In the People’s Republic of China, an approach has been adopted to ensure that all children born as a result of the one-child policy are healthy. The World Health Organization/United Nations Children’s Fund (WHO/UNICEF) has encouraged the Chinese Government to embrace this philosophy. Part of this approach has resulted in an attempt to increase the breastfeeding rates. This report describes a visit by two nursing faculty members of a Canadian university to an urban hospital maternity unit in the northeast of (...) China, where the staff were attempting to incorporate this philosophy into their maternity care with the assistance of nursing faculty members from the local university. The method chosen to integrate this philosophy was the Baby-Friendly Hospital Initiative initiated by WHO/UNICEF. (shrink)

This article is based largely on a research study undertaken by the author into the teaching of human rights in nursing courses in the UK on behalf of the national section of the human rights organization Amnesty International. It attempts to provide a baseline estimate of human rights education in nursing curricula in the UK while making suggestions on how the teaching of human rights issues could be more clearly incorporated into nursing curricula, ending with some recommendations for further research.

In the People’s Republic of China, an approach has been adopted to ensure that all children born as a result of the one-child policy are healthy. The World Health Organization/United Nations Children’s Fund has encouraged the Chinese Government to embrace this philosophy. Part of this approach has resulted in an attempt to increase the breastfeeding rates. This report describes a visit by two nursing faculty members of a Canadian university to an urban hospital maternity unit in the northeast of China, (...) where the staff were attempting to incorporate this philosophy into their maternity care with the assistance of nursing faculty members from the local university. The method chosen to integrate this philosophy was the Baby-Friendly Hospital Initiative initiated by WHO/UNICEF. (shrink)

This essay introduces the second installment of a symposium in Common Knowledge called “Apology for Quietism.” This introductory piece concerns the sociology of quietism and why, given the supposed quietude of quietists, there is such a thing at all. Dealing first with the “activist” Susan Sontag's attraction to the “quietist” Simone Weil, it then concentrates on the “activist” William Empson's attraction to the Buddha and to Buddhist quietism, with special reference to Empson's lost manuscript Asymmetry in Buddha Faces. The author, (...) who is also editor of the journal, argues against the effort of some contributors to substitute new terms for quietism and emphasizes instead what he calls “the need for repose.”. (shrink)

This essay introduces the second installment of a symposium in Common Knowledge called “Apology for Quietism.” This introductory piece concerns the sociology of quietism and why, given the supposed quietude of quietists, there is such a thing at all. Dealing first with the “activist” Susan Sontag's attraction to the “quietist” Simone Weil, it then concentrates on the “activist” William Empson's attraction to the Buddha and to Buddhist quietism, with special reference to Empson's lost manuscript Asymmetry in Buddha Faces (and to (...) Sharon Cameron's work on the topic in her book Impersonality). The author, who is also editor of the journal, argues against the effort of some contributors to substitute new terms for quietism and emphasizes instead what he calls (quoting Sontag) “the need for repose.”. (shrink)

There’s something else I haven’t told you, it might be important... I don’t know. Really. It’s probably nothing, it’s probably trivial, it won’t mean anything I’m sure. But it has been troubling me quite a bit... well, not a lot, but a bit, you know. I suppose I should have mentioned it earlier, but somehow....

The first comprehensive study of Nietzsche's earliest book, The Birth of Tragedy, this important volume by M. S. Silk and J. P. Stern examines the work in detail: its place in Nietzsche's philosophical career; its value as an account of ancient Greek culture; its place in the history of German ideas, and its value as a theory of tragedy and music. Presented in a fresh twenty-first-century series livery, and including a specially commissioned preface written by Lesley Chamberlain, illuminating its (...) enduring importance and relevance to philosophical enquiry, this accessible study has been revived for a new generation of readers. (shrink)

How do we judge whether an action is morally right or wrong? If an action is wrong, what reason does that give us not to do it? Why should we give such reasons priority over our other concerns and values? In this book, T. M. Scanlon offers new answers to these questions, as they apply to the central part of morality that concerns what we owe to each other. According to his contractualist view, thinking about right and wrong is thinking (...) about what we do in terms that could be justified to others and that they could not reasonably reject. He shows how the special authority of conclusions about right and wrong arises from the value of being related to others in this way, and he shows how familiar moral ideas such as fairness and responsibility can be understood through their role in this process of mutual justification and criticism. Scanlon bases his contractualism on a broader account of reasons, value, and individual well-being that challenges standard views about these crucial notions. He argues that desires do not provide us with reasons, that states of affairs are not the primary bearers of value, and that well-being is not as important for rational decision-making as it is commonly held to be. Scanlon is a pluralist about both moral and non-moral values. He argues that, taking this plurality of values into account, contractualism allows for most of the variability in moral requirements that relativists have claimed, while still accounting for the full force of our judgments of right and wrong. (shrink)

The paper describes the state and local parliamentary activity of Marcjan Ścibor Chełmski, one of the most interesting parliamentarians in the Polish-Lithuanian Commonwealth of the 17th century. The text is based on archival research including the Parliament manuscript diaries, private correspondence describing the debates; published sources: instructions, parliamentary resolutions, memoirs; and studies of the history of parliamentarism, on top of the functioning of the political elite and the circulation of information. M.S. Chełmski came from a family with a strong tradition (...) of public service settled in the Krakow province. He began his career as a parliamentarian by being elected to the Sejm in 1613, and later sat in the Parliaments of: 1616, 1618, 1619, 1620, 1621, 1625, 1626/I, 1626/II, 1629/I, 1629/II, 1631, 1632, 1633, 1634, 1635, 1637/I, 1637/II and 1638. He was one of the MPs who usually had a strong presence in the Chamber of Deputies. During the debates he addressed the issues of noble freedom in the spirit hostile to absolutum dominium, economic issues, procedural issues, and religious freedom. The collected source material confirms Chełmski’s great public activity in Lesser Poland and the evolution of his political stance at the Sejm from an oppositionist during the reign of Sigismund III Vasa to a moderate supporter of the royal court. Sources indicate that Chełmski had a reputation as an esteemed legal expert. He held the dignity of Marshal of the Crown Tribunal. For over 30 years he was one of the most active participants of the local parliament life in the Krakow province. The evolution of Chełmski’s political stance during the reign of Władysław IV Vasa resulted in his nomination for a prestigious office of the Chamberlain of Krakow. (shrink)

Aphantasia is a recently discovered disorder characterised by the total incapacity to generate visual forms of mental imagery. This paper proposes that aphantasia raises important theoretical concerns for the ongoing debate in the philosophy and science of consciousness over the nature of dreams. Recent studies of aphantasia and its neurobehavioral correlates reveal that the majority of aphantasics, whilst unable to produce visual imagery while awake, nevertheless retain the capacity to experience rich visual dreams. This finding constitutes a novel explanandum for (...) theories of dreaming. Specifically, I argue that the recent dream reports of aphantasics constitute an empirical challenge to the emerging family of views which claim that dreams are essentially imaginative experiences, constitutively involving the kinds of mental imagery which aphantasics, ex-hypothesi, lack. After presenting this challenge in the context of Jonathan Ichikawa’s recent arguments for this view, I argue that this empirical challenge may be overcome if the imagination theorist abandons Ichikawa’s account of dreaming in favour of a modified version. This involves the claim that dreams are essentially inactive and constitutively involve non voluntary forms of imagination. I conclude with a suggestion for further research which can test the viability of this alternative hypothesis, and move the debate forward. (shrink)

Much has changed in maternal-fetal medicine since the early 2000s, when the previous ethical frameworks for fetal therapy trials were established. We applaud Hendriks and colleagues for taking on t...

It is difficult for a philosopher to contemplate with equanimity the fate which is overtaking, if it has not already overtaken, the word logical. “Logical” is one of a trio of words selected by the Greeks to represent the three main departments of philosophy; and of this trio the other two members, the words “ethical” and “physical,” have at least remained respectable; and to be called “philosophical” is almost a compliment. But to be logical is apparently, at least in England, (...) to enter on very questionable courses: it is to class yourself with every reckless extremist, with the latest and wildest ism in art, politics, and literature, with Russians and Frenchmen and the “Latin mind.” No less a person than H.M. Secretary of State for Foreign Affairs, on no less an occasion than an Assembly of the League of Nations, has lately proclaimed proudly to the gathered nations that lack of logic is the special virtue and privilege of the British Empire. The “lesser breeds with in the law” heard no doubt and trembled, wondering how they could ever compete with a Power to which the laws of thought themselves were mere expediencies. Thus it appears, if Sir Austen Chamberlain is right, that to be logical is to fall into a human weakness or vice, and that this weakness or vice is fortunately commoner outside than inside the British Empire. (shrink)

It is difficult for a philosopher to contemplate with equanimity the fate which is overtaking, if it has not already overtaken, the word logical. “Logical” is one of a trio of words selected by the Greeks to represent the three main departments of philosophy; and of this trio the other two members, the words “ethical” and “physical,” have at least remained respectable; and to be called “philosophical” is almost a compliment. But to be logical is apparently, at least in England, (...) to enter on very questionable courses: it is to class yourself with every reckless extremist, with the latest and wildest ism in art, politics, and literature, with Russians and Frenchmen and the “Latin mind.” No less a person than H.M. Secretary of State for Foreign Affairs, on no less an occasion than an Assembly of the League of Nations, has lately proclaimed proudly to the gathered nations that lack of logic is the special virtue and privilege of the British Empire. The “lesser breeds within the law” heard no doubt and trembled, wondering how they could ever compete with a Power to which the laws of thought themselves were mere expediencies. Thus it appears, if Sir Austen Chamberlain is right, that to be logical is to fall into a human weakness or vice, and that this weakness or vice is fortunately commoner outside than inside the British Empire. (shrink)

Unlike inert objects, organisms and their cells have the ability to initiate activity by themselves and thus change their properties or states even in the absence of an external cause. This crucial difference led us to search for principles suitable for the study organisms. We propose that cells follow the default state of proliferation with variation and motility, a principle of biological inertia. This means that in the presence of sufficient nutrients, cells will express their default state. We also propose (...) a principle of variation that addresses two central features of organisms, variation and historicity. To address interdependence between parts, we use a third principle, the principle of organization, more specifically, the notion of the closure of constraints. Within this theoretical framework, constraints are specific theoretical entities defined by their relative stability with respect to the processes they constrain. Constraints are mutually dependent in an organized system and act on the default state.Here we discuss the application and articulation of these principles for mathematical modeling of morphogenesis in a specific case, that of mammary ductal morphogenesis, with an emphasis on the default state. Our model has both a biological component, the cells, and a physical component, the matrix that contains collagen fibers. Cells are agents that move and proliferate unless constrained; they exert mechanical forces that act (i) on collagen fibers and (ii) on other cells. As fibers are organized, they constrain the cells’ ability to move and to proliferate. This model exhibits a circularity that can be interpreted in terms of the closure of constraints. Implementing our mathematical model shows that constraints to the default state are sufficient to explain the formation of mammary epithelial structures. Finally, the success of this modeling effort suggests a stepwise approach whereby additional constraints imposed by the tissue and the organism can be examined in silico and rigorously tested by in vitro and in vivo experiments, in accordance with the organicist perspective we embrace. (shrink)

This project was provoked by the almost nonexistent pushback from the Democratic liberal establishment to the (2020) exoneration of Kyle Rittenhouse, despite his acknowledged killing of two Black Lives Matters protesters against the police murder of George Floyd. It builds on three prior articles arguing for the revival of ancient Dionysian practice, Haitian Vodou, and Indigenous South American shamanism to empower leftist revolution. In essence, I propose an assemblage of spiritual practices that are accessible today for the neo-colonized 99% of (...) the global population, by synthesizing and reconstructing three democratic, lower-SES, Indigenous religions, all of which share a militant defiance of their respective tyrannical plutocracies. To avoid cultural appropriation, I center these reconstructed spiritual practices on the figure of the “mage,” a psychosocial healer loosely analogous to a shaman. And the mage’s signature activity, “magic,” I redefine naturalistically as free interpersonal performative action, practiced using two theoretical disciplines (philosophy and psychology) and two practical disciplines chosen by each mage. More precisely, Spirit/Dance channels the “spirits” of dead ancestors, historical figures, legendary heroes, mythical beings, and fictional characters, into the three ultimate objectives of “mindfulness” for psyches/souls, “liberation” for mindful bodies, and “social justice” for liberated communities, indirectly empowering long-term revolution. (shrink)

In the last decade, the organization of pharmaceutical research on neglected tropical diseases has undergone transformative change. In a context of perceived “market failure,” the development of new medicines is increasingly handled by public-private partnerships. This shift toward hybrid organizational models depends on a particular form of exchange: the sharing of proprietary assets in general and of intellectual property rights in particular. This article explores the paradoxical role of private property in this new configuration of global health research and development. (...) Rather than a tool to block potential competitors, proprietary assets function as a lever to attract others into risky collaborative ventures; instead of demarcating public and private domains, the sharing of property rights is used to increase the porosity of that boundary. This reimagination of the value of property is connected to the peculiar timescape of global health drug development, a promissory orientation to the future that takes its clearest form in the centrality of “virtual” business models and the proliferation of strategies of deferral. Drawing on the anthropological literature on inalienable possessions, we reconsider property’s traditional exclusionary role and discuss the possibility that the new pharmaceutical “commons” proclaimed by contemporary global health partnerships might be the precursor of future enclosures. (shrink)

Some recent uses of artificial intelligence for facial recognition, evaluating resumes, and sorting photographs by subject matter have revealed troubling disparities in performance or impact based on the demographic traits of subject populations. These disparities raise pressing questions about how using artificial intelligence can work to promote justice or entrench injustice. Political theorists and philosophers have developed nuanced vocabularies and theoretical frameworks for understanding and adjudicating disputes about what justice requires and what constitutes injustice. The interdisciplinary community committed to understanding (...) and conscientiously using big data could benefit from this work. Thus, in the spirit of encouraging cross-disciplinary dialogue and collaboration, this piece examines contemporary scholarship in political theory and philosophy to illustrate some of the vocabularies and frameworks political theorists and philosophers have developed for thinking about justice and injustice. It then draws on these frameworks to illuminate how the use of artificial intelligence can implicate questions of justice, with a focus on institutional discrimination, structural injustice, and epistemic injustice. Ultimately, the piece argues that the use of artificial intelligence—far from representing a decision to take power out of human hands—represents a novel way of harnessing human power, making questions of justice central to its conscientious undertaking. (shrink)

Emily Carroll and Parker Crutchfield propose a new inconsistency argument against abortion restrictivism. In response, I raised several objections to their argument. Recently Carroll and Crutchfield have replied and seem to be under the impression that I’m a restrictivist. This is puzzling, since my criticism of their view included a very thinly veiled, but purposely more charitable, anti-restrictivist inconsistency argument. In this response, I explain how Carroll and Crutchfield mischaracterize my position and that of the restrictivist.

In the late 1960s, the Federal Bureau of Investigation (FBI), a United States of America (US) intelligence agency, developed what is famously known as Counter Intelligence Program (COINTELPRO). Its mission was to surveil, misinform, misdirect and subvert or destroy black ‘subversive’ militant groups. The main intention of COINTELPRO was to ‘prevent the rise of a messiah’ who could ‘unify, and electrify, the militant black nationalist movement’. This insight is important as it reveals how those outside of black life (FBI) would (...) invoke biblical language to define the possibility of revolution. This article through Black liberation theology seeks to present the idea of messianism as both an experience of Africans and oppressed peoples in the Global North and Global South. The idea of messianism is part of biblical reception in Africa and the African experience of colonialism. In South Africa, messianism would be observed from the perspective of African Christianity, while another form of messianism would be seen from Nat The Prophet Turner as well as the radical identity of Christ in Black liberation theology. The article will not take lightly the idea of surveillance of black militant groups in the same way as the priestly class surveillance Christ ministry. At the same time, the article would reflect on why lunacy is associated with those that seek to subvert oppression. This article seeks to discuss the role of messianism and militancy in Black or African Christianity and highlighting biblical reception and African affectivity. Contribution: This article explores the imaginative ways the Bible or its themes have been used by both the oppressor and the oppressed, often the latter using the Bible for its prerogative, namely, revolution and liberation. (shrink)

BackgroundHealth behavior change is among the top recommendations for improving health of patients with lifestyle-related chronic diseases. An array of behavior change techniques have been developed to support behavior change initiation and maintenance. These BCTs often show limited success when they are not informed by theory, leading to a mismatch between the intention of the BCT and patients’ needs or expectations. Previous studies have identified a number of resources which patients may require to initiate and maintain health behavior change. Indeed, (...) not yet well established is how BCTs address these resources, i.e., the functional mechanisms of BCTs.PurposeProvide a theoretical framework of the functional mechanisms of BCTs for developing and implementing successful interventions for health behavior change.MethodsConceptual review, including literature analysis and synthesis as well as conceptualization of a new model based on the synthesis.ResultsThrough the integration of dual-process models as well as reward and motivation proceeding, i.e., affective, emotional, or intuitive neurobiological cues, into the rational framework of rather linear cognitive or task-related decision progress, we categorize previously identified resources into three distinct sets: external, internal reflective, and internal affective resources. Based on this triad, we classify BCTs according to their functional mechanisms into facilitating, boosting, and nudging. Consequently, we present a simplified Behavior Change Resource Model that is centered on patients’ resources.ConclusionThe model can be applied to develop health behavior change interventions, which promote engagement and empowerment. Future studies should aim at testing the applicability and practicality of the BCRM. (shrink)

The idea of a role in nursing that includes expertise in ethics has been around for more than 30 years. Whether or not one subscribes to the idea that nursing ethics is separate and distinct from bioethics, nursing practice has much to contribute to the ethical practice of healthcare, and with the strong grounding in ethics and aspiration for social justice considerations in nursing, there is no wonder that the specific role of the nurse ethicist has emerged. Nurse ethicists, expert (...) in nursing practice and the application of ethical theories and concepts, are well positioned to guide nurses through complex ethical challenges. However, there is limited discussion within the field regarding the specific job responsibilities that the nurse ethicist ought to have. The recent appearance of job postings with the title “nurse ethicist” suggest that some healthcare institutions have identified the value of a nurse in the practice of ethics and are actively recruiting. Discomfort about the possibility of others defining the role of the nurse ethicist inspired this paper (and special issue). If the nurse ethicist is to be seen as an integral part of addressing ethical dilemmas and ethical conflicts that arise in healthcare, then nurse ethicists ought to be at the forefront of defining this role. In this paper, we draw upon our own experiences as nurse ethicists in large academic healthcare systems to describe the essential elements that ought to be addressed in a job description for a nurse ethicist practicing in a clinical setting linked to academic programs. Drawing upon our experience and the literature, we describe how we perceive the nurse ethicist adds value to healthcare organizations and teams of professional ethicists. (shrink)

In this paper, I will argue that a number of Hume’s claims generate a putative inconsistency with regard to complex ideas and independent existence. I first provide a prima facie argument for the existence of this inconsistency. Then, I examine a number of attempts to rescue Hume from this problem, and argue that each of them fails, before proposing my own solution.

In this article, I analyze survey data from more than 1,000 financial services employees to understand how gender inequality manifests itself in employees' informal networks. I found that even when Black and white women had jobs in which they controlled organizational resources and had ties to powerful employees, they received less work-related help from their network members than did white men. Drawing on status characteristics theory, I explain that network members were less likely to invest in women than in white (...) men because of cultural beliefs that rank women below that of white men. While past research has documented how employers use gender to rank workers and distribute rewards unequally, my research indicates that workers use gender to categorize and rank their network members as well. (shrink)

Sacred Harp singers the world over gather weekly to sing out ofThe Sacred Harp, a collection of shape-note songs first published in 1844. Their tradition is highly ritualized, and it plays an important role in the lives of many participants. Following the implementation of lockdown protocols to combat the COVID-19 pandemic, groups of Sacred Harp singers quickly and independently devised a variety of means by which to sing together online using Zoom, Jamulus, and Facebook Live. The rapidity and creativity with (...) which Sacred Harp singers developed ways to sustain their activities attests to the strength and significance of this community of practice, and in this article I describe each modality and provide an account of how it came to be developed and widely used. As a participant-observer, I completed extensive fieldwork across these digital sites and conducted semi-structured interviews with 22 other singers. I found that online singing practices have reshaped the Sacred Harp community. Many singers who did not previously have the opportunity to participate now have access, while others have lost access due to technological barriers or lack of interest in online activities. At the same time, geographical barriers have disintegrated, and singing organizers must make an effort to maintain local identity. A stable community of singers has emerged in the digital realm, but it is by no means identical to the community that predated the pandemic. I also identify the ways in which online singing has proven meaningful to participants by providing continuity in their personal and communal practice. Specifically, online singing allows participants to access and celebrate their collective memories of the Sacred Harp community, carry out significant rituals, and continue to grow as singers. While no single modality replicates the complete Sacred Harp singing experience, together they function “like pieces in a puzzle”, allowing individual participants to access many of the elements of Sacred Harp singing that are most meaningful to them. (shrink)

This study examined cancer patients’ perceived emotional and informational support from a variety of interpersonal and media sources. We recruited patients from cancer patient association websites and online cancer forums and asked them to report to what extent they received support from interpersonal and media sources. Patients rated professional sources and personal sources as nearly equal sources of emotional support; however, professional sources were rated as significantly greater sources of informational support. Although family and oncologists were the most mentioned interpersonal (...) sources of support, they were also the most mentioned disappointing sources. Of the media sources, online interaction sources were rated as nearly equivalent sources of emotional support as interpersonal sources. That patients perceived emotional support, not only informational support, from various media sources is promising since interpersonal sources can be disappointing to some patients. (shrink)

In this article, I build on my recent conceptions of law as poetry and of justice as dance by articulating three new conceptions of the relationship between law and justice. In the first, “poetry-based justice”, justice consists of a rigid choreography to a kind of musical recitation of the law’s poetry. In the second, “dancing-based law”, justice consists of spontaneous, freely improvised movement patterns that the poetry of the law tries to capture in a kind of musical notation. And in (...) the third, “reciprocal-legal justice”, justice and law consist of a reciprocally determining artistic collaboration between the democratic dancing masses and the aristocratic poetising elites. Given that each of these predominates in one of three types of community, I then present a reclassification of right-leaning, centrist and leftist societies as dominated by “literalist”, “kinetic” and “mutualist” communities (respectively), and offer suggestions for legislators and activists working in each type. In conclusion, law and justice, qua poetry and dance, become more flexible, inclusive and open to creative improvising and collaboration, a new form that I name, after Astraea, Greek goddess of divine justice, “astral legal justice”. (shrink)

Tüm dünyayı etkisi altına alan koronavirüs pandemisinin siyasi tutumlarla ilişkisini öğrenmek ve siyasetin kriz durumlarında halkın tutum ve davranışlarını yönlendirip yönlendirmediğini öğrenmek amacıyla 767 kişiyle çevrimiçi anket yapılmıştır. Yapılan nicel araştırma sonucunda, alınan önleyici tedbirlere uymanın, bu tedbirlerin yerinde oluşuna/haklılığına olan tutumun, aşı olma niyetinin ve aşının koruyuculuğuna olan inancın siyasi görüşlere göre farklılaştığı bulunmuştur. Ayrıca katılımcıların yapılan Covid-19 açıklamaları bakımından siyasi partilerine, parti temsilcilerinden daha çok güvendikleri, alınan önlem ve tedbirleri kısmen yerinde/haklı buldukları ve çok büyük çoğunluğun bu önlemlere (...) uyduğu görülmüştür. Araştırma sonucunda virüsün kökenine yönelik inançlar bakımından virüsün gerçek olduğuna inanıldığı, ortaya çıkış nedeni bakımından ise ülkelerin ekonomilerini kötüleştirmek ve dünya nüfusunu azaltmak için ortaya çıktığına inanıldığı görülmüştür. Araştırmadan çıkan bir başka sonuç ise katılımcıların televizyon, dergi ve gazetelerin ideolojik nedenlerle ve siyasi yanlılıklarına bağlı olarak virüs haberlerini halka farklı yansıttığını düşündükleridir. Sosyal medyadaki haberlerin ise yanıltıcı, yanlış olduğu görüşündelerdir. Bu çalışma sonucunda salgın hastalık, afet, savaş, ekonomik krizler gibi olağanüstü durumlarda siyasetin, siyasi görüşlerin dikkate alınmasının hem krizin üstesinden gelmede hem de toplumun tüm üyelerini kapsamada önemli bir rol oynayacağı vurgulanmaktadır. (shrink)

Comparative risk assessment is playing an ever-increasing role in environmental policy priority setting, as manifested in national and numerous subnational comparative risk projects. It is widely accepted that public values, interests, and concerns should play an important role in CRA. However, the philosophical basis for public involvement in CRA has not been adequately explored, nor have comparative risk projects always made explicit their rationales for public involvement. The author examines the political, normative, and epistemic rationales for public involvement and explores (...) the case for public involvement in the making of ethical, valuation, and evidentiary judgments. The author considers key issues each rationale raises, problems eachfaces, and some of the implications of each for specific aspects of CRA. (shrink)

Ethical climate (EC) has been broadly described as how well institutions respond to ethical issues. Developing a tool to study and evaluate EC that aims to achieve sustained improvements requires a contemporary framework with identified relevant drivers. An extensive literature review was performed, reviewing existing EC definitions, tools and areas where EC has been studied; ethical challenges and relevance of EC in contemporary paediatric intensive care (PIC); and relevant ethical theories. We surmised that existing EC definitions and tools designed to (...) measure it fail to capture nuances of the PIC environment, and sought to address existing gaps by developing an EC framework for PIC founded on ethical theory. In this article, we propose a Paediatric Intensive Care Ethical Climate (PICEC) conceptual framework and four measurable domains to be captured by an assessment tool. We define PICEC as the collective felt experience of interdisciplinary team members arising from those factors that enable or constrain their ability to navigate ethical aspects of their work. PICEC both results from and is influenced by how well ethical issues are understood, identified, explored, reflected on, responded to and addressed in the workplace. PICEC encompasses four, core inter-related domains representing drivers of EC including: (1) organisational culture and leadership; (2) interdisciplinary team relationships and dynamics; (3) integrated child and family-centred care; and (4) ethics literacy. Future directions involve developing a PICEC measurement tool, with implications for benchmarking as well as guidance for, and evaluation of, targeted interventions to foster a healthy EC. (shrink)

Epistemic structuralism, the idea that social structures have an immense influence on our inquiries and epistemic behavior, presents a unique challenge to the emerging field of vice epistemology. The most extreme application of this challenge results in the rejection of vice explanations in favor of structural explanations for epistemic behavior. Some vice epistemologists have expressed the intuitive idea that vice explanations and structural explanations may be synthesized, but the exact details of such a synthesis have yet to be adequately examined. (...) This paper starts by trying to gain clarity about structuralism and structuralist explanations in epistemology, then it discusses how a well-developed vice-structural explanation can be done. I end this paper by briefly noting a few crucial issues that demand further investigation. (shrink)

This article challenges a reductive analysis of social practices by distinguishing five kinds of reason for following the rules of conventional practices. Depending on one’s preferred intellectual tradition, conventional practices enable coordination, facilitate cooperation, constitute activities, fulfil reciprocity, or specify abstract rights. Instead of being rival theories of social practices, these different models complement one another in a normative analysis of social practices. By distinguishing five kinds of reasons to follow conventional rules, this paper supports a more dynamic conventionalist analysis (...) of subjects like property, the law, professional obligation, civic responsibility, and culture. (shrink)

That which constitutes a ‘good death’, or dying well, has long been of interest to philosophers and clinicians alike. While difficult to define due to its deeply personal nature and dependency on spiritual and cultural beliefs and past experiences, Wilkinson1 has drawn parallels from art and music to consider key ethical components. Few in clinical practice would dispute that a ‘good death’ is one that does not rob the person of a valuable life, is aligned with the preferences of the (...) patient and/or their family, where comfort and solace is provided, distress to family and caregivers is minimised or even that dying is not prolonged. However, what is more contentious is how tensions within the principles of a ‘good death’ should be managed or prioritised. In the context of caring for critically ill babies and children, the tension often takes the form of prolonging the dying process through providing life-sustaining interventions to meet the needs of, and to lessen the longer term distress of, the bereaved family, who must live with the decisions that are made. Though often justifiable, such interventions may result in considerable moral distress within caregivers—particularly, as often the case, when interventions are perceived by some clinicians to be of greater benefit to the family than the patient. Some clinicians may have difficulty …. (shrink)

The author presents reasons for thinking that the evil we observe in the world is not even prima facie evidence against the existence of God.

In lieu of an abstract, here is a brief excerpt of the content:The Little Way:Ferdinand Ulrich on AccidentsRachel M. ColemanWe live in a material reality. Obviously it is not the case that we live in a merely material reality, but it is worth remembering that we are corporeal substances given to be in a corporeal reality. Our materiality informs every aspect of our being, everything about us—including how we come to know.The German philosopher Ferdinand Ulrich never forgets this about the (...) human being or the reality in which the human is given to be—indeed, Ulrich, like his intellectual mentor and constant dialogue partner Thomas Aquinas, is a realist. That is to say that, like Thomas, Ulrich is always thinking about the world as it is given to man to inhabit and understand. This then includes thinking about matter, which, because of its status as lowest rung on the ladder of creation, is often overlooked in our thinking. Our materiality, with all of its implications for man, the world, and the task of man that is philosophy—that is, thinking and knowing being itself—is a touchstone for Ulrich's metaphysics and indeed all of his work.1Ulrich's dense and textured metaphysics can be approached in many ways, but perhaps none is so crucial as his attention to the small and seemingly insignificant, which is why he gives so much time and attention to matter throughout his corpus—for what could be more insignificant than that which does not exist in itself? Ulrich's attention to matter, however, is not simply in the speculative mode, wondering about the nature of potentia pura (though this is also included), but rather this kind of speculation leads [End Page 377] Ulrich to thinking through the implications of materiality for man's being and knowing. One of these is what Ulrich refers to repeatedly throughout Homo Abyssus, his great work of metaphysics and meta-anthropology, as "the little way." In the first chapter of that book, Ulrich writes:The light of being, since it doesn't cling to itself or allow reason to come to an end "next to" God, is therefore precisely what compels speculative reason to transcend beings into the absolute ground. This act of transcendence enraptures reason, which has been illuminated by being, elevating reason into the light of absolute truth, while reason precisely thereby enters onto the "little way" in the multiplicity of finite being.2According to Ulrich, in order to know and understand being itself, or "absolute truth," as quoted just above, human reason must enter onto this "little way," which can be reached only "in the multiplicity of finite being."The materiality of the world and the multiplicity of finite being therein have everything to do with each other, and Ulrich claims that, in order to know and understand absolute truth or being itself, precisely this multiplicity must be our starting point. Already then, at the beginning of Homo Abyssus, Ulrich draws our attention to the significance of matter.Ulrich receives this phrase, "the little way," from none other than St. Thérèse of Lisieux, who, in accepting her littleness, so to speak, not as a burden but as a gift, was given to work great acts.3 We have a clue already, [End Page 378] then, for beginning to understand how Ulrich conceives of matter and multiplicity: as that which, though nothing in itself, allows us to know the greatest truths—indeed, the "absolute truth." [End Page 379]Here we cannot explore every aspect of what Ulrich means when he uses the phrase "the little way," nor can we outline the entirety of how Ulrich's thinking about matter and materiality informs his metaphysics.4 We can, however, approach this topic in Ulrich's thinking through one particular implication of material being: accidents, or accidental being. Accidents do not subsist in themselves, but rather only in another—that is, substance—and as such, according to Ulrich, often get passed over in our thinking in favor of what we think of as more important subjects. And yet, in a certain sense, accidents are all we ever encounter in the world: while the tree could theoretically be any color at all, it... (shrink)

Paternalist policies in public health often aim to improve people’s well-being by reducing their options, regulating smoking offering a prime example. The well-being challenge is to show that people really are better off for having their options reduced. The distribution challenge is to show how the policies are justified since they produce losers as well as winners. If we start from these challenges, we can understand the importance of the empirical evidence that a very high proportion of smokers regret smoking. (...) In short, it is important that they regret it and important that the proportion is so high. This paper explains how, philosophically, regret can relate to well-being and it considers some of the strengths and weakness in the empirical research that the explanation brings out. The regret case for regulating smoking is indeed strong, although not as strong as the empirical researchers think. It is much weaker for paternalistic intervention in other public health problems, such as obesity and binge drinking. (shrink)