An aging population is often taken to require a profound reorganization of the prevailing health care system. In particular, a more cost-effective care system is warranted and ICT-based home care is often considered a promising alternative. Modern health care devices admit a transfer of patients with rather complex care needs from institutions to the home care setting. With care recipients set up with health monitoring technologies at home, spouses and children are likely to (...) become involved in the caring process and informal caregivers may have to assist kin-persons with advanced care needs by means of sophisticated technology. This paper investigates some of the ethical implications of a near-future shift from institutional care to technology-assisted home care and the subsequent impact on the care recipient and formal- and informal care providers. (shrink)

The philosophy of science of Patrick Suppes is centered on two important notions that are part of the title of his recent book (Suppes 2002): Representation and Invariance. Representation is important because when we embrace a theory we implicitly choose a way to represent the phenomenon we are studying. Invariance is important because, since invariants are the only things that are constant in a theory, in a way they give the “objective” meaning of that theory. Every scientific theory gives a (...) representation of a class of structures and studies the invariant properties holding in that class of structures. In Suppes’ view, the best way to define this class of structures is via axiomatization. This is because a class of structures is given by a definition, and this same definition establishes which are the properties that a single structure must possess in order to belong to the class. These properties correspond to the axioms of a logical theory. In Suppes’ view, the best way to characterize a scientific structure is by giving a representation theorem for its models and singling out the invariants in the structure. Thus, we can say that the philosophy of science of Patrick Suppes consists in the application of the axiomatic method to scientific disciplines. What I want to argue in this paper is that this application of the axiomatic method is also at the basis of a new approach that is being increasingly applied to the study of computer science and information systems, namely the approach of formal ontologies. The main task of an ontology is that of making explicit the conceptual structure underlying a certain domain. By “making explicit the conceptual structure” we mean singling out the most basic entities populating the domain and writing axioms expressing the main properties of these primitives and the relations holding among them. So, in both cases, the axiomatization is the main tool used to characterize the object of inquiry, being this object scientific theories (in Suppes’ approach), or information systems (for formal ontologies). In the following section I will present the view of Patrick Suppes on the philosophy of science and the axiomatic method, in section 3 I will survey the theoretical issues underlying the work that is being done in formal ontologies and in section 4 I will draw a comparison of these two approaches and explore similarities and differences between them. (shrink)

In order to contain public care expenditure, policymakers in the Netherlands have over the last decades formulated in ever more stringent ways what ought to be expected from spouses, partners, and family members with regard to care for dependent relatives. The current Dutch coalition cabinet plans to shift the principal responsibility for nonmedical care, including demanding forms of care such as long-term personal care, to individuals and families. I argue that these policy developments imply cost (...) redistribution rather than cost containment and that this redistribution is disadvantageous for women. (shrink)

ObjectiveOur objective was to evaluate whether those individuals with previous involvement with formal clinical ethics processes differ in their attitudes towards the resolution of prototypical clinical ethics cases than general health care professionals. We hypothesized that those individuals with previous participation in ethics consultation would have significantly different attitudes on the appropriate role of ethics committees in the assessment and resolution of clinical ethical dilemmas than those who have not.MethodsWe conducted a case-based survey of health care professionals (...) at six US hospitals. We administered the survey to health care professionals in a variety of clinical roles at each center and further sub-categorized these by respondents reporting or not reporting their membership on an ethics committee or participation as an ethics consultant/requestor of ethics consult services. Using the analysis of variance test, we present the variation in attitudes using a 5-point Likert scale with 95% confidence intervals and significance set at p ≤ 0.05.ResultsA total of 240 respondents completed the survey (response rate: 63.6%) from all six surveyed centers (128 respondents with involvement with ethics consultation, 112 respondents without). Health care professionals not previously involved with formal clinical ethics processes were less likely to view the ethics committee as having a role in resolving the presented clinical ethical dilemmas ( p = 0.01 for analysis of variance comparison).ConclusionIn this multi-center survey study, health care providers without previous involvement with formal clinical ethics processes were less likely than those with previous involvement to support a role for ethics committees aiding in ethical case resolution. (shrink)

In _Caring_, Peta Bowden extends and challenges recent debates on feminist ethics. She takes issue with accounts of the ethics of care that focus on alleged principles of caring rather than analysing caring in practice. Caring, Bowden argues, must be understood by 'working through examples'. Following this approach, Bowden explores four main caring practices: mothering, friendship, nursing and citizenship. Her analysis of the differences and similarities in these practices - their varying degrees of intimacy and reciprocity, formality and informality, (...) vulnerability and choice - reveals the practical complexity of the ethics of care. _Caring_ recognizes that ethical practices constantly outrun the theories that attempt to explain them, and Bowden's unique approach provides major new insights into the nature of care without resorting to indiscriminate unitary models. It will be essential reading for all those interested in ethics, gender studies, nursing and the caring professions. (shrink)

Teens' experiences with reproductive health care have been ignored by both the “social problems” moral discourse on teen pregnancy and feminist critiques of medicalization. These perspectives are both gendered and racialized in ways that marginalize African American teen mothers. Interview data with 51 poor African American teen mothers suggest that their reproductive experiences occur within very different contexts than those that have inspired feminist criticisms of medicalization. Before their pregnancies, teens are largely denied access to formal health (...) class='Hi'>care services and reproductive information and knowledge, and once pregnant, like adult women, they alternately embrace and resist specific aspects of medical care. Their perspectives provide insights into women's experiences with the formal medical system from an understudied social location, and their narratives expand our understanding of how women's and girls' sexuality is socially constructed as problematic and managed, controlled, and regulated in particular ways depending on their social locations. (shrink)

Type theory is a fast-evolving field at the crossroads of logic, computer science and mathematics. This gentle step-by-step introduction is ideal for graduate students and researchers who need to understand the ins and outs of the mathematical machinery, the role of logical rules therein, the essential contribution of definitions and the decisive nature of well-structured proofs. The authors begin with untyped lambda calculus and proceed to several fundamental type systems culminating in the well-known and powerful Calculus of Constructions. The book (...) also covers the essence of proof checking and proof development, and the use of dependent type theory to formalize mathematics. The only prerequisites are a good knowledge of undergraduate algebra and analysis. Carefully chosen examples illustrate the theory throughout. Each chapter ends with a summary of the content, some historical context, suggestions for further reading and a selection of exercises to help readers familiarize themselves with the material. (shrink)

Is medieval logic formal? And if yes, in what sense? There are striking affinities between medieval and contemporary theories of language. Authors from the two periods share formal ambitions and maintain complex, and at time uneasy, relations with natural language. However, modern scholars became careful not to overlook the specificities of theories developed more than five hundred years apart, in particular with respect to their 'formal' character. In 1972, Alfonso Maieru noted that the efforts of medieval logicians (...) to identify logical structures in language formal enough to become objects of scientific consideration. He also stressed that the language investigated is a historical one, Latin, so that one can legitimately wonder to which extent... one is allowed to speak of 'formal logic' in the middle ages. In other words, medieval logic is characterized by a tension between 'formalist ambitions' and constraints proper to natural language. Today, our knowledge of the field has considerably expanded, calling for a new assessment of the question. (shrink)

The ethics of care and Confucian care ethics are both characterised by relations-based moral reasoning and decision-making. Acknowledging this similarity, this article compares and contrasts these two ethics, highlighting Western and Eastern moral concerns. One of the main differences between the two ethical theories is their different focus on vulnerability and inequality as factors in achieving equality in the ethics of care; another is the reciprocity, rather than equality, dimension in Confucian ethics. Both theories enshrine the view (...) that the characteristics of care offer scope for developing the capacity for judgement. However, a fundamental difference is revealed when considering that Confucian ethics emphasises care as a virtue in the cultivation of one's moral agency, whereas the ethics of care sees care as both a disposition and practice, and the caring relationship to be a primary means of moral evaluation. For the care ethicists, the practice of care embraces communicative morality, within fluid, dynamic interpersonal relationships - in sharp contrast to Confucian care practices, which are constructed within formal standards and fixed, role-based relationships. (shrink)

This paper contains a careful derivation of principles of Interpretability Logic valid in extensions of I0+1.

Caring for a child in a pediatric intensive care unit is emotionally and physically challenging and often leads to conflict. Skilled mediators may not always be available to aid in conflict resolution. Careproviders at all levels of training are responsible for managing difficult conversations with families and can often prevent escalation of conflict. Bioethics mediators have acknowledged the important contribution of mediation training in improving clinicians’ skills in conflict management. Familiarizing careproviders with basic mediation techniques is an important step (...) towards preventing escalation of conflict. While training in effective communication is crucial, a sense of fairness and justice that may only come with the introduction of a skilled, neutral third party is equally important. For intense conflict, we advocate for early recognition, comfort, and preparedness through training of clinicians in de-escalation and optimal communication, along with the use of more formally trained third-party mediators, as required. (shrink)

In a recent discussion article in this journal, Gila Sher responds to some of my criticisms of her work on what she calls the formal-structural account of logical consequence. In the present paper I reply and attempt to advance the discussion in a constructive way. Unfortunately, Sher seems to have not fully understood my 1997. Several of the defenses she mounts in her 2001 are aimed at views I do not hold and did not advance in my 1997. Most (...) prominent among these are her claims that I reject the formal-structural account, because it licenses “unnatural” logical constants, and that I consider the “truth-functional criterion” for connectives “a paradigm of a successful criterion of logicality”. Both of these claims are simply false, as even a moderately careful reading of my 1997 will show. Other charges she makes have some basis in fact but are inaccurate. For example, she says that I claim that FS is “neutral with regard to the apriority of logic,” and that this neutrality “renders it inconsistent”. What I actually say is that Sher’s acceptance of the neutrality in question is “inconsistent with part of the legacy of Tarski, a legacy that she finds very congenial”, not that FS itself is inconsistent. More interestingly, she misunderstands my claim about the apriority of logic, and clarification of this misunderstanding suggests two distinct ways in which logic might be held to be free of empirical influence. It is also noteworthy that Sher’s statements about the apriority of logic constitute both a change in the position she took in her 1991 and, although she seems not to realize it, an admission that she does not take issue with one of my major criticisms. (shrink)

In a recent discussion article in this journal, Gila Sher responds to some of my criticisms of her work on what she calls the formal-structural account of logical consequence. In the present paper I reply and attempt to advance the discussion in a constructive way. Unfortunately, Sher seems to have not fully understood my 1997. Several of the defenses she mounts in her 2001 are aimed at views I do not hold and did not advance in my 1997. Most (...) prominent among these are her claims that I reject the formal-structural account, because it licenses “unnatural” logical constants, and that I consider the “truth-functional criterion” for connectives “a paradigm of a successful criterion of logicality”. Both of these claims are simply false, as even a moderately careful reading of my 1997 will show. Other charges she makes have some basis in fact but are inaccurate. For example, she says that I claim that FS is “neutral with regard to the apriority of logic,” and that this neutrality “renders it inconsistent”. What I actually say is that Sher’s acceptance of the neutrality in question is “inconsistent with part of the legacy of Tarski, a legacy that she finds very congenial”, not that FS itself is inconsistent. More interestingly, she misunderstands my claim about the apriority of logic, and clarification of this misunderstanding suggests two distinct ways in which logic might be held to be free of empirical influence. It is also noteworthy that Sher’s statements about the apriority of logic constitute both a change in the position she took in her 1991 and, although she seems not to realize it, an admission that she does not take issue with one of my major criticisms. (shrink)

This paper outlines briefly care as a formal construct of a highly regulatory approach to being looked after in the setting of foster care. It then moves on to consider care and its expression within the interdependencies and everyday moral ?workings out? between people in caring relationships. These relationships are informed partly by exterior regulation, but also emerge predominantly from care as a social process and daily human activity in which the self exists through and (...) with others. Drawing from an in-depth qualitative study of 10 foster families supported by local authorities or independent agencies in Wales, the paper examines the meaning of care in what is often a nebulous mix of paid and unpaid fostering. The moral texture of the foster family is revealed in regard to three areas of everyday domestic life that are often taken for granted and rarely researched: the symbolism of food, issues of the body, and aspects of touch. The paper concludes with a brief reprise of foster care as relational, constitutive and contextual in contrast with care as a professional and regulatory discipline. (shrink)

Is medieval logic formal? And if yes, in what sense? There are striking affinities between medieval and contemporary theories of language. Authors from the two periods share formal ambitions and maintain complex, and at time uneasy, relations with natural language. However, modern scholars became careful not to overlook the specificities of theories developed more than five hundred years apart, in particular with respect to their 'formal' character. In 1972, Alfonso Maieru noted that the efforts of medieval logicians (...) to identify logical structures in language which are formal enough to become objects of scientific consideration. He also stressed that the language investigated is a historical one, Latin, so that one can legitimately wonder to which extent... one is allowed to speak of 'formal logic' in the middle ages. In other words, medieval logic is characterized by a tension between 'formalist ambitions' and constraints proper to natural language. Today, our knowledge of the field has considerably expanded, calling for a new assessment of the question. (shrink)

Departing from an epistemological tradition for which knowledge properly achieved must be objective, especially in eschewing affect and/or special interests; and against a backdrop of my thinking about epistemic responsibility, I focus on two situations where care informs and enables good knowing. The implicit purpose of this reclamation of care as epistemically vital is to show emphatically that standard alignments of care with femininity—the female—are simply misguided. Proposing that the efficacy of epistemic practices is often enhanced when (...) would-be knowers care about the outcomes of investigation, I suggest that epistemic responsibility need not be compromised when caring motivates and animates research. Indeed, the background inspiration comes from the thought, integral to feminist and post-colonial theory and practice that, despite often-justified condemnations of research that serves "special interests," particularities do matter, epistemically. Such thoughts, variously articulated, are integral to enacting a shift in epistemology away from formal abstraction and toward engaging with the specificities of real-world, situated knowledge projects. They are not unequivocally benign, for villains too care about the outcomes of their projects. Hence multi-faceted engagements with epistemic practices and processes are urgently required across the social-political world. (shrink)

This paper examines moral dilemmas faced by family caregivers of older adults who employ live-in migrant care workers. Being both a family caregiver as well as an employer of a live-in migrant care worker often puts family members at a crossroad, where moral decisions must be made. Lacking a formal role, family members do not have a professional code of ethics or other clear rules that can guide their actions, and their choices are rooted in cultural, community, (...) familial, and personal values. This paper discusses moral dilemmas that result from family caregivers’ dual commitment, to the wellbeing of their older sick relative who is the recipient of care, and to the wellbeing of the live-in care worker whom they employ. The paper uses relational ethics as a theoretical framework to discuss three cases that involve complex moral decision making in real life. (shrink)

Understanding between care providers and patients with stroke and aphasia: a phenomenological hermeneutic inquiry The present study illuminates the understanding in communication between formal care providers and patients with stroke and aphasia. Five care providers and three such patients participated in the study. Video recordings were made during conversations about pictures (n = 15), and the care providers were also interviewed (n = 15) after the video‐recorded conversations. A phenomenological hermeneutic method of interpretation of the (...) interview text was used. The findings showed that a range of conditions for ‘understanding and being understood’ in the communication on the part of the care providers exists. These different conditions are: lacking both knowledge and understanding; having knowledge but not necessarily accompanied by understanding; and being in understanding. Within the condition ‘being in understanding’, the care providers create a feeling of at‐homeness in a relaxed atmosphere and thus have the opportunity to be in ‘understanding and being understood’ together with the patient. The condition ‘being in understanding’ appears in connection with the care providers’ creating of a ‘calm liturgy of caring’ by mediating humility and calm vitality affects to the patients, and further, when needed, being present on the level of mystery, i.e. caring communion. (shrink)

Nurses make an important contribution to the organisation and coordination of patient care but receive little formal educational preparation for this work. This paper builds on Allen's care trajectory management framework to specify evidence‐based and theoretically informed competencies for this component of the nursing role and proposes how these might be incorporated into nursing curricula. This is necessary so that at the point of registration nurses have the expertise to realise their potential as both providers and organisers (...) of patient care and are better able to articulate and develop this aspect of nursing practice. (shrink)

We propose a typology of representational artifacts for health care and life sciences domains and associate this typology with different kinds of formal ontology and logic, drawing conclusions as to the strengths and limitations for ontology in a description logics framework. The four types of domain representation we consider are: (i) lexico-semantic representation, (ii) representation of types of entities, (iii) representations of background knowledge, and (iv) representation of individuals. We advocate a clear distinction of the four kinds of (...) representation in order to provide a more rational basis for using ontologies and related artifacts to advance integration of data and enhance interoperability of associated reasoning systems. We highlight the fact that only a minor portion of scientifically relevant facts in a domain such as biomedicine can be adequately represented by formal ontologies as long as the latter are conceived as representations of entity types. In particular, the attempt to encode default or probabilistic knowledge using ontologies so conceived is prone to produce unintended, erroneous models. (shrink)

While the philosophical literature has extensively studied how decisions relate to arguments, reasons and justifications, decision theory almost entirely ignores the latter notions. In this article, we elaborate a formal framework to introduce in decision theory the stance that decision-makers take towards arguments and counter-arguments. We start from a decision situation, where an individual requests decision support. We formally define, as a commendable basis for decision-aid, this individual’s deliberated judgment, a notion inspired by Rawls’ contributions to the philosophical literature, (...) and embodying the requirement that the decision-maker should carefully examine arguments and counter-arguments. We explain how models of deliberated judgment can be validated empirically. We then identify conditions upon which the existence of a valid model can be taken for granted, and analyze how these conditions can be relaxed. We then explore the significance of our framework for the practice of decision analysis. Our framework opens avenues for future research involving both philosophy and decision theory, as well as empirical implementations. (shrink)

Faced with the disenchantment and disengagement expressed by their employees, business leaders are considering ways of incorporating more benevolence into managerial practices. Nevertheless, ‘benevolence’—care and concern for the well-being of others—has not yet been studied in an organizational profit-focused context. In this paper, we seek to investigate the emergence and practice of benevolence with an eye on profit and performance. We begin by investigating the main ethical approaches to benevolence—virtue ethical, utilitarian, and deontological. Then, based on an empirical study, (...) we identify two distinct types of benevolence. On the one hand, formal benevolence is defined and monitored by the organizational processes and actions of leaders; it is understood by all concerned to be bounded by organizational performance. On the other hand, informal benevolence exists at the margin of these processes, in interpersonal and discretionary relationships. We set out to analyze these two types of benevolence and the complementarity between them. We also discuss to what extent they can be managed, teasing out some implications for managers and some potential avenues for further research. (shrink)

Assessments of health care needs are embedded in contracts for health services. Such contracts are the formal link between the identification of health care needs and the purchasing of services to satisfy those needs. They are a central part of the procedural relationship between the British health service (NHS) and the satisfaction of human needs. To evaluate contracts it is necessary to investigate this relationship. A number of headings under which it may be possible to begin to (...) evaluate contracts are described, and the potential of a ‘universalist’ approach to interrogate contract-based decision-making is briefly discussed. (shrink)

The goal of this paper is to highlight the manner in which custodial care is structured by the environment in which it takes place. For this, I analyze how formal service providers respond to custodial care needs in two locations, in the home and within long-term care facilities. While relying on an apparent objective measure of the care receiver’s needs, the formal response to care is shaped both by the location in which caregiving (...) takes place as well as by the availability of unpaid caregivers. I argue that a better understanding of custodial care would be that of a relational activity that takes into account the environment and the actors involved in the care relationship. (shrink)

Within the liberal framework, policies designed to rectify inequality generally take two forms: the formal equality option of equal treatment for everyone or the substantive equality option of "special" treatment for those whose difference continues to matter. Martha Minow argues that the framework creates a "dilemma of difference" because each option risks creating or perpetuating further disadvantages for members of oppressed groups. This paper examines the framework and the dilemma by highlighting the relational features of the language of equality (...) and of people who make determinations of equality. Relational insights are used to reexamine feminist work on care ethics, work considered to be hostile to equality analysis and justice theory. By providing a relational critique both of care ethics and of justice theory, I attempt to bring the two closer together by highlighting various connections. Care and justice are not entirely or always in opposition, but they inevitably interact and intertwine in ways that allow new possibilities and ways of being in social relations to emerge. (shrink)

Logic Works is a critical and extensive introduction to logic. It asks questions about why systems of logic are as they are, how they relate to ordinary language and ordinary reasoning, and what alternatives there might be to classical logical doctrines. It considers how logical analysis can be applied to carefully represent the reasoning employed in academic and scientific work, better understand that reasoning, and identify its hidden premises. Aiming to be as much a reference work and handbook for further, (...) independent study as a course text, it covers more material than is typically covered in an introductory course. -/- Topics include: translation, proofs, and trees for sentential and predicate logic with identity, definite descriptions, and functional terms; normal forms; proofs and trees for the principal normal modal systems; an introduction to second order and quantified modal logic; formal syntax and semantics; mathematical induction; metatheory for many of these systems; semantics and trees for free logic, intuitionistic logic, and three-valued and paraconsistent logics. -/- A companion website contains a detailed student solutions manual with a running commentary on all starred exercises and a set of editable slides for instructors to customize their courses. (shrink)

There has been much discussion about how to obtain legitimacy at macro-level priority setting in health care by use of fair procedures, but how should we consider priority setting by individual clinicians or health workers at the micro-level? Despite the fact that just health care totally hinges upon their decisions, surprisingly little attention seems being paid to the legitimacy of these decisions. This paper addresses the following question: what are the conditions that have to be met in order (...) to ensure that individual claims on health care are well aligned with an overall concept of just health care? Drawing upon a distinction between individual and aggregated needs, I argue that even though we assume the legitimacy of macro-level guidelines, this legitimacy is not directly transferable to decisions at micro-level simply by adherence to the guidelines’ recommendation. Further, I argue that individual claims are subject to the formal principle of equality and the demands of vertical and horizontal equity in a way that gives context- and patient-related equity concerns precedence over equity concerns captured at the macro-level. I conclude that if we aim to achieve just health care, we need to develop a complementary framework for legitimising individual judgment of patients’ claims on health care resources. Moreover, I suggest the basic structure of such a framework. (shrink)

Against the background of a recent exchange between Cristina Lafont and Hubert Dreyfus, I argue that Heidegger's method of ?formal indication? is at the heart of his attempt in Sein und Zeit to answer ?the ontological question of the being of the ?sum?? (SZ, p. 46). This method works reflexively, by picking out certain essential features of one's first-person singular being at the outset of its investigation that are implicit in the question ?what is it to be the entity (...) I am?? On the basis of these features, various further a priori, ontological structures (care and temporality) that constitute one as a first-person singular entity then become accessible. Formal indication is thus formal in two senses: it officially designates or signals certain first-person singular phenomena as the topic of investigation, and it picks out features which define the ontological form of the entity in question. It is thereby the method by which a legitimately transcendental account of our being may be begun to be generated by each of us from out of our factical, immanent existence. (shrink)

Concerns about non-participation in lifelong learning may indicate an emerging moral authoritarianism arising from pessimism about the future. Low expectations of potential for social progress, human agency and learners' motivation to take part in formal learning, exacerbate moves towards a 'minimalist pedagogy' regulated by government agencies and encourages the idea that lifelong learning should be compulsory for adults 'at risk'.

The care of patients with many illnesses often appears fragmented by many boundaries in the health care system when the care is provided in several locations of primary and secondary care. In the article, boundaries are examined in an interaction between patients and multiple providers in an effort to develop collaboration in inter-organizational provision in a Change Laboratory intervention. Firstly, it will be traced how the boundaries are expressed in the interaction. Secondly, it will be studied (...) how the boundaries expressed in the interaction relate to health care organizations and patient care practices. Thirdly, the practical activity that was embedded in the interaction between patients and providers will be focused on at the laboratory. The expression of boundaries was examined in activity theoretical terms as discursive actions. In discursive actions the ‘lived past’ becomes involved in the situational actions that orient towards future activity. The findings suggest that expressing boundaries uses various linguistic means and it seems relevant to propose that boundaries cannot be studied in a formal way; the analysis needs to be related to the organizational context of the specific study. However, the linguistic means may serve as useful “landmarks” or “pointers” of boundaries that are often expressed implicitly in the interaction. The laboratory session provides an opportunity to study boundaries “on the spot”, or “in their own right”. The realization of the emergent inter-organizational care at the session created challenges for the provision while contradicting some elements of the prevailing provision. During these kinds of interaction, the boundaries between providers became obvious. Furthermore, challenging the boundaries in the normal flow of interaction may be a potential for boundary crossing and even further, a re-constitution of boundaries. Consequently, a boundary crossing represents an interesting unit of analysis for future studies of boundaries and boundary crossing in interaction and discourse. At the laboratory setting was displayed the ability to control others through an indirect use of power that may reflect a simultaneous value system supported by the prevailing hierarchies. In the studies to come, it will be important to pay attention to these implicit power linkages when monitoring the boundaries in horizontal collaborations. (shrink)

This paper examines the ‘justice’ and ‘care’ orientations in ethical theory as characterized in Carol Gilligan's research on moral development and the philosophical work it has inspired. Focus is placed on challenges to the justice orientation – in particular, to the construal of impartiality as the mark of the moral point of view, to the conception of moral judgment as essentially principle-driven and dispassionate, and to models of moral responsibility emphasizing norms of formal equality and reciprocity. Suggestions are (...) made about the implications of these challenges, and of the care orientation in ethics, for the ethical theory taught, the issues addressed, and the skills and sensitivities encouraged through bioethical education. Keywords: bioethical education, ethics of care, impartiality, moral judgment, moral psychology CiteULike Connotea Del.icio.us What's this? (shrink)

Digital health and welfare technologies and artificial intelligence are proposed to revolutionise healthcare systems around the world by enabling new models of care. Digital health and welfare technologies enable remote monitoring and treatments, and artificial intelligence is proposed as a means of prediction instead of reaction to individuals’ health and as an enabler of proactive care and rehabilitation. The digital transformation not only affects hospital and primary care but also how the community meets older people's needs. Community (...) care is often provided by informal and formal care‐givers, most of whom are women. Gender equality is at the heart of many national strategies, but do all genders have equal rights, responsibilities and opportunities when it comes to community care and its digital transformation? The digital transformation of community care is entangled with how care is provided to older people and the working conditions of community‐care professionals. Current and, even more so, future community‐care systems are and will be partly constituted by networks of technological artefacts. These health and welfare technological artefacts and the discourse surrounding them mediate and constitute social relations and community care. This article looks into how health and welfare technology and artificial intelligence‐based devices and systems mediate and constitute gender relations in community care and presents an argument for reflexivity, embodiment, pluralism, participation and ecology as an alternative strategy to treating community care as one‐size‐fit‐all and being blind to gender‐related issues. (shrink)

Background: SNOMED CT is a large terminology system designed to represent all aspects of healthcare. Its current form and content result from decades of bottom-up evolution. Due to SNOMED CT’s formal descriptions, it can be considered an ontology. The Basic Formal Ontology (BFO) is a foundational ontology that proposes a small set of disjoint, hierarchically ordered classes, supported by relations and axioms. In contrast, as a typical top-down endeavor, BFO was designed as a foundational framework for domain ontologies (...) in the natural sciences and related disciplines. Whereas it is mostly assumed that domain ontologies should be created as extensions of foundational ontologies, a post-hoc harmonization of consolidated domain ontologies in use, such as SNOMED CT, is known to be challenging. Methods: We explored the feasibility of harmonizing SNOMED CT with BFO, with a focus on the SNOMED CT Clinical Finding hierarchy. With more than 100,000 classes, it accounts for about one third of SNOMED CT’s content. In particular, we represented typical SNOMED CT finding/disorder concepts using description logics under BFO. Three representational patterns were created and the logical entailments analyzed. Results: Under a first scrutiny, the clinical intuition that diseases, disorders, signs and symptoms form a homogeneous ontological upper-level class appeared incompatible with BFO’s upper-level distinction into continuants and occurrents. The Clinical finding class seemed to be an umbrella for all kinds of entities of clinical interest, such as material entities, processes, states, dispositions, and qualities. This suggests the conclusion that Clinical finding would not be a suitable upper-level class from an BFO perspective. On closer inspection of the taxonomic links within this hierarchy and the implicit meaning derived thereof, it became clear that Clinical finding classes do not characterize the entity (e.g. a fracture, allergy, tumor, pain, hemorrhage, seizure, fever) in a literal sense but rather the condition of a patient having that fracture, allergy, pain etc. This gives sense to the current characteristic of the Clinical Finding hierarchy, in which complex classes are modeled as subclasses of their constituents. Most of these taxonomic links are inferred, as the consequence of the ‘role group’ design pattern, which is ubiquitous in SNOMED CT and has often been subject of controversy regarding its semantics. Conclusion: Our analyses resulted in the proposal of (i) equating SNOMED CT’s ‘role group’ property with the reflexive and transitive BFO relation ‘has occurrent part’; and (ii) reinterpreting Clinical Findings as Clinical Occurrents, i.e. temporally extended entities in an organism, having one or more occurrents as temporal parts that occur in continuants. This re-interpretation was corroborated by a manual analysis of classes under Clinical Finding, as well as the identification of similar modeling patterns in other ontologies. As a result, SNOMED CT does not require any content redesign to establish compatibility with BFO, apart from this re-interpretation, and a suggested re-labeling. Regarding the feasibility of harmonizing terminologies with principled foundational ontologies post-hoc, our results provide support to the assumption that this does not necessarily require major redesign efforts, but rather a careful analysis of the implicit assumptions of terminology curators and users. (shrink)

Background:The public domain of midwifery practice, represented by the educational and hospital institutions could be blamed for a subconscious ethical dilemma for midwifery practitioners. The result of such tension can be seen in complaints from maternity service users of dehumanised care. When expectations are not met, women report dehumanising experiences that carry long term consequences to both them and their child.Objectives:To revisit the ethical foundation of midwifery practice to reflect the feminist Ethic of Care and reframe what is (...) valuable to women and midwives during the childbirth experience.Research Design:A comprehensive literature review is presented from the midwifery and feminist ethics discourse.Ethical Considerations:Nil to report.Findings:Women are vulnerable during childbirth as they need care, yet they prioritise elements of relationship in their experience. The Ethic of Care approach equalises the relationship between the midwife and the woman, providing the space for relationship building and allowing midwives to meet the expectations of their accepted responsibility.Discussion:Some midwives manage to balance the demands of the institution with the needs of the woman. This is described as both an emotional and professionally challenging balancing act.Conclusion:Until there is a formal acknowledgement of the different ethical approach to midwifery practice from within the profession and the Institution, midwifery identity and practice will continue to be compromised. (shrink)

The Sleeping Beauty Problem attracts so much attention because it connects to a wide variety of unresolved issues in formal epistemology, decision theory, and the philosophy of science. The problem raises unanswered questions concerning relative frequencies, objective chances, the relation between self-locating and non-self-locating information, the relation between self-location and updating, Dutch Books, accuracy arguments, memory loss, indifference principles, the existence of multiple universes, and many-worlds interpretations of quantum mechanics. After stating the problem, this article surveys its connections to (...) all of these areas. (shrink)

This study addresses the nature of the contribution made by Christian feminist thinkers who claim that mutuality is a necessary part of a Christian social ethical framework. The theological method employed is analytical and comparative toward the end of illuminating, testing, and demonstrating the thesis: mutuality is a formal norm for Christian social ethics that functions along with love and justice to promote a balance of power that is required for optimum human flourishing, a flourishing set within the interdependent (...) context of the whole of creation. ;Chapter One analyzes selected primary sources of Rosemary Radford Ruether, Carter Heyward, Beverly Wildung Harrison, and Elizabeth A. Johnson isolating their definition and treatment of the term, "mutuality." A consensus definition of mutuality drawn from definitions by the four feminists. It is concluded that, similar to the tripartite nature of justice, mutuality has four forms--cosmic, gender, generative, and social. ;Chapters Two and Three illustrate several moments in the history of Christian thought wherein antecedents of the feminists' notion of mutuality are found. Selected primary works of Thomas Aquinas, John Duns Scotus, Martin Buber, and H. Richard Niebuhr are examined. ;Chapter Four compares the four feminists' definition of mutuality with definitions of formal norm by Josef Fuchs, Lisa Sowle Cahill, and Timothy E. O'Connell, determining that mutuality is a formal norm for Christian social ethics. Chapter Five is a case study. Utilizing our definition, it is shown how consideration of mutuality and its four forms influences the ethical analyses of George Weigel, Jean Bethke Elshtain, and Stanley Hauerwas in determining if the Persian Gulf War was a just war. It is concluded that the probative value of the formal norm, mutuality, is multifaceted. First and foremost, it requires the moral agent to deal concretely in moral reflection and moral decision-making. Specific and careful attention needs to be given to the reality revealing questions in the concrete, as well as in the abstract. Second, mutuality requires the moral agent to probe the dynamics of power in an ethical dilemma and to seek out ways to shape those dynamics to serve power-with. It is a complement to and corrective of love and justice. Third, engaging the norm of mutuality presses the moral agent toward inclusivity drawing into the process of moral reflection concern for the thriving and flourishing of all involved. More than the norms of love and justice, mutuality places humans in a perspective within the whole of creation. (shrink)

Judaic Logic is an original inquiry into the forms of thought determining Jewish law and belief, from the impartial perspective of a logician. Judaic Logic attempts to honestly estimate the extent to which the logic employed within Judaism fits into the general norms, and whether it has any contributions to make to them. The author ranges far and wide in Jewish lore, finding clear evidence of both inductive and deductive reasoning in the Torah and other books of the Bible, and (...) analyzing the methodology of the Talmud and other Rabbinic literature by means of formal tools which make possible its objective evaluation with reference to scientific logic. The result is a highly innovative work – incisive and open, free of clichés or manipulation. Judaic Logic succeeds in translating vague and confusing interpretative principles and examples into formulas with the clarity and precision of Aristotelean syllogism. Among the positive outcomes, for logic in general, are a thorough listing, analysis and validation of the various forms of a-fortiori argument, as well as a clarification of dialectic logic. However, on the negative side, this demystification of Talmudic/Rabbinic modes of thought (hermeneutic and heuristic) reveals most of them to be, contrary to the boasts of orthodox commentators, far from deductive and certain. They are often, legitimately enough, inductive. But they are also often unnatural and arbitrary constructs, supported by unverifiable claims and fallacious techniques. Many other thought-processes, used but not noticed or discussed by the Rabbis, are identified in this treatise, and subjected to logical review. Various more or less explicit Rabbinic doctrines, which have logical significance, are also examined in it. In particular, this work includes a formal study of the ethical logic (deontology) found in Jewish law, to elicit both its universal aspects and its peculiarities. With regard to Biblical studies, one notable finding is an explicit formulation (which, however, the Rabbis failed to take note of and stress) of the principles of adduction in the Torah, written long before the acknowledgement of these principles in Western philosophy and their assimilation in a developed theory of knowledge. Another surprise is that, in contrast to Midrashic claims, the Tanakh (Jewish Bible) contains a lot more than ten instances of qal vachomer (a-fortiori) reasoning. In sum, Judaic Logic elucidates and evaluates the epistemological assumptions which have generated the Halakhah (Jewish religious jurisprudence) and allied doctrines. Traditional justifications, or rationalizations, concerning Judaic law and belief, are carefully dissected and weighed at the level of logical process and structure, without concern for content. This foundational approach, devoid of any critical or supportive bias, clears the way for a timely reassessment of orthodox Judaism (and incidentally, other religious systems, by means of analogies or contrasts). Judaic Logic ought, therefore, to be read by all Halakhists, as well as Bible and Talmud scholars and students; and also by everyone interested in the theory, practise and history of logic. (shrink)

This essay assesses the rationale for regulating research administrators as carefully as they regulate researchers. The reasons for such regulation are identical: protecting scientific integrity, ensuring responsible use of public funds, addressing the lack of effective recourse for victims, creating negative consequences for misbehaving actors, and addressing high incentives for misconduct. Whereas the reasons compelling us to regulate research administrators are obvious, counterarguments to administrative oversight are based on suggestions that the incidence and prevalence of cases of administrative misconduct are (...) too low to warrant formal regulation. I briefly describe examples of the phenomenon drawn from publicly available records. My analysis suggests that the misconduct of research administrators is both serious and worthy of better oversight. Improved oversight of research administration will help steward tax dollars appropriately and enhance the overall integrity of the scientific record and of the free pursuit of knowledge more generally. (shrink)

Norton has argued for the salience of deliberative strategies for making environmental decisions which is supposed to be preferable to formal decision analysis. This paper argues that formal multicriteria decision analysis, when deployed with care, has the flexibility to absorb the advantages of deliberative decision making. It can also be used for decision support during a deliberative process. This feature of decision analysis is illustrated using a case study from Merauke in Papua province of Indonesian New Guinea.

This article uses elements of autoethnography to theorize an in/formal support relationship between a friend with a physical disability, who uses attendant services, and me. Through thinking about our particular “frien-tendant” relationship, I find the common scholarly orientations toward “care” are inadequate. Starting from the conversations between feminist and disability perspectives on care, I build on previous work to further develop the theoretical framework of accessible care. Accessible care takes a critical, engaged approach that moves (...) beyond understanding “accessibility” as merely concrete solutions to create more inclusive forms of care. Care, in this context, is positioned as an unstable tension among competing definitions, including that it is a complex form of oppression. Accessible care draws on feminist disability perspectives and the feminist political ethic of care to build bridges in four areas: from daily experiences of disability and support to theoretical discussions; across feminist care research and disability perspectives; across divisions and anxieties within disability communities; and from the local to transnational applications. These bridges do not aim to resolve debates but allow us to travel back and forth between differing perspectives and demonstrate the tenuous possibility of accessible practices and concepts of care. (shrink)

Teachers and critics have much to learn from [Harold] Bloom's work, and in this paper I want to try to show what it is we can learn from him and how we might go about it. In doing so, I also mean to analyze his attack upon formal criticism and to consider the merits of that attack. In the end, I propose an assessment of what in my view is the crucial weakness of both formal and dialectical criticism (...) alike. This will involve an explication of the meaning of critical care and an enlargement of our customary understanding of critical method and procedure. . . . In The Anxiety of Influence Bloom presents theory based frankly upon Freudian models, or what Bloom calls Family Romance. Every new poet is caught up in a struggle with his forebears, or precursors. Being Freudian forebears, they naturally both teach the poet and threaten him as teachers. The problem for the poet is to learn from his forebearing family without losing his integral self. If he succeeds he becomes what Bloom calls a "strong poet," and, hence, again quite naturally, he lives to present much trouble to coming generations, who have their own paths to go. Jerome McGann, professor of English at John Hopkins University, has written books on Byron and Swinburne and is presently working on the Oxford English Text edition of Byron's Complete Poetical Works, Don Juan in Context, and a collection of poetry, Air Heart Sermons. See also: "Poetry, Revisionism, Repression" by Harold Boom in Vol. 2, No. 2; "The Poet as Elaborator: Analytical Psychology as a Critical Paradigm" by David D. Cooper in Vol. 6, No. 1. (shrink)

Resurrecting the neglected question of what we mean by legal justice, this book seeks to re-imagine rather than simply critique contemporary notions of the rule of law, rights and legal equality. A work of reconstruction, it offers a progressive and egalitarian approach to concepts that have become overly associated with the idea of limited government and social conservatism. Focusing on the necessary conditions of co-operative community life, the book presents a vision of law that facilitates rather than frustrates politics, an (...) anlysis of rights that boosts our capacities for caring, and an idea of equality that captures a cosmopolitan vision based on the recognition of shared humanity. (shrink)

“Hooking up,” a popular type of sexual behavior among college students, has become a pathway to dating relationships. Based on open-ended narratives written by 273 undergraduates, we analyze how students interpreted a vignette describing a heterosexual hookup followed by a sexless first date. In contrast to the sexual script which holds that women want relationships more than sex and men care about sex more than relationships, students generally accorded women sexual agency and desire in the hookup and validated men’s (...) post-hookup relationship interest. However, in explaining the sexless date, students typically reasoned the woman was being chaste and withholding sex to redeem her reputation whereas they often characterized the man’s abstinence in terms of a pity date. The findings underscore the tenacity of gendered sexual scripts around heterosexual dates and hookups but also reveal fissures and contradictions that suggest some changes to the sexual double standard. (shrink)