The doctor-patient relationship -- Consent, choice, and refusal : adults with capacity -- Treating adults who lack capacity -- Children and young people -- Confidentiality -- Health records -- Contraception, abortion, and birth -- Assisted reproduction -- Genetics -- Caring for patients at the end of life -- Euthanasia and physician assisted suicide -- Responsibilities after a patient's death -- Prescribing and administering medication -- Research and innovative treatment -- Emergency situations -- Doctors with dual obligations -- Providing treatment and (...) care in detention settings -- Education and training -- Teamwork, referral, delegation, and shared care -- Public health dimensions of medical practice -- Reducing risk, clinical error, and poor performance. (shrink)

At the outset of an ethnographic inquiry, we navigated national and international resources to search for theoretical and practical guidance on obtaining parents and children’s informed consent/assent. While much theoretical guidance debating ethical issues to children’s participation in research was found, a paucity of published papers offering practical guidance on assent processes and/or visual representations of child assent forms and information sheets was discovered. The purpose of this article is to describe our experiences, both theoretically and practically, of negotiating the (...) process of obtaining informed consent and assent with parents and children for a non-therapeutic qualitative research study. We hope this article instigates a platform for others to explicate their experience and contributes to the construction of a coherent body of knowledge which will clearly delineate important elements that must be considered when negotiating children’s agreement to participate in research. (shrink)

A general consensus has been reached in health care organizations that the disclosure of medical errors can be a very powerful way to improve patients and physicians well-being and serves as a core component to high quality health care. This practice strongly encourages transparent communication with patients after medical errors or unanticipated outcomes. However, many countries, such as Brazil, do not have a culture of disclosing harmful errors to patients or standards emphasizing the importance of disclosing, taking responsibility, apologizing, and (...) discussing the prevention of recurrences. Medical error is not discussed or approached during medical school. The stigma of error has a strong connection with value judgments, and emotional support for physicians does not exist. This paper suggests that open communication with the patient is essential. Guidance about error disclosure from health care organizations would be helpful for quality and patient safety and for health care professionals in countries like Brazil. (shrink)

A general consensus has been reached in health care organizations that the disclosure of medical errors can be a very powerful way to improve patients and physicians well-being and serves as a core component to high quality health care. This practice strongly encourages transparent communication with patients after medical errors or unanticipated outcomes. However, many countries, such as Brazil, do not have a culture of disclosing harmful errors to patients or standards emphasizing the importance of disclosing, taking responsibility, apologizing, and (...) discussing the prevention of recurrences. Medical error is not discussed or approached during medical school. The stigma of error has a strong connection with value judgments, and emotional support for physicians does not exist. This paper suggests that open communication with the patient is essential. Guidance about error disclosure from health care organizations would be helpful for quality and patient safety and for health care professionals in countries like Brazil. (shrink)

Desde os anos 1960, muitos educadores populares atuaram no Brasil com “objetivos políticos”, buscando construir uma hegemonia popular alcançada “antes de conquistar o poder governamental”. Pretende-se pesquisar a contribuição dessa síntese fecunda entre educação e política nos movimentos populares para o declínio do regime autoritário e para o fortalecimento de um projeto popular de democracia, que disputou a hegemonia política nos anos 1978-1989, bem como analisar os desdobramentos, limites e possibilidades atuais desse projeto, através da consulta a documentos e fontes (...) bibliográficas, além de entrevistas. (shrink)

ResumoNo presente artigo procura-se oferecer uma análise e avaliação críticas da posição de João Duns Scotus (ca. 1265 – 1308) a respeito do problema dos universais. Para tanto, é levada a cabo primeiramente uma breve exposição dos argumentos e conceitos centrais dos quais ele se utiliza para defender seu realismo. Em seguida, algumas críticas à posição de Scotus, em especial o cerne da que devemos a Guilherme de Ockham (ca. 1287 – 1347), são apresentadas em detalhes e então respondidas.Palavras-chave: Scotus, (...) Ockham, escolástica, universais, realismo, nominalismo.AbstractThe current paper aims to offer an analysis and evaluation of John Duns Scotus’ (ca. 1265 – 1308) position regarding the problem of universals. In order to do so, a brief exposition of the central arguments and concepts he employs to defend his realism is first carried out. Some criticisms of Scotus’ position, especially the core of the one we owe to William of Ockham (ca. 1287 – 1347), are then presented in detail and answered. (shrink)

Named entity recognition (NER) is a very relevant task for text information retrieval in natural language processing (NLP) problems. Most recent state-of-the-art NER methods require humans to annotate and provide useful data for model training. However, using human power to identify, circumscribe and label entities manually can be very expensive in terms of time, money, and effort. This paper investigates the use of prompt-based language models (OpenAI’s GPT-3) and weak supervision in the legal domain. We apply both strategies as alternative (...) approaches to the traditional human-based annotation method, relying on computer power instead human effort for labeling, and subsequently compare model performance between computer and human-generated data. We also introduce combinations of all three mentioned methods (prompt-based, weak supervision, and human annotation), aiming to find ways to maintain high model efficiency and low annotation costs. We showed that, despite human labeling still maintaining better overall performance results, the alternative strategies and their combinations presented themselves as valid options, displaying positive results and similar model scores at lower costs. Final results demonstrate preservation of human-trained models scores averaging 74.0% for GPT-3, 95.6% for weak supervision, 90.7% for GPT + weak supervision combination, and 83.9% for GPT + 30% human-labeling combination. (shrink)

Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or (...) it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example. (shrink)

Based on a mixed-methods study involving triad tasks and ethnobiological models, we analyze local categories and knowledge of key ethnospecies of fish exploring partial overlaps between artisanal fishers’ and academic knowledge in a fishing community in northeast Brazil. We argue that fishers’ and academic knowledge overlaps may provide common ground for transdisciplinary collaboration, while their partiality requires reflection on epistemological and ontological differences. Here, we show how knowledge of artisanal fishers can complement academic knowledge and bring about tensions that need (...) to be addressed through intercultural dialogue. By integrating a general philosophical framework of partial overlaps with a mixed-methods study on fishers’ knowledge, we show how ethnobiology can contribute to reflective and empirically-grounded transdisciplinary practices. (shrink)

Background:Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty.Objectives:The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi.Methodology:A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were (...) collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0.Ethical consideration:The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi.Results:The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings.Conclusion:The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

In this paper, we examine the scientific, legal, and ethical foundations for inclusion of transgender women athletes in competitive sport, drawing on IOC principles and relevant Court of Arbitration for Sport decisions. We argue that the inclusion of trans athletes in competition commensurate with their legal gender is the most consistent position with these principles of fair and equitable sport. Biological restrictions, such as endogenous testosterone limits, are not consistent with IOC and CAS principles. We explore the implications for recognizing (...) that endogenous testosterone values are a ‘natural physical trait’ and that excluding legally recognized women for high endogenous testosterone values constitutes discrimination on the basis of a natural physical trait. We suggest that the justificatory burden for such prima facie discrimination is unlikely to be met. Thus, in place of a limit on endogenous testosterone for women, we argue that ‘legally recognized gender’ is most fully in line with IOC and CAS principles. (shrink)

Este artigo busca mapear as diferenças e transformações que marcam a trajetória da noção leibniziana de substância ao longo dos quase trinta anos que separam suas primeiras e últimas sínteses de ar sistemático; percurso que vai do _Discurso de Metafísica_ à _Monadologia_ e aos _Princípios da Natureza e da Graça _. Poderemos, deste modo, fornecer um quadro de mecanismos conceituais e doutrinários que nos permita melhor compreender o estatuto coesivo de sua obra filosófica, donde encontraremos uma noção ampla mas singular (...) de substância que se define, sobretudo, pela articulação reversiva entre unidade e ação. (shrink)

A country‘s development is bound to be influenced by external occurrences. This article analyses two astronomical examples in which Portuguese nationals used high visibility events in the international scientific community to press their own scientific interests upon the government, whether these interests were, or were not, directly linked to the events themselves.During the 1840s and 1850s the parallax, i.e. the distance, of Groombridge’s star 1830 was hotly debated. The astronomer Hervé Faye‘s suggestion at the Académie des Sciences de Paris that (...) observations be made in Lisbon due to its privileged location and the inadequacy of the Lisbon Navy Observatory to perform them rekindled the efforts to improve the Portuguese Navy observatory.In the 1850s and 1860s other Portuguese higher education institutions also wanted to upgrade their facilities or build new ones. Following accepted traditions, scientific field trips were considered a useful part of the acquisition planning for larger instruments, and therefore an important part of regeneration and renewal projects. The Portuguese scientists were, however, limited in their travels by government imposed budget constraints. The total solar eclipse of 18 July 1860 provided an extra argument to send Portuguese scientists abroad. The government support of the eclipse expedition led to an opportunity to travel through other countries and view their observatories and equipment.In the end, neither the Navy astronomers nor those from the Coimbra Astronomical observatory, the other significant site of Portuguese astronomical research, managed to fulfil their objectives, but the contacts initiated by some of the Portuguese travellers were important for the development of the Portuguese national Meteorological and Magnetic Observatories. (shrink)

This present research seeks to introduce to some of the recent developments in analytical philosophy of religion. Thus, the revival of philosophical theism in scholarly debates in the analytic philosophy ocurring since the 60' will be looked at. As a byproduct of this revival, natural theology makes a comeback with its traditional arguments for the existence of God. We discuss this in light of the controversy on same subject involving theologians Karl Barth and Emil Brunner.

O modelo escolar moderno que foi universalizado durante o século XX, mostrou-se incapacitado de responder todas as demandas sociais que lhe foram impostas. Dessa forma, durante a segunda metade deste século a crise do sistema de ensino formal deu abertura a diversos debates sobre questões que permeiam a ação de educar, como os espaços, os atores e porque não sobre próprio conceito: o que é educar? Sendo assim, neste artigo trago reflexões sobre a educação formal, dentre outras formas, analisando o (...) contexto da educação no Brasil e em Cabo Verde, para compreender de que maneira determinados atores sociais, como os rappers, podem contribuir para a construção de uma educação emancipadora. (shrink)

Multiple-conclusion Hilbert-style systems allow us to finitely axiomatize every logic defined by a finite matrix. Having obtained such axiomatizations for Paraconsistent Weak Kleene and Bochvar–Kleene logics, we modify them by replacing the multiple-conclusion rules with carefully selected single-conclusion ones. In this way we manage to introduce the first finite Hilbert-style single-conclusion axiomatizations for these logics.

In this article I argue against the arbitrariness of the concept of music and for an essentialist and naturalist framework, according to which music is a cross-cultural human phenomenon, defined by relational properties held together by uniform features of human nature. Building on Dickie’s classification of theories of art in natural kind theories and cultural-kind theories, I argue for an enhanced natural-kind theory (which explains the institutional element), and use some developments in social ontology to show the inadequacy of an (...) institutionalist approach to art and music. (shrink)

. Modern science is one form of knowledge, demarcated by its time (modernity) and by other “knowledges.” There is a fair amount of clarity as to what does not count as scientific, but there is a twilight zone of knowledges whose scientific status is ambivalent. In this zone the encounter between science and religion takes place. The particular contribution of religion and theology in this encounter is to call for an ethics of knowledge in the epistemological endeavors of science.

In this paper, I discuss which semantic theory moral subjectivists should adopt. Moral subjectivism is understood broadly to include all theories according to which moral sentences are truth-apt, at least sometimes true, and made true by the mental attitudes of certain relevant agent or set of agents. Due to the breadth of this definition, an initial concern is whether a unified semantic approach is able to accommodate all varieties of subjectivism. I argue that it is. I then proceed to analyse (...) the main semantic theories for moral sentences as they apply to the standard issue of moral disagreements. I conclude in favour of so-called Non-Indexical Contextualism. (shrink)

The presence of stigmatizing language in the electronic health record (EHR) has been used to measure implicit biases that underlie health inequities. The purpose of this study was to identify the presence of stigmatizing language in the clinical notes of pregnant people during the birth admission. We conducted a qualitative analysis on N = 1117 birth admission EHR notes from two urban hospitals in 2017. We identified stigmatizing language categories, such as Disapproval (39.3%), Questioning patient credibility (37.7%), Difficult patient (21.3%), (...) Stereotyping (1.6%), and Unilateral decisions (1.6%) in 61 notes (5.4%). We also defined a new stigmatizing language category indicating Power/privilege. This was present in 37 notes (3.3%) and signaled approval of social status, upholding a hierarchy of bias. The stigmatizing language was most frequently identified in birth admission triage notes (16%) and least frequently in social work initial assessments (13.7%). We found that clinicians from various disciplines recorded stigmatizing language in the medical records of birthing people. This language was used to question birthing people's credibility and convey disapproval of decision‐making abilities for themselves or their newborns. We reported a Power/privilege language bias in the inconsistent documentation of traits considered favorable for patient outcomes (e.g., employment status). Future work on stigmatizing language may inform tailored interventions to improve perinatal outcomes for all birthing people and their families. (shrink)

Husserlian phenomenology of time, as it is developed on theLectures on the Phenomenology of Inner Time Consciousness, shows some difficulties to explain certain temporal experiences. This is the case of the incompatibility between the rigidity of the retentional modification and the effective approach that a subject may have with his memories. On the one hand, according to the Lectures’ explanation, the darkening of the past occurs in an homogeneous way: The more distant an experience is, the lower the clarity of (...) the associated retention. However, our relation with the past is not so direct. Complementing the studies of the Lectureswith those of the Analysis concerning passive synthesiscould allow to explain this kind of temporal phenomena. (shrink)

RESUMEN Aunque las Lecciones de fenomenología de la conciencia interna del tiempo tienen pocas referencias al marco metódico, ciertos pasajes apuntan a la reducción fenomenológica, de modo que su status se diferenciaría del de las Investigaciones lógicas y se acercaría al de Ideas i. Se ha señalado que aun si la reducción es empleada en este texto, no lo sería en su "versión madura". Se busca determinar el estatus metodológico de las Lecciones a partir de una comparación entre los desarrollos (...) metódicos y las descripciones fenomenológicas que se presentan allí y aquellos consignados en Investigaciones e Ideas, teniendo como idea regulativa el esclarecimiento del papel del tiempo en la ampliación del dominio de la fenomenología como conjunto. ABSTRACT Although there are few references to the methodological framework in On the Phenomenology of the Consciousness of Internal Time, certain passages point to the phenomenological reduction. Therefore, its status would differ from that of the Logical Investigations and approach that of Ideas I. Some have argued that the reduction used in this text is not the "mature version" of the same. The article seeks to determine the methodological status of PCIT on the basis of the comparison between the methodological developments and phenomenological descriptions found in this work and those found in Investigations and Ideas. The regulative idea guiding the analysis is the clarification of the role of time in broadening the sphere of phenomenology as a whole. (shrink)

many symbols. We define o, as the probability that an arbitrary machine be circular and we prove that o, is a random number that goes beyond..

We contribute to feminist and gender scholarship on cultural notions of motherhood by analyzing the importance of motherhood among mothers and non-mothers. Using a national probability sample of U.S. women ages 25-45, we find a continuous distribution of scores measuring perceptions of the importance of motherhood among both groups. Employing OLS multiple regression, we examine why some women place more importance on motherhood, focusing on interests that could compete with valuing motherhood, and controlling for characteristics associated with becoming a mother. (...) Contrary to cultural schemas that view mother and worker identities as competing, we find that education level is not associated with the importance of motherhood for either group and that valuing work success is positively associated with valuing motherhood among mothers. Consistent with feminist explanations for delayed fertility, valuing leisure is negatively associated with valuing motherhood for non-mothers. (shrink)

According to a tradition going back to Socrates, one should thoroughly examine the grounds of one’s judgments before settling on what one has reason to do or believe. According to contemporary metaethical constructivism, assumed in this essay, reflective scrutiny is also central to assessing a judgment’s claim to justification. This essay argues against the injunctions to thoroughly examine oneself and seek ultimate reasons for one’s normative judgments. In other words, the essay argues against the ideal of the philosophical way of (...) life. It shows that in most cases one does not have reason to question the practical conclusion of one’s initial deliberation. It is only under very limited conditions, specified in the essay, that one is justified in engaging in further reflection. Furthermore, the essay argues that if one does go for full self-examination, the consequences are most likely to be bad for oneself, given one’s practical interests. (shrink)

Este trabajo examina diferentes perspectivas docentes para externalizar criterios de evaluación. Se presentan hallazgos de una investigación doctoral que abordan, por una parte, una metodología analítica, que cautela la claridad y transparencia en la comunicación de criterios, segmentando la meta de aprendizaje en pequeñas secuencias, transmitiendo de este modo una idea atomizada acerca del conocimiento. Por otra parte, se explora una visión más holística, sustentada en la interdependencia de los criterios de evaluación, favoreciendo la comprensión del propósito de la tarea (...) en su conjunto. Se analiza la significancia de estos enfoques para la retroalimentación y evaluación formativa. (shrink)

Montaigne, no "De l'art de conferer", discute critérios que permitem distinguir os homens segundo suas capacidades (suffisances). A "maneira" de discursar ocupa o centro desta questão e entre suas qualidades se destaca a "ordem", que nos é apresentada, sobretudo, a partir dos desvios da "tolice" (sottise) e "obstinação" (opiniastreté), símbolos do dogmatismo e de uma errônea lide com os saberes que se apoiam na memória. Procura-se mostrar que a ordem se funda na assimilação e penetração do julgamento nas matérias que (...) garantem o nexo necessário para o desenvolvimento adequado da conversação (conference). Montaigne, in "De l'art de conferer", discusses the criteria to distinguish men according to their capabilities (suffisances). The "manner" of discussing is central to this issue and among its qualities "order" distinguishes itself. The "order" is presented to us by the exposition of its deviations: foolishness ("sottise") and obstinacy ("opiniastreté"). These inadequacies represent both dogmatism and an erroneous way of using knowledge based on memory. We intend to show how order is founded on a kind of judgment which assimilates and penetrates matters and subjects - being it the only way to assure the necessary connection to adequately develop the conversation ("conference"). (shrink)

El canon literario implica un proceso de selección sistemático y jerárquico de escritores, obras y géneros con el fin de delimitar un corpus modélico imitableligado fuertemente a la instrucción pedagógica. En el presente trabajo se analizará el particular proceso de formación y conformación del canon –así como surecepción y transformación respecto de los cánones previos– establecido por Quintiliano en el Libro 10 de la Institutio Oratoria, a fin de demostrar que los criterios de selección que guían dicho canon exceden la (...) mera función didáctica. (shrink)

Abordaremos a crítica marxiana à noção hegeliana de "ser" , mostrando que a historicidade e a objetividade, em verdade, são determinações desta . Deste modo, intentamos mostrar que analogias entre a lógica hegeliana e a teoria marxiana podem eclipsar aspectos centrais à abordagem materialista proposta pelo autor de "O capital". Apontando a inversão hegeliana entre sujeito e predicado, Marx trata da apreensão do real que, muito embora seja traçada em diálogo com a dialética hegeliana, é também sua antítese direta . (...) We will deal with the Marxian criticism to the Hegelian notion of "being". It will be shown that historicity and objectivity are determinations of this category . So, the analogy between the Hegelian logic and the Marxian theory may, sometimes, hide essential aspects of the materialist comprehension of history. Here, we intend to prove that, by questioning the treatment dispensed to the matter of being by Hegel, Marx criticizes the Hegelian inversion between subject and predicate in a way that, although dialoguing with Hegel, his conception is the exact opposite at the same time. (shrink)

The article discusses a relatively obscure but significant aspect of work of the Russian and Soviet thinker Alexander Bogdanov—his science fiction novels. The author points out that, using the form...