This paper investigates the medical law and ethics learning needs of Foundation doctors by means of a national survey developed in association with key stakeholders including the General Medical Council and Health Education England. Four hundred sevnty-nine doctors completed the survey. The average self-reported level of preparation in MEL was 63%. When asked to rate how confident they felt in approaching three cases of increasing ethical complexity, more FYs were fully confident in the more complex cases than in the more (...) standard case. There was no apparent relationship with confidence and reported teaching at medical school. The less confident doctors were no more likely to ask for further teaching on the topic than the confident doctors. This suggests that FYs can be vulnerable when facing ethical decisions by being underprepared, not recognising their lack of ability to make a reasoned decision or by being overconfident. Educators need to be aware of this and provide practical MEL training based on trainee experiences and real-world ethics and challenge learners’ views. Given the complexities of many ethical decisions, preparedness should not be seen as the ability to make a difficult decision but rather a recognition that such cases are difficult, that doubt is permissible and the solution may well be beyond the relatively inexperienced doctor. Educators and supervisors should therefore be ensuring that this is clear to their trainees. This necessitates an environment in which questions can be asked and uncertainty raised with the expectation of a supportive response. (shrink)

Searches for the sources and means for a disciplined practical approach to exploring human experience.

Game theory is central to modern understandings of how people deal with problems of coordination and cooperation. Yet, ironically, it cannot give a straightforward explanation of some of the simplest forms of human coordination and cooperation--most famously, that people can use the apparently arbitrary features of "focal points" to solve coordination problems, and that people sometimes cooperate in "prisoner's dilemmas." Addressing a wide readership of economists, sociologists, psychologists, and philosophers, Michael Bacharach here proposes a revision of game theory that resolves (...) these long-standing problems. In the classical tradition of game theory, Bacharach models human beings as rational actors, but he revises the standard definition of rationality to incorporate two major new ideas. He enlarges the model of a game so that it includes the ways agents describe to themselves their decision problems. And he allows the possibility that people reason as members of groups, each taking herself to have reason to perform her component of the combination of actions that best achieves the group's common goal. Bacharach shows that certain tendencies for individuals to engage in team reasoning are consistent with recent findings in social psychology and evolutionary biology. As the culmination of Bacharach's long-standing program of pathbreaking work on the foundations of game theory, this book has been eagerly awaited. Following Bacharach's premature death, Natalie Gold and Robert Sugden edited the unfinished work and added two substantial chapters that allow the book to be read as a coherent whole. (shrink)

Drawing on recent findings in the cognitive and neurosciences, this article discusses how people manage to predict each other’s actions, which is fundamental for joint action. We explore how a common coding of perceived and performed actions may allow actors to predict the what, when, and where of others’ actions. The “what” aspect refers to predictions about the kind of action the other will perform and to the intention that drives the action. The “when” aspect is critical for all joint (...) actions requiring close temporal coordination. The “where” aspect is important for the online coordination of actions because actors need to effectively distribute a common space. We argue that although common coding of perceived and performed actions alone is not sufficient to enable one to engage in joint action, it provides a representational platform for integrating the actions of self and other. The final part of the paper considers links between lower‐level processes like action simulation and higher‐level processes like verbal communication and mental state attribution that have previously been at the focus of joint action research. (shrink)

There is a long-standing debate in philosophy about whether it is morally permissible to harm one person in order to prevent a greater harm to others and, if not, what is the moral principle underlying the prohibition. Hypothetical moral dilemmas are used in order to probe moral intuitions. Philosophers use them to achieve a reflective equilibrium between intuitions and principles, psychologists to investigate moral decision-making processes. In the dilemmas, the harms that are traded off are almost always deaths. However, the (...) moral principles and psychological processes are supposed to be broader than this, encompassing harms other than death. Further, if the standard pattern of intuitions is preserved in the domain of economic harm, then that would open up the possibility of studying behavior in trolley problems using the tools of experimental economics. We report the results of two studies designed to test whether the standard patterns of intuitions are preserved when the domain and severity of harm are varied. Our findings show that the difference in moral intuitions between bystander and footbridge scenarios is replicated across different domains and levels of physical and non-physical harm, including economic harms. (shrink)

Background:Moral distress is a complex phenomenon frequently experienced by critical care nurses. Ethical conflicts in this practice area are related to technological advancement, high intensity work environments, and end-of-life decisions.Objectives:An exploration of contemporary moral distress literature was undertaken to determine measurement, contributing factors, impact, and interventions.Review Methods:This state of the science review focused on moral distress research in critical care nursing from 2009 to 2015, and included 12 qualitative, 24 quantitative, and 6 mixed methods studies.Results:Synthesis of the scientific literature revealed (...) inconsistencies in measurement, conflicting findings of moral distress and nurse demographics, problems with the professional practice environment, difficulties with communication during end-of-life decisions, compromised nursing care as a consequence of moral distress, and few effective interventions.Conclusion:Providing compassionate care is a professional nursing value and an inability to meet this goal due to moral distress may have devastating effects on care quality. Further study of patient and family outcomes related to nurse moral distress is recommended. (shrink)

Participatory deliberation, whereby diverse experts and publics collectively engage in decision‐making, can ensure a more informed and just decision by centering historically marginalized perspectives and engaging a spectrum of value systems. Broad and diverse participation is crucial for the equitable distribution of risks and benefits resulting from complex and uncertain decisions such as environmental gene editing. From an ethical position that gives intrinsic value to the nonhuman and recognizes the interconnectedness of species across generations, we argue that deliberation over environmental (...) gene editing must include the voice of nature and the voice of future generations. Inclusion of these key participant groups can encourage reflection on the human relationship with nature and help safeguard intergenerational equity of decisions reached. By drawing from the legal rights of nature movement, the Boardman River Dams Project, and methods for representative participation, we offer strategies for inclusion of nonhuman nature and future generations in deliberative processes about environmental gene editing and other crucial decisions about our shared environments. (shrink)

Within the Kantian ethics consciousness of the moral principle is a fact of reason which cannot be grounded in any antecedent data, empirical or rational. Hegel however argues that the fact of reason is necessarily embedded in the fact of „Sittlichkeit“, that a pure reason is an empty and chimerical construction, that moral knowledge is unavoidably rootet in the contingent moral convictions of the given cultural and social environment. This essay defends Hegel’s critique of Kant’s moral philosophy and – by (...) generalizing Hegel’s hermeneutic approach – sketches the outlines of an explicatory concept of ethics which contradicts the scientistic understanding of moral philosophy characteristic for Kant, the utilitarianism and the supporters of discourse ethics likewise. (shrink)

Wieviel normative Gemeinsamkeit benötigt die Demokratie? Wie groß ist der Konsensbedarf der gesellschaftlichen Diskurse in pluralistischen Gesellschaften? Wie ist die Neutralitätsverpflichtung des Liberalismus zu verstehen? Gibt es Grenzen der Toleranz? Welche Rolle kommt den starken metaphysischen und moralischen Überzeugungen der Bürger in einer Demokratie zu? Müssen sie eingeklammert werden? Muß der Bürger verstummen, wenn es um wichtige weltanschauliche Dinge geht, um den Konsens nicht zu gefährden? Im Rahmen einer kritischen AuseinanderSetzung mit Rawls' Konzeption des politischen Liberalismus werden diese Probleme der (...) Integration pluralistischer Gesellschaften diskutiert. Der dabei entwickelte Lösungsweg vermeidet sowohl die diskurSethische Überforderung der Konsensfähigkeit pluralistischer Gesellschaften als auch die Rawlssche Vorstellung einer gerechtigkeitSethischen Verfassung des öffentlichen Vernunftgebrauchs und plädiert zugleich für eine Entdramatisierung des Pluralismus und für einen selbstbehauptungswilligen Liberalismus, der sich von seiner neutralistischen Selbstlähmung befreit und handelt, wenn die Grenzen der Argumentation erreicht sind. (shrink)

The diagnostic category of borderline personality disorder (BPD) has come under increasing criticism in recent years. In this paper, we analyze the role and impact of epistemic injustice, specifically testimonial injustice, in relation to the diagnosis of BPD. We first offer a critical sociological and historical account, detailing and expanding a range of arguments that BPD is problematic nosologically. We then turn to explore the epistemic injustices that can result from a BPD diagnosis, showing how they can lead to experiences (...) of testimonial injustice which impede patient engagement in meaning-making activities, thereby undermining standard therapeutic goals. We conclude by showing how our arguments bolster ongoing efforts to replace the diagnostic category of BPD with alternatives such as complex post-traumatic stress disorder. (shrink)

COVID-19 and its social and political consequences have led to increased attention to the sometimes philosophically neglected concept of solidarity. This paper reflects the discourse on solidarity in times of COVID-19 from the viewpoint of the philosophical debate on solidarity. We argue that currently – regarding this debate – the critical potential of solidarity as a political concept is often undermined. Solidarity should rather be used as a social-diagnostic lens to focus on and criticise problematic exclusions caused by current political (...) developments. This applies especially to the cross-border and transnational dimension of political solidarity, which is often neglected in the national constrictions of political COVID-19 strategies. The paper concludes with observations on which levels and in which directions the reflection on solidarity could stimulate both the political and the philosophical debate on global crises such as COVID-19. (shrink)

In der 1970 gegründeten Reihe erscheinen Arbeiten, die philosophiehistorische Studien mit einem systematischen Ansatz oder systematische Studien mit philosophiehistorischen Rekonstruktionen verbinden. Neben deutschsprachigen werden auch englischsprachige Monographien veröffentlicht. Gründungsherausgeber sind: Erhard Scheibe (Herausgeber bis 1991), Günther Patzig (bis 1999) und Wolfgang Wieland (bis 2003). Von 1990 bis 2007 wurde die Reihe von Jürgen Mittelstraß mitherausgegeben.

In the literature of collective intentions, the ‘we-intentions’ that lie behind cooperative actions are analysed in terms of individual mental states. The core forms of these analyses imply that all Nash equilibrium behaviour is the result of collective intentions, even though not all Nash equilibria are cooperative actions. Unsatisfactorily, the latter cases have to be excluded either by stipulation or by the addition of further, problematic conditions. We contend that the cooperative aspect of collective intentions is not a property of (...) the intentions themselves, but of the mode of reasoning by which they are formed. We analyse collective intentions as the outcome of team reasoning, a mode of practical reasoning used by individuals as members of groups. We describe this mode of reasoning in terms of formal schemata, discuss a range of possible accounts of group agency, and show how existing theories of collective intentions fit into this framework. (shrink)

Feminist epistemologies hold that differences in the social locations of inquirers make for epistemic differences, for instance, in the sorts of things that inquirers are justified in believing. In this paper we situate this core idea in feminist epistemologies with respect to debates about social constructivism. We address three questions. First, are feminist epistemologies committed to a form of social constructivism about knowledge? Second, to what extent are they incompatible with traditional epistemological thinking? Third, do the answers to these questions (...) raise serious problems for feminist epistemologies? We argue that some versions of two of the main strands in feminist epistemology – feminist standpoint theory and feminist empiricism – are committed to a form of social constructivism, which requires certain departures from traditional epistemological thinking. But we argue that these departures are less problematic than one might think. Thus, (some) feminist epistemologies provide a plausible way of understanding how (some) knowledge might be socially constructed. (shrink)

A framing effect occurs when an agent's choices are not invariant under changes in the way a decision problem is presented, e.g. changes in the way options are described (violation of description invariance) or preferences are elicited (violation of procedure invariance). Here we identify those rationality violations that underlie framing effects. We attribute to the agent a sequential decision process in which a “target” proposition and several “background” propositions are considered. We suggest that the agent exhibits a framing effect if (...) and only if two conditions are met. First, different presentations of the decision problem lead the agent to consider the propositions in a different order (the empirical condition). Second, different such “decision paths” lead to different decisions on the target proposition (the logical condition). The second condition holds when the agent's initial dispositions on the propositions are “implicitly inconsistent,” which may be caused by violations of “deductive closure.” Our account is consistent with some observations made by psychologists and provides a unified framework for explaining violations of description and procedure invariance. (shrink)

In this paper I make the case for a feminist hinge epistemology in three steps. My first step is to explain hinge epistemologies as contemporary epistemologies that take Wittgenstein’s work in On Certainty as their starting point. My second step is to make three criticisms of this literature as it currently stands. My third step is to introduce feminist epistemologies, which argue that social factors like race and gender affect what different people and groups justifiably believe, and argue that developing (...) a feminist hinge epistemology is both plausible and desirable. (shrink)

This paper explores the assimilation of the flightless dodo into early modern natural history. The dodo was first described by Dutch sailors landing on Mauritius in 1598, and became extinct in the 1680s or 1690s. Despite this brief period of encounter, the bird was a popular subject in natural-history works and a range of other genres. The dodo will be used here as a counterexample to the historical narratives of taxonomic crisis and abrupt shifts in natural history caused by exotic (...) creatures coming to Europe. Though this bird had a bizarre form, early modern naturalists integrated the dodo and other flightless birds through several levels of conceptual categorization, including the geographical, morphological and symbolic. Naturalists such as Charles L'Ecluse produced a set of typical descriptive tropes that helped make up the European dodo. These long-lived images were used for a variety of symbolic purposes, demonstrated by the depiction of the Dutch East India enterprise in Willem Piso's 1658 publication. The case of the dodo shows that, far from there being a dramatic shift away from emblematics in the seventeenth century, the implicit symbolic roles attributed to exotic beasts by naturalists constructing them from scant information and specimens remained integral to natural history. (shrink)

I connect commodification arguments to an empirical literature, present a mechanism by which commodification may occur, and show how this may restrict the range of goods and services that are subject to commodification, therefore having implications for the use of commodification arguments in political theory. Commodification arguments assert that some people’s trading a good or service can debase it for third parties. They consist of a normative premise, a theory of value, and an empirical premise, a mechanism whereby some people’s (...) market exchange affects how goods can be valued by others. Hence, their soundness depends on the existence of a suitable candidate mechanism for the empirical premise. The ‘motivation crowding effect’ has been cited as the empirical base of commodification. I show why the main explanations of motivation crowding – signaling and over-justification – do not provide mechanisms that could underpin the empirical premise. In doing this, I reveal some requirements on any candidate me... (shrink)

Homeopathy is over 200 years old and is still experiencing an uninterrupted influx of new practitioners and patients. Many patients and therapists swear by this "alternative healing method", which in some countries is even financed by health insurances. This seems completely incomprehensible to critics: For them it is clearly evident that homeopathy is hopelessly unscientific and has at best a placebo effect. The positions of supporters and opponents seem to be just as immutable as they are incompatible. This book answers (...) some essential and fascinating questions: What remains of the founding ideas of homeopathy in 21st century medicine? Does it really work and, if so, how? Which of the original theories can we still apply today with a clear conscience and use for the benefit of patients and the healthcare system? Where does homeopathy have its limits and does it indeed need to be critically reconsidered and evaluated? The author has dealt with the points of criticism for years, but at the same time also takes seriously the wishes and concerns of patients who often feel insufficiently cared for by conventional medical practice. Against the background of her own personal history, her book attempts to bridge the gap between these two traditionally opposing camps. (shrink)

Based on Pacherie’s dynamic theory of intentions, this study investigated how the way an intention is formed and sustained affects action performance and the experience of control during acting. In Experiment 1, task-irrelevant verbal commands were given while participants responded to stimuli in a two-choice reaction time task. The commands referred to an action goal congruent or incongruent with the actor’s current intention, or ordered the initiation or abortion of the action. In Experiment 2, the same commands were given as (...) participants freely chose between two actions. The distractors affected performance in the reactive task only. In both experiments, feelings of control were based on movement parameters as well as perceived matches between distractors and intended actions. These findings suggest that the way an intention is implemented affects how well it can be shielded against external perturbations and how much one feels in control. (shrink)

In this paper I explore the relationship between social epistemology and relativism in the context of feminist epistemology. I do this by focusing on one particular branch of feminist epistemology - a branch known as standpoint theory - and investigating the connection between this view and epistemic relativism. I begin by defining both epistemic relativism and standpoint theory, and by briefly recounting the standard way that the connection between these two views is understood. The literature at the moment focuses on (...) an aspect of standpoint theory called the epistemic advantage thesis, and on an aspect of relativism which has been called equality. I then show that the connection between relativism and standpoint theory actually turns on a different aspect of standpoint theory, known as the standpoint thesis, and on an aspect of relativism which has been called non-neutrality. I argue that shifting our attention to these other aspects reveals that standpoint theory is clearly and unavoidably relativist, but that this isn’t a problem - standpoint theory can capture everything that it set out to, even on a relativist understanding of the view. (shrink)

The definitive account of Aristotle's life and school This definitive biography shows that Aristotle's philosophy is best understood on the basis of a firm knowledge of his life and of the school he founded. First published in Italian, and now translated, updated, and expanded for English readers, this concise chronological narrative is the most authoritative account of Aristotle's life and his Lyceum available in any language. Gathering, distilling, and analyzing all the evidence and previous scholarship, Carlo Natali, one of the (...) world's leading Aristotle scholars, provides a masterful synthesis that is accessible to students yet filled with evidence and original interpretations that specialists will find informative and provocative. Cutting through the controversy and confusion that have surrounded Aristotle's biography, Natali tells the story of Aristotle's eventful life and sheds new light on his role in the foundation of the Lyceum. Natali offers the most detailed and persuasive argument yet for the view that the school, an important institution of higher learning and scientific research, was designed to foster a new intellectual way of life among Aristotle's followers, helping them fulfill an aristocratic ideal of the best way to use the leisure they enjoyed. Drawing a wealth of connections between Aristotle's life and thinking, Natali demonstrates how the two are mutually illuminating. For this edition, ancient texts have been freshly translated on the basis of the most recent critical editions; indexes have been added, including a comprehensive index of sources and an index to previous scholarship; and scholarship that has appeared since the book's original publication has been incorporated. (shrink)

Hypothetical trolley problems are widely used to elicit moral intuitions, which are employed in the development of moral theory and the psychological study of moral judgments. The scenarios used are outlandish, and some philosophers and psychologists have questioned whether the judgments made in such unrealistic and unfamiliar scenarios are a reliable basis for theory-building. We present two experiments that investigate whether differences in moral judgment due to the role of the agent, previously found in a standard trolley scenario, persist when (...) the structure of the problem is transplanted to a more familiar context. Our first experiment compares judgments in hypothetical scenarios; our second experiment operationalizes some of those scenarios in the laboratory, allowing us to observe judgments about decisions that are really being made. In the hypothetical experiment, we found that the role effect reversed in our more familiar context, both in judgments about what the actor ought to do and in judgments about the moral rightness of the action. However, in our laboratory experiment, the effects reversed back or disappeared. Among judgments of what the actor ought to do, we found the same role effect as in the standard hypothetical trolley scenario, but the effect of role on moral judgments disappeared. (shrink)

A shift towards more environmentally friendly and socially responsible food systems is a key step in the achievement of global sustainable development goals. To obtain significant results, however, it is essential to find participative ways to frame food sustainability objectives, so they can speak to a wide array of actors of change. This article addresses the promising potential of empowering actors across the food system to make a shift in their food choices, by facilitating the association of food sustainability values (...) with contemporary moral issues. In this context, a conceptual framework for a transition towards food sustainability is proposed, based upon the concept of the moral circle. This approach transcends the human-centred methods enacted in traditional sustainable development agendas, offering an alternative with a more holistic perspective. It is expected that emphasising moral reflection around sustainability might encourage societal participation in the creation of sustainable, fair and healthier food systems. (shrink)

A shift towards more environmentally friendly and socially responsible food systems is a key step in the achievement of global sustainable development goals. To obtain significant results, however, it is essential to find participative ways to frame food sustainability objectives, so they can speak to a wide array of actors of change. This article addresses the promising potential of empowering actors across the food system to make a shift in their food choices, by facilitating the association of food sustainability values (...) with contemporary moral issues. In this context, a conceptual framework for a transition towards food sustainability is proposed, based upon the concept of the moral circle. This approach transcends the human-centred methods enacted in traditional sustainable development agendas, offering an alternative with a more holistic perspective. It is expected that emphasising moral reflection around sustainability might encourage societal participation in the creation of sustainable, fair and healthier food systems. (shrink)

Trolley problems have been used in the development of moral theory and the psychological study of moral judgments and behavior. Most of this research has focused on people from the West, with implicit assumptions that moral intuitions should generalize and that moral psychology is universal. However, cultural differences may be associated with differences in moral judgments and behavior. We operationalized a trolley problem in the laboratory, with economic incentives and real-life consequences, and compared British and Chinese samples on moral behavior (...) and judgment. We found that Chinese participants were less willing to sacrifice one person to save five others, and less likely to consider such an action to be right. In a second study using three scenarios, including the standard scenario where lives are threatened by an on-coming train, fewer Chinese than British participants were willing to take action and sacrifice one to save five, and this cultural difference was more pronounced when the consequences were less severe than death. (shrink)

Philosophers, psychologists, neuroscientists, and psychiatrists examine the will and its pathologies from theoretical and empirical perspectives, offering a conceptual overview and discussing schizophrenia, depression, prefrontal lobe damage, and substance abuse as disorders of volition. Science tries to understand human action from two perspectives, the cognitive and the volitional. The volitional approach, in contrast to the more dominant "outside-in" studies of cognition, looks at actions from the inside out, examining how actions are formed and informed by internal conditions. In Disorders of (...) Volition, scholars from a range of disciplines seek to advance our understanding of the processes supporting voluntary action by addressing conditions in which the will is impaired. Philosophers, psychologists, neuroscientists, and psychiatrists examine the will and its pathologies from both theoretical and empirical perspectives, offering a conceptual overview and discussing specific neurological and psychiatric conditions as disorders of volition. After presenting different conceptual frameworks that identify agency, decision making, and goal pursuit as central components of volition, the book examines how impairments in these and other aspects of volition manifest themselves in schizophrenia, depression, prefrontal lobe damage, and substance abuse. Contributors George Ainslie, Tim Bayne, Antoine Bechara, Paul W. Burgess, Anna-Lisa Cohen, Daniel Dennett, Stéphanie Dubal, Philippe Fossati, Chris Frith, Sam J. Gilbert, Peter Gollwitzer, Jordan Grafman, Patrick Haggard, Jay G. Hull, Marc Jeannerod, Roland Jouvent, Frank Krueger, Neil Levy, Peter F. Liddle, Kristen L. Mackiewitz, Thomas Metzinger, Jack B. Nitschke, Jiro Okuda, Adrian M. Owen, Chris Parry, Wolfgang Prinz, Joëlle Proust, Michael A. Sayette, Werner X. Schneider, Natalie Sebanz, Jon S. Simons, Laurie B. Slone, Sean A. Spence. (shrink)

Background: Limited knowledge of the experiences of conflicts of conscience found in nursing literature. Objectives: To explore the individual experiences of a conflict of conscience for neonatal nurses in Alberta. Research design: Interpretive description was selected to help situate the findings in a meaningful clinical context. Participants and research context: Five interviews with neonatal nurses working in Neonatal Intensive Care Units throughout Alberta. Ethical consideration: Ethics approval from the Health Research Ethics Board at the University of Alberta. Findings: Three common (...) themes emerged from the interviews: the unforgettable conflict with pain and suffering, finding the nurse’s voice, and the unique proximity of nurses. Discussion and conclusion: The nurses described a conflict of conscience when the neonate in their care experienced undermanaged pain and unnecessary suffering. During these experiences, they felt guilty, sad, hopeless, and powerless when they were unable to follow their conscience. Informal ways to follow their conscience were employed before declaration of conscientious objection was considered. This study highlights the vital importance of respecting a conflict of conscience to maintain the moral integrity of neonatal nurses and exposes the complexities of conscientious objection. (shrink)