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Patients with disorders of consciousness after severe brain injury need surrogate decision makers to guide treatment decisions on their behalf. Formal guidelines for surrogate decisionmaking generally instruct decision makers to first appeal to a patient’s written advance directive, followed by making a substituted judgment of what the patient would have chosen, and lastly, to make decisions according to what seems to be in the patient’s best medical interests. Substituted judgment is preferable because it is taken to preserve patient autonomy, by using a patient’s past wishes and values to reconstruct what they would have chosen for themselves. In this paper, the author argues that for a certain population of patients, the standard interpretation of substituted judgment cannot ensure the preservation of patient autonomy. Patients with “covert awareness” may continue to have values and an authentic sense of self, which may differ from their past values and wishes. Accordingly, surrogate decision makers should make decisions based on how the patient is likely to experience their condition in the present, rather than their past wishes and values.
Patients with amyotrophic lateral sclerosis (ALS) face many difficult, timing-sensitive decisions over the course of their illness, weighing present versus future harms and benefits. Supplemented by interviews with people with ALS, we argue for a relational approach to understanding these decisions and their effects on identity. We highlight two critical aspects of the patient–caregiver relationship: (1) the extent to which each may rely on the other leaves their wellbeing intimately intertwined and (2) patients often require others to help with the imaginative task of considering possible futures for each therapeutic option. We show why family involvement in decisionmaking practices can be so critical, and shed light on the ways intimate others help preserve and protect people’s identities amidst the destabilizing uncertainty illness and treatment can bring.
This paper analyzes in the use of virtual reality when used to induce full-body ownership in violent offenders in order to elicit empathetic feelings by allowing them to embody the virtual body of a victim of domestic abuse. The authors explore potentially harmful effects to individuals participating in this kind of therapy and question whether consent is fully informed. The paper concludes with guidelines for ethical research and rehabilitation using this innovative technology.
It is generally believed that when the Mozart family arrived in Vienna on 6 October 1762, they initially may have spent a night or two in the inn ‘Zum weißen Ochsen’ on Fleischmarkt, then moved for the remainder of their stay to lodgings on Tiefer Graben, either in a house belonging to Johann Heinrich Ditscher (Otto Erich Deutsch, 1961) or one belonging to Gottlieb Friedrich Fischer (Walter Brauneis, 1991). All modern Mozart biographies transmit either Deutsch's claim or Brauneis's, and many continue to state that the Mozarts stayed at ‘Zum weißen Ochsen’. We have been able to show that none of these claims has any merit, and no primary evidence supports them. The notion that the Mozarts stayed at ‘Zum weißen Ochsen’ can be traced back to an article published in 1860, where it is asserted without evidence; the idea was then popularized in a children's story about Wolfgang. The claim that the Mozarts lodged on Tiefer Graben is based on a fanciful interpretation of a mistranscribed street name in Schiedermair's 1914 edition of Leopold Mozart's letter of 19 October 1762.
Leopold actually wrote that the family lodged in ‘Fierberggaßl’. We argue that this refers to the still-existing Färbergasse, and that the Mozarts may have stayed in a house on that street (today the site of Färbergasse 3), with a long narrow wing fitting Leopold's description of their cramped quarters. We present other new details about this episode in Wolfgang's early life, including the identity of a customs official to whom he played a minuet on the violin, and the literary source of Leopold's remark that their lodgings were ‘1000 Schritt lang und 1. Schritt breit’. We also discuss the history of the house name ‘Zum rothen Säbel’, which is used incorrectly in the Mozart literature; at the time of the Mozarts’ visit in 1762, it referred to the house on Färbergasse in which – we argue – they actually stayed.
Since the mid-eighteenth century the fandango has been regarded as the epitome of Spanish cultural identity. It became increasingly popular in instrumental chamber music, as well-known examples by Domenico Scarlatti, Antonio Soler and Luigi Boccherini show. To date, published musicological scholarship has not considered the role of solo violin music in the dissemination of the fandango or the shaping of a ‘Spanish’ musical identity. Now, eight rediscovered pieces – which can be dated to the period 1730–1775 – show that the violin was frequently used to perform fandangos, including stylized chamber-music versions. In addition to offering evidence of the violin's role in the genre, these pieces reveal the hybridization of the fandango with foreign musical traditions, such as the Italian violin sonata and French courtly dances, demonstrating hitherto overlooked negotiations between elite and popular culture in mid-eighteenth-century Spain. Analysis of these works’ musical features challenges traditional discourses on the ‘Spanishness’ of the fandango and, more broadly, on the opposition between ‘native’ and ‘foreign’ music in eighteenth-century Spain.
Winton Dean described Handel's 1740 ode L'Allegro, il Penseroso, ed il Moderato (hwv55), with its pastoral texts by Milton, as ‘perhaps the profoundest tribute Handel ever paid to the land of his adoption’. Yet for the first revival in January 1741, Handel prepared Italian-texted movements for this quintessentially ‘English’ ode in order to accommodate his star castrato that season, Giovanni Battista Andreoni. With the help of Paolo Rolli, a librettist long associated with Handel and a respected translator of Milton, Handel reset four English-texted arias and one accompagnato with Italian contrafacta and composed a completely new Italian accompagnato and bravura aria for Andreoni, to be performed before the very last chorus. While these Italian-texted movements in macaronic Handel revivals are often either neglected by Handel scholars or dismissed as unfortunate compromises, a textual and musical analysis of the accompagnato ‘L'insaziabil fantasia’ and the aria ‘Troppo audace’ reveals a quasi-operatic mini-scena that had personal and professional resonances for both Handel and Rolli – an artistic manifesto of sorts on moderation, ambition, imitation and freedom within the transnational mid-eighteenth-century European world of letters and music.