Many normative claims are substantive claims about reasons— claims, for example, about the reasons that a person in certain circumstances has to do or to believe something. But not all normative claims are substantive claims about reasons. In particular, some claims about what it would be irrational for someone to do are normative claims but not claims about the reasons that person has. Here are some examples. (I will state these in terms of “reasons for belief” and “reasons for intending,” (...) although I will later raise doubts about whether this is the best way of describing these cases.) If a person believes that p, then it would be irrational for him to refuse to rely on p as a premise in further reasoning, and to reject arguments because they rely on it. To say this is not to say that the person has good reason to accept these arguments. Perhaps what he has most reason to do is to give up his belief that p. The claim is only that as long as he believes that p, it is irrational of him to refuse to accept such arguments. Similar claims hold in regard to practical reasoning: if a person intends to do A at t, and believes that in order to do this she must first do B, then it is irrational for her not to count this as a reason for doing B. This is not to say that she has any reason to do B. Perhaps what she has most reason to do is to abandon her intention to do A, or to change her mind about.. (shrink)
Erving Goffman’s “Asylums” is a key text in the development of contemporary, community-orientated mental health practice. It has survived as a trenchant critique of the asylum as total institution, and its publication in 1961 in book form marked a further stage in the discrediting of the asylum model of mental health care. In this paper, some responses from a range of disciplines to this text, 50 years on, are presented. A consultant psychiatrist with a special interest in cultural psychiatry and (...) mental health legislation, two collaborating psychotherapists in adult and forensic mental health, a philosopher, and a recent medical graduate, present their varying responses to the text. The editors present these with the hope of encouraging further dialogue and debate from service users, carers, clinicians, and academics and researchers across a range of disciplines. (shrink)
We draw on ancient Greek philosophy and contemporary psychosocial theorists to analyse the ethical implications of social policies implemented through the welfare state with the espoused objective of achieving social inclusion. We argue that many such policies establish a boundary between domains of inclusion and exclusion that perversely maintains the very problem such policies are designed to solve. They then also provide ?rationalisations? for social exclusion which imply that such states can be explained?that they are ethical, and so legitimate. We (...) illustrate our argument with reference to a specific area of social policy?Improving Access to Psychological Therapies?and discuss how it impacts on our own area of practice as state employed psychotherapists. We analyse how this policy frames aspects of social exclusion (un(der)employment?) as a ?psychological? problem: a move that grants the excluded a specific kind of identity and then locates the problem of exclusion in this identity. We invoke Plato's Republic to show how this offer of psychological ?help? subliminally suggests that these mental disorders result from individuals' failures to ?know their place? and to ?mind their own business?, rather than as a consequence of complex networks of social (dis)orders, exclusions and injustices within which we are all embedded. (shrink)
Background International collaborators face challenges in the design and implementation of ethical biomedical research. Evaluating community understanding of research and processes like informed consent may enable researchers to better protect research participants in a particular setting; however, there exist few studies examining community perspectives in health research, particularly in resource-limited settings, or strategies for engaging the community in research processes. Our goal was to inform ethical research practice in a biomedical research setting in western Kenya and similar resource-limited settings. Methods (...) We sought to use mabaraza , traditional East African community assemblies, in a qualitative study to understand community perspectives on biomedical research and informed consent within a collaborative, multinational research network in western Kenya. Analyses included manual, progressive coding of transcripts from mabaraza to identify emerging central concepts. Results Our findings from two mabaraza with 108 community members revealed that, while participants understood some principles of biomedical research, they emphasized perceived benefits from participation in research over potential risks. Many community members equated health research with HIV testing or care, which may be explained in part by the setting of this particular study. In addition to valuing informed consent as understanding and accepting a role in research activities, participants endorsed an increased role for the community in making decisions about research participation, especially in the case of children, through a process of community consent. Conclusions Our study suggests that international biomedical research must account for community understanding of research and informed consent, particularly when involving children. Moreover, traditional community forums, such as mabaraza in East Africa, can be used effectively to gather these data and may serve as a forum to further engage communities in community consent and other aspects of research. (shrink)
A medical student's ability to present a case history is a critical skill that is difficult to teach. Case histories presented without theatrical engagement may fail to catch the attention of their intended recipients. More engaging presentations incorporate ‘stage presence’, eye contact, vocal inflection, interesting detail and succinct, well organised performances. They convey stories effectively without wasting time. To address the didactic challenge for instructing future doctors in how to ‘act’, the Mayo Medical School and The Mayo Clinic Center for (...) Humanities in Medicine partnered with the Guthrie Theater to pilot the programme ‘Telling the Patient's Story’. Guthrie teaching artists taught storytelling skills to medical students through improvisation, writing, movement and acting exercises. Mayo Clinic doctors participated and provided students with feedback on presentations and stories from their own experiences in patient care. The course's primary objective was to build students' confidence and expertise in storytelling. These skills were then applied to presenting cases and communicating with patients in a fresher, more engaging way. This paper outlines the instructional activities as aligned with course objectives. Progress was tracked by comparing pre-course and post-course surveys from the seven participating students. All agreed that the theatrical techniques were effective teaching methods. Moreover, this project can serve as an innovative model for how arts and humanities professionals can be incorporated for teaching and professional development initiatives at all levels of medical education. (shrink)
This essay argues that normative judgments, in general, and moral judgments, in particular, are "truth apt" and can be objects of belief. Other main claims are: judgments about reasons, if interpreted as true, do not have metaphysical implications that are incompatible with a scientific view of the world. Two kinds of normative claims should be distinguished: substantive claims about what reasons people have and structural claims about what attitudes people must have insofar as they are rational. Employing this distinction, the (...) practical significance of substantive normative judgments is explained, and critical analysis of expressivist and Kantian views on this question is offered. (shrink)
Knobe reports that subjects' judgments of whether an agent did something intentionally vary depending on whether the outcome in question was seen by them as good or as bad. He concludes that subjects' moral views affect their judgments about intentional action. This conclusion appears to follow only if different meanings of “intention” are overlooked.
We point out that a certain complex compact manifold constructed by Lieberman has the dimensional order property, and has U-rank different from Morley rank. We also give a sufficient condition for a Kahler manifold to be totally degenerate (that is, to be an indiscernible set, in its canonical language) and point out that there are K3 surfaces which satisfy these conditions.
This sense of attributability, or internality, is the quarry in many of Frankfurt's articles, and it has proved to be an elusive one. In this paper I want to explore, in a tentative fashion, the question of why we should be interested in finding this quarry. It seems to me that there are at least two quite distinct kinds of reason for this concern, and that when they are distinguished the problem may look less difficult than it has seemed.
This article looks back at some aspects of the heritage of Edmund Husserl's Logical Investigations on the occasion of that work's centennial, following some clues Husserl offered in his own 1925 retrospective evaluation. The themes pursued are: Dilthey's surprisingly enthusiastic appreciation of the work; Husserl's subsequent recognition of the kernel of truth in psychologism; the complex question of phenomenology as descriptive psychology; and, finally, the distinctive view of mental life introduced in that work.
It is a particular pleasure to be able to participate in this symposium in honor of Amartya Sen. We agree on a wide range of topics, but I will focus here on an area of relative disagreement. Sen is much more attracted to consequentialism than I am, and the main topic of my paper will be the particular version of consequentialism that he has articulated and the reasons why he is drawn to this view.
We recall the notions of weak and strong Euler characteristics on a first order structure and make explicit the notion of a Grothendieck ring of a structure. We define partially ordered Euler characteristic and Grothendieck ring and give a characterization of structures that have non-trivial partially ordered Grothendieck ring. We give a generalization of counting functions to locally finite structures, and use the construction to show that the Grothendieck ring of the complex numbers contains as a subring the ring of (...) integer polynomials in continuum many variables. We prove the existence of a universal strong Euler characteristic on a structure. We investigate the dependence of the Grothendieck ring on the theory of the structure and give a few counter-examples. Finally, we relate some open problems and independence results in bounded arithmetic to properties of particular Grothendieck rings. (shrink)
While ethical quandaries and dilemmas are commonplace for nurses, recent advances in human genetics have and will continue to create new challenges and controversies. Throughout time, nursing has been an ethical endeavour, with nurses viewing the ethical mandates of their responsibilities on a par with other core dimensions of their professional life. The (American) profession’s code of ethics, Code for nurses with interpretive statements, provides direction for practice and for the fulfilment of ethical obligations. The explication of these ethical norms (...) and values that shape professional practice is necessary as nurses confront the integration of genetic services into health care. The goal of preserving professional integrity and ethical soundness in the context of genetic health care mandates that nurses rely on and act upon the profession’s national and international codes of ethics. (shrink)
[T. M. Scanlon] It is clearly impermissible to kill one person (or refrain from giving him treatment that he needs in order to survive) because his organs can be used to save five others who are in need of transplants. It has seemed to many that the explanation for this lies in the fact that in such cases we would be intending the death of the person whom we killed, or failed to save. What makes these actions impermissible, however, is (...) not the agent's intention but rather the fact that the benefit envisaged does not justify an exception to the prohibition against killing or the requirement to give aid. The difference between this explanation and one appealing to intention is easily overlooked if one fails to distinguish between the prospective use of a moral principle to guide action and its retrospective use to appraise the way an agent governed him or herself. Even if this explanation is accepted, however, it remains an open question whether and how an agent's intention may be relevant to the permissibility of actions in other cases. \\\ [Jonathan Dancy] My first four sections concentrate on the second section of Professor Scanlon's contribution (hereafter IP), where he lays out his conception of moral principles and of the role they play in theory and practice. I will raise questions on the following issues: 1. Scanlon's initial introduction of the notion of a principle. 2. His rejection of the standard view that principles are concerned with the forbidding, permitting and requiring of actions. 3. His rejection of pro tanto conceptions of principles in favour of a conception of them as conclusive. 4. The resulting account of what it is for a principle to face and survive exceptions. Scanlon's discussion of these matters here both appeals to and is in some respects more detailed than the relevant section of his recent What We Owe to Each Other (hereafter WWO). The topic is interesting both for the role played by principles in Scanlon's present discussion of intention and permissibility, and more generally because of his account of wrongness: an act is wrong iff it is ruled out by principles that nobody could reasonably reject. The remainder of my contribution is concerned with the ostensible focus of IP, namely the relevance (if any) of agent-intentions to the permissibility of what is done. (shrink)
The notion of a D-ring, generalizing that of a differential or a difference ring, is introduced. Quantifier elimination and a version of the Ax-Kochen-Eršov principle is proven for a theory of valued D-fields of residual characteristic zero.