The clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions (decisional autonomy) to the virtual exclusion of the capacity to execute the treatment plan (executive autonomy). However, the one-component concept of autonomy is problematic in the context of multiple chronic conditions. Adherence to complex treatments commonly breaks down when patients have functional, educational, and cognitive barriers that impair their capacity to plan, sequence, and carry out tasks associated with chronic care. (...) The purpose of this article is to call for a two-component re-conceptualization of autonomy and to argue that the clinical assessment of capacity for patients with chronic conditions should be expanded to include both autonomous decision-making and autonomous execution of the agreed-upon treatment plan. We explain how the concept of autonomy should be expanded to include both decisional and executive autonomy, describe the biopsychosocial correlates of the two-component concept of autonomy, and recommend diagnostic and treatment strategies to support patients with deficits in executive autonomy. (shrink)

The clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions to the virtual exclusion of the capacity to execute the treatment plan. However, the one-component concept of autonomy is problematic in the context of multiple chronic conditions. Adherence to complex treatments commonly breaks down when patients have functional, educational, and cognitive barriers that impair their capacity to plan, sequence, and carry out tasks associated with chronic care. The purpose of this (...) article is to call for a two-component re-conceptualization of autonomy and to argue that the clinical assessment of capacity for patients with chronic conditions should be expanded to include both autonomous decision-making and autonomous execution of the agreed-upon treatment plan. We explain how the concept of autonomy should be expanded to include both decisional and executive autonomy, describe the biopsychosocial correlates of the two-component concept of autonomy, and recommend diagnostic and treatment strategies to support patients with deficits in executive autonomy. (shrink)

This study aimed to determine the factors influencing the use of spacing contraceptive methods in India, particularly from men’s perspective. Data were obtained through a semi-structured interview schedule from 2687 married men aged between 18 and 40 years from central Mumbai City, India, during 1999. Chi-squared tests and binary logistic regression analysis was carried out to determine the relationship between various variables and the likelihood of a couple using spacing contraceptive methods. Of the 2687 couples, 1395 (51·9%) were using one (...) or other method of spacing contraceptives and 1292 (48·1%) were not using any method at the time of survey. Male participation in contraceptive use was 23% (condom and withdrawal). The results indicate that the use of spacing contraceptive methods was significantly higher among those couples where the men desired one or two children (OR=4·3), had knowledge of five or more contraceptive methods (OR=1·9) and discussed with their wives obtaining family planning information (OR=3·2), spacing (OR=2·7) and permanent (OR=2) contraceptive methods. Age, income, desired number of children, knowledge of a greater number of contraceptive methods, inter-spouse communication regarding obtaining family planning information, spacing and permanent methods were found to be strong predictors of the use of spacing contraceptive methods. The study underlines the importance of intervention programmes aimed at promoting a small family norm, increasing the number of contraceptive choices available and encouraging inter-spouse communication. Hence, policymakers and programme managers should encourage interventions in this direction, targeting couples to enhance the use of spacing contraceptive methods. (shrink)

A. D. M. Walker; III*—Gratefulness and Gratitude, Proceedings of the Aristotelian Society, Volume 81, Issue 1, 1 June 1981, Pages 39–56, https://doi.org/10.1093.

An attempt is made to pinpoint the way in which perception is related to belief. Although, for familiar reasons, it is not true to say that we necessarily believe in the existence of the objects we perceive, nor that they actually have their ostensible characteristics, it is argued that the relation between perception and belief is more than merely contingent.There are two main issues to address. The first is that ‘collateral’ beliefs may impede perceptual belief. It is argued that this (...) still assigns an essential role to belief in perception, though the belief may be of an attenuated form. The second is Fred Dretske’s claim that even attenuated belief may be entirely absent from perception. It is argued that ‘non-epistemic’ perception can be understood only by employing the concept of ‘epistemic’ perception; that the former can occur only partially---i.e., within perceptions that are otherwise epistemic; and that by switching attention from the perception of objects to the Phenomenological tradition’s concern with the perception of world, we can see that perception must be entirely permeated with ‘doxastic’ force. (shrink)

An attempt is made to pinpoint the way in which perception is related to belief. Although, for familiar reasons, it is not true to say that we necessarily believe in the existence of the objects we perceive, nor that they actually have their ostensible characteristics, it is argued that the relation between perception and belief is more than merely contingentThere are two main issues to address. the first is that ‘collateral’ beliefs may impede perceptual belief. It is argued that this (...) still assigns an essential role to belief in perception, though the belief may be of an attenuated form. the second is Fred Dretske's claim that even attenuated belief may be entirely absent from perception. It is argued that (a) ‘non‐epistemic’perception can be understood only by employing the concept of ‘epistemic’perception; (b) that the former can occur only partially—i.e., within perceptions that are otherwise epistemic; and (c) that by switching attention from the perception of objects to the Phenomenological tradition's concern with the perception of world, we can see that perception must be entirely permeated with ‘doxastic’force. (shrink)

The Problem of Perception offers two arguments against direct realism--one concerning illusion, and one concerning hallucination--that no current theory of ...

First published in 1991. Routledge is an imprint of Taylor & Francis, an informa company.

In this paper I want to examine a view of the Darwinian theory of evolution which was put forward fairly recently by A. R. Manser. His approach is of interest not only in itself, but also because it may be expanded to raise some fundamental questions about the nature of the science of biology in general. I shall not consider these further implications here, but shall concentrate on an examination of his thesis in the context in which it is raised. (...) My paper falls into two sections. In the first I shall state Manser's thesis and some of the arguments with which he supports it, and shall try to show how a series of objections raised by A. G. N. Flew and K. Connolly may be answered. In the second I shall offer on my own account a positive argument to provide a possible basis for his point of view, with the aim of indicating why the theory should be of the kind he suggests, and what form the study of evolution must take. (shrink)

One of Hume's most well-known works and a masterpiece of philosophy, A Treatise of Human Nature is indubitably worth taking the time to read.

The paper examines a single, apparently simple argument for the existence of incompatibilities between the virtues as traits of character. This argument appeals not to empirical truths about human psychology or human nature but to the possibility of conflict between the exercise of different virtues in action. There are, for example, situations in which we can exercise the virtue of truthfulness only at the expense of not exercising the virtue of tact, as when we are asked a question to which (...) the straightforward answer will pain our questioner. The person who in these situations would give a straightforward answer possesses the virtue of truthfulness to a higher degree than the person who would respond more evasively, whereas the latter person possesses the virtue of tact to a higher degree than the former. But since the two responses are mutually exclusive, it follows that the degree to which we possess the virtue of truthfulness must, at least in some measure, correlate inversely with the degree to which we possess the virtue of tact. And similarly for many other pairs of virtues. My paper focusses on the two cardinal assumptions of this argument, viz., (i) that sometimes the exercise of one virtue can conflict with the exercise of another, and (ii) that the degree to which a person possesses a virtue correlates directly with the extent of its exercise, and defends both assumptions against a variety of objections which allege that, in different ways, they are insensitive to the complexity of the virtues. (shrink)

There are many possible ways of approach to philosophy, and there is also an impossible one, though one that has often been tried. That the philosopher can somehow spin his philosophy out of what he finds inside himself; that he has some private internal source of information in virtue of which he can decide what the Universe must be, without needing to take the trouble to look at it, is a belief that dies hard. But it is now dying, if (...) not dead, so that it is hardly necessary to refute it in detail. It should suffice to say that anybody who cherishes the belief will not find anything to interest him in what follows. I shall simply assume that the philosopher is, what we all are to some extent, a spectator of the world and of man's life in it and a commentator on what he sees. Where the philosopher differs from others is in the kind of interest he takes in the facts, not in the kind of facts that are there to be interested in. (shrink)

At the risk of proving myself such a caviller, I want to ask a question which I have seldom heard raised, and which I have never seen discussed in anything that I have read about Berkeley. If I am right, it poses a problem for his immaterialism, not only different, but coming from a different direction, from those objections that are commonly levelled against him. If I am wrong, it will show how right Berkeley was to stress the difficulty of (...) using for one purpose our language which has become fashioned for another. At least, I hope that I shall not fail to be the ‘fair and ingenuous reader’for whom he asked. (shrink)

In her careful consideration of my book, The Problem of Perception, Susanna Siegel highlights what she takes to be a number of shortcomings in the work. First, she suggests that a sense-datum theorist has two options—what she calls the “complex sense-data option” and the “two-factor option”—that survive the argument of my book unscathed. I consider these two options in the first two sections of this reply. Secondly, she criticizes my suggestion that there are three and only three basic and independent (...) sources of perceptual consciousness: an issue I take up in my third section. Thirdly, she expresses reservations about my response to the argument from hallucination. In particular, she argues that the phenomenological considerations on which I put so much weight cannot settle the fundamental issue here. I address this criticism in the fourth section of this reply. Finally, she spends a certain amount of time discussing the notion of a “veridicality-relevant property”, a topic to which I devote the concluding section of this reply. (shrink)

For over a century we have attempted to understand human aesthetic experience using scientific methods. A typical experiment could be described as reductive and quasi-psychophysical. We vary some aspect of the stimulus and systematically measure some aspect of the aesthetic response. The limitations of this approach can be categorized as problems on the Y axis and the X axis. The most enigmatic components of aesthetic experience include inclination to cry, aesthetic rapture, a sense of the sublime, and intense fascination. However, (...) we cannot evoke these 'hot' aesthetic emotions in the lab, at least not with well controlled stimuli on multiple trials. We thus resort to measuring cold, cognitive preference ratings. There are also problems on the X axis. The reductive psychophysical approach explicitly assumes that there are lawful relations between different stimulus dimensions and preferences. It also tacitly assumes that these dimensions are independent and orthogonal. The second assumption is implausible. Whatever stimulus-preference laws we discover are likely to be twisted and modulated when another dimension is added to the stimuli. This 'gestalt nightmare' has long been recognized, but never resolved. This matters, because human aesthetic faculties are probably tuned to the balance and relationship of parts which make up a whole and are indifferent to the parts presented in isolation. I conclude that the future of scientific aesthetics depends on how successfully we can transcend reductive, quasi-psychophysical approaches. (shrink)

In her careful consideration of my book, The Problem of Perception (henceforth, PP), Susanna Siegel highlights what she takes to be a number of shortcomings in the work. First, she suggests that a sense‐datum theorist has two options–what she calls the “complex sense‐data option” and the “two‐factor option”–that survive the argument of my book unscathed. I consider these two options in the first two sections of this reply. Secondly, she criticizes my suggestion that there are three and only three basic (...) and independent sources of perceptual consciousness: an issue I take up in my third section. Thirdly, she expresses reservations about my response to the argument from hallucination. In particular, she argues that the phenomenological considerations on which I put so much weight cannot settle the fundamental issue here. I address this criticism in the fourth section of this reply. Finally, she spends a certain amount of time discussing the notion of a “veridicality‐rele‐vant property”, a topic to which I devote the concluding section of this reply. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Humanism, Female Education, and Myth:Erasmus, Vives, and More's To CandidusA. D. CousinsWhen considering pleasure and chance as aspects of human experience, Thomas More sometimes gendered them female; that is to say, at times he represented them by drawing from the mythographies of Venus and of Fortune. But what did he suggest that actual women, as distinct from goddesses, were or should be or might become: what were his notions (...) of being a woman, of femaleness? Further, what did he suggest that women might contribute to the common weal? A useful way to start answering that question is to look at what More seems to have thought about educating women: in particular, women who were entering adult life—entering into what was agreed to be the major female role—by marrying for the first time and therefore newly taking upon themselves the management of a household. In one of his most ambitious Latin poems, as nowhere else, More wrote elaborately, concisely and problematically on the education of women who were in just those circumstances. My discussion attempts a repositioning of that poem, To Candidus: How to Choose A Wife A Poem in Iambic Dimeter Brachycatalectic (Versvs Iambici Dimetri Brachycatalectici ad Candidvm, Qvalis Vxor Deligenda). To make the attempt involves examining More's other Latin poems on women, as would be anticipated; however, I am mainly concerned here with affinities between To Candidus—then, to a lesser extent, some of More's associated Latin poems—and notions about female education that were or were to become part of the already long, and mostly male, debate about the nature of femaleness.1 To be [End Page 213] specific, I am chiefly concerned with affinities between More's poem and writings by Erasmus and by Vives on the education of prospective or of recent brides.Because the primary concern in my discussion is to clarify the relations between More's To Candidus and humanist notions on female education, especially notions put forward by two of More's humanist friends about young brides, I want initially to revisit the early modern debate on educating women, of course an important element of the wider debate about femaleness itself. One medieval and thence early modern idea on female education was that, in addition to what their mothers taught them, most women needed merely to receive religious and ethical instruction from their husbands, who would likewise instruct them in how to govern a household.2 After all, it was often pointed out, the household was women's natural domain: since, therefore, they would not normally engage with the world at large as would men—since, for example, they would not normally be educators, or writers, or politicians—women did not usually need the broad education appropriate to men.3 Assertion to the contrary was variously argued—and differences between or among those contrary assertions did not always depend on whether an author was male or female. In The Book of the City of Ladies (1405), a response to Boccaccio's De Mulieribus Claris and, perhaps unknowingly, also to Plutarch's The Virtues of Women, Christine de Pizan attempted to construct at once a refuge and a resource for [End Page 214] women, whom she recognized as having been misrepresented to themselves no less than to men throughout generations of misogynistic male fictions, ranging from satire to epic, from fable to history.4 Her City, in so far as it is a revisionist history of women, forms a textual space which does indeed offer a refuge as well as a resource, for Christine advocates that women, fulfilling their capabilities as women, aim at "cultivat[ing] virtue" and thereby gaining inclusion in the true, illustrious record of female achievement: membership of a textual community within which they will see themselves reflected and which is at one with the City of God.5 Inseparable from their seeking to do so, she emphasizes, will be their receiving education.6 Despite that emphasis—and despite her emphasizing that women are men's intellectual equals or, not infrequently, superiors—Christine nevertheless defends the concept that the domestic sphere and not the public is in general that "appropriate" to women.7... (shrink)