Relational Autonomy, Maternalism, and the Nocebo Effect

In their target article, Menkes et al. suggest that the nocebo effect, in which an individual experiences an adverse effect of medical treatment due to negative expectations, occasions a dilemma between autonomy and nonmaleficence. They work to resolve the dilemma by arguing that in some cases, nonmaleficence outweighs autonomy. In this commentary article, we suggest that the concept of autonomy presumed to underlie informed consent practices is at the root of this predicament – not a pro tanto conflict between autonomy and nonmaleficence. We propose that if the concept of relational autonomy (understood in terms of autonomy competencies) is utilized instead, this conflict dissolves. To concretize this conceptual point, we describe how the types of informed consent practices described as untenable by the authors (in which disclosure is calibrated to the individual patient) are actually widely practiced in Japan. Elucidation of these practices requires a wider lens on informed consent practices that includes support staff such as nurses and medical social workers as well as family members. These practices, best understood as maternalistic, are ethically justifiable from a relational autonomy perspective. As we argue, there are good reasons to approach the nocebo effect from this perspective; doing so both dissolves the autonomy/best interests dilemma and grounds concrete suggestions for reducing the nocebo effect

Updating our selves : synthesizing philosophical and neurobiological perspectives on incorporating new information into our worldview

Given the ubiquity and centrality of social and relational influences to the human experience, our conception of self-governance must adequately account for these external influences. The inclusion of socio-historical, externalist (i.e., “relational”) considerations into more traditional internalist (i.e., “individualist”) accounts of autonomy has been an important feature of the debate over personal autonomy in recent years. But the relevant socio-temporal dynamics of autonomy are not only historical in nature. There are also important, and under-examined, future-oriented questions about how we retain autonomy while incorporating new values into the existing set that guides our interaction with the world. In this paper, we examine these questions from two complementary perspectives: philosophy and neuroscience. After contextualizing the philosophical debate, we show the importance to theories of autonomous agency of the capacity to appropriately adapt our values and beliefs, in light of relevant experiences and evidence, to changing circumstances. We present a plausible philosophical account of this process, which we claim is generally applicable to theories about the nature of autonomy, both internalist and externalist alike. We then evaluate this account by providing a model for how the incorporation of values might occur in the brain; one that is inspired by recent theoretical and empirical advances in our understanding of the neural processes by which our beliefs are updated by new information. Finally, we synthesize these two perspectives and discuss how the neurobiology might inform the philosophical discussion

Pre-Authorization: A Novel Decision-Making Heuristic That May Promote Autonomy

First paragraphs: While the nature of autonomy has been debated for centuries, recent scholarship has been re-examining our conception(s) of autonomy in light of findings from the behavioral, cognitive, and neural sciences (Felsen and Reiner 2011; Blumenthal-Barby 2016). Blumenthal-Barby’s target article provides us with a timely and helpful framework for thinking about this issue in a systematic way, specifically in relation to the wide range of cognitive biases and heuristics that we employ in our decision making. Building on this, we wish to expand the framework beyond the article’s focus on the threat posed by biases and heuristics by suggesting that it is possible for at least some heuristics to promote autonomy. We hope to demonstrate this point by introducing the conceptual framework for a novel heuristic that we call pre-authorization. Blumenthal-Barby argues that biases and heuristics “pose a serious threat to autonomous decision-making and human agency” and that, consequently, efforts should be made to remove, mitigate, or counter them. While recognizing the autonomy-threatening potential of these ‘fast thinking’ mechanisms, as well as agreeing with the author about the types of cases in which this potential is likely to be actualized, we suggest that it does not capture the full range of interactions that are relevant to a balanced assessment of their impact on autonomy. If, as is widely acknowledged, at least some heuristics are adaptive responses to particular real-world decision-making situations (Gigerenzer 2008), the issue at hand becomes elucidating whether, and under what conditions, the cognitive influence of any particular heuristic is autonomy-threatening, autonomy-preserving, or even autonomy-promoting. Blumenthal-Barby focuses on the first of these categories; and, with respect to the component of absence of controlling or alienating influence, she contends that if the person’s attitude towards the influence is one of feeling controlled or alienated from her decision on account of the workings of a cognitive bias or heuristic, her autonomy is diminishe

Perceptions of Undue Influence Shed Light on the Folk Conception of Autonomy

Advances in psychology and neuroscience have elucidated the social aspects of human agency, leading to a broad shift in our thinking about fundamental concepts such as autonomy and responsibility. Here, we address a critical aspect of this inquiry by investigating how people consider the socio-relational nature of their own agency,particularly the influence of others on their perceived control over their decisions and actions. Specifically, in a series of studies using contrastive vignettes, we examine public attitudes about when external influences on everyday decisions are perceived as “undue” – that is, as undermining the control conditions for these decisions to be considered autonomous – vs. when they are perceived as appropriate and even supportive of autonomous decision-making. We found that the influence of preauthorized agents – individuals and institutions with whom we share a worldview –was judged to be less undue than non-preauthorized agents, even after controlling for the familiarity of the agent. These effects persisted irrespective of the extent to which respondents identified as communitarian or individualistic, and were consistent across two distinct scenarios. We also found that external influences that were rational were perceived as less undue than those that were arational. Our study opens new avenues of inquiry into the “folk conception” of autonomy, and we discuss the implications of our findings for the ethics of public policies designed to influence decisions and for information sharing in social networks

El derecho de la reserva tributaria y la vulneración de la reserva tributaria con la aplicación de la ley de transparencia en los Juzgados Civiles de Ucayali, 2021

La presente investigación es un trabajo descriptivo – correlacional, pues la investigación tiene como objetivo evaluar la relación entre dos o más conceptos tomando como referencia la Ley de Transparencia la cual Promueve la transparencia en la acción del Estado y establece el derecho fundamental de acceso a la información pública. Para ello, el libro se divide en cinco capítulos. En primer lugar, el planteamiento del problema. En segundo lugar, el marco teórico. Tercero, Marco Metodológico. El cuarto, es el resultado. En quinto lugar, discutimos los resultados. Finalmente, presentamos nuestras conclusiones y recomendaciones. En las consecuencias de la investigación, se consideró que los derechos de las reservas fiscales y las reservas tributarias aplicaban la transparencia, y esto significa privacidad, porque le permite eliminar la verdad sobre el conocimiento, el conocimiento o el comportamiento general que se refieren a las personas, porque estos derechos protegen la información económica, de las transacciones en el sistema bancario y el financiamiento o se basan en datos fiscales y obligaciones no avanzadas de nosotros. Como se señala en este estudio, con la publicación de la Ley de Transparencia y Acceso a la Información Pública, muchos ciudadanos y contribuyentes han manifestado su preocupación por sentirse impotentes ante la seguridad de su información disponible en su vida diaria. Vida en la Agencia Tributaria, ya que es claro que los datos económicos, que son tratados principalmente por la autoridad tributaria, son de carácter personal, y por lo tanto en la recolección y almacenamiento de datos a través de esos datos habrá inevitablemente una cuestión de intimidad

Incorporación de botellas de plástico reciclado y cemento portland tipo I para estabilizar la subrasante arcillosa carretera Huamanga, Ticllas, Ayacucho 2022

La presente investigación se centra en determinar la influencia de la adición de triturado de botellas de plástico reciclado y el Cemento Portland tipo I en las propiedades del suelo de baja calidad. La población de análisis está definida por el tramo San Juan de Orccohuasi – Virgen Asunción de Chaca Puquio, con la finalidad de mejorar la calidad de la subrasante se ha empleado el tipo de investigación aplicada con un enfoque de investigación cuantitativo y un diseño de investigación cuasiexperimental. Se verifico. la influencia del TBPR en el IP reduciéndolo de un inicial de 12.52% a 4.23% con la adición del 9% de TBPR, en la MDS el 6% de TBPR con el 10% de CPT-I minimizo el inicial que fue 1.959 gr/cm3 a 1.877 gr/cm3, en cuanto al CBR el 6% de TBPR alcanzo un CBR de 7.60% al 95% y 9% al 100% siendo este el óptimo y para el 6% de TBPR con 10% de CPT-I alcanzo un máximo de CBR de 37.20% al 95% y 47.30% al 100%. Se concluye que el TBPR y la combinación de este con el CPT-I mejora la calidad de una subrasante pobre a una subrasante excelente

What Social Media Facilitates, Social Media should Regulate: Duties in the New Public Sphere

This article offers a distinctive way of grounding the regulative duties held by social media companies (SMCs). One function of the democratic state is to provide what we term the right to democratic epistemic participation within the public sphere. But social media has transformed our public sphere, such that SMCs now facilitate citizens’ right to democratic epistemic participation and do so on a scale that was previously impossible. We argue that this role of SMCs in expanding the scope of what counts as fair democratic epistemic participation, and in becoming the providers of access to the digital public sphere, brings with it duties of regulation

Harnessing the Epistemic Value of Crises for Just Ends

Public debate surrounding COVID-19 has been infused with a dimension of hope. This chapter examines the nature and value of this optimism. First, it argues that crises perform the epistemic function of transforming people’s understanding of the world in significant ways. Second, drawing on interdisciplinary literature about salience and nudging, the chapter explores how this epistemic function might be enhanced through both direct and indirect means, for the purposes of achieving a more just world. In so doing, it addresses some psychological and ethical concerns that such means raise

Impacto de la publicidad con el uso de las redes sociales de facebook y twitter, en las mypes comerciales de la ciudad de Huánuco

The micro and small enterprises in contemporary society at local, national and international level, are now a factor of growth and dynamism in the economic and social development of the region and the country, are not yet reached that leadership role to address this dynamic context, because they lack the economic , financial, technological and human resources that do not allow the strengthening and development sustained over time . One of the technological factors that lack the micro and small enterprises is the proper use of Information and Communication Technology (ICT). Besides the lack of a sense of partnership and business cooperation, not strategic alliances aimed at establishing business networks, prevents overcome barriers to reach the regional, national and international markets. Internal and external communication has become the cornerstone of any business and can not be outside of the new trends that rule the world of telecommunications. One type of communication is shaped by social networks. The appearance of these pathways changed the way to navigate the Internet. Many people and organizations use the web to  find a specific topic, but to connect with their friends via Facebook Twitter or any other similar network, this is an opportunity that companies can not be missed. Social networks have become the new advertising platform companies (other than size ) used to reach millions of consumers. “In Peru , the use of social networking is still not widespread , as in the case of micro- enterprises , 90 percent devotes its resources to sales and do not see social media a new way to announce “ said the president of the Peruvian Society of micro and small enterprises ( SPMYPES ), Jorge Panizo . In the present research work has made the following main question : What impact has on users , advertising implemented by micro and small business enterprises of the city of Huánuco , through social networks Facebook and Twitter ? which by the results obtained from users that constitute the population of 18 to 60 who have and use an email account as well as the owners and representatives , give answer to this question and the results are shown in the present work. The theoretical basis of the research was based on the fundamental concepts of social networking platforms on the Internet, as well as the components of the marketing mix of the scientific research process. What level has the characteristics of a descriptive and explanatory study , the research methods used were : descriptive , analytical and explanatory . The techniques used in the development of this work were: surveys, interviews, documentary analysis and navigation in Internet search engines , with their instruments , the latter allowed us to collect and process data. At the end of the investigation, the results obtained were: There is a high and frequent use of social networks Facebook and Twitter by the users, and activities that motivate users to continue to use social media is to keep in touch with family / friends and other entertainment. En look shows that users surveyed said the micro and small enterprises in a regular level placed publish and make promoting their products and services through social networks Facebook and Twitter. Most Facebook users speak little or mention products / services / companies through social network while 42.3% never do. Twitter users, although representing the minority , they tend to mention more often the products / services / companies through the social network. Regarding the desire / motivation felt by users to an intention to purchase or to find more information about products / services / companies, you can say it is not. To this point it could be concluded that the higher frequency of information seeking greater will be the motivation to make a purchase. On the other hand, it can be concluded that more than 50 % of respondents are very dissatisfied after trying a product / service met at a social network. But regardless of the level of dissatisfaction exists a large number of people who recommend products and services on the same social networks. Within social networks can make 4 promotional tools. Sales promotion, public relations, advertising and direct marketing. Generally you can see a very good acceptance of these tools by the users of social networks, but do not exert much influence on decision-making or user actionLas MYPE de la sociedad contemporánea a nivel local, nacional e internacional, son en la actualidad un factor de crecimiento y dinamismo en el desarrollo económico y social de la Región y del país, sin embargo no están alcanzado ese rol protagónico para afrontar este contexto dinámico, debido a que carecen de recursos económicos, financieros, tecnológicos y humanos que no permiten el fortalecimiento y desarrollo sostenido a lo largo del tiempo. Uno de los factores tecnológicos que carecen las MYPEs, es el uso adecuado de la Tecnología de Información y Comunicación (TIC). Además la falta de un sentido de asociatividad y cooperación empresarial, el no realizar alianzas estratégicas orientadas a establecer redes empresariales, impide superar las barreras para llegar al mercado regional, nacional e internacional. La comunicación interna y externa se ha convertido en el pilar fundamental de todo negocio y las no pueden estar al margen de las nuevas tendencias que gobiernan el mundo de las telecomunicaciones. Uno de estos tipos de comunicación está conformado por las redes sociales. La aparición de estas vías cambió la manera de navegar por el Internet. Muchas personas y organizaciones no utilizan la web para buscar un determinado tema, sino para conectarse con sus amigos mediante el Facebook, Twitter o cualquier otra red similar; este es una oportunidad que las empresas no pueden desaprovechar. Las redes sociales se han convertido en la nueva plataforma publicitaria que las empresas (del tamaño que sean) utilizan para poder llegar a millones de consumidores. “En el Perú, el uso de las redes sociales aún no es muy difundido, puesto que en el caso de las microempresas, el 90 por ciento destina sus recursos a las ventas y no ven en las redes sociales una nueva forma de anunciar”, afirmó el presidente de la Sociedad Peruana de Pymes (SPP), Jorge Panizo. En el presente trabajo de investigación se ha formulado la siguiente interrogante principal: ¿Qué impacto ejerce en los usuarios, la publicidad implementada por las MYPEs comerciales de la ciudad de Huánuco, a través de las redes sociales de Facebook y Twitter?, el cual mediante los resultados obtenidos desde los usuarios que constituyen la población de 18 hasta 60 años que tienen y usan una cuenta de correo electrónico, así como los propietarios y representantes, dan respuesta a dicha interrogante y se muestran en los resultados del presente trabajo. El sustento teórico del trabajo de investigación se basó en los conceptos fundamentales de las plataformas de redes sociales en la Internet, así como de los componentes de la mezcla de mercadotecnia del proceso de investigación científica. Por su nivel reúne las características de un estudio descriptivo y explicativo, los métodos de investigación que se utilizaron fueron: descriptivo, analítico y explicativo. Las técnicas que se utilizaron en el desarrollo del trabajo fueron: las encuestas, las entrevistas, el análisis documentario y la navegación en los buscadores de Internet, con sus respectivos instrumentos, éstos últimos nos permitieron recopilar y procesar los datos. Al final de la investigación, los resultados que se obtuvieron fueron: Existe un alto y frecuente uso de las redes sociales Facebook y Twitter por parte de los usuarios, y las actividades que más motivan a los usuarios a continuar utilizando las redes sociales son para mantenerse en contacto con los familiares/amistades y por entretenimiento. En otro aspecto se muestra que los usuarios encuestados señalan que las MYPEs en un nivel regular colocan publican y realizan promoción de sus productos y servicios mediante las redes sociales de Facebook y Twitter. La mayoría de los usuarios de Facebook hablan o mencionan poco los productos/servicios/ empresas a través de la red social mientras que un 42.3 % nunca lo hace. Los usuarios de Twitter, aunque representan la minoría, tienden a mencionar con mayor frecuencia los productos/servicios/empresas a través de la red social. Con relación al deseo/motivación que sienten los usuarios para una intención de compra o para buscar más información sobre productos/servicios/empresas, se puede decir que es poco. Para este punto se pudo concluir que mientras mayor sea la frecuencia de búsqueda de información mayor será la motivación a realizar una compra. Por otro lado, se puede concluir que más del 50% de los encuestados se sienten muy insatisfechos luego de probar un producto/servicio conocido en una red social. Pero independientemente de este nivel de insatisfacción existe un gran número de personas que recomiendan los productos y servicios en las mismas redes sociales. Dentro de las redes sociales se pueden realizar 4 herramientas promocionales. Promoción de ventas, relaciones públicas, publicidad y mercadeo directo. De forma general se puede apreciar una muy buena aceptación de estas herramientas por parte de los usuarios de las redes sociales, aunque no ejercen tanta influencia en la toma de decisión o acción de los usuarios