Caregiving robots are often lauded for their potential to assist with geriatric care. While seniors can be wise and mature, possessing valuable life experience, they can also present a variety of ethical challenges, from prevalence of racism and sexism, to troubled relationships, histories of abusive behavior, and aggression, mood swings and impulsive behavior associated with cognitive decline. I draw on Confucian ethics, especially the concept of filial piety, to address these issues. Confucian scholars have developed a rich set of (...) theoretical resources for dealing with beloved but imperfect elders, and navigating the challenges of supporting seniors whose ethical commitments are unreliable. These resources provide a way to reconcile two important but conflicting desiderata: to value and care for seniors, but also to clear-mindedly deal with their moral shortcomings. In particular, they articulate a duty to remonstrate with our elders when they err. Confucian filial piety can helpfully inform robot design and use in geriatric care. They can be used to strengthen and protect emotional connections in important relationships, but should not be used to reinforce patient preferences when doing so damages relationships or their ability to act morally. Rather than conceive of patient wellbeing as in tension with moral behavior, and care as a burden for caregivers, not a source of value and meaning, Confucian accounts of filial piety help identify both new areas of concern and new potential in the development of caregiving technologies, ones which see these goods as complementary. (shrink)

Proprioception, a sense of bodily position and movement, is rarely the focus of conscious experience. If we are ordinarily conscious of proprioception, we seem only peripherally so. Thus, evidence that proprioception is present in the periphery of at least some conscious experiences seems to be good evidence that conscious experience is fairly rich. Anosognosia for paralysis is a denial of paralysis of one's limbs, usually in the wake of brain damage from stroke. Because anosognosic patients overlook their paralysis, anosognosia seems (...) be a counter-example to the claim that proprioception exists in the periphery of conscious experience. However, careful consideration of the data shows that anosognosia makes a poor counterexample to a rich theory of consciousness. Thus, we retain reason to believe that proprioception exists in the periphery of conscious experience, and so to conclude that conscious experience is relatively rich. (shrink)

Healthcare is becoming increasingly automated with the development and deployment of care robots. There are many benefits to care robots but they also pose many challenging ethical issues. This paper takes care robots for the elderly as the subject of analysis, building on previous literature in the domain of the ethics and design of care robots. Using the value sensitive design approach to technology design, this paper extends its application to care robots by integrating the (...) values of care, values that are specific to AI, and higher-scale values such as the United Nations Sustainable Development Goals. The ethical issues specific to care robots for the elderly are discussed at length alongside examples of specific design requirements that work to ameliorate these ethical concerns. (shrink)

The population ageing of Chinese society is deepening. The elderly care policy is a policy standard formulated by the government to protect the rights and interests of older people in the process of actively coping with the population ageing. It has crucial guiding significance for improving the elderly care services and carrying out pension practice. Since the reform and opening-up, China’s elderly care policy system has gone through three stages of initial construction, development, and transformation, showing a (...) development direction from aid to service, from one to multiple, from unique to general. In general, China has primarily formed a complete framework of the elderly care policy system, the rights, and interests of older people have been strongly guaranteed, the elderly care service industry has developed rapidly, and the quality of elderly care service has been effectively improved. However, in the process of policy development, there are still problems such as difficulty in implementing policies, low effectiveness, vague content, and fragmentation of policies. In the future, it is urgent to establish a complete, scientific, reasonable, and effective elderly care policy system. It should further expand the scope of benefits of old-age care policies, promote the coordinated development of the elderly care policies between urban and rural areas and among regions, strengthen the guiding and leading role of the government, and refine policies on personnel training, so as to form a powerful driving force for old-age care. (shrink)

The growing proportion of elderly people in society, together with recent advances in robotics, makes the use of robots in elder care increasingly likely. We outline developments in the areas of robot applications for assisting the elderly and their carers, for monitoring their health and safety, and for providing them with companionship. Despite the possible benefits, we raise and discuss six main ethical concerns associated with: (1) the potential reduction in the amount of human contact; (2) an increase (...) in the feelings of objectification and loss of control; (3) a loss of privacy; (4) a loss of personal liberty; (5) deception and infantilisation; (6) the circumstances in which elderly people should be allowed to control robots. We conclude by balancing the care benefits against the ethical costs. If introduced with foresight and careful guidelines, robots and robotic technology could improve the lives of the elderly, reducing their dependence, and creating more opportunities for social interaction. (shrink)

The elderly face very challenging situations due to their mental and physical conditions. Like the other country in the world, Bangladesh Government has enacted laws to protect the elderly rights. However, the law does not seem to represent what the elderly actually needs. Therefore, 385 elderly people, aged between 60 and 90 years were surveyed to understand their expectations from family, society, and government. There were 57.1% men and 42.9% women. Most of the elderly (80%) were educated. Just over half (...) (53.5%) had ordinary mental and physical health, while a quarter (31.4%) had good status. More than half (53%) of the participants required 2000–5000 BDTK (Bangladeshi Taka) equivalent to $20-50 to cover monthly treatment expenditures. The majority (67.3%) felt government Old Age Allowance should be increased to BDT 5,000 ($50). Of 13.8% of individuals experienced harsh discourse from family because of the cost of therapy. However, 16.9% of people choose not to respond to this question. More than half (57.4%) of the respondents’ thought caregivers were insufficient. One-third felt that legislation should be changed to take care of parents (33.5%) and One-third felt that children should take care of more (33.5%). Some (3.6%) thought that children should act as they did in their childhood respectively. Almost half (44.2%) of respondents did not know that the elderly should receive a separate senior citizen card for preferential treatment, yet 51.9% thought this. Some (44.7%) felt the elderly should get priority in any queue and discounts in Bus/Uber/Rickshaw. Results also showed that expectation is more than the service provided. Further, a one-stop elderly care clinic is required to provide integrated care and support for the quality of life of the elderly. (shrink)

Technological developments involving robotics and artificial intelligence devices are being employed evermore in elderly care and the healthcare sector more generally, raising ethical issues and practical questions warranting closer considerations of what we mean by “care” and, subsequently, how to design such software coherently with the chosen definition. This paper starts by critically examining the existing approaches to the ethical design of care robots provided by Aimee van Wynsberghe, who relies on the work on the ethics of (...) care by Joan Tronto. In doing so, it suggests an alternative to their non-principled approach, an alternative suited to tackling some of the issues raised by Tronto and van Wynsberghe, while allowing for the inclusion of two orientative principles. Our proposal centres on the principles of autonomy and vulnerability, whose joint adoption we deem able to constitute an original revision of a bottom-up approach in care ethics. Conclusively, the ethical framework introduced here integrates more traditional approaches in care ethics in view of enhancing the debate regarding the ethical design of care robots under a new lens. (shrink)

To assess the perception regarding the quality of life, a qualitative study was conducted on 20 old people of balance gender in Dhaka, Bangladesh. Most of the participants of our study were upper poor class and literate. Male participants were a little higher than females. The majority were between 60 and 65years. They were significantly more active, independent, and took part in productive work contributing in the country’s economy, and had significantly greater decision power than other age group. Quality of (...) life of the elderly is related to physical and, economical wellbeing and coping mechanism during old age. The government of Bangladesh has taken varying degrees of initiative to improve the elder condition, but that was not publicized well. Old age Allowance should be increased to BDT 5000/ ($50). Family attachment and emotional support is also related to the self-assurance, self-respect, and self-drive of the elderly. Parent's Care Act 2013 should be implemented for retrospective care of seniors. (shrink)

As the world population is rapidly aging, stakeholders must address the care of the elderly with great concern. Also, loss of dignity is often associated with aging due to dementia, mobility problems and diminished functional autonomy. However, dignity is a polysemic term that is deemed useless by some ethicists. To counter this claim, we propose four concepts to define it better and make use accurately of this notion. These are human dignity, dignity of identity, dignities of excellence and attributed (...) dignities. Finally, we explain the importance of solicitude and human dignity in the care of the elderly. This will ensure the respect, friendship and dignity of the elderly in providing geriatric ethical care. (shrink)

This paper explores the relationship between dignity and robot care for older people. It highlights the disquiet that is often expressed about failures to maintain the dignity of vulnerable older people, but points out some of the contradictory uses of the word ‘dignity’. Certain authors have resolved these contradictions by identifying different senses of dignity; contrasting the inviolable dignity inherent in human life to other forms of dignity which can be present to varying degrees. The Capability Approach (CA) is (...) introduced as a different but tangible account of what it means to live a life worthy of human dignity. It is used here as a framework for the assessment of the possible effects of eldercare robots on human dignity. The CA enables the identification of circumstances in which robots could enhance dignity by expanding the set of capabilities that are accessible to frail older people. At the same time, it is also possible within its framework to identify ways in which robots could have a negative impact, by impeding the access of older people to essential capabilities. It is concluded that the CA has some advantages over other accounts of dignity, but that further work and empirical study is needed in order to adapt it to the particular circumstances and concerns of those in the latter part of their lives. (shrink)

The world population is aging rapidly. Fear of falling among the elderly constitute a significant problem in health care. Among community-dwelling elderly, fear of falling is frequent, with prevalence ranging from 3% to 85% % in community-based epidemiologic studies. The aim of this review is to reveal the prevalence and risk factors of fear of falling (FOF) among elderly. The review has identified that age, sex, physical performance, comorbidity, a history of falls, hearing impairment, poor self-related health and depressive (...) symptoms affect fear of falling. The consequences that develop as a result of a fear of falling can include: loss of confidence, decreased quality of life, mobility or activity restriction and the development of deconditioning, leading to loneliness, depression, and anxiety, subsequent falls and physical, psychological and mental function declines. Maintenance of physical function and pain management might be important for older adults with fear of falling. (shrink)

Since the subsidised economy was substituted by privatisation in 1986, family became the main source of support for the majority of Vietnamese elderly. Traditionally, old aged parents live under the same roof with their adult children, so that they can be looked after. Recently, the process of modernisation of its economy with the focus on urban areas in Vietnam has pushed young rural generations away from home and torn rural families apart. Scholars and experts have tried to understand if that (...) movement is having any impact on the left-behind parents. However, the majority of the existing studies used secondary data, and quantitatively tested only the economic aspects. Other aspects of life of the left-behind elders attracted a limited amount of research. The voice of those left-behind elderly parents was also underestimated, and often not heard. This study utilised a qualitative approach and drew on the voice of those insiders, whose children had migrated to urban areas for employment. It explores the wellbeing of rural elderly individuals, not only the material aspects, but also emotional and physical care. (shrink)

AI, in the form of artificial carers, provides a possible solution to the problem of a growing elderly population Yet, concerns remain that artificial carers ( such as care-or chat-bots) could not emphathize with patients to the extent that humans can. Utilising the concept of empathy perception,we propose a Turing-type test that could check whether artificial carers could do many of the menial tasks human carers currently undertake, and in the process, free up more time for doctors to offer (...) empathy. -/- . (shrink)

I defend social media’s potential to support Aristotelian virtue friendship against a variety of objections. I begin with Aristotle’s claim that the foundation of the best friendships is a shared life. Friends share the distinctively human and valuable components of their lives, especially reasoning together by sharing conversation and thoughts, and communal engagement in valued activities. Although some have charged that shared living is not possible between friends who interact through digital social media, I argue that social media preserves the (...) relevantly human and valuable portions of life, especially reasoning, play, and exchange of ideas. I then consider several criticisms of social media’s potential to host friendships, and refute or weaken the force of these objections, using this conception of a distinctively human shared life. I conclude that we should use the shared life to evaluate features of specific social media and norms for users’ conduct. (shrink)

The status and functioning of shame is contested in moral psychology. In much of anglophone philosophy and psychology, it is presumed to be largely destructive, while in Confucian philosophy and many East Asian communities, it is positively associated with moral development. Recent work in human-robot interaction offers a unique opportunity to investigate how shame functions while controlling for confounding variables of interpersonal interaction. One research program suggests a Confucian strategy for using robots to rebuke participants, but results from experiments with (...) educational technologies imply a different and potentially opposing account of shame’s role in personal development. By digging deeper into the details of Confucian theorizing about shame, I identify a unifying explanation for these apparently conflicting results. I conclude by offering suggestions for future empirical research in human-robot interactions to further investigate shame’s role in moral development. (shrink)

Digital records, from chat transcripts to social media posts, are being used to create chatbots that recreate the conversational style of deceased individuals. Some maintain that this is merely a new form of digital memorial, while others argue that they pose a variety of moral hazards. To resolve this, I turn to classical Chinese philosophy to make use of a debate over the ethics of funerals and mourning. This ancient argument includes much of interest for the contemporary issue at hand, (...) including the use of impersonators of the dead to help the bereaved to deal well with their grief. I connect this historical discussion with a modern trend in clinical psychology that reframes therapeutic interventions with bereaved individuals. The trend directs practitioners away from facilitating detachment and toward affirming continuing bonds. I conclude that these chatbots can offer an important source of support to mourners, but also discuss parameters and features of social context that will be important to avoid the moral hazards identified by sceptics. (shrink)

Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search.In sum, teaching in all three subjects combined (...) comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics. (shrink)

Feminized AIs designed for in-home verbal assistance are often subjected to gendered verbal abuse by their users. I survey a variety of features contributing to this phenomenon—from financial incentives for businesses to build products likely to provoke gendered abuse, to the impact of such behavior on household members—and identify a potential worry for attempts to criticize the phenomenon; while critics may be tempted to argue that engaging in gendered abuse of AI increases the chances that one will direct this abuse (...) toward human beings, the recent history of attempts to connect video game violence to real-world aggression suggests that things may not be so simple. I turn to Confucian discussions of the role of ritualized social interactions both to better understand the roots of the problem and to investigate potential strategies for improvement, given a complex interplay between designers and device users. I argue that designers must grapple with the entrenched sexism in our society, at the expense of “smooth” and “seamless” user interfaces, in order to intentionally disrupt entrenched but harmful patterns of interaction, but that doing so is both consistent with and recommended by Confucian accounts of social rituals. (shrink)

Must the best friends necessarily be good people? On the one hand, as Aristotle puts it, ‘people think that the same people are good and also friends’. But on the other hand, friendship sometimes seems to require that one behave badly. For example, a normally honest person might lie to corroborate a friend's story. What I will call closeness, which I take to include sensitivity to friends' subjective values and concerns as well as an inclination to take their subjective interests (...) as reasons for action, is characteristic of friendship. But this seems to require that good friends should be morally flexible, more so than is compatible with a virtuous character. This would imply tension between ideals of friendship and ideals of character. But there is an important connection between virtue and friendship which arises precisely from friends' closeness, when concern for wellbeing, another important feature of friendship, is also taken into account. This helps mitigate the tension and shows how friendship and virtue are interconnected. The connection in turn provides friendship-based reason to think the best friends must be good people, even though concerns of friendship may occasionally clash with other moral concerns. (shrink)

Editor’s NoteThanks to the initiative of Alan Norrie, we are pleased to present here a symposium on Nick Wilson’s book The Space that Separates: A Realist Theory of Art. Several authors have contri...

In post-Gricean pragmatics, communication is said to be successful when a hearer recovers a speaker’s intended message. On this assumption, proposals for ‘what is said’ – the semantic, propositional meaning of a speaker’s utterance – are typically centred around the content the speaker aimed to communicate. However, these proposals tend not to account for the fact that speakers can be deliberately vague, leaving no clear proposition to be recovered, or that a speaker can accept a hearer’s misconstrual even though the (...) speaker didn’t intend it. In such cases, identifying ‘what is said’ is more contentious, even though communication is arguably no less successful. Building on recent interactionist approaches to meaning, this chapter offers a proposal for ‘what is said’ that can account for cases of ‘imperfect’ communication in which the recovery of a speaker’s intention goes awry. This involves taking ‘what is said’ as the co-constructed meaning that the speaker and hearer jointly agree on, giving ‘grounded meanings’ – those mutually and manifestly accepted into the discourse by speaker and hearer – higher precedence in a theory of communication than simply the speaker’s intended meaning. In such cases, rather than speaker and hearer converging at the level of explicit utterance content, communication is expected to be successful as long as the hearer recovers a proposition which is compatible with the speaker’s higher-order discursive goal. The hearer’s uptake is then allowed to override the content of the speaker’s intended meaning in the process of negotiating ‘what is said’. (shrink)

This paper aims to bridge the relationship between metalinguistic if you like as a non-propositional discourse marker and its conditional counterparts. This paper claims that metalinguistic if you like is polysemous between a hedge that denotes the speaker’s reduced commitment to some aspect of the main clause, and an optional yet potential conditional reading that interlocutors can legitimately draw on in interaction which is brought about due to the ‘if p, q’ sentence form. That is, although the metalinguistic reading is (...) most likely obtained automatically by default, it also carries an available conditional reading that is akin to other metalinguistic conditional clauses such as if you see what I mean. Next, a semantic representation of metalinguistic if you like is developed that takes on board a characterization of conditionality that departs from lexico-grammatical conventions, such that conditionals of the form ‘if p, q’ no longer bear a one-to-one correspondence with “conditional” truth conditions. Employing a radical contextualist semantic framework in which the unit of truth-conditional analysis is not constrained to the sentence form, utterances employing metalinguistic if you like are given a semantic representation such that the if-clause does not contribute propositional content, yet they also maintain their status as conditionals as the sentence form gives rise to a potential conditional secondary meaning. (shrink)

When it comes to social robotics (robots that engage human social responses via “eyes” and other facial features, voice-based natural-language interactions, and even evocative movements), ethicists, particularly in European and North American traditions, are divided over whether and why they might be morally considerable. Some argue that moral considerability is based on internal psychological states like consciousness and sentience, and debate about thresholds of such features sufficient for ethical consideration, a move sometimes criticized for being overly dualistic in its framing (...) of mind versus body. Others, meanwhile, focus on the effects of these robots on human beings, arguing that psychological impact alone can qualify an entity for moral status. What both sides overlook is the importance for ordinary moral reasoning of integrating questions about an entity’s “inner life,” and its psychological effect on us. Turning to accounts of relationships in virtue ethics, especially those of the Confucian tradition, we find a more nuanced theory that can provide complex guidance on the moral considerability of social robots, including ethical considerations about whether and how to question this to begin with. (shrink)

Despite the initial promise of social media platforms as a means of facilitating discourse on matters of civic discourse, in practice it has turned out to impair fruitful conversation on civic issues by a number of means. From self-isolation into echo chambers, to algorithmically supported filter bubbles, to widespread failure to engage politically owing to psychological phenomena like the ‘spiral of silence’, a variety of factors have been blamed. I argue that extant accounts overlook the importance of interpersonal relationships to (...) sustaining quality civic discourse on social media. Drawing on an Aristotelian account of friendship with an emphasis on the value of interpersonal difference plus the influence of interactions on individual character, I argue that a common scapegoat for the failure of civic discourse online—the variety of “unfriend” disconnection tools offered on various platforms—actually show promise at promoting better-quality civic conversation and overcoming the obstacles present on social media platforms. (shrink)

Zhuangzi suggests that death is a transformation that we commonly and mistakenly think means the end of someone but really just marks a new phase of existence. This metaphysical thesis is presented at several points in the text as an explanation of distinctively Daoist responses to death and loss. Some take a Daoist response to death, as presented by Zhuangzi, to indicate dual perspectives on friendship and death. But I argue that the metaphysical view sketched above is consistent with a (...) unified perspective, allowing the Daoist to enjoy deep friendships without risking some potential for grief typically associated with strong attachment. However, it leaves the Daoist best suited to friendships with those who endorse the same metaphysics. Furthermore, while the grief associated with the death of a friend is somewhat mitigated, the Daoist has reason to mourn even given this thesis. (shrink)

We provide to readers the 11th volume of the "Czech-Polish-Slovak Studies in Andragogy and Social Gerontology" series. We are delighted to announce that the presented study is the result of the work of scientists from seven countries: Austria, China, Ghana, Hungary, Japan, Poland, and Russia. This international collection of texts is part of the global discourse on the determinants of adult education and the functioning of people in late adulthood. The 11th volume is a collection of research results that show (...) both the positive and negative dimensions of ageing through the prism of research experience from various geographical and cultural areas. The researchers invited to the presented volume tried to illustrate the issues assigned to the following topics: ageing with dignity; retirement age; assumptions and conditions resulting from living in the home; the relationship between challenges concerning life expectancy and needs; care and ageing services; and foundations and potential changes in pension systems. The research results presented in this volume have a common denominator, which is caring for the quality of life of the older people regardless of their place of residence. Thus, the study "Between Successful and Unsuccessful Ageing: Selected Aspects and Contexts" brings new insights from scientists who scrupulously characterize the complexity of processes that affect the positive and negative conditions of functioning in old age, which is a mosaic of various nuances. Inviting readers to familiarize themselves with the content of the monograph, we would like to thank the reviewers who contributed to the improvement of the quality of the texts and open new fields for participation in further joint publishing projects. (shrink)

An elderly patient in a care home only wants human nurses to provide her care – not robots. If she selected her carers based on skin colour, it would be seen as racist and morally objectionable, but is choosing a human nurse instead of a robot also morally objectionable and speciesist? A plausible response is that it is not, because humans provide a better standard of care than robots do, making such a choice justifiable. In this paper, (...) I show why this response is incorrect, because robots can theoretically care as well as human nurses can. I differentiate between practical caring and emotional caring, and I argue that robots can match the standard of practical care given by human nurses, and they can simulate emotional care. There is growing evidence that people respond positively to robotic creatures and carebots, and AI software is apt to emotionally support patients in spite of the machine’s own lack of emotions. I make the case that the appearance of emotional care is sufficient, and need not be linked to emotional states within the robot. After all, human nurses undoubtedly ‘fake’ emotional care and compassion sometimes, yet their patients still feel adequately cared for. I show that it is a mistake to claim that ‘the human touch’ is in itself a contributor to a higher standard of care; ‘the robotic touch’ will suffice. Nevertheless, it is not speciesist to favour human nurses over carebots, because carebots do not suffer as the result of such a choice. (shrink)

Abstract: Artificial Morality is a new, emerging interdisciplinary field that centres around the idea of creating artificial moral agents, or AMAs, by implementing moral competence in artificial systems. AMAs are ought to be autonomous agents capable of socially correct judgements and ethically functional behaviour. This request for moral machines comes from the changes in everyday practice, where artificial systems are being frequently used in a variety of situations from home help and elderly care purposes to banking and court algorithms. (...) It is therefore important to create reliable and responsible machines based on the same ethical principles that society demands from people. New challenges in creating such agents appear. There are philosophical questions about a machine’s potential to be an agent, or mora l agent, in the first place. Then comes the problem of social acceptance of such machines, regardless of their theoretic agency status. As a result of efforts to resolve this problem, there are insinuations of needed additional psychological (emotional and cogn itive) competence in cold moral machines. What makes this endeavour of developing AMAs even harder is the complexity of the technical, engineering aspect of their creation. Implementation approaches such as top- down, bottom-up and hybrid approach aim to find the best way of developing fully moral agents, but they encounter their own problems throughout this effort. (shrink)

Older people are encouraged to participate more in the economic, social, and governmental sectors as part of progressive aging policies worldwide. Very little is known about applying engagement techniques or carrying out strategies in Bangladesh that are important for involving seniors in social engagement. Therefore, this qualitative research was conducted in Dhaka, Bangladesh, among 385 people aged sixty or above to assess their understanding of the quality of life and the gap in government policy. Results showed that between 60 and (...) 65 were more mobile, creative, engaged in productive activity, and had significantly higher decision-making power (p<0.000). Aging greatly enhances dependency (p<0.000). Lower-educated people were significantly dependent on their families (p<0.000).Moreover, elderly income and the cost of treatment were significantly correlated to abuse (p<0.001). Furthermore, 10% of participants reported negative relationships with family members (p<0.031). However, most (61.6%) were unaware of the 2013 Parent's Care Act. Though most participants (73.2%) knew of the government-funded Old Age Allowance, 92.5% received no non-governmental assistance. The research concluded that education and economic condition have a long-term relationship with reducing dependency. In recommendation, Government can increase the retirement age from 59 to 65 years which may increase self of security, respect, and self-esteem and reduce harassment. Parent's Care Act 2013 should implement. Government should include Community Health and Social Service centers for the quality of life of the elderly. (shrink)

Objective: Primary care, which is often the first level of contact for patients with various communicable diseases (CDs) and noncommunicable diseases (NCDs), might exhibit patterns of injectable drug utilization different from hospitals. We aimed to examine injection prescribing to adults with CD or NCD in primary care. -/- Methods: In this retrospective study, single-diagnosis injectable drug-containing prescription data from Family Medicine Information System comprising 32 provinces of Turkey were analysed. The prescriptions were grouped by diagnosis as “CD” (n=3848) (...) and “NCD” (n=9338). Injectable drug utilization patterns in these groups were analysed by demographics, diagnoses, and drug subgroups. -/- Results: Out of 13186 prescriptions, 70.8% were issued for NCDs. NCD prescriptions were mostly generated for women and elderly (p<0.05 for both). About 63.3% (n=2948) of injectable drugs in CD prescriptions were antibiotics and 12.6% were analgesics. Cefazolin (15.2%) was the most commonly prescribed antibiotic for acute pharyngitis and acute sinusitis, and benzathine benzylpenicillin (12.8%) was the top-choice for acute tonsillitis and rheumatic fever. In NCD prescriptions, 34.0% (n=4214) of injectable agents were analgesics and 16.9% were muscle relaxants. The most frequently encountered drug in NCD prescriptions was thiocolchicoside (16.3%), which was the top-choice in all seven common musculoskeletal diagnoses. -/- Conclusion: Muscle relaxants and analgesics were the most commonly prescribed injectable drugs for NCDs, musculoskeletal diseases in particular. Antibiotics were frequently encountered in CD prescriptions, mostly as broad-spectrum for lower respiratory tract infections (RTIs) and narrow-spectrum for upper RTIs. These findings may elucidate the issues to especially focus on regarding excessive use of injections. (shrink)

Given that one of the major goals of the practice of Philosophy for Children (P4C) is the development of critical thinking skills (Sharp 1987/2018, pp. 4 6), an urgent question that emerged for one of the authors, who is of Chinese Heritage and a novice practitioner at a P4C summer camp was whether this emphasis on critical thinking might make this practice incompatible with the fabric of Chinese culture. Filial piety (孝), which requires respect for one’s parents, elders, and ancestors (...) is considered an important virtue in Asian culture, as is the preservation of harmony. But if one of the goals of P4C is to teach youngsters to courageously pursue reasoned dialogue, does this not set-up young Asians for serious conflict when they come face-to-face with positions that are articulated by elders, but which are ones to which they are diametrically opposed; a racist grandmother, for instance, or an uncle who insists that those at the Tiananmen Square uprising were nothing but hooligan’s. It is this question that we will explore in this presentation. In the process, we will come to the conclusion that, when positions seem irreconcilable, rather than continuing to pursue rigorous critical interchange that may do little other than escalate insult, the facilitator, rather, ought to move toward creating a deeper understanding of each position juxtaposed against its opposing view (a process that we refer to as ‘collaborative caring’), so as to produce side-by-side understanding, knowing that communal bonds have been maintained and, hence, that the opportunity for genuine reasoned collaborative inquiry on other issues and at future times remains open. (shrink)

This essay investigates the demands on adult children to provide care for their elderly/ill parents from a socio-moral perspective. In order to narrow the examination, the question pursued here is agent-relative: What social and moral complexities are involved for the adult child when her parent(s) need care? First, this article examines our society’s expectation that adult children are morally obligated to provide care for their parents. Second, the essay articulates how transgressing against this normative expectation can inure (...) significant moral criticism. The final sections present these tensions within the context of disability. (shrink)

ABSTRACT In this article, I indicate how the naturalized and individualized conception of disability that prevails in philosophy informs the indifference of philosophers to the predictable COVID-19 tragedy that has unfolded in nursing homes, supported living centers, psychiatric institutions, and other institutions in which elders and younger disabled people are placed. I maintain that, insofar as feminist and other discourses represent these institutions as sites of care and love, they enact structural gaslighting. I argue, therefore, that philosophers must engage (...) in conceptual engineering with respect to how disability and these institutions are understood and represented. To substantiate my argument, I trace the sequence of catastrophic events that have occurred in nursing homes in Canada and in the Canadian province of Ontario in particular during the pandemic, tying these events to other past and current eugenic practices produced in the Canadian context. The crux of the article is that the COVID-19 pandemic has thrown into vivid relief the carceral character of nursing homes and other congregate settings in which elders and younger disabled people are confined. -/- KEYWORDS carceral, conceptual engineering, nursing home-industrial-complex, philosophy of disability, structural gaslighting. (shrink)

Social studies of science have often treated natural field sites as extensions of the laboratory. But this overlooks the unique specificities of field sites. While lab sites are usually private spaces with carefully controlled borders, field sites are more typically public spaces with fluid boundaries and diverse inhabitants. Field scientists must therefore often adapt their work to the demands and interests of local agents. I propose to address the difference between lab and field in sociological terms, as a difference in (...) style. A field style treats epistemic alterity as a resource rather than an obstacle for objective knowledge production. A sociological stylistics of the field should thus explain how objective science can co-exist with radical conceptual difference. I discuss examples from the Canadian North, focussing on collaborations between state wildlife biologists and managers, on the one hand, and local Aboriginal Elders and hunters, on the other. I argue that a sociological stylistics of the field can help us to better understand how radically diverse agents may collaborate across cultures in the successful production of reliable natural knowledge. (shrink)

The Salivaomics Knowledge Base (SKB) is designed to serve as a computational infrastructure that can permit global exploration and utilization of data and information relevant to salivaomics. SKB is created by aligning (1) the saliva biomarker discovery and validation resources at UCLA with (2) the ontology resources developed by the OBO (Open Biomedical Ontologies) Foundry, including a new Saliva Ontology (SALO). We define the Saliva Ontology (SALO; http://www.skb.ucla.edu/SALO/) as a consensus-based controlled vocabulary of terms and relations dedicated to the salivaomics (...) domain and to saliva-related diagnostics following the principles of the OBO (Open Biomedical Ontologies) Foundry. The Saliva Ontology is an ongoing exploratory initiative. The ontology will be used to facilitate salivaomics data retrieval and integration across multiple fields of research together with data analysis and data mining. The ontology will be tested through its ability to serve the annotation ('tagging') of a representative corpus of salivaomics research literature that is to be incorporated into the SKB. Background Saliva (oral fluid) is an emerging biofluid for non-invasive diagnostics used in the detection of human diseases. The need to advance saliva research is strongly emphasized by the National Institute of Dental and Craniofacial Research (NIDCR), and is included in the NIDCR's 2004- 2009 expert panel long-term research agenda [1]. The ability to monitor health status, disease onset, progression, recurrence and treatment outcome through noninvasive means is highly important to advancing health care management. Saliva is a perfect medium to be explored for personalized individual medicine including diagnostics, offering a non-invasive, easy to obtain means for detecting and monitoring diseases. Saliva testing potentially allows the patient to collect their own saliva samples at home, yielding convenience for the patient and savings in health costs, and facilitating multiple sampling. Specimen collection is less objectionable to patients and easier in children and elderly individuals. Due to these advantages. (shrink)

In this paper we examine how the use of robots in caring for elders can impact the meaningfulness of elders’ lives. We present a framework for understanding ‘meaningfulness in life’, and then apply that framework in discussing ways in which the use of robots to assist in activities of daily living can preserve, enhance or undermine the meaningfulness of elders’ lives. We conclude with a discussion of if and how having false beliefs about companion robots can affect meaningfulness in the (...) life of the person having those false beliefs. (shrink)

The advent of the so-called Companion Robots is raising many ethical concerns among scholars and in the public opinion. Focusing mainly on robots caring for the elderly, in this paper we analyze these concerns to distinguish which are directly ascribable to robotic, and which are instead preexistent. One of these is the “deception objection”, namely the ethical unacceptability of deceiving the user about the simulated nature of the robot’s behaviors. We argue on the inconsistency of this charge, as today formulated. (...) After that, we underline the risk, for human-robot interaction, to become a hallucinatory relation where the human would subjectify the robot in a dynamic of meaning-overload. Finally, we analyze the definition of “quasi-other” relating to the notion of “uncanny”. The goal of this paper is to argue that the main concern about Companion Robots is the simulation of a human-like interaction in the absence of an autonomous robotic horizon of meaning. In addition, that absence could lead the human to build a hallucinatory reality based on the relation with the robot. (shrink)

Generacja sandwicz - grupa osób w wieku średnim, która ze wzglȩdu na swoj¸a} centraln¸a} pozycjȩ w strukturze wieku i w zwi¸a}zanej z ni¸a} stratyfikacji wiekowej stanowi generacjȩ, które jednocześnie opiekuje siȩ osobami starszymi i osobami młodszymi. Zjawisko to określane jest też jako "kobiety w środku" lub "złapani w środku". Koncepcja "generacji sandwicz" w w¸a}skim ujȩciu odnoszona jest przeważnie do tradycyjnie postrzeganych ról opiekuńczych kobiet, które s¸a} w wieku środkowym, a zarazem na przedpolu starości. W ujȩciu feministycznym społeczne oczekiwania wobec kobiet (...) znajduj¸a}cych siȩ miȩdzy 40. a 60. rokiem życia s¸a} zorientowane z jednej strony na udzielanie pomocy dzieciom i młodzieży w uzyskaniu samodzielnego dorosłego życia, z drugiej zaś s¸a ukierunkowane na udzielanie pomocy pielȩgnacyjnej starszemu pokoleniu szczególnie w przypadku niepełnosprawności, otȩpienia lub choroby Alzheimera. Oczekiwania wobec powyższych ról opiekuńczych s¸a sformalizowane w mniejszym lub wiȩkszym stopniu co prowadzi do nierówności miȩdzy kobietami i mȩżczyznami. ** Sandwich generation - a group of middle-aged people who, due to its central position in the age structure and related age stratification is a generation that simultaneously takes care of elderly people and younger people. This phenomenon is also referred to as "women in the middle" or "caught in the middle". The concept of "sandwich generation" in a narrow sense refers mainly to the traditionally perceived caring roles of women who are middle-aged and at the same time on the forefront of old age. In the feminist approach, the social expectations towards women between 40 and 60 years old are oriented on helping children and young people to get an independent adult life, on the other hand they are oriented towards providing care to the older generation, especially in the case of disability, dementia or Alzheimer’s disease. Expectations regarding these care roles are formalized in a smaller one or to a greater extent which leads to inequality between women and men. (shrink)

Michel Houellebecq’s Anéantir has received mixed reviews. Houellebecq’s focus on loving intimacy and care for the elderly within the nuclear family allegedly showcases his transformation from an embittered critic of the capitalist status quo to an apolitical novelist interested in the private sphere. I argue that this criticism overlooks Houellebecq’s concerns about old age and love in his earlier novels and how they relate to his social critique. Particularly Houellebecq’s Possibilité d’une île presents a critique of lonely precarity as (...) the dominant mode of being-in-the-world today. Though critics of post-Fordism have already described post-Fordist forms of life as opportunistic, fearful, and cynical, Houellebecq adds that this uncertain marketized lifestyle also leads to bitterness that increases with old age. By confronting Houellebecq’s phenomenology of contemporary life to Heidegger’s analysis of Dasein, I argue that, whereas Heidegger highlights the role of anxiety and death in fostering a sense of meaning to human existence, Houellebecq rather argues that such an authentic confrontation with death has become impossible in contemporary culture and that love is instead the emotional tonality most responsive to the cultivation of a meaningful good life. (shrink)

Do adult children have a particular duty, or set of duties, to their aging parents? What might the normative source and content of filial obligation be? This chapter examines Kant’s duty of beneficence in The Doctrine of Virtue and the Groundwork, suggesting that at its core, performance of filial duty occurs in response to the needs of aging parents. The duty of beneficence accounts for inevitable vulnerabilities that befall human rational beings and reveals moral agents as situated in communities of (...) dependence and mutual aid. Other accounts of filial obligation, such as those based on a notion of gratitude, virtue, or friendship, generate various difficulties and fail to adequately address and emphasize four morally significant features of the adult child/ aging parent relationship. First, the relationship between adult children and their aging parents is one of dependency created by the increasing frailty and need of those parents. Second, the obligations that adult children have to aging parents take place in the context of a relationship not voluntarily assumed, but not coerced. Third, given a cultural tendency toward paternalistic care of elderly individuals, the content of filial obligation should safeguard against such treatment. Fourth, because dependency relations between adult children and aging parents can involve an immense degree of sacrifice on the part of the caretaker, an acknowledgment of duties should be accompanied by a concurrent acknowledgment of the necessary limitation of duties. Addressing these four issues is essential in offering a coherent account of the normative source, content, nature, and scope of adult children’s duty to care for their aging parents. This essay demonstrates that the Kantian duty of beneficence, when functioning as the philosophical foundation of filial obligation, allows for ample light to be shed upon and for proper analysis to take place of these four issues. (shrink)

Altruism is embedded in our biology and in our culture. We offer our bus seats to the disabled and elderly, give directions to disoriented tourists, and donate a portion of our income charity. Yet for all the good it does, there are deep problems with altruism as it is practiced today. Nearly all of us, when asked, will say that we care about practicing altruism in a way that effectively improves the lives of others. Almost none of us, when (...) asked, can honestly say that we have made a serious effort to ensure that we are practicing altruism in a way that effectively improves the lives of others. Disparities like these are indicative of flaws in our cognitive architecture - biases which ensure that the traditional practice of altruism is incongruous with our own values. This disconnect between our values and our actions causes our altruistic efforts to help fewer people to a lesser extent than they otherwise could. I argue that traditional altruism is in need of reformation and defend a social and philosophical movement aimed at achieving this reformation known as effective altruism. The reason effective altruism is such a promising alternative to traditional altruism is its application of economic thinking to the realm of altruism and morality. An economist’s mentality is, I suggest, a necessary instrument for bridging the gap between our values and our actions, allowing us to practice altruism in a way that more effectively improves the lives of others. (shrink)

Measurement of ability or inability to perform activities of daily living is important to in describing the functional status of a person and then implementing an intervention. Evaluations of ADLs are mainly used in nursing and in rehabilitation of people with disabilities and the elderly. Measuring ability to perform ADLs is crucial for the management of healthcare in aging societies. It is important to understand differences between categories of ADLs and challenges in their evaluation that are connected to the roles (...) of family members. (shrink)

Robots as social companions in close proximity to humans have a strong potential of becoming more and more prevalent in the coming years, especially in the realms of elder day care, child rearing, and education. As human beings, we have the fascinating ability to emotionally bond with various counterparts, not exclusively with other human beings, but also with animals, plants, and sometimes even objects. Therefore, we need to answer the fundamental ethical questions that concern human-robot-interactions per se, and (...) we need to address how we conceive of »good lives«, as more and more of the aspects of our daily lives will be interwoven with social robots. (shrink)

With significant advances in equal rights for lesbians, gay men, bisexual and transgender (LGBT) citizens, achieved across the western world during the past few decades, one group that continues to be overlooked is LGBT elders. This article examines the unique discrimination and homophobia faced by older LGBT people living in nursing and residential care homes. It investigates ways in which these environments construct and perpetuate heteronormativity by addressing the needs of heterosexual residents, while at the same time, failing to (...) meet the specific preferences of their LGBT residents. The assumption of heterosexuality in residential care is the ‘norm’ whereby non-normative sexualities are negated. For those considering long-term care, the fear of alienation and having to go back into the ‘closet’ is of profound concern. The argument most frequently presented to counter this is training managers and care staff to deliver non-discriminatory health and social care practices, targeting the unique needs of LGBT residents. However, from within the gay community has come a solution to end the type of homophobic behavior often encountered in mainstream care environments. This has seen the radical and sometimes controversial growth in alternative forms of retirement housing for gay older adults, in the United States of America, the United Kingdom, and across Europe. This article explores these schemes, taking into account criticism that deems such positive discrimination is contrary to the principles of equality legislation and the spirit of social inclusion. (shrink)

This essay investigates the demands on adult children to provide care for their elderly/ill parents from a socio-moral perspective. In order to narrow the examination, the question pursued here is agent-relative: What social and moral complexities are involved for the adult child when their parent(s) need care? First, this article examines our society’s expectation that adult children are morally obligated to provide care for their parents. Second, the essay articulates how transgressing against this normative expectation can inure (...) significant moral criticism. The final sections present these tensions within the context of disability. (shrink)

Why do we so often care about the outcomes of games when nothing is at stake? There is a paradox here, much like the paradox of fiction, which concerns why we care about the fates and threats of merely fictional beings. I argue that the paradox threatens to overturn a great deal of what philosophers have thought about caring, severing its connection to value and undermining its moral weight. I defend a solution to the paradox that draws on (...) Kendall Walton's solution to the paradox of fiction, developing his idea that it be extended to games. The solution takes games to involve make‐believe: in particular, players and spectators make‐believe that the outcome of the game matters. I also explore how the phenomenon extends beyond games. And I explore some moral implications: in particular, my view preserves the idea that we have reason not to impede others in their pursuit of what they care about. (shrink)

Being aware of social injustices can cause existential and mental pain; comes with a burden; and may impede a flourishing life. However, I shall argue that this is not a reason to despair or to choose to be willfully ignorant. Rather, it’s a reason to conclude that being conscious is not enough. Rather, during times of oppression, resisters must also prioritize well-being. One way to do this is by extending what I refer to as solidarity care. I begin by (...) providing an account of solidarity care. I then offer pragmatic ways in which one can extend solidarity care to others. I conclude by responding to two possible worries. (shrink)