According to David Chalmers, the hard problem of consciousness consists of explaining how and why qualitative experience arises from physical states. Moreover, Chalmers argues that materialist and reductive explanations of mentality are incapable of addressing the hard problem. In this chapter, I suggest that Chalmers’ hard problem can be usefully distinguished into a ‘how question’ and ‘why question,’ and I argue that evolutionary biology has the resources to address the question of why qualitative experience arises from brain states. (...) From this perspective, I discuss the different kinds of evolutionary explanations (e.g., adaptationist, exaptationist, spandrel) that can explain the origins of the qualitative aspects of various conscious states. This argument is intended to clarify which parts of Chalmers’ hard problem are amenable to scientific analysis. (shrink)

BackgroundLow literacy of study participants in Sub - Saharan Africa has been associated with poor comprehension during the consenting process in research participation. The concerns in comprehension are far greater when consenting to participate in genomic studies due to the complexity of the science involved. While efforts are made to explore possibilities of applying genomic technologies in diseases prevalent in Sub Saharan Africa, we ought to develop methods to improve participants’ comprehension for genomic studies. The purpose of this study was (...) to understand different approaches that can be used to seek consent from individuals with low literacy in Sub-Saharan African countries in genomic research to improve comprehension.MethodsUsing qualitative study design, we conducted focus-group discussions, in-depth interviews and participant observations as data collection methods. This study was embedded in a hospital based genomic study on Sickle Cell Disease at Muhimbili National Hospital in Tanzania. Thematic content analysis was used to analyse the transcripts and field notes.ResultsFindings from this study show that literacy level has little influence on understanding the research details. According to the participants of this study, the methods used to provide information, the language, and time spent with the study participants were the key factors influencing understanding. The availability of group sessions held before individual consent to allow for a detailed questions and answers format was agreed to be the best method to facilitate the comprehension.ConclusionThe quality of the consenting process of participants will be influence by a number of factors. The type of research consented for, where the research will be implemented and who are the potential study participants are amongst the factors that need to be assessed during the consenting. Measures to improve participants’ comprehension need to be developed when consenting participants with low literacy level in genomic studies. (shrink)

As it has been pointed out in the literature, a Theory of Consciousness should satisfy two desiderata: i) account for the particular qualitative character of any particular conscious state, and ii) account for the fact that a conscious state is conscious ‘for the subject’.. Many have claimed that the RepresentationaI Theory of Consciousness can satisfy the first desideratum. It obviously fails, however, to meet the second desideratum. Higher-Order Approaches to Consciouness satisfy the second desideratum straightforwardly, but it remains unclear (...) whether they satisfy the first desideratum. In the first section, I underscore some problems indicating that RTC fails to satisfy the first desideratum. These problems suggest that qualitative character should be understood not as a non-mental represented feature of the world, as RTC suggests, but as a represented feature of the very conscious state itself. This suggests that HOAC are, after all, in a better position than RTC to satisfy the first desideratum, and hence both desiderata. I argue, however, that insofar as HOAC are supposed to satisfy the first desideratum, they are faced with an intolerable vicious regress. I propose that an alternative approach, the Self-Representational Theory of Consciousness is in a better position than HOAC to satisfy both desiderata. (shrink)

Corporate sustainability reports are supposed to provide a complete and balanced picture of corporate sustainability performance. They are, however, usually voluntary and thus prone to interpretation and even greenwashing tendencies. To overcome this problem, the Global Reporting Initiative (GRI) provides standardized reporting guidelines challenging companies to report positive and negative aspects of an organization’s sustainability performance. However, the reporting of “negative aspects” in particular can endanger corporate legitimacy if perceived by the stakeholders as not being in line with societal norms (...) and values. Starting from the theoretical lenses of economics-based disclosure theories and socio-political theories of disclosure, the focus of this study therefore was to analyze the communicative legitimation strategies companies use to report “negative aspects,” i.e., negative ecological and social impact caused by corporate activity. Using qualitative content analysis of GRI-oriented sustainability reports from companies listed on the US Dow Jones Industrial Average Index and on the German DAX Index, we identified six legitimation strategies. We discuss these strategies regarding to symbolic and substantial management of legitimacy. We show that symbolic legitimation strategies aiming at modifying the perception of legitimizing stakeholders dominate in the reports at hand. Such persuasion, however, does not meet the requirement of impartiality as postulated by the GRI guidelines. Building upon this conclusion we propose a concise characterization of “negative aspects” and develop a GRI-compliant schema of reporting about them. In doing so, we offer a way to improve the overall “balance” of sustainability reporting contributing to a true and fair view in sustainability disclosure. (shrink)

If we suppose that reasonable belief is reasonable not because it has a foundation but because it is self-correcting, and that bodies of reasonable belief are self-correctable in virtue of their web-like internal structure, then it becomes natural to ask for explicit accounts both of self-correction itself, and of the web-like internal structure that makes self-correction possible: The theory of rational belief change. ;In this essay we study qualitative, logical theories of rational belief change, in particular the AGM account, (...) and its offshoot, the theory base account. Throughout, however, we use quantitative, probabilistic models as foils. ;We first undertake a systematic, critical study of the AGM account, focusing especially on its "possible worlds" formulation and on its theory of belief revision. According to the AGM account we can represent AGM revision by simple computations over total preorders of possibilities. We investigate iterated AGM revision from this perspective, and prove that symmetry considerations familiar from social choice theory essentially determine a particular ordering dynamics. These symmetry arguments put an upper bound on the sorts of responsiveness we can expect from the AGM model of rational belief change. The most widely criticized feature of the AGM account is its "recovery" condition on belief contraction. We show how to deflect all existing criticisms to recovery by paying close to attention to exactly which beliefs are given up in a particular case. The principal cost of this strategy is that the AGM account becomes harder to apply and to test. ;Theory base accounts add a layer of syntactically-encoded information to the AGM model. We show that this approach fails comprehensively: that it cannot successfully coordinate the syntactic layer of information with underlying contents or with necessary ordering information, and that it sanctions demonstrably irrational belief changes. Our diagnosis is, in part, that the theory base account conflates two distinct sorts of nonmonotonic belief change. ;Lastly, we summarize our current research into quantitative accounts of rational belief change, focusing on a model that generalizes irreducibly two-place probability, and that has the AGM account as a limiting case. (shrink)

Disorders of consciousness (DOC) are a family of related neurological syndromes characterized by deficits of varying degrees of wakefulness (e.g., sleep–wake cycles and arousal) or awareness (e.g., reacting to stimuli, interacting with the environment). Although coma rarely persists for more than a few weeks, some patients remain in a subsequent vegetative state or a minimally conscious state for months or years. Caring for patients with DOC raises ethical questions, but the perspectives of healthcare providers on these questions remain poorly documented. (...) We conducted a qualitative study involving healthcare providers with different backgrounds. Semistructured interviews were used to explore attitudes toward ethical issues. We found that contextual (e.g., time, resource allocation) and relational aspects (e.g., communication process, families) shaped how ethical challenges surfaced and were managed. We call for greater awareness of contextual, institutional and social aspects and focus on these issues in training programs. (shrink)

It is difficult to find agreement on what constitutes perceiving.at Rovereto, Italy. The term is used in a wide array of domains ranging from psychology to physiology to aesthetics, and over time it has also acquired diverse connotations within various disciplines. Current perceptual science, however, even when it deals with qualitative aspects of experience, for example phenomena of lightness and colour, almost exclusively explains them in terms of primary qualities or stimuli quantitatively understood. The fact that science treats (...) class='Hi'>qualitative experiences in terms of stimuli is important, because almost nothing of phenomenal perception as such is quantitative in nature. The paper argues for a qualitative science of perceiving, its methodology, its laws, and its possible developments. (shrink)

Neither ethics committees nor qualitative researchers can predict the types of ethical dilemmas that will happen in the field, only that they will routinely occur. In Qualitative Ethics in Practice, a team of fifteen top researchers from various disciplines and nationalities offer ethical strategies unique to qualitative researchers for those "big ethical moments" beyond what can be predicted by ethics committees. Ideally structured for qualitative classes that tackle ethics issues, the book -calls for an ethical code (...) unique to the practice of qualitative research; -uses a variety of cases from education, community development, tourism, family, and other settings to examine how researchers addressed ethical dilemmas in practice, including the infamous Belfast Project; -highlights some relevant models and programs being developed that may lead to solutions. (shrink)

The aim of our study was to explore the first three associations for the following two stimulus words: compassion and self-compassion. In addition, we were interested in whether the participants would conceptualise these words more in terms of emotions, cognitions, or behaviours. The sample consisted of 151 psychology students. A consensual qualitative research approach was adopted. Three members of the core team and an auditor analysed the free associations of compassion and self-compassion. The data showed that there were four (...) domains for both compassion and self-compassion: the Emotional, Cognitive, Behavioural and Evaluative Aspects of compassion/self-compassion. The only domains that differed were the Biological Aspect of compassion and the Situational Aspect of self-compassion. The most frequently represented domain for both compassion and self-compassion was the Emotional Aspect, while both more positive as well as negative emotions were associated with self-compassion than was the case with compassion. The findings of our study show that the participants perceived compassion as mainly consisting of empathy; the emotions of love, sadness and remorse; cognitive understanding; and behavioural displays of help, physical or mental closeness. Compassion was seen as being mainly directed at those close to them, such as family and friends, and at vulnerable people. Compassion occurs in situations of loss or any other kind of suffering. The participants viewed self-compassion primarily in terms of the positive emotions of love and calmness; the negative emotions of unhappiness, sadness and remorse; cognitive understanding; and behavioural displays of self-help through the provision of self-support and self-assurance. Self-compassion is triggered mainly in situations involving internal suffering caused by criticism or externally as a response to a difficult situation. Self-compassion is evaluated in both negative (because of its misuse) as well as positive terms (because of its connection to virtues). The findings of our qualitative study support the idea that compassion is a multidimensional construct consisting of emotional, cognitive, and behavioural aspects. (shrink)

A qualitative analysis of societal silences, demonstrating how the unsaid directs social action and shapes individual and collective lives.

Criticism and self-criticism have far reaching impacts on wellbeing and emotional balance. In order to create better interventions for criticism and self-criticism, more in-depth knowledge about these two constructs is required. The goal of our study was to examine three associations for criticism and self-criticism. The data were collected from a sample of 151 psychology students: 114 women and 37 men (Mean age 22.2; SD 4.4). We were interested in the associations participants would produce in relation to criticism and self-criticism, (...) whether participants conceptualized these two concepts in the same categories and whether the categories were equally important for each concept. The data were analyzed using Consensual Qualitative research (CQR). The team consisted of four core members and one auditor. Separately all four members analyzed the data multiple times and then discussed it until all the researchers including the auditor reached a consensus. We identified four domains common to both criticism and self-criticism. These were – Emotional Aspects, Cognitive Aspects, Behavioral Aspects, and Preconditions. For both stimulus words, the most saturated domain was Behavioral Aspects. These findings suggest that both concepts – criticism and self-criticism – are multidimensional constructs consisting of Behavioral Aspects, Cognitive aspects, Emotional Aspects, and Preconditions. Further research on this topic would be beneficial. (shrink)

Knowledge about aspects that influence recovery and adaptation in the postacute phase of disabling health events is key to understanding how best to provide appropriate rehabilitation and health services. Qualitative longitudinal research makes it possible to look for patterns, key time points and critical moments that could be vital for interventions and supports. However, strategies that support robust data management and analysis for longitudinal qualitative research in health‐care are not well documented in the literature. This article reviews three (...) challenges encountered in a large longitudinal qualitative descriptive study about experiences of recovery and adaptation after traumatic brain injury in New Zealand, and the strategies and technologies used to address them. These were (i) tracking coding and analysis decisions during an extended analysis period; (ii) navigating interpretations over time and in response to new data; and (iii) exploiting data volume and complexity. Concept mapping during coding review, a considered combination of information technologies, employing both cross‐sectional and narrative analysis, and an expectation that subanalyses would be required for key topics helped us manage the study in a way that facilitated useful and novel insights. These strategies could be applied in other qualitative longitudinal studies in healthcare inquiry to optimise data analysis and stimulate important insights. (shrink)

In the light of growing political and religious fundamentalism, this open access book defends the idea of freedom as paramount for the attempt to find common ethical ground in the age of globality. The book sets out to examine as yet unexhausted ways to boost the resilience of the principle of liberalism. Critically reviewing the last 200 years of the philosophy of freedom, it revises the principle of liberty in order to revive it. It discusses many different aspects that fall (...) under its three main topics: the metaphysics of freedom, quantitative freedom and qualitative freedom. Open societies worldwide have come under increasing pressure in the last decades. The belief that politics and markets fare best when guided by the principle of liberty presently faces multiple challenges such as terrorism, climate warming, inequality, populism, and financial crises. In the view of its critics, the idea of freedom no longer offers adequate guidance to meet these challenges and should be partially corrected or even entirely replaced by countervailing values. Against the reduction of freedom to the merely quantitative question as to how much liberties individuals call their own, this book draws attention to the qualitative concerns which and whose opportunities society should foster. It argues that, correctly understood, the idea of liberty commits us to defend as well as advance the freedom of each and every world citizen. (shrink)

This study aimed to examine the thoughts and expectations of patients receiving healthcare from their physicians and evaluate the ethical aspects of these thoughts and expectations. To determine the ethical aspects of the thoughts and expectations of patients, an open-ended question was asked on the web page of the Turkish Armed Forces (TAF) Health Care Command, which is accessible to the users of the TAF intranet system (the internet system used within TAF institutions). The participants were asked to express their (...) thoughts in their own words. A total of 804 participants answered the question by providing their input. The statements of the participants were classified separately by two public health specialists. The classification was made in accordance with the basic principles of patient rights, and they were collected under various headings including expectations about respect and care, good communication, informed consent, and fair and non-privileged distribution of healthcare services. The results show that patients tend to consider the physicians they see as solely responsible for all the negative issues that they encounter during their healthcare. This indicates that there is a need for extensive research on the underlying factors involved in the negative thoughts and feelings toward healthcare professionals in both TAF and Turkey in general. (shrink)

This volume, edited by three leading proponents and practitioners of human science psychology, serves as an invitation to readers new to this approach while also renewing that invitation to those who have long embraced and advanced research in the field from this perspective. It is a timely and important invitation. In 2009, the American Psychological Association declared psychology to be a core STEM (science, technology, engineering, mathematics) discipline and advocated the teaching and practice of psychology with this natural science understanding (...) in mind, but in 2014 further reaffirmed alternative methods by adding a new journal, Qualitative Psychology. The varied essays in this volume, certainly, bolster the view that a purely STEM-centered vision would ignore much about the very experience of being human.In fact, it would be dangerous to rely solely on the methods of the natural sciences to study human beings, who operate in the realm of meanings, lived experience, and complex and complicated relationships with self and others. We create societies and belief systems, orient ourselves in time, experience beauty and pain. The Qualitative Vision for Psychology: An Invitation to a Human Science Approach argues that because we have aspects that are distinctly and uniquely human -- we are not rats, hydrogen, or rocks, for example -- this necessitates a distinctly human science, one that regards persons as humans rather than objects of study. The laws and formulas of the natural sciences simply do not take into account that particularly human way of being in the world.There are few comprehensive books on psychology conceived as a human science, even though it has a long history with roots in phenomenology, existentialism, psychoanalysis, humanistic psychology, and hermeneutics. In recent years, as these essays discuss, the field has been transformed through its contact with feminism, critical historical analysis, and deconstruction, and it has continued to examine new challenges. Further, we see here its specific applicability to issues as diverse as empathy, cultural history, apartheid, sexual assault, fetishes, and our natural environment. (shrink)

We recast parts of decision theory in terms of channel theory concentrating on qualitative issues. Channel theory allows one to move between model theoretic and language theoretic notions as is necessary for an adequate covering. Doing so clarifies decision theory and presents the opportunity to investigate alternative formulations. As an example, we take some of Savage’s notions of decision theory and recast them within channel theory. In place of probabilities, we use a particular logic of preference. We introduce a (...) logic for describing actions separate from the logic of preference over actions. The structures introduced by channel theory that represent the decision problems can be seen to be an abstract framework. This frame-work is very accommodating to changing the nature of the decision problems to handle different aspects or theories about decision making. (shrink)

The qualitative method of phenomenology provides a theoretical tool for educational research as it allows researchers to engage in flexible activities that can describe and help to understand complex phenomena, such as various aspects of human social experience. This article explains how to apply the framework of phenomenological qualitative analysis to educational research. The discussion within this article is relevant to those researchers interested in doing cross-cultural qualitative research and in adapting phenomenological investigations to understand students’ cross-cultural (...) lived experiences in different social educational contexts. (shrink)

Background International collaborators face challenges in the design and implementation of ethical biomedical research. Evaluating community understanding of research and processes like informed consent may enable researchers to better protect research participants in a particular setting; however, there exist few studies examining community perspectives in health research, particularly in resource-limited settings, or strategies for engaging the community in research processes. Our goal was to inform ethical research practice in a biomedical research setting in western Kenya and similar resource-limited settings. Methods (...) We sought to use mabaraza , traditional East African community assemblies, in a qualitative study to understand community perspectives on biomedical research and informed consent within a collaborative, multinational research network in western Kenya. Analyses included manual, progressive coding of transcripts from mabaraza to identify emerging central concepts. Results Our findings from two mabaraza with 108 community members revealed that, while participants understood some principles of biomedical research, they emphasized perceived benefits from participation in research over potential risks. Many community members equated health research with HIV testing or care, which may be explained in part by the setting of this particular study. In addition to valuing informed consent as understanding and accepting a role in research activities, participants endorsed an increased role for the community in making decisions about research participation, especially in the case of children, through a process of community consent. Conclusions Our study suggests that international biomedical research must account for community understanding of research and informed consent, particularly when involving children. Moreover, traditional community forums, such as mabaraza in East Africa, can be used effectively to gather these data and may serve as a forum to further engage communities in community consent and other aspects of research. (shrink)

Barbara Montero considers whether or not we are able to remember what pain feels like. In order to properly answer this question, she introduces a new type of memory called 'qualitative memory', which seems common to exteroceptive sensations. Having concluded that there is arguably no qualitative memory for pain and other bodily sensations, Montero considers possible philosophical implications for areas including rational choice-making and empathy. In addressing the relationship between pain and memory, the paper raises an issue that (...) has not received much attention and indicates various interesting fields of research for which the apparent inability to remember pain might prove relevant. My comment primarily focuses on the core concepts of pain and qualitative memory which are foundational for the paper. I argue that a deeper engagement with some key aspects of these concepts is necessary. A more fine-grained discussion could have made Montero's argument more convincing. (shrink)

Confucius gave counsel that is notoriously hard to follow: "What you do not wish for yourself, do not impose on others" (Huang 1997: 15.24). People tend to be concerned with themselves and to be indifferent to most others. We are distinct from others so our self-concern does not include them, or so it seems. Were we to realize this distinctness is merely apparent--that our true self includes others--Confucius's counsel would be easier to follow. Concern for our true self would extend (...) concern beyond the narrow selves we appear to be. The neo-Confucians held just such a view. They espoused an identity with the universe and everything in it, arguing that this identity explains a natural concern for everyone and everything, not just for our narrow selves. However, many things in the universe differ from each other, that is, some have qualities others lack. If they are all one and the same thing then that one thing differs from itself. I will suggest that the objection can be answered with some metaphysical innovation. I will address the objection by sketching a theory--call it the theory of aspects--that explains how numerically identical things can differ qualitatively. (shrink)

While the pursuitworthiness of philosophical ideas has changed over time, philosophical practice and methodology have not kept pace. The worthiness of a philosophical pursuit includes not only the ideas and objectives one pursues but also the methods with which one pursues them. In this paper, we articulate how empirical approaches benefit philosophy of science, particularly advocating for the use of qualitative methods for understanding the social and normative aspects of scientific inquiry. After situating qualitative methods within empirical philosophy (...) of science, we discuss how to adapt these traditionally sociological methods to empirically inform philosophical questions. Our aim is to normalize and legitimize qualitative methods for philosophical purposes and discuss how they can elucidate descriptive and normative components of scientific practice in a more generalizable non-idealized manner. We contend that qualitative methods are particularly well suited to philosophical interest in the social norms of science, their achievability, and their mutability. Furthermore, unlike more historical case studies in philosophy, qualitative methods enable more confidence in generalizability, albeit limited, from a concrete sample to a larger class. We conclude by addressing anxieties about the distinctness of empirical philosophy of science from social epistemology and from sociology of science. (shrink)

Perceptual experience seems to involve distinct intentional and qualitative features. Inasmuch as one can visually perceive that there is a Coke can in front of one, perceptual experience must be intentional. But such experiences seem to differ from paradigmatic intentional states in having introspectible qualitative character. Peacocke argues that a perceptual experience’s qualitative character is determined by intrinsic, nonrepresentational properties. But and also argues that perceptual experiences have nonconceptual representational content in addition to conceptual content and nonrepresentational (...) sensational properties. He thus distinguishes between conceptual, nonrepresentational, and nonconceptual but representational aspects of perceptual experience. I will argue that Peacocke posits too much. Contrary to his arguments, the sensational properties Peacocke claims are nonrepresentational are best construed as representational; they are best explained in terms of their relation to the perceptible properties they enable us to perceive. Since sensational properties are arguably nonconceptual, they are best construed as nonconceptual representational properties. I offer the Homomorphism View of sensory qualities, pioneered by Sellars , as a unified account of qualitative character and nonconceptual sensory representation. According to this view, a sensory quality represents a perceptible stimulus property in virtue of resembling and differing from other sensory qualities in ways parallel to the ways the stimulus property resembles and differs from other perceptible properties. (shrink)

Background In this qualitative analysis we aimed to explore addiction physicians’ perspectives on safer injection education for people who inject drugs, especially: (1) on possible means of introducing safer injection education in the medical environment, (2) on the compatibility of safer injection education with each physician’s core values and goals, and (3) on possible reasons for the ethical dilemma in safer injection education. Methods We conducted semi-structured interviews with eleven physicians practicing addiction medicine in France in clinical and harm (...) reduction settings. Results All participants were in favor of educational interventions for people who inject drugs. Nonetheless, these interventions varied from simple advice to injection supervision and they were seen as less acceptable when they concerned the practical and material aspects of injection. Some participants found that physicians practicing in clinical settings, where patients consult mostly to stop their drug use, should not practice safer injection education. On the contrary, other participants claimed that safer injection education was essential in all settings and was not a choice but rather a duty for addiction physicians. The ethical dilemma of such intervention when delivered by medical staff was viewed as a complex phenomenon, related to the representations of intravenous drug use and to societal expectations from physicians. Conclusion Physicians’ views on safer injection education for people who inject drugs reveal an emotionally charged subject related to the structural organization of addiction management in France. Such education is marked by an arduous history of harm reduction policies in France. IRB registration: #00011928. (shrink)

The scarcity of resources during the COVID‐19 pandemic caused ethical dilemmas in prioritizing patients for treatment. Medical and ethical guidance only emphasizes clinical procedures but does not consider the sociocultural aspect. This study explored the perception of former COVID‐19 patients and their families on the decision‐making process of the patient's selection at a time of scarcity of resources. The result will inform the development of an ethical guide for allocating scarce resources that aligns with Indonesian culture. We conducted (...) class='Hi'>qualitative research with in‐depth interviews between May ‐ December 2022 involving sixteen participants from various cities in Indonesia. We transcribed the interviews and analyzed the results using thematic analysis. This study found that doctor's decisions often differed from patient's expectations in allocating scarce resources, and therefore, it should be communicated appropriately. Medical decisions were not sufficiently made ethically, but must also be made communicatively. In Indonesia's strong communal culture, community involvement was essential to distributing limited resources. A better approach to ethical education, including adequate communication skills, is necessary to prepare health professionals for facing unpredictable future pandemics. (shrink)

BackgroundThe pharmaceutical market in Bangladesh is highly concentrated. Due to high competition aggressive marketing strategies are adopted for greater market share, which sometimes cross limit. There is lack of data on this aspect in Bangladesh. This exploratory study aimed to fill this gap by investigating current promotional practices of the pharmaceutical companies including the role of their medical representatives.MethodsThis qualitative study was conducted as part of a larger study to explore the status of governance in health sector in (...) 2009. Data were collected from Dhaka, Chittagong and Bogra districts through in-depth interview, observation, and round table discussion.ResultsFindings reveal a highly structured system geared to generate prescriptions and ensure market share instituted by the pharmaceuticals. A comprehensive training curriculum for the MRs prepares the newly recruited science graduates for generating enough prescriptions by catering to the identified needs and demands of the physicians expressed or otherwise, and thus grab higher market-share for the companies they represent. Approaches such as inducements, persuasion, emotional blackmail, serving family members, etc. are used. The type, quantity and quality of inducements offered to the physicians depend upon his/her capacity to produce prescriptions. The popular physicians are cultivated meticulously by the MRs to establish brand loyalty and fulfill individual and company targets. The physicians, willingly or unwillingly, become part of the system with few exceptions. Neither the regulatory authority nor the professional or consumer rights bodies has any role to control or ractify the process.ConclusionsThe aggressive marketing of the pharmaceutical companies compel their MRs, programmed to maximize market share, to adopt unethical means if and when necessary. When medicines are prescribed and dispensed more for financial interests than for needs of the patients, it reflects system’s failed ability to hold individuals and entities accountable for adhering to basic professional ethics, code of conduct, and statutory laws. (shrink)

The arts provide openings for symbolic expression by engaging the sensory experience in the body they become a source of insight through embodied cognition and emotion, enabling meaning-making, and acting as a catalyst for change. This synthesis of sensation and enactive, embodied expression through movement and the arts is capitalized on in The BodyMind Approach®. It is integral to this biopsychosocial, innovative, unique intervention for people suffering medically unexplained symptoms applied in primary healthcare. The relevance of embodiment and arts practices (...) in TBMA are discussed in relation to the views of participants in the pursuit of self-management. If widely employed TBMA could have an enormous impact, reach, and significance for patients and global health services. This original pre-clinical trial of qualitative research reports on the perceptions of participant patients with generic MUS, a world-wide issue usually treated by either psychological therapy or physiotherapy. TBMA is not a therapy but a health education program founded upon the concept of an integration of psychological elements with physiological, bodily, and sensory experiences. Thematic analysis of qualitative data sets from open-ended questions in semi-structured interviews and a written questionnaire post intervention is presented. Five aspects which appear to be key to learning self-management were derived from analyzing the data: body with mind connections; importance of facilitation; potential benefits; preparedness for change; self-acceptance/compassion. This article advances the discourse on the nature of self-management for MUS through changing the mind-set and the relationship participants have with their bodily symptom/s through employing embodied methods and arts practices, challenging current, and solely verbal, psychological conceptual frameworks. Rigor lies in the method of data analysis using cross verification of credibility between reported findings and scrutiny by stakeholders. We conclude that facilitated TBMA groups employing embodied methods and arts practices can act as a method for developing the self-management of MUS and improving wellbeing. (shrink)

Background: Emergency exception to informed consent regulation was introduced to provide a venue to perform research on subjects in emergency situations before obtaining informed consent. For a study to proceed, institutional review boards need to determine if the regulations have been met.Aim: To determine IRB members’ experience reviewing research protocols using emergency exception to informed consent.Methods: This qualitative research used semistructured telephone interviews of 10 selected IRB members from around the US in the fall of 2003. IRB members were (...) chosen as little is known about their views of exception to consent, and part of their mandate is the protection of human subjects in research. Interview questions focused on the length of review process, ethical and legal considerations, training provided to IRB members on the regulations, and experience using community consultation and notification. Content analysis was performed on the transcripts of interviews. To ensure validity, data analysis was performed by individuals with varying backgrounds: three emergency physicians, an IRB member and a layperson.Results: Respondents noted that: emergency exception to informed consent studies require lengthy review; community consultation and notification regulations are vague and hard to implement; current regulations, if applied correctly, protect human subjects; legal counsel is an important aspect of reviewing exception to informed-consent protocols; and IRB members have had little or no formal training in these regulations, but are able to access materials needed to review such protocols.Conclusions: This preliminary study suggests that IRB members find emergency exception to informed consent studies take longer to review than other protocols, and that community consultation and community notification are the most difficult aspect of the regulations with which to comply but that they adequately protect human subjects. (shrink)

In this paper I explicate a technique which can be used to make subtle relational features of experience more evident to awareness. Results of this method could be employed to diffuse one intuition that drives the common critique of functionalist-information theoretic accounts of mind that "qualia" cannot be exhaustively characterized in information theoretic-functional terms. An intuition that commonly grounds this critique is that the qualitative aspects of experience do not entirely appear in consciousness as informational-functional structures. The first section (...) of the paper is a schematic overview of nature of the qualitative and the problem that qualia are taken to create for information theoretic-functionalist theories of mind. §2 contains a précis of the concept of different levels of functional scale in mental activity that was developed by Armstrong and the Churchlands and that is needed to interpret (possible) results of the proposed experiment. In §3, I outline a method whereby analogies would be generated between purely relational forms, structures, configurations, etc. and purely qualitative aspects of experience. These analogies would be created by subjects through forced choice selection of presented images of structures that "most resembled" a pure quality. Repeated choices would then be shaped by a genetic program into the structural configuration that "most resembled" the pure quality. The final section of the paper explores how consistent, reliable results from the experiment would make information-theoretic functionalism more intuitively plausible in spite of the "fact" that the qualitative aspects of experience do not immediately appear as entirely relational/structural. (shrink)

There are two fundamental models to understanding the phenomenon of natural life. One is thecomputational model, which is based on the symbolic thinking paradigm. The other is the biologicalorganism model. The common difficulty attributed to these paradigms is that their reductive tools allowthe phenomenological aspects of experience to remain hidden behind yes/no responses (behavioraltests), or brain ‘pictures’ (neuroimaging). Hence, one of the problems regards how to overcome meth-odological difficulties towards a non-reductive investigation of conscious experience. It is our aim in (...) thispaper to show how cooperation between Eastern and Western traditions may shed light for a non-reductive study of mind and life. This study focuses on the first-person experience associated withcognitive and mental events. We studied phenomenal data as a crucial fact for the domain of livingbeings, which, we expect, can provide the ground for a subsequent third-person study. The interventionwith Jhana meditation, and its qualitative assessment, provided us with experiential profiles based uponsubjects' evaluations of their own conscious experiences. The overall results should move towards anintegrated or global perspective on mind where neither experience nor external mechanisms have thefinal word. (shrink)

Background In June 2016, Canada legalized medical assistance in dying (MAiD). From the outset, some healthcare institutions (including faith-based and non-faith-based hospitals, hospices, and residential aged care facilities) have refused to allow aspects of MAiD onsite, resulting in patient transfers for MAiD assessments and provision. There have been media reports highlighting the negative consequences of these “institutional objections”, however, very little research has examined their nature and impact. Methods This study reports on findings from 48 semi-structured qualitative interviews conducted (...) with MAiD assessors and providers, MAiD team members (working to coordinate care and lead MAiD programs in institutions and health authorities), and family caregivers on their experiences with institutional objection. Participants were recruited from the Canadian provinces of British Columbia, Ontario, and Nova Scotia. Data were analyzed using inductive thematic analysis. Results Themes identified were: (1) basis for institutional objection (with objections commonly rooted in religious values and a particular philosophy of palliative care); (2) scope of objection (demonstrating a wide range of practices objected to); (3) lack of transparency regarding institutional position; (4) impacts on patients; (5) impacts on health practitioners; and (6) catalysts for change. Participants reported that many institutions’ objections had softened over time, lessening barriers to MAiD access and adverse impacts on patients and health practitioners. Participants attributed this positive change to a range of catalysts including advocacy by health practitioners and family members, policymaking by local health authorities, education, and relationship building. Nevertheless, some institutions, particularly faith-based ones, retained strong objections to MAiD, resulting in forced transfers and negative emotional and psychological impacts on patients, family members, and health practitioners. Conclusions This paper adds to the limited evidence base about the impacts of institutional objection and can inform practical and regulatory solutions in Canada and abroad. Reform is needed to minimize the negative impacts on patients, their caregivers, and health practitioners involved in MAiD practice. (shrink)

The aim of the paper is to discuss the views, which approach the qualitative and quantitative methods in social sciences as either separable, or irreconcilable. First, the author gives an outline of those views and shows, how they deal with various aspects of the qualitative/quantitative divide. Next, he tries to identify the roots of that divide in the works of Herbert Blumer. Further, his analysis of the categories of quantity, quality, and measure is designed to show that the (...) divide in question is based on a wrong, one-sided understanding of the qualitative as well as quantitative approaches, which in fact can neither be separated nor conceived of as contradictory. (shrink)

While certain substantial moral dilemmas in health care have been given much attention, like abortion, euthanasia or gene testing, doctors rarely reflect on the moral implications of their daily clinical work. Yet, with its aim to help patients and relieve suffering, medicine is replete with moral decisions. In this qualitative study we analyse how doctors handle the moral aspects of everyday clinical practice. About one hundred consultations were observed, and interviews conducted with fifteen clinical doctors from different practices. It (...) turned out that the doctors’ approach to clinical cases followed a rather strict pattern across specialities, which implied transforming patients’ diverse concerns into specific medical questions through a process of ‘essentialising’: Doctors broke the patient’s story down, concretised the patient’s complaints and categorised the symptoms into a medical sense. Patients’ existential meanings were removed, and the focus placed on the patients’ functioning. By essentialising, doctors were able to handle a complex and ambiguous reality, and establish a medically relevant problem. However, the process involved a moral as well as a practical simplification. Overlooking existential meanings and focusing on purely functional aspects of patients was an integral part of clinical practice and not an individual flaw. The study thus questions the value of addressing doctors’ conscious moral evaluations. Yet doctors should be aware that their daily clinical work systematically emphasises beneficence at the expense of others—that might be more important to the patient. (shrink)

I argue that an individual has aspects numerically identical with it and each other that nonetheless qualitatively differ from it and each other. This discernibility of identicals does not violate Leibniz's Law, however, which concerns only individuals and is silent about their aspects. They are not in its domain of quantification. To argue that there are aspects I will appeal to the internal conflicts of conscious beings. I do not mean to imply that aspects are confined to such cases, but (...) the best way to start is to recognize them experientially. We can feel the conflicts within ourselves. In doing so we can feel some of our aspects. I will try to enhance our understanding of the concept of aspect by listing and formalizing some principles for its use. After that I will argue that all sorts of individual things have aspects, not just people who are conflicted. (shrink)

ABSTRACT According to David Lewis, alteration is "qualitative difference between temporal parts of something." It follows that moments, since they are simple and lack temporal parts, cannot alter from future to present to past. Here then is another way to put McTaggart's paradox about change in tense. I will appeal to my theory of Aspects to rebut the thought behind this rendition of McTaggart. On my theory, it is possible that qualitatively differing things be numerically identical. I call these (...) differing, numerically identical things "aspects." I will argue that alteration can be a qualitative difference between temporal aspects of something that lacks temporal parts. So a moment can alter in tense. By rejecting Lewis's assumption my theory can solve this version of McTaggart's paradox. (shrink)

Background One of the objectives of medicine is to relieve patients' suffering. As a consequence, it is important to understand patients' perspectives of suffering and their ability to cope. However, there is poor insight into what determines their suffering and their ability to bear it. Purpose To explore the constituent elements of suffering of patients who explicitly request euthanasia or physician-assisted suicide (EAS) and to better understand unbearable suffering from the patients' perspective. Patients and methods A qualitative study using (...) in-depth face-to-face interviews was conducted with 31 patients who had requested EAS. The grounded theory approach was used to analyse the data. Results Medical, psycho-emotional, socio-environmental and existential themes contributed to suffering. Especially fatigue, pain, decline, negative feelings, loss of self, fear of future suffering, dependency, loss of autonomy, being worn out, being a burden, loneliness, loss of all that makes life worth living, hopelessness, pointlessness and being tired of living were constituent elements of unbearable suffering. Only patients with a psychiatric (co)diagnosis suffered unbearably all the time. Conclusions Unbearable suffering is the outcome of an intensive process that originates in the symptoms of illness and/or ageing. According to patients, hopelessness is an essential element of unbearable suffering. Medical and social elements may cause suffering, but especially when accompanied by psycho-emotional and existential problems suffering will become ‘unbearable’. Personality characteristics and biographical aspects greatly influence the burden of suffering. Unbearable suffering can only be understood in the continuum of the patients' perspectives of the past, the present and expectations of the future. (shrink)

Research ethics committees (RECs) have a crucial role in protecting children in research. However, studies on REC members’ perspectives on paediatric research are scarce. We conducted a qualitative study to explore Swedish scientific REC members’ perspectives on ethical aspects in applications involving children with severe health conditions. The REC members considered promoting participation, protecting children and regulatory adherence to be central aspects. The results underscored the importance of not neglecting ill children’s rights to adapted information and participation. REC members (...) supported a contextual and holistic approach to vulnerability and risk, which considers the child’s and parents’ psychological wellbeing and the child’s integrity, both short and long term. The ethical complexity of paediatric research requires continuous ethical competence development within RECs. (shrink)

In this article, I am interested in dual-aspect monism as a solution to the mind-body problem. This view is not new, but it is somewhat under-represented in the contemporary debate, and I would like to help it make its way. Dual-aspect monism is a parsimonious, elegant and simple view. It avoids problems with “mental causation”. It naturally explains how and why mental states are correlated with physical states while avoiding any mysteries concerning the nature of this relation. It (...) fits well with our ordinary picture of the world, as well as with the scientific picture. It gives its rightful place to the phenomenal, qualitative, subjective character of experience, instead of reducing it or eliminating it. It does not unnecessarily multiply ontological categories. It can come in many versions, and is compatible with other interesting views, such as panpsychism. (shrink)

Les décisions politiques sur les risques environnementaux complexes font fréquemment intervenir des éléments scientifiques contestés. Il n’y a généralement pas de « faits » qui conduisent à une politique correcte unique. Les éléments de preuve qui sont intégrés dans les avis scientifiques destinés à une décision politique nécessitent une évaluation de leur qualité. En 2003, l’Agence néerlandaise d’évaluation environnementale a adopté une méthode standardisée, désignée sous le nom de « guide », dans le cadre de laquelle les principaux aspects de (...) la production et de l’utilisation des connaissances sont présentés grâce à une liste de contrôle visant à l’évaluation et à la communication des incertitudes. Dans cet article, nous présentons des résultats de l’application de ce guide à la controverse sur les risques des particules en suspension. La délibération active sur l’incertitude dans un contexte d’expertise entraîne un processus d’apprentissage commun entre les experts et les décideurs politiques, ce qui conduit à une meilleure prise de conscience du phénomène d’incertitude et de ses implications politiques.Policy decisions on complex environmental risks often involve disputed science. Typically, there are no “ facts” to support a single unequivocally correct policy. The evidence provided in scientific studies for policy-making decisions requires high-quality assessment. In 2003, the Netherlands Environmental Assessment Agency adopted a standardized method, referred to as “guidelines”, whereby key quality aspects of knowledge production and use are presented in the form of a checklist for uncertainty assessments and communication. In this article, we present the outcomes of applying the guidelines in controversies on the risks of ambient particulate matter. In the policy–advisory context, active deliberation on uncertainty produces a common learning process for advisors and policy makers, which leads to a deeper understanding and increased awareness of the phenomenon of uncertainty and its policy implications. (shrink)

Philosophy of aesthetics and beauty has traditionally prioritized the sense of vision while deprioritizing the more basic-bodily and thus less “noble” sense of touch. This paper examines bodily aspects of how beauty appears in the experience of visual art and motivates the view that touch is fundamental to such experiences. We appeal to Merleau-Ponty to show the relevance given to touch in his phenomenology of aesthetics, to unfold the meaning of touch as “reversible,” and to understand how vision can be (...) conceptualized as a form of touch. Further, we present four cases of feeling touched by beauty in experiences of visual art collected through interviews with art museum visitors. The descriptions of these experiences show that when people open themselves to an artwork they also open themselves to themselves. Based on the qualitative descriptions, we discuss how Merleau-Ponty’s phenomenology of touch is revelatory of the meaning of feeling “touched” in experiences of beauty. (shrink)

On the powerful qualities view, every fundamental property is both dispositional and qualitative. Identity theory is the standard account of the view, which makes the stronger claim that a property’s dispositionality and qualitativity are identical to each other, and identical to the property itself. Recent defences of the powerful qualities view have involved novel theories of powerful qualities which are not also variants of identity theory. Giannotti (Erkenntnis 86:603–621, 2021a) has suggested a novel theory of his own, the dual (...) aspect account, which makes use of a particular notion of aspects. For Giannotti, dispositionality and qualitativity are each an aspect of a property, and an aspect is a property’s way of being. The importance of aspects is twofold. Firstly, by introducing aspects to identity theory, the theory becomes more precise. Secondly, aspects allow for a novel theory of powerful qualities, the dual aspect account, which maintains that dispositionality and qualitativity are aspects, but rejects the identity claim. Giannotti’s aim is to show that even if identity theory is false, the dual aspect account remains an available theory for advocates of powerful qualities. This paper will be a critical examination of Giannotti’s ideas. Firstly, I will clarify Giannotti’s notion of aspects, explaining how it involves a misunderstanding of supervenience, and why it does not offer the advantages that he claims it does. Secondly, in light of my discussion of aspects, I will argue that the dual aspect account lacks relative advantages over the compound view of powerful qualities. (shrink)

The Daily Spiritual Experience Scale is an instrument designed to provide researchers with a self-report measure of spiritual experiences as an important aspect of how religiousness/spirituality is expressed in daily life for many people. The sixteen-item scale includes constructs such as awe, gratitude, mercy, sense of connection with the transcendent, compassionate love, and desire for closeness to God. It also includes measures of awareness of discernment/inspiration and transcendent sense of self. This measure was originally developed for use in health (...) studies, but has been increasingly used more widely in the social sciences, for program evaluation, and for examining changes in religious/spiritual experiences over time. It has been included on the U. S. General Social Survey , and the items have shown high prevalence in that population. The challenge of identifying items that tap the underlying constructs was addressed through qualitative methods, both in the development and testing of the instrument. Translations have been made into Spanish, Korean, Hebrew, Vietnamese, and French, and the scale has been effectively used outside the United States. Detailed discussion of item construction based on qualitative work is given to assist in use, interpretation and translation development. Options for scoring and suggestions for exploring correlations with other variables using individual items and subgroups are also presented. (shrink)