Knowledge of the ethical and legal basis of medicine is as essential to clinical practice as an understanding of basic medical sciences. In the UK, the General Medical Council requires that medical graduates behave according to ethical and legal principles and must know about and comply with the GMC’s ethical guidance and standards. We suggest that these standards can only be achieved when the teaching and learning of medical ethics, law and professionalism are fundamental to, and thoroughly integrated both vertically (...) and horizontally throughout, the curricula of all medical schools as a shared obligation of all teachers. The GMC also requires that each medical school provides adequate teaching time and resources to achieve the above. We reiterate that the adequate provision and coordination of teaching and learning of ethics and law requires at least one full-time senior academic in ethics and law with relevant professional and academic expertise. In this paper we set out an updated indicative core content of learning for medical ethics and law in UK medical schools and describe its origins and the consultative process by which it was achieved. (shrink)

In 'On the nature of truth and falsehood' Russell offers both a multiple relation theory of judgment and a correspondence theory of truth. It has been a prevailing understanding of the Tractatus that Wittgenstein rejects Russell’s multiple relation idea but endorses the correspondence theory. Ramsey took the opposite view. In his 'Facts and Propositions', Ramsey endorses Russell’s multiple relation idea, rejects the correspondence theory, and then asserts that these moves are both due to Wittgenstein. This chapter will argue that Ramsey’s (...) ascriptions are both correct. The extent of the agreement between Ramsey and Wittgenstein will be argued, moreover, to count definitively against standard understandings of Ramsey as a redundancy theorist of truth. Wittgenstein is no correspondence theorist and Ramsey is no redundancy theorist; rather, both philosophers offer identity theories of truth. (shrink)

The Australian Royal Commission into Aged Care Quality and Safety acknowledged understaffing and substandard care in residential aged care and home care services, and recommendations were made that that the Australian Government should promote assistive technology within aged care. Robotic care assistants can provide care and companionship for the elderly—both in their own homes and within health and aged care institutions. Although more research is required into their use, studies indicate benefits, including enabling the elderly to live independently at home, (...) assistance with medication and monitoring of safety. Nevertheless, there are inherent ethical challenges in the use of robots as carers, including loss of privacy, unwarranted restrictions on autonomy, lack of dignity, deception, and the exacerbation of loneliness. Ethics by design can counter these issues in development of robotics and clinical ethics committees have been put forward as a way of dealing with the ethical use of robotic care in healthcare institutions. In this paper I outline the ethical challenges of robotic care assistants and how these may be mediated in their design and use. (shrink)

ABSTRACT Frege characterizes judgement as the acknowledgement of the truth of a thought, appearing thereby to rule out false judgement. First in this paper I explain Frege’s characterization so that it does not have this consequence. Frege is not saying that for a subject S to judge that p is for S to acknowledge the truth of the thought that p. Rather, he is articulating judgement’s nature within self-consciousness. From within, to judge means to acknowledge a truth. Second, I suggest (...) that this articulation is centrally operative in Frege’s argument for the indefinability of truth. As Frege argues, it follows from judgement’s self-consciousness that truth is indefinable. (shrink)

Maude's excellent translation of Tolstoy's treatise on the emotionalist theory of art was the first unexpurgated version of the work to appear in any language. More than ninety years later this work remains, as Vincent Tomas observed, "one of the most rigorous attacks on formalism and on the doctrine of art for art's sake ever written". Tomas' Introduction makes this the edition of choice for students of aesthetics and anyone with philosophical interests.

The identity theory of truth takes on different forms depending on whether it is combined with a dual relation or a multiple relation theory of judgment. This paper argues that there are two significant problems for the dual relation identity theorist regarding thought’s answerability to reality, neither of which takes a grip on the multiple relation identity theory.

It is not immediately clear from Wittgenstein’s Tractatus how to connect his idea there of an object with the logical ontologies of Frege and Russell. Toward clarification on this matter, this paper compares Russell’s and Wittgenstein’s versions of the thesis of an atomic fact that it is a complex composition. The claim arrived at is that whilst Russell (at times at least) has one particular of the elements of a fact – the relation – responsible for the unity of the (...) whole, for Wittgenstein the unity of a fact is the product of copulative powers inherent in all its elements. All kinds of constituents of Tractarian facts – all kinds (forms) of object – are, to use Fregean terminology, unsaturated. (shrink)

The teaching of ethics in UK medical schools has recently been reviewed, from the perspective of the teachers themselves. A questionnaire survey of medical undergraduates at King’s College London School of Medicine provides useful insight into the students’ perception of ethics education, what they consider to be the value of learning ethics and law, and how engaged they feel with the subject.

It has been much debated whether Tractarian objects are what Russell would have called particulars or whether they include also properties and relations. This paper claims that the debate is misguided: there is no logical category such that Wittgenstein intended the reader of the Tractatus to understand his objects either as providing examples of or as not providing examples of that category. This is not to say that Wittgenstein set himself against the very idea of a logical category: quite the (...) contrary. However, where Russell presents his logical variety of particulars and the various types of universal, and Frege presents his of objects and the various types of function, Wittgenstein denies the propriety of such a priori expositions. Wittgenstein envisages a variety of logical types of entity but insists that the nature of these types is something to be discovered only through analysis. (shrink)

The Mental Capacity Act received Royal Assent on 7 April 2005, and it will be implemented in 2007. The Act defines when someone lacks capacity and it supports people with limited decision-making ability to make as many decisions as possible for themselves. The Act lays down rules for substitute decision making. Someone taking decisions on behalf of the person lacking capacity must act in the best interests of the person concerned and choose the options least restrictive of his or her (...) rights and freedoms. Decision making will be allowed without any formal procedure unless specific provisions apply, such as a written advance decision, lasting powers of attorney or a decision by the court of protection. (shrink)

Warming temperatures in the circumpolar north have led to new discussions around climate-driven frontiers for agriculture. In this paper, we situate northern food systems in Canada within the corporate food regime and settler colonialism, and contend that an expansion of the conventional, industrial agriculture paradigm into the Canadian North would have significant socio-cultural and ecological consequences. We propose agroecology as an alternative framework uniquely accordant with northern contexts. In particular, we suggest that there are elements of agroecology that are already (...) being practiced in northern Indigenous communities as part of traditional hunter-gatherer food systems. We present a framework for agroecology in the North and discuss its components of environmental stewardship, economies, knowledge, social dimensions and governance using examples from the Dehcho region, Northwest Territories, Canada. Finally, we discuss several challenges and cautions in creating policy around agroecology in the North and encourage community-based research in developing and testing this framework moving forward. (shrink)

This paper is concerned with the status of a symbol in Wittgenstein’s Tractatus. It is claimed in the first section that a Tractarian symbol, whilst essentially a syntactic entity to be distinguished from the mark or sound that is its sign, bears its semantic significance only inessentially. In the second and third sections I pursue this point of exegesis through the Tractarian discussions of nonsense and the context principle respectively. The final section of the paper places the forgoing work in (...) a secondary context, addressing in particular a debate regarding the realism of the Tractatus. (shrink)

First paragraph: This paper seeks to understand various paradoxes as cases of conflicting rules. In particular, the ambition is to outline a new perspective on and response to the Liar -- though it will take us a while to get that far. We begin in Section 1 with an account of simple rule confliction. Section 2 then brings this account to bear on a paradox, the Secretary Liberation Paradox, which is readily seen to involve conflicting rules. Finally in Section 3 (...) I suggest that the Liar can also be seen as a case of rule confliction, and outline briefly how that perspective provides for Liar arguments to be blocked. (shrink)

Frege maintains that there are not two distinct acts, assertion and denial; rather, denying p is one and the same as asserting not-p. Wittgenstein appears not to recognise this identity in Frege, attributing to him the contrary view that a proposition may have one of two verbs, "is true" or "is false". This paper explains Wittgenstein’s attribution as a consequence of Frege’s treatment of content as theoretically prior to the act of judgment. Where content is prior to judgment, the denial (...) of p—what is rejected in asserting p—is distinct from the assertion of not-p. Wittgenstein’s own embrace of Frege’s identity is then considered, an embrace explained in part by his repudiation of Frege’s theoretical order. (shrink)

Wittgenstein held that Russell’s multiple relation theory of judgment fails to explain an atomic judgment’s representation of entities as combined. He demonstrated this failure as follows. Under the multiple relation theory, an atomic judgment is a complex whose relating relation is judgment, the universal, and whose terms include the entities the judgment represents as combined. Taking such a complex we may arrive through the substitution of constituents at a complex whose relating relation is again judgment but whose terms do not (...) include entities which are logically suited for combination. This second judgment complex will not represent any of its terms as combined, for entities that are logically uncombinable are unrepresentable as combined. Russell’s theory does not, however, explain how the original judgment differs from the complex arrived at by the substitution of constituents such that the former but not the latter represents certain of its terms as combined. (shrink)

Wittgenstein responds in his Notes on Logic to a discussion of Russell's Principles of Mathematics concerning assertion. Russell writes: "It is plain that, if I may be allowed to use the word assertion in a non-psychological sense, the proposition "p implies q" asserts an implication, though it does not assert p or q. The p and the q which enter into this proposition are not strictly the same as the p or the q which are separate propositions." (PoM p35) Wittgenstein (...) replies: "Assertion is merely psychological. In not-p, p is exactly the same as if it stands alone; this point is absolutely fundamental." (NB p95) Wittgenstein's response is intriguing, not least because of the centrality to his Tractatus of the idea that a proposition says something. This paper will examine that idea, distinguishing it from 'merely psychological' assertion, and explore in this context how we should understand the occurrence of a Tractarian proposition within another. (shrink)

Members of the Student Clinical Ethics Committee discussed the ethical and legal issues arising in a case referred for consideration – the family of a very elderly non-English speaking Asian lady did not want her to be informed that she had incurable lymphoma. The case study summarises the reflections of the Committee and focusses on: the role of cultural norms in healthcare decision making; the extent to which the views of the family about what is best for the patient should (...) be respected, whether the patient should have been informed of her terminal diagnosis and the role of the clinician in navigating complex family dynamics. (shrink)

This chapter focuses on picture theory, which is sometimes spoken of as a theory of the proposition. By a proposition, Wittgenstein like Frege means something that determines its sense by means of a correlation between the mode of combination of its constituent symbols and the structure of its sense. It has been an orthodoxy amongst Tractatus interpreters, and continues to be such in the wider philosophical community, that Wittgenstein follows the Russell in offering a correspondence theory of truth. The expression (...) of a Tractarian fact provides that fact's mode of combination, and from here there can be no further question as to the ontological types of its constituents. Tractarian facts, it is however added, are not truth conditions but items whose existence explains the obtaining of truth conditions: a Tractarian atomic fact is not a truth condition but a truthmaker. (shrink)

This article examines the standard of disclosure, set by law, of risks of treatment and alternative procedures that should normally be disclosed to patients. Therapeutic privilege has been recognized by the courts as an exception to this standard of disclosure. It provides a justification for withholding such information from competent patients in the interests of patient welfare. The article explores whether this justification is either legally or ethically defensible. In assessing patient welfare, the health care professional is required to consider (...) the patient's overall best interests - but this is not limited to an assessment of medical best interests. It is contended that the health care professional is neither qualified nor justified in making such a judgement, as the law recognizes that a competent adult patient determines her own best interests. This is not possible without sufficient information of risks to inform the decision. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 22 (2002) 17-29 [Access article in PDF] A Christian Critique of Economics Carol Johnston Christian Theological Seminary Introduction: A Word About History Contrary to the assertions of many contemporary economists, no economic model is "value-free." Both of the major models in the world today, capitalism (or neoclassical economic theory) and Marxism (or Marxian economics), have a long history in which basic assumptions and value choices were made (...) that govern the models. Those assumptions and value choices have deep roots in Western culture, and were certainly shaped by Christianity as it has been practiced in the West (as opposed, often, to how it should have been practiced!). But in both cases, alternative choices were possible, and, as we shall see, some opportunities were missed. However, it is not my purpose to attempt to determine to what extent Christianity can be blamed or credited with the economics we must live with today. Rather, I hope to examine economics from the perspective of my Christian faith to ask how the economic models so powerful today have missed (or worked against) crucial elements of Jewish and Christian standards of justice, and how they might be transformed to create economies that are healthier for human and natural communities, and ecologically sustainable.When Adam Smith published his Inquiry into the Nature and Causes of the Wealth of Nations in 1776, he was asking if there could be a better way to run economies than the entrenched mercantilism of his day, which operated through state monopolies to benefit an elite. He and many others in his time were frustrated with mercantilism and searching for alternatives. They never imagined that the ideas they wrote about would some day coalesce into what we now call "capitalism," and succeed beyond their wildest dreams. They were just trying to make the system more open to more participation by a wider range of people. I believe that today we are in a similar situation. Capitalism has been wildly successful in its single goal: constant growth in the production of "goods." From a Christian perspective, this is an ambiguous goal and in and of itself cannot be supported. In addition, capitalism also has serious negative effects on both communities and the natural environment that must be dealt with, and it has a built-in tendency to leave many people marginalized—not only unemployed and often unemployable within the capitalist market system, but even worse, [End Page 17] stripped of traditional access to subsistence living. Consequently, many of us are searching for solutions—for ways to go beyond cosmetic reforms and really transform capitalism to make it a more equitable and environmentally sustainable system. Surely if Adam Smith and others of his day could think their way through to better ideas about economics than those offered in mercantilism, we can do the same with the economic models available to us today. If they could do it, we can do it. Thinking Theologically About Economics and Acting Responsibly As a Christian, I already approach economics with a number of assumptions, value choices, and perspectives that come from my tradition. I hope to be clear about what those are and compare them with those that are embedded in economics.First of all, the world (which is both material and spiritual) is created by God, who recognizes it as "good" (Gen. 1). This world then is not something to be escaped (contrary to the beliefs of some Christians), but is to be lived in as fully as possible as the gracious gift of a generous and loving God. From a Christian perspective, science has for the most part focused solely on the material aspect of creation and ignored the spiritual. Insofar as economics has tried to be "scientific," it has also worked within a narrow framework of "facts" that focuses solely on "natural laws" and how things work at a material level. This is very inadequate from a Christian perspective, but as far as it goes, it is true enough. If economics would carefully stay within its own realm of "facts," Christians could have little to quarrel with. However... (shrink)

In W v M and Others (Re M) the Court of Protection considered whether withdrawal of artificial nutrition and hydration was in the best interests of a person in minimally conscious state. The Mental Capacity Act 2005 states that in determining best interests the decision-maker must consider, so far as is reasonably ascertainable, the patient's wishes, feelings, beliefs and values. Baker J. indicated that a high level of specificity is required in order to attribute significant weight to these factors. It (...) is preservation of life which carries substantial weight in the best interests' balance sheet. Could the (prior) values of a patient ever meet the probative standard necessary to offset the weight accorded to preservation of life? Rather than referencing the patient's values to specific circumstances and treatments they could be more effectively considered as part of the patient narrative, how the patient would want her life story to continue/cease. (shrink)

ABSTRACTZalabardo argues that the Tractatus makes an important contribution towards explaining how a representation doesn¹t merely introduce various objects, but furthermore represents them as comb...

This article considers the provisions of the Mental Capacity Act 2005 in respect of advance decisions. It considers the new statutory regulation of advance directives (termed 'advance decisions' in the Act) and the formalities necessary to effect an advance decision purporting to refuse life-sustaining treatment. The validity and applicability of advance decisions is discussed with analogy to case law and the clinician's reasonable belief in following an advance decision is considered. The article assesses the new personal welfare Lasting Powers of (...) Attorney, the situation where an attorney purports to refuse life-sustaining treatment on behalf of the donor, and the contrast between best interests and substituted judgment. (shrink)

Frege's strict alignment between his syntactic and ontological categories is not, as is commonly assumed, some kind of a philosophical thesis. There is no thesis that proper names refer only to objects, say, or that what refers to an object is a proper name. Rather, the alignment of categories is internal to Frege's conception of what syntax and ontology are. To understand this, we need to recognise the pride of place Frege assigns within his theorising to the notion of truth. (...) For both language and the world, the Fregean categories are logical categories, categories, that is, of truth. The elaboration of this point makes clear the incoherence of supposing that they might not align. (shrink)

People are using innovative internet of things technologies to gain individualised management of their type 1 diabetes. The #WeAreNotWaiting movement supports them to build their own hybrid closed loop systems and access their real time blood sugar data via any web connected device. A small number of parents in Australia use such DIY looping systems to manage their child’s type 1 diabetes, but these systems have not been approved by the Therapeutic Goods Administration in Australia, creating ethical dilemmas for clinicians (...) about how to respond to the use of medical devices that are not registered on the Australian Register of Therapeutic Goods. This article considers whether the use of DIY looping is in the best interests of the child and, if not, whether intervention in parental decision making is justified to prevent harm to the child. It addresses the ongoing duty of healthcare professionals to provide care to children who are ‘looping.’ Reference is made to findings from a study, Personalised Closed Loop Systems for Childhood Diabetes, to illustrate stakeholders’ perceptions of benefits and harms of DIY looping systems. I conclude that the decision of parents to use DIY looping technology could be considered to be in a child’s best interests, broadly defined, and falls within the Zone of Parental Discretion, however healthcare practitioners who support parents may have professional concerns in doing so. (shrink)