A large proportion of the total global burden of disease is caused by emergency medical conditions. Emergency care research is essential to improving emergency medicine but this research can raise some distinctive ethical challenges, especially with regard to (1) standard of care and risk–benefit assessment; (2) blurring of the roles of clinician and researcher; (3) enrolment of populations with intersecting vulnerabilities; (4) fair participant selection; (5) quality of consent; and (6) community engagement. Despite the importance of research to improve emergency (...) care in low-income and middle-income countries (LMICs) and the widely acknowledged ethical challenges, very little has been written on the ethics of emergency care research in LMICs. This paper examines the ethical and regulatory challenges to conducting emergency care research with human participants in LMICs. We outline key challenges, present potential solutions or frameworks for addressing these challenges, and identify gaps. Despite the ethical and regulatory challenges, conducting high-quality, ethical emergency care research in LMICs is possible and it is essential for global health. (shrink)

We identify the \-ideals of a distributive demi-pseudocomplemented algebra L as the kernels of the boolean congruences on L, and show that they form a complete Heyting algebra which is isomorphic to the interval \ of the congruence lattice of L where G is the Glivenko congruence. We also show that the notions of maximal \-ideal, prime \-ideal, and falsity ideal coincide.

Selected as a Financial Times Best Book of 2013Governments today in both Europe and the United States have succeeded in casting government spending as reckless wastefulness that has made the economy worse. In contrast, they have advanced a policy of draconian budget cuts--austerity--to solve the financial crisis. We are told that we have all lived beyond our means and now need to tighten our belts. This view conveniently forgets where all that debt came from. Not from an orgy of government (...) spending, but as the direct result of bailing out, recapitalizing, and adding liquidity to the broken banking system. Through these actions private debt was rechristened as government debt while those responsible for generating it walked away scot free, placing the blame on the state, and the burden on the taxpayer. That burden now takes the form of a global turn to austerity, the policy of reducing domestic wages and prices to restore competitiveness and balance the budget. The problem, according to political economist Mark Blyth, is that austerity is a very dangerous idea. First of all, it doesn't work. As the past four years and countless historical examples from the last 100 years show, while it makes sense for any one state to try and cut its way to growth, it simply cannot work when all states try it simultaneously: all we do is shrink the economy. In the worst case, austerity policies worsened the Great Depression and created the conditions for seizures of power by the forces responsible for the Second World War: the Nazis and the Japanese military establishment. As Blyth amply demonstrates, the arguments for austerity are tenuous and the evidence thin. Rather than expanding growth and opportunity, the repeated revival of this dead economic idea has almost always led to low growth along with increases in wealth and income inequality. Austerity demolishes the conventional wisdom, marshaling an army of facts to demand that we austerity for what it is, and what it costs us. (shrink)

In this essay on epistemological development in college students, I argue that “subjectivism” (a.k.a. “multiplism;” often identified in female undergraduates) should be understood and treated not as amanifestation of a primitive, irrational notion of knowing that must be exterminated and replaced by the more impersonal, detached, objective procedures embodied in scientific method and critical thinking. Rather, it should be regarded as a point of departure for moving into more reflective modes of thought when approached via, and encouraged into, the more (...) personal, empathic procedure made known in Women’s Ways of Knowing as “connected knowing.” Along the way, I develop further the difference between “connected knowing” and “separate knowing” (the latter being the dominant academic paradigm of knowing), bringing out how connected knowing is an important and at times indispensable complement to separate knowing in achieving an objectivity integrated with subjectivity. (shrink)

This essay is a short response to comments made by Cannon, Meeks, and Yu to my articles “Beyond Subjectivism,” published in this special edition of Tradition and Discovery (34:1), and “Connected andSeparate Knowing: A Marriage of Two Minds,” published in Knowledge, Difference, and Power, edited by Nancy Goldberger, et al., focusing on convergences between my work and the ideas of Michael Polanyi.

In the present essay, I explore some ways in which Polanyi’s concepts can be applied to enrich our understanding of epistemological development and the educational practices that seem to facilitate orsuppress it. Among the concepts discussed are Polanyi’s notion of uncertainty, combined with confidence as driving intellectual activity; the role of conviviality in the collaborative construction of knowledge,· the act of discovery as beginning with a problem that obsesses the thinker and proceeding through the integration of (often tacit) fragments into (...) a coherent whole; the notion of personal knowledge and commitment as transcending the disjunction between subjective and objective; apprenticeship as a personal relationship between a learner and a more sophisticated master, and most important, the assertion that beliefis prior to doubt. Thus, in terms ofthe concepts my colleagues and I have developed, “connected knowing” (a personal approach) is not simply equal to “separate knowing” (a detached, impersonal mode) as a procedure for arriving at knowledge, but is prior to it, “making meaning” being a necessary prerequisite to testing the validity ofa position. Drawing on interview data and memoirs of academic experiences, I argue that because these priorities are often reversed in educational practice, students learn to delete their personal responses from their essays in order to meet what they perceive as the utterly objective standards of the academy. When educators “endorse” uncertainty, students are encouraged to engage in the collaborative making of meaning and the pursuit of problems of personal importance. (shrink)

Literature on racism, anti‐racism, whiteness, nursing education and nurse educators was reviewed and analysed for the development of race consciousness and application of anti‐racist pedagogy. The literature describes an oppressive educational climate for non‐white identifying people, a curriculum that does not attend to the social construction of difference, and a nursing culture that is not consciously situated in a broader sociopolitical context. A particular focus on studies of nurse educators demonstrates a stark need for personal and professional development towards effectively (...) delivering anti‐racist pedagogy and a deconstruction of white normativity and dominance amongst white faculty. The protection and reproduction of white privilege is identified through the scholarship itself through a lack of racial analysis, an externalization of the root of oppression and non‐specific study measures and outcomes. The persistence and pervasiveness of white dominance in nursing and the lack of anti‐racist competence in white educators, particularly, merits a shift in anti‐racist efforts away from short‐term skill acquisition initiatives towards the deconstruction of socialized white supremacy and enactments of white privilege in nurse educators themselves. (shrink)

Three ethical conflicts in particular are paradigmatic of what we define as “clerkship ethics.” First, a distinction that differentiates the clerkship student from the practicing physician involves the student’s principal role as a learner. The clerkship student must skillfully balance her commitment to her own education against her commitment to patient care in a fashion that may compromise patient care. While the practicing physician can often resolve the tension between these two goods when they come into conflict, the clerkship student (...) is left with a more ambiguous set of choices. Second, evaluative scrutiny during clinical clerkships often forces medical students to balance doing what is morally fitting against the perceived expectations of the medical teams in which they work. Third and finally, a deeply entrenched culture of medical hierarchy presents a particular challenge to innovation and improvement in ethics education during the clerkship years. Students regard faculty as exemplars, but are not provided with the tools to assess when technical medical competence is not matched by moral competence; moreover, these faculty are unlikely to have experienced the ethics education in which students are asked to demonstrate mastery. (shrink)

In this commentary we concur with Frost's view of the centrality of universal principles in models of word identification. However, we argue that other processes in sentence comprehension also fundamentally constrain the nature of written word identification. Furthermore, these processes appear to be universal. We, therefore, argue that universality in word identification should not be considered in isolation, but instead in the context of other linguistic processes that occur during normal reading.

In their target article, Millum and Bromwich situate their article against a backdrop of well-documented empirical research demonstrating that many participants have variable and often poor...

In _Aristotle’s Ever-turning World in _Physics _8_ Blyth analyses the reasoning in Aristotle’s explanation of cosmic movement, with detailed evaluation of ancient and modern commentary on this central text in the history of ancient and medieval philosophy and science.

There are substantial numbers of frozen embryos in storage that will not be used by those who produced them for their own fertility treatment. One option for such embryos is to donate them to others to use in their fertility treatment. There has been considerable debate about how this process should be organized. In the US, there are embryo adoption programmes that mediate between those relinquishing embryos and potential recipients. This is a form of conditional embryo donation, where the relinquishing (...) couple can choose the recipient of their embryo. This article examines the ethical debate over conditional embryo donation for family building and explores the question of whether those who have unused frozen embryos should be able to determine who receives their embryos. The main objections to conditional embryo donation are examined: first, the embryo is not a person and therefore such concern over the placement of an embryo is unwarranted; secondly, potential donors might impose morally problematic conditions on who should receive their embryo; and thirdly, there are practical difficulties regarding organizational arrangements and the associated costs involved. It will be concluded that these objections can be countered and that if people wish to donate and receive embryos in this way there is no ethical objection to them doing so. (shrink)

Market metaphors have come to dominate discourse on medical practice. In this essay, we revisit Peter Berger and colleagues’ analysis of modernization in their book The Homeless Mind and place that analysis in conversation with Max Weber’s 1917 lecture “Science as a Vocation” to argue that the rise of market metaphors betokens the carry-over to medical practice of various features from the institutions of technological production and bureaucratic administration. We refer to this carry-over as the product presumption. The product presumption (...) foregrounds accidental features of medicine while hiding its essential features. It thereby confounds the public understanding of medicine and impedes the professional achievement of the excellences most central to medical practice. In demonstrating this pattern, we focus on a recent article, “Physicians, Not Conscripts—Conscientious Objection in Health Care,” in which Ronit Stahl and Ezekiel Emanuel decry conscientious refusals by medical practitioners. We demonstrate that Stahl and Emanuel’s argument depends on the product presumption, ignoring and undermining central features of good medicine. We conclude by encouraging conscientious resistance to the product presumption and the language it engenders. (shrink)

Healthcare environments continue to prove discriminatory and marginalizing towards patients and healthcare workers themselves, which contributes to inequitable health outcomes across lines of socially constructed difference. This content and discourse analysis of nursing identity scholarship asks whether there is a connection between nursing identity and oppressive behaviour by examining the construction of nursing identity and the foundational discourses, sometimes in absentia, that support such a construction. Bourdieu's concepts of social fields and Audre Lorde's concept of the master's house are applied (...) as a framework towards understanding the constructs of power and status in healthcare. The analysis identifies a gap in nursing identity literature where social constructs of difference are not considered. In the reviewed literature, nursing identity has been co‐opted by the professionalization project in effort to stabilize a conceptualization of nursing's contribution to healthcare towards gaining professional and societal status. This leads to a monolithic, apolitical representation of nursing identity that erases difference, denies historical influence, universalizes nursing work and further marginalizes marginalized identities. The oppressive and hegemonic nature of a universal nursing identity may contribute to a lack of disciplinary reflexivity about the ongoing influences of foundational discursive constructs of gender, epistemology, power and professional status. (shrink)

Colexification refers to the phenomenon of multiple meanings sharing one word in a language. Cross‐linguistic lexification patterns have been shown to be largely predictable, as similar concepts are often colexified. We test a recent claim that, beyond this general tendency, communicative needs play an important role in shaping colexification patterns. We approach this question by means of a series of human experiments, using an artificial language communication game paradigm. Our results across four experiments match the previous cross‐linguistic findings: all other (...) things being equal, speakers do prefer to colexify similar concepts. However, we also find evidence supporting the communicative need hypothesis: when faced with a frequent need to distinguish similar pairs of meanings, speakadjust their colexification preferences to maintain communicative efficiency and avoid colexifying those similar meanings which need to be distinguished in communication. This research provides further evidence to support the argument that languages are shaped by the needs and preferences of their speakers. (shrink)

This article discusses when it is ethically acceptable to withdraw consent for the storage and use of embryos and gametes. Currently, the law in the UK states that consent to use of a gamete or embryo can be withdrawn up to the point of the embryo's transfer to the recipient's uterus or when the gamete is used in providing treatment services; that is, the ‘point of no return’. In this article, we will consider other points of no return and argue (...) that having a single point of no return, a one size fits all form of consent can, in some cases, lead to restrictions on individuals’ autonomy and cause particular types of harm. Therefore, having different points of no return that fit different circumstances could extend autonomy and allow people to enter into agreements that are tailored more to their own particular needs and circumstances. (shrink)

Notre enquête porte sur la réception à la fois philosophique et théologique de la pensée de saint Thomas d’Aquin dans la culture roumaine à l’âge moderne.Nous avons essayé de marquer les étapes principales d’une histoire qui reflète dans une culture religieuse d’origine byzantine les tribulations de la réception dela philosophie médiévale en Occident. Formés dans les universités françaises ou allemandes, les philosophes et les théologiens orthodoxes roumains sont redevables aussi bien aux traditions philosophiques des XVIIIᵉ-XIXᵉ siècles qu’à la découverte gilsonienne (...) de la pensée médiévale. Entre polémique confessionnelle et approche scientifique, saint Thomas d’Aquin devient au XXᵉ siècle une présence significative dans les discours philosophiques et théologiques roumains (notamment dans le débat concernant la possibilité d’une philosophie chrétienne), en dépit d’une préférence traditionnelle accordée à saint Augustin. Il importe de remarquer aussi le fait que la spécificité des approches des philosophes roumains de la pensée de saint Thomas d’Aquin consiste dans l’effort de transgresser un thomisme «historique» vers des possibles enjeux modernes. (shrink)

In his famous Crisis of the Early Italian Renaissance Hans Baron treated the Dominican political thinker Ptolemy of Lucca as purely medieval, his ideas totally separate from the doctrine that Baron named civic humanism. However, in an unpublished, and previously-unstudied, manuscript written more than a decade earlier, Baron maintained that Ptolemy's ideology evolved into something quite close to civic humanism. He attempted to prove this through a comparison of early and late work of Ptolemy and through an analysis of Ptolemy's (...) process of composition of his De Regimine Principum. This article analyses Baron's arguments and in general supports them, with some qualifications. Baron's manuscript supports the conclusions previously published by Blythe and is also significant in what it reveals about the intellectual evolution of one of the twentieth century's most significant historians of political thought. (shrink)

I argue here that a properly Platonic theory of the nature of number is still viable today. By properly Platonic, I mean one consistent with Plato's own theory, with appropriate extensions to take into account subsequent developments in mathematics. At Parmenides 143a-4a the existence of numbers is proven from our capacity to count, whereby I establish as Plato's the theory that numbers are originally ordinal, a sequence of forms differentiated by position. I defend and interpret Aristotle's report of a Platonic (...) distinction between form and mathematical numbers, arguing that mathematical numbers alone are cardinals, by reference to certain non-technical features of a set-theoretical approach and other considerations in philosophy of mathematics. Finally I respond to the objections that such a conception of number was unavailable in antiquity and that this theory is contradicted by Aristotle's report in Metaph . XIII that Platonic numbers are collections of units. I argue that Aristotle reveals his own misinterpretation of the terms in which Plato's theory was expressed. (shrink)

Journal Name: Apeiron Issue: Ahead of print.

Reductive representationalism offers a promising route to an intelligible account of phenomenal consciousness. However, reductive representationalist accounts entail phenomenal externalism. Here I develop a new argument against phenomenal externalism and, by extension, standard reductive representationalism. I argue that the external determination of ‘here-and-now’ phenomenal properties entails an irreconcilable unintelligibility at the heart of reductive representationalist accounts. As reductive representationalism is motivated by the promise of rendering phenomenal experience intelligible, this criticism is fatal.

This article argues for the importance of studying life after mental illness. A significant proportion of people who experience mental illness recover, but the experience continues to affect their lives. Historical examination of the birth of mental after-care through the Mental After-Care Association (MACA) highlights the challenges faced by those who were discharged recovered from English and Welsh lunatic asylums between 1879 and 1928. This research demonstrates the relationship between ideas regarding psychiatric recovery and citizenship. Throughout the period, certification of (...) insanity for institutional treatment stripped patients of the status and rights of citizenship. Discharge on account of recovery restored a patient's legal access to citizenship, yet suspicions about their right and ability to particate in society lingered. The MACA designed after-care to facilitate restoration to full citizenship. The MACA was a product of the active citizenship movement, according to which, one's right to identify as a citizen depended on the performance of certain duties to the community. These duties varied according to socio-economic position and sex, meaning that each individual was prescribed a gendered personal citizenship role. MACA personnel saw their endeavours as part of their own citizenship roles, and designed their treatments accordingly. The MACA used a patient's assumption of a citizenship role to indicate recovery, and believed that supporting the performance of that role had mentally healing effects for patients who had been discharged recovered. MACA workers thus imbued the psychiatric innovation of after-care with the liberal political and social values of active citizenship. (shrink)