Despite recent increasing support for the brain disease model of alcohol and drug addiction, the extent to which the model may clinically impact addiction treatment and client behaviour remains unclear. This qualitative study explored the views of community-based clinicians in Australia and examined: whether Australian community-based clinicians support the BDM of addiction; their attitudes on the impact the model may have on clinical treatment; and their views on how framing addiction as a brain disease may impact addicted clients’ behaviour. Six (...) Australian community-based clinicians participated in semi-structured in-depth interviews that were analysed using thematic analysis. Whilst the BDM was not fully supported by this purposive sample of Australian community-based clinicians, there was acceptance that addiction neuroscience formed a key part of a wider addiction framework. Participants believed the BDM ignored key social, psychological and environmental factors important for successful treatment. The BDM was seen as potentially irrelevant for certain client types, however the model was believed to integrate with particular therapies. Participants believed that for clients viewing their addiction in terms of a brain disease, there were potential positive and negative impacts on client behaviour. Implications for addiction treatment practice and public health policy are discussed. (shrink)

Ethics education is recognized as an integral component of health professionals’ education and has been occurring in various guises in the curricula of health professional training in many countries since at least the 1970s. However, there are a number of different aims and approaches adopted by individual educators, programs, and, importantly, different health professions that may be characterized according to strands or trends in ethics education.

Pickard (2012) claims that the neurobiological or disease model of addiction hinders the recovery of people because it undermines their feeling of self-efficacy and agency. Sub- stance users are “not aided by being treated as victims of a neurobiological disease, as opposed to agents of their own recovery” (40).Although Pickard acknowledges that claims of powerlessness or loss of agency can have a functional role in the self-narratives of substance users in excusing them from blame, she primarily focuses on the negative (...) effects of the diseasemodel on the recovery of substance users. Preliminary evidence from in-depth interviews with heroin-dependent participants in our current cohort study on addiction and moral identity supports Pickard’s claims in part: Substance users describe grades of control, psychological distress, and loss of options, and an ambivalent attitude toward their belief in self-efficacy. However the interviews also provide points of critique. While Pickard is right to dismiss the more extreme claims of proponents of the disease model—namely, that drug use in addicts is literally compelled—user responses suggest that an understanding of the neurobiology of addiction might in some respects support rather than undermine a sense of agency. Moreover, there is reason to suppose that the relation be- tween substance use and psychological distress is not as straightforward as Pickard claims. In this respect we believe the debate must become more nuanced and move beyond a simple opposition between the disease model and the rational choice model endorsed by Pickard. (shrink)

The concepts of ‘biopolitics’ and ‘naked life’ have become increasingly relevant in the debate on substance dependency due to the growing prominence of neuroscience in defining the nature of addiction1 and its threat to agency. However, these concepts are not necessarily well understood, and therefore may lead to oversight rather than insight. In this article we review the literature on Italian philosopher Giorgio Agamben, whose founding works on both concepts shed a different light on addiction. We argue that the current (...) debate is missing a key insight from Agamben's work: the idea of agency past the subject, of agency past identity. We will illustrate how this can be an important form of agency against the stigmatization of users, making use of empirical data from our ongoing work on addiction and agency. (shrink)

National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In (...) this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing. (shrink)

How can we talk meaningfully about the past if it does not exist to be talked about? What gives time its direction? Is time travel possible? This defence of presentism - the view that only the present exists - makes an original contribution to a fast growing and exciting debate.

How can we talk meaningfully about the past if it does not exist to be talked about? What gives time its direction? Is time travel possible? This defence of presentism - the view that only the present exists - makes an original contribution to a fast growing and exciting debate.

The counterfactual mental state of negligent criminal activity invites skepticism from those who see mental states as essential to responsibility. Here, I offer a revision of the mental state of criminal negligence, one where the mental state at issue is actual and not merely counterfactual. This revision dissolves the worry raised by the skeptic and helps to explain negligence’s comparatively reduced culpability.

This 2-in-1 anthology and guide brings together the most influential readings on key topics in philosophy of religion from the Christian tradition and sets them in context.

Politics pervades every aspect of our lives as human beings. As Aristotle said, we are "political animals.

In this paper I argue that Theodor W. Adorno 's philosophy of freedom needs an ontological picture of the world. Adorno does not make his view of natural order explicit, but I suggest it could be neither the chaotic nor the strictly determined ontological images common to idealism and positivism, and that it would have to make intelligible the possibility both of human freedom and of critical social science. I consider two possible candidates, Nancy Cartwright 's ‘patchwork of laws’, and (...) Roy Bhaskar 's critical realism. Arguing that Cartwright 's position conflicts with the spirit of Adorno 's philosophy, I suggest that Bhaskar 's realism is compatible with and to a significant extent implicit in Adorno 's position. Whilst Adorno is clearly not a critical realist, Bhaskar 's position does provide the best overall account of the ontological commitments of Adorno 's critical theory. It becomes possible in turn to locate Bhaskar 's arguments in a broader critical tradition and give fuller expression to the concerns that structure his work, in particular by locating the epistemic fallacy in the narrative account of the natural history of subjective reason and its tendency towards ‘identity thinking ’. The discussion goes on to consider the interdependence of reason, nature and freedom in the idea of emancipatory critique, confirming the deeper affinities between critical realism and critical theory. (shrink)

Drunk drivers and other culpably incapacitated wrongdoers are often taken to pose a problem for reasons-responsiveness accounts of moral responsibility. These accounts predicate moral responsibility upon an agent having the capacities to perceive and act upon moral reasons, and the culpably incapacitated wrongdoers lack exactly those capacities at the time of their wrongdoing. Many reasons-responsiveness advocates thus expand their account of responsibility to include a tracing condition: The culpably incapacitated wrongdoer is blameworthy despite his incapacitation precisely because he is responsible (...) for becoming incapacitated. As some skeptics have suggested, it is not clear that we need tracing. Here, however, I make a stronger case against tracing: I show that tracing gets things wrong. I consider a new sort of case, the case of the Odysseus agent, whose incapacitation is non-culpable (sometimes merely permissible and sometimes praiseworthy). Tracing would have us hold responsible and therefore blame unlucky Odysseus agents, Odysseus agents who commit a wrongdoing in the throes of their non-culpably induced incapacitation. But we should not hold these unlucky Odysseus agents responsible for their incapacitated wrongdoing. Because tracing gets these cases wrong, we should reject tracing. (shrink)

Excerpt from Wissen, Glaube und Ahndung Ich habe an; einem andern Orte, reinhold Fichte und Schelling 1, ]i den; f_unt'e1{s chied des arbeit Ma1en platonisehen'nogrnatisrnugx und deanfleiesigen; Kriticiemus 511159in hier - mu ichbemmv. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the (...) aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

For many philosophers, bad-history wrongdoers are primarily interesting because of what their cases might tell us about the interaction of moral responsibility and history. However, philosophers focusing on blameworthiness have overlooked important questions about blame itself. These bad-history cases are complicated because blame and sympathy are both fitting. When we are careful to consider the rich natures of those two reactions, we see that they conflict in several important ways. We should see bad-history cases as cases about whether and how (...) we should blame, rather than as cases giving us ready insight into the nature of moral responsibility. (shrink)

The Russian philosopher and cultural theorist Mikhail Bakhtin has traditionally been seen as the leading figure in the group of intellectuals known as the Bakhtin Circle. The writings of other members of the Circle are considered much less important than his work, while Bakhtin's achievement has been exaggerated in proportion to the downgrading of the thinkers with whom he associated in the 1920s. This volume, which includes new translations and studies of the work of the most important members of the (...) Circle, sets out to correct the distortions in the established representations of its activity. The original contributions to literary and linguistic theory made by Valentin Voloshinov and Pavel Medvedev (but frequently credited to Bakhtin) are assessed, and the distinctiveness of their approaches is highlighted. (shrink)

Objective: To examine current research payment practices and to inform development of clearer guidelines for researchers and ethics committees.Design: Exploratory email based questionnaire study of current research participant reimbursement practices. A diverse sample of organisations and individuals were targeted.Setting: Australia.Participants: Contacts in 84 key research organisations and select electronic listservers across Australia. A total of 100 completed questionnaires were received with representations from a variety of research areas .Main measurements: Open-ended and fixed alternative questions about type of research agency; type (...) of research; type of population under study; whether payment is standard; amounts and mechanisms of payment; factors taken into account when deciding on payment practices; and whether payment policies exist.Results: Reimbursement practice is highly variable. Where it occurs it is largely monetary and is for time and out-of-pocket expenses. Ethics committees were reported to be often involved in decision making around reimbursement.Conclusions: Research subject payment practices vary in Australia. Researchers who do provide payments to research participants generally do so without written policy and procedures. Ethics committees have an important role in developing guidelines in this area. Specific guidelines are needed considering existing local policies and procedures; payment models and their application in diverse settings; case study examples of types and levels of reimbursement; applied definitions of incentive and inducement; and the rationale for diverse payment practices in different settings. (shrink)

As we navigate through life, we model time as flowing, the present as special, and the past as “dead.” This model of time—manifest time—develops in childhood and later thoroughly infiltrates our language, thought, and behavior. It is part of what makes a human life recognizably human. Yet if physics is correct, this model of the world is deeply mistaken. This book is about this conflict between manifest and physical time. The first half dives into the physics and philosophy to establish (...) the conflict’s existence; but it also argues that the claim that physics “spatializes” time is overstated. Rather, even relativity theory makes time special in deep and significant ways. The second half turns to psychology, biology, and more, seeking to understand why creatures like us develop manifest time. The novel picture that results is that manifest time is a natural reaction to the many cognitive and evolutionary challenges that we face. For subjects embedded in our circumstances, it makes sense to develop—even if fundamentally wrong. (shrink)

Duress is a defense in both law and morality. The bank teller who provides an armed robber with the bank vault combination, the innocent suspect who fabricates a story after hours of interrogation, the Good Samaritan who breaks into a private cabin in the woods to save a stranded hiker, and the father who drives at high speed to rush his injured child to the hospital—in deciding how to respond to agents like these, we should take into account that they (...) have acted under duress. In this paper, I offer a new duress defense, which I call “distinctive duress.” The distinctive-duress defense is neither ordinary justification nor ordinary excuse. Rather, it is a defense available to agents who act wrongly because they are appropriately insensitive to certain reasons. In the distinctive-duress cases, an agent’s normative sensitivities are rightly directed elsewhere, leading them awry. (shrink)

A framework for pragmatic analysis is proposed which treats discourse as a game, with context as a scoreboard organized around the questions under discussion by the interlocutors. The framework is intended to be coordinated with a dynamic compositional semantics. Accordingly, the context of utterance is modeled as a tuple of different types of information, and the questions therein — modeled, as is usual in formal semantics, as alternative sets of propositions — constrain the felicitous flow of discourse. A requirement of (...) Relevance is satisfied by an utterance (whether an assertion, a question or a suggestion) iff it addresses the question under discussion. Finally, it is argued that the prosodic focus of an utterance canonically serves to reflect the question under discussion (at least in English), placing additional constraints on felicity in context. (shrink)

This very short introduction will first outline how ontological investigations and questions of practice go together. The second section will bring in the next pole of this entire book, history of mathematics. How do ontology, practice, and history go together? Is this a forced marriage or one born in true love? That is, do these three belong together in some very basic way? One chapter in the section argues that the philosophy of mathematical practice intersects with the history of mathematics (...) essentially. If the first section of this introduction is persuasive that will also show that the history of mathematics intersects with ontological questions as well, specifically, that historical questions are very much about the ontological commitments of past mathematicians. The last section will take up what might seem a very different theme, namely, how these things matter to mathematics education. This section is connected closely to the second section since mathematics education has taken an interest in the role of history of mathematics in mathematics education, and much insight can be gained by seeing the issues in relation to the ontology-practice-history triad. The question of education is also important since teachers must consider what it is exactly that they are teaching, or, to adapt the title of Reuben Hersh’s well-known book, “What is mathematics really about?” And the “aboutness” of mathematics is really the ontological question. (shrink)

Last year, the Joint Commission on Accreditation of Healthcare Organizations for the first time included provisions in its Hospital Accreditation Manual requiring institutions to have mechanisms in place to consider ethical issues arising in the care of patients and to educate care givers and patients on bioethical issues. This new requirement is notably vague. There is no indication of what type of mechanisms would be appropriate or how those involved in considering ethical issues should conduct themselves. This vagueness is by (...) no means accidental, but it reflects a recognition that clinical bioethics is still in its formative stages and that there are currently almost as many different mechanisms for dealing with bioethical issues in the healthcare setting as there are institutions that have such mechanisms. The Joint Commission's action, however, also implies that the time for experimentation will soon be over. (shrink)

Harry C. Boyte. Craig Calhoun. Geoff Eley. Nancy Fraser. Nicholas Garnham. JürgenHabermas. Peter Hohendahl. Lloyd Kramer. Benjamin Lee. Thomas McCarthy. Moishe Postone. Mary P.Ryan. Michael Schudson. Michael Warner. David Zaret.

Background: Legislation on physician-assisted suicide is being considered in a number of states since the passage of the Oregon Death With Dignity Act in 1994. Opinion assessment surveys have historically assessed particular subsets of physicians.Objective: To determine variables predictive of physicians’ opinions on PAS in a rural state, Vermont, USA.Design: Cross-sectional mailing survey.Participants: 1052 physicians licensed by the state of Vermont.Results: Of the respondents, 38.2% believed PAS should be legalised, 16.0% believed it should be prohibited and 26.0% believed it should (...) not be legislated. 15.7% were undecided. Males were more likely than females to favour legalisation . Physicians who did not care for patients through the end of life were significantly more likely to favour legalisation of PAS than physicians who do care for patients with terminal illness . 30% of the respondents had experienced a request for assistance with suicide.Conclusions: Vermont physicians’ opinions on the legalisation of PAS is sharply polarised. Patient autonomy was a factor strongly associated with opinions in favour of legalisation, whereas the sanctity of the doctor–patient relationship was strongly associated with opinions in favour of not legislating PAS. Those in favour of making PAS illegal overwhelmingly cited moral and ethical beliefs as factors in their opinion. Although opinions on legalisation appear to be based on firmly held beliefs, approximately half of Vermont physicians who responded to the survey agree that there is a need for more education in palliative care and pain management. (shrink)

Given his view that the modern world is ‘radically evil’, Adorno is an unlikely contributor to business ethics. Despite this, we argue that his work has a number of provocative implications for the field that warrant wider attention. Adorno regards our social world as damaged, unfree, and false and we draw on this critique to outline why the achievement of good work is so rare in contemporary society, focusing in particular on the ethical demands of roles and the ideological nature (...) of management’s self-understanding. Nevertheless, we show that Adorno’s comments on activities such as art and philosophy mean that it is possible to draw on his work in a way that contributes constructively to the conversation about good and meaningful work within business ethics. (shrink)

The_ Routledge Encyclopedia of Philosophy_ is the most ambitious international philosophy project in many years. Edited by Edward Craig and assisted by thirty specialist subject editors, the REP consists of ten volumes of the world's most eminent philosophers writing for the needs of students and teachers of philosophy internationally. The REP is a project on an unparalleled scale: Over 2000 entries ranging from 500 to 15,000 words in length - thematic, biographical and national 10 volumes consisting of over 5 (...) million words of text plus considerable bibliographic material A Chief Editor and thirty specialist Subject Editors from across the world Over 1200 authors from all over the world. The importance of the REP is not to be found just in the sheer size of the project but also in its breadth of subject matter. It covers: The core of most Anglo-American philosophy - the metaphysical, epistemological and logical questions The usual menu of ethics, political philosophy and the history of philosophy The philosophy of other cultures - from Chinese, Arabic and Jewish philosophy to the philosophy of Africa and Latin America The most impressive range of authors have been gathered together on this unique project: William Alston, Roderick Chisolm, Fred Dretske, Joel Feinberg, Sandra Harding, Larry Laudan, Martha Nussbaum, Richard Popkin, Richard Rorty, Alan Ryan, Gyatri Chakravorty Spivak, Stephen Stich, Patrick Suppes and Bernard Williams, to name just a few. Also available online: www.rep.routledge.com. (shrink)

In deciding whether to forgive, we often focus on the wrongdoer, looking for an apology or a change of ways. However, to fully consider whether to forgive, we need to expand our focus from the wrongdoer and their wrongdoing, and we need to consider who we are, what we care about, and what we want to care about. The difference between blame and forgiveness is, at bottom, a difference in priorities. When we blame, we prioritize the wrong, and when we (...) forgive, we shift our priorities away from the wrong. Recognizing this essential role for priorities in forgiveness allows us to address a thorny puzzle in thinking about forgiveness: how is it that forgiveness can be both principled and elective? If there is sufficient reason to forgive, as will sometimes be the case because forgiveness is principled, how can it be reasonable to withhold forgiveness? Recognizing that forgiveness is a shift in our priorities dissolves this apparent tension between forgiveness being principled and forgiveness being elective. (shrink)

This paper challenges the conventional wisdom dominating the social sciences and philosophy regarding temporal discounting, the practice of discounting the value of future utility when making decisions. Although there are sharp disagreements about temporal discounting, a kind of standard model has arisen, one that begins with a normative standard about how we should make intertemporal comparisons of utility. This standard demands that in so far as one is rational one discounts utilities at future times with an exponential discount function. Tracing (...) the justification for this standard through economics, philosophy and psychology, I’ll make what I believe is the best case one can for it, showing how a non-arbitrariness assumption and a dominance argument together imply that discounting ought to be exponential. Ultimately, however, I don’t find the case compelling. Non-exponential temporal discounting is often rational. If this is correct, Instead of trying to ‘fix’ non-exponential discounting because it is irrational and associated with negative life outcomes, we might instead focus attention on why the conditions obtain that make such discounting rational. (shrink)

Is the quantum state part of the furniture of the world? Einstein found such a position indigestible, but here I present a different understanding of the wavefunction that is easy to stomach. First, I develop the idea that the wavefunction is nomological in nature, showing how the quantum It or Bit debate gets subsumed by the corresponding It or Bit debate about laws of nature. Second, I motivate the nomological view by casting quantum mechanics in a “classical” formalism (Hamilton–Jacobi theory) (...) and classical mechanics in a “quantum” formalism (Koopman–von Neumann theory) and then comparing and contrasting classical and quantum wave functions. I argue that Humeans about laws can treat classical and quantum wave functions on a par and that doing so yields many benefits. (shrink)

In order to determine whether a particular course of conduct is ethically permissible it is important to have a concept of what it means to be harmed. The dominant theory of harm is the counterfactual account, most famously proposed by Joel Feinberg. This determines whether harm is caused by comparing what actually happened in a given situation with the ‘counterfacts’ i.e. what would have occurred had the putatively harmful conduct not taken place. If a person's interests are worse off than (...) they otherwise would have been, then a person will be harmed. This definition has recently faced challenges from bioethicists such as John Harris, Guy Kahane and Julian Savulescu who, believing it to be severely flawed, have proposed their own alternative theories of the concept. In this article I will demonstrate that the shortcomings Harris, Kahane and Savulescu believe are present in Feinberg's theory are illusory and that it is their own accounts of harm that are fraught with logical errors. I maintain that the arguments presented to refute Feinberg's theory not only fail to achieve this goal and can be accommodated within the counterfactual account but that they actually undermine the theories presented by their respective authors. The final conclusion will be that these challenges are misconceived and fail to displace the counterfactual theory. (shrink)