BACKGROUND: A programmatic research effort investigated how lay people weigh information on hypothetical patients when making decisions regarding the allocation of scarce medical resources. This study is partly replicative and partly innovative, and looks particularly at whether overweight patients would be discriminated against in allocating resources. AIMS: This study aims to determine the importance given to specific patient characteristics when lay participants are asked to allocate scarce medical resources. SAMPLE: In all, 156 British adults (82 males, 73 females), aged 19 (...) to 84 years, took part. There were few students. METHOD: Participants completed a questionnaire requiring them to rank 16 hypothetical patients for access to a kidney dialysis machine.The demographic information presented regarding each hypothetical patient differed on four dimensions: gender, weight, mental health, and religiousness. RESULTS: There were significant main effects for gender, weight, and mental health; females, patients of normal weight, and the mentally well were ranked the highest priority for access to a kidney dialysis machine. Participants discriminated most regarding the weight of hypothetical patients. CONCLUSION: Different patient characteristics, unrelated to medical prognoses, particularly being overweight, may have an impact on decisions regarding the use of scarce medical resources. (shrink)

Studying the most ethical way to allocate scarce medical resources has been of interest within the last year, due to shortages associated with the COVID-19 pandemic. This study aimed to establish differences between what healthcare providers (HCP) and laypeople consider to be the most ethical way to prioritise the distribution of scarce resources. Healthcare providers ( n = 100) and laypeople ( n = 102) were asked to rank ethical principles from most to least ethical for the allocation of ICU (...) beds in a COVID-19 outbreak, COVID-19 vaccinations and organ transplantation, and the rankings from each scenario across the two groups were compared. Results indicated that HCPs preferred utilitarian principles informed by medical knowledge, such as ‘prognosis’, whereas laypeople preferred less situation-specific and prioritarian principles, such as ‘sickest first’, replicating pre-pandemic findings. Laypeople showed increased in-group agreement when ranking principles, potentially due to the collective experience of the pandemic. Demographic variables such as older age, identifying as Black, Asian or minority ethnic and greater experience with COVID-19, were also associated with a preference for ‘prognosis’. (shrink)

This article explores three ways in which physics may involve counterpossible reasoning. The first way arises when evaluating false theories: to say what the world would be like if the theory were true, we need to evaluate counterfactuals with physically impossible antecedents. The second way relates to the role of counterfactuals in characterizing causal structure: to say what causes what in physics, we need to make reference to physically impossible scenarios. The third way is novel: to model metaphysical dependence in (...) physics, we need to consider counterfactual consequences of metaphysical impossibilities. Physics accordingly bears substantial and surprising counterpossible commitments. (shrink)

Our successful engagement with the world is plausibly underwritten by our sensitivity to affordances in our immediate environment. The considerable literature on affordances focuses almost exclusively on affordances for bodily actions such as gripping, walking or eating. I propose that we are also sensitive to affordances for mental actions such as attending, imagining and counting. My case for this ‘Mental Affordance Hypothesis’ is motivated by a series of examples in which our sensitivity to mental affordances mirrors our sensitivity to bodily (...) affordances. Specifically, subjects perceive opportunities to perform a mental action and their doing so leads, under the right conditions, to the automatic preparation of that action. I conclude by sketching a mental affordance research program that would reinforce my case for the Mental Affordance Hypothesis and establish its ramifications for a number of debates across philosophy and psychology. (shrink)

In this paper we focus on a kind of perceptual states that we call perceptual motivations, that is, perceptual experiences that plausibly motivate us to act, such as itching, perceptual salience and pain. Itching seems to motivate you to scratch, perceiving a stimulus as salient seems to motivate you to attend to it and feeling a pain in your hand seems to motivate actions such as withdrawing from the painful stimulus. Five main accounts of perceptual motivation are available: Descriptive, Conative, (...) Imperativist, Reflexive and Dual Content views. Some of these have been developed in detail and others are natural extensions of existing views. However, we argue that none provides a satisfactory account of the target perceptual states. Driven by the failings of each account, we identify three conditions that any satisfactory theory of perceptual motivation must meet: Direct Motivational Force, Non-Obligatory Force and Intention-Independent Influence. Then we offer an account that attempts to fulfil these conditions: the Affordance Model. This model of perceptual motivation is premised on the claim that each of the target states involves the perception of a specific affordance for action and the triggering of Automatic Motor Initiations (AMIs). We suggest that AMIs can explain the motivational force of these perceptual states. (shrink)

Kierkegaard and Philosophy makes many of the most important papers on Kierkegaard available in one place for the first time. These seventeen essays, written over a period of over twenty years, have all been substantially revised or specially prepared for this collection, with a new introduction by the author. In the first part, Alastair Hannay concentrates on Kierkegaard's central philosophical writings, offering closely text-based accounts of the slient concepts Kierkegaard uses. The second part shows the relevance of other thinkers' (...) treatments of shared themes, pointing our where they differ from Kierkegaard. The concluding chapter provides a reason Kierkegaard himself would give for disagreeing with those who claim his texts are infinitely interpretable. Written by the world's foremost Kierkegaard scholar and translator, Kierkegaard and Philosophy is an indispensible resource for all students of Kierkegaard's work. (shrink)

First Published in 2004. Routledge is an imprint of Taylor & Francis, an informa company.

Deftly quilting themes of Latin American and feminist liberation theologies with those of philosophers such as Immanuel Kant and John Rawls, Alastair V. Campbell displays our rich interconnectedness and our moral responsibilities to one another. Suggesting that many American citizens are oppressed by our current health-care system, he contends that prior to questions of health-care allocation are questions of what we mean as a society by the term health--and how that term is inextricably linked to personal and social freedom (...) and liberation. In the forceful final chapter of the book, Campbell articulates ethical standards for just health-care delivery in the United States--standards that, above all, take account of deep religious faith and concern for one's neighbor. Health as Liberation is a critical analysis of justice and modern health care, and of a society's moral obligations to its citizens. (shrink)

This book equips readers with a sound understanding of the value-base of mental health care and provides them with the skills and knowledge to demystify complex values in decision-making in order to reach outcomes which are focused on the needs of service users. Engaging case examples and exercises link theory and practice throughout.

There is a systematic and suggestive analogy between grounding and causation. In my view, this analogy is no coincidence. Grounding and causation are alike because grounding is a type of causation: metaphysical causation. In this paper I defend the identification of grounding with metaphysical causation, drawing on the causation literature to explore systematic connections between grounding and metaphysical dependence counterfactuals, and I outline a non-reductive counterfactual theory of grounding along interventionist lines.

The on-going debate over the ‘admissible contents of perceptual experience’ concerns the range of properties that human beings are directly acquainted with in perceptual experience. Regarding vision, it is relatively uncontroversial that the following properties can figure in the contents of visual experience: colour, shape, illumination, spatial relations, motion, and texture. The controversy begins when we ask whether any properties besides these figure in visual experience. We argue that ‘ensemble properties’ should be added to the list of visually admissible properties. (...) Ensemble properties are features that belong to a set of perceptible objects as a whole as opposed to the individuals that constitute that set. They include such features as the mean size of an array of shapes or the average emotional expression of an array of faces. Recent work in vision science has yielded compelling evidence that the visual system routinely encodes such properties. We argue that epistemological considerations provide strong reasons to think that these properties figure in visual experience. Judgements about ensemble properties are immediately warranted by our perceptual experience, and the only plausible way that a perceptual experience could confer this warrant is if it confers awareness of ensemble properties. (shrink)

This book defends a radical new theory of contingency as a physical phenomenon. Drawing on the many-worlds approach to quantum theory and cutting-edge metaphysics and philosophy of science, it argues that quantum theories are best understood as telling us about the space of genuine possibilities, rather than as telling us solely about actuality. When quantum physics is taken seriously in the way first proposed by Hugh Everett III, it provides the resources for a new systematic metaphysical framework encompassing possibility, necessity, (...) actuality, chance, counterfactuals, and a host of related modal notions. -/- Rationalist metaphysicians argue that the metaphysics of modality is strictly prior to any scientific investigation; metaphysics establishes which worlds are possible, and physics merely checks which of these worlds is actual. Naturalistic metaphysicians respond that science may discover new possibilities and new impossibilities. This book's quantum theory of contingency takes naturalistic metaphysics one step further, allowing that science may discover what it is to be possible. As electromagnetism revealed the nature of light, as acoustics revealed the nature of sound, as statistical mechanics revealed the nature of heat, so quantum physics reveals the nature of contingency. (shrink)

Media outlets, industry researchers, and policy-makers are today busily extolling new robotic advances that promise to transform agriculture, bringing us ever closer to self-farming farms. Yet such techno-optimist discourse ignores the cautionary lessons of past attempts to mechanize farms. Adapting the Social Construction of Technology framework, we trace the history of efforts to replace human labor with machine labor on fruit, nut, and vegetable farms in California between 1945 and 1980—a place and time during which a post-WWII culture of faith (...) in the beneficence of technoscience applications to agriculture reached an apex. The degree to which and forms whereby mechanization gains momentum hinges on whether, how, and among whom a technological frame for mimicking human capabilities and supplanting workers coalesces. These frames, we find, vary considerably across crops, reflecting complex interactions of biology, farmer and farm worker behavior, industry supply chains, agricultural research and development, financial flows, and beliefs about labor, race, gender, and immigration. To tease out these complex dynamics, we draw directly from archival evidence to follow the development of cultivation and harvest machines through four cases spanning a spectrum of outcomes—tomatoes, nuts, peaches, and lettuce. In comparing across these cases, we find that although agricultural engineers, scientists, and their boosters framed mechanization as a triumphal narrative of progress in ‘human vs. nature’ conflicts, this techno-optimist rhetoric camouflaged deeper ‘human vs. human’ conflicts, particularly among agribusiness, farmers, and farm workers. We conclude with several insights that this historical study brings to the study of agricultural automation today. (shrink)

The evolutionary framework suggested by Müller & Schumann (M&S) can be extended further by considering drug-taking in terms of Niche Construction Theory (NCT). It is suggested here that genetic and environmental components of addiction are modified by cultural acceptance of the advantages of non-addicted drug taking and the legitimate supply of performance-enhancing drugs. This may then reduce the prevalence of addiction.

This paper outlines a non-reductive counterfactual account of grounding along interventionist lines, and uses the account to argue that taking grounding seriously requires ascribing non-trivial truth-conditions to a range of counterpossible counterfactuals. This result allows for a diagnosis of a route to scepticism about grounding, as deriving at least in part from scepticism about non-trivial counterpossible truth and falsity.

This collection contains twenty-one thought-provoking essays on the controversies surrounding the moral and legal distinctions between euthanasia and "letting die." Since public awareness of this issue has increased this second edition includes nine entirely new essays which bring the treatment of the subject up-to-date. The urgency of this issue can be gauged in recent developments such as the legalization of physician-assisted suicide in the Netherlands, "how-to" manuals topping the bestseller charts in the United States, and the many headlines devoted to (...) Dr. Jack Kevorkian, who has assisted dozens of patients to die. The essays address the range of questions involved in this issue pertaining especially to the fields of medical ethics, public policymaking, and social philosophy. The discussions consider the decisions facing medical and public policymakers, how those decisions will affect the elderly and terminally ill, and the medical and legal ramifications for patients in a permanently vegetative state, as well as issues of parent/infant rights. The book is divided into two sections. The first, "Euthanasia and the Termination of Life-Prolonging Treatment" includes an examination of the 1976 Karen Quinlan Supreme Court decision and selections from the 1990 Supreme Court decision in the case of Nancy Cruzan. Featured are articles by law professor George Fletcher and philosophers Michael Tooley, James Rachels, and Bonnie Steinbock, with new articles by Rachels, and Thomas Sullivan. The second section, "Philosophical Considerations," probes more deeply into the theoretical issues raised by the killing/letting die controversy, illustrating exceptionally well the dispute between two rival theories of ethics, consequentialism and deontology. It also includes a corpus of the standard thought on the debate by Jonathan Bennet, Daniel Dinello, Jeffrie Murphy, John Harris, Philipa Foot, Richard Trammell, and N. Ann Davis, and adds articles new to this edition by Bennett, Foot, Warren Quinn, Jeff McMahan, and Judith Lichtenberg. (shrink)

The author explores different views of the significance of the human body and contrasts those which regard it as a commodity or personal possession with those which stress its moral value as integral to the personal identity of individuals. This study provides background to many of the controversies in medical ethics.

Distinctions in fundamentality between different levels of description are central to the viability of contemporary decoherence-based Everettian quantum mechanics (EQM). This approach to quantum theory characteristically combines a determinate fundamental reality (one universal wave function) with an indeterminate emergent reality (multiple decoherent worlds). In this chapter I explore how the Everettian appeal to fundamentality and emergence can be understood within existing metaphysical frameworks, identify grounding and concept fundamentality as promising theoretical tools, and use them to characterize a system of explanatory (...) levels (with associated laws of nature) for EQM. This Everettian level structure encompasses and extends the ‘classical’ levels structure. The ‘classical’ levels of physics, chemistry, biology, etc. are recovered, but they are emergent in character and potentially variable across Everett worlds. EQM invokes an additional fundamental level, not present in the classical levels picture, and a novel potential role for self-location in interlevel metaphysics. When given a modal realist interpretation, EQM also makes trouble for supervenience-based approaches to levels. (shrink)

In ‘Quiddistic Knowledge’ (Schaffer in Philos Stud 123:1–32, 2005), Jonathan Schaffer argued influentially against the view that the laws of nature are metaphysically necessary. In this reply I aim to show how a coherent and well-motivated form of necessitarianism can withstand his critique. Modal necessitarianism—the view that the actual laws are the laws of all possible worlds—can do justice to some intuitive motivations for necessitarianism, and it has the resources to respond to all of Schaffer’s objections. It also has certain (...) advantages over contingentism in the domain of modal epistemology. I conclude that necessitarianism about laws remains a live option. (shrink)

The article offers a critical analysis of the cognitive science of religion (CSR) as applied to new and quasi-religious movements, and uncovers implicit conceptual and theoretical commitments of the approach. A discussion of CSR’s application to new religious movement (NRM) case studies (charismatic leadership, paradise representations, Aḥmadiyya, and the International Society for Krishna Consciousness) identifies concerns about the theorized relationship between CSR and wider socio-cultural factors, and proposals for CSR’s implication in wider processes are discussed. The main discussion analyses three (...) themes in recent work relating CSR to religious and religion-like activities that extend and reframe the model. These include (1) identification of distinctive and accessible cognitive pathways associated with new forms of religious belief and practice (in particular in ‘New Age’ movements), (2) application of CSR to movements and practices outside traditional definitions of religion (near death experiences, conspiracy theories, virtual reality), and (3) engaging CSR in wider cultural processes and negotiations (religion in healthcare settings, and the definition of the study of esoteric religious traditions within academic domains). The conclusion identifies two particular findings: (1) that application of CSR in these areas renders underlying cognitive processes more available to scrutiny and (2) that CSR is employed to identify and enlarge the category of religion. The conclusion suggests that the study of CSR in its application to NRMs and quasi-religion identifies a wide field of common and overlapping themes and interests in which CSR is a more active operand than is commonly assumed. (shrink)

By the 1880s it had become clear that the intellectual tide in Britain was turning against the idea of a minimal state. Under the influence of the New Idealists, the Liberal Party, once the champion of individual liberty, had changed into an organ for interventionist legislation. Challenging this movement was an assortment of anti-collectivists including Old Liberals, Tories, and radical individualists. Spearheading the defence of individualism was the 10th Earl of Wemyss, Francis Wemyss-Charteris-Douglas. Most famous for his role in the (...) formation of the Liberty and Property Defence League, Wemyss worked tirelessly in parliament to obstruct legislation deemed inimical to liberty, as well as to organise a mass educational effort to instruct the public about the errors of collectivist philosophy and policy. This paper examines the role Wemyss played within late Victorian individualism and considers how the melding of traditionalism and individualism provided an intellectual home for libertarianism on the Right. (shrink)

One property of the emulator framework presented by Grush is that imagery operates off-line. Contrary to this viewpoint, we present evidence showing that mental rotation of a simple figure modulates low-level features of drawing articulation. This effect is dependent upon the type of rotation, suggesting a more integrative online role for imagery than proposed by the target article.

One of the currently popular dogmata of anti-consequentialism is that consequentialism doesn't respect, recognize, or in some important way account for what is referred to as the The charge is often made, but rarely explained in any detail, much less argued for. In this paper I explain what I take to be the most plausible interpretation of the separateness of persons charge. I argue that the charge itself can be deconstructed into at least two further objections to consequentialist theories. These (...) objections amount to (i) the rejection of axiological aggregation, and (ii) the rejection of deontic aggregation. Of these two objections, I argue that the first one, though often made, is untenable. I also argue that the second objection, in its various forms, relies on distinctions whose moral significance is vigorously denied by almost all consequentialist theorists. I thus argue that the separateness of persons objection poses no special threat to consequentialism. (shrink)

This paper examines the range of symbolic associations surrounding the relief sculpture (Democracy crowning the Athenian people) that accompanied the law proposed by Eukrates against the establishment of tyranny. It examines some of the investments made in it by various communities and individuals. The role of personifications in political allegory is examined. This analysis shows both the potency of personifying representations of the Athenian people and the interpretative complexities that they create.