...) an effort to move away from these paradigmatic conceptions. This approach requires that we examine the way(s) in which the family has been defined descriptively – that is, how families have been defined historically – in an effort to determine what a normative theory of the family might look like. The goal of this inquiry is to define a family in terms of what it ought to be – a goal that moves our understanding of the family to a new conceptual landscape. I then present my own account of familial relations that aims to capture a normative understanding of the unique primary purpose that the family serves for its members. (shrink)

According to constructive empiricists, accepting a scientific theory involves belief only that it is true of the observable world, where observability is defined in terms of what is detectable by the unaided senses. On this view, scientific instruments are machines that generate new observable data, but this data need not be interpreted as providing access to a realm of phenomena beyond what is revealed by the senses. A recent challenge to the constructive empiricist account of instruments appeals to the extended (...) mind thesis, according to which cognitive processes are sometimes constituted not just by brain activity, but can extend into the rest of the body and the surrounding environment. If this is right, scientific instruments may, in the right circumstances, literally become part of our perceptual processes. In this article, I examine this extended perception argument, and I find that it fails for the vast majority of scientific instruments. Even if the extended mind thesis is accepted, the constructive empiricist can draw a line between observables and unobservables that makes very few concessions to the realist. (shrink)

Ethics guidance and ethical frameworks are becoming more explicit and prevalent in health policy proposals. However, little attention has been given to evaluating their roles and impacts in the policy arena. Before this can be investigated, fundamental questions must be asked about the nature of ethics in relation to policy, and about the nexus of the fields of applied ethical analysis and health policy analysis. This paper examines the interdisciplinary stretch between bioethics and health policy analysis. In particular, it highlights (...) areas of scholarship where a health policy ethicsspecialization—as distinctive from bioethics—might develop to address health policy concerns. If policy and ethics both ask the same question, that question is: “What is the good, and how do we achieve (create, protect, cultivate) it?” To answer this question, the new field of “health policy ethics” requires development. First, we should develop a full set of ethical principles and complementary ethical theories germane to public policy per se. Second, we must understand better how explicit attention to ethical concerns affects policy dynamics. Third, we require new policy and ethical analytic approaches that contribute to constructive (not obstructive) policy making. Finally, we need indicators of robust, high quality ethical analysis for the purpose public policy making. (shrink)

This book critically reviews all principal contributions to the American animal rights debate by activists, campaigners, academics, and lawyers, while placing animal rights in context with other related and competing movements.

Contemporary Americans often view politics as a necessary evil. This cogent and original work uses the ancient philosophical/political tradition of the West to rehabilitate the high vocation of the politician and the citizen in the modern world. Kane seeks to locate human beings and such philosophical notions as the public good, public virtue, public speech, and public action in the complicated middle between the bestial and the divine. To live as best we can on that middle path is, he (...) believes, our vocation as citizens. The classical tradition comes alive in fresh ways as Kane applies it to key contemporary events and figures, from Elizabeth Bouvia (who wanted medical practitioners to help her die) to Rosa Parks (who wanted equal treatment on a city bus). By paying close attention to our public transactions, Kane shows how the reality of the common good operates in our lives. Kane contends that we are more likely to rediscover our political selves not in broad national or international forums but in our local communities where character can be displayed and authentic speech and action become possible. Aimed at a broad interdisciplinary and inter-professional audience, Kane's book is accessible to the interested citizen. Weaving through the tangled web of contemporary politics, including issues of character and virtue, Kane sails against the prevailing currents of strident individualism and political cynicism. (shrink)

Health care systems throughout the developed world face ‘crises’ of quality, financing and sustainability. These pressures have led governments to look for more efficient and equitable ways to allocate public resources. Prioritisation of health care services for public funding has been one of the strategies used by decision makers to reconcile growing health care demands with limited resources. Priority setting at the macro level has yet to demonstrate real successes. This paper describes international approaches to explicit prioritisation at the macro-governmental (...) level in the six experiences most published in the English literature; analyzes the ways in which values, principles and other normative concepts were presented in these international priority setting experiences; and identifies key elements of a more robust framework for ethical analysis which could promote meaningful and effective health priority setting. (shrink)

ABSTRACT:Officials must understand why and how the public lost confidence in the federal government’s ability to manage financial turmoil. Officials outsourced to private parties responsibility for monitoring and policing the safety-net exposures that were bound to be generated by weaknesses in the securitization process. When the adverse consequences of this imprudent arrangement first emerged, officials claimed for months that the difficulties that short-funded, highly leveraged firms were facing in rolling over debt reflected only a shortage of aggregate liquidity and not (...) individual-firm shortages of economic capital. Then, in September 2008, the president and other officials created an unwise sense of urgency that delays in implementation show to have been greatly exaggerated.That authorities and financiers violated common-law duties of loyalty, competence, and care they owe to taxpayers indicates a massive incentive breakdown in industry and government. Taxpayers deserve a thorough-going reorientation of: (1) how regulatory agencies report on their regulatory performance and back-room interactions with Congress and the Treasury, and (2) the contract structures and performance measures used by the financial industry and its government overseers. (shrink)

This article examines how the formation of markets in bottled water has relied on assembling a particular subject: the subject of hydration. The discourse of hydration is a conspicuous feature of efforts to market bottled water, allowing companies to appeal to scientifically framed principles and ideas of health in order to position the product as an essential component in self-health and healthy lifestyles. Alongside related principles, such as the ‘8 × 8 rule’, hydration has done much to establish new practices (...) of water drinking and consumption in which the consumer appears to be always at risk of dehydration and must engage in practices of ‘frequent sipping’. This article traces the emergence of the concept of hydration from its origins in exercise science and explores its circulation, contemporary uses and purchase. I argue that the appeal to biomedical languages and concepts found in the discourse of hydration connects with much broader ways of conceiving and acting upon the self that have become prevalent in contemporary society – what Rose and Novas call ‘biological citizenship’ – indicating how the ensemble of hydration participates in wider-ranging transformations in forms of rule. The story of hydration reveals how biomedical techniques of the self can be made to double up as ‘market devices’ by offering specific procedures for assessing the self and calculating the body’s needs. In order to grasp these developments, I position the health sciences, and health and fitness in particular, as a potent site of popular culture in which bodies learn to be affected by the procedures of scientific experiment. A critical grasp of this context is best enabled, I argue, by situating the producers and consumers of scientific principles and commercial products as embodied and looking at their interconnection in processes of emergence. Through these means, we can begin to develop a fully materialized account of the question: how have we become so thirsty? (shrink)

This introduction outlines the importance that Hans-Georg Backhaus’s transcript of Adorno’s 1962 seminar on ‘Marx and the Basic Concepts of Sociological Theory’ has for shedding light on the relationship between Adorno’s critical theory and the critique of political economy. PartIsignals the importance of the seminar by assaying the Anglophone scholarship on Adorno. PartIIcontextualises the seminar in the development of his thought. PartsIIIandIVfocus on what the transcript tells us about Adorno’s interpretation of Marx and the importance this interpretation held for Adorno’s (...) critical social theory. PartVpoints to the influence this interpretation of the critique of political economy had on the formation of the New German Reading of Marx. (shrink)

Physicians and nurses need to sustain their unique strengths and work in true collaboration, recognizing their interdependence and the complementarity of their knowledge, skills and perspectives, as well as their common moral commitments. In this article, challenges often faced by both nurses and physicians in working collaboratively are explored with a focus on the ways in which each profession's preparation for practice has differed over time, including shifts in knowledge development and codes of ethics guiding their practice. A call for (...) envisioning their practice as shared moral work as well as practical strategies to begin that work are offered as a basis for reflection towards enhanced nurse-physician relationships. (shrink)