In cases of sudden, life-threatening illness where the chance of survival appears negligible to the admitting physician, this opinion is not always revealed during the initial meeting with the patient's relatives. Reasons as to why this withholding of the truth may be acceptable are explored through review of available evidence and personal reflection. Factors identified include: the importance of hope in families' coping mechanisms, and the instinct to preserve it; the fallibility of physicians' perception of poor prognosis in the early (...) phase of illness; the need to avoid large swings in relatives' expectations that occur when patients appear to rally during initial resuscitation; and the adverse effect that an atmosphere of hopelessness can have on the provision of medical care. A strategy for the staged disclosure of information and the confirmation of hopelessness is then described, the aim being to find a compromise between providing a true opinion about a patient's prognosis, and regard for the opposing factors described. (shrink)

McCullough and colleagues draw an historical line from the writings of Percival, who found himself resolving arguments (sometimes violent) between physicians, surgeons and apothecaries, to the concept of civility as a professional virtue and duty. The authors show that civility is a prerequisite to effective cooperation, which itself underpins patient safety and positive clinical outcomes—desirable endpoints of any discussion about healthcare. They exhort academic leaders to teach, role model and reward correct behaviours.1 Why then, as a clinician manager with a (...) deep interest in fostering civility and psychological safety, am I not satisfied? Three reasons: the paper does not adequately explore the reasons why, its focus is largely restricted to academic institutions, and it does not encompass the non-clinical workforce; as a result, its proposed solutions appear ungrounded. Why are ‘good people’, who were attracted to careers that demand altruism and empathy, uncivil in the workplace? What are the competing goals that result in curt, disrespectful or downright rude exchanges? This has been studied. Leape et al concluded that endogenous factors such as personality, insecurity, anxiety, depression, narcissism and responses to prior …. (shrink)

Introduction No consent for health and medical research is appropriate when the criteria for a waiver of consent are met, yet some ethics committees and data custodians still require informed consent. Methods A single-blind parallel-group randomised controlled trial: 1129 families of children born at a South Australian hospital were sent information explaining data linkage of childhood immunisation and hospital records for vaccine safety surveillance with 4 weeks to opt in or opt out by reply form, telephone or email. A subsequent (...) telephone interview gauged the intent of 1026 parents (91%) in relation to their actions and the sociodemographic differences between participants and non-participants in each arm. Results The participation rate was 21% (n=120/564) in the opt-in arm and 96% (n=540/565) in the opt-out arm (χ2 (1 df) = 567.7, p<0.001). Participants in the opt-in arm were more likely than non-participants to be older, married/de facto, university educated and of higher socioeconomic status. Participants in the opt-out arm were similar to non-participants, except men were more likely to opt out. Substantial proportions did not receive, understand or properly consider study invitations, and opting in or opting out behaviour was often at odds with parents' stated underlying intentions. Conclusions The opt-in approach resulted in low participation and a biased sample that would render any subsequent data linkage unfeasible, while the opt-out approach achieved high participation and a representative sample. The waiver of consent afforded under current privacy regulations for data linkage studies meeting all appropriate criteria should be granted by ethics committees, and supported by data custodians. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12610000332022. (shrink)

Philip Berry examines the case of euthanasia from very close emotional range.

Patient autonomy and distributive justice are fundamental ethical principles that may be at risk in liver transplant units where decisions are dictated by the need to maximise the utility of scarce donor organs. The processes of patient selection, organ allocation and prioritisation on the wait list have evolved in a constrained environment, leading to high levels of complexity and low transparency. Regarding paternalism, opaque listing and allocation criteria, patient factors such as passivity, guilt, chronic illness and sub-clinical encephalopathy are cited (...) as factors that may inhibit patient engagement. Regarding justice, established regional, gender and race based inequities are described. The paradox whereby hepatologists both advocate for individual patients and discharge their duty of stewardship to apportion organs according to larger utilitarian principles is explored. Competing subjective factors such as physicians’ perception of moral responsibility, the qualitative nature of expert medical assessment and institutional or personal loyalty to re-transplantation candidates are described. Realistic limits of self-determination and justice are discussed, and possible future directions in terms of patient involvement proposed. (shrink)

Assisted dying (AD) has not been legalized despite a number of presentations to parliament. It is necessary for doctors who support AD to justify themselves in the context of repeated legislative failure. This article describes the author's personal approach to the problem, one that prioritizes respect for autonomy above legal or societal objections. It is argued that for debilitated patients, the preservation of autonomy depends on a doctor's empathy and willingness to advocate. This sequence can be interrupted by externally and (...) internally imposed barriers. External factors include indiscriminate respect for the law and society's institutions, an inaccurate perception of the balance of risks to society and insufficient compensation for the dying person's inability to mount a sustained challenge. Internal brakes to advocacy such as elevation of personal morality above the needs of patients, attenuation of the therapeutic relationship in cases of moral complexity and the temptation to abdicate the role of physician are also explored. It is concluded that if AD could in theory be of benefit to a patient, but cannot be achieved due to its illegality, doctors have a duty to actively represent their demands as they would for other forms of treatment. (shrink)

Cardiopulmonary resuscitation is frequently performed on patients who, in retrospect, had a very low chance of survival. This is because all patients are ‘For cardiopulmonary resuscitation’ on admission to hospital by default, and delays occur before cardiopulmonary resuscitation can be ‘de-prescribed’. This article reviews the nature of potential harms caused by futile cardiopulmonary resuscitation, the reasons why de-prescription may be delayed, recent legal judgements relevant to timely do not attempt cardiopulmonary resuscitation decision making, and the possible detrimental effects of do (...) not attempt cardiopulmonary resuscitation discussions on end of life care. The moral and operational feasibility of a model in which informed consent must be obtained before cardiopulmonary resuscitation is attempted in some patient groups is then explored. (shrink)

Due to the ethical breaches of tobacco companies over a 50-year period, a U.S. Court ruled in United States v. Philip Morris USA, Inc. that major U.S. tobacco companies had misled consumers and the government about tobacco’s addictiveness, effects of environmental smoke, marketing targeted at adolescents, and deceptive practices related to harmfulness of smoking. We address the actions of the tobacco companies based on the consumer’s right to be informed and values for ethical corporate behavior, and we draw from (...) psychological theories and the smoking literature to develop our conceptual framework and test the effectiveness of the ensuing corrective advertising campaign mandated in the Court decision. We use a quota sample of 470 smokers and non-smoker participants in a longitudinal study to test the impact of the corrective advertising campaign on key antismoking beliefs from the campaign. Results reveal that the corrective ad campaign has not been successful in affecting smokers’ or non-smokers’ antismoking beliefs. However, differences are found between smokers’ and non-smokers’ beliefs about the adverse health effects of smoking, effects of secondhand smoke, and tobacco company deceptiveness, with these beliefs being stronger for non-smokers. Smokers’ weaker beliefs about the effects of secondhand smoke are viewed as particularly problematic, given the established health risks. We address the implications of the ethical breaches and the corrective advertising attempt to address the deception identified by the Court. (shrink)

Introductory Chapter to the _Cambridge Handbook of Situated Cognition_ (CUP, 2009).

In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...

Husserlian phenomenology, as the study of conscious experience, has often been accused of solipsism. Husserl’s method, it is argued, does not have the resources to provide an account of consciousness of other minds. This chapter will address this issue by providing a brief overview of the multiple angles from which Husserl approached the theme of intersubjectivity, with specific focus on the details of his account of the concrete interpersonal encounter – “empathy.” Husserl understood empathy as a direct, quasi-perceptual form of (...) intentionality through which the sense of the Other is constituted. Furthermore, his account of empathy is holistically integrated with his overall theory of intersubjectivity, including his discussions of the objectivity of nature, and the social, historical, and communal aspects of subjectivity. Husserl’s theory of empathy continues to cast a long shadow, influencing both the analytic and continental approaches to the problem of other minds, as well as contemporary account of social cognition in the cognitive sciences. (shrink)

_Time_ offers a comprehensive history of the philosophy of time in western philosophy from the Greeks through to the twentieth century. In the first half of the book, Philip Turetzky explores theories in ancient and modern philosophy chronologically: from Aristotle to Nietzsche. In the latter half, Turetzky describes the philosophy of time in three twentieth-century philosophical traditions: * analytic philosophy including philosophers such as McTaggart and Mellor * phenomenology Husserl and Heidegger * a distaff tradition which Turetzky identifies as (...) including Bergson and Deleuze. (shrink)

This article draws on the antebellum political thought of Black abolitionists Frederick Douglass and Martin Delany in critically assessing the efficacy of reasonableness in advancing the aims of emancipatory politics in political discourse. I argue, through a reading of Douglass and Delany, that comporting oneself reasonably in the face of oppressive ideology can be counterproductive, if one’s aim is to undermine such ideology and the institutions it supports. Douglass and Delany, I argue, also provide us with a framework for evaluating (...) alternative discursive strategies we might wish to employ in light of the limited value of reasonableness for emancipatory politics. (shrink)

Four of the commentaries criticised my claim that assisted suicide for the terminally ill is discriminatory. 1 They were united in this judgement roughly because they insisted that assisted suicide is in fact a benefit and not a harm. I concede that if it is a benefit, then there is no way in which the terminally ill can be disadvantaged by it and hence no way it can be an instance of discrimination. I pointed out in the article that this (...) issue is controversial and could not be settled in my article, nor can it be settled in this brief response. Assisted suicide harms the terminally ill in several ways. First, it harms the people who do not adopt it by forcing them to defend their continued existence. Second, it harms many of the people who adopt it in so far as they are deprived of a life... (shrink)

We provide empirical examples to conceptually clarify some items on Firestone & Scholl’s (F&S’s) checklist, and to explain perceptual effects from an attentional and memory perspective. We also note that action and embodied cognition studies seem to be most susceptible to misattributing attentional and memory effects as perceptual, and identify four characteristics unique to action studies and possibly responsible for misattributions.

In lieu of an abstract, here is a brief excerpt of the content:The Pyrrhonian Revival in Montaigne and NietzscheJessica N. BerryMichel de Montaigne occupies a unique place in Nietzsche's history of ideas. He is one of a very few figures for whom Nietzsche expresses deep admiration and about whom he has virtually nothing critical to say. This is a rare enough mark of distinction; but contrary to what it might lead us to expect, the relationship between Montaigne and Nietzsche has (...) seldom been carefully examined. There has yet to be a book-length study devoted solely to Montaigne and Nietzsche,1 and article-length treatments of the relationship between their works and thought have been surprisingly scarce. What discussions there have been tend to locate the connections between Nietzsche and Montaigne mainly in matters of either literary or personal style,2 but studies that examine Montaigne's influence on Nietzsche with an eye toward philosophical rather than literary or stylistic issues have been almost non-existent.3 This dearth of treatments can be explained, at least in part, by the fact that, while Montaigne is rightly recognized for the literary merits of his work and for its subsequent influence on later prose stylists (and not only in French), his work on the whole has seldom been appreciated as having any philosophical value in its own right. Small wonder, then, that the connection between Montaigne and Nietzsche has [End Page 497] appeared more significant to commentators on Montaigne who are interested in tracing his influence on later thinkers than to scholars of Nietzsche—even those Nietzsche scholars who take an acute interest in his intellectual heritage. What I will argue here is that Montaigne makes a more concrete and philosophically more substantive contribution to Nietzsche's thought than has generally been appreciated; specifically, by giving impetus to the naturalism that develops in Human, All Too Human as an antidote to Schopenhauer's pessimistic metaphysics of will.In this essay, I present a two-fold thesis about Montaigne's influence on Nietzsche's early work. First, I will argue that the "naturalistic turn" in Human, All Too Human reflects Nietzsche's engagement with Montaigne during a crucial moment in the development of his thought. Second, I will demonstrate that the naturalism Nietzsche adopts from Montaigne has roots in the tradition of Pyrrhonian skepticism that Montaigne carries forward into the Renaissance. In the end, a better understanding of the skeptical ancestry of Nietzsche's naturalism should help us make better sense of Human, All Too Human and its immediate successors in Nietzsche's oeuvre, which cultivate what otherwise seems to be an uneasy partnership between naturalism and skepticism.I. It is by now widely accepted that Nietzsche's estimation of the value of the techniques and methods of the natural sciences undergoes radical revision in the period culminating in the first volume of Human, All Too Human (HAH),4 a book sometimes described as inaugurating a "positivist" phase in Nietzsche's work. From the first of its nine major sections, "Of First and Last Things," HAH narrates a struggle between science on the one hand and philosophy on the other. It is important to note the breadth of the extension of the term "science" (Wissenschaft), which includes not only what we think of as the "hard" or physical sciences (physics, chemistry, and the like) but also areas of inquiry we now consider "behavioral sciences" such as psychology and sociology—and, Nietzsche would say, philology as well. "Philosophy," by contrast is specified more narrowly. As Nietzsche uses the term throughout HAH, "philosophy" is usually shorthand for "metaphysical philosophy" and singles out for criticism the discourse of metaphysics that has dominated the philosophical landscape at least since Plato.In the sense in which Nietzsche worries about it "metaphysical philosophy" promotes speculation about such supra-sensible entities as Platonic forms, Descartes's "immaterial substances," and Kantian things-in-themselves. That its contributions include, for instance, theories about the existence and immortality of the soul accounts for Nietzsche's grouping "metaphysical philosophy" [End Page 498] together with religion and art as "arts of narcosis."5 Consciously or not they endeavor to comfort us by assuaging our fear of death, our existential anxieties about the purposelessness of... (shrink)

Political ecology has developed as an academic discipline in reaction to the increased concern of nations and individuals about humanity's adverse impact on the environment and the ways international bodies have moved to counter this impact. This new text draws together international experts at the cutting edge of this new field to focus on real world examples of problems and the tension between developed and developing states.

This paper addresses the problem of the strategies and theories of democratic participation in Nigeria that breed institutional marginality and bad governance due to shortfalls in pursuing the values of justice and empowerment as core democratic characteristics. The same democratic principles such as voting, parliament, constitution, judiciary, that are suggestive of gains such as responsible use, and peaceful transfer of power may not have translated fully into sociopolitical empowerment for responsibility and representation in evolving democratic practice in Nigeria due to (...) problems of agency and political ideology. Democratic theorizing and participation in Nigeria has defied orthodox presuppositions seen in the disrespect for basic rights and the disregard for the rule of law in democracy that allow for fair play within and among the elites and political grassroots. Thus this study investigates the Nigerian predicament as a model or case study, raising questions about the reasons for the systematic disempowerment of groups. (shrink)

The questions -- The purpose of morality and law -- The past and the future -- What is religion? -- What is the rule of law? -- The families of religion : western religions -- The families of religion : eastern religions -- The families of law -- A brief tour of secular law -- Money, banks and corporations -- Secularisation and religious decline -- Reasons for the decline of religiosity -- Secularisation of government -- The rise of the lawyers (...) -- Who rules the world : lawyers or economists? -- What is wrong with the law? -- Scientific progress and the law -- A way of living -- A billion years from now. (shrink)

The _Platform Sutra_ records the teachings of Hui-neng, the Sixth Patriarch, who is revered as one of the two great figures in the founding of Ch'an (Zen) Buddhism. This translation is the definitive English version of the eighth-century Ch'an classic. Phillip B. Yampolsky has based his translation on the Tun-huang manuscript, the earliest extant version of the work. A critical edition of the Chinese text is given at the end of the volume. Dr. Yampolsky also furnishes a lengthy and detailed (...) historical introduction which contains much information hitherto unavailable even to scholars, and provides the context essential to an understanding of Hui-neng's work. He gives an account of the history and legends of Ch'an Buddhism, with particular attention to the traditions associated with Hui-neng, quoting or summarizing the most important narratives. He then discusses the various texts of the _Platform Sutra_, and analyzes its contents. (shrink)

The actualism/possibilism debate in ethics concerns the relationship between an agent’s free actions and her moral obligations. The actualist affirms, while the possibilist denies, that facts about what agents would freely do in certain circumstances partly determines that agent’s moral obligations. This paper assesses the plausibility of actualism and possibilism in light of desiderata about accounts of blameworthiness. This paper first argues that actualism cannot straightforwardly accommodate certain very plausible desiderata before offering a few independent solutions on behalf of the (...) actualist. This paper then argues that, contrary to initial appearances, possibilism is subject to its own comparably troubling blameworthiness problem. (shrink)

For liberal contractarians, moral and political principles are justified if agreeable to persons as free and equals. But for critics of liberal contractarianism, this justification applies only to those capable of agreement. Understanding why contractarianism suffers from the problem of exclusion helps up understand the distinctive character of contractarianism and the importance of agreement in particular. I suggest contractarianism need not be objectionably exclusive. I first consider why agreement is important in contractarianism, and then introduce the main versions of contemporary (...) contractarianism and their different understandings of agreement. I discuss how agreement results in exclusion in each, and distinguish two kinds of response to the problem of exclusion: differential inclusion and permissive inclusion. Differential inclusion is unsuccessful because it offers those not fully capable of agreement unequal status. Permissive inclusion may either make the circumstances of agreement more open, or characterize the capacities required for inclusion more permissively. I advocate the latter as the most promising response to the problem of exclusion. I outline a more inclusive contractualism based on the capacity to share goals. (shrink)

ABSTRACT Constitutive panpsychism is the doctrine that macro-level consciousness—that is, consciousness of the sort possessed by certain composite things such as humans—is built out of irreducibly mental features had by some or all of the basic physical constituents of reality. On constitutive panpsychism, changes in macro-level consciousness amount to changes in either the way that micro-conscious entities ‘bond’ or the way that micro-conscious qualities ‘blend’. I pose the ‘Selection Problem’ for constitutive panpsychism—the problem of explaining how high-level functional states of (...) the brain ‘select’ micro-conscious qualities for bonding or blending. I argue that there are no empirically plausible solutions to this problem. (shrink)

The impact of Nietzsche's engagement with the Greek skeptics has never before been systematically explored in a book-length work - an inattention that belies the interpretive weight scholars otherwise attribute to his early career as a professor of classical philology and to the fascination with Greek literature and culture that persisted throughout his productive academic life. Jessica N. Berry fills this gap in the literature on Nietzsche by demonstrating how an understanding of the Pyrrhonian skeptical tradition illuminates Nietzsche's own (...) reflections on truth, knowledge, and ultimately, the nature and value of philosophic inquiry. This entirely new reading of Nietzsche's epistemological and ethical views promises to make clear and render coherent his provocative but often opaque remarks on the topics of truth and knowledge and to grant us further insight into his ethics-since the Greek skeptics, like Nietzsche, take up the position they do as a means of promoting well-being and psychological health. In addition, it allows us to recover a portrait of Nietzsche as a philologist and philosophical psychologist that has been too often obscured by commentaries on his thought. "The book addresses a number of central issues in Nietzsche's philosophy, including perspectivism and his conception of truth. The idea that his views in these areas owe much to the ancient Pyrrhonists casts them in an important new light, and is well supported by the texts. A lot of people from a lot of different areas in philosophy will have good reason to take notice." - Richard Bett, Johns Hopkins University. (shrink)

Advocates of “Mendelism” early on stressed the usefulness of Mendelian principles for breeders. Ever since, that usefulness—and the favourable opinion of Mendelism it supposedly engendered among breeders—has featured in explanations of the rapid rise of Mendelian genetics. An important counter-tradition of commentary, however, has emphasized the ways in which early Mendelian theory in fact fell short of breeders’ needs. Attention to intellectual property, narrowly and broadly construed, makes possible an approach that takes both the tradition and the counter-tradition seriously, by (...) enabling a more complete description of the theory-reality shortfall and a better understanding of how changing practices, on and off the Mendelians’ experimental farms, functioned to render that shortfall unproblematic. In the case of plant breeding in Britain, a perennial source of lost profits and disputes over ownership was the appearance of individual plants departing from their varietal types—so-called “rogues.” Mendelian plant varieties acquired a reputation for being rogue-free, and so for demonstrating the correctness of Mendelian principles , at a time when Mendelians were gradually taking control of the means for distributing their varieties. Mendelian breeders protected their products physically from rogue-inducing contamination in such a way that when rogues did appear, the default explanation—that contamination had somehow occurred—ensured that there was no threat to Mendelian principles. (shrink)

There are many touch points between the work of Jacques Derrida and René Girard. To me, as a student of literature, these two writers particularly stand out as great readers or great exegetes.1 The way they handle and combine texts, the way they dare to break with reading conventions, has proved to be really fruitful.Some time ago I watched a documentary about Derrida, made by Kirby Dick and Amy Ziering Kofman, published in 2002, carrying the simple title Derrida.2 I found (...) that this experimental documentary at the same time reflected Derrida’s many reservations, not to say his skepticism, as to the possibility of making portraits—and—proved to be far more revealing, even intimate, than a conventional documentary... (shrink)

A and B continue their conversation concerning the Identity of Indiscernibles. Both are aware of recent critiques of the principle that haven’t received replies; B summarizes those critiques, and A offers the replies that are due. B then raises a new worry.

Next SectionAn attempt to resolve the controversy regarding the solution of the Sleeping Beauty Problem in the framework of the Many-Worlds Interpretation led to a new controversy regarding the Quantum Sleeping Beauty Problem. We apply the concept of a measure of existence of a world and reach the solution known as ‘thirder’ solution which differs from Peter Lewis’s ‘halfer’ assertion. We argue that this method provides a simple and powerful tool for analysing rational decision theory problems.

The way a rational agent changes her belief in certain propositions/hypotheses in the light of new evidence lies at the heart of Bayesian inference. The basic natural assumption, as summarized in van Fraassen's Reflection Principle, would be that in the absence of new evidence the belief should not change. Yet, there are examples that are claimed to violate this assumption. The apparent paradox presented by such examples, if not settled, would demonstrate the inconsistency and/or incompleteness of the Bayesian approach, and (...) without eliminating this inconsistency, the approach cannot be regarded as scientific. The Sleeping Beauty Problem is just such an example. The existing attempts to solve the problem fall into three categories. The first two share the view that new evidence is absent, but differ about the conclusion of whether Sleeping Beauty should change her belief or not, and why. The third category is characterized by the view that, after all, new evidence is involved. My solution is radically different and does not fall into either of these categories. I deflate the paradox by arguing that the two different degrees of belief presented in the Sleeping Beauty Problem are in fact beliefs in two different propositions, i.e., there is no need to explain the change of belief. The Sleeping Beauty Problem The Problem Deflated 2.1 From contradiction to consistency 2.2 The inanimate version 2.3 Back to SB Summary CiteULike Connotea Del.icio.us What's this? (shrink)

This book introduces Christian ethics from a theological perspective. Philip Turner, widely recognized as a leading expert in the field, explores the intersection of moral theology and ecclesiology, arguing that the focus of Christian ethics should not be personal holiness or social reform but the common life of the church. A theology of moral thought and practice must take its cues from the notion that human beings, upon salvation, are redeemed and called into a life oriented around the community (...) of the church. This book distills a senior scholar's life work and will be valued by students of Christian ethics, theology, and ecclesiology. (shrink)

Runkel links Perceptual Control Theory (PCT) thinking to psychological literature and discusses it against that background.

Introduction -- Constructing social identity through discourse : a socio-rhetorical approach for the study of Valentinian paraenesis -- Defining paraenesis I : historical phases within the academic study of paraenesis -- Defining paraenesis II : towards a functional understanding of paraenesis -- Literary aspects of paraenesis : indicators of moral exhortation from the Greco-Roman world within Valentinianism -- Two schools and the call to reconciliation : literary and social aspects of moral exhortation in the Interpretation of knowledge -- Existing in (...) error : literary and social aspects of moral exhortation in the Gospel of truth -- Conclusion. (shrink)

From idealism to phenomenology -- Existential phenomenology: Heidegger -- From hermeneutics to post-structuralism.