In lieu of an abstract, here is a brief excerpt of the content:The Transformation:Power in Persistence and PerspectiveTyler BendrickWe've got another meth napper," my resident stated. With an introduction like that, it is hard not to be immediately labeled as a "difficult patient." Being the only Spanish-speaking person on the team, I, a third-year medical student, became the primary point of contact for this severely injured patient. He was an only-Spanish-speaking, 36-year-old male admitted [End Page 7] to our trauma service (...) after he was hit by a truck while riding his bicycle. Unbeknownst to me at the time, the 14 days I spent caring for this man would become one of the most pivotal learning experiences of my medical school career. It changed not only how I understand and approach "difficult patients" but expanded my knowledge of the complexities and challenges of the current healthcare system and how we, as physicians and healthcare providers, can deliver the best care to patients with low health literacy and limited resources.So, what is a "meth napper?" I questioned. "Well, meth is a super stimulant," my resident explained. "When people are frequent meth users, they get used to functioning normally with high levels of stimulants in their body, reducing the normal regulation of wakefulness. When the amphetamine is removed (such as upon admission to the hospital), the body is left to fend for itself, and thus patients oftentimes sleep for 23 hours a day for about 3 to 5 days while their body works to detox and normalize hormones."As predicted, my new friend, "Joe," was napping when I first went to see him. Thinking back, the word "napping" does not accurately describe his level of somnolence. He was virtually unarousable, and I took to a sternal rub to wake him up at 5 a.m. after his traumatic exploratory laparotomy the night before. Once aroused, he was furious. "Estoy bien. Tengo dolor y tengo hambre," he grunted at me. (I am fine, and I am in pain and hungry!). "Ok, Joe," I replied in Spanish, "I am just going to do a quick exam and you can go back to sleep. We will give you medications for your pain. You had a big surgery on your intestines, so you cannot eat or drink right now. If everything goes well in the next couple of days and you start walking around, we can advance your diet." He begrudgingly let me examine him, never opening his eyes, and I left and went about my day.We continued this routine for five days. I would periodically check on him and usually found him sleeping. When awake, he refused to work with physical therapists, get up and walk or go to the bathroom, shower, use his spirometer, or converse with the nursing staff. He seemed completely disinterested in recovery. About day three, we slowly advanced his diet to clear liquids so he could quench his thirst. Sometimes his wife was there, and she would ask for updates, to which I could only reply, "We have to wait until he is more awake or willing to work with us." I was getting frustrated, as it seemed that his noncompliance was becoming his barrier to discharge.But on day six, everything changed. I went to check on Joe, and he was wide awake, vomiting, and irate. He shouted that he was in incredible pain, and his incision was wet. He was also complaining that he had not eaten in five days, and was insisting that we were starving him. Again, I calmly explained (as I had multiple times a day for the past five days) that his major abdominal surgery prevented us from feeding him until his intestines healed. We were giving him fluids and nutrition through his IV lines, so he was not starving to death. I rushed to get my resident to examine his oozing wound, and after a CT scan and an x-ray, we discovered what we feared: His wound had opened down to the fascia, "dehiscence," as it is called. On top of this, he now had a bowel obstruction, causing his vomiting. His lack of mobility for the past five days had slowed his... (shrink)

Many real-world agents recognise that they impose harms by choosing to emit carbon, e.g., by flying. Yet many do so anyway, and then attempt to make things right by offsetting those harms. Such offsetters typically believe that, by offsetting, they change the deontic status of their behaviour, making an otherwise impermissible action permissible. Do they succeed in practice? Some philosophers have argued that they do, since their offsets appear to reverse the adverse effects of their emissions. But we show that (...) they do not. In practice, standard carbon offsetting does not reverse the harms of the original action, nor does it even benefit the same group as was harmed. Standard moral theories hence deny that such offsetting succeeds. Indeed, we show that any moral theory that allows offsetting in this setting faces a dilemma between allowing any wrong to be offset, no matter how grievous, and recognising an implausibly sharp discontinuity between offsettable actions and non-offsettable actions. The most plausible response is to accept that carbon offsetting fails to right our climate wrongs. (shrink)

Waiting time is widely used in health and social policy to make resource allocation decisions, yet no general account of the moral significance of waiting time exists. We provide such an account. We argue that waiting time is not intrinsically morally significant, and that the first person in a queue for a resource does not ipso facto have a right to receive that resource first. However, waiting time can and sometimes should play a role in justifying allocation decisions. First, there (...) is a duty of fairness prohibiting line-cutting where a sufficiently just queue exists. Second, waiting time has several morally attractive features that can justify its incorporation into allocation schemes. Where candidates are in relevantly similar circumstances, allocating by waiting time is relatively efficient, maximizes distribution equality relative to other Pareto efficient distributions, and treats candidates fairly. The claim that allocation using waiting time is fair is controversial. Some have claimed that formal lotteries are a fairer way to select among equal beneficiaries. We argue that lotteries are no fairer than allocation based on waiting time when it is equiprobable how a prospective queue will be ordered. In practice, lotteries share many of the disadvantages of queues; which is fairer will depend on contingent features of the allocation scenario. The upshot is that first-come, first-served is in fact a just way to allocate resources in many of the cases where it seems pre-theoretically compelling, and waiting time has unique normative properties which frequently justify its incorporation into resource allocation schemes. (shrink)

One widely used method for allocating health care resources involves the use of cost-effectiveness analysis (CEA) to rank treatments in terms of quality-adjusted life-years (QALYs) gained. CEA has been criticized for discriminating against people with disabilities by valuing their lives less than those of non-disabled people. Avoiding discrimination seems to lead to the ’QALY trap’: we cannot value saving lives equally and still value raising quality of life. This paper reviews existing responses to the QALY trap and argues that all (...) are problematic. Instead, we argue that adopting a moderate form of prioritarianism avoids the QALY trap and disability discrimination. (shrink)

Do philosophic views affect job performance? The authors found that possessing a belief in free will predicted better career attitudes and actual job performance. The effect of free will beliefs on job performance indicators were over and above well-established predictors such as conscientiousness, locus of control, and Protestant work ethic. In Study 1, stronger belief in free will corresponded to more positive attitudes about expected career success. In Study 2, job performance was evaluated objectively and independently by a supervisor. Results (...) indicated that employees who espoused free will beliefs were given better work performance evaluations than those who disbelieve in free will, presumably because belief in free will facilitates exerting control over one’s actions. (shrink)

Este trabajo se inscribe en una revisión in progress del Derecho antidiscriminatorio moderno que las autoras vienen efectuando desde hace más de tres lustros. En la primera parte del mismo se examinan los textos de una f ilósofa política y de dos juristas esta- dounidenses (I. M. Young, C. A. MacKinnon y K. Crensahw) que inspiran la propuesta de un concepto de discriminación y de una visión de la interseccionalidad basados en el reconocimiento de los sistemas de opresión. La segunda (...) parte se centra en el análisis del concepto de discriminación múltiple o interseccional propuesto por la doctrina jurídica española a partir de la jurisprudencia referida al caso de una mujer (“La Nena”) casada por el rito gitano que ve denegada su pensión de viudedad. A partir de lo anterior, el trabajo concluye con una serie de propuestas entre las que destacan las referidas a la necesidad de evitar que el discurso sobre la interseccionalidad disuelva la identidad política de los grupos en la individualidad, refuerce el sistema sexo-género y consolide un Derecho antidiscriminatorio de corte excesivamente jurisprudencial. (shrink)

Epidemiological evidence supports a health‐promoting effect of the Mediterranean Diet (MedDiet), especially in the prevention of cardiovascular diseases. These cardiovascular benefits have been attributed to a number of components of the MedDiet such as monounsaturated fatty acids, antioxidant vitamins and phytochemicals. However, the underlying mechanisms remain unknown. Likewise, little is known about the genes that define inter‐individual variation in response to the MedDiet, although the TCF7L2 gene is emerging as an illustrative candidate for determining relative risk of cardiovascular events in (...) response to the MedDiet. Moreover, omics technologies are providing evidence supporting potential mechanisms, some of them implicating epigenetics (i.e. microRNAs, methylation), and certain data suggest that some traditional foods could contribute via microRNAs possibly acting as exogenous regulators of gene expression. Future research should aim at increasing and consolidating the nutrigenetic and nutrigenomic knowledge of the MedDiet in order to provide sound, personalized and optimized nutritional recommendations. (shrink)

This chapter starts from the claim that the state is plagued with problems of political short-termism: excessive priority given to near-term benefits at the expense of benefits further in thefuture. One possible mechanism to reduce short-termism involves apportioning greater relative political influence to the young, since younger citizens generally have greater additional life expectancy than older citizens and thus it looks reasonable to expect that they have preferences that are extended further into the future. But the chapter shows that this (...) is unlikely to make states significantly less short-termist: no empirical relationship has been found between age and willingness to support long-termist policies. Instead, the chapter proposes a more promising age-based mechanism. States should develop youth citizens’ assemblies that ensure accountability to future generations through a scheme of retrospective accountability. (shrink)

The sounds of the college campus raise important questions of participation, identity, privilege, disability, and marginalization. During the 2019–2020 academic year, three university instructors from distinct disciplines (music, history, and political science) and a student research assistant (history) used sound as a method for inquiring into contested and erased sites on the campus of Western Carolina University, a regional comprehensive university located in the southeastern United States. The project came to be called Sonic Histories. Paid student volunteers were led on (...) a soundwalk and completed three online questionnaires that engaged questions of race and belonging on campus. This study presents findings on how students experience and interpret contested and erased sites through sounds heard and imagined. Sonic Histories explores two central questions. Historically, whose voices have been included and whose have been excluded on college campuses? How can sound promote awareness of racialized spaces and, in turn, achieve social engagement? The authors challenge the triumphant narrative of campus histories, which highlights racial reconciliation and progress while eliding the ways predominantly white campuses still exclude minorities. By re-centering minority voices in campus spaces, the authors explore the systemic exclusion of minorities that has occurred on college campuses across the country. At a time when places of higher education are refining and developing their commitment to diversity and inclusivity—while assessing their past in honest ways—the Sonic Histories project builds upon ongoing initiatives to position the college campus as a scholarly community that lives up to its democratic ideals of inclusion. (shrink)

Political short-termism costs the global economy hundreds of billions to trillions of dollars annually, and leads to many millions of deaths from disasters and suboptimal spending. In this paper, I propose a futures assembly explicitly incentivised to promote the interests of future generations as a promising strategy to ameliorate short-termism. The assembly I propose is governed by citizens randomly selected from among the populace, who are rewarded in the future to the extent that they successfully promote the welfare of future (...) generations. The most initially promising such retrospective accountability mechanism is an iterated mechanism, in which each generation of policymakers rewards the previous generation for their policy choices and for their own evaluation of the previous generation. Such an assembly, supplemented with the duties, powers, and tools that I describe, and with appropriate support from archivists and experts, may manage to represent generations many years into the future. (shrink)

En relación con los derechos humanos de las mujeres y con la finalidad de poder alcanzar sociedades más justas, pacíficas e inclusivas, el acceso a la justicia, la igualdad y la paz, se presentan como metas importantes en la Agenda 2030 sobre Objetivos de Desarrollo Sostenible (ODS) de Naciones Unidas. Para la consecución de estos objetivos y para evitar la discriminación que todavía su­fren las mujeres en el disfrute de sus derechos en los conflictos armados con la utilización de los (...) métodos tradicionales de justicia, la mediación se presenta como método idóneo en el que ellas pueden mostrar sus saberes y habilidades y construir, junto con los hombres, una convivencia más armónica y en paz. (shrink)

Taking as its starting point significant similarities between a formal language model—Grammar Systems—and a grammatical theory—Autolexical Syntax—in this paper we suggest the application of the former to the topic of the latter. To show the applicability of Grammar Systems Theory to grammatical description, we introduce a formal-language-theoretic framework for the architecture of natural language grammar: Linguistic Grammar Systems. We prove the adequacy of this model by highlighting its features (modularity, parallelism, interaction) and by showing the similarity between this framework and (...) accepted and well-known grammatical models (e.g. Autolexical Syntax). (shrink)

Increased investment in ethics education has prompted a variety of instructional objectives and frameworks. Yet, no systematic procedure to classify these varying instructional approaches has been attempted. In the present study, a quantitative clustering procedure was conducted to derive a typology of instruction in ethics education. In total, 330 ethics training programs were included in the cluster analysis. The training programs were appraised with respect to four instructional categories including instructional content, processes, delivery methods, and activities. Eight instructional approaches were (...) identified through this clustering procedure, and these instructional approaches showed different levels of effectiveness. Instructional effectiveness was assessed based on one of nine commonly used ethics criteria. With respect to specific training types, Professional Decision Processes Training and Field-Specific Compliance Training appear to be viable approaches to ethics training based on Cohen’s d effect size estimates. By contrast, two commonly used approaches, General Discussion Training and Norm Adherence Training, were found to be considerably less effective. The implications for instruction in ethics training are discussed. (shrink)

In 2015 and 2016, European newspapers covered the Syrian migration into Europe in great detail, describing the path followed by millions of refugees as European authorities put up both physical and...

In Subjects That Matter, Namita Goswami attends to philosophy’s institutional and disciplinary failures to reconcile its identitarian claims to universality and reason with the feminist and postcolonial modes of thinking it traditionally keeps at bay. This essay places Goswami’s critique within a context of “the thought from outside,” which, beginning with Foucault’s reading of Blanchot, continuing through the geopolitics of Dussel’s philosophy of liberation, and prominent in Catherine Malabou’s conceptualization of plasticity, demonstrates how political critiques of philosophical hegemony contain an (...) implicit theorization of “literature.” If “literature” gives voice to the thought from outside, does it in turn “decolonize” philosophy? If so, what itinerary of thought ought to follow the relationship between this literary decolonization of philosophy and its imbrication within the fold of philosophical thought? How to conceptualize the plastic relation between inside and outside, between center and periphery, without subordinating the latter to the hegemony of the former? This essay argues for a coherence between Goswami’s and Malabou’s materialist understandings of difference and a conceptualization of literature as an “outside” to philosophy that operates “excentrically” “inside” philosophy. (shrink)

In this article we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (...) (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research. (shrink)

Pleiotropy, in which one mutation causes multiple phenotypes, has traditionally been seen as a deviation from the conventional observation in which one gene affects one phenotype. Epistasis, or gene–gene interaction, has also been treated as an exception to the Mendelian one gene–one phenotype paradigm. This simplified perspective belies the pervasive complexity of biology and hinders progress toward a deeper understanding of biological systems. We assert that epistasis and pleiotropy are not isolated occurrences, but ubiquitous and inherent properties of biomolecular networks. (...) These phenomena should not be treated as exceptions, but rather as fundamental components of genetic analyses. A systems level understanding of epistasis and pleiotropy is, therefore, critical to furthering our understanding of human genetics and its contribution to common human disease. Finally, graph theory offers an intuitive and powerful set of tools with which to study the network bases of these important genetic phenomena. (shrink)

ABSTRACT:After a transgression has occurred within an organization, a primary concern is the reintegration of the affected parties back into the organizational community. However, beyond offenders and victims, reintegration depends on the views of organizational peers and their desire to interact with these parties. In two studies, we demonstrated that offender amends and victim forgiveness interact to predict peer reintegrative outcomes. We found evidence of backlash against unforgiving victims: Peers wanted to work the least with victims who rejected appropriate amends, (...) thus penalizing them for their failure to contribute to the restoration process. This backlash effect was due to decreased liking of the victim and the perceived failure to repair the offender-victim relationship. These findings demonstrate that peers expect both offenders and victims to do their part to achieve reconciliation following transgression, and both may suffer the consequences of failing to meet peer expectations. Implications for reintegration within organizations are discussed. (shrink)

After a transgression has occurred within an organization, a primary concern is the reintegration of the affected parties back into the organizational community. However, beyond offenders and victims, reintegration depends on the views of organizational peers and their desire to interact with these parties. In two studies, we demonstrated that offender amends and victim forgiveness interact to predict peer reintegrative outcomes. We found evidence of backlash against unforgiving victims: Peers wanted to work the least with victims who rejected appropriate amends, (...) thus penalizing them for their failure to contribute to the restoration process. This backlash effect was due to decreased liking of the victim and the perceived failure to repair the offender-victim relationship. These findings demonstrate that peers expect both offenders and victims to do their part to achieve reconciliation following transgression, and both may suffer the consequences of failing to meet peer expectations. Implications for reintegration within organizations are discussed. (shrink)

ABSTRACT:After a transgression has occurred within an organization, a primary concern is the reintegration of the affected parties (namely offenders and victims) back into the organizational community. However, beyond offenders and victims, reintegration depends on the views of organizational peers and their desire to interact with these parties. In two studies, we demonstrated that offender amends and victim forgiveness interact to predict peer reintegrative outcomes. We found evidence of backlash against unforgiving victims: Peers wanted to work the least with victims (...) who rejected appropriate amends, thus penalizing them for their failure to contribute to the restoration process. This backlash effect was due to decreased liking of the victim and the perceived failure to repair the offender-victim relationship. These findings demonstrate that peers expect both offenders and victims to do their part to achieve reconciliation following transgression, and both may suffer the consequences of failing to meet peer expectations. Implications for reintegration within organizations are discussed. (shrink)

Nowadays, there is a quite considerable amount of literature on the use of analogy or more generally of inferences by parallel reasoning in contemporary legal reasoning and particularly so within Common Law. These studies are often motivated by research in artificial intelligence seeking to develop suitable software-support for legal reasoning. Recently, Rahman et al. developed a dialogical approach in the framework of Constructive Type Theory to what in Islamic Jurisprudence was called qiyās or correlational inferences. In their last chapter the (...) authors suggested that such an approach contributes to the study of patterns of reasoning by precedent cases within contemporary Common Law. In the present paper we will further motivate the deployment of the dialogical framework developed in Rahman et al. within Civil and Common Law. After a presentation of Scott Brewer’s take on analogy within Common Law, that has striking structural similarities to reasoning by precedent case rooted in ratio legis, we will illustrate the implementation of the framework with a brief discussion of some cases of legal reasoning based on Spanish Civil Law but where the accent is put in the emerging ruling rather than in the existing of a case in Common Law. Moreover, quite surprisingly, the case under study suggests that even cases of Law interpretation fit the argumentation pattern of qiyās al-‘illa. A caveat: in the present paper we will focus mainly in discussing the dynamics of the meaning constitution involved rather than in setting the rules of the underlying dialogical framework, the latter is the subject of a follow-up paper. (shrink)

Previously diagnosed by symptoms alone, Alzheimer's disease is now also defined by measures of amyloid and tau, referred to as “biomarkers.” Biomarkers are detectible up to twenty years before symptoms present and open the door to predicting the risk of Alzheimer's disease. While these biomarkers provide information that can help individuals and families plan for long-term care services and supports, insurers could also use this information to discriminate against those who are more likely to need such services. In this article, (...) we evaluate whether state laws prohibit long-term care insurers from making discriminatory or unfair underwriting and coverage decisions based Alzheimer's disease biomarkers status. We report data demonstrating that current state laws do not provide meaningful protections from discrimination by long-term care insurers based on biomarker information. (shrink)

This article traces the development and growth of health justice partnerships (HJPs) in three countries: the United States, Australia and the United Kingdom.

Alzheimer’s disease (AD) in its most common form results in cognitive changes in memory function leading to dementia due to underlying neurodegenerative disease. Recent research advancements in AD...

Yarkoni highlights patterns of overgeneralization in psychology research. In this comment, we note that such challenges also pertain to applied psychological and organizational research and practice. We use two examples – cross-cultural generalizability and implicit bias training – to illustrate common practices of overgeneralization from narrow research samples to broader operational populations. We conclude with recommendations for research and practice.

Presymptomatic testing for Huntington's disease has given rise to several ethical problems relating to such issues as confidentiality, the privacy of the individual, the testing of minors and informed consent in connection with blood sample donation. A multidisciplinary conference of staff from genetic centres involved with presymptomatic testing was organised in Cardiff to discuss these and other problems. Recommendations on good practice are described under four headings: pre- and post-test counselling; confidentiality in relation to test results; collection and storage of (...) DNA, and criteria for testing. (shrink)

Enclosed is a guidebook for philanthropists, advocates, and policymakers who want to do the most good possible. This book introduces the philosophy of “longtermism,” the idea that it is particularly important that we act now to safeguard future generations. -/- The future is vast in scale: depending on our choices in the coming centuries, the future could stretch for eons or it could dwindle into oblivion, and be inordinately good or inordinately bad. And yet future generations are utterly disenfranchised in (...) the world today: they cannot participate in our markets, our movements, or our civil society. This presents 21st Century philanthropists with a historically unprecedented opportunity to do good by protecting the long-term future. -/- The essays within are from the pioneers who have developed the intellectual foundations of longtermism, as well as the experts and advocates who are now putting it into practice. Readers will hear the case for longtermism from professors at the University of Oxford and Longview’s own founders; longtermist policy proposals from political philosophers, members of the House of Lords, and the All-party Parliamentary Group for Future Generations; the case for work on biosecurity, artificial intelligence, and climate change from leading experts; and the first ever essay on longtermist cultural change from the former Chief of Cabinet to the Finnish President. -/- Together, these essays chart the path forward toward maximising the good that we do for our grandchildren, our grandchildren’s grandchildren, and every generation beyond. (shrink)

Growing awareness of the ethical implications of neuroscience in the early years of the 21st century led to the emergence of the new academic field of “neuroethics,” which studies the ethical implications of developments in the neurosciences. However, despite the acceleration and evolution of neuroscience research on nonhuman animals, the unique ethical issues connected with neuroscience research involving nonhuman animals remain underdiscussed. This is a significant oversight given the central place of animal models in neuroscience. To respond to these concerns, (...) the Center for Neuroscience and Society and the Center for the Interaction of Animals and Society at the University of Pennsylvania hosted a workshop on the “Neuroethics of Animal Research” in Philadelphia, Pennsylvania. At the workshop, expert speakers and attendees discussed ethical issues arising from neuroscience research involving nonhuman animals, including the use of animal models in the study of pain and psychiatric conditions, animal brain-machine interfaces, animal–animal chimeras, cerebral organoids, and the relevance of neuroscience to debates about personhood. This paper highlights important emerging ethical issues based on the discussions at the workshop. This paper includes recommendations for research in the United States from the authors based on the discussions at the workshop, loosely following the format of the 2 Gray Matters reports on neuroethics published by the Presidential Commission for the Study of Bioethical Issues. (shrink)