Suppose you want to live a happy life. Who should you turn to for advice? We normally think that we know best about our own happiness. But recent work in psychology and neuroscience suggests that we are often mistaken about our own natures, and that sometimes scientists know us better than we know ourselves. Does this mean that to live a happy life we should ask scientists for advice rather than relying on our introspection? In what follows, we highlight ways (...) in which the science of happiness could help us live happy lives, but we also argue that, in other ways, our navel gazing will remain indispensable. (shrink)

Background In the wake of mandates for biomedical research to increase participation by members of historically underrepresented populations, community engagement (CE) has emerged as a key intervention to help achieve this goal.Methods Using interviews, observations, and document analysis, we examine how stakeholders in precision medicine research understand and seek to put into practice ideas about who to engage, how engagement should be conducted, and what engagement is for.Results We find that ad hoc, opportunistic, and instrumental approaches to CE exacted significant (...) consequences for the time and resources devoted to engagement and the ultimate impacts it has on research. Critical differences emerged when engagement and research decisionmaking were integrated with each other versus occurring in parallel, separate parts of the study organization, and whether community members had the ability to determine which issues would be brought to them for consideration or to revise or even veto proposals made upstream based on criteria that mattered to them. CE was understood to have a range of purposes, from instrumentally facilitating recruitment and data collection, to advancing community priorities and concerns, to furthering long-term investments in relationships with and changes in communities. These choices about who to engage, what engagement activities to support, how to solicit and integrate community input into the workflow of the study, and what CE was for were often conditioned upon preexisting perceptions and upstream decisions about study goals, competing priorities, and resource availability.Conclusions Upstream choices about CE and constraints of time and resources cascade into tradeoffs that often culminated in “pantomime community engagement.” This approach can create downstream costs when engagement is experienced as improvised and sporadic. Transformations are needed for CE to be seen as a necessary scientific investment and part of the scientific process. (shrink)

Background Over the last decade, the return of results (ROR) in precision medicine research (PMR) has become increasingly routine. Calls for individual rights to research results have extended the “duty to report” from clinically useful genetic information to traits and ancestry results. ROR has thus been reframed as inherently beneficial to research participants, without a needed focus on who benefits and how. This paper addresses this gap, particularly in the context of PMR aimed at increasing participant diversity, by providing investigator (...) and researcher perspectives on and questions about the assumed value of ROR in PMR.Methods Semi-structured interviews with a purposive sample of investigators and researchers across federally funded PMR studies in three national consortia, as well as observations of study activities, focused on how PM researchers conceptualize diversity and implement inclusive practices across research stages, including navigating ROR.Results Interviewees (1) validated the value of ROR as a benefit of PMR, while others (2) questioned the benefit of clinically actionable results to individuals in the absence of sufficient resources for translating findings into health care for diverse and disadvantaged populations; (3) expressed uncertainties in applying the presumed value of ROR as a benefit for non-clinical results; and (4) and debated when the promise of the value of ROR may undermine trust in PMR, and divert efforts to return value beyond ROR.Conclusions Conceptualizations of diversity and inclusion among PM researchers and investigators raise unique ethical questions where unexamined assumptions of the value of ROR inform study recruitment efforts to enroll minoritized and under-represented populations. A lack of consideration for resources and infrastructure necessary to translate ROR into actionable information may hinder trustworthy community-research relationships. Thus, we argue for a more intentional interrogation of ROR practices as an offer of benefit and for whom. (shrink)

_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

L’article fournit un exemple concret des possibilités qu’ouvre l’exploration des données numérisées, et notamment de la Toile, en matière de morphologie dérivationnelle. Il y a une soixantaine d’années, en se fondant sur un exemple unique (silvio-pelliqueste), Edouard Pichon avançait l’hypothèse qu’en contexte vélaire, le suffixe –esque pouvait, par un phénomène de dissimilation préventive, se voir remplacé par la finale –este. Depuis, aucun argument n’était venu étayer cette hypothèse, sinon peut-être des remarques hésitantes de Zwanenburg (1975) et de Björkman (1984) sur (...) la difficulté de trouver des dérivés en –esque après vélaire. Les données réunies confirment que l’adjonction de –esque à une base dont la dernière syllabe comporte une vélaire engendre des tensions dissimi-latives. Lorsque le contexte s’y prête, ces tensions se manifestent tantôt par l’effacement de certaines vélaires finales, tantôt par le maintien inattendu d’une voyelle finale précédée d’une vélaire. Elles se manifestent aussi, comme l’avaient entrevu nos prédécesseurs, par une moindre productivité de cette suffixation après les radicaux en vélaire. Dans l’établissement de ces résultats, l’utilisation d’un outil permettant de récupérer automatiquement sur la Toile des néologismes en fonction de leur terminaison, s’est révélée déterminante. Les recherches automatisées ont joué aussi un rôle capital quand il s’est agi de trouver des dérivés en ‑este et de montrer que ce suffixe n’était utilisé productivement qu’après vélaire, conformément à la conjecture de Pichon. (shrink)

L’article fournit un exemple concret des possibilités qu’ouvre l’exploration des données numérisées, et notamment de la Toile, en matière de morphologie dérivationnelle. Il y a une soixantaine d’années, en se fondant sur un exemple unique (silvio-pelliqueste), Edouard Pichon avançait l’hypothèse qu’en contexte vélaire, le suffixe –esque pouvait, par un phénomène de dissimilation préventive, se voir remplacé par la finale –este. Depuis, aucun argument n’était venu étayer cette hypothèse, sinon peut-être des remarques hésitantes de Zwanenburg (1975) et de Björkman (1984) sur (...) la difficulté de trouver des dérivés en –esque après vélaire. Les données réunies confirment que l’adjonction de –esque à une base dont la dernière syllabe comporte une vélaire engendre des tensions dissimi-latives. Lorsque le contexte s’y prête, ces tensions se manifestent tantôt par l’effacement de certaines vélaires finales, tantôt par le maintien inattendu d’une voyelle finale précédée d’une vélaire. Elles se manifestent aussi, comme l’avaient entrevu nos prédécesseurs, par une moindre productivité de cette suffixation après les radicaux en vélaire. Dans l’établissement de ces résultats, l’utilisation d’un outil permettant de récupérer automatiquement sur la Toile des néologismes en fonction de leur terminaison, s’est révélée déterminante. Les recherches automatisées ont joué aussi un rôle capital quand il s’est agi de trouver des dérivés en ‑este et de montrer que ce suffixe n’était utilisé productivement qu’après vélaire, conformément à la conjecture de Pichon. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

De Marco et al 1 argue that the standard account of medical ‘invasiveness’ (as ‘incision’ or ‘insertion’) fails to capture three aspects of its existing use, namely that invasiveness can come in degrees, often depends on features of alternative medical interventions and can be non-physical. They propose a new schematic account that suggests that medical interventions can possess ‘basic invasiveness’ (which can come in degrees and of which they suggest at least two types: physical and mental), and ‘threshold invasiveness’ which (...) can depend on the alternatives a specific intervention is being compared with. While we agree that the standard account of invasiveness fails to capture existing use and are supportive of their aim, here we express scepticism about the practical utility of De Marco et al ’s revised account. Our scepticism concerns the application of De Marco et al’s revised account in the narrow context of clinician–patient communication and deliberation about medical interventions within clinical practice, which we see as a crucial context for its use. While De Marco et al do not specify the contexts in which their revised account could be used, we assume from their discussion of treatment interventions (e.g. non-invasive prenatal testing, ventilation) and their comparison to ‘more or less invasive’ options, that at least one of the purposes in mind for …. (shrink)

BackgroundThis case report discusses an ethical communication dilemma in prehospital patient interaction, involving a patient who was about to board a plane at a busy airport. The article argues that the situation raised dilemmas about communication, patient autonomy and paternalism. Paramedics should be able to find good solutions to these dilemmas, but they have not received much attention in the literature on prehospital ambulance work.Case presentationThe patient had chest pains that were consistent with serious heart disease, but she wanted to (...) catch her plane and was unwilling to let paramedics assess her heart activity by means of an electrocardiogram (ECG). The paramedics had to decide, there and then, whether the patient’s refusal to submit to an ECG should be respected, or whether they should set the patient’s expressed wishes aside by exercising verbal power and persuasive communication techniques. The paramedics chose to do the latter. It later turned out that the patient was grateful that the paramedics had been very direct, almost brutal, in their communication. When the patient regained her autonomy, she saw clearly that taking time to obtain and monitor an ECG was the best option for her.ConclusionLooking forward in time might be a good professional strategy for deciding whether ethical paternalism in communication is justified. If there is good reason to believe that patients who later regain their autonomy will agree that paternalistic verbal actions were in their best interests, and if acting in accordance with patients’ preferences can have severe negative health consequences for them, then paramedics have good reason to believe that ethical paternalism is justified. (shrink)

Many cognitive accounts of emotional processing assume that emotions have representational content that can be influenced by beliefs and desires. It is generally thought that emotions also have non-cognitive, affective components, including valence and arousal. To clarify the impact of cognition on these affective components we asked participants to rate sentences along cognitive and affective dimensions. For the former case, participants rated the believability of the material. For the latter case, they provided valence and arousal ratings. Across two experiments, we (...) show that valence and arousal are differently influenced by beliefs, suggesting that these two largely independent affective components of emotion differ in their cognitive penetrability. While both components depended upon overall comprehension of sentence meaning, only valence was influenced by the consistency of the sentences with participants’ beliefs (i.e., whether it was believable or unbelievable). We discuss the implications of these findings for understanding cognition–emotion relationships. (shrink)

This book is a collection of articles about communication and ethics in the field of medicine and health care. Common to all the articles is that they are not directly based on empirical investigations. The discussions refer to research, but this is research that has already been carried out and documented in existing literature. In this sense the articles belong to what is often called applied philosophy. All the articles address communicative and ethical challenges in patient interaction on the basis (...) of assumptions in modern moral philosophy and philosophy of language. There is a great need for literature that deals more comprehensively with the themes in this book than many introductory books do. It is particularly difficult to find suitable reading material that can be used in teaching at graduate and master levels. This book is designed to meet this need. It is suitable for use in all higher-level courses where the aim is to give students a theoretical understanding of ethical dilemmas and communicative challenges in health care. (shrink)

Much has been written about the need for trustworthy artificial intelligence (AI), but the underlying meaning of trust and trustworthiness can vary or be used in confusing ways. It is not always clear whether individuals are speaking of a technology’s trustworthiness, a developer’s trustworthiness, or simply of gaining the trust of users by any means. In sociotechnical circles, trustworthiness is often used as a proxy for ‘the good’, illustrating the moral heights to which technologies and developers ought to aspire, at (...) times with a multitude of diverse requirements; or at other times, no specification at all. In philosophical circles, there is doubt that the concept of trust should be applied at all to technologies rather than their human creators. Nevertheless, people continue to intuitively reason about trust in technologies in their everyday language. This qualitative study employed an empirical ethics methodology to address how developers and users define and construct requirements for trust throughout development and use, through a series of interviews. We found that different accounts of trust (rational, affective, credentialist, norms based, relational) served as the basis for individual granting of trust in technologies and operators. Ultimately, the most significant requirement for user trust and assessment of trustworthiness was the accountability of AI developers for the outputs of AI systems, hinging on the identification of accountable moral agents and perceived value alignment between the user and developer’s interests. (shrink)

The paper explores consequences of applying the view that illness is negative first‐person experience in caring practice. The main reason this is an important issue is that it is empirically documented that patients conceive of illness in different ways. Communicating about illness in caring practice can therefore involve difficulties. I argue that many of these difficulties can be avoided if nurses focus directly on the extension of the concept of illness – patients’ experiences like the state of being in pain (...) – and not on how this extension is represented as (the intension) illness. This argument is compatible with different views on the nurse–patient relationship as a communicative process. All it requires is the acceptance of minimal assumptions about concepts and concept possession. The argument has a descriptive and a normative dimension. It is descriptive in the sense that it seeks to use concepts from philosophy of mind to explain how many nurses succeed in talking about illness without applying the concept of illness. It is normative in the sense that it provides a philosophical justification for this practice. (shrink)

The proliferation of violations within industry sectors (e.g., banking, doping in sport, abuse in religious organizations) highlights how trust violations can thrive in particular sectors. However, scant research examines how macro institutional factors influence micro level trustworthy conduct. To shed light on how sectoral features may influence trust violations in organizations, we adopt a multilevel perspective to investigate the perceived causes of trust violations within the not-for-profit (NFP) sector, a sector that has witnessed a number of high-profile trust breaches. Drawing (...) on interviews with board members and senior executives of NFPs with cross-sectoral experience, we analyze the causes of trust violations to inductively develop a conceptual model of the multilevel factors contributing to trust violations in NFPs. Our model highlights how trust violations have their roots in sectoral-level factors, which trickle-down to influence the ethical infrastructure at the organizational-level, and in turn individual-level factors and violations. We identify how three NFP sectoral features influence trustworthy behavior: corporatization, resource scarcity, and assumed moral integrity. Our findings speak to the importance of looking beyond the organization to understand both the causes and prevention of trust violations and developing the concept of sector-level ethical infrastructure. (shrink)

In recent philosophy of mind a non-holistic view on concept possession, originally developed by Tyler Burge, has emerged as an alternative to holistic analyses of language mastery. The article discusses the implications of this view for analyses of communication in doctor—patient-interaction. The central question Burge's theory gives an answer to is this: to what extent must a doctor and a patient understand a medical term in the same way in order to communicate in the sense that they express the same (...) concept by the term? Many empirical studies have shown that patients do not, typically, understand medical terms in the same way as doctors they encounter. Holistic approaches therefore imply that doctors and patients seldom communicate. Burge's position, on the other hand, implies that it is sufficient that patients have a minimal understanding. In an important range of cases doctors can make sure that patients have a minimal understanding by being explicit about common dictionary definitions of the terms in question. (shrink)

Young children learn about the power of God's love and creation through simple text and illustrations.

A comprehensive collection of classic texts, contemporary interpretations, guidelines for activists, issue-specific information, and materials for environmentally-oriented religious practice. Sources and contributors include Basho, the Dalai Lama, Thich Nhat Hanh, Gary Snyder, Chogyam Trungpa, Gretel Ehrlich, Peter Mathiessen, Helen Tworkov (editor of Tricycle ), and Philip Glass.

It is a fundamental assumption in nursing theory that it is important for nurses to understand how patients think about themselves and the contexts they are in. According to modern theories of hermeneutics, a nurse and a patient must share the same concepts in order to communicate beliefs with the same content. But nurses and patients seldom understand medical concepts in exactly the same way, so how can this communicative aim be achieved in interaction involving medical concepts? The article uses (...) a theory of concepts from recent cognitive science and philosophy of mind to argue that nurses and patients can share medical concepts despite the diversity of understanding. According to this theory, two persons who understand medical language in different ways will nevertheless possess the same medical concepts if they agree about the normative standards for the applications of the concepts. This entails that nurses and patients normally share medical concepts even though patients’ conceptions of disease and illness are formed in idiosyncratic ways by their social and cultural contexts. Several practical implications of this argument are discussed and linked to case studies. One especially important point is that nurses should seek to make patients feel comfortable with deferring to a medical understanding. In many cases, an adequate understanding of patients presupposes that nurses manage to do this. Another implication is that deference‐willingness to normative meaning is not equivalent to the actual application of concepts. Deference‐willingness should rather be thought of as a pre‐communicative attitude that it is possible for patients who are not fully able to communicate to possess. What is important is that nurses and patients have the intention of conforming to the same meaning. (shrink)

In this collected volume, the authors analyze the deficiencies of existing theory and present alternate explanations of Third World foreign policy behavior. The essays show how examining Third World experience can broaden our understanding of how and why states and non-state actors interact in the international system.

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors that are crucial for the reproductive success of animals living in groups. The Perception-Action Model, (...) together with an understanding of how representations change with experience, can explain the major empirical effects in the literature. It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations. Key Words: altruism; cognitive empathy ; comparative; emotion; emotional contagion; empathy ; evolution; human; perception-action; perspective taking. (shrink)

When information activated in memory involves emotional associations, the ability to shift attention away from an emotional cue is impaired compared to an emotionally neutral cue. The purpose of the present study was to investigate how emotional stimuli modulate attentional processes, and how this is reflected in localised brain electrical activity. Eight emotion and eight neutral words served as cues in a covert attention spatial orienting task. The cues were either valid or invalid indicators of which hemifield the target would (...) be presented to. In the remaining trials, no cue was presented prior to the target. Twenty subjects were instructed to manually respond to the target as fast as possible. Event-related potentials (ERPs) showed an enhanced P3 component to the emotion words. The ERPs to the target showed enhanced P1 and P3 components on invalid trials, with emotional cues. There were faster reaction times (RTs) to validly cued targets, but only when the emotion words served as cues. The results demonstrated that the emotional cues elicited sustained focused attention, facilitating an engage mechanism of spatial orienting. (shrink)

Many meta-ethicists are alethists: they claim that practical considerations can constitute normative reasons for action, but not for belief. But the alethist owes us an account of the relevant difference between action and belief, which thereby explains this normative difference. Here, I argue that two salient strategies for discharging this burden fail. According to the first strategy, the relevant difference between action and belief is that truth is the constitutive standard of correctness for belief, but not for action, while according (...) to the second strategy, it is that practical considerations can constitute motivating reasons for action, but not for belief. But the former claim only shifts the alethist's explanatory burden, and the latter claim is wrong—we can believe for practical reasons. Until the alethist can offer a better account, then, I argue that we should accept that there are practical reasons for belief. (shrink)

Etrange personnage que Pierre Nicole. La postérité l'a rangé parmi les deuxièmes rôles de Port-Royal, une sorte de permanent du parti janséniste. Il a secondé le grand Arnauld, instruit Racine dans les Petites Ecoles, aidé Pascal et traduit en latin ses Provinciales. Fidèle entre les fidèles, et en même temps mal à l'aise dans cette atmosphère de fronde et de résistance que représente le milieu de Port-Royal, au sein de la France du XVII e siècle, ce latiniste timoré ne (...) songeait qu'aux Moyens de conserver la paix avec les hommes - titre de l'un de ses essais les plus célèbres. Dès que les tensions semblent s'apaiser, pendant la trêve appelée "la Paix de l'Eglise", Nicole peut enfin laisser libre cours à sa vocation de moraliste et de psychologue. Il publie, volume après volume ses Essais de morale : le succès sera tel que le libraire, après la mort de Pierre Nicole, s'ingéniera à en augmenter la série jusqu'à atteindre vingt-cinq volumes. Depuis la fin du XVIII e siècle, ce classique de la littérature morale était devenu pour ainsi dire inaccessible. On en publie parfois quelques pages choisies, défigurées par les coupures et les corrections. Il est proposé ici au lecteur moderne de redécouvrir dix essais de Nicole, donnés dans leur intégralité. Certains nous replongent dans les principes moraux d'un autre âge (et tirent de cet exotisme une part de leur valeur). D'autres présentent les qualités de finesse, le piquant, le goût du paradoxe qui ont longtemps fait juger Nicole comme un des grands représentants, à côté de Pascal et de La Rochefoucauld, de la littérature morale classique. L'oeuvre morale de Nicole s'avère ainsi demeurer passionnante pour un lecteur moderne, au moins à trois égards : 1/ ses considérations sur l'amour-propre, qui constituent les premiers jalons d'un utilitarisme économique ; 2/ ses réflexions sur la sociabilité et une approche originale de la civilité ; 3/ ses observations pédagogiques, émanant d'un des principaux maîtres des Petites Ecoles de Port-Royal. (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

“Dumpster diving” is a term generally used for obtaining items, in this case food for consumption, from dumpsters. This study evaluates the prevalence of dumpster diving in two low-income urban communities in Minneapolis, Minnesota. Additionally, attitudes and beliefs of adults who engage in this behavior are reported. Surveys (n=396) were used to collect data including individual dumpster diving behavior, food security, health, and demographic data. Nearly one-fifth of those surveyed had used dumpster diving as a means to obtain food. Focus (...) groups (n=17) were conducted to further evaluate dumpster divers’ attitudes and beliefs about dumpster diving, use of food assistance programs including benefits and barriers, and other strategies used to obtain food such as stealing. Focus group participants were primarily homeless and most were high school educated. Ways to improve delivery of food assistance are suggested. In conclusion, more research on the use of dumpsters as a source of food is needed. Utilizing more of the 96 billion pounds of food wasted each year in the US through food recovery and donation programs could help to provide socially acceptable means for low-income urban dwellers to obtain food. (shrink)

This chapter argues that the best way for a non-naturalist to explain why the normative supervenes on the natural is to claim that, while there are some sui generis normative properties whose essences cannot be fully specified in non-normative terms and do not specify any non-normative sufficient conditions for their instantiation, there are certain hybrid normative properties whose essences specify both naturalistic sufficient conditions for their own instantiation and sufficient conditions for the instantiation of certain sui generis normative properties. This (...) is the only metaphysical explanation for supervenience on offer, the chapter argues, that can both clearly maintain the pre-theoretical commitments of non-naturalism, and provide a metaphysical explanation not just for supervenience, but for all metaphysical necessities involving natural and normative properties. (shrink)

Hermeneutical injustice, as a species of epistemic injustice, is when members of marginalized groups are unable to make their experiences communicatively intelligible due to a deficiency in collective hermeneutical resources, where this deficiency is traditionally interpreted as a lack of concepts. Against this understanding, this paper argues that even if adequate concepts that describe marginalized groups’ experiences are available within the collective hermeneutical resources, hermeneutical injustice can persist. This paper offers an analysis of how this can happen by introducing the (...) notion of hermeneutical excess: the introduction of additional concepts into collective hermeneutical resources that function to obscure agents’ understanding of the lived experiences of marginalized groups. The injustice of hermeneutical excesses happens not due to hermeneutical marginalization (the exclusion of members of marginalized groups from the construction of hermeneutical resources), but rather hermeneutical domination: when members of dominant groups have been inappropriately included in the construction of hermeneutical resources. By taking as exemplary cases the concepts of “reverse racism” and “non-consensual sex” this paper shows how such excesses are introduced as a kind of defensive strategy used by dominant ideologies precisely when progress with social justice is made. (shrink)

L'expression de nos émotions est-elle la même d'une langue à l'autre? À partir d'un large éventail de langues présentes continents, cet ouvrage témoigne de la grande variété des modalités d'expression des émotions, en fonction des codes culturels de différentes sociétés à tradition écrite ou orale. Les situations envisagées ici vont de la communication orale spontanée dans des contextes divers aux récits en passant par la création théâtrale et la poésie. S'appuyant sur ces sources multiples, l'ouvrage expose les procédés lexicaux grammaticaux, (...) métaphoriques et discursifs ou encore les représentations graphiques mis en oeuvre pour exprimer les émotions. (shrink)

A surfeit of research confirms that people activate personal, affective, and conceptual representations when perceiving the states of others. However, researchers continue to debate the role of self–other overlap in empathy due to a failure to dissociate neural overlap, subjective resonance, and personal distress. A perception–action view posits that neural-level overlap is necessary during early processing for all social understanding, but need not be conscious or aversive. This neural overlap can subsequently produce a variety of states depending on the context (...) and degree of common experience and emotionality. We outline a framework for understanding the interrelationship between neural and subjective overlap, and among empathic states, through a dynamic-systems view of how information is processed in the brain and body. (shrink)

Nicole Shukin pursues a resolutely materialist engagement with the "question of the animal," challenging the philosophical idealism that has dogged the question by tracing how the politics of capital and of animal life impinge on one ...

Growing interest in embedded research approaches—where research is incorporated into clinical care—has spurred numerous studies to generate knowledge relevant to the real-world needs of patients and other stakeholders. However, it also has presented ethical challenges. An emerging challenge is how to understand the nature and extent of investigators’ obligations to patient-subjects. Prior scholarship on investigator duties has generally been grounded upon the premise that research and clinical care are distinct activities, bearing distinct duties. Yet this premise—and its corresponding implications—are challenged (...) when research and clinical care are deliberately integrated. After presenting three case studies from recent pragmatic clinical trials, we identify six differences between explanatory trials and embedded research that limit the application of existing scholarship for ascertaining investigator duties. We suggest that these limitations indicate a need to account for the implications of usual care and to move beyond a narrow focus on the investigator-subject dyad, one that better reflects the team- and institution-based nature of contemporary health systems. (shrink)

Business and Society Review, Volume 127, Issue S1, Page 283-298, Spring 2022.

Digital phenotyping will potentially enable earlier detection and prediction of mental illness by monitoring human interaction with and through digital devices. Notwithstanding its promises, it is certain that a person’s digital phenotype will at times be at odds with their first-person testimony of their psychological states. In this paper, we argue that there are features of digital phenotyping in the context of psychiatry which have the potential to exacerbate the tendency to dismiss patients’ testimony and treatment preferences, which can be (...) instances of epistemic injustice. We first explain what epistemic injustice is, and why it is argued to be an extensive problem in health and disability settings. We then explain why epistemic injustice is more likely to apply with even greater force in psychiatric contexts, and especially where digital phenotyping may be involved. Finally, we offer some tentative suggestions of how epistemic injustice can be minimised in digital psychiatry. (shrink)

Classic statements of research ethics advise against permitting physician-investigators to obtain consent for research participation from patients with whom they have preexisting treatment relationships. Reluctance about “dual-role” consent reflects the view that distinct normative commitments govern physician–patient and investigator–participant relationships, and that blurring the research–care boundary could lead to ethical transgressions. However, several features of contemporary research demand reconsideration of the ethics of dual-role consent. Here, we examine three arguments advanced against dual-role consent: that it creates role conflict for the (...) physician-investigator; that it can compromise the voluntariness of the patient-participant’s consent; and that it promotes therapeutic misconceptions. Although these concerns have merit in some circumstances, they are not dispositive in all cases. Rather, their force—and the ethical acceptability of dual-role consent—varies with features of the particular study. As research participation more closely approximates usual care, it becomes increasingly acceptable, or even preferable, for physicians to seek consent for research from their own patients. It is time for a more nuanced approach to dual-role consent. (shrink)

Unconsented pelvic exams under anesthesia are assaults cloaked in defense of healthcare education. Preemptive linguistic qualifiers “presumed” or “implied” attempt to justify such violations with flippancy toward their oxymoronic implications: to suggest a priori that consent can be assumed undermines its otherwise standalone social, ethical, and medico-legal reverence. In this paper I conceptualize “medical sexual assault” and argue that presumed consent for intimate exams exemplifies its definition. By bluntly describing pelvic exams as “penetration,” this work aims to reify the intimate (...) reality of the clinical label “pelvic exam” and to call attention to cisheteronormative and androcentric assumptions involved in its practice. Additionally, this scholarship seeks to create a foundation toward broader work in conceptualizing clinical rape culture. Given recent national survey data indicating a surprising frequency of unconsented intimate exams, detailed language as to their problematics is necessary for ongoing legal and ethical efforts. Explicit consent for intimate exams must be the standard of care for conscious and unconscious patients. (shrink)