Trigger-Based Dexterous Operation with Multimodal Sensors for Soft Robotic Hand

This paper focuses on how to improve the operation ability of a soft robotic hand (SRH). A trigger-based dexterous operation (TDO) strategy with multimodal sensors is proposed to perform autonomous choice operations. The multimodal sensors include optical-based fiber curvature sensor (OFCS), gas pressure sensor (GPS), capacitive pressure contact sensor (CPCS), and resistance pressure contact sensor (RPCS). The OFCS embedded in the soft finger and the GPS series connected in the gas channel are used to detect the curvature of the finger. The CPCS attached on the fingertip and the RPCS attached on the palm are employed to detect the touch force. The framework of TDO is divided into sensor detection and action operation. Hardware layer, information acquisition layer, and decision layer form the sensor detection module; action selection layer, actuator drive layer, and hardware layer constitute the action operation module. An autonomous choice decision unit is used to connect the sensor detecting module and action operation module. The experiment results reveal that the TDO algorithm is effective and feasible, and the actions of grasping plastic framework, pinching roller ball pen and screwdriver, and handshake are executed exactly.

Quandaries of Autonomy and Empowerment in Evidence-Based Nursing Care

Empowerment and evidence-based practice represent two influential principles in nursing care: that decision-making should be based upon the patient’s autonomous choice, and the most up-to-date research findings, respectively. In this article, patient empowerment is taken to imply a transfer of control and power from the nurse to the patient through communication and care and acknowledging the patient’s perspectives and values. Empowerment-based nursing may thus be central to enhancing a patient’s autonomy. Evidence-based nursing combines up-to-date research findings, the nurse’s clinical expertise and the patient’s preferences. This article concerns some of the potential conflicts these principles may give rise to in everyday deliberations in nursing care. It is argued that patient empowerment and autonomy potentially both have paternalistic connotations. It is also questioned whether an increased emphasis on patient empowerment and autonomy may lead to a risk of diminished professional autonomy.

To be, or not to be? The role of the unconscious in transgender transitioning: identity, autonomy and well-being

The exponential rise in transgender self-identification invites consideration of what constitutes an ethical response to transgender individuals’ claims about how best to promote their well-being. In this paper, we argue that ‘accepting’ a claim to medical transitioning in order to promote well-being would be in the person’s best interests iff at the point of request the individual is correct in their self-diagnosis as transgender (i.e., the distress felt to reside in the body does not result from another psychological and/or societal problem) such that the medical interventions they are seeking will help them to realise their preferences. If we cannot assume this—and we suggest that we have reasonable grounds to question an unqualified acceptance in some cases—then ‘acceptance’ potentially works against best interests. We propose a distinction between ‘acceptance’ and respectful, in-depth exploration of an individual’s claims about what promotes their well-being. We discuss the ethical relevance of the unconscious mind to considerations of autonomy and consent in working with transgender individuals. An inquisitive stance, we suggest, supports autonomous choice about how to realise an embodied form that sustains well-being by allowing the individual to consider both conscious and unconscious factors shaping wishes and values, hence choices.

Respecting patient autonomy: voluntary informed consent in modern medicine

The article reveals the most influential in modern bioethics approach to understanding voluntary informed consent as a way to implement the principle of respect for patient autonomy, which is determined by both legal regulation and socio-cultural factors. The authors discuss the main elements of informed consent, its specificity in clinical trials, and criteria for autonomous choice.

Predictors of the importance of everyday preferences for older adults with cognitive impairment

ABSTRACT Objectives: Among older people with cognitive impairment and mild dementia, relatively little is known about the factors that predict preferences for everyday living activities and experiences and that influence the relative importance of those activities and experiences. Design: Cross-sectional study. Setting: Participants were recruited from the Massachusetts Alzheimer’s Disease Research Center (MADRC) Clinical Core longitudinal cohort. Participants: The sample included 62 community-dwelling older adults with cognitive impairment (Clinical Dementia Rating global score ≥ 0.5). Measurements: We used the Preferences for Everyday Living Inventory (PELI) to assess preferences for activities and lifestyle experiences among persons with cognitive impairment. Within-subjects analysis of variance was used to test for significant differences in the mean ratings of importance for four domains of the PELI (“autonomous choice,” “social engagement,” “personal growth,” and “keeping a routine”). Multiple regression models were used to relate predictors, including neuropsychiatric symptoms, to importance ratings for each domain. Results: Significant differences were noted in the mean importance ratings of the preferences domains: “social engagement” preferences were rated as most important, followed by “autonomous choice,” “personal growth,” and “keeping a routine.” For the “social engagement” preferences domain, female sex was significantly associated with higher importance of “social engagement,” while depressive symptoms (Geriatric Depression Scale-15 scores) were significantly associated with lower importance. Conclusions: This study adds novel insight into the everyday preferences of community-dwelling older adults with cognitive impairment and highlights the impact of a number of factors, particularly level of depression, on how important various everyday experiences are perceived.

Religion is Secularised Tradition: Jewish and Muslim Circumcisions in Germany

This article demonstrates that the legal reasoning dominant in modern states secularises traditions by converting them into ‘religions’. Using a case study on Germany’s recent regulation of male circumcision, we illustrate that religions have (at least) three dimensions: religiosity (private belief, individual right and autonomous choice); religious law (a divinely ordained legal code); and religious groups (public threat). When states restrict traditions within these three dimensions, they construct ‘religions’ within a secularisation triangle. Our theoretical model of a secularisation triangle illuminates that, in many Western states, there is a three-way relationship between a post-Christian state and both its Jewish and Muslim minorities. Our two theoretical proposals—the secularisation triangle and the trilateral relationship—contribute to a re-examination of religious freedom from the perspective of minority traditions and minority communities.

And How Would That Make You Feel? How People Expect Nudges to Influence Their Sense of Autonomy

ObjectiveWhile nudges are increasingly utilized in public policy settings, their potential threat to autonomous choice is the topic of heated debate. Regardless of the actual effects of nudges on autonomy, the mere perception of nudges as autonomy threatening by the general public or policy makers could negatively influence nudge acceptability. The present online studies examined how people expect (different) nudges to affect their perception of autonomy.MethodsIn the first study (N = 455), participants were presented with a hypothetical choice that employed either a default nudge, direct persuasion, or no persuasion, to steer to the desired choice. The presented influence technique was explained before participants reported their expected autonomy, as well as their expected choice satisfaction. Study 2 (N = 601) involved a replication of Study 1 with an additional social norm nudge condition. In Study 3 (N = 750), the explanation of how choice had been influenced was omitted.ResultsWhile participants expected the default nudge to violate autonomy (Study 1), they had no such expectations for social norm nudges (Study 2). Omitting the explanation that most people are unaware of nudges influencing their choice, reduced the negative impact of nudges on expected autonomy (Study 3).ConclusionEffects of nudges on expectations of autonomy differ by type of nudge. Negative expectations are primarily driven by the explanation that decision makers are often unaware of nudges.

The Body as a Site of Politics

The body, political theorists well know, has long served as a metaphor for the structure and relations of the polis. But embodiment is something that political theory has frequently bracketed when theorizing citizenship, agency, and the category of “the human.” Against this tendency, how might we reimagine the political potential of embodiment, or make space for considering “the virtues of vulnerability”? This chapter sets up the book as a whole, by raising and situating this question, and introducing readers to the key concepts grounding this inquiry: humility, autonomy, citizen-subjectivity, awakenings, medicalization, and neoliberalism. How does the problem of bodies get taken up within contemporary healthcare, where the consumer-patient gets hailed as an autonomous choice-maker, and what lessons can we learn about health, and health citizenship, from examining the tensions at work here?