Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
15
result(s) for
"Gligorov, Nada"
Sort by:
Scientific claims are constitutive of common sense about health
Endorsing the view that commonsense conceptions are shaped by scientific claims provides an explanation for why microbiota-gut-brain (MGB) research might become incorporated into commonsense notions of health. But scientific claims also shape notions of personal identity, which accounts for why they can become entrenched in common sense even after they have been refuted by science.
Journal Article
White Ignorance in Pain Research: Racial Differences and Racial Disparities
Racial disparities in pain treatment are well documented. Such disparities are explained with reference to factors related to providers, health care structures, and patient behaviors. Racial differences in pain experiences, although well documented, are less well understood. Explanations for such differences usually involve genetic or psychological factors. Here, we argue that racial differences in pain experiences might also be explained by disparities in pain treatment. Based on what we know about the nature of pain, particularly the cognitive and affective aspects of the phenomenon, it is likely that disparities in the treatment of racialized patients can lead to significant racial differences in pain experience that show up at the population level. We argue that the failure of research programs to consider this causal factor is an example of white ignorance. We also consider several implications of the link between racial disparities in pain treatment and racial differences in pain experience.
Journal Article
Complexity, Not Severity: Reinterpreting the Sliding Scale of Capacity
In this article, we focus on the definition and application of the sliding scale of capacity. We show that the current interpretations of the sliding scale confound distinct features of the medical decision, such as its urgency, its severity, or its complexity, that do not always covary. We propose that the threshold for assessing capacity should be adjusted based solely on the cognitive complexity of the decision at hand. We further suggest that the complexity of a decision should be identified based on a patient’s particular cognitive deficits. We utilize the current research on the types of deficits that characterize amnestic dementias and examine which types of medical decisions might be most complex for patients with that type of dementia. We conclude that applying the sliding scale based on individualized judgments of cognitive complexity will improve accuracy of assessment of capacity and enable capable patients to participate in medical decision making.
Journal Article
Don’t Worry, This Will Only Hurt a Bit
To cause pain, it is not enough to deliver a dose of noxious stimulation. Pain requires the interaction of sensory processing, emotion, and cognition. In this paper, I focus on the role of cognition in the felt intensity of pain. I provide evidence for the cognitive modulation of pain. In particular, I show that attention and expectation can influence the experience of pain intensity. I also consider the mechanisms that underlie the cognitive effects on pain. I show that all the proposed mechanisms of pain modulation affirm the view that cognition impacts the sensory and discriminative aspects of pain. I conclude that pain perception is a cognitively penetrated phenomenon.
Journal Article
A Defense of Brain Death
In 1959 two French neurologists, Pierre Mollaret and Maurice Goullon, coined the term
coma dépassé
to designate a state beyond coma. In this state, patients are not only permanently unconscious; they lack the endogenous drive to breathe, as well as brainstem reflexes, indicating that most of their brain has ceased to function. Although legally recognized in many countries as a criterion for death, brain death has not been universally accepted by bioethicists, by the medical community, or by the public. I this paper, I defend brain death as a biological concept. I challenge two assumptions in the brain death literature that have shaped the debate and have stood in the way of an argument for brain death as biological. First, I challenge the dualism established in the debate between the body and the brain. Second, I contest the emphasis on consciousness, which prevents the inclusion of psychological phenomena into a biological criterion of death. I propose that the term organism should apply both to the functioning of the body and the brain. I argue that the cessation of the organism as a whole should take into account three elements of integrated function. Those three elements are: 1) the loss of integrated bodily function; 2) the loss of psychophysical integration required for processing of external stimuli and those required for behavior; and, 3) the loss of integrated psychological function, such as memory, learning, attention, and so forth. The loss of those three elements of integrated function is death.
Journal Article
Reconsidering the Impact of Affective Forecasting
The disparities between what we know and how we reason are part of what restricts the benefits of affective forecasting research. In medical ethics, the impact of the bias is not as extensive as claimed by Rhodes and Strain. The information about the bias cannot be used to draw conclusions about policy because it does not help identify any new values and goods to be promoted. Furthermore, the impact bias influences doctors and patients in different ways, which prevents the far-reaching consequences cited by the authors. More generally, the biases do not affect people deciding for others as they do people making decisions for themselves. Finally, the biases do not affect capacity in a way that would justify paternalism because their ubiquity and permanence seem to indicate that they are part of the baseline for human reasoning.
Journal Article
The Impact of Personal Identity on Advance Directives
The problem of personal identity within philosophy centers on establishing a metaphysical criterion of identity for persons across time. The issue is not immediately apparent, because the problem does not exist from a rst-person perspective. It is not the case that anybody actually has a personal problem of establishing identity across time. A person could wonder, perhaps looking at her own childhood photograph, whether she is the same person she was in her youth, but she would be raising the metaphysical question of numerical identity as it applies to her. The metaphysical question of personal identity does not arise from an introspectively perceived numerical discontinuity between various person stages; instead it is a problem of explanation.
Journal Article
Bridging the Gap between Knowledge and Skill: Integrating Standardized Patients into Bioethics Education
Upon entering the examination room, Caitlyn encounters a woman sitting alone and in distress. Caitlyn introduces herself as the hospital ethicist and tells the woman, Mrs. Dennis, that her aim is to help her reach a decision about whether to perform an autopsy on her recently deceased husband. Mrs. Dennis begins the encounter by telling the ethicist that she has to decide quickly, but that she is very torn about what to do. Mrs. Dennis adds, “My sons disagree about the autopsy.” As a standardized patient (SP), a specialized actor, the woman playing Mrs. Dennis has already delivered the same opening lines several times to different learners practicing their clinical ethics consultation skills. An SP encounter is a simulated patient encounter used for educational purposes that requires the standardization of verbal and behavioral responses. In the encounter, the simulator, or “patient,” uses a scripted medical history to enable the learner to employ a certain skill, say, the ability to perform a neurological exam. The use of standardized patients in the evaluation of clinical skills has become a staple in medical education. To tackle the challenge of teaching clinical ethics consultation skills, we have incorporated SP encounters into the curriculum of the Bioethics Program of The Union Graduate College and the Icahn School of Medicine at Mount Sinai. SP encounters are incorporated into one of our onsite classes, the Onsite Clinical Ethics Practicum, and they are part of the capstone examination, which all of our graduates must complete successfully. The inclusion of simulated encounters into the curriculum is one way in which we equip our students with the core competencies specified by the American Society for Bioethics and Humanities Task Force for clinical ethicists.
Journal Article