The substituted judgement principle is often recommended as a means of promoting the self-determination of an incompetent individual when proxy decision makers are faced with having to make decisions about health care. This article represents a critical ethical analysis of this decision-making principle and describes practical impediments that serve to undermine its fundamental purpose. These impediments predominantly stem from the informality associated with the application of the substituted judgement principle. It is recommended that the principles upon which decisions are made (...) about health care for another person should be transparent to all those involved in the process. Furthermore, the substituted judgement principle requires greater rigour in its practical application than currently tends to be the case. It may be that this principle should be subsumed as a component of advance directives in order that it fulfils its aim of serving to respect the self-determination of incompetent individuals. (shrink)

Life saving or life sustaining treatment may not be instigated in the clinical setting when such treatment is deemed to be futile and therefore not in the patient’s best interests. The concept of futility, however, is related to many assumptions about quality and quantity of life, and may be relied upon in a manner that is ethically unjustifiable. It is argued that the concept of futility will remain of limited practical use in making decisions based on the best interests principle (...) because it places such high demands on the individual responsible for decision making. This article provides a critical analysis of futility (in the context of the best interests decision-making principle), and proposes an ethically defensible notion of futility. (shrink)

The best interests principle is commonly utilized in acute care settings to assist with decision making about life-saving and life-sustaining treatment. This ethical principle demands that the decision maker refers to some conception of quality of life that is relevant to the individual patient. The aim of this article is to describe the factors that are required to be incorporated into an account of quality of life that will provide a morally justifiable basis for making a judgement about the future (...) quality of life, and therefore the best interests, of critically ill patients who are mentally incompetent. This account consists of three major components - pain and suffering, body functioning, and autonomy - and is applicable in situations where very limited information is available to guide decision making. This framework helps to make decisions about the provision of life-saving treatment that are as consistent as possible in all patient situations. (shrink)

Recent years have seen educationalists turning to Emmanuel Levinas when considering the relationship between ethics and education. While it is true that Levinas never speaks of ethics in relation to the practice of classroom education, nonetheless, for Levinas, ethics is a teaching, and learning can only take place in the presence of the Other. This book considers how, within the constraints of the Irish primary school education system, teachers can develop a Levinasian approach to teaching, that affords both them and (...) the children they teach multiple opportunities throughout the school day to take up their ethical responsibility for each other as Other. Beginning from a Levinasian understanding of learning and teaching as constituting primordially relational and ethical events, and weaving the philosophies of Levinas, and the educationalists he inspires, into the approaches of philosophy with children, restorative practice, and PAX, this book suggests a unique approach to ethics in Irish primary school classrooms. The focus of this thesis, then, is on both the philosophical underpinnings that anchor teaching as a Levinasian, and a consideration of what practical approaches could be employed by the Levinasian teacher. (shrink)

In this collection, white women philosophers engage boldly in critical acts of exploring ways of naming and disrupting whiteness in terms of how it has defined the conceptual field of philosophy. Focuses on the whiteness of the epistemic and value-laden norms within philosophy itself, the text dares to identify the proverbial elephant in the room known as white supremacy and how that supremacy functions as the measure of reason, knowledge, and philosophical intelligibility.

In lieu of an abstract, here is a brief excerpt of the content:A Painful Lack of ConnectionChristopher Bailey (bio)Keywordsdepression, detachment (as a defense), empathy, evolution, masculinityI greatly appreciate the incredibly thoughtful responses to my clinical anecdote, “A Painful Lack of Wounds.” There is, in some more than others, a peculiar aura of detachment that, for me, evokes the very abyss (and its lack of an opposing force) that Colin and I found ourselves staring into that day. I realize, of (...) course, that some level of detachment is necessary to allow airspace for intellectual arrivals and departures.Detachment, moreover, is a form of emotional and psychological escape. In contrast with physical escape, detachment makes something that is present seem absent and, in that regard, is more like camouflage than flight. In some of the responses, therefore, I find myself tuning out the intellectual labyrinth and tuning in to how well it obscures its creator. What wounds or weaknesses, I wonder, is the author trying to hide? Insulin-dependent diabetes? An inferiority complex? Cannot climb chain-link fences? Is he or she hiding these problems from him- or herself? Or just the rest of us?This drive to connect, to regain the biological and the personal, was the ultimate point of my anecdote. I am not suggesting that human beings are biologically built for warfare or that all forms of pathology, at one time, must have conferred some evolutionary advantage. But as omnivorous, social primates, we are definitely adapted for engagement (of all varieties).Certainly, we need to avoid overidentification or sweepingly premature conclusions. Still, no doctor would deny his or her nostrils if cued by a foul, fetid odor to examine a patient for bed sores or gangrene. Likewise, we cannot in our clinical efforts recoil from the same instincts for sniffing out pathology that once made us successful predators. To paraphrase Jeffrey Masson and Susan McCarthy, the authors of When Elephants Weep, when one feels, from observing a bear, that the bear is sad, chances are the bear is sad. To call this anthropomorphizing is a much less parsimonious explanation than the possibility that evolutionary cousins can accurately read one another. And if inter-mammalian empathy is not too much of a stretch, we can probably trust what we feel from an animal of our own species.Granted, it is a long way from feeling to formulation. I chose to write about Colin because he expressed a kind of craving I am finding in a lot of men these days. I do not doubt that cultural pressure, heaped on personal issues and genetic prerogatives, can push a man to place heroism at the center of his psychic universe. Nonetheless, I find it odd that ostensibly comprehensive formulations, like the biopsychosocial model, fail to acknowledge the greater ecosystem in which we dwell. The wheelchair-accessible communities we have created to detach from natural selection are [End Page 249] the same frictionless planes on which masculinity, like a grotesque evolutionary artifact, tends to stumble nowadays.In short, were we not so dependent on the very things we call progress, had we not atrophied from a well-adapted ape to one that can die of hypothermia in 50° weather, I doubt if Colin's insecurity (or anyone's) would be so great. Not that I did not challenge Colin on aspects of his self-doubt. But I did not see it as “inappropriate” either. And although I agree a sense of helplessness can be both cause and effect of depression, his self-doubt, to me, was more than just a “cognitive error” unconsciously conceived as cover for a dark mood. Nondepressed people, after all, score higher than their depressed counterparts on measures of self-deception. The same false sense of security that we, as a culture, have coasted on for decades was shattered for Colin in Iraq. And I believe that is a good thing.Related ArticlesFeature Article: Clinical Anecdotes: A Painful Lack of WoundsCommentary: The Nature of Proof in PsychiatryCommentary: Truth and Healing a Veteran's DepressionCommentary: Inappropriate RegretCommentary: The Cultural Context of Post-traumatic Stress DisorderCommentary: Explication or Explanation?Commentary: The Importance of What Psychiatrists Care AboutCommentary: Mourning or MelancholiaResponse: A... (shrink)

_First Philosophy: Values and Society_ brings together classic and ground-breaking readings on ethics and political philosophy. Andrew Bailey’s highly regarded introductory anthology has been revised and updated in this new edition. The comprehensive introductory material for each chapter and selection remains, and new sections on philosophical puzzles and paradoxes and philosophical terminology have been added. New to this edition is an article by Susan Moller Okin on justice and gender.

_The Broadview Introduction to Philosophy_ is a comprehensive anthology that surveys core topics in Western philosophy, including philosophy of religion, theories of knowledge, metaphysics, ethics, social-political philosophy, and issues of life, death, and happiness. Unlike other introductory anthologies, the Broadview offers considerable apparatus to assist the student reader in understanding the texts without simply summarizing them. Each selection includes an introduction discussing the context and structure of the primary reading, as well as thorough annotations designed to clarify unfamiliar terms, references, (...) and argument forms. Canonical texts from the history of philosophy are presented alongside contemporary scholarship; women authors are included throughout. (shrink)

My strategy is to examine a recent trend in philosophical discussions of responsibility, a trend that tries, but I think ultimately fails, to give an acceptable analysis of the conditions of responsibility. It fails due to what at first appear to be deep and irresolvable metaphysical problems. It is here that I suggest that the condition of sanity comes to the rescue. What at first appears to be an impossible requirement for responsibility---the requirement that the responsible agent have created her- (...) or himself---turns out to be the vastly more mundane and non controversial requirement that the responsible agent must, in a fairly standard sense, be sane. (shrink)

The Rejected Body argues that feminist theorizing has been skewed toward non-disabled experience, and that the knowledge of people with disabilities must be integrated into feminist ethics, discussions of bodily life, and criticism of the cognitive and social authority of medicine. Among the topics it addresses are who should be identified as disabled; whether disability is biomedical, social or both; what causes disability and what could 'cure' it; and whether scientific efforts to eliminate disabling physical conditions are morally justified. Wendell (...) provides a remarkable look at how cultural attitudes towards the body contribute to the stigma of disability and to widespread unwillingness to accept and provide for the body's inevitable weakness. (shrink)

: Chronic illness is a major cause of disability, especially in women. Therefore, any adequate feminist understanding of disability must encompass chronic illnesses. I argue that there are important differences between healthy disabled and unhealthy disabled people that are likely to affect such issues as treatment of impairment in disability and feminist politics, accommodation of disability in activism and employment, identification of persons as disabled, disability pride, and prevention and "cure" of disabilities.

Bioethics has paid surprisingly little attention to the special problems faced by women and to feminist analyses of current health care issues other than ...

The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration -- Clients (...) with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)

Humans are an exceptionally cooperative species, but there is substantial variation in the extent of cooperation across societies. Understanding the sources of this variability may provide insights about the forces that sustain cooperation. We examined the ontogeny of prosocial behavior by studying 326 children 3–14 y of age and 120 adults from six societies (age distributions varied across societies). These six societies span a wide range of extant human variation in culture, geography, and subsistence strategies, including foragers, herders, horticulturalists, and (...) urban dwellers across the Americas, Oceania, and Africa. When delivering benefits to others was personally costly, rates of prosocial behavior dropped across all six societies as children approached middle childhood and then rates of prosociality diverged as children tracked toward the behavior of adults in their own societies. When prosocial acts did not require personal sacrifice, prosocial responses increased steadily as children matured with little variation in behavior across societies. Our results are consistent with theories emphasizing the importance of acquired cultural norms in shaping costly forms of cooperation and creating cross-cultural diversity. (shrink)

Only human beings have a rich conceptual repertoire with concepts like tort, entropy, Abelian group, mannerism, icon and deconstruction. How have humans constructed these concepts? And once they have been constructed by adults, how do children acquire them? While primarily focusing on the second question, in The Origin of Concepts , Susan Carey shows that the answers to both overlap substantially. Carey begins by characterizing the innate starting point for conceptual development, namely systems of core cognition. Representations of core (...) cognition are the output of dedicated input analyzers, as with perceptual representations, but these core representations differ from perceptual representations in having more abstract contents and richer functional roles. Carey argues that the key to understanding cognitive development lies in recognizing conceptual discontinuities in which new representational systems emerge that have more expressive power than core cognition and are also incommensurate with core cognition and other earlier representational systems. Finally, Carey fleshes out Quinian bootstrapping, a learning mechanism that has been repeatedly sketched in the literature on the history and philosophy of science. She demonstrates that Quinian bootstrapping is a major mechanism in the construction of new representational resources over the course of childrens cognitive development. Carey shows how developmental cognitive science resolves aspects of long-standing philosophical debates about the existence, nature, content, and format of innate knowledge. She also shows that understanding the processes of conceptual development in children illuminates the historical process by which concepts are constructed, and transforms the way we think about philosophical problems about the nature of concepts and the relations between language and thought. (shrink)

I address the problem of how to locate "traitorous" subjects, or those who belong to dominant groups yet resist the usual assumptions and practices of those groups. I argue that Sandra Harding's description of traitors as insiders, who "become marginal" is misleading. Crafting a distinction between "privilege-cognizant" and "privilege-evasive" white scripts, I offer an alternative account of race traitors as privilege-cognizant whites who refuse to animate expected whitely scripts, and who are unfaithful to worldviews whites are expected to hold.

A claim that is widely accepted and often invoked by philosophers working within ‘new classical natural law theory’ is that choosing directly against ‘basic goods’ is never morally permissible. In this essay, I address the question of whether one can coherently accept the fundamental commitments of new classical natural law theory and yet reject this absolutist claim. I argue that one can.

This paper aims to achieve a better understanding of what Socrates means by "συμφωνε[unrepresentable symbol]ν" in the sections of the "Phaedo" in which he uses the word, and how its use contributes both to the articulation of the hypothetical method and the proof of the soul's immortality. Section I sets out the well-known problems for the most obvious readings of the relation, while Sections II and III argue against two remedies for these problems, the first an interpretation of what the (...) συμφωνε[unrepresentable symbol]ν relation consists in, the second an interpretation of what sorts of thing the relation is meant to relate. My positive account in Section IV argues that we should take the musical connotations of the term seriously, and that Plato was thinking of a robust analogy between the way pitches form unities when related by certain intervals, and the way theoretical claims form unities when related by explanatory co-dependence. Section V surveys the work of IV from the point of view of the initial difficulties and suggests further consequences for the hypothetical method, including the logical relation between the συμφωνν[unrepresentable symbol]ν and διαφωνε[unrepresentable symbol]ν relations, and the need for care in ordering the results of a hypothesis. (shrink)

Book Review of Chris Cuomo's The Philosopher Queen.

If, following Masuzawa, Fitzgerald and others we assume that “the religious” is a category produced by Western colonial regimes in tandem with that of “the secular,” then consequently the post-secular would need to be post-religious, as well. Here I demonstrate how in one metropolitan case, Germany, the religious and secular divide is evoked to produce a particular exclusivist narrative of national identity. A substantial part of German civil society, media, and legal establishment mobilize an imagined culturally Christian vision of Germany (...) in order to exclude from public visibility and political participation German born Muslims of Turkish descent. The colonial twin categories of secular-religious still operate in the shaping of the German polity. Decolonizing it would thus require not only to enter a post-secular dialogue with religious presentations in the public sphere, as Habermas contends; rather a post-secular polity would require the post-religious. (shrink)

If there actually is a third wave of feminism, it is too close to the second wave for its definition to be clear and uncontroversial, a fact which emphasizes the political nature of declaring the existence of this third wave. Through an examination of some third wave literature, a case is made for emphasizing the continuity of the second and third waves without blurring the differences between older and younger feminists.

An interdisciplinary and jurisprudential primer that seeks to ground students in basic concepts that undergird and influence legal reasoning and process. Presented in clear and compelling prose that efficiently plugs this common gap in baseline knowledge. Student-friendly orientation that synthesizes numerous books on individual topics to create a full-blown inquiry into various jurisprudential fields. An even-handed and efficient student guide that includes Theory and the Law; Law and Economics; Political Philosophy and Law; American Governmental Structure: Its Impact on Law; Law, (...) Dispute Resolution, and the Adversary System; and Historical, Jurisprudential, and Multidisciplinary Influences on Law. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Clinical Anecdotes: A Painful Lack of WoundsChristopher Bailey (bio)Keywordsdepression, post-traumatic stress disorder (PTSD), evolution, fight-or-flight, veteran (treatment of)Colin came to me complaining of depression, which started after he got back from Iraq in 2005. Although he had served in the National Guard, he volunteered absolutely nothing about his time in Iraq as we spoke, instead focusing on other factors, like problems at his job and a family history (...) of depression.Colin's depression seemed serious but not severe. He had been functioning fairly well at work and was not suicidal, although his home life had begun to suffer. As the interview proceeded, I myself fell into Colin's blind spot, all but forgetting his tour of duty as I forged ahead with my list of questions. My avoidance was conscious at first, a deliberate reluctance to come across as one more morbidly curious onlooker recklessly inflaming the wounds of war.When Colin complained of irritability, however, and being kept awake by sinister, shadowy “flashes” at night, I knew I had to ask about Iraq. He was probably suffering from post-traumatic stress disorder, I decided, and was thus trying to avoid the very memories that were haunting and hunting him. And for fear of retraumatizing him (if not suffering second-hand trauma myself), I had colluded in his denial.So when I finally got around to asking about Iraq, I fully expected to hear horror stories, half-articulated perhaps, but all the more grisly for the graininess of their images. Instead, Colin surprised me. He had not experienced anything he considered traumatic. No bombs, bloodshed, or shattered bodies. And in fact, he felt like a “wimp” for having been assigned to a noncombat detail where he missed what might have been his last, best chance “to be a hero.”Most of us would consider this a good thing, but in Colin's case, it had left him feeling somehow uninitiated, like he had not done his part or proven his manhood. Contrary to my assumption, it was the lack of trauma that seemed to trigger his depression upon returning from Iraq. In a relatively safe homeland, rife with middle-class comforts and lacking all but metaphorical rites of passage, perhaps we all feel this way at some level.I pointed out to Colin that people have been dying everywhere in Iraq and under all different circumstances, not just combat. From my stateside perspective, just being there is brave. Although I meant to honor him, he seemed to take my offering as more evidence of his failure, reassuring me that nothing he did could ever compare with the unspeakable horrors endured by veterans of Viet Nam and World War II.Now, as a civilian, he questions whether or not he would respond with sufficient ferocity if, say, he had to defend his family against an attacker. Although powerfully built, Colin (to his credit) has never been a brawler or a bully. Nonetheless, [End Page 223] I have no doubt he could do whatever it took to protect his family. What concerns me more is the opposite: That in trying to prove himself, he might unwittingly put himself and his family in harm's way, if not hurt someone who was never really a threat to begin with.With a new family member, I too feel the burden of hypervigilance. But although terrorists, serial killers, and gangs grab headlines, activating our visceral alarm systems, data from the Centers for Disease Control and Prevention suggest that a sedentary lifestyle still exacts a higher death toll among white American men, like Colin and myself. Although the effect of inertia on the body has been discussed extensively, its impact on mental health has received relatively little attention. Maybe for a creature who evolved on the African savannah, competing over territory and trying not to get eaten, the absence of a visceral challenge can be as debilitating as too much of one.Colin seemed receptive to my concerns, which I took to be a good sign. Although insecure men are quick to fear emasculation, Colin did not seem to be the least bit threatened when I suggested a course... (shrink)

Allthough small business accounts for over 90% of businesses in U.K. and indeed elsewhere, they remain the largely uncharted area of ethics. There has not been any research based on the perspective of small business owners, to define what echical delemmas they face and how, if at all, they resolve them. This paper explores ethics from the perspective of small business owner, using focus groups and reports on four clearly identifiable themes of ethical delemmas; entrepreneurial activity itself, conflicts of personal (...) values with business needs, social responsibility and the impact of owners' personality on business ethics. The mechanisms for resolving ethical dilemmas is not at all clear, as there appears to be a web of filters which are used in an inter-connected way. However a common starting point for resolving an ethical delemma which involves others is based on identifying who it is (e.g., a friend or institution) and the quality of the relationship with that person. The research yielded a rich source of material on business ethics and it is clear that future researchers must focus on this sector if business ethics is to make significant advances. (shrink)

Many translations have been made from the original Sanskrit of the Yoga Sutras of Patanjali. They have become well loved, well used, and well applied by many in all parts of the world and of all religious beliefs. The Sutras have a power and a timelessness about them which demonstrate the accuracy with which they pinpoint the basic truths of human evolution from subservience to personality clamours to the serene freedom of the soul. Most human problems today originate in selfish (...) desire; the prostitution of the feeling nature to self-centred physical appetites. This is also brought out clearly in the teaching of the Lord Buddha, the treading of the Noble Eight-Fold path providing the only way out of the maze: Right Values; Right Speech; Right Mode of Living; Right Thinking; Right Expression; Right Conduct; Right Effort; Right Rapture or True Happiness. These are attributes of the soul. Patanjali explores exhaustively the means, the techniques and the mental posture which create the connecting thread between the form-centred personality and these stages towards spiritual achievement and soul fusion. The four parts of the book develop: 1. The Problem of Union (51 sutras). 2. sutras). 4. Illumination (34 sutras). Many different training techniques have been available over the centuries, depending on the condition of human consciousness and the phase of spiritual growth to be accomplished. Each Yoga has had its place, fulfilled its function, and become an absorbed part of human experience. In this book the factor of mind in meeting present-day needs is again given prominence as the agent of the soul, and the key to personality release. These Yoga Sutras of Patanjali are based on Raja Yoga, the kingly science of the soul: Through the science of Raja Yoga the mind will be known as the instrument of the soul and the means whereby the brain of the aspirant becomes illuminated and knowledge gained of those matters which concern the realm of the soul. The soul is concerned with the working out of planetary purpose and plan; so again we find that mental training, and the self-achievement of the individual, lead to cooperation and service on a scale far more comprehensive and of far greater evolutionary significance than merely the individual effects on the life of the disciple. venture on the path of union with the soul. When through the removal of hindrances and the purification of the sheaths, the totality of knowledge becomes available, naught further remains for the man to do. (shrink)

Sara Ruddick's contemporary philosophical account of mothering reconsiders the maternal arguments used in the women's peace movements of the earlier part of this century. The culmination of this project is her 1989 book, Maternal Thinking: Toward a Politics of Peace. Ruddick's project is ground-breaking work in both academic philosophy and feminist theory. -/- In this chapter, I first look at the relationship between the two basic components of Ruddick's argument in Maternal Thinking: the "practicalist conception of truth" (PCT) and feminist (...) standpoint theory (FST). I argue that Ruddick is never clear about the exact relation between the two components. These tensions point to a deeper problem in Ruddick's discussion of the critical power of maternal thinking. -/- The diversity of maternal practices presents a genuine challenge to Ruddick’s account. I argue that neither of the components she explores can adequately ground a feminist peace politics without first answering the question of who speaks for mothers. While I can suggest ways to make Ruddick's argument consistent, she still faces-despite her claims of universality- the deeper problem of reconciling her account of maternal practice with the genuine diversity of actual maternal practices. (shrink)