Abstract.The United Kingdom Department of Health initiative on “The Expert Patient” (2001) reflects recent trends in political philosophy, ethics and health services research. The overall objective of the initiative is to encourage patients, particularly those suffering from chronic conditions to become more actively involved in decisions concerning their treatment. In doing so there would be (perhaps) an expectation of better patient compliance and (arguably) a resultant improvement in quality of life. Despite these anticipated beneficial influences on health outcomes, there may (...) be a danger that such initiatives are being carried along by the general swell of enthusiasm for recognising and facilitating the claims of disadvantaged or discriminated against groups. What more attractive than that patients should be “liberated” from what might be seen as the oppression of medical paternalism? To a great extent the potential for success of the Expert Patient venture turns on:(a) whether and to what extent a patient can be considered truly to be an expert and (b) full acceptance by the medical and heath care professions of allowing patients a more equitable and positive role.Whilst clearly the patient is an expert in the hermeneutic sense – it is they and they alone who experience their illness – there is nevertheless a risk of confusing experience with expertise. Experience limited to an individual does not of itself give rise to the generalisations that underlie reliable clinical treatment. Neither do the vast majority of patients possess the physiological and pharmacological knowledge to fully appreciate the biological nature of their illness nor the basis, risks or limitations of therapeutic measures. Might the notion of “The Expert Patient” as informed co-decision maker become a well-meaning but rather vacuous aspiration similar to that of informed consent? Even worse, could patient “empowerment” have a deleterious effect? The paper reviews some of the major issues and concludes that the expert patient initiative could have benefits for both patients and health professionals if operated on the basis of concordance: an informed collaborative alliance that optimises the potential benefits of medical care. (shrink)

The paper is a preliminary examination of the origin and role of psychological perception or “feeling” of dignity in human beings. Following Ayala's naturalistic account of morality, a sense of emotional dignity is seen as an outcome of processes of natural selection, cultural evolution, and above all a need for social inclusion. It is suggested that the existence of emotional dignity as part of a human species-related continuum provides an explanation of why we treat those in a persistent vegetative state, (...) the severely and hopelessly mentally impaired, the senile demented, cadavers and archaeological remains with dignity and respect. For older Europeans, dissonance between physical and mental abilities, unfamiliarity with social and cultural changes and relative proximity to death may influence their emotional dignity and hence vulnerability. (shrink)

General practice (community) pharmacy as a healthcare profession is largely devoted to therapeutic treatment of individual patients whether in dispensing medically authorised prescriptions or by providing members of the public with over-the-counter advice and service for a variety of common ailments. Recently, community pharmacy has been identified as an untapped resource available to undertake important aspects of public health and in particular health promotion. In contrast to therapeutic treatment, public health primarily concerns the health of the entire population, rather than (...) the health of individuals (Childress et al. in J Law Med Ethics 30:170–178, 2002). Thus, an important question for the profession is whether those moral and professional values that are appropriate to the therapeutic care of individual patients are relevant and adequate to support the additional public health role. (shrink)

Pharmacogenetics and pharmacogenomics are related facets of cutting edge therapeutic research in a field that relates pharmacological properties to the genetic characteristics of human beings. An optimistic interpretation suggests that “One-Size-Fits-All” therapeutics, whose effects can only be predicted in probabilistic terms, will give way eventually to individual tailor-made therapies with entirely predictable properties in each patient. Yet the concept of anticipating individual pharmacotherapeutic response appears to disregard some of the fundamental limitations of causal understanding in the biological world of structure–action (...) relationships. It is not simply a problem of confronting complexity – which might be overcome in time with advances in biotechnology and computing power – but the inescapable paradox of the genetic characteristics of individuals within the human species. The aleatory process of evolution ensures that with the exception of monozygotic twins, every human being is genetically unique. At the same time there appears to be more in common than divides. Pharmacogenomics provides a climate in which to explore and better understand the variable causal relationships between genetic element, protein and therapeutic or toxic actions, but can only do so in abstraction. Thus␣predictive power may be enhanced but is ultimately constrained by insuperable probabilistic considerations. (shrink)

There is no lack of criticisms frequently levelled against the international pharmaceutical industry (Big Pharma): excessive profits, dubious or even dishonest practices, exploiting the sick and selective use of research data. Neither is there a shortage of examples used to support such opinions. A recent book by Brody (Hooked: Ethics, the Medical Profession and the Pharmaceutical Industry, 2008) provides a précis of the main areas of criticism, adopting a twofold strategy: (1) An assumption that the special nature and human need (...) for pharmaceutical medicines requires that such products should not be treated like other commodities and (2) A multilevel descriptive approach that facilitates an ethical analysis of relationships and practices. At the same time, Brody is fully aware of the nature of the fundamental dilemma: the apparent addiction to (and denial of) the widespread availability of gifts and financial support for conferences etc., but recognises that ‘Remove the industry and its products, and a considerable portion of scientific medicine’s power to help the patient vanishes’ (Brody 2008, p. 5). The paper explores some of the relevant issues, and argues that despite the identified shortcomings and a need for rigorous and perhaps enhanced regulation, and realistic price control, the commercially competitive pharmaceutical industry remains the best option for developing safer and more effective medicinal treatments. At the same time, adoption of a broader ethical basis for the industry’s activities, such as a triple bottom line policy, would register an important move in the right direction and go some way toward answering critics. (shrink)

Pharmacogenetics and pharmacogenomics are related facets of cutting edge therapeutic research in a field that relates pharmacological properties to the genetic characteristics of human beings. An optimistic interpretation suggests that “One-Size-Fits-All” therapeutics, whose effects can only be predicted in probabilistic terms, will give way eventually to individual tailor-made therapies with entirely predictable properties in each patient. Yet the concept of anticipating individual pharmacotherapeutic response appears to disregard some of the fundamental limitations of causal understanding in the biological world of structure–action (...) relationships. It is not simply a problem of confronting complexity – which might be overcome in time with advances in biotechnology and computing power – but the inescapable paradox of the genetic characteristics of individuals within the human species. The aleatory process of evolution ensures that with the exception of monozygotic twins, every human being is genetically unique. At the same time there appears to be more in common than divides. Pharmacogenomics provides a climate in which to explore and better understand the variable causal relationships between genetic element, protein and therapeutic or toxic actions, but can only do so in abstraction. Thus␣predictive power may be enhanced but is ultimately constrained by insuperable probabilistic considerations. (shrink)

Attitudes to questions of whether physician-assisted dying should be legalised in the UK, reflect one of the greatest challenges to moral stance in health care for both individuals and professional bodies, not least as indicated by public opinion. However, public opinion is a seductively deceptive notion, seemingly readily identifiable but in practice multifarious. At best, consensus regarding public opinion and assisted dying is illusory, sometimes transient and what is relevant in this matter is a comprehension of both majority (popular) opinion (...) and vocal dissent, but which do not them selves have a simple relationship with Parliamentary attitudes and legislation. Arguably, an increasingly important consideration to take account of is the influence of increasing population diversity. (shrink)

From religion to philosophy to science, all human systems of definition are formed by human brains. The nature and limits of the human brain are the nature and limits of those systems. This essay shows how the human brain works normally then unusually, and what this reveals about the limits of human knowledge. There are many conditions and instances where the brain processes information unusually, including mental disorders, physical events, and drug use. This essay focuses on the neurological events called (...) mystical experiences. (shrink)

This short peer-reviewed text is a concise look at the psychology of how human beings make decisions, including how they form their worldviews and make arguments.

This paper aims to provide two abductive considerations adducing in favor of the thesis of Necessitism in modal ontology. I demonstrate how instances of the Barcan formula can be witnessed, when the modal operators are interpreted 'naturally' -- i.e., as including geometric possibilities -- and the quantifiers in the formula range over a domain of natural, or concrete, entities and their contingently non-concrete analogues. I argue that, because there are considerations within physics and metaphysical inquiry which corroborate modal relationalist claims (...) concerning the possible geometric structures of spacetime, and dispositional properties are actual possible entities, the condition of being grounded in the concrete is consistent with the Barcan formula; and thus -- in the geometric setting -- merits adoption by the Necessitist. (shrink)

Part of the appeal of the biological approach to personal identity is that it does not have to countenance spatially coincident entities. But if the termination thesis is correct and the organism ceases to exist at death, then it appears that the corpse is a dead body that earlier was a living body and distinct from but spatially coincident with the organism. If the organism is identified with the body, then the unwelcome spatial coincidence could perhaps be avoided. It is (...) argued that such an identification would be a mistake. A living organism has a different part/whole relationship and persistence conditions than the alleged body. A case will be made that the concept ‘human body’ is a conceptual mess, vague in an unprincipled manner, and that an eliminativist stance towards dead bodies is the appropriate response. CiteULike Connotea Del.icio.us What's this? (shrink)

Oxford Philosophical Texts Series Editor: John Cottingham The Oxford Philosophical Texts series consists of authoritative teaching editions of canonical texts in the history of philosophy from the ancient world down to modern times. Each volume provides a clear, well laid out text together with a comprehensive introduction by a leading specialist, giving the student detailed critical guidance on the intellectual context of the work and the structure and philosophical importance of the main arguments. Endnotes are supplied which provide further commentary (...) on the arguments and explain unfamiliar references and terminology, and a full bibliography and index are also included. The series aims to build up a definitive corpus of key texts in the Western philosophical tradition, which will form a reliable and enduring resource for students and teachers alike. David Hume's aim in writing An Enquiry concerning Human Understanding was to introduce his philosophy to a European culture in which many educated people read original works of philosophy. He gives an elegant and accessible presentation of strikingly original and challenging views about the limited powers of human understanding, the attractions of scepticism, the compatibility of free will and determinism, and weaknesses in the foundations of religion. Hume's philosophy was highly controversial in the eighteenth century and remains so today. The text printed in this edition is that of the Clarendon critical edition of Hume's works. A substantial introduction by the editor explains the intellectual background to the work and surveys its main themes. The volume also includes detailed explanatory notes on the text, a glossary of terms, a full list of references, and a section of supplementary readings. (shrink)

As a continuation of the work of the third author in [5], we make further observations on the features of Galois cohomology in the general model theoretic context. We make explicit the connection between forms of definable groups and first cohomology sets with coefficients in a suitable automorphism group. We then use a method of twisting cohomology (inspired by Serre’s algebraic twisting) to describe arbitrary fibres in cohomology sequences—yielding a useful “finiteness” result on cohomology sets. Applied to the special case (...) of differential fields and Kolchin’s constrained cohomology, we complete results from [3] by proving that the first constrained cohomology set of a differential algebraic group over a bounded, differentially large, field is countable. (shrink)

[This is an edited version of a keynote talk at the conference on Neural Information Processing Systems (NeurIPS) on November 28, 2022, with some minor additions and subtractions.] -/- There has recently been widespread discussion of whether large language models might be sentient or conscious. Should we take this idea seriously? I will break down the strongest reasons for and against. Given mainstream assumptions in the science of consciousness, there are significant obstacles to consciousness in current models: for example, their (...) lack of recurrent processing, a global workspace, and unified agency. At the same time, it is quite possible that these obstacles will be overcome in the next decade or so. I conclude that while it is somewhat unlikely that current large language models are conscious, we should take seriously the possibility that successors to large language models may be conscious in the not-too-distant future. (shrink)

This volume is devoted to Lewis's work in metaphysics and epistemology. Topics covered include properties, ontology, possibility, truthmaking, probability, the mind-body problem, vision, belief, and knowledge. The purpose of this collection, and the volumes that precede and follow it, is to disseminate more widely the work of an eminent and influential contemporary philosopher. The volume will serve as a useful work of reference for teachers and students of philosophy.

Religion, science, and naturalism -- Perception and religious experience -- Panexperientialism, freedom, and the mind-body relation -- Naturalistic, dipolar theism -- Natural theology based on naturalistic theism -- Evolution, evil, and eschatology -- The two ultimates and the religions -- Religion, morality, and civilization -- Religious language and truth -- Religious knowledge and common sense.

"My work has had nothing to do with gay liberation," Michel Foucault reportedly told an admirer in 1975. And indeed there is scarcely more than a passing mention of homosexuality in Foucault's scholarly writings. So why has Foucault, who died of AIDS in 1984, become a powerful source of both personal and political inspiration to an entire generation of gay activists? And why have his political philosophy and his personal life recently come under such withering, normalizing scrutiny by commentators as (...) diverse as Camille Paglia, Richard Mohr, Bruce Bawer, Roger Kimball, and biographer James Miller? David M. Halperin's Saint Foucault is an uncompromising and impassioned defense of the late French philosopher and historian as a galvanizing thinker whose career as a theorist and activist will continue to serve as a model for other gay intellectuals, activists, and scholars. A close reading of both Foucault and the increasing attacks on his life and work, it explains why straight liberals so often find in Foucault only counsels of despair on the subject of politics, whereas gay activists look to him not only for intellectual inspiration but also for a compelling example of political resistance. Halperin rescues Foucault from the endless nature-versus-nurture debate over the origins of homosexuality ("On this question I have absolutely nothing to say," Foucault himself once remarked) and argues that Foucault's decision to treat sexuality not as a biological or psychological drive but as an effect of discourse, as the product of modern systems of knowledge and power, represents a crucial political breakthrough for lesbians and gay men. Halperin explains how Foucault's radical vision of homosexuality as a strategic opportunity for self-transformation anticipated the new anti-assimilationist, anti-essentialist brand of sexual identity politics practiced by contemporary direct-action groups such as ACT UP. Halperin also offers the first synthetic account of Foucault's thinking about gay sex and the future of the lesbian and gay movement, as well as an up-to-the-minute summary of the most recent work in queer theory. "Where there is power, there is resistance," Michel Foucault wrote in The History of Sexuality, Volume I. Erudite, biting, and surprisingly moving, Saint Foucault represents Halperin's own resistance to what he views as the blatant and systematic misrepresentation of a crucial intellectual figure, a misrepresentation he sees as dramatic evidence of the continuing personal, professional, and scholarly vulnerability of all gay activists and intellectuals in the age of AIDS. (shrink)

Conceptual engineering is the design, implementation, and evaluation of concepts. Conceptual engineering includes or should include de novo conceptual engineering (designing a new concept) as well as conceptual re-engineering (fixing an old concept). It should also include heteronymous (different-word) as well as homonymous (same-word) conceptual engineering. I discuss the importance and the difficulty of these sorts of conceptual engineering in philosophy and elsewhere.

*[[This paper appears in _Toward a Science of Consciousness II: The Second Tucson Discussions and Debates_ (S. Hameroff, A. Kaszniak, and A.Scott, eds), published with MIT Press in 1998. It is a transcript of my talk at the second Tucson conference in April 1996, lightly edited to include the contents of overheads and to exclude some diversions with a consciousness meter. A more in-depth argument for some of the claims in this paper can be found in Chapter 6 of my (...) book _The Conscious Mind_ (Chalmers, 1996). ]]. (shrink)

In this innovative study, Lea David critically investigates the relationship between human rights and memory, suggesting that, instead of understanding human rights in a normative fashion, human rights should be treated as an ideology. Conceptualizing human rights as an ideology gives us useful theoretical and methodological tools to recognize the real impact human rights has on the ground. David traces the rise of the global phenomenon that is the human rights memorialization agenda, termed 'Moral Remembrance', and explores what (...) happens once this agenda becomes implemented. Based on evidence from the Western Balkans and Israel/Palestine, she argues that the human rights memorialization agenda does not lead to a better appreciation of human rights but, contrary to what would be expected, it merely serves to strengthen national sentiments, divisions and animosities along ethnic lines, and leads to the new forms of societal inequalities that are closely connected to different forms of corruptions. (shrink)

Liberal thinkers of the eighteenth and nineteenth centuries were alert to the political costs and human cruelties involved in European colonialism, but they also thought that European expansion held out progressive possibilities. In Progress, Pluralism, and Politics David Williams examines the colonial and anti-colonial arguments of Adam Smith, Immanuel Kant, Jeremy Bentham, and L.T. Hobhouse. Williams locates their ambivalent attitude towards European conquest and colonial rule in a set of tensions between the impact of colonialism on European states, the (...) possibilities of progress in distant and diverse places, and the relationship between universalism and cultural pluralism. In so doing he reveals some of the central ambiguities that characterize the ways that liberal thought has dealt with the reality of an illiberal world. Of particular importance are appeals to various forms of universal history, attempts to mediate between the claims of identity and the reality of difference, and the different ways of thinking about the achievement of liberal goods in other places. Pointing to key elements in still ongoing debates within liberal states about how they should relate to illiberal places, Progress, Pluralism, and Politics enriches the discussion on political thought and the relationship between liberalism and colonialism. (shrink)

Confronted with the apparent explanatory gap between physical processes and consciousness, there are many possible reactions. Some deny that any explanatory gap exists at all. Some hold that there is an explanatory gap for now, but that it will eventually be closed. Some hold that the explanatory gap corresponds to an ontological gap in nature.

Thus, Meyers provides a valuable account, not only of current medical attitudes, but also of relevant case and statute law as it stands at present.

In Phenomenology and the Problem of History. David Carr examines the paradox involving Husserl's transcendental philosophy and his later historicist theory.

This Introduction introduces readers to the concepts of political philosophy: authority, democracy, freedom and its limits, justice, feminism, multiculturalism, and nationality. Accessibly written and assuming no previous knowledge of the subject, it encourages the reader to think clearly and critically about the leading political questions of our time. THe book first investigates how politcial philosophy tackles basic ethical questions such as 'how should we live together in society?' It furthermore looks at political authority, discusses the reasons society needs politics in (...) the first place, explores the limitations of politics, and asks if there are areas of life that shouldn't be governed by politics. Moreover, the book explores the connections between political authority and justice, a constant theme in political philosophy, and the ways in which social justice can be used to regulate rather than destroy a market economy. In his travels through this realm, Miller covers why nations ar the natural units of government and wonders if the rise of multiculturalism and transnational co-operation will change all this, and asks in the end if we will ever see the formation of a world government. (shrink)

Recent objections to epistemic permissivism have a metaepistemic flavor. Impermissivists argue that their view best accounts for connections between rationality, planning and deference. Impermissivism is also taken to best explain the value of rational belief and normative assessment. These objections pose a series of metaepistemic explanatory challenges for permissivism. In this paper, I illustrate how permissivists might meet their explanatory burdens by developing two permissivist metaepistemic views which fare well against the explanatory challenges.

Beneath the stylized violence and thrilling car crashes, the Mad Max films consider universal questions about the nature of human life, order and anarchy, justice and moral responsibility, society and technology, and ultimately, human redemption. In Mad Max and Philosophy, a diverse team of political scientists, historians, and philosophers investigates the underlying themes of the blockbuster movie franchise, following Max as he attempts to rebuild himself and the world. -/- This book guides you through the barren wastelands of a post-apocalyptic (...) future as you explore ethics and politics in The Wasteland, the importance of costumes and music, humankind's relationship with nature, commerce, gender, religion, madness, and more. (shrink)

How should we account for the extraordinary regularity in the world? Humeans and Non-Humeans sharply disagree. According to Non-Humeans, the world behaves in an extraordinarily regular way because of certain necessary connections in nature. However, Humeans have thought that Non-Humean views are metaphysically objectionable. In particular, there are two general metaphysical principles that Humeans have found attractive that are incompatible with all existing versions of Non-Humeanism. My goal in this paper is to develop a novel version of Non-Humeanism that is (...) consistent with (and even entails) both of these general metaphysical principles. By endorsing such a view, one can have the explanatory benefits of Non-Humeanism while at the same time avoiding two of the major metaphysical objections towards Non-Humeanism. (shrink)

Making Sense of Education provides a contemporary introduction to the key issues in educational philosophy and theory. Exploring recent developments as well as important ideas from the twentieth century, this book aims to make philosophy of education relevant to everyday practice for teachers and student teachers, as well as those studying education as an academic subject.

This paper responds to comments and criticisms by Stefan Brandt and Eva-Maria Jung, directed at the book "Know-how as Competence. A Rylean Responsibilist Account".

The model of human intelligence that is most widely adopted derives from psychometrics and behavioral genetics. This standard approach conceives intelligence as a general cognitive ability that is genetically highly heritable and describable using quantitative traits analysis. The paper analyzes intelligence within the debate on natural kinds and contends that the general intelligence conceptualization does not carve psychological nature at its joints. Moreover, I argue that this model assumes an essentialist perspective. As an alternative, I consider an HPC theory of (...) intelligence and evaluate how it deals with essentialism and with intuitions coming from cognitive science. Finally, I highlight some concerns about the HPC model as well, and conclude by suggesting that it is unnecessary to treat intelligence as a kind in any sense. (shrink)

1 Introduction 2 Perceptual Concepts 2.1 Perceptual Concepts are not Demonstrative 2.2 Perceptual Concepts as Stored Templates 2.3 Perceptual Semantics 2.4 Perceptually Derived Concepts 3 Phenomenal Concepts.

The arithmetical -- Tripartite city, tripartite soul -- The one, the two, and the three -- The arithmetical character of Kallipolis -- Eros -- Intimations of Eros -- The three waves -- Kallipolis v. The republic -- Democracy, psychology, poetry -- Democracy -- Narrative psychology -- Psychological narrative -- Appendix -- The meaning of "dialectical" -- The technical meaning of "dialectic" -- The non-technical of "dialectic" -- Dialectic in The republic.