Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage (...) payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated. (shrink)

Empathy is a form of emotionally charged imaginative perspective‐taking. It is also the unique source of a particular form of understanding, which I will call humane understanding. Humane understanding consists in the direct apprehension of the intelligibility of others’ emotions. This apprehension is an epistemic good whose ethical significance is multifarious. In this paper, I focus on elaborating the sense in which humane understanding of others is non‐instrumentally valuable to its recipients. People have a complex but profound need (...) to be humanely understood. Because we respond to others’ very real need when we pursue this sort of understanding of their emotions, empathy is best understood as itself a way of caring, rather than just a means to promote other caring behavior. (shrink)

Several studies have illuminated how processing manual action verbs (MaVs) affects the programming or execution of concurrent hand movements. Here, to circumvent key confounds in extant designs, we conducted the first assessment of motor–language integration during handwriting—a task in which linguistic and motoric processes are co‐substantiated. Participants copied MaVs, non‐manual action verbs, and non‐action verbs as we collected measures of motor programming and motor execution. Programming latencies were similar across conditions, but execution was faster for MaVs than for the other (...) categories, regardless of whether word meanings were accessed implicitly or explicitly. In line with the Hand‐Action‐Network Dynamic Language Embodiment (HANDLE) model, such findings suggest that effector‐congruent verbs can prime manual movements even during highly automatized tasks in which motoric and verbal processes are naturally intertwined. Our paradigm opens new avenues for fine‐grained explorations of embodied language processes. (shrink)

According to the sceptic Saul Kripke envisages in his celebrated book on Wittgenstein on rules and private language, there are no facts about an individual that determine what she means by any given expression. If there are no such facts, the question then is, what justifies the claim that she does use expressions meaningfully? Kripke’s answer, in a nutshell, is that she by and large uses her expressions in conformity with the linguistic standards of the community she belongs to. While (...) Kripke’s sceptical problem has gripped philosophers for over three decades, few, if any, have been satisfied by his proposed solution, and many have struggled to come up with one of their own. The purpose of this paper is to show that a more satisfactory answer to Kripke’s challenge can be developed on the basis of Donald Davidson’s writings on triangulation, the idea of two individuals interacting simultaneously with each other and the world they share. It follows from the triangulation argument that the facts that can be regarded as determining meaning are irreducible. Yet, contra Kripke, they are not mysterious, for the argument does spell out what is needed for an individual’s expressions to be meaningful. (shrink)

Are there limits to what it is morally okay to imagine? More particularly, is imaginatively inhabiting morally suspect perspectives something that is off-limits for truly virtuous people? In this paper, I investigate the surprisingly fraught relation between virtue and a familiar form of imaginative perspective taking I call empathy. I draw out a puzzle about the relation between empathy and virtuousness. First, I present an argument to the effect that empathy with vicious attitudes is not, in fact, something that the (...) fully virtuous person can indulge in. At least one prominent way of thinking about the psychology of the virtuous person excludes the possibility that the virtuous could emotionally apprehend the world in a less than virtuous way, and empathizing with vicious outlooks does seem to run afoul of that restriction. Then, I develop an argument that runs in the contrary direction: virtue in fact requires empathy with vicious outlooks, at least in some situations. There is reason to think that a crucial part of being virtuous is ministering effectively to others’ needs, and there is also reason to think that other people may need to be empathized with, even if their emotional outlooks are at least minorly vicious. Finally, I outline two different solutions to this puzzle. Both solutions hold some promise, but they also bring new challenges in their train. (shrink)

In this article, it will be concluded that the major automotive racing league, Formula 1, is failing in its efforts to be a truly unisex sport. In the current Formula 1 series, there are no female drivers. Although women have never been officially prohibited from competing in Formula 1, there have been fewer than 10 female drivers since its inception. This inquiry focuses on why women drivers have been prevented from securing professional driving positions in Formula 1 and racing on (...) equal terms with men. I argue that there are five major barriers which perpetuate women’s exclusion from this league: historical and current attitudes, assumed physical and mental inferiority, sexualisation, money, and representation and visibility. In this cultural examination, I demonstrate that the situation for women in Formula 1 appears to be bleaker than in other sports that are making progress in their quest for gender equality. However, I also suggest that, despite ethical issues, W Series – a new, women-only, single-seater car racing championship – could potentially motivates positive change for women’s car racing by promoting gender equity through a new league which enables women to improve themselves in a protected category. This article also considers the impact of sex in Formula 1, which is pertinent to the discussion surrounding alleged biological differences. The discussion employs Simone de Beauvoir’s conceptualisation of ‘Otherness’, as well as Helmut Pflugfelder’s account of female embodiment in motorsport. The overall findings are that more focused research is required for gender issues in Formula 1 to be accurately addressed. (shrink)

This paper examines the meaningfulness of pointing in great apes. We appeal to Hannah Ginsborg’s conception of primitive normativity, which provides an adequate criterion for establishing whether a response is meaningful, and we attempt to make room for a conception according to which there is no fundamental difference between the responses of human infants and those of other great apes to pointing gestures. This conception is an alternative to Tomasello’s view that pointing gestures and reactions to them reveal a fundamental (...) difference between humans and other apes. (shrink)

Critics contend that Aristotelianism demands too much of the virtuous person in the way of knowledge to be credible. This general charge is usually directed against either of two of Aristotelianism’s apparent claims about the necessary conditions for the possession of a single virtue, namely that 1) one must know what all the other virtues require, and 2) one must also be the master of a preternatural range of technical/empirical knowledge. I argue that Aristotelianism does indeed have a very high (...) standard when it comes to the knowledge necessary for the full possession of a virtue, in both of these respects. However, focus on the necessary conditions for full virtue tends to obscure an important fact: some kinds of knowledge are much more important to various virtues than others are. A proper appreciation of the significance of this fact will go a long way toward answering critics’ worries about Aristotelianism’s knowledge requirements. (shrink)

Adherence to professional ethics in nursing is fundamental for high-quality ethical care. However, analysis of the use and impact of nurses’ codes of ethics as a part of professional ethics is limited. To fill this gap in knowledge, the aim of our review was to describe the use and impact of the Code of Ethics for Nurses with Interpretive Statements published by the American Nurses Association as an example of one of the earliest and most extensive codes of ethics for (...) nurses with their interpretative statements and constituting a strong basis for the International Council of Nurses’ Code of Ethics for Nurses. We based our review on previous literature using a scoping review method. We included both non-scientific and scientific publications to provide an analysis of codes of ethics which can be utilized in development and revision of other nurses’ codes of ethics. In the searches, we used CINAHL and PubMed databases limiting publications to texts with a connection to the Code of Ethics for Nurses published from January 2001 to November 2022 and written in English. Searches yielded 1739 references, from which 785 non-scientific and 71 scientific publications were included for analysis of the data. Although non-scientific and scientific publications addressed different number of categories, the results indicated that in the both groups the use and impact focused on professional ethics, nursing practice, and work environment and less on education, research, or social health issues. Nurses’ ethical standards were not addressed in non-scientific publications, and clinical issues and leadership were not in focus in scientific publications. To increase evidence-based knowledge of the impact of codes of ethics additional research is needed. Good scientific conduct was followed. (shrink)

School performance and cognitive competence can be conceptualized as social and relational constructs. Thus, we expect their association to vary as a function of other socially-embedded variables which have proven meaningful in the academic domain. The present study takes a critical theory approach to assess gender-related and contextual variability in the association between peer-assessed school performance and self-perceived cognitive competence. The sample consisted of 719 preadolescents living in lower- and upper-middle-class neighborhoods in Montreal, Canada and Barranquilla, Columbia. Multigroup comparisons revealed (...) that peer-assessed school competence was more strongly associated with self-perceived cognitive competence for upper-middle-class than lower-middle-class participants from Barranquilla, whereas the opposite pattern was observed with Montreal participants, and that the association between communal orientation and self-perceived cognitive competence was stronger for girls than for boys across the sample, especially in the upper-middle-class school in Montreal. These findings highlight the nuanced degree of gender differences in preadolescents’ perceived academic competence and emphasize the role of SES in shaping self-perceptions. (shrink)

Memory consolidation is the process in which memory traces are strengthened over time for later retrieval. Although some theories hold that consolidation can only occur during sleep, accumulating evidence suggests that brief periods of wakeful rest may also facilitate consolidation. Interestingly, however, Varma and colleagues reported that a demanding 2-back task following encoding produced a similar performance to a wakeful reset condition. We tested whether participants’ recall would be best following a wakeful rest condition as compared to other distractor conditions, (...) consistent with the extant wakeful rest literature, or whether we would replicate the finding by Varma and colleagues such that participants’ memory benefitted from both a rest and a 2-back task following encoding. Across two experiments, we used similar and the same encoding material as used the one by Varma and colleagues, employed a wakeful rest condition adapted for online testing, and compared participants’ recall across post-encoding conditions. In the first experiment, we used a between-subjects design and compared participants’ cued recall performance following a period of wakeful rest, a 2-back task, or a rest + sounds condition. The second experiment more closely replicated the experimental design used by Varma and colleagues using a within-subjects manipulation. Ultimately, our findings more consistently aligned with the canonical wakeful rest finding, such that recall was better following the rest condition than all other post-encoding conditions. These results support the notion that wakeful rest may allow for consolidation by protecting recently encoded information from interference, thereby improving memory performance. (shrink)

The Protein Ontology (PRO; http://proconsortium.org) formally defines protein entities and explicitly represents their major forms and interrelations. Protein entities represented in PRO corresponding to single amino acid chains are categorized by level of specificity into family, gene, sequence and modification metaclasses, and there is a separate metaclass for protein complexes. All metaclasses also have organism-specific derivatives. PRO complements established sequence databases such as UniProtKB, and interoperates with other biomedical and biological ontologies such as the Gene Ontology (GO). PRO relates to (...) UniProtKB in that PRO’s organism-specific classes of proteins encoded by a specific gene correspond to entities documented in UniProtKB entries. PRO relates to the GO in that PRO’s representations of organism-specific protein complexes are subclasses of the organism-agnostic protein complex terms in the GO Cellular Component Ontology. The past few years have seen growth and changes to the PRO, as well as new points of access to the data and new applications of PRO in immunology and proteomics. Here we describe some of these developments. (shrink)

The moral acceptability of anonymous gamete donation remains contested. Although the view that the value of parent–child relationships should not depend on genetic ties is “nearly axiomatic” among philosophers and bioethicists, one well-known dissenter remains: David Velleman. I argue that most rebuttals to Velleman have simply talked past him because they have failed to understand his fundamental point—that donor conception is a violation of human dignity and as such is wrong even if it does not harm individuals. I challenge Velleman (...) on his own terms by endorsing his metaphysical picture before showing that donor conception is not necessarily a violation of human dignity. I show this by arguing that gamete donation is held to a double standard of self-knowledge. I develop an account of the self that recognizes that certain kinds of challenges to one's flourishing can contribute to an individual's strength and self-knowledge. I defend my view against objections that genetic knowledge is categorically different from other ways of knowing oneself and I show that donor conception can respect human dignity as long as it meets certain conditions. (shrink)

The moral acceptability of anonymous gamete donation remains contested. Although the view that the value of parent–child relationships should not depend on genetic ties is “nearly axiomatic” among philosophers and bioethicists, one well‐known dissenter remains: David Velleman. I argue that most rebuttals to Velleman have simply talked past him because they have failed to understand his fundamental point—that donor conception is a violation of human dignity and as such is wrong even if it does not harm individuals. I challenge Velleman (...) on his own terms by endorsing his metaphysical picture before showing that donor conception is not necessarily a violation of human dignity. I show this by arguing that gamete donation is held to a double standard of self‐knowledge. I develop an account of the self that recognizes that certain kinds of challenges to one's flourishing can contribute to an individual's strength and self‐knowledge. I defend my view against objections that genetic knowledge is categorically different from other ways of knowing oneself and I show that donor conception can respect human dignity as long as it meets certain conditions. (shrink)

This book introduces a set of methods and techniques for studying mathematical theories and relating them to each other through the use of Grothendieck toposes.

This chapter weighs a challenge to the attractive notion that by enabling empathy, fiction affords wide-ranging knowledge of what others’ experiences are like. It is commonly held that ‘seeing the world through others’ eyes’ often requires the empathizer to undergo an imaginative shift in sensibility, and we might naturally think that fiction helps us to effect that shift. However, some recent work on empathy and imagination encourages the conclusion that we are actually rigidly restricted to our own sensibilities (...) even in the wildest flights of imagination great literature can inspire. Drawing on the work of the novelist Zadie Smith, the chapter argues that while our imaginative capacities are not entirely unconstrained by our sensibilities, fiction can still help us to learn about a wide range of human experiences, including the experiences of people whose sensibilities substantially diverge from our own. Notably, fiction can work on our patterns of attention in such a way that we become temporarily ‘not ourselves.’. (shrink)

The use of perfumes, incense, colognes, and plant and flower essences in Amazonian healing practices is a hallmark feature of vegetalismo, a form of healing in Peru’s Amazonian regions. Sprayed, smoked, rubbed on bodies, and poured in medicinal baths, these odorous tools are vital allies to the curandero for cleansing bodies and spaces, for protection, or to add potency to medicinal plants. Certain perfumes are more common than others, particularly the citrusy Agua de Florida, an 18th Century eau de (...) cologne from the United States. Focusing in on the history of Agua de Florida and its ubiquity in Western Amazonia, I suggest the necessity of a sensory anthropology for exploring the vast healing potential of vegetalismo. Going beyond the visual to consider other sensory experiences lends insight into the various healing mechanisms in Amazonian shamanism that are often overlooked by western epistemologies of health and healing. (shrink)

Empathy is a familiar form of emotionally charged imaginative perspective taking. In this dissertation I offer an account of empathy’s moral importance that emphasizes the special value of its unique epistemic functions. Specifically, I defend what I call the humane understanding thesis: empathy is the source of a distinct epistemic good, humane understanding, which consists in the appreciation of the intelligibility of others’ emotional perceptions, and humane understanding is necessary for fully virtuous relations with other people. Adam Smith held (...) that empathy is the unique means by which we judge the propriety of other’s emotions. I draw out the kernel of truth in this surprising claim. Emotions inevitably present the world in a certain evaluative light. When I see my situation as calling out for my anger, or fear, or adoration, my emotion appears to me to be properly responsive to my situation. I can judge my emotion to be inappropriate, all things considered. However, I cannot both be angry at your betrayal and be totally mystified by my own anger, or resent you but see no absolutely nothing in your conduct that appears to call out for my resentment. This insight applies to empathy. When we empathize, we feel genuine emotions. And when we feel these emotions, we cannot fail to appreciate the intelligibility of the other’s original emotion first-hand. This appreciation constitutes humane understanding of the other’s emotion. I further clarify the nature of this epistemic achievement by distinguishing it from two other nearby forms of understanding, one that is achieved through narrative rather than perspective taking, and one that is achieved through unemotional perspective taking. Empathy has recently come in for some heavy criticism. It has been described as not only morally unnecessary, but positively morally corrosive. Recognizing that empathy is the unique means by which we secure humane understanding of others’ emotional perceptions enables us to appreciate aspects of empathy’s moral significance that its most prominent detractors have neglected. Humane understanding is a powerful way of being close to another person, and closeness is something that social beings like ourselves crave, not for any further or deeper purpose, but just because it is valuable to us in and of itself. People have a powerful need to be empathized with because empathy relieves a painful form of loneliness. Empathy can be a way of caring, rather than just a means of getting us to care. In further defense of empathy’s moral significance, I also argue that empathy has a meaningful role to play in the development of both our reflective beliefs about moral properties and our emotional sensitivity to those same properties. Empathy can allow us to discover new moral distinctions through imaginative emotional experience, and it can also help us to shape and sharpen our moral emotional perception. Finally, I round out my review of empathy’s moral significance with an argument that empathy with others makes it very difficult to intend to treat them in certain immoral ways. We cannot both empathize with someone and see them as unfeeling, as unthinking, or as lacking a normative perspective on the world. Consequently, empathizing with someone is at least not compatible with treating them as a mere object. I offer my Smithian picture of empathy’s moral and epistemic functions as an alternative to the popular Humean view that empathy moves us from our default position of solipsism and egoism to knowledge of and care for other’ inner lives. That view’s ambition is tantalizing, but it distorts both the nature of empathy and the nature of our other-oriented concern and understanding. Hume’s account of empathy’s significance, and the more recent accounts that take after it, end up making it look as though empathy simply contributes to the expansion of egoism, and/or as though empathy depends for its motivational efficacy on a kind of epistemic mistake. (shrink)

This paper is concerned with the early documented history of featherwork in China, as described in historical texts and literature up until the end of the Tang dynasty in 907 CE. Although featherwork from several Pacific islands and Latin America has recently been the subject of academic attention, the important Chinese tradition has been neglected. Drawing on studies of featherwork from other cultures, this paper divides these accounts by technical criterion into flexible base featherwork ; rigid base featherwork ; and (...) most remarkably of all, deconstructionist featherwork, whereby the barbs of individual feathers were peeled apart and then spun with a silk core to create a feather thread, which was then woven into cloth. Featherwork was produced in vast quantities in early and medieval China to satisfy demand for these luxurious and brightly colored items, and exotic birds—kingfishers, parrots, pheasants, and so on—were traded across the empire to create these wonderful works of art. (shrink)

Contentless experience involves an absence of mental content such as thought, perception, and mental imagery. In academic work it has been classically treated as including states like those aimed for in Shamatha, Transcendental, and Stillness Meditation. We have used evidence synthesis to select and review 135 expert texts from within the three traditions. In this paper we identify the features of contentless experience referred to in the expert texts and determine whether the experiences are the same or different across the (...) practices with respect to each feature. We identify 65 features reported or implied in one or more practices, with most being reported or implied in all three. While there are broad similarities in the experiences across the traditions, we find that there are differences with respect to four features and possibly many others. The main difference identified is that Shamatha involves substantially greater attentional stability and vividness. Another key finding is that numerous forms of content are present in the experiences, including wakefulness, naturalness, calm, bliss/joy, and freedom. The findings indicate that meditation experiences described as contentless in the academic literature can in fact involve considerable variation, and that in many and perhaps most cases these experiences are not truly contentless. This challenges classical understandings in academic research that in these so-called contentless experiences all content is absent, and that the experiences are therefore an identical state of _pure consciousness_ or consciousness itself. Our assessment is that it remains an open question whether the experiences aimed for in the three practices should be classed as pure consciousness. Implications of our analysis for neuroscientific and clinical studies and for basic understandings of the practices are discussed. (shrink)

When a woman is pregnant, how should we understand the moral status of the life within her? How should we understand its status as conceptus, as embryo, when an early or again matured fetus? According to some, human life in all of these forms is inviolable: early human life has a moral status equivalent to a person from the moment of conception. According to others, such life has no intrinsic status, even late in pregnancy. According to still others, (...) moral status emerges when sentience does. Until the fetus is conscious - a point somewhere at the end of the second trimester, it has no moral status at all; after it is conscious, it does. (shrink)

Per the OpenNotes directive of the 21st Century Cures Act implemented in 2021, patients and their legally recognized representatives must be able to access the electronic medical record in real time. This is an opportunity for clinical ethicists and other providers to reflect on their charting practices, particularly how and when they quote patients. Although using direct quotations is common because it seems to avoid misinterpretation, it may not always be appropriate. In this article, we discuss some of the risks (...) and benefits of quoting in the context of OpenNotes and provide suggestions for how clinical ethicists can leverage their unique position to help mitigate some of these risks and promote more reflective charting practices among the teams they work with. (shrink)

Museum visitors partake in the effect of what we can call the domestication of the view. They witness the constant changes in how objects are allowed to exist in a museological space. In this way, visitors are challenged to cultivate new sensibilities that simultaneously reveal and conceal things and their relationships. These meanings have been subject to political debates, controversies, disputes, and conflicts around property rights involving museum representatives and other actors. As a result, the domesticated things inside the museums (...) threaten to displace themselves, moving towards the uncertainty of other shelters and other hands. Each time other flows and movements towards other ‘homes’ are asserted by different sort of groups and communities to reclaim or ‘bring home’ objects previously obtained through a mixture of pillaging, acquisitions, donations, and violent actions, distinct voices ask the same question: whose home? By exploring a case concerning the restitution of objects outside and inside museums, this article explores an alternative understanding of the notion of the house as a legitimate relationship between materiality and those worlds in which objects dwell. In the first sections, to explore the idea of heterotopy coined by Michel Foucault from an anthropological perspective, I return to some interpretations of notions such as ‘home’ and ‘house’ drawing on classical ethnographies. Secondly, I focus on what Ghassan Hage calls a ‘diasporic lenticularity’ to explore other “modes of existing” in multiple places and realities. Finally, I conclude by revolving distinct cases concerning museum practices and reallocation processes, transforming and (re)creating new spaces to locate and house unstable objects and presences. (shrink)

Asomatognosia designates the experience that one’s body has faded from awareness. It is typically a somaesthetic experience but may target the visual modality. Frequently associated symptoms are the loss of ownership or agency over a limb. Here, we elaborate on the rigorous nosographic classification of asomatognosia and introduce a structured interview to capture both its core symptoms and associated signs of bodily estrangement. We additionally report the case of a pure left-sided hemiasomatognosia occurring after surgical removal of a meningioma in (...) the right atrium. Despite the wide lesions of the right angular gyrus and of the temporo-parietal junction, the patient did not present visuospatial deficits or bodily awareness disorders other than hemiasomatognosia. The patient and 10 matched controls’ motor imagery was formally assessed with a limb laterality task in which they had to decide whether hands and feet presented under different angles of rotation depicted a left or a right limb. Bayesian statistics showed that patient’s reaction times were significantly impaired exclusively for the left foot and especially for mental rotations requiring somatomotor rather than visual limb representations. This was in accordance with a more enduring left-sided hemiasomatognosia for the lower limbs confined to the somesthetic modality. Our findings shed new light on motor imagery in asomatognosia and encourage the future use of the structured interview introduced here. In addition, the limb laterality task may capture phenomenological elements of a case by chronometric means. This allows a more standardized reporting of phenomenological detail and improves communication across different clinical facilities. (shrink)

This article investigates African women commuter trading activities in Nairobi in the first decade after World War One. Its findings derive mainly from a research project carried out in 1989-1996. The major source of data for the study was oral interviews with the women who traded in Nairobi during the years under study, as well as with eyewitnesses to their trading activities. Sampling of such respondents employed the purposive technique because of its ability to deal with the problem of an (...) incomplete population frame by conveniently drawing the required study sample from available resources. The research drew other data from library and archival sources, especially to corroborate the oral evidence. However, this article utilises additional archival and library data to achieve greater comprehensiveness than was attained in the earlier version. The article therefore makes an important intellectual contribution to the ongoing debate on the social, political and economic role and impact of African women’s economic activities such as commodity trade in African towns. (shrink)

Background: The 21-item Nurses’ Moral Courage Scale was developed and validated in 2018 in Finland with the purpose of measuring moral courage among nurses. Objectives: The objective of this study was to make a Dutch translation of the Nurses’ Moral Courage Scale to describe the level of nurses’ self-assessed moral courage and associated socio-demographic factors in Flanders, Belgium. Research design: A forward–backward translation method was applied to translate the English Nurses’ Moral Courage Scale to Dutch, and a pilot study was (...) conducted to improve readability and understandability. A non-experimental, descriptive cross-sectional exploratory design was used to conduct a survey. Descriptive analysis was used. Participants: The data were collected from a convenience sample of 559 nurses from two hospitals in Flanders. Ethical considerations: Ethical approval was obtained from the university ethics committee, permission to conduct the study was obtained from the participating hospitals. Participants received a guide letter and gave their informed consent. Findings: The readability and understandability of the Dutch Nurses’ Moral Courage Scale were positively evaluated, and the scale revealed a good level of internal consistency for the total scale and all subscales. Nurses’ mean score of the 21-item Nurses’ Moral Courage Scale was 3.77. The total Nurses’ Moral Courage Scale score was associated with age, experience, professional function, level of education and personal interest. Discussion and Conclusion: The Nurses’ Moral Courage Scale was successfully translated to Dutch. The Flemish nurses perceived themselves as morally courageous, especially when they were in a direct interpersonal relationship with their patients. Acting courageously in ethical dilemmas that involved other actors or organizations appeared to be more challenging. The results strongly suggest the important role of education and ethical leadership in developing and supporting this essential virtue in nursing practice. (shrink)

Background: Nurses encounter complex ethical dilemmas in everyday nursing care. It is important for nurses to have moral courage to act in these situations which threaten patients’ safety or their good care. However, there is lack of research of moral courage. Purpose: This study describes nurses’ experiences of care situations demanding moral courage and their actions in these situations. Method: A qualitative descriptive research design was applied. The data were collected with an open-ended question in the questionnaire used in validation (...) of the Nurses’ Moral Courage Scale. The sample consisted of 286 nurses from four different clinical fields in a major university hospital in Finland, providing a total of 611 answers. Data were analyzed using inductive content analysis. Ethical considerations: The study followed the commonly recognized principles of good scientific practice. The use of data was authorized by the developer of the instrument, the data collector, and the participating hospital. Ethical approval was obtained from the university ethics committee. Findings: Nurses acted morally courageously in most situations but sometimes they failed to do so. Although situations demanding moral courage varied, they could be categorized into seven main domains relating to colleagues, physicians, patients, relatives, nurses themselves, managers, and organizations. Nurses acted in the situations in different ways. The main acts in solving the situations were verbal communication or immediate action, such as interrupting of action. Conclusion: Care situations demanding moral courage focus on good and safe patient care and the patient’s good is at the center of attention. The situations are mostly related to the activities of other healthcare professionals. Findings may be applied in developing ethical nursing care through basic and continuing nursing education. Research is needed on the moral courage of physicians and managers, as well as on patients’ and their relatives’ experiences of care situations demanding moral courage. (shrink)

Contemporary bioethics education has been developed predominately within Euro-American contexts, and now, other global regions are increasingly joining the field, leading to a richer global understanding. Nevertheless, many standard bioethics curriculum materials retain a narrow geographic focus. The purpose of this article is to use local cases from the Asia-Pacific region as examples for exploring questions such as ‘what makes a case or example truly local, and why?’, ‘what topics have we found to be best explained through local cases or (...) examples?’, and ‘how does one identify a relevant local case?’ Furthermore, we consider the global application of local cases to help extend the possible scope of the discussion, opening new avenues for the development of practical bioethics educational materials. We begin with a background description and discussion of why local cases enhance bioethics education, move to an overview of what is currently available and what is not for the region, and then outline a discussion of what it means to be local using example cases drawn from Hong Kong, Australia, Pakistan, and Malaysia. We are not creating a casebook but rather constructing by example a toolbox for designing active and dynamic learning cases using regional diversity as contextualised cases with generalised principles. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Procreative Liberty, Biological Connections, and MotherhoodMargaret Olivia Little (bio)Given the complex and dramatic array of issues currently facing us in reproductive ethics, bioethicists working on the topic might be forgiven feelings of trepidation when they cast their minds toward the next century. Currently, technologies such as artificial insemination by donor (AID), once the source of intense controversy, are used on a routine basis; mainstream newspapers carry advertisements offering (...) “excellent compensation” to ova “donors;” courts are arguing whether women who serve as gestational or “surrogate” mothers have any parental rights; and proposals resurface to jail pregnant women who take street drugs. Sorting out which developments are to be welcomed and which are to be resisted—and why—will require us not only to clarify some of our most basic value commitments, but also to reflect on our understanding of concepts, such as motherhood, that we previously had the luxury of thinking obvious. Let me highlight two issues I think we will be forced to confront as we try to navigate the ethics of reproduction into the twenty-first century—namely, the value of biological connection and the meaning of motherhood.Procreative Liberty and the Value of Biological ReproductionPeople who are unable to conceive a child or to carry one to term now face a variety of extraordinary means of procreative assistance: they can buy sperm and ova, undergo in vitro fertilization, or contract another woman to gestate and give birth to the baby. Those who are enthusiastic about these new technologies [End Page 392] and arrangements often explain their support in terms of many people’s deep desire or even right to bear children biologically related to them; those who are suspicious of the techniques often explain their resistance by criticizing our culture’s “pronatalist” emphasis on biological rather than social relations with children. Focusing on such clear-cut positions, though, undersells the complexity and difficulty of the issues involved. Few want to dismiss altogether the importance of biological connection; but the question remains, what measure of importance should it be granted? Or again, while most agree that procreative liberty is one of our most fundamental rights, the question remains, whose procreation, in what context, and by which means? The truly difficult questions, that is, pertain to how we are to value biological relatedness and how we are to draw the contours of procreative liberty.One perspective emerging in current debates urges an expansive answer to these questions, arguing that the new reproductive technologies and arrangements deserve constitutional protection. Procreative liberty is deeply important, it is urged, given how fundamental the decision to have or to refrain from having children is to our sense of dignity, identity, and meaning of life. But if we recognize a right to reproduce coitally, it is claimed, we should also recognize a right to reproduce noncoitally: people with infertile partners should no more be barred from exercising their right to “beget, bear, and raise” children biologically linked to them by using surrogate arrangements or AID than those who are blind should be barred from exercising their right to written information by using Braille texts. 1The fundamental question is whether the value of biological reproduction persists when pursued outside of the intimacies of marriage and family that form its traditional home. The new reproductive technologies and arrangements, after all, represent a departure not simply because they are noncoital but because they involve reproduction with strangers, under contract, and for pay. One question that demands our reflection, then, is whether the procreative liberty we value attaches to individuals atomistically, as it were, or to individuals only insofar as they are in relationships of an intimate and ongoing nature.Other developments on the horizon sound a restrictive note about procreative liberty. Many IVF clinics, for instance, have denied services to would-be single parents or to gay or lesbian couples. Some legislators have proposed making certain welfare payments for women conditional upon their use of contraceptives such as Norplant—an odd view if one regards procreative liberty as a fundamental right. After all, we do not usually make the receipt of public aid contingent on waiving a constitutional right. (Imagine the government stipulating that... (shrink)

I defend moral objectivism against charges that it cannot plausibly preserve or explain morality's action-guiding nature. I take as my starting point the intuitive view that morality has a special connection to motivation: one who genuinely accepts a moral verdict must have a motivating reason to follow its dictates and, indeed, must often enough be motivated to act as it recommends. ;Many have argued that this connection vindicates subjectivism. Some argue that there can be no universally accessible truths whose acknowledgements (...) necessarily give one reason to act, because all reasons for action are based on desires that vary across rational agents. I argue against the Humean doctrine, implicit in this claim, that beliefs alone cannot move rational agents. The 18th-century metaphors of "passive" belief and "active" desire rest on arguments which either beg the question, equivocate, or misunderstand what would be involved in attributing the appropriate motivational power to belief. Others ground their objection in morality's holistic tie to desire, claiming that desires distort truth, rather than reveal it to us. I argue that there is nothing mysterious about the idea that possession of certain desires can be preconditions to seeing how things are. (shrink)

The global #MeToo movement has precipitated a reckoning with gendered, sexual, and other forms of harassment and bullying in higher education. In academia, harassment is rooted in the history of re...

Shamatha, Transcendental, and Stillness Meditation are said to aim for “contentless” experiences, where mental content such as thoughts, perceptions, and mental images is absent. Silence is understood to be a central feature of those experiences. The main source of information about the experiences is texts by experts from within the three traditions. Previous research has tended not to use an explicit scientific method for selecting and reviewing expert texts on meditation. We have identified evidence synthesis as a robust and transparent (...) method that is suitable for this purpose. In this paper we use evidence synthesis based on expert texts to examine silence/quietness as a feature of the contentless experiences in the three practices. Objective criteria were used to select a sample of 135 expert texts. A database containing the expert descriptions of the meditation techniques and experiences was produced by extracting the relevant material from the publications and coding that material to differentiate individual features. The database, which forms part of the supplementary material for this paper, identifies each feature of the contentless experiences referred to in the expert texts, including silence/quietness. Our key finding is that the experts indicate silence/quietness has a particular connection with stillness, and the absence of concepts, mental activity/noise, thoughts, and disturbance. Further analysis leads to the following insights. The silence/quietness reflects the absence of thoughts and sounds, and this fits neatly with a conception of silence/quietness as the absence of internal and external noise. In some cases the terms silence and quietness may also reflect the absence of other disturbances such as non-auditory perceptions, mental images, and negative feelings. That would fit with a conception of silence/quietness as complete calm or absence of disturbance. It is not clear from the expert texts how silence/quietness is distinct from other features such as stillness that also reflect the absence of disturbances. As a separate matter, silence/quietness has connections with all the other features of the contentless experiences, but the closeness of the connections varies. Our work uncovers fine distinctions and ambiguities which lead to new research questions that can be explored in future studies. (shrink)

Food sharing may be used for mate attraction, sexual access, or mate retention in humans, as in many other species. Adult humans tend to perceive more intimacy in a couple if feeding is observed, but the increased perceived intimacy may be due to resource provisioning rather than feeding per se. To address this issue, 210 university students (66 male) watched five short videos, each showing a different mixed-sex pair of adults dining together and including feeding or simple provisioning or no (...) food sharing. A survey concerning attraction and intimacy in the dyad was completed after each video. Both provisioning and feeding produced higher ratings of “Involvement,” with feeding producing the highest ratings. Similarly, the perceived attraction of each actor to the other was lowest when no food sharing was shown and highest when feeding was displayed. These findings are consistent with a view of feeding as a courtship display in humans. (shrink)

In contentless experience there is an absence of mental content such as thought, perception, and mental imagery. The path to contentless experience in meditation can be taken to comprise the meditation technique, and the experiences on the way to the contentless “goal-state/s”. Shamatha, Transcendental, and Stillness Meditation are each said to access contentless experience, but the path to that experience in each practice is not yet well understood from a scientific perspective. We have employed evidence synthesis to select and review (...) 135 expert texts from those traditions. In this paper we describe the techniques and interim-states based on the expert texts and compare them across the practices on key dimensions. Superficially, Shamatha and Transcendental Meditation appear very different to Stillness Meditation in that they require bringing awareness to a meditation object. The more detailed and systematic approach taken in this paper indicates that posturally Shamatha is closer to Stillness Meditation, and that on several other dimensions Shamatha is quite different to both other practices. In particular, Shamatha involves greater measures to cultivate attentional stability and vividness with respect to an object, greater focusing, less tolerance of mind-wandering, more monitoring, and more deliberate doing/control. Achieving contentless experience in Shamatha is much slower, more difficult, and less frequent. The findings have important implications for taxonomies of meditation and for consciousness, neuroscientific, and clinical research/practice, and will provide new and useful insights for meditation practitioners. (shrink)

This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, (...) the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage. (shrink)

Healthcare professionals are currently working under extreme pressure as they respond to the pandemic outbreak of COVID-19. At the time of writing, there is currently no effective vaccine or anti-viral treatment. The pandemic is fast-moving, relatively unpredictable and of uncertain duration. In many countries, it is placing an enormous stress on healthcare resources and providing care to existing standards is proving difficult. Unfortunately, in some countries, health services have been overwhelmed. The impact of the pandemic on resource-poor countries is of (...) particular concern. This extraordinary situation is raising, or has the potential to raise, many ethical challenges for doctors delivering care to patients. It is possible, for example, that there may be points in this pandemic where decisions need to be made about who should have access to finite specialised intensive care beds, drugs and equipment. This has happened in some countries and, despite efforts by the UK Government to reduce demand and increase supply, it is still possible that this could happen in the UK. Some hospital trusts in the UK are already reporting concerningly low supplies of oxygen and vital medicines such as propofol and alfentanil.1 In these circumstances, where not everyone can be treated, difficult ethical decisions will have to made. For example, can some patients be prioritised over others? How should a doctor decide on which patients to treat? Can treatment be withdrawn from patients who are currently being treated, but are not responding, in order to offer treatment to those who may have a better chance of benefiting? The UK is also reporting concerningly low supplies of vital personal protective equipment for frontline workers, raising the question - what are a doctor’s obligations to treat patients, in circumstances that present a high …. (shrink)

If you are an anthropologist wanting to use digital methods or programming as part of your research, where do you start? In this commentary, we discuss three ways in which anthropologists can use computational tools to enhance, support, and complement ethnographic methods. By presenting our reflections, we hope to contribute to the stirring conversations about the potential future role of data science vis-a-vis anthropology and ethnography, and to inspire other anthropologists to take up the use of digital methods, programming, and (...) computational tools in their own research. (shrink)

An Amnesty International briefing, published in July 2020, highlights the grave risks health workers are facing globally, particularly in the face of the COVID-19 pandemic.1 The report uses data from 63 countries across the world from January to June 2020 and is rich with examples. While recognising that information about the pandemic is constantly evolving, and each country is in a separate phase of the outbreak, Amnesty International draws attention to several troubling trends. By virtue of the role undertaken by (...) health workers, they face a greater exposure to COVID-19, which has contributed to many of the concerns they now deal with. The briefing notes the evidence of the higher death rate from health workers compared with the general population in countries ranging from Denmark to Argentina, while also pointing out the significantly higher death rate in BAME health workers raised by the BMA in the UK.2 PPE shortages had been reported in nearly all of the 63 countries analysed. Many health workers globally stated that they had to buy their own PPE and others described cases of ‘improvisation’, when suitable PPE was not available, such as using bin bags or raincoats. Furthermore, health workers in several countries had experienced increases in workload with formal measures to extend health workers’ contracted hours passed in some countries as well as further changes to their terms and conditions of service. There were also reports of increased mental stress, particularly from those working in ICUs; the increased work and stress is not being matched with suitable compensation or remuneration. Despite many countries passing special benefits for health workers, it was commonly stated that these benefits had not been received yet or that they did not apply to all health workers, with cleaners and other lower-paid yet vital roles excluded. Deeply concerning …. (shrink)

How do ethics show up in the everyday behaviors and conversations of researchers in a scientific laboratory? How does the microcosmic culture of the laboratory shape researchers’ understandings of scientific ethics? We, an interdisciplinary team representing anthropology, computer science, and rhetorical studies, investigated these questions in two university STEM labs. Similar to previous work mapping out the epistemic cultures, we sought to understand the ethical cultures of these research groups. We observed their lab meetings for several months and conducted interviews (...) with members of the research laboratories. Ultimately, we recognized two distinct ethical cultures within the two laboratories: one focused on the relationship between science and social justice, and the other focused on clean data and accuracy as an ethical issue. These two distinct ethical cultures were discernable through ethnography, close reading of laboratory members’ language, as well as broad-scale topic modeling. Our project complements previous studies of ethics in science that have focused on codes of ethics or student curricula as ways in which scientists develop an understanding of scientific ethics. Our project demonstrates that everyday interactions between the members of scientific research labs additionally shape, at a decidedly local level, how scientists understand and ultimately approach ethical decision-making in the scientific research process. (shrink)

BackgroundHeavy media use has been linked to sleep problems in children, which may also extend to the infancy period. While international parent-advisory agencies, such as the American Academy of Pediatrics, advise no screen time before 18 months, parents often do not follow this recommendation. Research on Italian infants’ early access to media is sparse, and only very few studies have investigated links with sleeping habits.MethodTo address this gap, we examined concurrent associations between parent-reported surveys of child technology use and sleeping (...) patterns. The Italian version of the 60 item Comprehensive Assessment of Family Media Exposure Survey, developed as part of a larger international study,, the Brief Screening Questionnaire for Infant Sleep Problems Sadeh, 2004) were completed online by 264 Italian parents of 8- to 36-month-olds and a subset completed the Parenting Stress Index Abidin, 1995) between April 2017 and April 2018.ResultsMore devices located in the child’s room and the more time spent watching TV or using an iPad were associated with less hours of sleep at night. Furthermore, more time spent watching TV or using a smartphone, as well as the number of devices in the room was associated with going to sleep later at night. Instrumental media use was associated with less sleep.ConclusionLike other countries, Italian infants have high levels of exposure to media, and differences in media patterns were associated with sleep patterns. Cultural factors influence both instrumental reasons for media use and sleep practices. Further research should explore how media use may serve to regulate emotion as a function of both contextual factors and individual differences. (shrink)

This article discusses the triage response to the COVID-19 delta variant surge of 2021. One issue that distinguishes the delta wave from earlier surges is that by the time it became the predominant strain in the USA in July 2021, safe and effective vaccines against COVID-19 had been available for all US adults for several months. We consider whether healthcare professionals and triage committees would have been justified in prioritising patients with COVID-19 who are vaccinated above those who are unvaccinated (...) in first-order or second-order triage. Given that lack of evidence for a correlation between short-term survival and vaccination, we argue that using vaccination status during first-order triage would be inconsistent with accepted triage standards. We then turn to notions of procedural fairness, equity and desert to argue that that there is also a lack of justification for using vaccination status in second-order triage. In planning for future surges, we recommend that medical institutions base their triage decisions on principles meant to save the most lives, minimise inequity and protect the public’s trust, which for the time being would not be served by the inclusion of vaccination status. (shrink)

Background:Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one’s moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous.Objective:This article is an analysis of the concept (...) of moral courage in nursing.Design:Rodgers’ evolutionary method of concept analysis provided the framework to conduct the analysis.Data sources:The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher’s Index. The following key words were used: “moral” OR “ethical” AND “courage” OR “strength” AND “nurs*” with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis.Ethical considerations:This study was conducted according to good scientific guidelines.Results:Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment.Discussion and conclusion:This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice. (shrink)

Background:Moral courage is required at all levels of nursing. However, there is a need for development of instruments to measure nurses’ moral courage.Objectives:The objective of this study is to develop a scale to measure nurses’ self-assessed moral courage, to evaluate the scale’s psychometric properties, and to briefly describe the current level of nurses’ self-assessed moral courage and associated socio-demographic factors.Research design:In this methodological study, non-experimental, cross-sectional exploratory design was applied. The data were collected using Nurses’ Moral Courage Scale and analysed (...) statistically.Participants and research context:The data were collected from a convenience sample of 482 nurses from four different clinical fields in a major university hospital in Finland for the final testing of the scale. The pilot comprised a convenience sample of 129 nurses.Ethical considerations:The study followed good scientific inquiry guidelines. Ethical approval was obtained from the university ethics committee and permission to conduct the study from the participating hospital.Findings:Psychometric evaluation showed that the 4-sub-scale, 21-item Nurses’ Moral Courage Scale demonstrates good reliability and validity at its current state of development showing a good level of internal consistency for a new scale, the internal consistency values ranging from 0.73 to 0.82 for sub-scales and 0.93 for the total scale, thus well exceeding the recommended Cronbach’s alpha value of >0.7. Principal component analysis and confirmatory factor analysis supported the theoretical construct of Nurses’ Moral Courage Scale. Face validity and expert panel assessments markedly contributed to the relevance of items in establishing content validity.Discussion and conclusion:Nurses’ Moral Courage Scale provides a new generic instrument intended for measuring nurses’ self-assessed moral courage. Recognizing the importance of moral courage as a part of nurses’ moral competence and its assessment offers possibilities to develop interventions and educational programs for enhancement of moral courage. Research should focus on further validation measures of Nurses’ Moral Courage Scale in international contexts. (shrink)

Law moves, whether we notice or not. Set amongst a spatial turn in the humanities, and jurisprudence more specifically, this book calls for a greater attention to legal movement, in both its technical and material forms. Despite various ways the spatial turn has been taken up in legal thought, questions of law, movement and its materialities are too often overlooked. This book addresses this oversight, and it does so through an attention to the materialities of legal movement. Paying attention to (...) how law moves across different colonial and contemporary spaces, this book reveals there is a problem with common law's place. Primarily set in the postcolonial context of Australia - although ranging beyond this nationalised topography, both spatially and temporally - this book argues movement is fundamental to the very terms of common law's existence. How, then, might we move well? Explored through examples of walking and burial, this book responds to the challenge of how to live with a contemporary form of colonial legal inheritance by arguing we must take seriously the challenge of living with law, and think more carefully about its spatial productions, and place-making activities. Unsettling place, this book returns the question of movement to jurisprudence. (shrink)

Dans cet ouvrage, il s'agira non seulement d'aborder différentes facettes de l'activité mathématique de Descartes, assez peu connues, mais également diverses dimensions de sa pensée mathématique.

The life of the political philosopher whose pamphlets Common Sense and The American Crisis greatly influenced colonial opinion during the Revolution.