Why Bioethics Should Be Concerned With Medically Unexplained Symptoms

Biomedical diagnostic science is a great deal less successful than we've been willing to acknowledge in bioethics, and this fact has far-reaching ethical implications. In this article I consider the surprising prevalence of medically unexplained symptoms, and the term's ambiguous meaning. Then I frame central questions that remain answered in this context with respect to informed consent, autonomy, and truth-telling. Finally, I show that while considerable attention in this area is given to making sure not to provide biological care to patients without a need, comparatively little is given to the competing, ethically central task of making sure never to obstruct access to biological care for those with diagnostically confusing biological conditions. I suggest this problem arises from confusion about the philosophical value of vagueness when it comes to the line between biological and psychosocial needs.     

The ethics of return migration and education: transnational duties in migratory processes

ABSTRACT

This paper argues that most prominent normative theories on immigration neglect a critical dimension of the migratory phenomenon, a neglect that blinds them to important rights that, under some circumstances, immigrants ought to have as a matter of justice. Specifically, the paper argues that these theories fail to appreciate that the children of immigrant families, regardless of whether they were born in their parents’ country or in the host country, should benefit from educational rights addressing needs that are particular to their situation. These children may be forced to move between these two countries. This situation generates an obligation for both states (‘receiving’ and ‘sending’) to act jointly to provide educational opportunities so that these children are fully conversant with both cultures and in both languages. Put succinctly, then, we argue that since children of immigrant families lack any certainty of permanent residence in the host society owing to the threat of deportation and the precarity of their legal status, host and home societies bear the duty to offer an education that allows them to be functional in both societies.     

South Asian American Daughter–Father Relationships in the Aftermath of Maternal Loss

ABSTRACT

In this transcendental phenomenological study, we interviewed five South Asian American daughter–father dyads regarding their experiences of coping and resiliency in the aftermath of maternal/spousal loss. Mothers play a crucial role in immigrant families as they serve not only as caregivers, but also as the main people who facilitate the transmission of culture. An untimely death of mothers in immigrant families can lead to confusion of roles within the family subsystems. Three main themes emerged for daughters from the interviews: (a) re-grieving, (b) coping/resiliency, and (c) daughter’s relationship with father following maternal loss. Three themes also emerged from the interviews with the fathers: (a) lack of traditional sources of familial support, (b) coping/resiliency, and (c) relationship with daughter following spousal loss. We utilized dyadic analysis to examine the dynamics of the daughter–father relationship. Overall, in the aftermath of maternal loss, the families experienced significant reorganization in its structure and reassignment of roles. For many of the daughters, cultural norms of patriarchy and traditional gender roles explained their pattern of assuming more responsibility in the household after the death of their mothers. Findings also showed how the intersection of gender, culture, and immigration status contributed to the process of complicated grief following maternal loss and the struggles experienced with reorganization of familial roles, rules, and expectations for South Asian American daughters and their fathers. Results from this study have implications for future research and clinical practice.     

When all COVID breaks loose: Examining determinants of working parents' job performance during a crisis

As governments mandated organization and school closures due to COVID-19, working parents involuntarily found themselves trying to balance both work and child educational responsibilities from home while still endeavoring to remain productive at work. As such, we integrate the crisis management literature with boundary theory and the work–home resources model to propose and test a process model to better understand how abrupt shifts to remote work and school closures impact working parents' job performance during a crisis. Using data collected across four time periods beginning at the time when most states had issued “safer at home” orders, we examine a serial mediation model and find, consistent with predictions, that early experiences of boundary violations and job insecurity impact work–family balance self-efficacy, which in turn drives future job performance by way of its effects on working parents' subjective well-being. Implications for theory and practice are discussed.     

The Peace Work and Witness of the Churches in the German Democratic Republic and the World Disorder of the 21st Century

This article is an edited translation of an address given in Erfurt, Germany, on 12 May 2019, to celebrate the 90th birthday of Heino Falcke, dean (provost) of Erfurt from 1973 until his retirement in 1994. Falcke, who was also a member of the working group on Church and Society of the World Council of Churches, played a central role in developing the theological and ethical response of Protestant churches in the German Democratic Republic (GDR) to the threats to peace in a nuclear age. This was expressed in the “renunciation of the spirt, logic, and practice of deterrence.” This article seeks to set out the insights from the peace work and witness of the churches in the GDR against the background of the “world disorder of the 21st century.”     

Leaning In and Out: Work–Life Tradeoffs,Self-Conscious Emotions,and Life Role Satisfaction

Drawing on self-discrepancy theory, which posits discomfort when actual selves deviate from ideal or ought selves (Higgins, 1987), we examine the complementary and compounding effects of work–life tradeoffs on self-conscious emotions, life role satisfaction, and spouse/partner work satisfaction. Across multiple samples, we augment and refine extant tradeoff measures to include minor tradeoffs (e.g., limiting networking, missing a family event) in addition to the more frequently researched major tradeoffs (e.g., quitting a job, choosing not to have children) and test their effects. Work compromising tradeoffs (i.e., sacrificing work for family/personal activities) were associated with negative self-conscious emotions and lower levels of job, career, and life satisfaction indirectly through professional self-discrepancy, suggesting that making work compromises for family affects how individuals see themselves as professionals. Family/personal compromising tradeoffs (i.e., sacrificing family/personal activities for work) were associated with negative self-conscious emotions and lower levels of job, career, family, and life satisfaction indirectly through family and professional self-discrepancy, suggesting individuals view their family and professional selves less favorably when they make family/personal compromises for work. Despite negative effects for the employees, our results suggest work tradeoffs are beneficial for spouse/partner work hours and satisfaction.     

Sustainable system-of-systems and francophone activity-centered approaches in ergonomics: Converging and diverging lines of dialogue

This paper initiates a dialogue between the sustainable system-of-systems (SSoS) approach and one particular situated approach of activity analysis within francophone activity-centered ergonomics (FACE). This paper explores the possible cross-fertilizations between FACE and SSoS in coping with the challenge of enlargement which ergonomists have to face in order to address sustainability issues. We present how the SSoS model and FACE have currently considered the challenges of sustainable development and the theoretical-methodological principles that frame their approaches. Then, eight topics of dialogue are introduced and debated in order to open the dialogue between the two approaches where emerging lines of convergence are generated. We conclude by further discussing the complementarity between FACE and SSoS in the objectives of their approaches and the levels analysed by each approach, and by highlighting the importance of taking into account the emergent and complex aspects of systems. One possible way forward might be to “situate the sustainable system-of-systems” while also “systemizing systems of sustainable situations” for the future.     

Absence of differences in the learning rate of a speed–accuracy movement task between women patients with mild and major depression and healthy adult women

This study tested the hypothesis that women patients with depression should perform movements more slowly and with greater variability, and their learning rate should be lower compared with age-matched healthy adult women. Three groups of adult women subjects (aged 33–37 years, women patients with mild and major depression and healthy adult women, n = 20 in each group) performed five series (20 repetitions in each series) of a speed–accuracy hand-movement task (SAT). The mean movement speed (V_a) of the SAT was lower and more stable (the coefficient of variation of V_a was lower) in women patients with major depression compared with those with minor depression and healthy adult women during the first series of the SAT. Only the V_a and movement accuracy (path of movement, S) of the SAT varied significantly in the five learning series regardless of the subject group (healthy women subjects and women patients with minor and major depression). The intraindividual variability of reaction time, V_a, maximal movement velocity to the target (tV_max), time to tV_max, and S did not change significantly in any of the groups. Our research data showed that although women patients with depression performed speed–accuracy movements more slowly, the stability of the performance of their movements and their learning rate did not differ from those of age-matched healthy adult women.     

An artificial opposition between grammaticality and frequency: comment on

In a recent Cognition paper (Cognition 85 (2002) B21), Bornkessel, Schlesewsky, and Friederici report ERP data that they claim “show that online processing difficulties induced by word order variations in German cannot be attributed to the relative infrequency of the constructions in question, but rather appear to reflect the application of grammatical principles during parsing” (p. B21). In this commentary we demonstrate that the posited contrast between grammatical principles and construction (in)frequency as sources of parsing problems is artificial because it is based on factually incorrect assumptions about the grammar of German and on inaccurate corpus frequency data concerning the German constructions involved.