Objective: To measure the stability of life-sustaining treatment preferences amongst older people and analyse the factors that influence stability. Design: Longitudinal cohort study. Setting: Primary care centres, Granada (Spain). Eighty-five persons age 65 years or older. Participants filled out a questionnaire with six contexts of illness (LSPQ-e). They had to decide whether or not to receive treatment. Participants completed the questionnaire at baseline and 18 months later. Results: 86 percent of the patients did not change preferences. Sex, age, marital status, (...) hospitalisation, and self-perception of health and pain did not affect preferences. Morbidity and the death of a relative did. Conclusion: Stability of preferences of older persons in relation to end-of-life decisions seems to be more probable than instability. Some factors, such as the death of a relative or the increase in morbidity, can change preferences. These findings have implications for advance directives (ADs) and advance care planning. (shrink)
This paper evaluates the content of the syllabi of postgraduate courses on public health ethics within accredited schools and programs of public health in the United States in order to gain an awareness of the topics addressed within these courses. Methods: Data was gathered via the analysis of syllabi of courses on PHE. In 2012, information was requested by e-mail from the 48 schools and 86 PH programs accredited by the U.S. Council on Education for Public Health for 2012. The (...) “Epidemiology and PHE Syllabi” project of the University of Miami also was consulted. A table of topics was drawn up in order to carry out content analysis of the documents. Results: Data was obtained from 25 schools and 36 accredited programs ; 36 syllabi were gathered and 75 different topics were found. Of these, 38 topics were addressed in six or more syllabi and can be grouped as follows: foundations of PHE; autonomy and its limits; infectious disease control; justice; research ethics; health education and promotion; environmental and occupational health; screening; genetics; privacy and confidentiality; and community-based practice and vulnerable populations. Conclusions: The analyzed syllabi show high variability in curricular content. The debate with regard to whether a core curriculum on PHE should be established is ongoing. The results of this work might be of interest for schools and programs of PH in other countries or regions of the world in order to develop or ameliorate their own PHE syllabi. (shrink)
Spain’s Roma community has its own cultural and moral values. These values influence the way in which end-of-life decision-making is confronted. The objective of this study was to explore the perspective of Roma women on end-of-life decision-making. It was a qualitative study involving thirty-three Roma women belonging to groups for training and social development in two municipalities. We brought together five focus groups between February and December 2012. Six mediators each recruited five to six participants. We considered age and care (...) role to be the variables that can have the most influence on opinion regarding end-of-life decision-making. We considered the discussion saturated when the ideas expressed were repeated. Data analysis was carried out according to five steps: describing, organizing, connecting, corroborating/legitimating, and representing the account. The main ideas gleaned from the data were as follows: the important role of the family in end-of-life care, especially the role of women; the large influence of community opinion over personal or family decisions, typical of closed societies; the different preferences women had for themselves compared to that for others regarding desired end-of-life care; unawareness or rejection of advance directives. Roma women wish for their healthcare preferences to be taken into account, but “not in writing.” The study concluded that the success of end-of-life healthcare in Roma families and of their involvement in the making of healthcare decisions depends upon considering and respecting their idiosyncrasy. (shrink)
The societal and ethical impacts of emerging technological and business systems cannot entirely be foreseen; therefore, management of these innovations will require at least some ethicists to work closely with researchers. This is particularly critical in the development of new systems because the maximum degrees of freedom for changing technological direction occurs at or just after the point of breakthrough; that is also the point where the long-term implications are hardest to visualize. Recent work on shared expertise in Science & (...) Technology Studies (STS) can help create productive collaborations among scientists, engineers, ethicists and other stakeholders as these new systems are designed and implemented. But collaboration across these disciplines will be successful only if scientists, engineers, and ethicists can communicate meaningfully with each other. The establishment of a trading zone coupled with moral imagination present one method for such collaborative communication. (shrink)
Novelty is a key concept to understand creativity. Evaluating a piece of artwork or other creation in terms of novelty requires comparisons to other works and considerations about the elements that have been reused in the creative process. Human beings perform this analysis intuitively, but in order to simulate it using computers, the objects to be compared and the similarity metrics to be used should be formalized and explicitly implemented. In this paper we present a study on relevant elements for (...) the assessment of novelty in computer-generated narratives. We focus on the domain of folk-tales, working with simple plots and basic narrative elements: events, characters, props and scenarios. Based on the empirical results of this study we propose a set of computational metrics for the automatic assessment of novelty. Although oriented to the implementation of our own story generation system, the measurement methodology we propose can be easily generalized to other creative systems. (shrink)
Patricia De Martelaere was a Belgian author, philosopher, and practitioner of shadowboxing. She wrote an inspiring little book on Taoism that stresses the physical, energetic, and martial aspects of its practice. This paper elaborates upon three central ideas from her work, turns them into a direction that she did not envision, and applies them to a critical-historical interpretation of the Taoist texts that she elaborates upon: an active way of non-knowing, the awareness of a shared ground, and the intellectual (...) fertility resulting from this approach. By occasionally putting aside certain assumptions from contemporary research on early Chinese Taoist philosophers - with respect to books, authors, philosophical consistency, schools, etc. - we can offer alternative accounts to the now dominant forms of interpretation. This approach does not take a position in favor of or against the existence or importance of such entities as “books‘, “philosophers‘, or “schools‘ in pre-imperial China. Nor does it promote an alternative for the dominant narratives. It simply allows for a degree of openness with respect to these narratives, thereby allowing for greater nuance that is at risk of being suffocated in the current context of academic philosophy. (shrink)
Critical Race Theory (C.R.T.) has developed out of a deep dissatisfaction that many black legal scholars in the U.S. felt with liberal civil rights discourse, a discourse premised upon the ideals of assimilation, ‘colour-blindness’ and integration. In addition, the emergence of the Critical Legal Studies movement provided Critical Race theorists with an innovative lexicon and practice which allowed them to develop a critique of traditional race analysis and U.S. law. Patricia Williams has played a key role in the formation (...) of the C.R.T. movement and is concerned with many of the C.R.T. themes: the understanding that traditional civil rights law has benefited whites more than blacks, the ‘call to context’, and the critique of liberalism by the assertion that racism is routine and not aberrational. Following the C.R.T. belief that form and substance are connected, Williams has also extended the boundaries of another C.R.T. theme by (largely) eschewing the conventional genre of legal writing in much of her work, including her two books, The Alchemy of Race and Rights and The Rooster's Egg. This was one of the issues Williams discussed in an interview that commenced when she visited Britain in 1997 to deliver the Reith Lectures. (shrink)
An imperfect duty such as the duty to aid those in need is supposed to leave leeway for choice as to how to satisfy it, but if our reason for a certain way of satisfying it is our strongest, that leeway would seem to be eliminated. This paper defends a conception of practical reasons designed to preserve it, without slighting the binding force of moral requirements, though it allows us to discount certain moral reasons. Only reasons that offer criticism of (...) alternatives can yield requirements, but our reasons for particular ways of satisfying imperfect duties merely count in favor of the acts in question. When the state is authorized to take over charitable obligations, it should not be seen as enforcing fulfillment of our imperfect duties, but rather as forcing us to help fulfill collective duties that may be substantially modified by transfer to the state, replacing imperfect duties with perfect. Besides the cost to us in freedom of choice there is a moral cost to replacing the virtuous motives of charity with those that tend to accompany paying taxes. However, a compensating feature of state involvement is the fact that its more precise demands come with limits. (shrink)
The ethical ‘eye’ of nursing, that is, the particular moral vision and values inherent in nursing work, is constrained by the preoccupations and practices of the superordinate biomedical structure in which nursing as a practice discipline is embedded. The intimate, situated knowledge of particular persons who construct and attach meaning to their health experience in the presence of and with the active participation of the nurse, is the knowledge that provides the evidence for nurses’ ethical decision making. It is largely (...) invisible to all but other nurses. Two nurse researchers, Joan Liaschenko of the University of Minnesota and Patricia Rodney of the University of Victoria, have investigated the ethical concerns of practising nurses and noted in their separate enquiries the invisible nature of critical aspects of nursing work. Noting the similarities in their respective observations, and with the feminist ethics of Margaret Urban Walker as a theoretical framework, this article examines the concept of ‘invisibility’ as it relates to nursing work and nursing ethics. (shrink)
La colección Revuelta Filosófica nos propone un retorno a pensadores que se pusieron por encima del orden filosófico establecido. Por esto mismo no nos sorprende que Kierkegaard esté en esta colección, y más bien decimos que no podía dejar de asistir a la reunión. Fiel a su pensamiento, Kierkegaard le pone el cuerpo, la pluma y el alma a sus escritos, en los cuales la literatura se entrelaza con la filosofía, y la psicología se vuelve un teatro en el que (...) uno tras otro aparecen figuras, pseudónimos y personajes que enmascaran el rostro del autor a través de la ironía. ¿Quién se encarga de darle voz a Kierkegaard? Patricia Dip, quien le ha dedicado gran parte de su vida académica a estudiar al danés, no puede ser mejor compañía. La autora presenta a Kierkegaard en dos dimensiones, la literaria y la filosófica, donde lo distintivo es la máscara, rasgo que le permiten ubicar al pensador danés entre los teóricos contemporáneos de la ideología, es decir Marx, Nietzsche y Freud. El escenario, 255 páginas, divididas en un estudio preliminar, selección de fuentes y bibliografía de referencia. El estudio preliminar del libro cuenta con cuatro apartados en los cuales la autora recorre tópicos fundamentales del pensamiento kierkegaardiano. (shrink)
I argue that Patricia Kitcher's Kant-inspired account of self-consciousness overintellectualizes the requirements for rational cognition. Kitcher claims that a person can only believe something on the ground of another belief if she is able to recognize the grounding belief as grounding the first belief and as one of her own. I criticize this claim by arguing that (i) someone can believe something for a certain reason without recognizing this reason as a reason (the possibility of unreflected reasons), and that (...) (ii) she can recognize something as a reason for something else without being able to self-ascribe either her original belief or the belief that grounds it (the possibility of reflected but not self-conscious reasons). (shrink)
There are now quite a number of popular or semi-popular works urging rejection of the old opposition between rationality and emotion. They present evidence or theoretical arguments that favour a reconception of emotions as providing an indispensable basis for practical rationality. Perhaps the most influential is neuroanatomist Antonio Damasio's Descartes' Error, which argues from cases of brain lesion and other neurological causes of emotional deficit that some sort of emotional ‘marking,’ of memories of the outcomes of our choices with anxiety, (...) is needed to support learning from experience. (shrink)
Los años 80 han atraido, en los últimos tiempos, una serie de miradas nostálgicas, sobre todo hacia su música. Lejos de esa atmósfera está “ El Canto Nuevo de Chile. Un Legado Musical ”, de Patricia Díaz-Inostroza.Por el contrario, se trata de una investigación que, si bien está centrada en el movimiento llamado Canto Nuevo, abarca mucho más que eso, dejando en claro las profundas raíces históricas que afirman este tipo de música. Ese es un aporte innegable, que permite (...) al lector (o lectora) .. (shrink)
(2011). Theory in Health Promotion Research and Practice: Thinking outside the Box. Patricia Goodson. Boston, MA: Jones and Bartlett. 2010. 245, pp. $78.95. Educational Studies: Vol. 47, No. 6, pp. 583-588.
A core thesis of Kitcher's is that thinking about objects requires awareness of necessary connections between one's object-directed representations ‘as such’ and that this is what Kant means by the transcendental unity of apperception. I argue that Kant's main point is the spontaneity or ‘self-made-ness’ of combination rather than the requirement of reflexive awareness of combination, that Kitcher provides no plausible account of how recognition of representations ‘as such’ should be constituted and that in fact Kant himself appears to lack (...) the theoretical resources to clearly distinguish between consciousness and self-consciousness or apperception properly so-called. (shrink)
This review describes central difficulties in the interdisciplinary study of dreaming, summarizes Jouvet's account of his role in the history of modern dream science, queries his positive speculations on the semantics of dreaming, and suggests work for historians of neuroscience.