Within any organization (e.g. a hospital or clinic) the perception of the way things operate may vary dramatically as a function of one’s location in the organizational hierarchy as well as one’s professional discipline. Interorganizational variability depends on organizational coherence, safety, and stability. In this four-nation (Canada, Ireland, Australia, and Korea) qualitative study of 42 nurses, we explored their perception of how ethical decisions are made, the nurses’ hospital role, and the extent to which their voices were heard. These nurses (...) suggested that their voices were silenced (often voluntarily) or were not expressed in terms of ethical decision making. Finally, they perceived that their approach to ethical decision making differed from physicians. (shrink)

Objectives—To evaluate a departmental computer system.Design—a. Direct comparison of the time taken to use a manual system with the time taken to use a computer system for lung function evaluation, loan of equipment and production of correspondence. b. Analysis of the accuracy of data capture before and after the introduction of the computer system. c. Analysis of the comparative running costs of the manual and computer systems.Setting—Within a department of respiratory medicine serving a hospital of 1323 beds.Main Outcome Measures—a. Time (...) taken to perform functions with the assistance of computerised methods, in comparison to the manual method used alone. b. Accuracy of data capture. c. Relative running costs.Results—a. The computer system (CS) was significantly faster than the manual system (MS) for lung function evaluation (CS=7.63 min/test, MS=12.25 min/test), loan of equipment (CS=0.40 min/loan, MS=2.07 min/loan), and checking for overdue equipment (CS=0.49 s/record, MS=9 s/record). The production of correspondence was slightly slower with the computer (CS=9.30 min/letter, MS=8.54 min/letter). b. All outpatient episodes, but only 43 of 65 (66%) of inpatient episodes, were captured. Lung function and managerial report data were accurate using both manual and computerised methods. The manual system for equipment loans was inefficient, and use of the computer resulted in the recovery of 221 nebulisers. c. Development costs for 1988–1990 were high (£72 178). Only £1200 to £1845 per year was recovered directly from staff time saved by the computer but larger savings resulted from changes in work practice (£4049–4765). After 10 years the projected deficit is £10 000 per annum in running costs.Conclusions—In comparison with the manual methods, the computer system has shown significant advantages which provide accurate information, with significant favourable effects on working practices. In evaluating computer systems used in clinical practice it is essential to ensure that the projected work practice benefits are achieved without unacceptable costs in staff time, inaccurate data and high financial outlay. (shrink)

Objectives—To evaluate a departmental computer system.Design—a. Direct comparison of the time taken to use a manual system with the time taken to use a computer system for lung function evaluation, loan of equipment and production of correspondence. b. Analysis of the accuracy of data capture before and after the introduction of the computer system. c. Analysis of the comparative running costs of the manual and computer systems.Setting—Within a department of respiratory medicine serving a hospital of 1323 beds.Main Outcome Measures—a. Time (...) taken to perform functions with the assistance of computerised methods, in comparison to the manual method used alone. b. Accuracy of data capture. c. Relative running costs.Results—a. The computer system was significantly faster than the manual system for lung function evaluation, loan of equipment, and checking for overdue equipment. The production of correspondence was slightly slower with the computer. b. All outpatient episodes, but only 43 of 65 of inpatient episodes, were captured. Lung function and managerial report data were accurate using both manual and computerised methods. The manual system for equipment loans was inefficient, and use of the computer resulted in the recovery of 221 nebulisers. c. Development costs for 1988–1990 were high. Only £1200 to £1845 per year was recovered directly from staff time saved by the computer but larger savings resulted from changes in work practice. After 10 years the projected deficit is £10 000 per annum in running costs.Conclusions—In comparison with the manual methods, the computer system has shown significant advantages which provide accurate information, with significant favourable effects on working practices. In evaluating computer systems used in clinical practice it is essential to ensure that the projected work practice benefits are achieved without unacceptable costs in staff time, inaccurate data and high financial outlay. (shrink)

Ted Shotter's founding of the London Medical Group 50 years ago in 1963 had several far reaching implications for medical ethics, as other papers in this issue indicate. Most significant for the joint authors of this short paper was his founding of the quarterly Journal of Medical Ethics in 1975, with Alastair Campbell as its first editor-in-chief. In 1980 Raanan Gillon began his 20-year editorship . Gillon was succeeded in 2001 by Julian Savulescu, followed by John Harris and Soren Holm (...) in 2004, with Julian Savulescu starting his second and current term in 2011. In 2000 an additional special edition of the JME, Medical Humanities , was published, under the founding joint editorship of Martyn Evans and David Greaves. In 2003 Jane Macnaughton succeeded David Greaves as joint editor. Deborah Kirklin, under whose auspices MH became an independent journal, took over in 2008, and she was succeeded in 2013 by Sue Eckstein. This short paper offers reminiscences and reflections from the two journals’ various editors.From the start the JME was committed to clearly expressed reasoned discussion of ethical issues arising from or related to medical practice and research. In particular, both Edward Shotter and Alastair Campbell, each a cleric , were at pains to make clear that the JME was not a religious journal and that it had no sort of partisan axe to grind.Campbell's appointment as founding editor was something of a surprise, as the original intention had been to appoint a medical doctor, who could be expected to know medical practice from the inside. However, in 1972 Campbell, a Joint Secretary of the Edinburgh Medical Group, had published Moral dilemmas in medicine. …. (shrink)

The idea that intuition plays a basic role in moral knowledge and moral philosophy probably began in the eighteenth century. British philosophers such as Anthony Shaftsbury, Francis Hutcheson, Thomas Reid, and later David Hume talk about a “moral sense” that they place in John Locke’s theory of knowledge in terms of Lockean reflexive perceptions, while Richard Price seeks a faculty by which we obtain our ideas of right and wrong. In the twentieth century intuitionism in moral philosophy was revived (...) by the works of G. E. Moore, H. A. Prichard, and W. D. Ross. These philosophers reject Kantian deontological ethics and utilitarianism insisting that intuition is the only source of moral knowledge. Recently, there is a renewed interest in intuition by philosophers doing meta-philosophy by reflecting on what philosophers do, and why they disagree. In this essay we plan to take some of this recent literature on intuition and apply it to moral philosophy. We will proceed by defining a conception of intuition, answering some skeptical challenges, delimiting its target, and arguing that intuition is often a source of moral knowledge. (shrink)

Michael Potts, Paul A. Byrne, an David W. Evans are critical of donation after cardiac death (DCD). Contrary to the authors’ assertion that the removal of vital organs is the proximate cause of death, the eventual fulfillment of the neurological criteria of death is solely dependant on the rate of brain cell death in the absence of circulation. Consistent with the “dead donor rule,” DCD is not the cause of death. There are also procedural mechanisms to address the (...) potential conflicts of interest that concern the authors. Rather than being prohibited, DCD may be an ethically justifiable exception to the rule that organ donors must be dead prior to organ recovery. (shrink)

The contents of this book were originally published in the September 1966 issue of Scientific American. A more appropriate-but perhaps less "catchy"—title would have been "Computers." The book is all about them and what they can—and cannot—do. Conspicuously missing is a chapter on the underlying mathematical theories of information, control, and computation. Nevertheless, there is a good deal of interesting material between the covers of this book. Of greatest concern to philosophers are the chapters on "Information" by John McCarthy, "Computer (...) Logic and Memory" by David C. Evans, "The Uses of Computers in Science" by Anthony G. Oettinger, "The Uses of Computers in Education" by Patrick Suppes, and "Artificial Intelligence" by Marvin L. Minsky. The first of these consists of a brief history of computing machines, an outline of the general principles of digital computers, and an interesting discussion of some of the moral and social issues which such machines raise. Evans' article is a popular description of binary logics and logic devices. The present reviewer has used some of the material in this chapter as embellishments in an undergraduate course in logic. Oettinger's article describes the novel way in which computers may aid in the formation of scientific theories. The paper by Suppes ought to be required reading for members of the "Teaching machines undermine intellectual development" school of thought. Finally, a philosopher of mind might have a field day with some of the remarkable and outrageous notions in Minsky's article; what, for example, is the difference between "thinking" and "exhibiting intelligence"? In sum, this is a stimulating book about a technological development which, for good or ill, is going to affect all of us.—H. P. K. (shrink)

This is the first sustained, whole-Bible treatment on the theme of meeting God face to face. Starting with Genesis and ending with Revelation, the author systematically covers the major events in salvation history, all of which reveal the beauty of encountering God's grace in abundance.

This book is the result of an idea launched by the present editors of providing a gift to Dr. Runner in the form of a Festschrift written by former students. The response was overwhelming. Glenn Andreas, one of Dr. Runner's closest friends, and Paul Schrotenboer, secretary of the Reformed Ecumenical Synod, enthusiastically joined us, together with Bernard Zylstra of the Institute for Christian Studies and Harry Van Dyke of the Free University of Amsterdam, to form a committee for this purpose... (...) Upon the appearance of this publication the editors wish to express their sincere thanks to the members of the committee for the advice and encouragement they gave and for the work they have done. (shrink)

In the past two to three decades health behavior scientists have increasingly emphasized affect-related concepts (including, but not limited to emotion) in their attempts to understand and facilitate change in important health behaviors, such as smoking, eating, physical activity, substance abuse, and sex. This article provides a narrative review of this burgeoning literature, including relevant theory and research on affective response (e.g., hedonic response to eating and drug use), incidental affect (e.g., work-related stress as a determinant of alcohol use), affect (...) processing (e.g., anticipated regret for illicit sex or skipping an exercise session), and affectively charged motivation (e.g., cigarette craving). An integrative dual-processing framework is presented that suggests pathways through which affect-related concepts may interrelate to influence health behavior. (shrink)

This new edition includes three new chapters, updating the book to take into account developments in the field over the past fifteen years.

A primary purpose of argument is to increase the degree of reasonable confidence that one has in the truth of the conclusion. A question begging argument fails this purpose because it violates what W. E. Johnson called an epistemic condition of inference. Although an argument of the sort characterized by Robert Hoffman in his response (Analysis 32.2, Dec 71) to Richard Robinson (Analysis 31.4, March 71) begs the question in all circumstances, we usually understand the charge that an argument is (...) question begging with reference to the beliefs of the person, or the sort of person, to whom the argument is directed. (shrink)

Everything red is colored, and all squares are polygons. A square is distinguished from other polygons by being four-sided, equilateral, and equiangular. What distinguishes red things from other colored things? This has been understood as a conceptual rather than scientific question. Theories of wavelengths and reflectance and sensory processing are not considered. Given just our ordinary understanding of color, it seems that what differentiates red from other colors is only redness itself. The Cambridge logician W. E. Johnson introduced the terms (...) determinate and determinable to apply to examples such as red and colored. Chapter XI, of Johnson's Logic, Part I (1921), “The Determinate and the Determinable,” is the main text for discussion of this distinction. (shrink)

This article answers John Biro's "Knowability, Believability, and Begging the Question: a Reply to Sanford" in "Metaphilosophy" 15 (1984). Biro and I agree that of two argument instances with the same form and content, one but not the other can beg the question, depending on other factors. These factors include actual beliefs, or so I maintain (against Biro) with the help of some analysed examples. Brief selections from Archbishop Whatley and J S Mill suggest that they also regard reference to (...) actual beliefs as essential to explaining begging the question. (shrink)

I criticize and emend J L Mackie's account of causal priority by replacing ‘fixity’ in its central clause by 'x is a causal condition of y, but y is not a causal condition of x'. This replacement works only if 'is a causal condition of' is not a symmetric relation. Even apart from our desire to account for causal priority, it is desirable to have an account of nonsymmetric conditionship. Truth, for example, is a condition of knowledge, but knowledge is (...) not a condition of truth. My definitions of 'sufficient condition for' and 'necessary condition for' do not imply that p is a sufficient condition of q if and only if q is a necessary condition of p. (shrink)

Locke thought it was a necessary truth that no two material bodies could be in the same place at the same time. Leibniz wasn't so sure. This paper sides with Leibniz. I examine the arguments of David Wiggins in defense of Locke on this point (Philosophical Review, January 1968). Wiggins’ arguments are ineffective.

At least since Descartes, philosophers have been interested in the special knowledge or authority that we exhibit when we speak about our own thoughts, attitudes, and feelings. This book contends that even the best work in contemporary philosophy of mind fails to account for this sort of knowledge or authority because it does not pay the right sort of attention to the notion of expression. What's at stake is not only how to understand self-knowledge and first-person authority, but also what (...) it is that distinguishes conscious from unconscious psychological states, what the mental life of a nonlinguistic animal has in common with our sort of mental life, and how to think about Wittgenstein's legacy to the philosophy of mind. (shrink)

To accommodate vague statements and predicates, I propose an infinite-valued, non-truth-functional interpretation of logic on which the tautologies are exactly the tautologies of classical two-valued logic. iI introduce a determinacy operator, analogous to the necessity operator in alethic modal logic, to allow the definition of first-order and higher-order borderline cases. On the interpretation proposed for determinacy, every statement corresponding to a theorem of modal system T is a logical truth, and I conjecture that every logical truth on the interpretation corresponds (...) to a theorem of T. the interpretation is extended to predicate logic. A borderline case of a predicate 'F’ is neither determinately F nor determinately not-F. Traditional sorites arguments are seen to fall apart early in their gradual stepwise passage from truth to falsity. (shrink)

In several works on modality, G. H. von Wright presents tree structures to explain possible worlds. Worlds that might have developed from an earlier world are possible relative to it. Actually possible worlds are possible relative to the world as it actually was at some point. Many logically consistent worlds are not actually possible. Transitions from node to node in a tree structure are probabilistic. Probabilities are often more useful than similarities between worlds in treating counterfactual conditionals.

If two statements are contraries if and only if they cannot both be true, but can both be false, then some corresponding A and E categorical statements are not contraries, even on the presupposition that something exists which satisfies the subject term. For some such statements are necessarily true and thus cannot be false. There is a similar problem with subcontraries.

Myles Brand and Marshall Swain advocate the principle that if A is the set of conditions individually necessary and jointly sufficient for the occurrence of B, then if C is a set of conditions individually necessary for the occurrence of B, every member of C is a member of A. I agree with John Barker and Risto Hilpinen who each argue that this principle is not true for causal necessity and sufficiency, but I disagree with their claim that it is (...) true for logical necessity and sufficiency. The original appeal of the principle may be due to confusing two kinds of totality: to say that when every member of set A obtains, then every condition necessary for E obtains is not to say that every condition necessary for E is a member of A. All the authors mentioned believe that causal necessity precludes logical necessity. I deny this on the basis of an example from kinematics. Hume has not refuted definitions of causation in terms of logically necessary and sufficient conditions, nor have Brand and Swain. (shrink)

The two main psychological theories of the ordinary conditional were designed to account for inferences made from assumptions, but few premises in everyday life can be simply assumed true. Useful premises usually have a probability that is less than certainty. But what is the probability of the ordinary conditional and how is it determined? We argue that people use a two stage Ramsey test that we specify to make probability judgements about indicative conditionals in natural language, and we describe experiments (...) that support this conclusion. Our account can explain why most people give the conditional probability as the probability of the conditional, but also why some give the conjunctive probability. We discuss how our psychological work is related to the analysis of ordinary indicative conditionals in philosophical logic. (shrink)

Self-consciousness and the self -- Diachronic unity, diachronic singularity, and the subject of consciousness -- A modal argument for immateriality -- Intelligibility concerns and causal objections -- Concluding remarks.

According to John A Barker, whether an argument begs the question is purely a matter of logical form. According to me, it is also a matter of epistemic conditions; some arguments which beg the question in some contexts need not beg the question in every context. I point out difficulties in Barker's treatment and defend my own views against some of his criticisms. In the concluding section, "Alleged difficulties with disjunctive syllogism," I defend the validity of disjunctive syllogism against the (...) views of Alan Ross Anderson and Nuel D Belnap, Jr., ask pointed questions about the notion of intensional disjunction, and suggest how my treatment of begging the question can be extended to deal with the so-called paradoxes of strict implication. (shrink)

Hume's arguments for the contention that causal necessity precludes logical necessity depend on the questionable principle that a cause must precede its effect. Hobbes' definition of entire cause, although it fails to account for causal priority, is not refuted by Hume. The objections of Myles Brand and Marshall Swain (Philosophical Studies, 1976) to my counterexample against Hume (Philosophical Studies, 1975) are ineffective. Their other objections to my criticisms of their argument against defining causation in terms of necessary and sufficient conditions (...) (Synthese, 1970) are also mostly ineffective. (shrink)

In this collection of provocative essays, historians and literary theorists assess the influence of Michel Foucault, particularly his History of Sexuality, on the study of classics. Foucault's famous work presents a bold theory of sexuality for both ancient and modern times, and yet until now it has remained under-explored and insufficiently analyzed. By bringing together the historical knowledge, philological skills, and theoretical perspectives of a wide range of scholars, this collection enables the reader to explore Foucault's model of Greek culture (...) and see how well his interpretation accounts for the full range of evidence from Greece and Rome. Not only do the essays bring to light the assumptions, ideas, and practices that constituted the intimate lives of men and women in the ancient Mediterranean world, but they also demonstrate the importance of the History of Sexuality for fields as diverse as Greco-Roman antiquity, women's history, cultural studies, philosophy, and modern sexuality. The essays include "Situating The History of Sexuality" (the editors), "Taking the Sex Out of Sexuality: Foucault's Failed History" (Joel Black), "Incipit Philosophia" (Alain Vizier), "The Subject in Antiquity after Foucault" (Page duBois), "This Myth Which Is Not One: Construction of Discourse in Plato's Symposium" (Jeffrey S. Carnes), "Foucault's History of Sexuality: A Useful Theory for Women?" (Amy Richlin), "Catullan Consciousness, the 'Care of the Self,' and the Force of the Negative in History" (Paul Allen Miller), "Reversals of Platonic Love in Petronius' Satyricon" (Daniel B. McGlathery), and an essay from Dislocating Masculinity (Lin Foxhall). (shrink)

Unger claims that we can block sorites arguments for the conclusion that there are no ordinary things only by invoking some kind of miracle, but no such miracle is needed if we reject the principle that every statement has a truth value. Wheeler's argument for the nonexistence of ordinary things depends on the assumptions that if ordinary things exist, they comprise real kinds, and that if ordinary predicates really apply to things, the predicates refer to real properties. If we accept (...) Wheeler's criteria for the reality of kinds and properties, we have no good reason to accept these assumptions. (shrink)