The Mental Health Act 2007 introduced Deprivation of Liberty safeguards into the Mental Capacity Act 2005 with potentially far reaching resource implications. There appears to be no scientific data regarding the prevalence of deprivation of liberty in clinical settings such as hospitals and nursing homes. We examined how many patients across a whole Trust area in Wales were subject to some lack of capacity, how well documented this was and how many were potentially deprived of their liberty. We found that (...) no patient was deprived of their liberty, but 8% lacked capacity to make either basic or complex decisions; another 5% lacked capacity to make complex decisions. Documentation was good in mental health and community directorates, but there were gaps in documentation (not practice) in the medical and surgical directorates. Routine collection of data improved documentation regarding deprivation of liberty criteria. There is a high likelihood that senior nursing staff underestimate the number of patients who lack capacity. (shrink)

Introduction: The decision of “do not attempt resuscitation” in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients’ own views regarding DNAR discussion.Aim: The aim of this study was to determine patients’ attitudes regarding discussing DNAR before they are critically ill.Methods: A prospective study was performed in a general out patients department. A questionnaire was distributed to (...) consecutive outpatients along with an explanatory leaflet in the adult outpatient clinic.Results: 364 patients completed the questionnaire . 90% of respondents wanted all patients to be asked regarding DNAR decision at some point during a hospital admission. The majority would not find a DNAR discussion distressing. Only 10% would find it upsetting, however, 48% of these still wanted a discussion. 37% of respondents wanted to discuss DNAR decisions on admission; 32% in outpatients; 17% at consent for surgery, 14% when they are critically ill. 87% of respondents would not object to their relatives being involved in making decisions about their resuscitation status. However, only 12% of the subjects in the study had been involved in discussing the resuscitation status of a relative and 21% would not be comfortable to discuss a relative’s resuscitation status. Although 33% of patients preferred their resuscitation status to simply be documented within their clinical notes, 77% wanted it to be more easily accessible.Conclusions: This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows. (shrink)

Introduction: The decision of “do not attempt resuscitation” in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients’ own views regarding DNAR discussion.Aim: The aim of this study was to determine patients’ attitudes regarding discussing DNAR before they are critically ill.Methods: A prospective study was performed in a general out patients department. A questionnaire was distributed to (...) consecutive outpatients along with an explanatory leaflet in the adult outpatient clinic.Results: 364 patients completed the questionnaire . 90% of respondents wanted all patients to be asked regarding DNAR decision at some point during a hospital admission. The majority would not find a DNAR discussion distressing. Only 10% would find it upsetting, however, 48% of these still wanted a discussion. 37% of respondents wanted to discuss DNAR decisions on admission; 32% in outpatients; 17% at consent for surgery, 14% when they are critically ill. 87% of respondents would not object to their relatives being involved in making decisions about their resuscitation status. However, only 12% of the subjects in the study had been involved in discussing the resuscitation status of a relative and 21% would not be comfortable to discuss a relative’s resuscitation status. Although 33% of patients preferred their resuscitation status to simply be documented within their clinical notes, 77% wanted it to be more easily accessible.Conclusions: This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows. (shrink)

This paper ethically analyses arising out the proposed changes to the Mental Health Act for England and Wales. It looks in particular at thea shift in philosophy that the author claims has occurred with the proposals away from rights-focused principles to more utilitarian or outcome-focused principles. It gives examples of these changes and explores itstheir consequences.

The incredible achievements of modern scientific theories lead most of us to embrace scientific realism: the view that our best theories offer us at least roughly accurate descriptions of otherwise inaccessible parts of the world like genes, atoms, and the big bang. In Exceeding Our Grasp, Stanford argues that careful attention to the history of scientific investigation invites a challenge to this view that is not well represented in contemporary debates about the nature of the scientific enterprise. The historical record (...) of scientific inquiry, Stanford suggests, is characterized by what he calls the problem of unconceived alternatives. Past scientists have routinely failed even to conceive of alternatives to their own theories and lines of theoretical investigation, alternatives that were both well-confirmed by the evidence available at the time and sufficiently serious as to be ultimately accepted by later scientific communities. Stanford supports this claim with a detailed investigation of the mid-to-late 19th century theories of inheritance and generation proposed in turn by Charles Darwin, Francis Galton, and August Weismann. He goes on to argue that this historical pattern strongly suggests that there are equally well-confirmed and scientifically serious alternatives to our own best theories that remain currently unconceived. Moreover, this challenge is more serious than those rooted in either the so-called pessimistic induction or the underdetermination of theories by evidence, in part because existing realist responses to these latter challenges offer no relief from the problem of unconceived alternatives itself. Stanford concludes by investigating what positive account of the spectacularly successful edifice of modern theoretical science remains open to us if we accept that our best scientific theories are powerful conceptual tools for accomplishing our practical goals, but abandon the view that the descriptions of the world around us that they offer are therefore even probably or approximately true. (shrink)

Objectives: To identify ethical attitudes about involuntary admission (known in Great Britain as formal admission) in mental health professionals and lay-people in England and Germany, especially looking at possible differences between Mental Health Professionals who are directly involved in the involuntary admission process and those who are not.Method: Three scenarios of potentially certifiable patients (known in Great Britain as sectionable patients) were presented to identify attitudes. A questionnaire asked about attitudes towards involuntary admission as well as treatment. A questionnaire analysis (...) was then performed.Results: There were similar attitudes towards involuntary admission between laypeople and mental health professionals involved in the involuntary admission process with the exception of professionals not actively involved in the involuntary admission process. Neither personal or professional experience with mental illness nor the different legal frameworks between Germany and England influenced attitudes much. Support for involuntary admission broadly increased with age.Conclusions: Psychiatrists and other mental health workers are in tune with society with regards to attitudes to involuntary admission. People involved with mentally ill patients but not in the involuntary admission process have negative attitudes towards involuntary admission. This may influence Mental Health Tribunals suggested in the new draft Mental Health Bill (2002) for England and Wales, because these Tribunals will potentially lack any involvement of professionals involved in the involuntary admission process. (shrink)

Internet usage data from around the globe show that adolescents are the most frequent Internet users, but mostly for leisure activities and maintaining social contacts. In the present study, we focused on Internet use for e-services, which could improve youth efficiency in the financial domain and bridge the online divide in youth. Specifically, we explored how societal constructs influence the use of the Internet for online shopping, e-banking and communication with providers of goods and services online. We used a representative (...) sample of adolescents from 10 countries of Southeast Europe where a great variability in Internet use is present, and where the use of e-services is generally lower than the EU average. This also allowed for meaningful cross-country comparisons. We tested a structural equation model of values predicting the use of the Internet through institutional trust which was grounded in social capital theory, cultural theory and Schwartz human values model. The model exhibited a good fit to the data but the strengths of regressional paths were rather modest. Looking into the cross-country stability of the model, however, revealed some notable differences: while the relationship between trust and use of the Internet for e-services was modest in some countries, the relationship was insignificant in other countries, where Internet usage is lower in general. This suggests that strategies aimed at leveraging e-services and digital technology potential in youth should also account for cultural specificities in the transitional economies and cultural settings with sub-optimal adoption of digital services. (shrink)

By the time of his death in 2006, Sir Peter Strawson was regarded as one of the world's most distinguished philosophers. Unavailable for many years,_ Scepticism and Naturalism_ is a profound reflection on two classic philosophical problems by a philosopher at the pinnacle of his career. Based on his acclaimed Woodbridge lectures delivered at Columbia University in 1983, Strawson begins with a discussion of scepticism, which he defines as questioning the adequacy of our grounds for holding various beliefs. He then (...) draws deftly on Hume and Wittgenstein to argue that we must distinguish between 'hard', scientific naturalism; or 'soft', humanistic naturalism. In the remaining chapters the author takes up several issues in which sceptical doubts play an important role, in particular the nature of transcendental arguments and including the objectivity of moral philosophy, the mental and the physical, and the existence of abstract entities. _Scepticism and Naturalism_ is essential reading for those seeking an introduction to the work of one of the twentieth century’s most important and original philosophers. This reissue includes a substantial new foreword by Quassim Cassam and a fascinating intellectual autobiography by Strawson, which together form an excellent introduction to his life and work. (shrink)

Psychiatric practice is often faced with complex situations that seem to pose serious moral dilemmas for practitioners. Methods for solving these dilemmas have included the development of more objective rules to guide the practitioner such as utilitarianism and deontology. A more modern variant on this objective model has been 'Principlism' where 4 mid level rules are used to help solve these complex problems. In opposition to this, there has recently been a focus on more subjective criteria for resolving complex moral (...) dilemmas. In particular, virtue ethics has been posited as a more sensitive method for helping doctors to reason their way through difficult ethical issues. Here the focus is on the character traits of the practitioner. Bloch and Green advocated another way whereby more objective methods such as Principlism and virtue ethics are combined to produce what they considered sound moral reasoning in psychiatrists. This paper points out some difficulties with this approach and instead suggests that a better model of ethical judgment could be developed through the use of narratives or stories. This idea puts equal prima facie value on the patient's and the psychiatrist's version of the dilemma they are faced with. It has the potential to lead to a more genuine empathy and reflective decision-making. (shrink)

Some scientific categories seem to correspond to genuine features of the world and are indispensable for successful science in some domain; in short, they are natural kinds. This book gives a general account of what it is to be a natural kind and puts the account to work illuminating numerous specific examples.

By the time of his death in 2006, Sir Peter Strawson was regarded as one of the world's most distinguished philosophers. Unavailable for many years,_ Scepticism and Naturalism_ is a profound reflection on two classic philosophical problems by a philosopher at the pinnacle of his career. Based on his acclaimed Woodbridge lectures delivered at Columbia University in 1983, Strawson begins with a discussion of scepticism, which he defines as questioning the adequacy of our grounds for holding various beliefs. He then (...) draws deftly on Hume and Wittgenstein to argue that we must distinguish between 'hard', scientific naturalism; or 'soft', humanistic naturalism. In the remaining chapters the author takes up several issues in which sceptical doubts play an important role, in particular the nature of transcendental arguments and including the objectivity of moral philosophy, the mental and the physical, and the existence of abstract entities. _Scepticism and Naturalism_ is essential reading for those seeking an introduction to the work of one of the twentieth century’s most important and original philosophers. This reissue includes a substantial new foreword by Quassim Cassam and a fascinating intellectual autobiography by Strawson, which together form an excellent introduction to his life and work. (shrink)

First published in 1987. Routledge is an imprint of Taylor & Francis, an informa company.

This practical and essential text, co-authored by an engineer and an ethicist, covers ethical dilemmas that any engineer might encounter on the job, emphasizing the responsibility of a practicing engineer to act in an ethical manner. To illustrate the complexities involved, the authors present characters who encounter situations that test the engineering code of ethics. The dialogue between the characters highlights different perspectives of each dilemma. As they proceed through the book, students see how the code of ethics can help (...) in decision making, as well as the implications of various decisions. The philosophical theory that supports the ethical situations encountered is presented as boxed material following each section. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. (shrink)

Do the ethical features of an artwork bear on its aesthetic value? This movie endorses misogyny, that song is a civil rights anthem, the clay constituting this statue was extracted with underpaid labor—are facts like these the proper bases for aesthetic evaluation? I argue that this debate has suffered from a false presupposition: that if the answer is yes (for at least some such ethical features), such considerations feature as pro tanto contributions to an artwork's overall aesthetic value, i.e., as (...) merits or flaws which make something have more or less overall aesthetic value. As the case of ethically laden, aesthetic evaluation makes clear, however, good aesthetic judgement is irreducibly multi-dimensional, e.g., "the movie has an engaging soundtrack, tasteful camera work, and takes a misogynistically prurient perspective on its female lead.'' Such a "non-summative" judgement refuses to reduce those various dimensions of aesthetic value to a single aggregate aesthetic evaluation, like "it's a 6/10" or "it's a pretty good movie!" I defend both the modest claim that such non-summative evaluations are not mistaken and the extremist claim that summative (i.e., unidimensional) aesthetic evaluation is defective by considering other domains of normative assessment in which summing seems inappropriate, notably including evaluations of people's character. (shrink)

Profoundly important ethical and political controversies turn on the question of whether biological life is an essential aspect of a human person, or only an extrinsic instrument. Lee and George argue that human beings are physical, animal organisms - albeit essentially rational and free - and examine the implications of this understanding of human beings for some of the most controversial issues in contemporary ethics and politics. The authors argue that human beings are animal organisms and that their personal identity (...) across time consists in the persistence of the animal organisms they are; they also argue that human beings are essentially rational and free and that there is a radical difference between human beings and other animals; criticize hedonism and hedonistic drug-taking; present detailed defenses of the prolife positions on abortion and euthanasia; and defend the traditional moral position on marriage and sexual acts. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Burma’s Healthcare Under Fire: My Experience as an Exiled Medical ProfessionalP. P. KyawI used to work as a medical doctor in a less developed state than many big cities in Burma1 that experienced prolonged civil wars and current similar atrocities decades before the urban areas of the country experienced them. Before everything started, I was responsible for the medical management of the most vulnerable communities and had been struggling (...) with pandemic-related medical activities. Those were the happiest years of my life. I was with one of the best international organizations, where every effort I made was directly delivered to the patients with no unnecessary paperwork. The system was efficient, my colleagues were supportive, and I had a good work-life balance. I supported my family and whoever needed temporary financial support, played music weekly, met good friends who I hung out with every weekend, and [End Page 164] found hobbies like gardening and crocheting. I was content and happy. I even postponed my plans to get registered as a doctor in the Western world.Before moving to this beautiful ethnic state in 2019, I previously worked as a government medical doctor in Yangon, the capital. As much as I loved working in those civilian hospitals, I could not support myself with a monthly pay of $100-$150 USD. It was a hard decision to leave the service because it meant I could not pursue the medical specialty that I had always longed for and had to leave like-minded supportive colleagues. In Myanmar, unless you are a civil servant, you cannot pursue further clinical specialties. However, after leaving the government’s service to work in humanitarian medical assistance in hard-to-reach areas of Burma, I learned that life is still beautiful outside my comfort zone, until February 2021 when the coup began. Democratically elected members of the country’s ruling party were overthrown by the military, which then bestowed power in a military junta.I expected the election prior to the coup in November 2020 to be an uphill battle for Burma, but nothing more. I was still in denial when I first heard the news from one of the town’s NGO staff. The person had to travel on a motorbike to inform everyone that the junta had staged the coup. No telephone or internet was working at that time. My colleagues and I cried in our office, saying, “We are so young, and the future is still ahead. I don’t think this is going to last long. Maybe it will be over in a few days or, at most, a few weeks.” Once the peaceful protests started nationwide, my friends and I provided medical cover for the protesters, initially for minor medical problems such as low sugar, low blood pressure, injuries from accidental minor slips and falls, etc. Never in my life had I imagined that I would be taking care of bullet wounds and people injured by live rounds. While learning about gunshot wounds in forensic medicine, I thought, “Oh, this is not going to be very useful because Burma is not America, and I am not going there.” Then suddenly, it became too real and more useful than I would’ve liked it to be.I always think back to one especially bloody day when many people in the town were shot with live rounds. We assisted many patients. Usually, we would go around with the protest groups until they were over in the late afternoon. The protesters were always peaceful. There were no riots, no harmful acts, or vandalism. Only when the protesters were cruelly dispersed with tear gas, high-pressure pumps, rubber bullets, and live rounds (to the head) did they decide to defend themselves while still making their voices heard. The only defenses people had to counteract the live rounds were things like metal covers, firecrackers, and slingshots.One afternoon in March 2021, my team and I took an early break for lunch—unaware that some people would lose their lives that afternoon. We followed the local protests through Facebook Live while having lunch and started to hear firecracker sounds. A few seconds later, we knew... (shrink)

A critical note on Christopher Bartel and Jack M. C. Kwong, ‘Pluralism, Eliminativism, and the Definition of Art’, Estetika 58 (2021): 100–113. Art pluralism is the view that there is no single, correct account of what art is. Instead, art is understood through a plurality of art concepts and with considerations that are different for particular arts. Although avowed pluralists have retained the word ‘art’ in their discussions, it is natural to ask whether the considerations that motivate pluralism should lead (...) us to abandon art talk altogether; that is, should pluralism lead to eliminativism? This paper addresses arguments both for and against this move. We ultimately argue that pluralism allows one to retain the word ‘art’, if one wants it, but only in a loose, conversational sense. The upshot of pluralism is that talk of art in general cannot be asked to do theoretical and philosophical work. (shrink)

This volume presents twenty-two uncollected philosophical essays by Sir Peter Strawson, one of the leading philosophers of the second half of the twentieth century. The essays (two of them previously unpublished) are drawn from seven decades of work, from 1949 to 2003. They span the broad range of Strawson's work: metaphysics, epistemology, philosophical logic, philosophy of language, ethical theory, and history of philosophy, along with metaphilosophical reflections and intellectual autobiography.

This collection of 11 studies provides a new discussion of Lucretius' History of the Human Mankind and of other topics (Lucretius' explanation of sleep, dreams and optical illusions) in relationship to other philosophical and scientific doctrines of Antiquity.

Originally published in 1957, The Uniqueness of the Individual is a collection of 9 essays published from the ten years preceding publication. The essays deal with some of the central problems of biology. These are among the questions put and answered from the standpoint of modern experimental biology. What is ageing and how is it measured? What theories have been held to account for it, and with what success? Did ageing evolve, and if so how? Is Lamarckism and adequate explanation (...) of evolutionary process? Does evolution sometimes go wrong? Do human beings evolve in a way peculiar to themselves? Other essays touch upon the problems of scientific method and of growth and transformation. This book will be of interest to natural historians, evolutionists and anthropologists. (shrink)

This book addresses the Confucian philosophy of common good and deals with the comparative philosophy on eastern and western understandings of common good. The common good is an essentially contested concept in contemporary moral and political discussions. Although the notion of the common good has a slightly antique air, especially in the North Atlantic discussion, it has figured prominently in both the sophisticated theoretical accounts of moral and political theory in recent years and also in the popular arguments brought for (...) particular political policies and for more general orientations toward policy. It has been at home both in the political arsenal of the left and the right and has had special significance in ethical and political debates in modern and modernizing cultures. This text will be of interest to philosophers interested in Chinese philosophy and issues related to individualism and communitarianism, ethicists and political philosophers, comparative philosophers, and those in religious studies working on Chinese religion. (shrink)

This book discusses the study and analysis of the physical aspects of social systems and models, inspired by the analogy with familiar models of physical systems and possible applications of statistical physics tools. Unlike the traditional analysis of the physics of macroscopic many-body or condensed matter systems, which is now an established and mature subject, the upsurge in the physical analysis and modelling of social systems, which are clearly many-body dynamical systems, is a recent phenomenon. Though the major developments in (...) sociophysics have taken place only recently, the earliest attempts of proposing "Social Physics" as a discipline are more than one and a half centuries old. Various developments in the mainstream physics of condensed matter systems have inspired and induced the recent growth of sociophysical analysis and models. In spite of the tremendous efforts of many scientists in recent years, the subject is still in its infancy and major challenges are yet to be taken up. An introduction to these challenges is the main motivation for this book. (shrink)

Priyanshu Prabal Upadhyaya, b. 1919, Sanskrit scholar; contributed articles on various aspects of Indic philosophy, Vedic and Sanskrit literature.

The author asks to what extent a knowledge of the concepts of yoga may prepare the way to a better understanding of Indian archaeology. The yoga at the basis of this study is that which forms the core of the Tantras. In the first chapter the author surveys the system of Tantrik yoga. He then continues with a discussion of the various forms of yantras, that is all the means employed by yogis in their meditational exercises as aids to the (...) concentration of thought. The author provides in-depth studies of ritual objects of the Lamaistic cult in Tibet and Nepal, the sacred cemeteries of Nepal, and pantheons in Java and Bali. (shrink)

Did the Greeks believe in their mythology? The answer is difficult, for “believe” means so many things… Not everyone believed that Minos continued to be a judge in Hell or that Theseus defeated the Minotaur, and they knew that poets “lie.” Nevertheless, their manner of not believing gave reason for concern, for Theseus was no less real in their eyes. It is simply necessary to “purify myth with reason’“ and to reduce the biography of the companion of Hercules to its (...) historic kernel. As for Minos, after a prodigious mental effort, Thucydides extracts the same kernel from his subject: “Of all those whom we know only by hearsay, Minos was the first to have a fleet.” The father of Phaedra, the husband of Pasiphaë is nothing more than a king who was master of the sea. The purification of the mythical by the logos is not an episode in the eternal struggle, from the beginning to Voltaire and Renan, between superstition and reason, a struggle which was the glory of Greek genius. The myth and the logos, despite Nestle, are not simple opposites like truth and error. Myth was a subject of serious reflections, and the Greeks had not yet finished with it six centuries after the Sophist movement which has been called their Aufklärung. Far from being a triumph of reason, the purging of myth by logos is a very dated program whose absurdity is surprising. Why did the Greeks make themselves unhappy for nothing by seeking to separate the wheat from the chaff instead of rejecting in one gesture the fantasy of both Theseus and the Minotaur, the very existence of a fabulous Minos as well as the implausible qualities with which the myth endows this Minos? (shrink)

In this engaging and spirited text, Michael Lynch argues that truth does matter, in both our personal and political lives. He explains that the growing cynicism over truth stems in large part from our confusion over what truth is.

Our aim in this entry is to articulate the state of the art in the moral psychology of personal identity. We begin by discussing the major philosophical theories of personal identity, including their shortcomings. We then turn to recent psychological work on personal identity and the self, investigations that often illuminate our person-related normative concerns. We conclude by discussing the implications of this psychological work for some contemporary philosophical theories and suggesting fruitful areas for future work on personal identity.

What lies at the heart of physical inquiry? What are the foundational ideas and working assumptions that inform the enterprise of natural science? What principles guide research? How do scientists decide whether they are building theories in the right direction? Is there a right direction? Do physical theories actually approximate an objective reality, or are they simply useful summaries, mnemonics for experimental results? This book is Nobel Prize winner Jim Peebles's contribution to such big, classic debates in the philosophy of (...) science, drawing on a lifetime of experience as a leading physicist and taking the development of physical cosmology as a "worked example." He begins with a consideration of the history of thought about the nature of the physical sciences since Einstein, culminating in a succinct statement of what he sees as the fundamental working assumptions of physics. Then, through a careful examination of the development of the general theory of relativity, Einstein's cosmological principle, the big bang theory, and our current model of the universe, he makes the argument that physical theories ultimately are useful approximations to an objective reality whose nature science is discovering. An essential reflection on and interrogation of the nature and practice of science by a giant in the field, The Whole Truth will be illuminating reading for cosmologists, physicists, and historians, philosophers, and sociologists of science alike. (shrink)