Book reviewed in this article: Long Term Care: Principles, Programs and Policies. By Rosalie A. Kane and Robert L. Kane. Long Term Health Care: providing a Spectrum of Services to the Aged. By Philip W. Brickner, Anthony J. Lechich, Roberta Lipsman, and Linda K. scharer.

Book reviewed in this article: Long Term Care: Principles, Programs and Policies. By Rosalie A. Kane and Robert L. Kane. Long Term Health Care: providing a Spectrum of Services to the Aged. By Philip W. Brickner, Anthony J. Lechich, Roberta Lipsman, and Linda K. scharer.

In a recent article, Director makes the case that many individuals with bipolar disorder have the capacity to consent to many decisions while acutely manic, even when those decisions are out of character and cause harm. Referring to recent qualitative evidence, I argue that Director overlooks a key mechanism of manic incapacity, an inflexible experience of the future that impairs one’s ability to value. Without attention to the illness-specific experience of decision-making, capacity assessments risk false negatives in people with mania.

Ronit Stahl and Ezekiel Emanuel have recently issued a stark challenge to conscience protections in medical law and ethics. Their argument is flawed, however. They misrepresent the nature and relevance of conscientious protection in the military, misinterpret the scope of consent tendered by modern medical professionals, and offer no reason to think either that conscientious objection harms patient well-being or that such harm should solely determine the permissibility of conscientious objection. Moreover, and most fundamentally, Stahl and Emanuel do not recognize (...) that conscience protections promote moral integrity, a basic aspect of human well-being that justifies protective action. (shrink)

Many important decisions depend on unknown states of the world. Society is increasingly relying on statistical predictive models to make decisions in these cases. While predictive models are useful, previous research has documented that (a) individual decision makers distrust models and (b) people’s predictions are often worse than those of models. These findings indicate a lack of awareness of how to evaluate predictions generally. This includes concepts like the loss function used to aggregate errors or whether error is training error (...) or generalisation error. To address this gap, we present three studies testing how lay people visually evaluate the predictive accuracy of models. We found that (a) participant judgements of prediction errors were more similar to absolute error than squared error (Study 1), (b) we did not detect a difference in participant reactions to training error versus generalisation error (Study 2), and (c) participants rated complex models as more accurate when comparing two models, but rated simple models as more accurate when shown single models in isolation (Study 3). When communicating about models, researchers should be aware that the public’s visual evaluation of models may disagree with their method of measuring errors and that many may fail to recognise overfitting. (shrink)

Most jurisdictions require that a mental capacity assessment be conducted using a functional model whose definition includes several abilities. In England and Wales and in increasing number of countries, the law requires a person be able to understand, to retain, to use or weigh relevant information and to communicate one’s decision. But interpreting and applying broad and vague criteria, such as the ability ‘to use or weigh’ to a diverse range of presentations is challenging. By examining actual court judgements of (...) capacity, we previously developed a descriptive typology of justifications used in the application of the Mental Capacity Act criteria. We here critically optimise this typology by showing how clear definitions—and thus boundaries—between the criteria can be achieved if the ‘understanding’ criterion is used narrowly and the multiple rationales that fall under the ability to ‘use or weigh’ are specifically enumerated in practice. Such a typology-aided practice, in theory, could make functional capacity assessments more transparent, accountable, reliable and valid. It may also help to create targeted supports for decision making by the vulnerable. We also discuss how the typology could evolve legally and scientifically, and how it lays the groundwork for clinical research on the abilities enumerated by the MCA. No data are available. This paper does not report any original data. (shrink)

Research using mHealth apps has the potential to positively impact health care management and outcomes. However, choosing an appropriate mHealth app may be challenging for the health researcher. The author team used existing evaluation tools, checklists, and guidelines to assess selected mHealth apps to identify strengths, challenges, and potential gaps within existing evaluation tools. They identified specific evaluation tool components, questions, and items most effective in examining app content, usability, and features, including literacy demand and cultural appropriateness; technical information; practical (...) aspects of app functionality; and evolving capabilities of mobile medical apps. Challenges included the subjective nature of the results, time required to complete the evaluation, lack of emphasis on evidence‐based content, and inadequate tool flexibility. Health researchers considering the integration of mobile apps into research will benefit from evaluation tools that assess both evidence‐based content and the ability of the mobile app to securely integrate with other digital technologies involved in patient care. Next steps will include the involvement of health care providers and professionals, including nurses a wide range of expertise, to develop an mHealth evaluation tool that focuses on identifying quality, evidence‐based mobile apps into patient outcomes research. (shrink)

Background:The concept of conscientious objection is well described; however, because of its nature, little is known about real experiences of nursing professionals who apply objections in their practice. Extended roles in nursing indicate that clinical and value-based dilemmas are becoming increasingly common. In addition, the migration trends of the nursing workforce have increased the need for the mutual understanding of culturally based assumptions on aspects of health care delivery.Aim:To present (a) the arguments for and against conscientious objection in nursing practice, (...) (b) a description of current regulations and practice regarding conscientious objection in nursing in Poland and the United Kingdom, and (c) to offer a balanced view regarding the application of conscientious objection in clinical nursing practice.Design:Discussion paper.Ethical considerations:Ethical guidelines has been followed at each stage of this study.Findings:Strong arguments exist both for and against conscientious objection in nursing which are underpinned by empirical research from across Europe. Arguments against conscientious objection relate less to it as a concept, but rather in regard to organisational aspects of its application and different mechanisms which could be introduced in order to reach the balance between professional and patient’s rights.Discussion and conclusion:Debate regarding conscientious objection is vivid, and there is consensus that the right to objection among nurses is an important, acknowledged part of nursing practice. Regulation in the United Kingdom is limited to reproductive health, while in Poland, there are no specific procedures to which nurses can apply an objection. The same obligations of those who express conscientious objection apply in both countries, including the requirement to share information with a line manager, the patient, documentation of the objection and necessity to indicate the possibility of receiving care from other nurses. Using Poland and the United Kingdom as case study countries, this article offers a balanced view regarding the application of conscientious objection in clinical nursing practice. (shrink)

Despite the fact that the requirement to obtain informed consent for medical procedures is deeply enshrined in both U.S. moral and legal doctrine, empirical studies and anecdotal accounts show that women's rights to informed consent and refusal of treatment are routinely undermined and ignored during childbirth. For example, citing the most recent Listening to Mothers survey, Marianne Nieuwenhuijze and Lisa Kane Low state that "a significant number of women said they felt pressure from a caregiver to agree to having (...) an intervention that they did not want during birth". Specifically, Nieuwenhuijze and Low cite that "19% of women who did not have epidural analgesia felt... (shrink)

This chapter talks about the first season of the TV series Veronica Mars. Additionally, the chapter explores the significance of Veronica Mars's photography. Veronica has found her life irrevocably altered in multiple ways. Her best friend, Lilly Kane, was murdered, her father, Keith Mars, lost his job as sheriff as the result of an apparently bungled investigation into Lilly's death, and Veronica lost her social status and former friends. Subsequently her mother, Lianne Mars, left home, apparently unable to deal (...) with the stress of it all. In addition to all this misfortune, Veronica, had attended a party at which she was drugged and then raped. She states in a voiceover, that she is a marshmallow, ironically though. But at the end of the season she has broken through to a new self‐understanding, which is illustrated in the final scene. (shrink)

This is an extremely lucid analysis of free will, the relativity of values, and the relationship between them, based on the “dignity of the individual … because one is the ultimate originator of one’s own ends”. It is an analysis which avoids “mystery at all costs … [and] … appeals to mysterious forms of agency”. Kane’s theory neither requires nor rules out mind/body dualism, the appeal to noumenal selves, or other nonoccurrent causes.

Positions taken in the current debate over free will can be seen as responses to the following conditional: -/- If every action is caused solely by another event and a cause necessitates its effect, then there is no action to which there is an alternative (C). -/- The Libertarian, who believes that alternatives are a requirement of free will, responds by denying the right conjunct of C’s antecedent, maintaining that some actions are caused, either mediately or immediately, by events whose (...) effects could be different, even if they were to recur under identical circumstances. We have here a denial of Laplacian Determinism (LD), according to which the condition of the world at any instant makes only one state possible at any other instant. One prominent defender of this view, Robert Kane, holds that unless an agent’s neural mechanisms operated indeterministicly in forming her character she is not responsible for its manifestations. This requirement is entailed by the principle of “ultimate responsibility” (UR) according to which an act is freely willed only if (a) its agent is personally responsible for its performance in the sense of having caused it to occur by voluntarily doing something that was avoidable and (b) there is no sufficient condition for its performance for which its agent is not personally responsible. The orthodox Compatibilist, adducing counterexamples to UR, argues that even if C and its antecedent are true, free will is possible. Ned Markosian has provided the Compatibilist with yet another response to UR-based objections to her view, wedding it to the notion of agent causation: here the deterministic causing of an act by its agent is necessary and sufficient for its being “morally free.” I criticize this view as inconsistent with the agent causalist's belief that moral responsibility precludes causation of a choice by any power other than the maker thereof: he being its efficient cause. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Free Will’s Value: Criminal Justice, Pride, and Love by John LemosJohn DavenportLEMOS, John. Free Will’s Value: Criminal Justice, Pride, and Love. New York: Routledge, 2023. 284 pp. Cloth, $160.00It is a pleasure to read John Lemos’s latest work on moral free will, understood as the control needed for us to be morally responsible in “the just deserts sense.” Lemos is a clear writer who carefully lays out the (...) positions that he reviews and critiques. This book would be wonderful as a main text in a graduate seminar: The first six chapters critically address most of the main theories and moves in this wide field during the last twenty to twenty-five years, providing a very helpful overview while setting up Lemos’s own position. He advances an “indeterministic weightings” version of leeway-libertarianism about moral freedom that builds on both Robert Kane’s event-causal account and Robert Nozick’s older account of fixing the weight of practical considerations in the moment of choice. Lemos’s new account significantly refines the position that he defended against hard incompatiblism in his 2018 book. [End Page 721]Free Will’s Value also discusses responsibility in applied contexts, such as criminal justice and loving relationships. There are two chapters arguing that hard incompatibilists cannot save the “just deserts” aspect of criminal punishment or explain all the wrongness of taking the liberty of innocent persons mistakenly convicted. Their “public health quarantine” account of criminal justice will be utilitarian, and thus have a hard time justifying the beyond-reasonable-doubt standard for conviction. And, building on the critiques of compatibilism that he develops partly from Derk Pereboom and Bruce Waller, Lemos includes three chapters arguing that “axiological/pragmatist reasons” provide more evidence for libertarian free will than psychological evidence alone can.The final chapter in particular offers a novel argument that valuable sorts of interhuman loves need to involve self- or character-forming initiatives that are not primarily determined by factors beyond our control. The intrinsic value of some types of love, such as deep friendships—including romantic friendships—involve their being autonomous (my term), which in turn requires a kind of leeway-control. This involves arguing that “our will, effort, or a decision to love” is important to values achieved in sustaining loving relationships.Lemos’s own theory contends that Kane’s account of “self-forming actions” (SFAs) and “willings” (SFWs) in terms of dual “tryings” (or decisions) to do A or B in a fraught situation suffers from the “phenomenological problem” stated by Laura Ekstrom and Marc Balaguer, namely, that we do not normally experience fraught choices as involving such opposed tryings. This is even more evident, I believe, if we consider choices involving three or more salient options. Lemos is not convinced by Kane’s reply that the dual or multiple simultaneous efforts are usually unconscious, because he thinks responsibility for unconscious mental processes will (normally) trace to patterns of conscious choices made earlier in life. In fact, unconscious efforts, Lemos says, cannot meet even “plausible minimal compatibilist standards of responsibility” for elements of agency.I’m not convinced by this last claim, because it seems that an unconscious choice, C, could be responsive to (or counterfactually guided by) reasons relevant to C that the agent has considered in the past. Perhaps the problem is that “trying” is normally associated with attempting to act on an intention, but Kane uses it to describe the more elusive processes of agency involved in forming an intention via decision in the face of competing relevant options, which thereby incorporates motives into the intention. This sheds light on the further problem that it appears irrational to try to do multiple incompatible things at once. Pace Lemos, I think that Kane is right that “will-settling” is a special context in which it is not irrational for a single person’s agency to be engaged along dual pathways. Even if we do not call this “trying,” the agent’s interactions with the salient options are not like those of a detached spectator; they are volitional as well as evaluative. [End Page 722]Lemos’s account recognizes three loci... (shrink)

This article articulates and defends an indeterministic weightings model of libertarian free will. It begins by defining the conception of free will at issue and then goes on to present versions of the luck objection which is often made against theories of LFW. It is argued that the sort of indeterministic weightings model of LFW which has been defended in the recent literature by Storrs McCall and E.J. Lowe and John Lemos has the resources to answer such luck objections while (...) possessing virtues which some other libertarian views lack. According to the indeterministic weightings model of LFW, in making undetermined free-willed choices between two courses of action, A or B, the reasons for choosing each option don’t come with pre-established evaluative weights. During the process of deliberation, the agent assigns weight in an undetermined way to the reasons for each option and this typically leads to the choice of the option that has been assigned a greater value. In the paper, it is not only argued that this theory can resolve worries about luck but also that the view has virtues which certain other libertarian views lack, as such the view is contrasted with the modest libertarian models of LFW from Daniel Dennett and Alfred Mele as well as Robert Kane’s view. (shrink)

The present author developed a calculus for the logic of ‘because’. In a recent paper in this journal, it has been claimed that the central inference rules for the logic are invalid and that the intuition upon which the rules are based is not accounted for. This note criticises these arguments and presents an independent argument in favour of the rules used in the logic.

Positions taken in the current debate over free will can be seen as responses to the following conditional: If every action is caused solely by another event and a cause necessitates its effect, then there is no action to which there is an alternative. The Libertarian, who believes that alternatives are a requirement of free will, responds by denying the right conjunct of C’s antecedent, maintaining that some actions are caused, either mediately or immediately, by events whose effects could be (...) different, even if they were to recur under identical circumstances. We have here a denial of Laplacian Determinism (LD), according to which the condition of the world at any instant makes only one state possible at any other instant.¹ One prominent defender of this view, Robert Kane, holds that unless an agent’s neural mechanisms operated indeterministicly in forming her character she is not responsible for its manifestations.² This requirement is entailed by the principle of “ultimate responsibility” (UR) according to which an act is freely willed only if (a) its agent is personally responsible for its performance in the sense of having caused it to occur by voluntarily doing something that was avoidable and (b). (shrink)

I first adumbrate pertinent aspectsof Robert Kane''s libertarian theory of free choice oraction and an objection of luck that has been levelledagainst the theory. I then consider Kane''s recentresponses to this objection. To meet these responses,I argue that the view that undetermined choices (ofthe sort implied by Kane''s theory) are a matter ofluck is associated with a view about actionexplanation, to wit: when Jones does A and hisdoing of A is undetermined, and when hiscounterpart, Jones*, in the (...) nearest possibleworld in which the past and the laws are held constantuntil the moment of choice does B instead, thereis no explanation (deterministic or indeterministic)of the difference in outcome – Jones''s A-ing butJones*''s B-ing – in terms of prior reasonsor motives of either agent. Absence of such anexplanation is one crucial factor that underliesthe charge that Jones''s A-ing and Jones*''sB-ing are matters of luck. I argue that thissort of luck is incompatible with responsibility. (shrink)

Free will and determinism have recently attracted the attention of Buddhist scholars who have defended conflicting views on this issue. I argue that there is no reason to think that this problem cannot arise in Buddhist philosophy, since there are two senses of ‘free will’ that are compatible with the doctrine of non-self. I propose a reconstruction of a problem of free will and determinism in Early Buddhism, given a) the assumption that Buddhist causation entails universal causal determinism, and b) (...) a crucial passage suggesting that Early Buddhism is committed to the principle of alternative possibilities which is arguably incompatible with a determinist interpretation of causation. This passage suggests that Early Buddhism must leave room for a robust, incompatibilist form of free will, and that a conception of indeterminist free will in the spirit of Robert Kane’s theory allows us to make sense of that notion. (shrink)

_The purpose_ of the article is to comprehend the Husserlian model of constituting temporal modes through the ability of intentional "retentional-protentional" consciousness, as well as to clarify the possibility of interpreting its positions in the reconstruction of the concept of anthropic time. _Theoretical basis._ The theoretical framework of the research includes: 1) the interpretation of the phenomenological reflection of "time-consciousness" by E. Husserl in the context of solving the problem of phased-differentiation of this form of temporality; 2) the concept of (...) anthropic time (V. Khanzhy). _Originality._ For the first time in research literature, the possibilities of applying the ideas of Husserl to the reconstruction of the concept of anthropic time are considered through the interpretation of the phenomenological solution to the problem of temporality, proposed and specified in Husserl’s "time-consciousness" concept. _Conclusions._ The comprehension of the Husserlian model of intentionality of consciousness through the "grasping-from-now" and the constitution of phases of phenomenological time through the component of "exiting-from-now" showed that solving the problem of phased-differentiation of phenomenological time leads to the observation of the impossibility of isolating the modes of past, present, and future as self-sufficient and unconditional. More accurate indications, based on the constitutive intentionality of consciousness on the "grasping-from-now" phases of time (as conventional), are as follows: a) the abilities of retention and recollection are the foundation for the constitution of the past and its connections to the present; b) the perception establishes the basis for the phase of the present itself; c) the possibilities of protention and anticipation (as forms of imagination) constitute the future and its connections to the present. By the concept of retention, Husserl fixes a certain primary memory (the present "now" of a past interval), which enables retaining the past in the present. The category of recollection or secondary memory is used by the philosopher to refer to the self-sufficient reproduction of past experiences (without being joined to present perception). The fundamental difference between recollection and retention is that the former _re-_presents a temporal interval, grasping its content and reproducing it as it was in the past, while in the latter, the perceived duration is presented as a fragment of time that has just passed. According to the German philosopher, the "grasping" of the present phase is performed by perception. Through the constitutive intentionality of consciousness, perception synthesizes the results of primary-actual activity and retentional holding of duration. The second part of the article will present solutions to the following research tasks: 1) analysis of the possibilities of protention and anticipation in constituting the future and its connections with the present; 2) understanding the possibility of using interpreted forms of Husser’s ideas in reconstructing the concept of anthropic time. (shrink)

Joel Feinberg : In Memoriam. Preface. Part I: INTRODUCTION TO THE NATURE AND VALUE OF PHILOSOPHY. 1. Joel Feinberg: A Logic Lesson. 2. Plato: "Apology." 3. Bertrand Russell: The Value of Philosophy. PART II: REASON AND RELIGIOUS BELIEF. 1. The Existence and Nature of God. 1.1 Anselm of Canterbury: The Ontological Argument, from Proslogion. 1.2 Gaunilo of Marmoutiers: On Behalf of the Fool. 1.3 L. Rowe: The Ontological Argument. 1.4 Saint Thomas Aquinas: The Five Ways, from Summa Theologica. 1.5 Samuel (...) Clarke: A Modern Formulation of the Cosmological Argument. 1.6 William L. Rowe: The Cosmological Argument. 1.7 William Paley: The Argument from Design. 1.8 Michael Ruse: The Design Argument. 1.9 David Hume: Dialogues Concerning Natural Religion. 2. The Problem of Evil. 2.1 Fyodor Dostoyevsky: Rebellion. 2.2 J. L. Mackie: Evil and Omnipotence. 2.3 Peter van Inwagen: The Argument from Evil. 2.4 Michael Murray and Michael Rea: The Argument from Evil. 2.5 B. C. Johnson: God and the Problem of Evil. 3. Reason and Faith. 3.1 W. K. Clifford: The Ethics of Belief. 3.2 William James: The Will to Believe. 3.3 Kelly James Clark: Without Evidence or Argument. 3.4 Blaise Pascal: The Wager. 3.5 Lawrence Shapiro: Miracles and Justification. 3.6 Simon Blackburn: Infini-Rien. Part III. HUMAN KNOWLEDGE: ITS GROUNDS AND LIMITS. 1. Skepticism. 1.1 John Pollock: A Brain in a Vat. 1.2 Michael Huemer: Three Skeptical Arguments. 1.3 Robert Audi: Skepticism. 2. The Nature and Value of Knowledge. 2.1 Plato: Knowledge as Justified True Belief. 2.2 Edmund Gettier: Is Justified True Belief Knowledge? 2.3 James Cornman, Keith Lehrer, and George Pappas: An Analysis of Knowledge. 2.4 Gilbert Ryle: Knowing How and Knowing That. 2.5 Plato: "Meno". 2.6 Linda Zagzebski, Epistemic Good and The Good Life. 3. Our Knowledge of the External World. 3.1 Bertrand Russell: Appearance and Reality and the Existence of Matter. 3.2 René Descartes: Meditations on First Philosophy. 3.3 John Locke: The Causal Theory of Perception. 3.4 George Berkeley: Of the Principles of Human Knowledge. 3.5 G. E. Moore: Proof of an External World. 4. The Methods of Science. 4.1 David Hume: An Inquiry Concerning Human Understanding. 4.2 Wesley C. Salmon: An Encounter with David Hume. 4.3 Karl Popper: Science: Conjectures and Refutations. 4.4 Philip Kitcher: Believing Where We Cannot Prove. Part IV: MIND AND ITS PLACE IN NATURE. 1. The Mind-Body Problem. 1.1 Brie Gertler: In Defense of Mind--Body Dualism. 1.2 Frank Jackson: The Qualia Problem. 1.3 David Papineau: The Case for Materialism. 1.4 Paul Churchland: Functionalism and Eliminative Materialism. 2. Can Non-Humans Think? 2.1 Alan Turing: Computing Machinery and Intelligence. 2.2 John R. Searle: Minds, Brains, and Programs. 2.3 William G. Lycan: Robots and Minds. 3. Personal Identity and the Survival of Death. 3.1 John Locke: The Prince and the Cobbler. 3.2 Thomas Reid: Of Mr. Locke’s Account of Our Personal Identity. 3.3 David Hume: The Self. 3.4 Derek Parfit: Divided Minds and the Nature of Persons. 3.5 Shelly Kagan: What Matters. 3.6 John Perry: A Dialogue on Personal Identity and Immortality. Part V: DETERMINISM, FREE WILL, AND RESPONSIBILITY. 1. Libertarianism: The Case for Free Will and Its Incompatibility with Determinism. 1.1 Roderick M. Chisholm: Human Freedom and the Self. 1.2 Robert Kane: Free Will: Ancient Dispute, New Themes. 2. Hard Determinism: The Case for Determinism and its Incompatibility with Its Incompatibility with Any Important Sense of Free Will. 2.1 James Rachels: The case against Free Will. 2.2 Derk Pereboom: Why We Have No Free Will and Can Live Without It. 3. Compatibilism: The Case for Determinism and Its Compatibility with the Most Important Sense of Free Will. 3.1 David Hume: Of Liberty and Necessity. 3.2 Helen Beebee: Compatibilism and the Ability to do Otherwise. 4. Freedom and Moral Responsibility. 4.1 Galen Strawson: Luck Swallows Everything. 4.2 Harry Frankfurt: Alternate Possibilities and Moral Responsibility. 4.3 Thomas Nagel: Moral Luck. 4.4 Susan Wolf: Sanity and the Metaphysics of Responsibility. Part VI: MORALITY AND ITS CRITICS. 1. Changes to Morality. 1.1 Joel Feinberg: Psychological Egoism. 1.2 Plato: The Immoralist’s Challenge. 1.3 Friedrich Nietzche: Master and Slave Morality. 1.4 Richard Joyce: The Evolutionary Debunking of Morality. 2. Proposed Standards and Right of Conduct. 2.1 Russ Shafer-Landau: Ethical Subjectivism. 2.2 Mary Midgley: Trying Out One’s New Sword. 2.3 Aristotle: Virtue and the Good Life. 2.4 Thomas Hobbes: Leviathan. 2.5 Plato: Euthyphro. 2.6 Immanuel Kant: The Good Will and the Categorical Imperative. 2.7 J.S. Mill: Utilitarianism, Chapters 2 and 4. 2.8 W. D. Ross: What Makes Right Acts Right? 2.9 Hilde Lindemann: What Is Feminist Ethics? 3. Ethical Problems. 3.1 Kwame Anthony Appiah: What Will Future Generations Condemn Us For? 3.2 Peter Singer: Famine, Affluence and Morality. 3.3 John Harris: The Survival Lottery. 3.4 James Rachels: Active and Passive Euthanasia. 3.5 Mary Anne Warren: The Moral and Legal Status of Abortion. 3.6 Don Marquis: Why Abortion Is Immoral. 4. The Meaning of Life. 4.1 Epicurus: Letter to Menoeceus. 4.2 Richard Taylor: The Meaning of Life. 4.3 Richard Kraut: Desire and the Human Good. 4.4 Leo Tolstoy: My Confession. 4.5 Susan Wolf: Happiness and Meaning. 4.6 Thomas Nagel: The Absurd. (shrink)

Background At the beginning of the coronavirus (Covid-19) pandemic, many non-Covid healthcare services were suspended. In April 2020, the Department of Health in England mandated that non-Covid services should resume, alongside the continuing pandemic response. This ‘resetting’ of healthcare services created a unique context in which it became critical to consider how ethical considerations did (and should) underpin decisions about integrating infection control measures into routine healthcare practices. We draw on data collected as part of the ‘NHS Reset Ethics’ project, (...) which explored the everyday ethical challenges of resetting England’s NHS maternity and paediatrics services during the pandemic. Methods Healthcare professionals and members of the public participated in interviews and focus group discussions. The qualitative methods are reported in detail elsewhere. The focus of this article is our use of Frith’s symbiotic empirical ethics methodology to work from our empirical findings towards the normative suggestion that clinical ethics should explicitly attend to the importance of relationships in clinical practice. This methodology uses a five-step approach to refine and develop ethical theory based on a naturalist account of ethics that sees practice and theory as symbiotically related. Results The Reset project data showed that changed working practices caused ethical challenges for healthcare professionals, and that infection prevention and control measures represented harmful barriers to the experience of receiving and offering care. For healthcare professionals, offering care as part of a relational interaction was an ethically important dimension of healthcare delivery. Conclusions Our findings suggest that foregrounding the importance of relationships across a hospital community will better promote the ethically important multi-directional expression of caring between healthcare professionals, patients, and their families. We offer two suggestions for making progress towards such a relational approach. First, that there is a change of emphasis in clinical ethics practice to explicitly acknowledge the importance of the relationships (including with their healthcare team) within which the patient is held. Second, that organisational decision-making should take into account the moral significance afforded to caring relationships by healthcare professionals, and the role such relationships can play in the negotiation of ethical challenges. (shrink)

Do we remember what pain feels like? Investigations into this question have sometimes led to ambiguous or apparently contradictory results. Building on research on pain memory by Rohini Terry and colleagues, I argue that this lack of agreement may be due in part to the difficulty researchers face when trying to convey to their study's participants the type of memory they are being tasked with recalling. To address this difficulty, I introduce the concept of 'qualitative memory', which, arguably, is the (...) sort of memory we have of what red looks like yet lack with respect to pain. I also briefly address a number of consequences the acknowledgment of qualitative memory would potentially have for philosophy, arguing that if we fail to have qualitative memories of certain sensations, such as pain, the standard philosophical accounts of experience, rational choice, and the sources of moral action may all need revision. (shrink)

Despite being eminently forgettable from the literary point of view, B. F. Skinner’s novel, Walden Two , provides us with an excellent opportunity, not so much to show what is wrong with mainstream accounts of free will, as Robert Kane thinks, but rather to explore another key and importantly neglected condition for genuine agency; namely, that properly lived human lives are those that are and must continue to be vulnerable to unforseable reversals, as Aldous Huxley speculates in his Brave (...) New World . In short, I argue, perhaps scandalously, that one of the central conditions for genuine agency is that our lives are and must continue to be, to a large extent, out of our personal control. The promise of too much personal control, not too little (as Kane thinks), is what is wrong with Skinner’s social utopia. (shrink)

In the wake of the advent of genome editing technology CRISPR-Cas9 (clustered regularly interspaced palindromic repeat (CRISPR)-associated protein 9), there has been a global debate around the implications of manipulating the human genome. While CRISPR-based germline gene editing is new, the debate about the ethics of gene editing is not – for several decades now, scholars have debated the ethics of making heritable changes to the human genome. The arguments that have been raised both for and against the use of (...) genetic technologies in human reproduction reiterate much of the arguments made in the pre-CRISPR debate. As such, it is instructive for South Africa to reflect on these arguments now, in considering our position on the regulation of the use of this novel biotechnology. There are two dominant schools of thought in this area, bioliberalism and bioconservatism. Bioconservatives raise concerns about the risks of genetic manipulation, and argue that it ought to be limited or prohibited to avert these risks to human health and human nature. Bioliberal scholars are more open to the prospect of genetic manipulation, because of its potential utility. In this article, I conclude that in liberal democracies such as our own, bioliberal arguments ought to be seriously considered when formulating policy on human genome editing because of the extent to which they resonate with our Constitutional values and human rights. I further suggest that there is a need for an enquiry into the relevance of African perspectives on the ethical questions that arise concerning germline genome editing. (shrink)

Even though the digital church has been in existence for some time, it was mainly a transmission of onsite church services and programmes in the online space. The coronavirus disease 2019 (COVID-19) pandemic and its demands for a global shutdown to mitigate and contain the disease moved almost all social activities including church services to the online space. It is evident that persons with disability experience extreme exclusion from the church’s theology, praxes, and ethos. Unfortunately, this phenomenon is replicated in (...) the virtual space. Research proves that persons with disability were not considered in the migration of churches to the virtual space; hence, digital accessibility is minimal or non-existent during and after the COVID-19 era.Contribution: This article explores the various transformational stages of both the church and media while further exploring possible ways by which the virtual church may grant accessibility to persons with disability. (shrink)

Nurses have moral obligations incurred by membership in the profession to participate knowingly in health policy advocacy. Many barriers have historically hindered nurses from realizing their potential to advance health policy. The contemporary political context sets additional challenges to policy work due to polarization and conflict. Nursing education can help nurses recognize their role in advancing health through political advocacy in a manner that is consistent with disciplinary knowledge and ethical responsibilities. In this paper, the authors describe an exemplar of (...) Elizabeth Barrett's “Power as Knowing Participation in Change” theory as a disciplinary lens within a doctoral nursing health policy course. Barrett (radically) emphasizes “power as freedom” instead of “power as control.” This approach is congruent with nursing disciplinary values and enhances awareness of personal freedom and building collaborative relationships in the policy process. The theory was used in concert with other traditional policy content and frameworks from nursing and other disciplines. We discuss the role of nursing ethics viewed as professional responsibility for policy action, an overview of Barrett's theory, and the design of the course. Four student reflections on how the course influenced their thinking about policy advocacy are included. While not specific to policymaking, Barrett's theory provides a disciplinary grounding to increase students' awareness of freedom and choices in political advocacy participation. Our experience suggests that Barrett's work can be fruitful for enhancing nurses' awareness of choices to participate in change across settings. (shrink)

On September 1, 2023, Texas made important revisions to it its decades‐old statute granting legal safe harbor immunity to physicians who withhold or withdraw life‐sustaining treatment over the objection of critically ill patients’ surrogate decision‐makers. However, lawmakers left untouched glaring flaws in a key safeguard for patients—the transfer option. The transfer option is ethically important because, when no hospital is willing to accept the patient in transfer, that fact is taken as strong evidence that the surrogates’ treatment requests fall outside (...) accepted medical practice. But there are serious shortcomings in how the transfer option is carried out in Texas and many other states, which undermines the ethical usefulness of the process. We identify these shortcomings and recommend revisions to state statutes and professional guidelines to overcome them. (shrink)

Calling is a very important concept in Christianity. In the medieval era, calling was restricted to ecclesiastical work alone, a devotion to the life of contemplation. Ordinary work or physical labour was not considered qualified to be a calling. Martin Luther was the one who taught that the ordinary work of the ordinary people was also God’s calling and equally spiritual as the ecclesiastical work. However, Miroslav Volf, a Croatian theologian, criticised Luther that his view of calling was too static (...) and irrelevant to the modern context where people often choose to quit a job because of its negative effects and some people have to do multiple jobs in order to make ends meet. While recognising the validity of Volf’s critique, this article seeks to demonstrate that even in the modern context, calling is still a very important theological concept to reflect upon work. Luther’s vocational view of work could be retrieved in discussing the theology of work by putting it in dialogue with Calvin, Kuyper, and other theologians.Contribution: This article seeks to show that the concept of calling is indispensable in constructing a sound theology of work for the modern context. By understanding work as calling, Christian workers are enabled to see how they are participating in God’s redemptive work through their jobs. (shrink)

In general, Confucians have taken a dim view of the law. They have felt warranted in this view by a reading of Confucius’ Analects 2.3 in which the Master apparently disparages law-centered governance. Two great Confucian philosophers, however, Zhu Xi and Jeong Yakyong (widely known by his pen name, Dasan), view the role of law in society differently. Like all Confucians, they teach the cultivation of virtue, but alongside building social harmony through ritual and good character, these two philosophers perceive (...) that social order also requires the penal law. In this paper, I argue that Zhu Xi and Dasan, and Dasan in particular, follow the evidentiary lead of the classical Chinese philosopher Mozi to support their legal philosophy. Mozi offered three standards for establishing truth claims: empirical evidence from common life, authoritative evidence, and evidence of outcomes. Mozi’s empirical standard takes evidence of common life from what ordinary people have seen. Zhu Xi and Dasan take the evidence of common life, not from what the people have seen, but from common understandings contained in the written language. They use this approach to arrive at a different understanding of Analects 2.3 than other Confucians, one that relates the content of that passage to Analects 12.17. They interpret the passage on a philological basis that supports the presence of penal law from a perspective of ordinary life. For authoritative evidence, Zhu Xi and Dasan like Mozi appeal to the authority of the ancient sages, who register their support for penal law. Dasan also follows Mozi’s evidentiary lead in the evidence of outcomes by fully developing a consequential picture of how the absence of law detrimentally affects society. On this point, Dasan establishes a new and revolutionary legal outlook that differs from that of Zhu Xi. I show Dasan taking lessons from the classical Legalists to arrive at this position warranted by the evidence of outcomes. Having satisfied the three evidentiary standards, Dasan thus establishes the importance of the penal law from a Confucian perspective. (shrink)

Responsible innovation (RI), also termed Responsible Research and Innovation, has emerged due to increasing concern over how to integrate ethical and societal values into research and innovation policy and governance (Von Schomberg 2013), in response to questioning of the societal role of science as well as populist resurgence in some countries (Long and Blok 2017a). Within a RI approach, innovators must consider three dimensions of responsibility, including the dimensions of (1) ‘avoiding harm’ to people and the planet, (2) ‘doing good’ (...) through the offering of innovations that foster sustainable development, and (3) the development of facilitative global governance schemes (Voegtlin and Scherer 2017). (shrink)