Simulations, in which healthcare professionals are observed in dialogue with role-played patients, are widely used for assessing professional skills. Medical education research suggests simulations should be as authentic as possible, but there remains a lack of linguistic research into how far such settings authentically reproduce talk. This article presents an analysis of a corpus of general practice simulations in the United Kingdom, comparing this to a dataset of real-life general practitioner consultations. Combining corpus linguistic and conversation analytic methodologies, key interactional (...) features of the simulations are identified, particularly those associated with successful/unsuccessful performance in terms of the examiner’s grading. The corpus analysis identifies various forms of the phrase ‘tell me more about’ to occur significantly more frequently in the simulations compared to real GP consultations, typically in the opening sequences and most frequently in successful cases. It falls to a conversation analysis of the data, examining this phrase within the interactional context of these opening sequences, to better understand the actions it performs. Successful candidates in the simulations are found to perform a consistent sequential pattern, often incorporating this phrase. Although simulated, these interactions have real professional consequences for those being assessed. Linguistic findings about what constitutes successful interaction or differences to real-life practice therefore have important implications for professional education and assessment. (shrink)

Many authors have argued that epistemic rationality sometimes comes into conflict with our relationships. Although Sarah Stroud and Simon Keller argue that friendships sometimes require bad epistemic agency, their proposals do not go far enough. I argue here for a more radical claim—romantic love sometimes requires we form beliefs that are false. Lovers stand in a special position with one another; they owe things to one another that they do not owe to others. Such demands hold for beliefs as (...) well. Two facets of love ground what I call the false belief requirement , or the demand to form false beliefs when it is for the good of the beloved: the demand to love for the right reasons and the demand to refrain from doxastic wronging. Since truth is indispensable to epistemic rationality, the requirement to believe falsely, consequently, undermines truth norms. I demonstrate that, when the false belief requirement obtains, there is an irreconcilable conflict between love and truth norms of epistemic rationality: we must forsake one, at least at the time, for the other. (shrink)

La passionnante biographie de Vera Atkins réalisée par Sarah Helm à l’issue de nombreuses enquêtes en Europe, est un document précieux, qui jette une lumière nouvelle sur l’engagement des femmes dans les services secrets britanniques opérant en France durant la Seconde Guerre mondiale. Née en Roumanie en 1908, dans une famille juive aisée, Vera Rosenberg fuit le nazisme et émigra en Angleterre en 1938 avec sa mère, dont elle prit le nom d’Atkins. En 1941, elle entre comme (...) secrétaire au SOE (... (shrink)

A prolific philosopher who also held Rome's highest political office, Cicero was uniquely qualified to write on political philosophy. In this book Professor Atkins provides a fresh interpretation of Cicero's central political dialogues - the Republic and Laws. Devoting careful attention to form as well as philosophy, Atkins argues that these dialogues together probe the limits of reason in political affairs and explore the resources available to the statesman given these limitations. He shows how Cicero appropriated and transformed (...) Plato's thought to forge original and important works of political philosophy. The book demonstrates that Cicero's Republic and Laws are critical for understanding the history of the concepts of rights, the mixed constitution and natural law. It concludes by comparing Cicero's thought to the modern conservative tradition and argues that Cicero provides a perspective on utopia frequently absent from current philosophical treatments. (shrink)

Abstract:In Charles Peirce and Modern Science, T.L. Short encourages us to read Peirce’s oeuvre in the spirit of philosophical experimentalism. The result is a rewarding and refreshing book that clarifies longstanding controversies and stakes out novel positions in the debates. In these comments, I subject Short’s statements regarding the validity of induction to critical scrutiny. I argue that while much of what he states is correct, he errs in holding that induction is invalid in the short run of an individual’s (...) life. (shrink)

The study examines the argumentative competencies of people with Asperger syndrome (AS) and compares this with those of normal – or what are called neurotypical (NT) – subjects. To investigate how people with AS recognise, evaluate and engage in argumentation, we have adapted and applied the empirical instrument developed by van Eemeren, Garssen and Meuffels to study the conventional validity of the pragma-dialectical freedom rule (van Eemeren, Gars- sen & Meuffels 2003a; 2003b; 2005a; 2005b; van Eemeren & Meuffels, 2002). Our (...) paper begins with some background information on Asperger syndrome and how it impacts upon communication and argumentation; then it addresses the research questions and methods used; thirdly, it presents some initial findings; finally, it will conclude with some im- plications for those people with AS, for those they come into contact with and for the pragma-dialectic model in general. (shrink)

Conceptual engineering is to be explained by appeal to the externalist distinction between concepts and conceptions. If concepts are determined by non-conceptual relations to objective properties rather than by associated conceptions (whether individual or communal), then topic preservation through semantic change will be possible. The requisite level of objectivity is guaranteed by the possibility of collective error and does not depend on a stronger level of objectivity, such as mind-independence or independence from linguistic or social practice more generally. This means (...) that the requisite level of objectivity is exhibited not only by natural kinds, but also by a wide range of philosophical kinds, social kinds and artefactual kinds. The alternative externalist accounts of conceptual engineering offered by Herman Cappelen and Derek Ball fall back into a kind of descriptivism which is antithetical to externalism and fails to recognise this basic level of objectivity. (shrink)

This essay will address a general philosophical concern about autonomy, namely, that a conception of autonomy focused on freedom of the will alone is inadequate, once we consider the effects of oppressive forms of socialization on individuals’ formation of choices. In response to this problem, I will present a brief overview of Diana Meyers’s account of autonomy as relational and practical. On this view, autonomy consists in a set of socially acquired practical competencies in self-discovery, self-definition, self-knowledge, and self-direction. This (...) account provides a distinction between choices that express unreflectively internalized social norms and those that are the result of a critical ‘self-reading’. I conclude that this practical conception of autonomy makes much higher demands upon nurses (and patients) than has previously been thought. In fact, if nurses are to be expected to genuinely promote autonomy, they are going to need specific training in counselling-type communication skills. (shrink)

In this scientific 'Credo', Peter Atkins considers the universal questions of origins, endings, birth, and death to which religions have claimed answers. With his usual economy, wit, and elegance, unswerving before awkward realities, Atkins presents what science has to say. While acknowledging the comfort some find in belief, he declares his own faith in science's capacity to reveal the deepest truths.

Collectively, Atkins examines their pursuit of sexual justice, the ideologies of manhood they challenged, the different types of gay spaces they created (geographic, architectural, online), and political obstacles they have encountered.

This study provides an additional partial test of the Hunt-Vitell theory [1986, Journal of Macro-marketing, 8, 5-16; 1993, 'The General Theory of Marketing Ethics: A Retrospective and Revision', in N. C. Smith and J. A. Quelch (eds.), Ethics in Marketing (Irwin Inc., Homewood), pp. 775-784], within the consumer ethics context. Using structural equation modeling, the relationships among an individual's personal values (conceptualized by the typology of Schwartz [1992, 'Universals in the Content and Structure of Values: Theoretical Advances and Empirical Tests (...) in 20 Countries', in M. P. Zanna (ed.), Advances in Experimental Social Psychology (Vol. 25, Academic Press, Orlando), pp. 1--65] ethical ideology and ethical beliefs are investigated. The validity of the model is assessed in a two-step procedure. First, a measurement model of constructs is tested for key validity dimensions. Next, the hypothesized causal relationships are examined in several path models, comparing no mediation, partial and complete mediation of ethical ideology. The empirical results indicate that individual differences in value priorities (resultant conservation and resultant self-enhancement) directly and indirectly (through idealism) influence the judgment of ethically questionable consumer practices. These findings may significantly contribute to the theoretical understanding of ethical decision-making. (shrink)

We sometimes strive to achieve difficult goals when our evidence suggests that success is unlikely – not just because it will require strength of will, but because we are targets of prejudice and discrimination or because success will require unusual ability. Optimism about one’s prospects can be useful for persevering in these cases. That said, excessive optimism can be dangerous; when our evidence is unfavourable, we should be at most agnostic about whether we will succeed. This paper explores the nature (...) and rational significance of agnostic practical commitments. Most importantly, the rationality of striving against the odds can depend on investing in a plan for failure: a plan B. I aim to make headway on an account of what backup plans are, how they are related to primary plans, and whether the standard norms of plan rationality apply to our agnostic commitments. (shrink)

Many of our most important goals require months or even years of effort to achieve, and some never get achieved at all. As social psychologists have lately emphasized, success in pursuing such goals requires the capacity for perseverance, or "grit." Philosophers have had little to say about grit, however, insofar as it differs from more familiar notions of willpower or continence. This leaves us ill-equipped to assess the social and moral implications of promoting grit. We propose that grit has an (...) important epistemic component, in that failures of perseverance are often caused by a significant loss of confidence that one will succeed if one continues to try. Correspondingly, successful exercises of grit often involve a kind of epistemic resilience in the face of failure, injury, rejection, and other setbacks that constitute genuine evidence that success is not forthcoming. Given this, we discuss whether and to what extent displays of grit can be epistemically as well as practically rational. We conclude that they can be (although many are not), and that the rationality of grit will depend partly on features of the context the agent normally finds herself in. In particular, grit-friendly norms of deliberation might be irrational to use in contexts of severe material scarcity or oppression. (shrink)

Ducks lay eggs' is a true sentence, and `ducks are female' is a false one. Similarly, `mosquitoes carry the West Nile virus' is obviously true, whereas `mosquitoes don't carry the West Nile virus' is patently false. This is so despite the egg-laying ducks' being a subset of the female ones and despite the number of mosquitoes that don't carry the virus being ninety-nine times the number that do. Puzzling facts such as these have made generic sentences defy adequate semantic treatment. (...) However complex the truth conditions of generics appear to be, though, young children grasp generics more quickly and readily than seemingly simpler quantifiers such as `all' and `some'. I present an account of generics that not only illuminates the strange truth conditions of generics, but also explains how young children find them so comparatively easy to acquire. I then argue that generics give voice to our most cognitively primitive generalizations and that this hypothesis accounts for a variety of facts ranging from acquisition patterns to cross-linguistic data concerning the phonological articulation of operators. I go on to develop an account of the nature of these cognitively fundamental generalizations and argue that this account explains the strange truth-conditional behavior of generics. (shrink)

The increasing workplace use of artificially intelligent (AI) technologies has implications for the experience of meaningful human work. Meaningful work refers to the perception that one’s work has worth, significance, or a higher purpose. The development and organisational deployment of AI is accelerating, but the ways in which this will support or diminish opportunities for meaningful work and the ethical implications of these changes remain under-explored. This conceptual paper is positioned at the intersection of the meaningful work and ethical AI (...) literatures and offers a detailed assessment of the ways in which the deployment of AI can enhance or diminish employees’ experiences of meaningful work. We first outline the nature of meaningful work and draw on philosophical and business ethics accounts to establish its ethical importance. We then explore the impacts of three paths of AI deployment (replacing some tasks, ‘tending the machine’, and amplifying human skills) across five dimensions constituting a holistic account of meaningful work, and finally assess the ethical implications. In doing so we help to contextualise the meaningful work literature for the era of AI, extend the ethical AI literature into the workplace, and conclude with a range of practical implications and future research directions. (shrink)

This paper offers an alternate explanation of cases from the doxastic wronging literature. These cases violate what I call the degree of inquiry right—a novel account of zetetic obligations to inquire when interests are at stake. The degree of inquiry right is a moral right against other epistemic agents to inquire to a certain threshold when a belief undermines one’s interests. Thus, the agents are sometimes obligated to leave inquiry open. I argue that we have relevant interests in reputation, relationships, (...) and the well-being of our social groups. These interests generate obligations against others to “do their homework” before closing inquiry. This alternate account makes better sense of puzzles that accounts of doxastic wronging fall prey to. (shrink)

Some omissions seem to be causes. For example, suppose Barry promises to water Alice’s plant, doesn’t water it, and that the plant then dries up and dies. Barry’s not watering the plant – his omitting to water the plant – caused its death. But there is reason to believe that if omissions are ever causes, then there is far more causation by omission than we ordinarily think. In other words, there is reason to think the following thesis true.

Clinical research under the usual regulatory constraints may be difficult or even impossible in a public health emergency. Regulators must seek to strike a good balance in granting as wide therapeutic access to new drugs as possible at the same time as gathering sound evidence of safety and effectiveness. To inform current policy, I reexamine the philosophical rationale for restricting new medicines to clinical trials, at any stage and for any population of patients (which resides in the precautionary principle), to (...) show that its objective to protect public health, now or in the future, could soon be defeated in a pandemic. Providing wider therapeutic access and coordinating observations and natural experiments, including service delivery by cluster (wedged cluster trials), may provide such a balance. However, there are important questions of fairness to resolve before any such research can proceed. (shrink)

Traditionally, discussions of moral participation – and in particular moral agency – have focused on fully formed human actors. There has been some interest in the development of morality in humans, as well as interest in cultural differences when it comes to moral practices, commitments, and actions. However, until relatively recently, there has been little focus on the possibility that nonhuman animals have any role to play in morality, save being the objects of moral concern. Moreover, when nonhuman cases are (...) considered as evidence of moral agency or subjecthood, there has been an anthropocentric tendency to focus on those behaviors that inform our attributions of moral agency to humans. For example, some argue that the ability to evaluate the principles upon which a moral norm is grounded is required for full moral agency. Certainly, if a moral agent must understand what makes an action right or wrong, then most nonhuman animals would not qualify (and perhaps some humans too). However, if we are to understand the evolution of moral psychology and moral practice, we need to turn our attention to the foundations of full moral agency. We must first pay attention to the more broadly normative practices of other animals. Here, we begin that project by considering evidence that great apes and cetaceans participate in normative practices. (shrink)

The prospect of using genome technologies to modify the human germline has raised profound moral disagreement but also emphasizes the need for wide-ranging discussion and a well-informed policy response. The Hinxton Group brought together scientists, ethicists, policymakers, and journal editors for an international, interdisciplinary meeting on this subject. This consensus statement formulated by the group calls for support of genome editing research and the development of a scientific roadmap for safety and efficacy; recognizes the ethical challenges involved in clinical reproductive (...) applications of genome editing but, importantly, rejects the idea that human reproductive germline modification is necessarily morally unacceptable; and highlights the importance of meaningful engagement in discussions of genome editing and the development of regulation and oversight mechanisms to govern future uses of such technologies. (shrink)

This chapter offers a sustained analysis of the two major feminist critiques of analytic philosophy of religion: Grace Jantzen’s Becoming Divine and Pamela Sue Anderson’s A Feminist Philosophy of Religion. Jantzen’s project draws on Lacan’s and Irigaray’s account of psycholinguistics to insist that analytic philosophy of religion is thoroughgoingly “phallocentric” and “necrophiliac;” a new “feminine imaginary” is needed to replace its “masculinist” obsession with empirical demonstration and epistemic realism. Anderson’s book mounts a similar critique of the analytic school but is (...) more concerned to expand the understanding of “rationality” found there by means of a revised, feminist Kantianism than it is to reject the discourse altogether. I criticize Jantzen for a “sectarian” epistemology that ironically reinstates the gender binary she seeks to up end; and Anderson for a less than coherent account of “standpoint epistemology” which appears to undo her own original appeal to “gender.” I argue, instead, that recent trends in analytic philosophy of religion have already suggested an implicit “turn to gender” which, if made more explicit, can enable a fruitful interaction with feminist thought. (shrink)

In order to be a self-governing agent, a person must govern the process by means of which she acquires the intention to act as she does. But what does governing this process require? The standard compatibilist answers to this question all assume that autonomous actions differ from nonautonomous actions insofar as they are a more perfect expression of the agent’s agency. I challenge this conception of autonomous agents as super agents. The distinguishing feature of autonomous agents is, I argue, the (...) nonagential role they play in the formation of their intentions. I offer an account of the relevant role. (shrink)

The first major publication in English on the bamboo slips excavated from a late fourth century B.C. Chu-state tomb at Guodian, Hubei, in 1993. The slip texts include both Daoist and Confucian works, many previously unknown. Thie monograph is a full account of the international conference held on these texts, at which leading scholars from China, the United States, Europe, and Japan analyzed the Laozi materials and a previously unknown cosmological text. In addition, the contents include nine essays on topics (...) such as the archaeological background of the discovery, conservation of the slip-texts, and the relation of the Guodian Laozi materials to the received Laozi text. An annotated edition of the Guodian Laozi materials and the cosmological text are included, as well as a critical bibliography with summary of Chinese scholarship on the Guodian texts in the year following the conference. (shrink)

Retributive theories of punishment argue that punishing a criminal for a crime she committed is sufficient reason for a justified and morally permissible punishment. But what about when the state gets lucky in its decision to punish? I argue that retributive theories of punishment are subject to “Gettier” style cases from epistemology. Such cases demonstrate that the state needs more than to just get lucky, and as these retributive theories of punishment stand, there is no anti-luck condition. I’ll argue that (...) Gettier-style cases demonstrate an impermissible instance of punishment, even though they meet the conditions of retributive theories of punishment. Retributive theories are, therefore, too weak. The safety condition from epistemology provides the anti-luck condition needed for permissible punishment. I argue that two forms of retributivism, rights-forfeiture and what I call standard retributivism, are both subject to Gettier-style cases. Unlike the literature on standards of proof, this paper argues that safety is a condition on punishment itself, i.e., in all nearby possible worlds, the accuser must correctly accuse the convicted for the crime they actually committed. (shrink)

The founder of both American pragmatism and semiotics, Charles Sanders Peirce is widely regarded as an enormously important and pioneering theorist. In this book, scholars from around the world examine the nature and significance of Peirce’s work on perception, iconicity, and diagrammatic thinking. Abjuring any strict dichotomy between presentational and representational mental activity, Peirce’s theories transform the Aristotelian, Humean, and Kantian paradigms that continue to hold sway today and, in so doing, forge a new path for understanding the centrality of (...) visual thinking in science, education, art, and communication. The essays in this collection cover a wide range of issues related to Peirce’s theories, including the perception of generality; the legacy of ideas being copies of impressions; imagination and its contribution to knowledge; logical graphs, diagrams, and the question of whether their iconicity distinguishes them from other sorts of symbolic notation; how images and diagrams contribute to scientific discovery and make it possible to perceive formal relations; and the importance and danger of using diagrams to convey scientific ideas. This book is a key resource for scholars interested in Perice’s philosophy and its relation to contemporary issues in mathematics, philosophy of mind, philosophy of perception, semiotics, logic, visual thinking, and cognitive science. (shrink)

Lacey J. Davidson (2023) raises several insightful objections to the group partiality account of wokeness. The paper aims to move the discussion forward by either responding to or developing Davidson’s objections. My goal is not to show that the partiality account is foolproof but to think about the direction of future discussion—future critique, modification, and response. Davidson thinks that the partiality account of wokeness does not sufficiently define wokeness, as the paper sets out to do. Davidson also alleges that the (...) account appropriates the term from minority communities. (shrink)

Since Mill's seminal work On Liberty, philosophers and political theorists have accepted that we should respect the decisions of individual agents when those decisions affect no one other than themselves. Indeed, to respect autonomy is often understood to be the chief way to bear witness to the intrinsic value of persons. In this book, Sarah Conly rejects the idea of autonomy as inviolable. Drawing on sources from behavioural economics and social psychology, she argues that we are so often irrational (...) in making our decisions that our autonomous choices often undercut the achievement of our own goals. Thus in many cases it would advance our goals more effectively if government were to prevent us from acting in accordance with our decisions. Her argument challenges widely held views of moral agency, democratic values and the public/private distinction, and will interest readers in ethics, political philosophy, political theory and philosophy of law. (shrink)

Advances in AI are powering increasingly precise and widespread computational propaganda, posing serious threats to national security. The military and intelligence communities are starting to discuss ways to engage in this space, but the path forward is still unclear. These developments raise pressing ethical questions, about which existing ethics frameworks are silent. Understanding these challenges through the lens of “cognitive security,” we argue, offers a promising approach.

Introduction: Thinking, writing, and reading about the real -- Dialectic and the real : Lacan, Hegel, and the alchemy of après-coup -- 'Reality' and the real : culture as anamorphosis -- The real of sexual difference : imagining, thinking, being -- Ethics and the real : the ungodly virtues of psychoanalysis -- Politics, or, the art of the impossible.

Cyberfeminism and Artificial Life examines construction, manipulation and re-definition of life in contemporary technoscientific culture. It takes a critical political view of the concept of life as information, tracing this through the new biology and the changing discipline of artificial life and its manifestation in art, language, literature, commerce and entertainment. From cloning to computer games, and incorporating an analysis of hardware, software and 'wetware', Sarah Kember demonstrates how this relatively marginal field connects with, and connects up global networks (...) of information systems. As well as offering suggestions for the evolution of [cyber]feminism in Alife environments, the author identifies the emergence of posthumanism; an ethics of the posthuman subject mobilized in the tension between cold war and post-cold war politics, psychological and biological machines, centralized and de-centralized control, top-down and bottom-up processing, autonomous and autopoietic organisms, cloning and transgenesis, species-self and other species. Ultimately, this book aims to re-focus concern on the ethics rather than on the 'nature' of life-as-it-could-be. (shrink)

As the usual regulatory framework did not fit well during the last Ebola outbreak, innovative thinking still needed. In the absence of an outbreak, randomised controlled trials of clinical efficacy in humans cannot be done, while during an outbreak such trials will continue to face significant practical, philosophical, and ethical challenges. This article argues that researchers should also test the safety and effectiveness of novel vaccines in wild apes by employing a pluralistic approach to evidence. There are three reasons to (...) test vaccines in wild populations of apes: i) protect apes; ii) reduce Ebola transmission from wild animals to humans; and iii) accelerate vaccine development and licensing for humans. Data obtained from studies of vaccines among wild apes and chimpanzees may even be considered sufficient for licensing new vaccines for humans. This strategy will serve to benefit both wild apes and humans. (shrink)

Mineral waters were a delicate and unstable product whose value as a remedy increased in early modern France. If it was once the prised luxury of the nobility travelling to the spa, the eighteenth century slowly watched it turned into a commodity. The waters became widely available in bottles and were sold in bureaus of distribution. Despite the logistical challenges of selecting and carrying the waters to their new urban public, many different springs made their way into most of France’s (...) cities. This took place under the watch and regulation of a uniquely dedicated institution, the Société de Médecine. This Société eventually settled its authority over the management of mineral waters, thanks to the backing of state power, the influence of the Academy and the newly recognized authority of chemists as analysts of waters. The purpose of this paper is to bring to light this overlooked institution and its essential role in the administration of mineral waters. Though it never eradicated fraud or succeeded in creating a full scientific and economic monopoly, it greatly broadened the budding trade of bottled water in France and gave a powerful incentive for chemists to better their mastering of the particularly challenging analysis of water. (shrink)

When we define something as a crime, we generally thereby criminalize the attempt to commit that crime. However, it is a vexing puzzle to specify what must be the case in order for a criminal attempt to have occurred, given that the results element of the crime fails to come about. I argue that the philosophy of action can assist the criminal law in clarifying what kinds of events are properly categorized as criminal attempts. A natural thought is that this (...) project should take the form of specifying what it is in general to attempt or try to perform an action, and then to define criminal attempts as attempts to commit crimes. Focusing on Gideon Yaffe's resourceful work in Attempts (Oxford University Press, 2010) as an example of this strategy, I argue that it results in a view that is overly inclusive: one will count as trying to commit a crime even in the far remote preparatory stages that we in fact have good reason not to criminalize. I offer an alternative proposal to distinguish between mere preparations and genuine attempts that has its basis not in trying, but doing: a criminal attempt is underway once what the agent is doing is a crime. Working out the details of this schema turns out to have important implications for action theory. A recently burgeoning view known as Naive Action Theory holds that all action can be explained by appeal to some further thing that the agent is doing, and that that the same explanatory nexus is at work even when we appeal to what the agent is intending, trying, or preparing to do -- these notions do explanatory work because they too refer to actions that are in progress, albeit in their infancy. If this is right, than the notion of 'doing' will also be too inclusive for the purposes of the criminal law. I argue that we should draw the reverse conclusion: the distinctions between pure intending, trying, preparing, and doing serve an important purpose in the criminal law, and this fact lends support to the view that they are genuine metaphysical and explanatory distinctions. (shrink)

This indispensible collection brings together feminist theory and cultural studies, looking at issues such as pop culture and the media, science and technology, ...

Gils-Schmidt and Salloch recognise that human and climate health are inextricably linked, and that mitigating healthcare-associated climate harms is essential for protecting human health.1 They argue that physicians have a duty to consider how their own practices contribute to climate change, including during their interactions with patients. Acknowledging the potential for conflicts between this duty and the provision of individual patient care, they propose the application of Korsgaard’s neo-Kantian account of practical identities to help navigate such scenarios. In this commentary, (...) we argue that by focusing attention on this physician–patient level, the authors overlook the complexity of climate change, both within the healthcare sector and beyond. We recognise the importance of individual agency in tackling this issue, and we also recognise that the authors do briefly acknowledge the importance of considering these broader complexities; however, we emphasise the need for climate and health discussions/action to be situated in a wider framework of systemic change. Our concern is that overemphasis on patient-level interactions risks normalising the prioritisation of individual-level approaches to addressing climate change, detracting from such a broader approach. Physician training emphasises the need for trust, confidentiality and shared decision-making in the doctor–patient relationship. …. (shrink)