At The Heart of a Decision is a Narrative

After a brief review of some of the issues facing ethicists becoming involved in actual clinical situations, as I experienced these at the beginning of my career, I present a detailed narrative focused on a encounter I had with parents of a badly damaged neonate, a situation for which I was asked to provide a consultation focused on unstated ethical issues. The narrative continues through these issues and concludes with what parents described as an acceptable resolution. The essay concludes with a brief indication of what are taken as the basic issues in the situation.Após revisitar brevemente algumas das questões com as quais são confrontados os eticistas implicados em casos clínicos concretos, tal como os que experienciei no início da minha carreira, apresento uma narrativa detalhada, centrada no encontro que tive com os pais de um neonato com imaturidade das funções fisiológicas, situação a propósito da qual me foi pedida uma consulta em torno de questões éticas não declaradas. A narrativa prossegue através destas questões e termina com aquilo que os pais descrevem ser uma resolução aceitável. O artigo conclui com uma indicação sumária das questões consideradas basilares no caso.info:eu-repo/semantics/publishedVersio

Two-point microrheology and the electrostatic analogy

The recent experiments of Crocker et al. suggest that microrheological measurements obtained from the correlated fluctuations of widely-separatedprobe particles determine the rheological properties of soft, complex materials more accurately than do the more traditional particle autocorrelations. This presents an interesting problem in viscoelastic dynamics. We develop an important, simplifing analogy between the present viscoelastic problem and classical electrostatics. Using this analogy and direct calculation we analyze both the one and two particle correlations in a viscoelastic medium in order to explain this observation

Force-Extension Relation and Plateau Modulus for Wormlike Chains

We derive the linear force-extension relation for a wormlike chain of arbitrary stiffness including entropy elasticity, bending and thermodynamic buckling. From this we infer the plateau modulus $G^0$ of an isotropic entangled solution of wormlike chains. The entanglement length $L_e$ is expressed in terms of the characteristic network parameters for three different scaling regimes in the entangled phase. The entanglement transition and the concentration dependence of $G^0$ are analyzed. Finally we compare our findings with experimental data.Comment: 5 pages, 1 eps-figure, to appear in PR

Dynamics of viscoelastic membranes

We determine both the in-plane and out-of-plane dynamics of viscoelastic membranes separating two viscous fluids in order to understand microrheological studies of such membranes. We demonstrate the general viscoelastic signatures in the dynamics of shear, bending, and compression modes. We also find a screening of the otherwise two-dimensional character of the response to point forces due to the presence of solvent. Finally, we show that there is a linear, hydrodynamic coupling between the in-plane compression modes of the membrane and the out-of-plane bending modes in the case where the membrane separates two different fluids or environments

The response function of a sphere in a viscoelastic two-fluid medium

In order to address basic questions of importance to microrheology, we study the dynamics of a rigid sphere embedded in a model viscoelastic medium consisting of an elastic network permeated by a viscous fluid. We calculate the complete response of a single bead in this medium to an external force and compare the result to the commonly-accepted, generalized Stokes-Einstein relation (GSER). We find that our response function is well approximated by the GSER only within a particular frequency range determined by the material parameters of both the bead and the network. We then discuss the relevance of this result to recent experiments. Finally we discuss the approximations made in our solution of the response function by comparing our results to the exact solution for the response function of a bead in a viscous (Newtonian) fluid.Comment: 12 pages, 2 figure

Issues and challenges in the application of Husserlian phenomenology to the Lived Experience of Hate Crime and Its Legal Aftermath

The field of hate crime research addresses the presence, sources and impact of particular types of expressions of prejudice, often perceived as particularly damaging and hurtful forms of interpersonal abuse and violence. Little, if any, credible academic research seeks to vindicate the specific racist, gendered and other vicious prejudices articulated by many perpetrators of hate crime. In turn, this raises the reflexive question of the possibilities of researchers themselves ever being able to adopt a truly "unprejudiced" approach to the presence of such damaging prejudices. Can this goal be realised without a researcher necessarily losing an experientially-grounded understanding of what these meanings, values and purposes have come to mean, and how they are themselves interpretatively re-constituted anew, including within the lived experience of victims, witnesses, police, prosecutors, judges and victim support workers? A possible philosophically-informed approach to the dilemmas posed by this topic is offered by Husserl's phenomenology. Husserl's perpetually unfinished philosophical methodology strives, with concerted if sometimes tragic reflective rigor, to "suspend," "bracket out" and "neutralise" those core presuppositions constitutive of the research field that typically pre-judge precisely whatever demands to be questioned and explored in a radically non-prejudicial manner. This study critically explores the possibilities, reflective stages and theoretical limitations of a sympathetically reconstructed Husserlian approach to hate crime, itself understood as a would-be qualitative "science of consciousness." It argues that despite its manifest tensions, gaps, ambiguities and internal contradictions, aspects of the Husserlian philosophical approach directed towards the different levels of experienced hate crime still retain the potential to both challenge and advance our understanding of this topic. It is the "instructive" part of "instructive failure" that this article highlights

A critical perspective on second-order empathy in understanding psychopathology: phenomenology and ethics

The centenary of Karl Jaspers’ General Psychopathology was recognised in 2013 with the publication of a volume of essays dedicated to his work (edited by Stanghellini and Fuchs). Leading phenomenological-psychopathologists and philosophers of psychiatry examined Jaspers notion of empathic understanding and his declaration that certain schizophrenic phenomena are ‘un-understandable’. The consensus reached by the authors was that Jaspers operated with a narrow conception of phenomenology and empathy and that schizophrenic phenomena can be understood through what they variously called second-order and radical empathy. This article offers a critical examination of the second-order empathic stance along phenomenological and ethical lines. It asks: (1) Is second-order empathy (phenomenologically) possible? (2) Is the second-order empathic stance an ethically acceptable attitude towards persons diagnosed with schizophrenia? I argue that second-order empathy is an incoherent method that cannot be realised. Further, the attitude promoted by this method is ethically problematic insofar as the emphasis placed on radical otherness disinvests persons diagnosed with schizophrenia from a fair chance to participate in the public construction of their identity and, hence, to redress traditional symbolic injustices

Anatomy of life and well-being: A framework for the contributions of phenomenology and complexity theory

This paper proposes an anatomy of the phenomena of life and of correlate qualitative modes of empirical research, theory, and professional practice concerned with health and well-being. I explicate the qualitative dynamic operative at every level of order, from the biological realm of cells and organisms, through distinctively human lifeworld experiences and practices, to communities of organisms in ecosystems and bio-cultural regions. This paper clarifies the unity of the dimensions of life and aligns these with demonstrated and emerging contributions of hermeneutical phenomenology and current complexity–autopoietic theory (including disciplinary and professional interpretations of empirical findings). The intent is begin to delineate a common framework upon which we could build—facilitating better understanding of the distinctive contributions of each specialization as well as the integration of diverse qualitative approaches with each other (and with quantitative complements)

Cultural diversity teaching and issues of uncertainty: the findings of a qualitative study

BACKGROUND: There is considerable ambiguity in the subjective dimensions that comprise much of the relational dynamic of the clinical encounter. Comfort with this ambiguity, and recognition of the potential uncertainty of particular domains of medicine (e.g.--cultural factors of illness expression, value bias in diagnoses, etc) is an important facet of medical education. This paper begins by defining ambiguity and uncertainty as relevant to clinical practice. Studies have shown differing patterns of students' tolerance for ambiguity and uncertainty that appear to reflect extant attitudinal predispositions toward technology, objectivity, culture, value- and theory-ladeness, and the need for self-examination. This paper reports on those findings specifically related to the theme of uncertainty as relevant to teaching about cultural diversity. Its focus is to identify how and where the theme of certainty arose in the teaching and learning of cultural diversity, what were the attitudes toward this theme and topic, and how these attitudes and responses reflect and inform this area of medical pedagogy. METHODS: A semi-structured interview was undertaken with 61 stakeholders (including policymakers, diversity teachers, students and users). The data were analysed and themes identified. RESULTS: There were diverse views about what the term cultural diversity means and what should constitute the cultural diversity curriculum. There was a need to provide certainty in teaching cultural diversity with diversity teachers feeling under considerable pressure to provide information. Students discomfort with uncertainty was felt to drive cultural diversity teaching towards factual emphasis rather than reflection or taking a patient centred approach. CONCLUSION: Students and faculty may feel that cultural diversity teaching is more about how to avoid professional, medico-legal pitfalls, rather than improving the patient experience or the patient-physician relationship. There may be pressure to imbue cultural diversity issues with levels of objectivity and certainty representative of other aspects of the medical curriculum (e.g.--biochemistry). This may reflect a particular selection bias for students with a technocentric orientation. Inadvertently, medical education may enhance this bias through training effects, and accommodate disregard for subjectivity, over-reliance upon technology and thereby foster incorrect assumptions of objective certainty. We opine that it is important to teach students that technology cannot guarantee certainty, and that dealing with subjectivity, diversity, ambiguity and uncertainty is inseparable from the personal dimension of medicine as moral enterprise. Uncertainty is inherent in cultural diversity so this part of the curriculum provides an opportunity to address the issue as it relates to patient care