ABSTRACT The Gorgias presents us with a mystery and an enigma: Who was Callicles? And, what was Plato trying to accomplish in this dialogue? While searching for the identity of Callicles, we gain a better understanding of Plato's purpose for this dialogue, which is to use justice as a means for staking out the boundaries of four types of rhetoric. This article argues that Plato uses the Gorgias to reveal the deficiencies of sophistic nomos-centered rhetorics and an unjust sophistic phusis-centered (...) rhetoric, opening the door for a “true” rhetoric that he articulates in the Phaedrus and a universal justice based on virtue that he describes in the Republic. (shrink)

The negative impact of adverse experiences in childhood on neurodevelopment is well documented. Less attention however has been given to the impact of variations in “normative” parenting behaviors. The influence of these parenting behaviors is likely to be marked during periods of rapid brain reorganization, such as late childhood. The aim of the current study was to investigate associations between normative parenting behaviors and the development of structural brain networks across late childhood. Data were collected from a longitudinal sample of (...) 114 mother-child dyads, recruited from low socioeconomic areas of Melbourne, Australia. At the first assessment parenting behaviors were coded from two lab-based interaction tasks and structural magnetic resonance imaging scans of the children were performed. At the second assessment, approximately 18 months later MRI scans were repeated. Cortical thickness was extracted from T1-weighted images using FreeSurfer. Structural covariance networks were constructed from partial correlations of CT estimates between brain regions and estimates of network efficiency and modularity were obtained for each time point. The change in these network measures, from Time 1 to Time 2, was also calculated. At Time 2, less positive maternal affective behavior was associated with higher modularity, while negative maternal affective behavior was not related. No support was found for an association between local or global efficacy and maternal affective behaviors at Time 2. Similarly, no support was demonstrated for associations between maternal affective behaviors and change in network efficiency and modularity, from Time 1 to Time 2. These results indicate that normative variations in parenting may influence the development of structural brain networks in late childhood and extend current knowledge about environmental influences on structural connectivity in a developmental context. (shrink)

SummaryIn 1968, a prospective study was started in collaboration with the Family Planning Association to try to provide a balanced view of the beneficial and harmful effects of different methods of contraception. This investigation is now in progress at seventeen clinics and over 17,000 women are under observation. At the time of recruitment, all these women were married white British subjects, aged 25–39 years, who voluntarily agreed to participate. Fifty-six per cent were using oral contraceptives, 25% were using a diaphragm (...) and 19% were using an intrauterine device. During follow-up each woman is questioned at return visits to the clinic and a record of pregnancies and their outcome, hospital referrals, changes in contraceptive methods and the results of cervical smears, is accumulated. Women who default are sent a postal questionnaire and, if this is not returned, are telephoned or visited in their homes to collect the necessary information.So far, data obtained during 56,000 woman-years of observation are available for analysis. Follow-up has been maintained with an annual lapse rate of about 0.3%due to withdrawal of co-operation or loss of contact; adherence to the method of contraception in use at recruitment has been reasonably good, and the reporting of pregnancies and hospital admissions appears to have been both reliable and unbiased.The present data include only 24 deaths, so the mortality associated with different contraceptive methods cannot yet be estimated. With regard to morbidity, however, our preliminary results closely resemble those obtained in the prospective study carried out by the Royal College of General Practitioners and in the principal retrospective studies carried out in Britain and the United States. Women who used oral contraceptives at the start of the study experienced adeficiencyof hospital referrals for cancer, benign lesions of the breast, menstrual disorders other than amenorrhoea, duodenal ulcer, and retention cysts of the ovary; they showed anexcessof referrals for cerebrovascular disease, cervical erosion, skin disorders, self-poisoning, migraine, venous thrombosis and embolism, hayfever, gallbladder disease, amenorrhoea, and sterility. Women who used a diaphragm showed adeficiencyof hospital referrals for carcinoma-in-situ and dysplastic lesions of the cervix uteri and accidental injury; and anexcessof referrals for haemorrhoids and cystitis. Women who used an IUD experienced anexcessof hospital referrals for anaemia, varicose veins and salpingitis. About half of these differences were predicted from other studies while some suggestive evidence already existed for a further five. Of the remaining six, some probably reflect the influence of selective factors or chance.Multiple pregnancies, stillbirths, malformations, the sex ratio and birthweight showed no consistent relationship to method of contraception. The outcome of unplanned pregnancies occurring in women using an IUD, however, was remarkably unfavourable both in terms of ectopic gestation and miscarriage.Clear evidence was found of impairment of fertility after discontinuation of oral contraceptives. Whether this is likely to lead to permanent sterility in some women is uncertain.The study has provided data on the efficacy of a wide variety of contraceptive methods. In general the failure rates are in keeping with those obtained in other large-scale studies, save that those for the diaphragm and the sheath are much lower than those usually quoted.The available evidence does not yet allow a final balance to be struck between the benefits and risks associated with the new methods of contraception that have become widely used during the last two decades. It seems clear, however, that there are no material risks associated with the use of the diaphragm apart from the risk of pregnancy and that there may be some unintended benefits. (shrink)

The significance of big data for driving health research and improvements in patient care is well recognised. Along with these potential benefits, however, come significant challenges, including those concerning the sharing and linkage of health and social care records. Recently, there has been a shift in attention towards a paradigm of data sharing centred on the ‘trusted research environment’ (TRE). TREs are being widely adopted by the UK’s health data initiatives including Health Data Research UK (HDR UK),1 Our Future Health2 (...) and Genomics England.3 A recent review commissioned by the UK’s Department of Health and Social Care (hereafter referred to as the ‘Goldacre Review’) places TREs at the heart of its recommendations around the future of National Health Service (NHS) health data sharing for research, describing them as the ‘clear path forward’ to a health data system in which trust is ‘earned’ through ‘provable, credible steps to protect patient privacy, and by being transparent with everyone about everything that is done with their deepest medical secrets’.4 We argue that rather than building public trust, the TRE model actually reduces the need for trust in the use and sharing of patient health data. This is because trust is importantly connected to vulnerability and uncertainty; an essential part of trusting someone is accepting that one’s trust could be disappointed or betrayed. In attempting to provide assurances or guarantees of data privacy and security, TREs strive to remove this vulnerability, and so remove the need for trust. We do not see this as a problem and are broadly supportive of this kind of data sharing model because of the increased security and oversight it provides. However, having argued that TREs are not actually concerned with trust, we consider the importance of being precise about the words that we use …. (shrink)

Cognitive Science, Volume 46, Issue 6, June 2022.

[164] As is well known, over the last decade some of the younger generation of German philosophers have been gravitating with ever increasing speed toward philosophical anthropology. Currently Wilhelm Dilthey's philosophy of life, a new form of anthropology, exercises a great deal of influence. But even the so-called "phenomenological movement" has got caught up in this new trend, which alleges that the true foundation of philosophy lies in human being alone, and more specifically in a doctrine of the essence of (...) human being's concrete worldly Dasein. Some view this as a necessary reform of the original constitutive phenomenology, one that for the very first time would supposedly permit phenomenology to attain the level of authentic philosophy. All of this constitutes a complete reversal of phenomenology's fundamental standpoint. Original phenomenology, which has matured into transcendental phenomenology, denies to any science of human being, whatever its form, a share in laying the foundations for philosophy, and opposes all related attempts at foundation-laying as being anthropologism or psychologism. Nowadays, however, the exact opposite is supposed to hold. Phenomenological philosophy is supposedly now to be constructed entirely anew from out of human Dasein. (shrink)

Research has consistently revealed gender differences in attitudes toward science and technology. One explanation is that women are more personally affected by particular technologies, so they consider them differently. However, not all women universally experience biomedical technologies. We use the concept of technological salience to address how differences in subjective implications of a technology might explain differences in women’s attitudes toward biotechnology. In a sample of U.S. women from the National Survey of Fertility Barriers, we examine how women with and (...) without a biomedical barrier to fertility evaluate biotechnology for infertility, which, we argue, reflects differences in technological salience. For women with a biomedical barrier, various experiences, beliefs, and values impacted their attitudes; yet, most of these did not affect attitudes if women had not experienced a fertility barrier. Results suggest that technological salience contextualizes women’s attitudes toward these biotechnologies and may also have broader implications for other biotechnologies. (shrink)

What role does love--of cinema, of cinema studies, of teaching and learning--play in teaching film? For the Love of Cinema brings together a wide range of film scholars to explore the relationship between cinephilia and pedagogy. All of them ask whether cine-love can inform the serious study of cinema. Chapter by chapter, writers approach this question from various perspectives: some draw on aspects of students' love of cinema as a starting point for rethinking familiar films or generating new kinds of (...) analyses about the medium itself; others reflect on how their own cinephilia informs the way they teach cinema; and still others offer new ways of writing with a love of cinema in the age of new media. Together, they form a collection that is as much a guide for teaching cinephilia as it is an energetic dialogue about the ways that cinephilia and pedagogy enliven and rejuvenate one another. (shrink)

Has moral relativism run its course? The threat of 9/11, terrorism, reproductive technology, and globalization has forced us to ask anew whether there are universal moral truths upon which to base ethical and political judgments. In this timely edited collection, distinguished scholars present and test the best answers to this question. These insightful responses temper the strong antithesis between universalism and relativism and retain sensitivity to how language and history shape the context of our moral decisions. This important and relevant (...) work of contemporary political and social thought is ideal for use in the classroom across many disciplines, including political science, philosophy, ethics, law, and theology. (shrink)

In our recent paper ‘Trust and the Goldacre Review: Why TREs are not about trust’1 we argue that trusted research environments (TREs) reduce the need for trust in the use and sharing of health data, and that referring to these data storage systems as ‘trusted’ raises a number of concerns. Recent replies to our paper have raised several objections to this argument. In this reply, we seek to build on the arguments presented in our original paper, address some of the (...) misunderstanding of our position expressed in these replies, and sketch out where further research is needed. One of the central arguments of our original paper was that the language we use to describe data-sharing initiatives matters, because the way things like TREs are presented and framed makes a difference to what people can, and should, expect from them. However, there is a more basic and obvious problem with referring to these institutions as ‘trusted’: it begs the question about whether these institutions are, in fact, trusted. We cannot know in advance of these initiatives being implemented, established, and appropriate assessments completed, whether they are actually trusted. Further questions abound: whom might TREs eventually be trusted by? If some people end up trusting them, but not others, is it appropriate to call them ‘trusted’? At best, this is simply a case of wishful thinking (and a more accurate name would be ‘hopefully-TREs’). More problematically, this may be an instance of ‘trustworthiness-signalling’: an attempt to convince others to trust, without meeting the requirements for genuine trustworthiness. By calling TREs ‘trusted’, the implication seems to be that placing our trust in them is perfectly fine: they are the kinds of things that are trusted by others and can safely be trusted by us. But not only does simply calling something ‘trusted’ …. (shrink)

Despite concerns about the relationships between health professionals and the medical device industry, the issue has received relatively little attention. Prevalence data are lacking; however, qualitative and survey research suggest device industry representatives, who are commonly present in clinical settings, play a key role in these relationships. Representatives, who are technical product specialists and not necessarily medically trained, may attend surgeries on a daily basis and be available to health professionals 24 hours a day, 7 days a week, to provide (...) advice. However, device representatives have a dual role: functioning as commissioned sales representatives at the same time as providing advice on approaches to treatment. This duality raises the concern that clinical decision-making may be unduly influenced by commercial imperatives. In this paper, we identify three key ethical concerns raised by the relationship between device representatives and health professionals: impacts on healthcare costs, the outsourcing of expertise and issues of accountability and informed consent. These ethical concerns can be addressed in part through clarifying the boundary between the support and sales aspects of the roles of device representatives and developing clear guidelines for device representatives providing support in clinical spaces. We suggest several policy options including hospital provision of expert support, formalising clinician conduct to eschew receipt of meals and payments from industry and establishing device registries. (shrink)

This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...) ‘integrating’ empirical methods and ethical argument as a standard for research practice within empirical bioethics. (shrink)

This article explores the rhetorics of President Bush and Prime Minister Blair in the aftermath of 11th September. It takes their differing versions of masculinity as a starting-point. The speeches refer extensively to `ways of life', a concept also worth recovering theoretically. Anti-terrorism is a defence of ways of living which are without moral ambiguity and are in absolute opposition to terrorist `evil'. Bush constructs a hegemony at home as a basis for unilateral global interventions. His Americanism draws on familiar (...) themes, but also invokes compassion, pugnacity and sporting masculinities, drawn especially from the game of baseball. Blair's more `intellectual' version aims at the construction of an international `community' or coalition with Britain in a pivotal role. The contexts, strengths, vulnerabilities, and political and ethical limits of anti-terrorism are explored in detail, including some correspondence with Al-Qa'ida's fundamentalism. (shrink)

This study examines firms that have experienced an industrial and/or environ-mental crisis and proposes that top management team (TMT) characteristics will affect a firm's ability to minimize the severity of these crisis events. Specifically, heterogeneity in the TMT will exhibit a curvilinear (U-shaped) relationship with the severity of firm crises. Our results suggest that a moderate level of age and tenure heterogeneity are positively related to a firm's ability to successfully minimize the severity of crises. Variance in educational backgrounds was (...) unrelated to crisis severity. Functional background heterogeneity exhibited a curvilinear relationship with crisis severity but was not U-shaped as hypothesized. (shrink)

This comprehensive Gandhi reader provides an essential new reference for scholars and students of his life and thought. It is the only text available that presents Gandhi's own writings, including excerpts from three of his books—An Autobiography: The Story of My Experiments with Truth, Satyagraha in South Africa, Hind Swaraj —a major pamphlet, Constructive Programme: Its Meaning and Place, and many journal articles and letters, along with a biographical sketch of his life in historical context and recent essays by highly (...) regarded scholars. (shrink)

ALL classical palaeographers are familiar with Persius' roster of writing materials: Now we take the book to hand, and the two-coloured parchment purged of hair, and papyrus, and a knotty reed. Of the items mentioned, only ‘two-coloured parchment’ presents any difficulty.I hope in this article to present at least a possible solution to this problem. An obvious supposition would be that Persius is merely referring to the natural differences in colour between the two sides of a piece of parchment.

Research involving adults who lack capacity to consent relies on proxy (or surrogate) decision making. Proxy decisions about participation are ethically complex, with a disparity between normative accounts and empirical evidence. Concerns about the accuracy of proxies’ decisions arise, in part, from the lack of an ethical framework which takes account of the complex and morally pluralistic world in which proxy decisions are situated. This qualitative study explored the experiences of family members who have acted as a research proxy in (...) order to develop an understanding of the ethical concepts involved, and the interactions between those concepts. Proxies described a complex process of respecting the wishes and preferences of the person they represented, whist integrating preferences with what they viewed as being in the interests of the person. They aimed to make a decision that was ‘best’ for the person and protected them from harm; they also aimed to make the ‘right’ decision, viewed as being authentic to the person’s values and life. Decisions were underpinned by the relationship between the person and their proxy, in which both trust and trustworthiness were key. Proxies’ decisions, based both on respect for the person and the need to protect their interests, arose out of their dual role as both proxy and carer. The findings raise questions about accounts which rely on existing normative assumptions with a focus on accuracy and discrepancy, and which fail to take account of the requirement for proxies to make authentic decisions that arise out of their caring obligations. (shrink)

Background: Research involving adults lacking mental capacity relies on the involvement of a proxy or surrogate, although this raises a number of ethical concerns. Empirical studies have examined attitudes towards proxy decision-making, proxies’ authority as decision-makers, decision accuracy, and other relevant factors. However, a comprehensive evidence-based account of proxy decision-making is lacking. This systematic review provides a synthesis of the empirical data reporting the ethical issues surrounding decisions made by research proxies, and the development of a conceptual framework of proxy (...) decision-making for research. Methods: A systematic review was conducted according to PRISMA guidelines. Databases including MEDLINE, EMBASE, and CINAHL were searched using a combination of search terms, and empirical data from eligible studies were retrieved. The review followed the framework synthesis approach to refine and develop a conceptual framework. Results: Thirty-four studies were included in the review. Two dimensions of proxy decision-making emerged. The ethical framing criteria of decision-making used by proxies: use of a substituted judgement, use of a best interests approach, combination of substituted judgement and best interests, and ‘something else’, and the active elements of proxy decision-making: ‘knowing the person’, patient-proxy relationship, accuracy of the decision, and balancing risks, benefits and burdens, and attitudes towards proxy decision-making. Interactions between the framing criteria and the elements of decision-making are complex and contextually-situated. Conclusions: The findings from this systematic review challenge the accepted reductionist account of proxy decision-making. Decision-making by research proxies is highly contextualized and multifactorial in nature. The choice of proxy and the relational features of decision-making play a fundamental role: both in providing the proxy’s authority as decision-maker, and guiding the decision-making process. The conceptual framework describes the relationship between the framing criteria used by the proxy, and the active elements of decision-making. Further work to develop, and empirically test the proposed framework is needed. (shrink)

ObjectiveTo examine health and social care professionals’ understanding of the legislation governing research involving adults lacking mental capacity in England and Wales.MethodsA cross-sectional online survey was conducted using a series of vignettes. Participants were asked to select the legally authorised decision-maker in each scenario and provide supporting reasons. Responses were compared with existing legal frameworks and analysed according to their level of concordance.ResultsOne hundred and twenty-seven professionals participated. Levels of discordance between responses and the legal frameworks were high across all (...) five scenarios. Nearly half of the participants provided responses that were discordant in all scenarios. Only two participants provided concordant responses across all five scenarios.DiscussionParticipants demonstrated a lack of knowledge about the legal frameworks, the locus of authority and the legal basis for decision-making. The findings raise concern about the accessibility of research for those who lack capacity, the ability to conduct research involving such groups and the impact on the evidence base for their care.ConclusionThis is the first study to examine health and social care professionals’ knowledge and understanding of the dual legal frameworks in the UK. Health and social care professionals’ understanding and attitudes towards research involving adults with incapacity may warrant further in-depth exploration. The findings from this survey suggest that greater training and education is required. (shrink)

The development and deployment of medical devices, along with most areas of healthcare, has been significantly impacted by the COVID-19 pandemic. This has had variable ethical implications, two of which we will focus on here. First, medical device regulations have been rapidly amended to expedite approvals of devices ranging from face masks to ventilators. Although some regulators have issued cessation dates, there is inadequate discussion of triggers for exiting these crisis standards, and evidence that this may not be feasible. Given (...) the relatively low evidence standards currently required for regulatory approval of devices, this further indefinite reduction in standards raises serious ethical issues. Second, the pandemic has disrupted the usual operations of device representatives in hospitals, providing an opportunity to examine and refine this potentially ethically problematic practice. In this paper we explain and critically analyse the ethical implications of these two pandemic-related impacts on medical devices and propose suggestions for their management. These include an endpoint for pandemic-related adjustments to device regulation or a mechanism for continued refinement over time, together with a review of device research conducted under crisis conditions, support for the removal and replacement of emergency approved devices, and a review of device representative credentialling. (shrink)

This article responds to Lash and Thoburn's articles in this volume by arguing for the value of Gramsci's strategic concept of hegemony today. It places post-hegemony theories as replicating one particular reading of Gramsci as a theorist of ideology and politics only, a reading that was deepened by certain appropriations of post-structuralist theory in the 1980s. It argues that the Prison Notebooks contain a richer legacy of concepts and historical methods, many of which are applicable to today's global reach of (...) power and communication. In particular, Gramsci was concerned with the relations between Fordist innovation and changes in state, civil society, intellectual formations and ways of living. He was especially interested in popular 'common sense', which, in his view, was the starting point of political work and could be the product of a renovative political activism. His ideas remain relevant to understanding recent transitions, especially since 11 September 2001, and the reach and limits of global neo-liberal hegemonies today, including the role of neo-liberal intellectuals and of a deepened individualism in everyday life. They also offer resources for counter-hegemonic strategies. Although Lash and Thoburn grasp a crucial coagulation of power today, their superseding of hegemony is based on an impoverished reading of the history of Gramscianism in cultural studies, and on a collapse of key complexities and local differences which is typical of some versions of social theory. (shrink)

ALL classical palaeographers are familiar with Persius' roster of writing materials: Now we take the book to hand, and the two-coloured parchment purged of hair, and papyrus, and a knotty reed. Of the items mentioned, only ‘two-coloured parchment’ presents any difficulty.I hope in this article to present at least a possible solution to this problem. An obvious supposition would be that Persius is merely referring to the natural differences in colour between the two sides of a piece of parchment.