BackgroundJunior medical doctors have a key role in discussions and decisions about treatment and end-of-life care for people with dementia in hospital. Little is known about junior doctors’ decision-making processes when treating people with dementia who have advance care directives, or the factors that influence their decisions. To describe among junior doctors in relation to two hypothetical vignettes involving patients with dementia: their legal compliance and decision-making process related to treatment decisions; the factors influencing their clinical decision-making; and the factors (...) associated with accurate responses to one hypothetical vignette. MethodA cross-sectional survey of junior doctors, including trainees, interns, registrars and residents, on clinical rotation in five public hospitals located in one Australian state. The anonymous, investigator-developed survey was conducted between August 2018 and June 2019. Two hypothetical vignettes describing patients with dementia presenting to hospital with an ACD and either: bacterial pneumonia; or suspected stroke were presented in the survey. Participants were asked to indicate whether they would commence treatment, given the ACD instructions described in each vignette.ResultsOverall, 116 junior doctors responded. In Vignette 1, 58% of respondents selected the legally compliant option. Participants who chose the legally compliant option perceived ‘following patient wishes’ and ‘legal requirements to follow ACDs’ as equally important reasons for complying with the ACD. The most common reason for not selecting the legally compliant option in Vignette 1 was the ‘ACD is relevant in my decision-making process, but other factors are more relevant’. In Vignette 2, 72% of respondents indicated they would commence treatment and 18% selected they would not commence treatment.. Similar reasons influenced participant decision-making in Vignette 2, a less legally certain scenario.ConclusionsThere are critical gaps in junior doctors’ compliance with the law as it relates to the implementation of ACDs. Despite there being differences in relation to the legal answer and its certainty, clinical and ethical factors guided decision-making over and above the law in both vignettes. More education and training to guide junior doctors’ clinical decision-making and ensure compliance with the law is required. (shrink)

People with dementia have commonly been excluded from research. The adverse impacts of this exclusion are now being recognized and research literature, position statements, and ethics guidelines increasingly call for inclusion of people with dementia in research. However, few published studies investigate the views of potential participants on taking part in research should they experience dementia-related cognitive impairment. This cross-sectional survey examined the views of people aged sixty and older attending hospital outpatient clinics about clinical research participation if they had (...) dementia and impaired decision-making ability. Over 90 percent of respondents were agreeable to participating in a wide range of research activities, such as cognitive testing, physical measurements, imaging procedures, and blood draws. For drug studies, however, agreement dropped to 60 percent. Altruism was a strong motivator for research participation. In regard to who should be involved in decisions about their participation in research during periods of incapacity, respondents mostly preferred the person they appoint as their substitute decision-maker for healthcare matters or a doctor or health professional on the research team. Over three-quarters expressed interest in making an advance research directive. The study findings are discussed in relation to law reforms in Australia that aim to strengthen respect and inclusion for people with impaired decision-making capacity, especially by providing frameworks for advance planning for research participation. (shrink)

Our goal in producing this special issue is to encourage our colleagues to incorporate topics related to LGBT populations into bioethics curricula and scholarship. Bioethics has only rarely examined the ways in which law and medicine have defined, regulated, and often oppressed sexual minorities. This is an error on the part of bioethics. Medicine and law have served in the past as society's enforcement arm toward sexual minorities, in ways that robbed many people of their dignity. We feel that bioethics (...) has an obligation to discuss that history and to help us as a society take responsibility for it.We can address only a small number of topics in this special issue of the Hastings Center Report, and we selected topics we believe will stimulate discourse. Andrew Solomon offers an elegant overview of the challenges that bioethics faces in articulating a solid basis for LGBT rights. Timothy F. Murphy asks whether bioethics still faces issues related to lesbian, gay, and bisexual people, given the deletion of homosexuality as a disease and the progress toward same‐sex marriage. Jamie Lindemann Nelson's essay addresses the search for identity for transgender persons and the role of science in that search. Two articles, those by Brendan S. Abel and by Jack Drescher and Jack Pula, take up the complex issue of medical treatment for children who reject their assigned birth gender. Celia B. Fisher and Brian Mustanski address the special challenges of engaging LGBT youth in research, balancing the need for better information about this vulnerable group against the existing restrictions on research involving children. Tia Powell and Edward Stein consider the merits of legal bans on psychotherapies intended to change sexual orientation, particularly in the light of current research on orientation. Mary Beth Foglia and Karen I. Fredricksen‐Goldsen highlight health disparities and resilience among LGBT older adults and then discuss the role of nonconscious bias in perpetuating disparities. Stephan Davis and Nancy Berlinger assess the challenges of access to care and health policy for transgender persons. Edward J. Callahan et al. tackle the ways in which diverse aspects of medicine should change to better incorporate the needs of LGBT patients, including through use of the electronic medical record, education of health professionals, and recruitment efforts for LGBT health professionals. Virginia Ashby Sharpe and Uchenna S. Uchendu describe multifaceted efforts within Veterans Administration facilities to create change for LGBT veterans across the largest integrated health care network in the United States. Lance Wahlert and Autumn Fiester find a mixed record in the use of case studies in teaching about LGBT issues. (shrink)

Within the context of China, this study seeks to examine the relationship between English language proficiency, the native dialect of the learner, and the learner’s reason, or motivation for learning English. English language proficiency can be an important vehicle for accessing high quality higher education, for interacting with non-Chinese, and for enhancing employment and career opportunities Data was gathered through an online survey with 985 usable responses recorded. Respondents included a distribution of speakers from five of the major distinct dialects (...) of China. The analysis provides empirical evidence of a diversity of propensities and motivations for English language acquisition among learners from different regions and native dialects. Access to international higher education as a type of motivation is found to have a moderating effect on English proficiency. Other findings suggest that learners in regions with more historic exposure to foreign interaction are more likely to be motivated for social reasons, those from regions with export focused commerce will be motivated for business related reasons. The results of this study may be of interest to policy makers, linguists, educators, and those with an interest in socioeconomic sustainability through language acquisition and education as a method of socioeconomic mobility. (shrink)

Revised to reflect the current status of scientific and professional theory, practices, and debate across all facets of ethical decision making, this latest edition of Celia B. Fisher's acclaimed book demystifies the American Psychological Association's (APA) Ethical Principles of Psychologists and Code of Conduct. The Fifth Edition explains and puts into practical perspective the format, choice of wording, aspirational principles, and enforceability of the code. Providing in-depth discussions of the foundation and application of each ethical standard to the broad (...) spectrum of scientific, teaching, and professional roles of psychologists, this unique guide helps practitioners effectively use ethical principles and standards to morally conduct their work activities, avoid ethical violations, and, most importantly, preserve and protect the fundamental rights and welfare of those whom they serve. This edition retains and expands upon the critical content of the previous editions to help readers apply the Ethics Code to contemporary social issues in the conduct of responsible psychological science and practice. (shrink)

This text meets the requirements of the OCR AS specification for critical thinking. Alec Fisher shows students how they can develop a range of creative and critical thinking skills that are transferable to other subjects and contexts.

This text offers an account of how philosophers in the 20th century have challenged the ideas of the modern philosophers of the 17th century on fundamental questions in epistemology. Featuring examples, self-study questions and further readings, the text introduces and critically defines logical analysis, foundationalism and coherentism.

Systems change requires complex interventions. Cross-sector partnerships face the daunting task of addressing complex societal problems by aligning different backgrounds, values, ideas and resources. A major challenge for CSPs is how to link the type of partnership to the intervention needed to drive change. Intervention strategies are thereby increasingly based on Theories of Change. Applying ToCs is often a donor requirement, but it also reflects the ambition of a partnership to enhance its transformative potential. The current use of ToCs in (...) partnering efforts varies greatly. There is a tendency for a linear and relatively simple use of ToCs that does limited justice to the complexity of the problems partnerships aim to address. Since partnership dynamics are already complex and challenging themselves, confusion and disagreement over the appropriate application of ToCs is likely to hamper rather than enhance the transformative potential of partnerships. We develop a complexity alignment framework and a diagnostic tool that enables partnerships to better appreciate the complexity of the context in which they operate, allowing them to adjust their learning strategy. This paper applies recent insights into how to deal with complexity from both the evaluation and theory of change fields to studies investigating the transformative capacity of partnerships. This can serve as a check to define the challenges of partnering projects and can help delineate the societal sources and layers of complexity that cross-sector partnerships deal with such as failure, insufficient responsibility taking and collective action problems at four phases of partnering. (shrink)

Fisher, Jin, and Scott push a central assumption of syntactic bootstrapping: that learners have a universal bias to map each noun in a sentence onto a participant role (i.e., argument of the verb). They propose two enrichments: First, that children use both semantic and syntactic information in representing nouns that accompany a verb; second, that children expect continuity across a discourse. They provide evidence for both learning mechanisms among young children, further spelling out the precise mechanisms underlying syntactic bootstrapping.

Philosophy in community projects provide powerful, immersive introductions to philosophical thinking for both children and tertiary students. Such introductions can jumpstart transformative learning as well as diversify who seeks out philosophy in the longer term, both in schools and in universities. Using survey responses from teachers, parents, participants, staff, and volunteers of two such programs – Eurekamp Oz! and philosothons – we show how participants find value in engaging in communities of inquiry and philosophical thinking more broadly. We argue correspondingly (...) that such philosophy in community projects are an asset to universities, both as highly successful university outreach programs and in offering high school, undergraduate, and postgraduate students mentoring and employment opportunities utilising their growing philosophical skills. For these reasons, philosophy in community programs provide alternative and supplementary pathways into sustained philosophical thinking to those available within traditional philosophy in the classroom approaches. (shrink)

Some moral theories, such as objective forms of consequentialism, seem to fail to be practically useful: they are of little to no help in trying to decide what to do. Even if we do not think this constitutes a fatal flaw in such theories, we may nonetheless agree that being practically useful does make a moral theory a better theory, or so some have suggested. In this paper, I assess whether the uncontroversial respect in which a moral theory can be (...) claimed to be better if it is practically useful can provide a ground worth taking into account for believing one theory rather than another. I argue that this is not the case. The upshot is that if there is a sound objection to theories such as objective consequentialism that is based on considerations of practical usefulness, the objection requires that it is established that the truth about what we morally ought to do cannot be epistemically inaccessible to us. The value of practical usefulness has no bearing on the issue. (shrink)

It is important and urgent to question therelationship between evidence-based medicineand power shifts in health care systems.Although definitions of EBM are phrased as ascientific approach to medicine, EBM is anormative concept: it aims to improve medicineand health care. Both proponents and opponentsuse a normative concept. More particularly,they provide particular views on positions,responsibilities, possibilities, norms andrelationships between professionals, patientgroups, governments and other parties in healthcare and society. From this perspective, wewant to analyse the role of EBM in modernwestern societies. By using (...) citizenshiptheory, we will argue that the role of EBM isnot fixed but depends on the relation betweenstate and society. We will first analyse thefundamental change in western societies duringthe past decades, from modern to post-modernsocieties. Then, we will elaborate a fourfoldmodel of possible relationships between stateand society, and discuss the issue of how EBM mayfit in, by giving some examples of the practiceof EBM in different European countries. On thisbasis, we conclude to consider EBM as a publicforum where proponents and opponents of EBMdiscuss diverse and possibly conflicting waysof changing medicine, health care, and healthpolicy. This requires the incorporation of theperspective of citizens and their socialnetworks, professionals with practical andtacit knowledge, and diverse public views onwhat is regarded as `a good life'. Inasmuch asEBM is expected to be practically relevant, itought to be tied to rather than separated fromthe normative world of emancipated patients anddiverse health care practices. Proponents andopponents of EBM should be prepared to defendthe normative claims and power effects that areinherently tied to any presentation ofevidence. (shrink)

Taking a fresh look at questions that have long troubled teachers committed to social change, No Angel in the Classroom provides a richly conceptualized and down-to-earth account of feminist teaching in higher education. Long-time feminist educator, Berenice Malka Fisher, gives a nuanced interpretation of second wave feminist consciousness-raising that bridges the gap between feminist activism and the academy. Candid classroom stories bring out the myths embedded in many activist ideals of the 1970s, while Fisher's informed analysis builds on (...) these tensions, offering a complex amount of experience, emotion, thought, and action in feminist teaching. (shrink)

A collection of transcripts from Mark Fisher's final series of lectures at Goldsmiths, University of London, in late 2016. Edited with an introduction by Matt Colquhoun, this collection of lecture notes and transcriptions reveals acclaimed writer and blogger Mark Fisher in his element -- the classroom -- outlining a project that Fisher's death left so bittersweetly unfinished. Beginning with that most fundamental of questions -- "Do we really want what we say we want?" -- Fisher explores (...) the relationship between desire and capitalism, and wonders what new forms of desire we might still excavate from the past, present, and future. From the emergence and failure of the counterculture in the 1970s to the continued development of his left-accelerationist line of thinking, this volume charts a tragically interrupted course for thinking about the raising of a new kind of consciousness, and the cultural and political implications of doing so. For Fisher, this process of consciousness raising was always, fundamentally, psychedelic -- just not in the way that we might think... (shrink)

Filling a gap in scholarship on 19th- and 20th-century religious thought, this book discusses the philosophy and theology of the influential Marburg School in Germany before 1914, focusing on the writings of Hermann Cohen, its leader, and on the Ritschlian theologian Wilhelm Herrmann, Karl Barth's teacher. In addition, Fisher examines Barth's earliest writings and clarifies the little-known liberal phase of Barth's theology.

This volume expands the concept and role of the schema, with three goals in mind: 1) to outline the continuing issues in the schema concept as the legacy of Kant's concept and analysis, 2) to show that Kant's challenges resulted in successful but truncated views of the schema and its functions, 3) to reconstruct Otto Selz's schema concept by proposing an alternative. The basis and scope of Selz's schema were intended to yield a more complete follow-up to Kant's challenges. These (...) had emerged out of his unresolved view of the schema as knowledge, on one hand, and thought, on the other. Sel'z concepts-'anticipatory schema,' 'coordinate relations,' and 'knowledge complex'-are more inclusive and psychologically dynamic than those of the influential but reductionist theorists: Piaget, Bartlett, and Craik. Harwood Fisher explores Sel'z ideas in past, present, and future temporal contexts. His predecessors' and his contemporaries' ideas influenced him. Present-day needs and future prospects round out a Selzian conception of the schema that would enrich a psychology of thought and knowledge. Harwood Fisher is Professor Emeritus, City College, City University of New York, USA. (shrink)

This article places the issue of quoting practices in journalism - widely debated in public and professional forums since the Masson-Malcolm (Masson v. New Yorker Magazine, 1991) dispute - into both practical and ethical contexts. It suggests that the multitude of ethical dilemmas facing journalists in the handling of quotations can be addressed by adapting Bok's (1979) test of publicity, which requires that journalists willingly imagine themselves under scrutiny. The spirit of the test asks journalists to embrace this central orienting (...) rhetorical question: Is my behavior such that I'd be comfortable having all my audiences - interview subject, editor, public, and self - simultaneously monitor my choice(s), knowing that I might later be called upon to justify my actions. (shrink)

It is well-known that a sense of belonging is crucial in relation to gaining and maintaining sound mental health. Work is also known to be an essential aspect of recovery from mental health problems. However, there is scant knowledge of what a sense of belonging in the workplace represents. This study explores the nature and meaning of a sense of belonging in the workplace as experienced by persons struggling with mental health issues.Using a descriptive phenomenological methodology, sixteen descriptions of the (...) lived experience of belonging in the workplace were analyzed. The analysis reveals that the experience of belonging in the workplace is restricted and fragile until the moment one becomes accepted, but grows stronger and more resilient as one chooses how one wants to participate. Nonetheless, the sense of belonging is haunted by mixed emotions and ambivalence between the wish to be taken care of and the longing for professional appreciation. (shrink)

Over 20 unstable microsatellite repeats have been identified as the cause of neurological disease in humans. The repeat nucleotide sequences, their location within the genes, the ranges of normal and disease‐causing repeat length and the clinical outcomes differ. Unstable repeats can be located in the coding or the non‐coding region of a gene. Different pathogenic mechanisms that are hypothesised to underlie the diseases are discussed. Evidence is given both from studies in simple model systems and from studies on human material (...) and in animal models. Since somatic instability might affect the clinical outcome, this is briefly touched on. Available data and theories on the timing and mechanisms of the repeat instability itself are discussed, along with factors that have been observed to affect instability. Finally, the question of why the often harmful unstable repeats have been maintained throughout evolution is addressed. (shrink)

Tim Fisher examines a troubling misconception about philosophy that he noticed his high school students possessed: that when it comes to philosophy, you can never be wrong. He expected incoming philosophy students to hold this belief, but was surprised to learn that even after completing his course, students still held the belief that philosophy had no wrong answers—that all views are equally reasonable. Fisher began to wonder where he went wrong. To rectify this misconception, Fisher details an (...) exercise that he developed for second graders that forces students to justify their beliefs and teaches them to examine why one claim is more or less reasonable than another; the exercise is equally appropriate for high school students. The key to this exercise is to teach students to detach personal opinions from their reasoning. (shrink)

Tim Fisher examines a troubling misconception about philosophy that he noticed his high school students possessed: that when it comes to philosophy, you can never be wrong. He expected incoming philosophy students to hold this belief, but was surprised to learn that even after completing his course, students still held the belief that philosophy had no wrong answers—that all views are equally reasonable. Fisher began to wonder where he went wrong. To rectify this misconception, Fisher details an (...) exercise that he developed for second graders that forces students to justify their beliefs and teaches them to examine why one claim is more or less reasonable than another; the exercise is equally appropriate for high school students. The key to this exercise is to teach students to detach personal opinions from their reasoning. (shrink)

Tim Fisher examines a troubling misconception about philosophy that he noticed his high school students possessed: that when it comes to philosophy, you can never be wrong. He expected incoming philosophy students to hold this belief, but was surprised to learn that even after completing his course, students still held the belief that philosophy had no wrong answers—that all views are equally reasonable. Fisher began to wonder where he went wrong. To rectify this misconception, Fisher details an (...) exercise that he developed for second graders that forces students to justify their beliefs and teaches them to examine why one claim is more or less reasonable than another; the exercise is equally appropriate for high school students. The key to this exercise is to teach students to detach personal opinions from their reasoning. (shrink)

I.What are the genre characteristics of an autobiography? Is it journalism about anecdotes from the writer’s life? Or is it a personal fiction based on truthful memories that conveys the nature and logic of the writer’s youth? Biographies certainly differ from philosophical texts with their argumentative strategies. How was I to read Germs? If I just read on, like one reads a novel, I might overlook details relevant to the life recounted. Reading intently, in contrast—like you would a philosophy book—might (...) make one miss the peculiar scope of events. Anecdotes may lack insight into the social context, the psychological background, and the future of those involved. A remark from Aristotle about the difference between art (poetry) and history motivates me in this review. Poetry, Aristotle thinks, is more philosophical than history because it delivers universal knowledge:By universal truths are to be understood the kinds of thing a certain type of person will probably or necessarily say or do in a given situation; and this is the aim of poetry, although it gives individual names to its characters. The particular facts of the historian are what, say, Alcibiades did, or what happened to him. (Aristotle, 1986, 1451b7, p. 43–44). (shrink)

A philosophical analysis of the future of art must explicate art’s nature, as well as discuss the historical nature of art practice. Only so can one explain those contemporary developments in art which have led many people to doubt whether art even has a future. Arguably, art practice as we know it started with the installing of the modern system of the fine arts. I explain the pragmatics of art so understood, and suggest that we can define art, internally. We (...) need not resort to a nominalist approach that claims that something is a work of art if some representative of the art world says it is. Instead of such empty proceduralism, I explain how all art’s focal objects, persons and activities are mutually adjusted and can only be understood in light of the whole. Within that whole of art practice, the contemporary samples of art’s alleged failure can be assessed. Now the modern system treats the arts as aesthetic, and prescribes that to judge a work one has to experience it for oneself. Why this should be so, I explain in terms of the perceivability of the artist in the work. Next, art develops as a whole rather than in a piecemeal manner. Particular contemporary works may alienate the audience from art practice, yet once they are recognisably in a procedure which has clear artistic potency they can be incorporated fruitfully in the modern system as explained. In all, the future of art is the future of the modern system, unless the system as a whole goes. We see this happen with the Taliban, but do not ourselves seem to be vulnerable to such onslaught. Yet, our culture may be in the process of eliminating the human mind from the objective reality, and if nothing stops us, art too will come to an end. Luckily, by then we will not be such as to lament that demise. (shrink)

In a recent article in this journal, Richard Gale and Alexander Pruss offer a new cosmological proof for the existence of God relying only on the Weak Principle of Sufficient Reason, W-PSR. We argue that their proof relies on applications of W-PSR that cannot be justified, and that our modal intuitions simply do not support W-PSR in the way Gale and Pruss take them to.

Dr. R. Michael Fisher, fearologist, educator and philosopher, explores existentialist frameworks within a new and exciting imaginary that goes beyond traditional philosophical and existential pursuits--he does that by taking off with a notion of having us all acknowledge "philosophical disability" and he creatively demonstrates what that might mean, how it could be applied--albeit, this is a very preliminary sketch only of this concept--and the way this philosophical work can prepare everyone interested in it for the coming "end times" or (...) more accurately, the coming of major cascading crises that will bring and are bringing already massive suffering and extinctions on the planet. This is a teaching video for the Anthropocene era. (shrink)

Dr. R. Michael Fisher shares thoughts on how we can all, in our own ways, more or less, make aware and educated choices to follow the philia of knowledge--that is, knowledge about fear and thy fearful self as part of the path of Fearlessness. He outlines the various forms of the spirit of Fearlessness: bravery, courageousness, fear-less, fearlessness and fearless. Errata: I should have said re: quote "Norman Vincent Peale" I should have said Philosophy is "love of wisdom" but (...) I wanted to say it more broadly and add the "love of knowledge" dimension; could have also said "love of truth". (shrink)

Dr. R. Michael Fisher continues this series of teaching videos on the history of transformation, as he weaves together many diverse threads of theories, philosophies, movements and critical thinkers, while sharing his own experiences of transformative dreams, nightmares, experiences with psychosis etc. Be sure to watch the first History of Transformation 1 to give more context to this 2nd video, but it is also not necessary. https://www.youtube.com/watch?v=0wcgf... In this video Dr. Fisher emphasizes how the very nature of "transformation" (...) itself is and has to transform as well. In particular, this is the case because of the inevitable social collapse, with psychic collapse going on as people become aware of what is happening to the world in the early 21st century, with global warming, mass extinction and a future image that is constantly shrinking and threatening everything. (shrink)

D. R. Fisher; IV*—Why Should I Be Just?, Proceedings of the Aristotelian Society, Volume 77, Issue 1, 1 June 1977, Pages 43–62, https://doi.org/10.1093/aristote.

Dr. R. Michael Fisher came across Ken Wilber's published work in 1982 and has ever since been a learner and critic of it. In this video he shares both his love of many aspects of Wilber's work and a few critiques that particularly focus on Conflict and Fear. He invites people to respond and also ask questions, and if enough of these are offered, he'll created another video on the topic and respond to your questions and concerns. If you'd (...) rather talk directly: r.michaelfisher52 [at] g[mail].com p.s. Phobos-Thanatos is what Wilber also articulates, again based on adaptation from Plotinus, as this never got into this video; likewise, it was missed that there are post-Integral levels of consciousness as well, beyond where Wilber writes from and where I work from... so, the "spectrum" is vast, at least 9-10 levels and "Integral" is only level 7 in this schema... (shrink)

This paper discusses the viability of claims of mathematical beauty, asking whether mathematical beauty, if indeed there is such a thing, should be conceived of as a sub-variety of the more commonplace kinds of beauty: natural, artistic and human beauty; or, rather, as a substantive variety in its own right. If the latter, then, per the argument, it does not show itself in perceptual awareness – because perceptual presence is what characterises the commonplace kinds of beauty, and mathematical beauty is (...) not among these. I conclude that the reference to mathematical beauty merely expresses the awe in the mathematician about the intricate complexities and simplicity of certain proofs, theorems or mathematical “objects.”. (shrink)

Pessoa et al. (1998a) underexposed the broad and rich variety of stimuli in the amodal completion domain. The disambiguation of occluded shapes depends on very specific figural properties. Elaborations on such disambiguations of rich and complex stimuli, tied up with a visuo-cognitive origin of amodal completion, further position Pessoa et al.'s considerations on neural filling-in and the personal-subpersonal distinction.

This is the first book published that specifically examines questions of ethics and advocacy that arise in conducting research on homelessness, exploring the issues through the deeply personal experiences of some of the field’s leading scholars. By examining the central queries from a broad range of perspectives, the authors presented here draw upon years of rich investigations to generate a framework that will be instructive for researchers across a wide spectrum of areas of inquiry.