BackgroundJunior medical doctors have a key role in discussions and decisions about treatment and end-of-life care for people with dementia in hospital. Little is known about junior doctors’ decision-making processes when treating people with dementia who have advance care directives, or the factors that influence their decisions. To describe among junior doctors in relation to two hypothetical vignettes involving patients with dementia: their legal compliance and decision-making process related to treatment decisions; the factors influencing their clinical decision-making; and the factors (...) associated with accurate responses to one hypothetical vignette. MethodA cross-sectional survey of junior doctors, including trainees, interns, registrars and residents, on clinical rotation in five public hospitals located in one Australian state. The anonymous, investigator-developed survey was conducted between August 2018 and June 2019. Two hypothetical vignettes describing patients with dementia presenting to hospital with an ACD and either: bacterial pneumonia; or suspected stroke were presented in the survey. Participants were asked to indicate whether they would commence treatment, given the ACD instructions described in each vignette.ResultsOverall, 116 junior doctors responded. In Vignette 1, 58% of respondents selected the legally compliant option. Participants who chose the legally compliant option perceived ‘following patient wishes’ and ‘legal requirements to follow ACDs’ as equally important reasons for complying with the ACD. The most common reason for not selecting the legally compliant option in Vignette 1 was the ‘ACD is relevant in my decision-making process, but other factors are more relevant’. In Vignette 2, 72% of respondents indicated they would commence treatment and 18% selected they would not commence treatment.. Similar reasons influenced participant decision-making in Vignette 2, a less legally certain scenario.ConclusionsThere are critical gaps in junior doctors’ compliance with the law as it relates to the implementation of ACDs. Despite there being differences in relation to the legal answer and its certainty, clinical and ethical factors guided decision-making over and above the law in both vignettes. More education and training to guide junior doctors’ clinical decision-making and ensure compliance with the law is required. (shrink)

Marine ecosystems are under increasing pressure from human activity, yet successful management relies on knowledge. The evidence-based policy (EBP) approach has been promoted on the grounds that it provides greater transparency and consistency by relying on ‘high quality’ information. However, EBP also creates epistemic responsibilities. Decision-making where limited or no empirical evidence exists, such as is often the case in marine systems, creates epistemic obligations for new information acquisition. We argue that philosophical approaches can inform the science-policy interface. Using marine (...) biosecurity examples, we specifically examine the epistemic challenges in the acquisition and acceptance of evidence to inform policy, discussing epistemic due care and biases in consideration of evidence. (shrink)

Public health nursing is grounded in public health ideologies and fundamental nursing values. Researchers have argued that ethical responsibility from the perspective of the nurse is an understudied phenomenon. This meta-ethnography provides in-depth knowledge of how public health nurses (PHNs) experience ethical responsibility when working to prevent injury and disease, and promote health and well-being in children, young people and their families. There are reciprocal findings across the 10 included studies. The findings reveal that these nurses often feel alone, have (...) worries and uncertainties and are afraid of doing wrong. They describe unclear boundaries in their work, creating a heightened sense of responsibility. PHNs fight lonely battles. Yet they show courage and commitment and are ready to stand up and fight for children and families who do not receive adequate care. A line of argument is developed and the metaphorical phrase Chivalrous knights in moral armour is used to express the authors’ overall interpretations of the findings. Reflection on the findings shows how the different dimensions of ethical responsibility are interconnected. The nurses’ ethical sensitivity enables them to feel compassion for others and they show indignation when vulnerable others are not treated with dignity and respect. Indignation and compassion are interrelated, and when human life and dignity are threatened, the ethical demand to respond emerges. Indignation is a precursor to moral courage, and the nurses’ moral sensitivity and respect for their clients emboldens them to stand up for vulnerable others. The findings also illustrate the paradoxical nature of freedom. Freedom of choice due to unclear boundaries heightens the nurses' sense of responsibility. This research is an important step in theory development and has implications for further research, education and practice. (shrink)

Under what conditions are people responsible for their choices and the outcomes of those choices? How could such conditions be fostered by liberal societies? Should what people are due as a matter of justice depend on what they are responsible for? For example, how far should healthcare provision depend on patients' past choices? What values would be realized and which hampered by making justice sensitive to responsibility? Would it give people what they deserve? Would it advance or hinder equality? The (...) explosion of philosophical interest in such questions has been fuelled by increased focus on individual responsibility in political debates. Political philosophers, especially egalitarians, have responded to such developments by attempting to map out the proper place for responsibility in theories of justice. This book both reflects on these recent developments in normative political theory and moves the debate forwards. (shrink)

This article explores the themes of trust and ethical conduct in social research, with particular attention to the trust that can develop between the members of a research team as well as between researchers and the researched. The authors draw upon a three-year empirical study of destinations and outcomes for young people excluded from alternative educational provision. They also make reference to a contemporary exposition of Aristotle's writing on friendship in order to explore two sets of relevant distinctions that have (...) a bearing upon our understanding of relationships that emerge in the context of social research projects. These distinctions are between impartiality and selectivity on the one hand, and between universality and particularity on the other. The authors attempt to demonstrate that these distinctions influence the development of trust and the conduct of ethical research, arguing that the latter is not synonymous with compliance to ethical guidelines. (shrink)

Nietzsche's opinions on philosophy and aesthetics developed under strong and lasting impulses from classical antiquity. These were not always the same, for at various periods in his life Nietzsche placed Heraclitus, Empedocles, Aeschylus, and even Socrates and Plato on the highest summit of wisdom. In his so-called first stage of development the pre-Socratics were generally his favourite thinkers, and in the third and last stage these same figures tend to come into prominence again. On the other hand, in the works (...) of Nietzsche's second, rationalistic period, when he was particularly influenced by Comte, Voltaire, and Darwin, Socrates and Plato—usually so hated and despised—are mentioned with affection, with gratitude or even with warm enthusiasm; and so, over and over again, is Epicurus. (shrink)

This long-awaited two-volume set constitutes the definitive presentation of the system of classifying moral judgment built up by Lawrence Kohlberg and his associates over a period of twenty years. Researchers in child development and education around the world, many of whom have worked with interim versions of the system, indeed, all those seriously interested in understanding the problem of moral judgment, will find it an indispensable resource. Volume I reviews Kohlberg's stage theory, and the by-now large body of research on (...) the significance and utility of his moral stages. Issues of reliability and validity are addressed. The volume ends with detailed instructions for using the forms in Volume 2. Volume 2, in a specially-designed, user-friendly format, includes three alternative functionally-equivalent forms of the scoring system. (shrink)

Institutional economics and discourse theory stand unconnected next to each other, in spite of the fact that they both ask for the legitimacy of institutions (normative) and the functioning and effectiveness of institutions (positive). Both use as theoretical constructions rational individuals and the concept of consensus for legitimacy. Whereas discourse theory emphasizes the conditions of a legitimate consensus and could thus enable institutional economics to escape the infinite regress of judging a consensus legitimate, institutional economics has a tested social science (...) paradigm (rational choice) of explaining and predicting the functioning of institutions. The article outlines a theoretical synthesis of the two theories by finding points in common and possibilities of fruitful combinations concerning the problem of legitimacy, institutional design and effectiveness of legal norms. (shrink)

Cherche à mettre en évidence les principes théoriques qui peuvent être au fondement de toute recherche ou réflexion en sociologie de la musique.

In [3], two different effective versions of Borel embedding are defined. The first, called computable embedding, is based on uniform enumeration reducibility, while the second, called Turing computable embedding, is based on uniform Turing reducibility. While [3] focused mainly on computable embeddings, the present paper considers Turing computable embeddings. Although the two notions are not equivalent, we can show that they behave alike on the mathematically interesting classes chosen for investigation in [3]. We give a “Pull-back Theorem”, saying that if (...) Φ is a Turing computable embedding of K into K’, then for any computable infinitary sentence φ in the language of K’, we can find a computable infinitary sentence φ* in the language of K such that for all. (shrink)

Many scholars assume a connection between the evolution of language and that of distinctively human group-level morality. Unfortunately, such thinkers frequently downplay a central implication of modern Darwinian theory, which precludes the possibility of innate psychological mechanisms evolving to benefit the group at the expense of the individual. Group level moral regulation is indeed central to public life in all known human communities. The production of speech acts would be impossible without this. The challenge, therefore, is to explain on a (...) Darwinian basis how life could have become subject to the rule of law. Only then will we have an appropriate social framework in which to contextualize our models of how language may have evolved. (shrink)

Who gets to decide what it means to live a healthy lifestyle, and how important a healthy lifestyle is to a good life? As more governments make preventing obesity and diet-related illness a priority, it's become more important to consider the ethics and acceptability of their efforts. When it comes to laws and policies that promote healthy eating--such as special taxes on sugary drinks and the banning of food deemed unhealthy--critics argue that these policies are paternalistic, and that they limit (...) individual autonomy over food choices. In Healthy Eating Policy and Political Philosophy: A Public Reason Approach, Anne Barnhill and Matteo Bonotti show that both paternalistic justifications for healthy eating efforts and anti-paternalistic arguments against them can be grounded in perfectionist views that overly prioritize some values over others. The authors therefore propose a more inclusive, public reason approach to healthy eating policy that will be appealing to those who take pluralism and cultural diversity seriously, by providing a framework through which different kinds of values, including but not limited to autonomy and health, can be factored into the public justification for healthy eating efforts. Additionally, the book adopts a 'farm to fork' approach to the ethics of healthy eating efforts: it engages with theories and debates in political philosophy, considers the implications of different theoretical positions for healthy eating efforts, and then develops a concrete tool for assessing policies that will be of interest to both scholars and policymakers. As well as offering a novel normative analysis of healthy eating policy, the authors offer a new theoretical framework that will be applicable to a wide range of public policy scenarios. (shrink)

This article argues that, suitably modified, the method of reflective equilibrium is a plausible way of selecting moral principles. The appropriate conception of the method is wide and radical, admitting consideration of a full range of moral principles and arguments, and requiring the enquiring individual to consider others' views and undergo experiences that may offset any formative biases. The individual is not bound by his initial considered judgments, and may revise his view in any way whatsoever. It is appropriate to (...) describe the method as a balance between coherentism and fallibilist foundationalism. With these points in mind, various criticisms, including the claims that considered judgments are not initially credible and are shaped by prejudice, and that the method itself fails to determine principle selection, are challenged. (shrink)

Analyzing Oppression asks: why is oppression often sustained over many generations? The book explains how oppression coercively co-opts the oppressed to join their own oppression and argues that all persons have a moral responsibility to resist it. It finally explores the possibility of freedom in a world actively opposing oppression.

Enhancing the usability of the brain, as a more intriguing alloy for interaction design, by employing the Brain Current Interface model (BCIm). Instead of studying interaction design through the angle of cognitive semiotics, where signs and signifiers produce meaning, I propose, in this case, to approach the paradigm of interaction design from a metaphorical angle, as a product of perceptual and intentional consciousness. Through this disposition, I argue, it is possible to approach the hypothesis of bringing together the use of (...) non-invasive brain computer interfaces (BCI) and the field of contemporary neuroscience, especially the role of the chemical modulation on a cellular level of the brain while learning, in order to propose a model for interaction via deliberate attention, that influences cognitive performance and advances well-being of individuals of any age.That which was previously mentally projected, which was lived as a metaphor in the terrestrial habitat is from now on projected entirely without metaphor …. (shrink)

Widely adopted as a textbook, Issues and Alternatives in Educational Philosophy has been a classic in its field for more than a quarter of a century. As a survey of philosophic issues relevent to the educational profession, it highlights the relationship between philosophic starting points and educational outcomes - between theory and practice. -- from back cover.

ABSTRACT:This article deploys Alasdair MacIntyre’s Aristotelian virtue ethics, in which meaningfulness is understood to supervene on human functioning, to bring empirical and ethical accounts of meaningful work into dialogue. Whereas empirical accounts have presented the experience of meaningful work either in terms of agents’ orientation to work or as intrinsic to certain types of work, ethical accounts have largely assumed the latter formulation and subjected it to considerations of distributive justice. This article critiques both the empirical and ethical literatures from (...) the standpoint of MacIntyre’s account of the relationship between the development of virtuous dispositions and participation in work that is productive of goods internal to practices. This reframing suggests new directions for empirical and ethical enquiries. (shrink)

We offer a topological treatment of scattered theories intended to help to explain the parallelism between, on the one hand, the theorems provable using Descriptive Set Theory by analysis of the space of countable models and, on the other, those provable by studying a tree of theories in a hierarchy of fragments of infinintary logic. We state some theorems which are, we hope, a step on the road to fully understanding counterexamples to Vaught's Conjecture. This framework is in the early (...) stages of development, and one area for future exploration is the possibility of extending it to a setting in which the spaces of types of a theory are uncountable. (shrink)

Non-suicidal self-harm is common in youth. The behavior may have negative and sometimes dangerous consequences, such as feelings of guilt, scars, nerve damage and accidental death. Is this behavior a mental disorder? This question is attracting serious consideration. I want to say that non-suicidal self-harm in youth is never a mental disorder in its own right. Yet, I do not want to commit to saying what is a mental disorder. So I identify the characteristic features and functions of non-suicidal self-harm (...) in youth and show that these features and functions are also seen in non-disordered behaviors in youth. This, I say, shows that non-suicidal self-harm in youth is non-disordered too. I say that non-suicidal self-harm in youth is a characteristic youth behavior that when seen in youth has an understandable practical function. I offer to the general discussion about mental disorder the strategy I use. (shrink)

Several attempts have been made to apply the choice-sensitive theory of distributive justice, luck egalitarianism, in the context of health and healthcare. This article presents a framework for this discussion by highlighting different normative decisions to be made in such an application, some of the objections to which luck egalitarians must provide answers and some of the practical implications associated with applying such an approach in the real world. It is argued that luck egalitarians should address distributions of health rather (...) than healthcare, endorse an integrationist theory that combines health concerns with general distributive concerns and be pluralist in their approach. It further suggests that choice-sensitive policies need not be the result of applying luck egalitarianism in this context. (shrink)

Anne Margaret Baxley offers a systematic interpretation of Kant's theory of virtue, whose most distinctive features have not been properly understood. She explores the rich moral psychology in Kant's later and less widely read works on ethics, and argues that the key to understanding his account of virtue is the concept of autocracy, a form of moral self-government in which reason rules over sensibility. Although certain aspects of Kant's theory bear comparison to more familiar Aristotelian claims about virtue, Baxley (...) contends that its most important aspects combine to produce something different - a distinctively modern, egalitarian conception of virtue which is an important and overlooked alternative to the more traditional Greek views which have dominated contemporary virtue ethics. (shrink)

COVID-19 vaccine refusal seems like a paradigm case of irrationality. Vaccines are supposed to be the best way to get us out of the COVID-19 pandemic. And yet many people believe that they should not be vaccinated even though they are dissatisfied with the current situation. In this paper, we analyze COVID-19 vaccine refusal with the tools of contemporary philosophical theories of responsibility and rationality. The main outcome of this analysis is that many vaccine-refusers are responsible for the belief that (...) they should not be vaccinated and epistemically rational in holding it. This is an important result because it provides insights into the legitimacy of certain public health policies. In particular, this result shows that a public health policy that would abandon the project of convincing certain vaccine-refusers with reasons – e.g., by simply making vaccination compulsory – is prima facie illegitimate. (shrink)

Rape, claims Ann J. Cahill, affects not only those women who are raped, but all women who experience their bodies as rapable and adjust their actions and self-images accordingly. Rethinking Rape counters legal and feminist definitions of rape as mere assault and decisively emphasizes the centrality of the body and sexuality in a crime which plays a crucial role in the continuing oppression of women.

Philosophical discussion about the reality of sensory perceptions has been hijacked by two tendencies. First, talk about perception has been largely centered on vision. Second, the realism question is traditionally approached by attaching objects or material structures to matching contents of sensory perceptions. These tendencies have resulted in an argumentative impasse between realists and anti-realists, discussing the reliability of means by which the supposed causal information transfer from object to perceiver takes place. Concerning the nature of sensory experiences and their (...) capacity to provide access to reality, this article challenges the standard categories through which most arguments in this debate have been framed to date. Drawing on the underexplored case of olfaction, I first show how the details of the perception process determine the modalities of sensory experiences. I specifically examine the role of measurement and analyze its influence on the characterization of perceptions in olfaction. My aim is to argue for an understanding of perception through a process view, rather than one pertaining to objects and properties of objects. (shrink)

Introduction The mainstream view in philosophy of language is that sentence meaning determines truth-conditions. A corollary is that the truth or falsity of an utterance depends only on what words mean and how the world is arranged. Although several prominent philosophers (Searle, Travis, Recanati, Moravcsik) have challenged this view, it has proven hard to dislodge. The alternative view holds that meaning underdetermines truth-conditions. What is expressed by the utterance of a sentence in a context goes beyond what is encoded in (...) the sentence itself. Truth-conditional content depends on an indefinite number of unstated background assumptions, not all of which can be made explicit. A change in background assumptions can change truth-conditions, even bracketing disambiguation and reference assignment. That is, even after disambiguating any ambiguous words in a sentence and assigning semantic values to any indexical expressions in the sentence, truth-conditions may vary with variations in the background. (shrink)

Do sensory measurements deserve the label of “measurement”? We argue that they do. They fit with an epistemological view of measurement held in current philosophy of science, and they face the same kinds of epistemological challenges as physical measurements do: the problem of coordination and the problem of standardization. These problems are addressed through the process of “epistemic iteration,” for all measurements. We also argue for distinguishing the problem of standardization from the problem of coordination. To exemplify our claims, we (...) draw on olfactory performance tests, especially studies linking olfactory decline to neurodegenerative disorders. (shrink)

. Although naturalistic perspectives are an important component of their accounts of divine action, most participants in the current dialogue between science and theology eschew a purely naturalistic model. They believe that certain events of divine providence require a special mode of divine action, over and above that inherent in naturalistic processes. The analogy of human providential action suggests, however, that a strong theistic naturalism can account for these events. This model does not depend on a particular notion of God's (...) relationship to time and is not inherently implausible from a scientific perspective. Although it can be interpreted deistically, the model also is consonant with a nondeistic theology that may be described as involving a pansacramental or incarnational naturalism. (shrink)