The principle of informed consent obligates physicians to explain possible side effects when prescribing medications. This disclosure may itself induce adverse effects through expectancy mechanisms known as nocebo effects, contradicting the principle of nonmaleficence. Rigorous research suggests that providing patients with a detailed enumeration of every possible adverse event—especially subjective self-appraised symptoms—can actually increase side effects. Describing one version of what might happen (clinical “facts”) may actually create outcomes that are different from what would have happened without this information (another (...) version of “facts”). This essay argues that the perceived tension between balancing informed consent with nonmaleficence might be resolved by recognizing that adverse effects have no clear black or white “truth.” This essay suggests a pragmatic approach for providers to minimize nocebo responses while still maintaining patient autonomy through “contextualized informed consent,” which takes into account possible side effects, the patient being treated, and the particular diagnosis involved. (shrink)

This investigation addresses the hypothesis that negative affect is associated with decreased ability to shift attention to a new focus. Thirty-nine participants completed a covert attentional orienting task and then viewed a distressing film clip. Mood was measured by self-report at the beginning and end of the session. Correlations between attentional orienting performance and self-reported mood indicated that participants with greater response time costs on invalidly cued trials reported more negative affect in response to the film. These results support the (...) hypothesis that negative affect is associated with a slowness to disengage attention. (shrink)

In this book, Andreas Serafim sets out to investigate the use of religious discourse, by which he means any reference to religious ideas, beliefs, and attitudes in public speaking contexts in classical Athens. Like Gunther Martin (Divine Talk: Religious Argumentation in Demosthenes, 2009), Serafim examines religion primarily as a tool for persuasion, but he differentiates himself from Martin’s book by offering a more comprehensive study: he aims to take into account all extant speeches from t...

The deceased's prior consent to posthumous reproduction is a common requirement in many common law jurisdictions. This paper critically evaluates four arguments advanced to justify the presumption against consent. It is argued that, in situations where death is caused by sudden trauma, not only is there inadequate justification for the presumption against consent, but there are good reasons to reverse the presumption. The article concludes that the precondition of prior consent may be inappropriate in these situations.

Realist ideology critique (RIC) is a strand of political realism recently developed in response to concerns that realism is biased toward the status quo. RIC aims to debunk an individual's belief that a social institution is legitimate by revealing that the belief is caused by that very same institution. Despite its growing prominence, RIC has received little critical attention. In this article, I buck this trend. First, I improve on contemporary accounts of RIC by clarifying its status and the role (...) of motivated reasoning. Second, I show that realist ideology critics face a dilemma: either their account makes deeply implausible epistemological assumptions, or they temper its epistemology at the expense of rendering it toothless. I argue for each horn in turn before revealing the dilemma to be a false one by making a novel distinction between varying strengths of RIC based on their underlying epistemological assumptions. I propose Moder-ate RIC as a solution: upon discovering that one reason for your belief that a social institution is legitimate is likely malignantly epistemically circular, the belief should undergo further epistemic testing. I respond to three potential objections and suggest that Moderate RIC would make a fruitful addition to political theorists' methodological toolkit. (shrink)

Acknowledgements -- Introduction: transformation, potential, futures -- Screening affect : images, representational thinking and the actualization of the virtual -- Bringing the image to life : interactive mirrors and intensive experience -- Becoming different : makeover television, proximity and immediacy -- Immanent measure : interaction, attractors and the multiple temporalities of online dieting -- Pre-empting the future : obesity, prediction and change4life -- Conclusion : transforming images : sociology, the future and the virtual -- Bibliography -- Index.

Thomas Reid thought of himself as a critic of the representative theory of perception, of what he called the ‘theory of ideas’ or ‘the ideal theory’.2 He had no kind words for that theory: “The theory of ideas, like the Trojan horse, had a specious appearance both of innocence and beauty; but if those philosophers had known that it carried in its belly death and destruction to all science and common sense, they would not have broken down their walls to (...) give it admittance.”3 Many have supposed that his opposition to the representative theory was grounded in his direct realism.4 A direct realist theory of perception holds that perception of external objects is not mediated by any mental entity whose intrinsic character licenses a move from the mental entity to the external object presented in perception. Reid himself, in an oration of 1759, delivered at graduation ceremonies over which he presided as regent and professor of philosophy at King’s College in Aberdeen, said that he did not “understand what need there is of an intermediate object for thought about something to be possible.”5 Hence, if Reid was not a direct realist, philosophers and historians would have to ask whether and to what degree Reid was what he thought himself to be. (shrink)

It is commonly said of modern philosophy that it introduced a representative theory of perception, a theory that places representative mental items between perceivers and ordinary physical objects. Such a theory, it has been thought, would be a form of indirect realism: we perceive objects only by means of apprehending mental entities that represent them. The moral of the story is that what began with Descartes’s revolution of basing objective truth on subjective certainty ends with Hume’s paroxysms of ambivalence and (...) skepticism in the conclusion of the first book of the.. (shrink)

Translational science is a 21st century mission. Government officials and industry leaders are making huge investments in an attempt to transform more basic science discoveries into therapeutic applications. Scientists and policymakers express great excitement about the medical advances that could come with the current bench-to-bedside campaign.A key step in translational science is the move from animal and other preclinical studies to initial human testing. Researchers ability to predict human effects is limited, and first-in-human tests present significant uncertainty. Participants in this (...) form of research face risks and can experience serious, even lethal, harm. Well-known incidents involving Jolee Mohr and Jesse Gelsinger, as well as subjects in the 2006 study of the investigational agent TGN1412, show the dangers that can arise in early human research.The bench-to-bedside campaign will need many volunteers to participate in early human testing. Investigators and regulators must not allow the policy enthusiasm for translational science to overshadow the commitment to protect human subjects. Participants in exploratory research are diverse and as a group lack characteristics usually associated with vulnerable populations, such as impaired decisional ability or economic or educational disadvantage. (shrink)

Fear of dementia leads some people to demand an opportunity to choose death over life with the illness. They want the power to make advance euthanasia directives and to refuse hand feeding at some point in the dementia process. But the choices we make in advance aren't always suited to the people we become. Experts and family members say people with dementia often adapt, becoming content with their lives. People should care about their future selves with dementia. Their advance instructions (...) about dementia care should give others freedom to respond to the up‐to‐date information required for good medical decision‐making. (shrink)

Under current U.S. law, physicians may prescribe drugs and devices in situations not covered on the label approved by the Food and Drug Administration. Those supporting this system say that requiring FDA approval for off-label uses would unnecessarily impede the delivery of benefits to patients. Patients do benefit from off-label prescribing that is supported by sound scientific and medical evidence. In the absence of such evidence, however, off-label prescribing can expose patients to risky and ineffective treatments. The medical community and (...) federal authorities should more actively promote patients' interests in receiving beneficial off-label treatments. To exercise responsible self-regulation, members of the medical community must determine whether available evidence justifies specific off-label uses and must promote information-gathering when the evidence is inadequate. Physicians should also discuss with patients the uncertainties accompanying off-label uses. Federal authorities should more closely monitor the effects of off-label prescribing and adopt other measures to reduce harm and enhance benefits produced by off-label prescribing. (shrink)

Research subjects do not always conform to research requirements. When their personal interests conflict with the demands of participation, some subjects surreptitiously break the rules. These subjects are subversive — they undermine the research endeavor. In rejecting the restrictions research imposes, subversive subjects diminish the value of research results. From one vantage point, subversive subjects engage in unethical behavior. They create risks to themselves and others; they also disregard ethical responsibilities to adhere to research agreements and tell the truth. At (...) the same time, subversive subjects expose ethical problems in the design and conduct of clinical trials. Features of the research environment create fertile ground for subject subversion. Intensified policing and guidance are two common strategies for reducing subject subversion, but collaborative reforms are more consistent with the partnership model of clinical research. (shrink)

The year 2014 brought a new development in the bioethics “laboratory of the states.” Five states adopted “right to try” laws intended to promote terminally ill patients' access to investigational drugs. Many more state legislatures are now considering such laws. The campaign for right to try laws is the latest move in an ongoing effort to give seriously ill patients access to drugs whose safety and effectiveness remain largely unknown. Although scientists and policy‐makers oppose the right to try approach, it (...) has proven quite popular among state legislators and the public. (shrink)

The case studies compiled in _Another Way: Decentralization, Democratization and the Global Politics of Community-Based Schooling_ offer a comparative look at how the global politics of educational decentralization have influenced the democratic aspirations of diverse community-based schooling initiatives in Europe, Africa, Asia and the Americas.

In this Introduction to a special section on ‘Visualizing Surfaces, Surfacing Vision’, the authors argue that to conceive vision in the contemporary world it is necessary to examine its embedding within, expression via and organization on the surface. First, they review recent social and cultural theories to demonstrate how and why an attention to surfaces is salient today. Second, they consider how vision may be understood in terms of surfaces, discussing the emergence of the term ‘surface’, and its transhistorical relationship (...) with vision. Third, they introduce the contributions to the special section, which cover written articles and artworks. They make connections between them, including their exploration of reflexivity and recursion, observation, objectivity and agency, ontology and epistemology, relationality, process, and two- and three-dimensionality. Fourth, the authors consider some implications of an understanding of visualizing surfaces/surfacing vision. (shrink)

This essay explores the familiar German ideology according to which a revolution in thought would, in varying proportions, precede, succeed, accommodate, and generally upstage a political revolution whose defining feature was increasingly thought to be its founding violence: the slide from 1789 to 1793. Germany thus sets out to quarantine the political threat of revolution while siphoning off and absorbing the revolution’s intensity and energy for thinking as such. The essay holds that this structure corresponds to the psychoanalytic logic of (...) trauma: the dissolution of the event into a missed event, and the hypertrophic investment in the trivial, the non-event, the negligible remainder. (shrink)

An argument that what is usually dismissed as the “mystical shell” of Hegel's thought—the concept of absolute knowledge—is actually its most “rational kernel.” This book sets out from a counterintuitive premise: the “mystical shell” of Hegel's system proves to be its most “rational kernel.” Hegel's radicalism is located precisely at the point where his thought seems to regress most. Most current readings try to update Hegel's thought by pruning back his grandiose claims to “absolute knowing.” Comay and Ruda invert this (...) deflationary gesture by inflating what seems to be most trivial: the absolute is grasped only in the minutiae of its most mundane appearances. Reading Hegel without presupposition, without eliminating anything in advance or making any decision about what is essential and what is inessential, what is living and what is dead, they explore his presentation of the absolute to the letter. The Dash is organized around a pair of seemingly innocuous details. Hegel punctuates strangely. He ends the Phenomenology of Spirit with a dash, and he begins the Science of Logic with a dash. This distinctive punctuation reveals an ambiguity at the heart of absolute knowing. The dash combines hesitation and acceleration. Its orientation is simultaneously retrospective and prospective. It both holds back and propels. It severs and connects. It demurs and insists. It interrupts and prolongs. It generates nonsequiturs and produces explanations. It leads in all directions: continuation, deviation, meaningless termination. This challenges every cliché about the Hegelian dialectic as a machine of uninterrupted teleological progress. The dialectical movement is, rather, structured by intermittency, interruption, hesitation, blockage, abruption, and random, unpredictable change—a rhythm that displays all the vicissitudes of the Freudian drive. (shrink)

In this issue, Paul Menzel and M. Colette Chandler‐Cramer propose a novel advance directive. Besides giving competent people the opportunity to refuse future life‐prolonging medical interventions, they say, advance directives should give people the opportunity to refuse ordinary food and water if they later experience severe dementia.This proposal is both appealing and unsettling. It is appealing because it offers some relief to people seeking to avoid the prolonged decline and extreme incapacity they have witnessed in relatives and friends with advanced (...) dementia. But does it sufficiently protect patients? Menzel and Chandler‐Cramer want to empower competent persons to impose potential discomfort and distress on a later self who cannot understand the reasons for that choice. In this situation, the price of respecting autonomy is paid by a frail incapacitated patient who has no idea why food and water are no longer offered to her. (shrink)

Much of the public debate over laboratory animal use has focused on either the scientist's demand for absolute freedom of inquiry, or the abolitionist's demand for an end to animal use in science. Yet many recent proposals for reform seek instead to balance the interests of laboratory animals in avoiding harm against the interests of research beneficiaries in continued animal use. This essay is an analysis of the intermediate reform positions and their underlying ethical principles. Keywords: animal research, animal experimentation, (...) ethics CiteULike Connotea Del.icio.us What's this? (shrink)

During the oppressive reign of Louis XIV, Gabrielle Suchon was the most forceful female voice in France, advocating women’s freedom and self-determination, access to knowledge, and assertion of authority. This volume collects Suchon’s writing from two works—_Treatise on Ethics and Politics_ and _On the Celibate Life Freely Chosen; or, Life without Commitments _—and demonstrates her to be an original philosophical and moral thinker and writer. Suchon argues that both women and men have inherently similar intellectual, corporeal, and spiritual capacities, which (...) entitle them equally to essentially human prerogatives, and she displays her breadth of knowledge as she harnesses evidence from biblical, classical, patristic, and contemporary secular sources to bolster her claim. Forgotten over the centuries, these writings have been gaining increasing attention from feminist historians, students of philosophy, and scholars of seventeenth-century French literature and culture. This translation, from Domna C. Stanton and Rebecca M. Wilkin, marks the first time these works will appear in English. (shrink)

This article explores the effectiveness of the decision of the Committee on the Elimination of Discrimination against Women in the case of Alyne da Silva Pimentel Teixeira (deceased) v. Brazil, concerning a poor, Afro-Brazilian woman. This is the first decision of an international human rights treaty body to hold a state accountable for its failure to prevent an avoidable death in childbirth. Assessing the future effectiveness of this decision might be undertaken concretely by determining the degree of Brazil's actual compliance (...) with the Committee's recommendations, and how this decision influences pending domestic litigation arising from the maternal death. Alternative approaches include: determining whether, over time, the decision leads to the elimination of discrimination against women of poor, minority racial status in the health sector, and if it narrows the wide gap between rates of maternal mortality of poor, Afro-Brazilian women and the country's general female population. Determining the effectiveness of this decision will guide whether to pursue a more general strategy of judicializing maternal mortality. (shrink)

Alyne da Silva Pimentel Teixeira died of postpartum hemorrhage following the stillbirth of a 27-week-old fetus on November 16, 2002 in Rio de Janeiro, Brazil. Her death led in 2011 to the first decision of an international treaty body holding a government accountable for a preventable maternal death. The decision, Alyne da Silva Pimentel Teixeira v. Brazil, was given by the Committee on the Elimination of Discrimination against Women, established to monitor compliance by member states with the UN Convention on (...) the Elimination of All Forms of Discrimination against Women. The decision upheld a complaint, filed in 2007 against the state and government of Brazil, finding discrimination in the field of health care for Alyne’s avoidable maternal death, in breach of the Women’s Convention. (shrink)