Patient engagement in healthcare is increasingly discussed in the literature, and initiatives engaging patients in quality improvement activities, organizational design, governance, and research are becoming more and more common and have even become mandatory for certain health institutions. Here we discuss a number of ethical challenges raised by this engagement from patients from the perspectives of research, organizational/quality improvement practices, and patient experiences, while offering preliminary recommendations as to how to address them. We identified three broad categories of ethical issues (...) that intersect between the different types of patient engagement: establishing a shared vision about goals of patient engagement and respective roles; the process and method of engaging with patients; and practical aspects of patient engagement. To explain these issues, we build from our personal, professional, and academic experiences, as well as traditions such as pragmatism and hermeneutics that stress the importance of participation, empowerment, and engagement. Patient engagement can be highly valuable at numerous levels, but particular attention should be paid to the process of engaging with patients and related ethical issues. Some lessons from the literature on the ethics of participatory research can be translated to organizational and quality improvement practices. (shrink)
Context: In most jurisdictions where medical-aid-in-dying is available, this option is reserved for individuals suffering from incurable physical conditions. Currently, in Canada, people who have a mental illness are legally excluded from accessing MAiD. Methods: We developed a questionnaire for mental health care providers to better understand their perspectives related to ethical issues in relation to MAiD in the context of severe and persistent suffering caused by mental illness. We used a mixed-methods survey approach, using a concurrent embedded model with (...) both closed and open-ended questions. Findings: 477 healthcare providers from the province of Québec completed the questionnaire. One third of the sample were nurses, one quarter psychologists and one quarter psycho-educators. Nearly half of the respondents considered that people with a severe mental illness should be granted the right to opt for MAiD as a way to end their suffering. Respondents were more likely to feel comfortable listening to the person and participating in discussions related to MAiD for a mental illness than offering care or the means for the person to access MAiD. Most reported that they had not received adequate/sufficient training, education or preparation in order to address ethical questions surrounding MAiD. Conclusions: The findings highlight how extending MAiD to people with a mental illness would affect daily practices for mental healthcare providers who work directly with people who may request MAiD. The survey results also reinforce the need for adequate training and professional education in this complex area of care. (shrink)
Bioethics has made a compelling case for the role of experience and empirical research in ethics. This may explain why the movement for empirical ethics has such a firm grounding in bioethics. However, the theoretical framework according to which empirical research contributes to ethics—and the specific role it can or should play—remains manifold and unclear. In this paper, we build from pragmatic theory stressing the importance of experience and outcomes in establishing the meaning of ethics concepts. We then propose three (...) methodological steps according to which the meaning of ethics concepts can be refined based on experience and empirical research: function identification, function enrichment, and function testing. These steps are explained and situated within the broader commitment of pragmatic ethics to a perspective of moral growth and human flourishing. We hope that this proposal will give specific direction to the bridging of theoretical and empirical research in ethics and thus support stronger actualization of ethics concepts. (shrink)
Is life different from the non-living? If so, how? And how, in that case, does biology as the study of living things differ from other sciences? These questions are traced through an exploration of episodes in the history of biology and philosophy. The book begins with Aristotle, then moves on to Descartes, comparing his position with that of Harvey. In the eighteenth century the authors consider Buffon and Kant. In the nineteenth century the authors examine the Cuvier-Geoffroy debate, pre-Darwinian geology (...) and natural theology, Darwin and the transition from Darwin to the revival of Mendelism. Two chapters deal with the evolutionary synthesis and such questions as the species problem, the reducibility or otherwise of biology to physics and chemistry, and the problem of biological explanation in terms of function and teleology. The final chapters reflect on the implications of the philosophy of biology for philosophy of science in general. (shrink)
Marjorie Perloff, among our foremost critics of twentieth-century poetry, argues that Ludwig Wittgenstein provided writers with a radical new aesthetic, a key to recognizing the inescapable strangeness of ordinary language. Taking seriously Wittgenstein's remark that "philosophy ought really to be written only as a form of poetry," Perloff begins by discussing Wittgenstein the "poet." What we learn is that the poetics of everyday life is anything but banal. "This book has the lucidity and the intelligence we have come to (...) expect from Marjorie Perloff.--Linda Munk, American Literature "[Perloff] has brilliantly adapted Wittgenstein's conception of meaning and use to an analysis of contemporary language poetry."--Linda Voris, Boston Review " Wittgenstein's Ladder offers significant insights into the current state of poetry, literature, and literary study. Perloff emphasizes the vitality of reading and thinking about poetry, and the absolute necessity of pushing against the boundaries that define and limit our worlds."--David Clippinger, Chicago Review "Majorie Perloff has done more to illuminate our understanding of twentieth century poetic language than perhaps any other critic. . . . Entertaining, witty, and above all highly original."--Willard Bohn, Sub-Stance. (shrink)
This is another volume in the Modern Studies in Philosophy, a series of anthologies under the general editorship of Prof. Amelie Oksenberg Rorty, which present contemporary interpretations and evaluations of the works of major philosophers. This volume, consisting of a collection of papers by an impressive gallery of scholars, offers a plurality of perspectives on Spinoza. Each interpretation conflicts with some other; yet each illuminates some aspect of the subject. All the papers reflect the "tensions" and "conflicts" which make for (...) very exciting and rewarding reading. Still the substantive puzzles remain and will continue to excite and fascinate successive generations of Spinoza's critics. (shrink)
Marjorie Perloff, among our foremost critics of twentieth-century poetry, argues that Ludwig Wittgenstein provided writers with a radical new aesthetic, a key to recognizing the inescapable strangeness of ordinary language. Taking seriously Wittgenstein's remark that "philosophy ought really to be written only as a form of poetry," Perloff begins by discussing Wittgenstein the "poet." What we learn is that the poetics of everyday life is anything but banal. "This book has the lucidity and the intelligence we have come to (...) expect from Marjorie Perloff.—Linda Munk, _American Literature_ "[Perloff] has brilliantly adapted Wittgenstein's conception of meaning and use to an analysis of contemporary language poetry."—Linda Voris, _Boston Review_ "_Wittgenstein's Ladder_ offers significant insights into the current state of poetry, literature, and literary study. Perloff emphasizes the vitality of reading and thinking about poetry, and the absolute necessity of pushing against the boundaries that define and limit our worlds."—David Clippinger, _Chicago Review_ "Majorie Perloff has done more to illuminate our understanding of twentieth century poetic language than perhaps any other critic.... Entertaining, witty, and above all highly original."—Willard Bohn, _Sub-Stance_. (shrink)
A scholarly edition of letters by Anne, Viscountess Conway, Henry More, and their friends. The edition presents an authoritative text, together with an introduction, commentary notes, and scholarly apparatus.
Can an assessment of individuals’ narcissism help explain the quality of a respondent’s ethical judgment? How is the relationship between religiosity and ethical judgment moderated by the effects of narcissism? With a sample of 385 undergraduate business majors, this study uses a taxonomic approach to examine the effects of intrinsic and extrinsic religiosity as well as orthodox Christian beliefs on ethical judgment. Three distinct clusters were identified: Skeptics, Nominals, and Devouts. Surprisingly, of the three clusters, Nominals and Devouts were the (...) only groups impacted by narcissism, although Skeptics overall demonstrate the worst ethical judgment. (shrink)
I argue that Irigaray's linguistic research is not merely supplementary to her theoretical writing, but, in its depiction of sexed linguistic “styles,” illuminates Irigaray's call for a new syntax. I show the effect of this research on her analysis of the unconscious meaning of interrogative expressions. 1 address the question of Irigaray's standing as a social scientist and argue that attention to her method reveals her positive program in this domain.
Treats, in retrospect and prospect, dominant themes and main currents in twentieth century philosophy, such as the European sources of Anglo-American philosophy, Continental philosophy in America, and German and French Existentialism. Special attention is directed toward Heidegger, Jaspers, Sartre, Merleau-Ponty, and their crucial ideas. Originally published in 1976 by the University of California Press. Co-published by arrangement with the Center for Advanced Research in Phenomenology.
Because of the difficulty posed by the contrast between the search for truth and truth itself, Michael Polanyi believes that we must alter the foundation of epistemology to include as essential to the very nature of mind, the kind of groping that constitutes the recognition of a problem. This collection of essays, assembled by Marjorie Grene, exemplifies the development of Polanyi's theory of knowledge which was first presented in _Science, Faith, and Society_ and later systematized in _Personal Knowledge_. Polanyi (...) believes that the dilemma of the modern mind arises from the peculiar relation between the positivist claim for total objectivity in scientific knowledge and the unprecedented moral dynamism characterizing the social and political aspirations of the last century. The first part of _Knowing and Being_ deals with this theme. Part two develops Polanyi's idea that centralization is incompatible with the life of science as well as his views on the role of tradition and authority in science. The essays on tacit knowing in Part Three proceed directly from his preoccupation with the nature of scientific discovery and reveal a pervasive substructure of all intelligent behavior. Polanyi believes that all knowing involves movement from internal clues to external evidence. Therefore, to explain the process of knowing, we must develop a theory of the nature of living things in general, including an account of that aspect of living things we call "mind." Part Four elaborates upon this theme. (shrink)
This paper examines the foreign direct investment decision from an ethical perspective, and considers the moral agency involved in such decisions, with emphasis upon the corporate decision-maker. Historical capital allocation models once regarded as both financially and ethically normative are shown to be deficient in today's environment. Work of modern western philososphical and theological ethicists is included in analyses of the applicability of selected ethical approaches or metaphors to multinational foreign direct investment decisions and the corporate manager's role and responsibility (...) as corporate decision-maker and moral agent. The ethical perspectives reviewed can serve as an aid to the individual manager's determination of what constitutes a responsible exercise of decision-making power. (shrink)
Infinite Awareness pairs Woollacott’s research as a neuroscientist with her self-revelations about the her mind’s spiritual power. Between the scientific and spiritual worlds, she breaks open the definition of human consciousness to investigate the existence of a non-physical mind.
A central tenet of constructivist models of conceptual development is that children's initial conceptual level constrains how they make sense of new evidence and thus whether exposure to evidence will prompt conceptual change. Yet little experimental evidence directly examines this claim for the case of sustained, fundamental conceptual achievements. The present study combined scaling and experimental microgenetic methods to examine the processes underlying conceptual change in the context of an important conceptual achievement of early childhood—the development of a representational theory (...) of mind. Results from 47 children (M age = 3.7 years) indicate that only children who were conceptually close to understanding false belief at the beginning of the study, and who were experimentally exposed to evidence of people acting on false beliefs, reliably developed representational theories of minds. Combined scaling and microgenetic data revealed how prior conceptual level interacts with experience, thereby providing critical experimental evidence for how conceptual change results from the interplay between conceptions and evidence. (shrink)
Norwegian health professionals, elderly people and family members experience ethical problems involving end-of-life decision making for elders in the context of the values of Norwegian society. This study used ethical inquiry and qualitative methodology to conduct and analyze interviews carried out with 25 health professionals, six elderly people and five family members about the ethical problems they encountered in end-of-life decision making in Norway. All three participant groups experienced ethical problems involving the adequacy of health care for elderly Norwegians. Older (...) people were concerned about being a burden to their families at the end of their life. However, health professionals wished to protect families from the burden of difficult decisions regarding health care for elderly parents at the end of life. Strategies are suggested for dialogue about end-of-life decisions and the integration of palliative care approaches into health care services for frail elderly people. (shrink)
Widespread acceptance of Hartshorne’s “correction” of Whitehead’s notion of God inhibited continuing exploration of Whitehead’s own vision of God as a single entity in which the physical and mental poles are reversed. As a result, the implications of this reversed concrescence have been paid scant attention. Whitehead himself did little more than hint at the consequences. My thesis is that consideration of a reversed concrescence highlights the essential dynamism of God as a whole, including the primordial nature, and has implications (...) for the provision of initial aims for the world. (shrink)
This paper was given as a keynote address at the international conference on Ethics of Intellectual Property Rights and Patents held in Warsaw, Poland on April 23–24, 2004. The address was the introductory presentation to the important topic of protecting individuals who participate in research as research subjects.
Mental model ascription – also called mindreading – is the process of inferring the mental states of others, which happens as a matter of course in social interactions. But although ubiquitous, mindreading is presumably a highly variable process: people mindread to different extents and with _different results._ We hypothesize that human mindreading ability relies on a large number of personal and contextual features: the inherent abilities of specific individuals, their current physical and mental states, their knowledge of the domain of (...) discourse, their familiarity with the interlocutor, the risks associated with an incorrect assessment of intent, and so on. This paper presents a theory of mindreading that models diverse artificial intelligent agents using an inventory of parameters and value sets that represent traits of humans and features of discourse contexts. Examples are drawn from Maryland Virtual Patient, a prototype system that will permit medical trainees to diagnose and treat cognitively modeled virtual patients with the optional assistance of a virtual tutor. Since real patients vary greatly with respect to physiological and cognitive features, so must a society of virtual patients. Modeling such variation is one of the goals of the overall OntoAgent program of research and development. (shrink)
Is "living together" in a marriage-like relationship compatible with the feminist ideal of individual self-development? Paradoxically, while the structure and social-historical context of marriage-like relationships seems in fundamental conflict with the goal of autonomous self-development, the development of individuality also seems to be better fostered by living with a significant other in a committed relationship than by living alone. This paradox is resolved through the suggestion of a three-stage account of self-development: inauthenticity, autonomous being oneself, and autonomous being with others. (...) At the third stage, living together in a marriage-like relationship is one social format in which autonomous relating to others is possible. Unless the partners have attained the second stage, however, such a relationship will be destructive rather than conducive to individuality. (shrink)
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