BackgroundDecision-making in initiating life-sustaining health technology is complex and often conducted at time-critical junctures in clinical care. Many of these decisions have profound, often irreversible, consequences for the child and family, as well as potential benefits for functioning, health and quality of life. Yet little is known about what influences these decisions. A systematic review of reasoning identified the range of reasons clinicians give in the literature when initiating technology dependence in a child, and as a result helps determine the (...) range of influences on these decisions.MethodsMedline, EMBASE, CINAHL, PsychINFO, Web of Science, ASSIA and Global Health Library databases were searched to identify all reasons given for the initiation of technology dependence in a child. Each reason was coded as a broad and narrow reason type, and whether it supported or rejected technology dependence.Results53 relevant papers were retained from 1604 publications, containing 116 broad reason types and 383 narrow reason types. These were grouped into broad thematic categories: clinical factors, quality of life factors, moral imperatives and duty and personal values; and whether they supported, rejected or described the initiation of technology dependence. The majority were conceptual or discussion papers, less than a third were empirical studies. Most discussed neonates and focused on end-of-life care.ConclusionsThere is a lack of empirical studies on this topic, scant knowledge about the experience of older children and their families in particular; and little written on choices made outside ‘end-of-life’ care. This review provides a sound basis for empirical research into the important influences on a child’s potential technology dependence. (shrink)

Background There is considerable variation in the functionality of bioethical services in different institutions and countries for children in hospital, despite new challenges due to increasing technology supports for children with serious illness and medical complexity. We aimed to understand how bioethics services address bioethical concerns that are increasingly encountered in paediatric intensive care. Methods A qualitative descriptive design was used to describe clinician’s perspectives on the functionality of clinical bioethics services for paediatric intensive care units. Clinicians who were members (...) of formal or informal clinical bioethics groups, or who were closely involved with the process of working through ethically challenging decisions, were interviewed. Interviews took place online. Resulting transcripts were analysed using thematic analysis. Results From 33 interviews, we identified four themes that described the functionality of bioethics services when a child requires technology to sustain life: striving for consensus; the importance of guidelines; a structure that facilitates a time-sensitive and relevant response; and strong leadership and teamwork. Conclusions Clinical bioethics services have the potential to expand their role due to the challenges brought by advancing medical technology and the increasing options it brings for treatment. Further work is needed to identify where and how bioethics services can evolve and adapt to fully address the needs of the decision-makers in PICU. (shrink)

A leader in the modern commentary on ethics and philosophy, Mary Warnock casts a critical eye over her life and times.

Fundamental principles : the nature of the dispute -- Types of euthanasia -- Psychiatric assisted suicide -- Neonates -- Incompetent adults -- Human life is sacred -- The slippery slope -- Medical views -- Four methods of easing death and their effect on doctors -- Looking further ahead.

How is hope to be found amid the ethical and political dilemmas of modern life? Writer and philosopher Mary Zournazi brought her questions to some of the most thoughtful intellectuals at work today. She discusses "joyful revolt" with Julia Kristeva, the idea of "the rest of the world" with Gayatri Spivak, the "art of living" with Michel Serres, the "carnival of the senses" with Michael Taussig, the relation of hope to passion and to politics with Chantal Mouffe and Ernesto (...) Laclau. A dozen stimulating minds weigh in with their visions of a better social and political order. The result is a collaboration - of writing, of thinking, and of politics - that demonstrates more clearly than any single-authored project could how ideas encountering one another can produce the vision needed for social change. (shrink)

Following the announcement in 1949 in the USA that cortisone offered rheumatoid arthritis sufferers effective treatment for their crippling disease, the Ministry of Health came under considerable pressure from the medical profession and the public to make cortisone available in Britain. The Ministry, therefore, urged British companies to start manufacturing cortisone. Among the several pharmaceutical firms responding to the Ministry’s request, Glaxo’s expertise in the field of vitamins gave them a head start. This paper describes the varied and flexible strategy (...) that enabled Glaxo to maintain this head start, and the scientific and technical capabilities which the company subsequently built up, enabling them to dominate the market for corticosteroids in Britain.Among the drugs to emerge out of the Glaxo project to manufacture cortisone, which began in 1950 and later became a wider R&D programme on steroids, was the topical steroid Betnovate, launched in 1963, which remains a best-seller today. However, although it led to successful new products, Glaxo’s programme had limitations. The paper identifies a missed opportunity, in the shape of the biosynthetic route to steroid drugs, often considered as a milestone in the development of the new biotechnology. Whether or not this missed opportunity proved costly to the company is uncertain. However, it illustrates the role of technological path-dependence, and the importance of the integration between different scientific disciplines, in this case chemistry and biology, in pharmaceutical innovation. (shrink)

Social purpose initiatives rarely take place in one sector or policy domain. They are likely to cross sector, community, local, national and indigenous boundaries and, in so doing, require alternative governance arrangements that are responsive and sustainable. This article focuses on the process of forging cross boundary governance processes drawing on a case study characterised by complex cross sector demands. The subject of the case study is a paradigm-breaking primary health and well-being initiative for a region of New Zealand with (...) longstanding healthcare challenges but contemporary possibilities. We were invited by the owners of this initiative to record and reflect on the challenges and successes, and from this to identify what might be possible for future innovations. In doing so we draw on the adaptive governance literature to frame the governance challenges and offer five paradoxes requiring collective navigation. We recognise the importance of our need to engage with Indigenous scholarship in future analyses and conclude with a series of recommendations on how such paradoxes are navigated for those needing to build governance practice in innovative social purpose initiatives. (shrink)

This chapter first distinguishes between originality and creativity. True originality is rare, whether in art, science, or LEGO, because to be truly original means to have done something that no one has ever done before, and that no one could have anticipated. Most LEGO creations will not meet that condition, for with the exception of serious hobbyists who undertake massive builds, most players who make original creations are making creations that are commonplace. Painting or remolding or placing stickers on the (...) bricks counts against the spirit of LEGO creation. The chapter then discusses The LEGO Movie embodies the paradox that presents three conflicting models of creative LEGO play, illustrated by the Master Builders, Finn's father, and Emmet. The movie's creators were deliberately playing around with conflicting popular conceptions of creativity: creativity as madness, creativity as thinking outside the box, and creativity as vision. (shrink)

This selection consists of extracts from writings of women concerned solely with the pursuit of abstract ideas, historically contextualized. The texts, for the most part, reflect issues widely debated in their contemporary societies. Extracts from lesser-known writers are also included, providing a diversity of arguments spanning four centuries and including some notable contemporary philosophers.

Nature and Mortality is a challenging look at some of the major public issues of our time through the eyes of one of our most influential and probing liberal humanists. It is a frank account on where we stand today on such controversial matters as human embryology, genetic engineering, euthanasia and abortion. Warnock's views may seem like a red rag to a bull to some, but her contribution to the debate is always stimulating. Enlivened by autobiographical anecdote and some delicious (...) side-swipes, Nature and Mortality is Mary Warnock at her most perceptive, wise and entertaining. (shrink)

The works of Mary Wollstonecraft (1759-1797) ranged from the early _Thoughts on the Education of Daughters_ to _The Female Reader_, a selection of texts for girls, and included two novels. But her reputation is founded on _A Vindication of the Rights of Woman_ of 1792. This treatise is the first great document of feminism—and is now accepted as a core text in western tradition. It is not widely known that the germ of Wollstonecraft’s great work came out of an (...) earlier and much shorter vindication—A Vindication of the Rights of Men (1790), written in the context of the issues raised by the French Revolution. This edition, which follows the model of other Broadview Editions in including a range of materials that help the reader to see the work in the context of its era out of which it emerged, is arranged chronologically, opening with Wollstonecraft’s “other vindication.” It also includes a wide range of other documents in appendices, as well as a comprehensive and authoritative introduction, chronology, and full index. (shrink)

This article analyses a footnote to the third version of the ‘Work of Art’ essay in which Walter Benjamin presents an account of ‘a certain oscillation’ between ‘cult value’ and ‘exhibition value’ as typical of the reception of all works of art. Benjamin's example in that footnote is the Sistine Madonna, a painting by Raphael in the Dresden Gemäldegalerie that has played an important part in German aesthetics since Winckelmann. Benjamin's footnote on the Sistine Madonna, along with his critique of (...) Hegel's aesthetics in that context, demand to be understood in relation to his remarks on Dada elsewhere in the artwork essay, and to his claim that technological reproducibility leads to the ‘actualization’ of the original reproduced. In that connection, the article concludes with an analysis of Kurt Schwitters's 1921 montage picture Knave Child Madonna with Horse. (shrink)

The rapid advancement of new digital technologies, such as smart technology, artificial intelligence (AI) and automation, robotics, cloud computing, and the Internet of Things (IoT), is fundamentally changing the nature of work and increasing concerns about the future of jobs and organizations. To keep pace with rapid disruption, companies need to update and transform business models to remain competitive. Meanwhile, the growth of advanced technologies is changing the types of skills and competencies needed in the workplace and demanded a shift (...) in mindset among individuals, teams and organizations. The recent COVID-19 pandemic has accelerated digitalization trends, while heightening the importance of employee resilience and well-being in adapting to widespread job and technological disruption. Although digital transformation is a new and urgent imperative, there is a long trajectory of rigorous research that can readily be applied to grasp these emerging trends. Recent studies and reviews of digital transformation have primarily focused on the business and strategic levels, with only modest integration of employee-related factors. Our review article seeks to fill these critical gaps by identifying and consolidating key factors important for an organization’s overarching digital transformation. We reviewed studies across multiple disciplines and integrated the findings into a multi-level framework. At the individual level, we propose five overarching factors related to effective digital transformation among employees: technology adoption; perceptions and attitudes toward technological change; skills and training; workplace resilience and adaptability, and work-related wellbeing. At the group-level, we identified three factors necessary for digital transformation: team communication and collaboration; workplace relationships and team identification, and team adaptability and resilience. Finally, at the organizational-level, we proposed three factors for digital transformation: leadership; human resources, and organizational culture/climate. Our review of the literature confirms that multi-level factors are important when planning for and embarking on digital transformation, thereby providing a framework for future research and practice. (shrink)

The unity of aesthetic and teleological judgment, the third and earlier Critiques, is based on Kant′s discovery of a “heuristic method” for applying judgments regarding sense phenomena to abstract thought, a “second attention” which enables an “idea of the whole”. Synthetic judgment, basis for cognition and human action, depends on efficacy of non-empirical insights: the transcendental standpoint, “regulative” ideas, consciousness of “ought” and the reality of freedom, universality of natural mechanism, the principle of “fortuitous” purposiveness. The activity of reflective judgment (...) in the encounter with the beautiful, sublime, living, and two paradigmatic types of explanation, inspired by Spinoza′s distinction of extensio and cogitatio, permit Kant to bridge the gap between freedom and necessity, theoretical knowledge and morality. (shrink)

All religion and much philosophy has been concerned with the contrast between the ephemeral and the eternal. Human beings have always sought ways to overcome time, and to prove that death is not the end. This book consists then in an exploration of certain closely related ideas: personal identity, time, history and our commitment to the future, and the role of imagination in life.

Mental health clinicians treating youth in foster care face several ethical challenges, such as competence for treating youth in foster care, understanding who can provide informed consent, and confidentiality. However, few articles have addressed these ethical concerns or provided recommendations for clinicians on how to navigate these issues. This article presents a brief summary of the foster care system, an overview of the major ethical challenges clinicians may encounter when treating youth in foster care, areas of the American Psychological Association’s (...) Ethics Code, Code of Ethics of the National Association of Social Workers, and American Counseling Association Code of Ethics most germane to the treatment of youth in foster care, and general recommendations for clinicians treating this population. (shrink)

This scarce antiquarian book is a facsimile reprint of the original. Due to its age, it may contain imperfections such as marks, notations, marginalia and flawed pages. Because we believe this work is culturally important, we have made it available as part of our commitment for protecting, preserving, and promoting the world's literature in affordable, high quality, modern editions that are true to the original work.

Aristotle believed that there were actually only three colours present in the rainbow, : of these, the first is produced by the dulling of white light when it is reflected in or obscured by a dark medium such as smoke, cloud, or water, and exemplified in the redness of the sun as seen through haze around the horizon. Successive failures of sight weaken the colour further, first to πράσινov and then to άλoυργóν. Between the first two colours a fourth, ξανθóν, (...) is often apparent, being the result of the juxtaposition of the two colours. This last statement, where it has not been ignored as one of the inexplicable or misguided things Aristotle says from time to time, has met with considerable criticism. (shrink)

Aristotle believed that there were actually only three colours present in the rainbow, : of these, the first is produced by the dulling of white light when it is reflected in or obscured by a dark medium such as smoke, cloud, or water, and exemplified in the redness of the sun as seen through haze around the horizon. Successive failures of sight weaken the colour further, first to πράσινov and then to άλoυργóν. Between the first two colours a fourth, ξανθóν, (...) is often apparent, being the result of the juxtaposition of the two colours. This last statement, where it has not been ignored as one of the inexplicable or misguided things Aristotle says from time to time, has met with considerable criticism. (shrink)

Cywydd Ffarwelio Rhys MERERID HOPWOOD Mae awr i fwynhau miri, y mae awr mi wn am hwyl cwmni, ond nawr, yn ein dathliad ni, mae un na fynnaf mo'ni. ...

This study used historical research methodology to assess the work of US nurses caring for patients with cancer from 1920 to 1950. Primary sources, obtained from several US archives, included nursing procedure books, student nurses’ lecture notes, hospital and nursing annual reports, and meeting minutes. Secondary sources included journal articles and textbooks. The aim was to document the clinical work of nurses caring for patients with cancer and assess this work for evidence of emerging specialization in cancer nursing. Following a (...) review of cancer in the 1920s, nursing education specific to cancer, nursing care related to specific cancer therapies, and the practice of concealing a diagnosis of cancer, were examined. Nurses were consistently educated in cancer nursing, but their cancer education became more focused over the decades. Nurses were closely involved with cancer patients as they monitored their patients’ radium or assisted patients following radical surgery. The issue of concealing the diagnosis of cancer was problematic to some nurses. This paper reveals the nature of nurses’ hospital work with cancer patients and demonstrates a core body of cancer nursing knowledge. The emergence of cancer nursing as a specialty is presented. (shrink)

Emerging research has examined individual differences in affective forecasting; however, we are aware of no published study to date linking psychopathology symptoms to affective forecasting problem...

Fraud in Europe is complex and well organised: it crosses organisational and geographic boundaries. The policing of fraud, on the other hand, is characterised both at national and transnational levels by fragmentation and divided accountability. This paper considers the issues involved in combating fraud in European institutions and spending programmes. It discusses the roles of those bodies with transnational responsibilities such as UCLAF, the European Fraud Prevention Office and the European Court of Auditors. The paper considers the difficulties associated with (...) the Corpus Juris proposals for a single European legal area to facilitate the fight against fraud related to the European Budget. It concludes that the task of policing Europe is hampered not only by the diversity of national political and jurisprudential systems, but also by the weakness and lack of independence of the transnational institutions. (shrink)

Scientific culture in Europe and the refugee generation -- Germany and Weimar Berlin as the City of Science -- Origins of a social perspective: doing physical chemistry in Weimar Berlin -- Chemical dynamics and social dynamics in Berlin and Manchester -- Liberalism and the economic foundations of the "Republic of Science" -- Scientific freedom and the social functions of science -- Political foundations of the philosophies of science of Popper, Kuhn, and Polanyi -- Personal knowledge: argument, audiences, and sociological engagement (...) -- Epilogue: SSK, scientific constructivism, and the paradoxical legacy of Polanyi and the 1930s generation. (shrink)

As an incapacitated patient is unable to make decisions regarding their care, physicians turn to next-of-kin when appointing a surrogate decision-maker in the absence of an advanced directive. With the increasing complexity of modern families, physicians are facing new ethical dilemmas when choosing the individual to make end-of-life decisions for their patients. Legal definitions and hierarchies are no longer adhering to the purpose of a surrogate-decision maker, which is to maintain a patient’s autonomy. Moral criteria for surrogates, which emphasize the (...) importance of making decisions that align with the patient’s desires and wishes and negate biological relationships over emotional connections, are becoming much more important. This paper explores a case study in which physicians must appoint a surrogate decision-maker for an incapacitated patient, forced to choose between a biological relationship and a strong emotional connection. (shrink)

‘Contract cheating’ has recently emerged as a form of academic dishonesty. It involves students contracting out their coursework to writers in order to submit the purchased assignments as their own work, usually via the internet. This form of cheating involves epistemic and ethical problems that are continuous with older forms of cheating, but which it also casts in a new form. It is a concern to educators because it is very difficult to detect, because it is arguably more fraudulent than (...) some other forms of plagiarism, and because it appears to be connected to a range of systemic problems within modern higher education. This paper provides an overview of the information and literature thus far available on the topic, including its definition, the problems it involves, its causal factors, and the ways in which educators might respond. We argue that while contract cheating is a concern, some of the suggested responses are themselves problematic, and that best practice responses to the issue should avoid moral panic and remain focussed on supporting honest students and good academic practice. (shrink)

ABSTRACTHélène Landemore's Democratic Reason offers a new justification for democracy and for broad-based citizen participation, appealing to the “emergent” intelligence of large, diverse groups. She argues that ordinary citizens should rule as directly as possible because they will make better informed, more intelligent decisions than, for example, appointed officials, councils of experts, or even elected representatives. The foundation of this conclusion is the premise that “diversity trumps ability” in a wide range of contexts. But the main support for that claim (...) is merely a series of computer experiments that are strongly biased toward that result and tell us essentially nothing about decision making in real-world political settings. Moreover, Landemore's analyses of alternative forms of rule deal only in abstract comparisons between sharply distinguished ideal types. Among other difficulties, they entirely overlook the central consideration in such comparisons: the relative ability of any decision-making process to go beyond stereotyped, intrinsic strategies and integrate multiple sources and varieties of information. In the end, Landemore's claims for the superior intelligence of broadly participatory forms are thus not supported by credible evidence. (shrink)

In this paper, we examine recent critiques of the debate about defining disease, which claim that its use of conceptual analysis embeds the problematic assumption that the concept is classically structured. These critiques suggest, instead, developing plural stipulative definitions. Although we substantially agree with these critiques, we resist their implication that no general definition of “disease” is possible. We offer an alternative, inductive argument that disease cannot be classically defined and that the best explanation for this is that the concept (...) is structured as a cluster. We further argue that we do not need to reject the possibility of defining the general concept “disease” to legitimate developing stipulative definitions of disease that are relative to particular purposes. A cluster definition of disease is compatible with contextually motivated definitions, which may be considered précisifications of the more general cluster concept. (shrink)

Recently, concerns have been raised about the phenomenon of ‘overdiagnosis’, the diagnosis of a condition that is not causing harm, and will not come to cause harm. Along with practical, ethical, and scientific questions, overdiagnosis raises questions about our concept of disease. In this paper, we analyse overdiagnosis as an epistemic problem and show how it challenges many existing accounts of disease. In particular, it raises ques- tions about conceptual links drawn between disease and dysfunction, harm, and risk. We argue (...) that ‘disease’ should be considered a vague concept with a non-classical structure. On this view, overdiagnosed cases are ‘borderline’ cases of disease, falling in the zone between cases that are clearly disease, and cases that are clearly not disease. We then develop a pre ́cising definition of disease designed to provide practical help in preventing and limiting overdiagnosis. We argue that for this purpose, we can define disease as dysfunction that has a significant risk of causing severe harm to the patient. (shrink)