B. Tracy

Lack of guidance and regulation for authorizing medical cannabis for conditions involving the health and neurodevelopment of children is ethically problematic as it promulgates access inequities, risk-benefit inconsistencies, and inadequate consent mechanisms. In two virtual sessions using participatory action research and consensus-building methods, we obtained perspectives of stakeholders on ethics and medical cannabis for children and youth. The sessions focused on the scientific and regulatory landscape of medical cannabis, surrogate decision-making and assent, and the social and political culture of medical cannabis. We found that evidence-gathering and data dissemination, pressures on clinical relationships, and the lack of integration of culturally diverse perspectives and Indigenous knowledges were key areas of concern. Participants emphasized the importance of utilizing adaptive study designs, highlighted the importance of trust-building between clinicians, patients and caregivers, and discussed barriers including historical and ongoing stigmatization of medical cannabis. We conclude that continued public consultation and strength-based research that integrate diverse perspectives are critical steps forward.

Le droit de manifester est souvent considéré comme un élément fondamental de la démocratie, et la protestation a une longue histoire, tant dans les démocraties que dans les régimes autoritaires. Manifester permet d'exprimer une opposition, un soutien ou une solidarité. Visant à faire évoluer les mentalités, la protestation peut influencer les convictions sur un sujet, sensibiliser et informer sur une injustice ou une crise, et modifier les réactions affectives. Souvent collective, la protestation peut aussi être individuelle et prendre de multiples formes : marches et rassemblements, débrayages, piquets de grève, pétitions, sit-in et occupations, grèves de la faim, perturbations du trafic routier et maritime, et actions spectaculaires telles que les attaques contre des œuvres d'art célèbres. Bien que la protestation ait fréquemment pour but de perturber l'ordre public, mais elle peut être efficace sans pour autant être agitatrice ou violente. Dans cet article, j'examine dans quelle mesure la protestation peut être considérée comme une forme d'argumentation et comme une composante légitime du débat public. Mon point de départ est la notion d'« événement visuel » et de pratique argumentative, développée par John Delicath et Kevin DeLuca (2002). Je considère les manifestations comme des exemples d'arguments multimodaux, en m'appuyant sur des exemples de manifestations actuelles pour montrer comment celles-ci se prêtent à des analyses multimodales.

This theoretical paper presents a mathematical framework for philosophical and psychological housecleaning as an essential component of lifespan development. The framework emerged from an intellectual exercise called "Connect Four"—a methodology I have refined over three decades of application—linking any concept to psychology, philosophy, and consilience. When applied to the mundane concept of "housecleaning" suggested by co-author Tracy L. Boether, unexpected theoretical richness emerged. Drawing support from existing empirical literature on cognitive accumulation (Murre & Dros, 2015), rumination (Nolen-Hoeksema et al., 2008), and treatment resistance (Taylor et al., 2012), we develop a theoretical model for understanding cognitive-emotional maintenance processes. We define the cognitive space Ψ as a theoretical quadruple (B, E, M, τ) representing beliefs, emotions, memories, and temporal ordering. Based on empirical findings that information intake exceeds forgetting rates, we propose that cognitive accumulation follows A(t) = A₀ + ∫₀ᵗ [I(s) - D(s)]ds. We theoretically distinguish between toxic elements T ⊂ Ψ requiring elimination (metaphorically "mold") and dormant valuable elements V ⊂ Ψ requiring revitalization (metaphorically "dust"). The theoretical housecleaning operator H: Ψ → Ψ' is formalized as Ψ' = (Ψ \ T) ∪ R(V), representing elimination and revitalization processes. Drawing from treatment resistance literature, we hypothesize that maintenance difficulty increases exponentially: D(t) = D₀e^(λt), suggesting optimal quarterly maintenance intervals. The mathematical framework demonstrates internal consistency and formal rigor, providing precision in theoretical statements, constraints on theoretical proliferation, and generation of non-obvious predictions. We acknowledge seven major challenges to the framework—from metaphorical oversimplification to cultural bias—and propose specific research pathways to address each. The paper presents both real-life applications of the Connect Four methodology across three decades and a defense of mathematical formalization in theoretical psychology. While entirely theoretical and speculative, this framework demonstrates how consilience can transform everyday concepts into formal theoretical structures, providing a mathematical language for understanding cognitive maintenance that may guide future empirical research.

In this essay, I address the challenges to good argumentation and reasoning posed by the post-truth order, and argue that there is an acute need for argumentation theory to re-present ways in which emotion and reason work together to form, scrutinise and revise deeply held beliefs. I begin by considering deeply held beliefs, discussing the types of beliefs that tend to be deeply held and the ways in which they are acquired. Focussing on deeply held beliefs that are relevant to our sociopolitical imaginaries, beliefs that are prone to prejudice, bias and stereotyping associated with gender, race, sexuality, disability, class and other markers of difference and marginalisation, I consider the ways deeply held beliefs play a framework role in reinforcing our ways of being within the world. With inspiration from Moira Gatens’ and Genevieve Lloyd’s Spinozistic take on the role of the imagination in changing our ways of being, as well as from Iris Marion Young’s work on asymmetrical reciprocity, in what follows I will discuss approaches to critical thinking that involve showing rather than stating alternatives to deeply held beliefs. In particular, I will focus on those involving narratives that provide alternative pictures and make epistemic use of lived experiences to shift and transform our imaginations by offering insights into the lives of others. I argue that such approaches offer more effective means of opening deeply held beliefs up to critical scrutiny and possible revision than approaches that seek simply to state the truth of contrary beliefs.

Flourishing is an increasingly common construct employed in the study of human wellbeing. But its appropriateness as a framework of wellbeing at certain stages of life is contested. In this paper, we consider to what extent it is possible for someone to flourish at the end of life. People with terminal illness often experience significant and protracted pain and suffering especially when they opt for treatments that prolong life. Certain aspects of human goods, however, that are plausibly constitutive of flourishing—such as meaning and purpose, deep personal relationships, and character and virtue—can be uniquely realised when life is ending. We argue that there is a qualified sense in which one can flourish at the end of life but that one must make important modifications to the criteria implicit in conventional conceptions of flourishing. We close with a discussion of the empirical assessment of wellbeing at the end of life and explore the possibility of introducing a flourishing measure in palliative care practice.

Critical thinking: a concise guide is a much-needed guide to argument analysis and a clear introduction to thinking clearly and rationally for oneself. Through precise and accessible discussion this book equips students with the essential skills required to tell a good argument from a bad one. This third edition has been revised and updated throughout, with new exercises, and up-to-date topical examples, including: "real-world" arguments; practical reasoning; understanding quantitative data, statistics, and the rhetoric used about them; scientific reasoning; and expanded discussion of conditionals, ambiguity, vagueness, slippery slope arguments, and arguments by analogy.

In this case report, we describe a woman with advancing dementia who still retained decisional capacity and was able to clearly articulate her request for deactivation of her implanted cardiac pacemaker—a scenario that would result in her death. In this case, the patient had the autonomy to make her decision, but clinicians at an outside hospital refused to deactivate her pacemaker even though they were in unanimous agreement that the patient had capacity to make this decision, citing personal discomfort and a belief that her decision seemed out of proportion to her suffering. We evaluated her at our hospital, found her to have decision-making capacity, and deactivated her pacer resulting in her death about 9 days later. While some clinicians may be comfortable discussing patient preferences for device deactivation in patients who are imminently dying, we can find no reports in the literature of requests for device deactivation from patients with terminal diagnoses who are not imminently dying.

The idea of patient advocacy as a function of clinical ethics consultation (CEC) has been debated in the bioethics literature. In particular, opinion is divided as to whether patient advocacy inherently is in conflict with the other duties of the ethics consultant, especially that of impartial mediator. The debate is complicated, however, because patient advocacy is not uniformly conceptualized. This article examines two literatures that are crucial to understanding patient advocacy in the context of bioethical deliberations: the CEC literature and the literature on advocacy in the social work profession. A review of this literature identifies four distinct approaches to patient advocacy that are relevant to CEC: (1) the best interest approach, (2) the patient rights approach, (3) the representational approach, and (4) the empowerment approach. After providing a clearer understanding of the varied meanings of patient advocacy in the context of CEC, we assert that patient advocacy is not inherently inconsistent with the function of the ethics consultant and the CEC process. Finally, we provide a framework to help consultants determine if they should adopt an advocacy role.

The rhetorical function of whataboutism is to redirect attention from the specific case at hand. Although commonly used as a rhetorical move, whataboutisms can appear in arguments. These tend to be weak arguments and are often instances of the tu quoque fallacy or other fallacies of relevance. In what follows, I show that arguments involving a whataboutist move can take a wide variety of forms, and in some cases, they can occur in good arguments. I end by considering how whataboutist arguing in social justice contexts can be harmful to arguers and to the audiences for their arguments.

Part of the job of the philosophy teacher, and in particular the critical thinking teacher, is to encourage students to critically examine their own beliefs. There are some beliefs that are difficult to think critically about, even for those who have critical thinking skills and are committed to applying them to their own beliefs. These resistant beliefs are not all of a kind, and so a range of different strategies may be needed to get students to think critically about them. In this paper we suggest some such strategies.

An important consideration in reproductive bioethics is the question of personhood, which impacts family and medical decision-making as well as policy and law. Anthropology is uniquely suited to provide both a cross-cultural and historical and prehistorical perspective on the status of fetuses. Far from being taken for granted as a natural or biological condition, personhood is a status and identity actively negotiated, ascribed, and contested through social and cultural processes that are the particular concern of cultural anthropologists and bioarchaeologists. This chapter draws on both ethnographic and bioarchaeological research to demonstrate how and whether personhood was/is ascribed to fetuses in specific prehistoric, historic, and modern examples. While cultural anthropology has contributed to the discussion of personhood, identity, and bioethics for some time, bioarchaeology has only recently begun to investigate identity in the past. However, its development of a focus on fetal personhood is an important contribution to both bioarchaeology and to bioethics. This chapter demonstrates the possibilities for the meaningful integration of bioarchaeology and cultural anthropology into an evolving conversation on reproductive bioethics.

In this paper, I consider whether there are limits to virtuous argumentation in certain situations. I consider three types of cases: 1) arguing against denier discourses, 2) arguing with people who make bigoted claims, and 3) cases in which marginalised people are expected to exercise virtues of argument from a position of limited agency. For each type of case, I look at where limits to arguing responsibly might be drawn. I argue that there are situations in which we might withdraw from engagement for practical reasons and others in which withdrawing or refraining from engagement is a responsible way to deal with a particular position. Finally, I argue that in the third type of case, expecting the marginalised to argue as though on even terms with the positions of the dominant risks perpetrating argumentative harm.

ABSTRACT:Clinical ethics consultants bear witness to the direct harms of intersecting axes of oppression—such as racism and classism—as they impinge on elucidating and resolving ethical dilemmas in health care. Health Care Ethics Consultation (HCEC) professional guidance supports recognizing and analyzing power dynamics and social-structural obstacles to good care. However, the most relied upon bioethical principles in clinical ethics have been criticized for insufficiency in this regard. While individual ethics consultants have found ways to expand their approaches, they do so in an ad hoc way without frameworks to guide consistency. Motivated by the practical expertise of clinical ethicists, this essay offers a new framework to support openness to analyzing power imbalances and respecting marginalized voices and values. This framework is grounded in transformative justice, where the aim is to take responsibility for oppression by centering and responding to moral perspectives and value systems that are all too often silenced.

The global coronavirus disease 2019 (COVID-19) pandemic has caused significant uncertainty for students and teachers. During this time, teacher and student creative beliefs and affect play a supportive role in adaptively managing stress, finding joy, and bouncing back from inevitable setbacks with resilience. Developing an adaptive orientation to creativity is a critically important step in helping teachers deal with the challenges and stress of reaching their students through distance learning, especially the most marginalized. This study aims to understand how teacher creativity linked to well-being in the face of COVID-19-related school shutdowns and how teachers planned to adapt creatively to distance learning through the guidance of a summer creative teaching training institute. Results from this sequential mixed method study demonstrated important relationships. Creative self-efficacy in teaching related to teacher buoyancy in the face of setbacks. Creative growth mindset related to teachers’ general positive affect in teaching. Lowered creative anxiety related to reduced effects of secondary traumatic stress and general negative affect in teaching. Environmental support and encouragement for creativity in schools may be foundational for teacher well-being by enhancing teachers’ dispositional joy, general positive affect, and reducing general negative affect. Results suggested additional stress and loss of creativity for most teachers due to the COVID-19 pandemic alongside substantial capacity for creative adaptations with the support of training for creativity in teaching and learning.

Our research addresses the issue of teaching and learning concepts in science education as an empirical question. We study the process of conceptualization by closely examining the unfolding of classroom lesson sequences. We situate our work within the practice turn line of research on epistemic practices in science education. We also adopt a practice turn approach when it comes to the learning of concepts, as we consider conceptualization as being inherent within epistemic practices. In our work, pedagogical practices are modeled as learning games and epistemic practices in science education are characterized as enacted epistemic games emerging through the unfolding of learning games. Science practices are modeled as source epistemic games since they are the source of the knowledge at stake in pedagogical practices. From this point, we examine closely how playing learning games can enable students to play enacted epistemic games and then in turn the source epistemic games at the core of conceptual understanding. Thus, the main contribution of this paper is to link pedagogical practices to epistemic practices in science education and to science practices in general. Our method is consistent with this epistemological framework as our case study on the concept of earthquakes in a 5th grade classroom sequence illustrates. Following an investigation of two experienced teachers and their classes during a teaching unit, our analysis shows how teaching effectiveness is determined by a dialectic. This entails on the one hand a didactic continuity between learning games and enacted epistemic games and, on the other, an epistemic continuity between enacted epistemic games and source epistemic games.

My starting point for this paper is a problem in critical thinking pedagogy—the difficult of bringing students to a point where they are able, and motivated, critically to evaluate their own deeply held beliefs. I first interrogate the very idea of a deeply held belief, drawing upon Wittgenstein’s idea of a framework belief—a belief that forms part of a ‘scaffolding’ for our thoughts—or of a belief that functions as a hinge around which other beliefs pivot. I then examine the role of deeply held beliefs, thus conceived, in our ways of being in the world, exploring the extent to which engagement with others whose deeply held beliefs differ from ours may be possible through imaginative ‘travel’. Finally, I reflect upon the extent to which these imaginative moments also offer up opportunities for critical reflection upon our own deeply held beliefs and, thus, the possibility of changing or adapting those beliefs.