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The promotion of tourists’ environmentally responsible behavior plays a central role in destination management for sustainability. Based on the stimulus–organism–response framework, this study proposes an integrated model for behavior management by examining the relationship between stimuli and response factors through the organism. Survey data from 458 tourists visiting Mount Heng in Hunan Province, Southern China, were used to empirically evaluate the proposed framework. The findings demonstrate that the perception of a destination’s natural environment positively impacts tourists’ sense of awe and (...) satisfaction; the perception of availability of infrastructure positively and significantly influences awe, satisfaction, and TERB; and awe positively impacts satisfaction and TERB. Moreover, the emotion of awe plays a significant mediating role in this proposed model. The theoretical significance of this study and the implications for tourism destinations are discussed. (shrink)

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An increasing number of patients receive diagnoses of disease without having any symptoms. These include diseases detected through screening programs, as incidental findings from unrelated investigations, or via routine checks of various biological variables like blood pressure or cholesterol. In this article, we draw on narrative identity theory to examine how the process of making sense of being diagnosed with asymptomatic disease can trigger certain overlooked forms of harm for patients. We show that the experience of asymptomatic disease can involve (...) ‘mismatches’ between one’s beliefs about one’s health status on the one hand, and bodily sensations or past experience on the other. Patients’ attempts to integrate these diagnoses into their self-narratives often involve either forming inaccurate beliefs about bodily sensations and/or past experience, or coming to believe that feelings and experience do not necessarily track or predict health status, leading to an ongoing sense of vulnerability to ill health. These resulting alterations in self-understanding can sometimes be considered harmful, in view of their implications for ascriptions of responsibility and ongoing anxiety. (shrink)

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Consumer engagement in decisions about the funding of medicines is often framed as a good in and of itself and as an activity that should be universally encouraged. A common justification for calls for consumer engagement is that it enhances equity. In this paper we systematically critique this assumption. We show that consumer engagement may undermine equity as well as enhance it and show that a simple relationship cannot be assumed but must be justified and demonstrated. In concluding, we present (...) a number of challenges that need to be overcome in order for consumer engagement to contribute to health technology assessment in a morally and politically sound manner. (shrink)

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While ethics and evidence‐based medicine are often viewed as separate domains of inquiry and practice, what we know influences what we can ethically justify doing, and what we see as our moral obligations shapes the way we interpret evidence. The boundaries between the moral and epistemic spheres become particularly blurred when the health of people is at stake and even more so when no “officially” recommended medical intervention is available to help a patient in need. The treatment of major hemorrhages (...) using recombinant factor VIIa (rFVIIa), which was originally approved under orphan drug legislation to treat hemophilia, is a case in point.Following reports in the late 1990s that rFVIIa was success­fully used to stop bleeding in gunshot trauma, there was much excitement about its potential to help patients with uncontrolled bleeding in other clinical settings, leading to wide‐spread off‐label use of the drug. In recent years, new evidence has raised questions about the off‐label use of rFVIIa for severe bleeding. Nonetheless, while some clini­cians are now adamantly opposed to prescribing rFVIIa for massive bleed­ing, many remain determined to continue the practice. This raises the question: why do clinicians have such variable responses to the same body of evidence?We analyzed the debate around off‐label use of rFVIIa and character­ized its main conceptual features and tensions. We did not seek to provide a normative analysis as to whether the evidence supports the case for off‐label prescribing, nor did we try to provide a historical analysis of how attitudes and clinical practice have changed. Rather, we sought to make visible the moral and epistemic values underpinning stakeholders’ opinions and practices. On the basis of our analysis, which is described in this ar­ticle, we suggest that debates such as those surrounding rFVIIa will not be resolved simply by conducting more studies and that, therefore, there is also a need for conceptual and pro­cedural frameworks that more sys­tematically incorporate values into clinical policy‐making. (shrink)

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In 2016, the Office of the State Coroner of New South Wales released its report into the death of an Australian woman, Sheila Drysdale, who had died from complications of an autologous stem cell procedure at a Sydney clinic. In this report, we argue that Mrs Drysdale's death was avoidable, and it was the result of a pernicious global problem of an industry exploiting regulatory systems to sell unproven and unjustified interventions with stem cells.

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Evidence in medicine can come from more or less trustworthy sources and be produced by more or less reliable methods, and its interpretation can be disputed. As such, it can be unclear when disagreements in medicine result from different, but reasonable, interpretations of the available evidence and when they result from unreasonable refusals to consider legitimate evidence. In this article, we seek to show how assessments of the relevance and implications of evidence are typically affected by factors beyond that evidence (...) itself, such as our beliefs about the credibility of the speaker or source of the evidence. In evaluating evidence, there is thus a need for reflective awareness about why we accept or dismiss particular claims. (shrink)

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This paper is devoted to a bibliographical study of Russell’s ad­dresses and lectures in China in 1920–21. In particular, the study focuses on providing a (nearly) com­plete and correct list of original sources per­taining to them, including speaking dates and translators. There has been, historically, considerable disagreement over the details. Extensive notes discuss and aim at solutions. The study adds significantly to our knowl­edge of Russell’s speaking and teaching activities in China.

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On affirme couramment que les trente-quatre homélies sur les Hébreux correspondent aux dernières années de Jean Chrysostome à Constantinople. Les AA. reprennent dans un premier temps les arguments des spécialistes depuis Henry Savile. En second lieu, ils s'arrêtent sur la thèse d'Opelt qui préfère Antioche plutôt que Constantinople comme lieu de provenance. Ces trente-quatre homélies constituent une partie importante de l'oeuvre de prédication de Jean Chrysostome et ne semblent pas appartenir à la série des dernières prédications assurées par ce dernier.

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Reply to a commentary by Felicitas Holzer and Ignacio Mastroleoon “Models of Consent to Return of Incidental Findings in Genomic Research.”.

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From the mid nineteenth to mid twentieth century sanatoria loomed large in the popular consciousness as the space for the treatment of tuberculosis (TB). A review of the historiography of sanatoria at the beginning of this paper shows that the nursing contribution to the care of TB patients is at best ignored and at worst attracts negative comment. Added to this TB nursing was not viewed as prestigious by contemporaries, leading to problems attracting recruits. Using a case study approach based (...) on surviving archival material, this paper sets out to provide a glimpse of the work of TB nurses in a rural sanatorium at Westwood, Queensland, Australia. For the nurses geographical isolation was compounded by professional stagnation, which created a working environment influenced by friction and discord among the staff. It reveals how despite this, nurses coped with working in hostile conditions, to make the long stay of their patients, separated from their families and familiar life style more bearable. (shrink)

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Much of the literature on public space focuses on physical inclusion and exclusion rather than social inclusion or exclusion. In this paper, the implications of this are considered in the context of two monuments, The Volunteers/Les Bénévoles, and The Emigrant, located outside the Canadian Museum of Immigration at Pier 21 in Halifax, Nova Scotia. These monuments, while perhaps designed to celebrate Canadian multiculturalism, can be read instead as signaling Canada’s enduring commitment to white supremacy, Eurocentricity and colonization, when viewed through (...) the eyes of racialized immigrants. Thus the “public space” becomes exclusionary. In the context in which the monuments are situated, the racial subtext cannot be ignored. This article purports that images, text and placement, regardless of intention, have significant implications on public space and public demeanor. (shrink)

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Relationships between degree/area of academic formation and religious and Darwinian views are controversial. This study aimed to compare the religious beliefs and acceptance of Darwinian evolution between two contrasting South American scientific communities (Chile and Colombia), accounting for different degrees and areas of academic formation. In 2018, 115 last year bachelor students (surveyed as freshmen in 2014 for a previous study) from Chile, and 283 first/last year bachelor students, graduate students, and professors from Colombia, all belonging to biology, chemistry, or (...) physics, were surveyed. Chilean students/faculty were significantly more agnostic/atheist, more accepting of Darwinian evolution, and less creationist than their Colombian counterparts. Academic degree and area differently affected these views in both countries, as only in Chile there was a clear tendency among biologists and physicists with higher degrees to hold less religious and creationist views. Marked differences between the history, socioeconomic contexts, and especially in high school and university curricula of both countries might explain these results. (shrink)

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Lloyd (2009) contends that climate models are confirmed by various instances of fit between their output and observational data. The present paper argues that what these instances of fit might confirm are not climate models themselves, but rather hypotheses about the adequacy of climate models for particular purposes. This required shift in thinking—from confirming climate models to confirming their adequacy-for-purpose—may sound trivial, but it is shown to complicate the evaluation of climate models considerably, both in principle and in practice.

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Wendy Rogers ist Professorin für klinische Ethik und Catriona Mackenzie ist Professorin für Philosophie. Beide lehren an der Macquarie University in Sydney, Australien. Susan Dodds ist Professorin für Philosophie an der La Trobe University in Melbourne, Australien. Alle drei befassen sich seit Jahren intensiv mit feministischer Theorie, angewandter und biomedizinischer Ethik sowie mit Moralphilosophie.

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Vocación es una categoría ética, que alude a la perspectiva en que ponemos nuestra vida y a las preferencias que la van orientando en la praxis cotidiana. En sentido ético, la vocación tiene cuatro notas definitorias: Las elecciones cotidianas, la prudencia, la realización efectiva del proyecto fundamental y la entrega personal y comunitaria a un quehacer, y a éstas hay que adicionarles la vertiente religiosa o trascendente. La tarea moral, consiste en llegar a ser lo que se puede ser, con (...) lo que se es, de donde resulta que el verdadero destino es nuestro ser mismo: «Llega a ser el que eres». La vocación más que un llamado es «un êthos de fidelidad a sí mismo», un programa de vida, un afán de ser responsable y «tomarse en serio la vida», buscando que sea auténtica y plena. (shrink)

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Democracy is usually conceived as based on self-rule or rule by the people, and it is this which is taken to ground the legitimacy of the democratic form of government. But who constitutes the people? Democratic political theory has a potentially fatal weakness at its core unless it can answer this question satisfactorily. In _The Time of Popular Sovereignty_, PaulinaOchoa Espejo examines the problems the concept of the people raises for liberal democratic theory, constitutional theory, and critical theory. (...) She argues that to solve these problems, the people cannot be conceived as simply a collection of individuals. Rather, the people should be seen as a series of events, an ongoing process unfolding in time. She then offers a new theory of democratic peoplehood, laying the foundations for a new theory of democratic legitimacy. (shrink)

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Across the Euro-Atlantic world, political leaders have been mobilizing their bases with nativism, racism, xenophobia, and paeans to “traditional values,” in brazen bids for electoral support. How are we to understand this move to the mainstream of political policies and platforms that lurked only on the far fringes through most of the postwar era? Does it herald a new wave of authoritarianism? Is liberal democracy itself in crisis? In this volume, three distinguished scholars draw on critical theory to address our (...) current predicament.Wendy Brown, Peter E. Gordon, and Max Pensky share a conviction that critical theory retains the power to illuminate the forces producing the current political constellation as well as possible paths away from it. Brown explains how “freedom” has become a rallying cry for manifestly un-emancipatory movements; Gordon dismantles the idea that fascism is rooted in the susceptible psychology of individual citizens and reflects instead on the broader cultural and historical circumstances that lend it force; and Pensky brings together the unlikely pair of Tocqueville and Adorno to explore how democracies can buckle under internal pressure. These incisive essays do not seek to smooth over the irrationality of the contemporary world, and they do not offer the false comforts of an easy return to liberal democratic values. Rather, the three authors draw on their deep engagements with nineteenth–and twentieth–century thought to investigate the historical and political contradictions that have brought about this moment, offering fiery and urgent responses to the demands of the day. (shrink)

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Here lies the vocation of those who preserve our understanding of past theories, who sharpen our sense of the subtle, complex interplay between political experience and thought, and who preserve our memory of the agonizing efforts of intellect to restate the possibilities and threats posed by political dilemmas of the past. —Sheldon S. Wolin, “Political Theory as a Vocation”In the same way in which the great transformation of the first industrial revolution destroyed the social and political structures as well as (...) the legal categories of the ancien regime, terms such as sovereignty, right, nation, people, democracy, and general will by now refer to a reality that no longer has anything to do with what these concepts used to designate—and those who continue to use these concepts uncritically literally do not know what they are talking about. —Giorgio Agamben, Means without Ends: Notes on PoliticsLooking obliquely at the edges of things, where they come together with other things, can tell you as much about them, often, as can looking at them directly, intently, straight on. —Clifford Geertz, “The Near East in the Far East”. (shrink)

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On Borders asks when are borders legitimate, and it offers a new theory to answer the question. The book challenges critical and normative theories that criticize or justify borders solely in terms of identity, and instead frames borders and border legitimacy from the perspective of place and presence. Instead of thinking of borders as the exclusionary limit of identity groups, the book develops a theory of territorial jurisdictions grounded on place-specific relations, giving central roles to urban settings and the environment. (...) PaulinaOchoa Espejo calls this the "watershed model" of territorial rights and borders. (shrink)

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The thesis of political theology holds that all justificatory theories of the state rely on metaphysical assumptions, rather than just empirical facts and accepted political conventions. For this reason, the thesis challenges liberal theories that justify the state on the basis of individual autonomy and popular will. The thesis is controversial because many theorists believe that metaphysical assumptions introduce decisionism – the view that a state depends on the unrestrained personal decision of a ruler – to the theory of the (...) state. But, does political theology entail decisionism? This article argues that decisionism does not follow necessarily from political theology because an omnipotent deciding sovereign is only one of many possible metaphysical assumptions in theology. It illustrates this claim with examples from the philosophy of Nicholas Cusanus and process philosophy. This conclusion challenges two different entrenched views: first, that the modern state is a continuation of theistic beliefs; and second, that metaphysical discussions have no place in contemporary normative political theory. (shrink)

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First published in 1982. Routledge is an imprint of Taylor & Francis, an informa company.

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Filial piety is a Confucian concept derived from Chinese culture, which advocates a set of moral norms, values, and practices of respect and caring for one’s parents. According to the dual-factor model of filial piety, reciprocal and authoritarian filial piety are two dimensions of filial piety. Reciprocal filial piety is concerned with sincere affection toward one’s parent and a longstanding positive parent-child relationship, while authoritarian filial piety is about obedience to social obligations to one’s parent, often by suppressing one’s own (...) wishes to conform the demands of the parent. The primary aim of this study is to investigate the moderating effect of culture on the relationships between filial piety and palliative care knowledge. The secondary aim is to investigate whether filial piety is a universal construct across Singaporean and Australian cultures. A total of 508 participants living in Singapore and Australia were surveyed between May and October 2020. The final sample comprised of 406 participants, with 224 Singaporeans and 182 Australians. There were 289 females, 115 males, and two unspecified gender in the sample, with an average age of 27.27 years. Results indicated a significant effect of culture on authoritarian filial piety and palliative care knowledge. Singaporeans showed higher authoritarian filial piety and higher palliative care knowledge than Australians. However, no effect of culture was found on reciprocal filial piety. Overall, no significant correlation existed between palliative care knowledge and reciprocal filial piety and authoritarian filial piety. For Singaporeans, a weak negative correlation was found between palliative care knowledge and authoritarian filial piety. In contrast, Australians and Singaporeans indicated a positive, moderate correlation between reciprocal and authoritarian filial piety. Further, culture moderated the relationship between authoritarian filial piety and palliative care knowledge. High authoritarian filial piety was associated with increased palliative care knowledge among Australians, while high authoritarian filial piety was associated with decreased palliative care knowledge among Singaporeans. The results support the conceptualization of filial piety as a possible psychological universal construct. In addition, the results point out an important implication that public health programs should target the appropriate filial piety types to enhance palliative care knowledge among Singaporeans and Australians. (shrink)

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Esta reflexión evidencia cómo desde los años sesenta Amílcar Osorio produce una práctica artística en procura de la desinstitucionalización de la literatura y del arte, al situar sus objetivos estéticos no solo en las letras como posibilidad narrativa y poética, sino en la utilización de lo visual, el espacio y la vida misma como recurso artístico. Con esto el autor consigue difuminar las fronteras entre literatura, artes visuales y de acción, y logra producir lo que se puede considerar hoy una (...) práctica intermedial, al tomar estrategias propias del arte conceptual que le permiten conectar la vida cotidiana, la literatura, las ideas como expresión artística, la imagen y la performance. (shrink)

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Recent evidence from psychological science and genetics suggests that genetic influences underlie all behavior as well as the most worrisome social inequalities. This may be considered to call into question traditional conceptions of agency and agent responsibility. They could be thought to be undermined if gene-environment transactions were sufficiently potent in influencing behaviors. Here we identify the theoretical parameters that require investigation and the conceptual challenges to agent responsibility that arise from research in behavior genetics. We (i) introduce the empirical (...) basis of the discussion, (ii) identify the particular questions that arise from considering the connection between behavior genetics and agent responsibility in the context of the legal system, (iii) bring into focus the general challenges to agent responsibility, and (iv) outline a potential resolution. (shrink)

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Introducción: se presenta un ensayo cuyo objetivo es fijar posiciones frente al resumen del Informe de la Comisión sobre Determinantes Sociales de la Salud (CDSS) proponer las acciones políticas que los movimientos sociales en salud deben emprender. Análisis: las recomendaciones de la CDSS no enfocan el problema en toda su compleja naturaleza y en especial desconoce la influencia decisiva de la formación económica social sobre la situación crítica de la salud en el mundo. Acción: se propone la unidad de los (...) movimientos sociales que actúan en el campo de salud para luchar contra los efectos de las políticas económicas y sociales dominantes en el mundo: reducción del papel del estado, privatización de servicios, desregulación laboral, privatización de la seguridad social, políticas migratorias y otras. Denunciemos toda política neoliberal en relación con la salud, practiquemos la solidaridad con los que luchan contra esas políticas, derrotemos el monopolio mediático neoliberal, enfocar el problema de los DSS como asunto político social, no técnico y defendamos el papel protagónico del estado, único capaz de asegurar servicios de salud al alcance de todos. Conclusión: "Nuestro deber es luchar", como nos advirtió Fidel Castro. Introduction: An essay is presented in order to set positions against the Report´s summary of the Commission on social determinants of public health (CSDPH) that suggests the political actions to be undertaken by Health social movements. Analysis: The CSDPH recommendations do not focus the problem in all its complex nature and do not recognize the decisive influence of the social economic formation on the critical situation of Health in the world. Action: unity of social movements acting in the field of health to fight against the effects of the dominant economic and social policies of today´s world: reduction of the role of the State, privatization of services, labour deregulation, privatization of social security, migratory policies and others. We denounce any neo-liberal policy in relation to Health. Let´s support those who struggle against those policies; let´s defeat the neoliberal media monopoly, let´s focus on the problem of social determinants as a sociopolitical issue , not as a technical one; let´s defend the leading role of the State, the only one capable to ensure health services to everyone. Conclusion: As Fidel Castro expressed: "Our duty is to fight. (shrink)

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Bioethics is a practically oriented discipline that developed to address pressing ethical issues arising from developments in the life sciences. Given this inherent practical bent, some form of advocacy or activism seems inherent to the nature of bioethics. However, there are potential tensions between being a bioethics activist, and academic ideals. In academic bioethics, scholarship involves reflection, rigour and the embrace of complexity and uncertainty. These values of scholarship seem to be in tension with being an activist, which requires pragmatism, (...) simplicity, certainty and, above all, action. In this paper I explore this apparent dichotomy, using the case example of my own involvement in international efforts to end forced organ harvesting from prisoners of conscience in China. I conclude that these tensions can be managed and that academic bioethics requires a willingness to be activist. (shrink)

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Unable to answer the call of our patients: mental health nurses’ experience of moral distress When health practitioners’ moral choices and actions are thwarted by constraints, they may respond with feelings of moral distress. In a Canadian hermeneutic phenomenological study, physicians, nurses, psychologists and non‐professional aides were asked to identify care situations that they found morally distressing, and to elaborate on how moral concerns regarding the care of patients were raised and resolved. In this paper, we describe the experience of (...) moral distress related by nurses working in mental healthcare settings who believed that lack of resources (such as time and staff) leads to dispiritedness, lack of respect, and absence of recognition (for both patients and staff) which severely diminished their ability to provide quality care. The metaphors of flashlight and hammer are used to elaborate nurses’ possible responses to intolerable situations. (shrink)

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Whether in characterizing Catharine MacKinnon's theory of gender as itself pornographic or in identifying liberalism as unable to make good on its promises,Wendy Brown pursues a central question: how does a sense of woundedness become the basis for a sense of identity? Brown argues that efforts to outlaw hate speech and pornography powerfully legitimize the state: such apparently well-intentioned attempts harm victims further by portraying them as so helpless as to be in continuing need of governmental protection. "Whether (...) one is dealing with the state, the Mafia, parents, pimps, police, or husbands," writes Brown, "the heavy price of institutionalized protection is always a measure of dependence and agreement to abide by the protector's rules." True democracy, she insists, requires sharing power, not regulation by it; freedom, not protection.Refusing any facile identification with one political position or another, Brown applies her argument to a panoply of topics, from the basis of litigiousness in political life to the appearance on the academic Left of themes of revenge and a thwarted will to power. These and other provocations in contemporary political thought and political life provide an occasion for rethinking the value of several of the last two centuries' most compelling theoretical critiques of modern political life, including the positions of Nietzsche, Marx, Weber, and Foucault. (shrink)

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To study Earth’s climate, scientists now use a variety of computer simulation models. These models disagree in some of their assumptions about the climate system, yet they are used together as complementary resources for investigating future climatic change. This paper examines and defends this use of incompatible models. I argue that climate model pluralism results both from uncertainty concerning how to best represent the climate system and from difficulties faced in evaluating the relative merits of complex models. I describe how (...) incompatible climate models are used together in ‘multi-model ensembles’ and explain why this practice is reasonable, given scientists’ inability to identify a ‘best’ model for predicting future climate. Finally, I characterize climate model pluralism as involving both an ontic competitive pluralism and a pragmatic integrative pluralism. (shrink)

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This pedagogical essay explores the tendency of undergraduate media ethics students to do what Bernard Gert calls “morality by slogans” and their tendency to misuse Aristotle's golden mean slogan. While not solving the dilemma of morality by slogans, the essay suggests some ways of rectifying the misuse of the golden mean and encouraging its more authentic application.

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On the 24th June 2015, Feminist Legal Studies and the London School of Economics Law Department hosted an afternoon event with ProfessorWendy Brown, Class of 1936 First Professor of Political Science, University of California. Professor Brown kindly agreed to discuss her scholarship on feminist theory, and its relationship to both the law and neoliberalism. The event included an interview by Dr Katie Cruz and a Q&A session, which are presented here in an edited version of the transcript. Sumi (...) Madhock, Professor of Gender Studies, LSE chaired the interview and discussion and introduced Professor Brown’s work. Katie Cruz askedWendy Brown to reflect upon topics that span her scholarship and activism, including the state of critical, feminist, and Left approaches to rights, neoliberalism, despair and utopianism, and the future of feminist theory and practice in the context of neoliberalism and current debates about intersectionality. Participants in the discussion asked questions on a wide range of issues, including the limits of feminist engagement with law as a tool for social change, the dominance of neoliberalism, imperialist feminism, Islamophobia, secularism, and our attachment to the figure of homo politicus. (shrink)

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Current conceptions of human language include a gestural component in the communicative event. However, determining how the linguistic and gestural signals are distinguished, how each is structured, and how they interact still poses a challenge for the construction of a comprehensive model of language. This study attempts to advance our understanding of these issues with evidence from sign language. The study adopts McNeill's criteria for distinguishing gestures from the linguistically organized signal, and provides a brief description of the linguistic organization (...) of sign languages. Focusing on the subcategory of iconic gestures, the paper shows that signers create iconic gestures with the mouth, an articulator that acts symbiotically with the hands to complement the linguistic description of objects and events. A new distinction between the mimetic replica and the iconic symbol accounts for the nature and distribution of iconic mouth gestures and distinguishes them from mimetic uses of the mouth. Symbiotic symbolization by hand and mouth is a salient feature of human language, regardless of whether the primary linguistic modality is oral or manual. Speakers gesture with their hands, and signers gesture with their mouths. (shrink)

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