The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

Introduction : animals and political theory -- Animals in the history of political thought -- Utilitarianism and animals -- Liberalism and animals -- Communitarianism and animals -- Marxism and animals -- Feminism and animals.

I argue for the possibility of an extremely intimate connection between the emotional content of the music and the emotional state of the person who produces that music. Under certain specified conditions, the music may not just influence, but also partially constitute the musician’s emotional state.

Fact-finding hearings may be held to determine disputed allegations of domestic violence in child contact cases in England and Wales, and can play a vital role for mothers seeking protection and autonomy from violent fathers. Drawing on the author’s empirical study, this article examines the implications for the holding of fact-finding hearings of judges’ and professionals’ understandings of domestic violence and the extent to which they perceive it to be relevant to contact. While more judges and professionals are developing their (...) understanding of domestic violence, the ambit of when and how it is considered relevant to contact has grown increasingly narrow, which suggests that many disputed allegations of domestic violence are disregarded and women and children continue to be put at risk from violent fathers. This bifurcated approach is likely to have significant implications for recent developments in this area of family law which are considered in this article. (shrink)

Probability theory promises to deliver an exact and unified foundation for inquiry in epistemology and philosophy of science. But philosophy of religion is also fertile ground for the application of probabilistic thinking. This volume presents original contributions from twelve contemporary researchers, both established and emerging, to offer a representative sample of the work currently being carried out in this potentially rich field of inquiry. Grouped into five parts, the chapters span a broad range of traditional issues in religious epistemology. The (...) first three parts discuss the evidential impact of various considerations that have been brought to bear on the question of the existence of God. These include witness reports of the occurrence of miraculous events, the existence of complex biological adaptations, the apparent 'fine-tuning' for life of various physical constants and the existence of seemingly unnecessary evil. The fourth part addresses a number of issues raised by Pascal's famous pragmatic argument for theistic belief. A final part offers probabilistic perspectives on the rationality of faith and the epistemic significance of religious disagreement. (shrink)

All states must make decisions about how to regulate the treatment of animals. In this book, Alasdair Cochrane argues that this must go further. In order to ensure that their interests are taken seriously, it is imperative that we represent them throughout the political process - not only rights to protection, but also to democratic membership.

This paper examines the causal basis of our ability to attribute emotions to music, developing and synthesizing the existing arousal, resemblance and persona theories of musical expressivity to do so. The principal claim is that music hijacks the simulation mechanism of the brain, a mechanism which has evolved to detect one's own and other people's emotions.

The author proposes a dimensional model of our emotion concepts that is intended to be largely independent of one’s theory of emotions and applicable to the different ways in which emotions are measured. He outlines some conditions for selecting the dimensions based on these motivations and general conceptual grounds. Given these conditions he then advances an 8-dimensional model that is shown to effectively differentiate emotion labels both within and across cultures, as well as more obscure expressive language. The 8 dimensions (...) are: (1) attracted—repulsed, (2) powerful—weak, (3) free—constrained, (4) certain—uncertain, (5) generalized—focused, (6) future directed—past directed, (7) enduring—sudden, (8) socially connected—disconnected. (shrink)

ABSTRACTThe standard view in philosophy of mind is that the way to understand the difference between perception and misperception is in terms of accuracy. On this view, perception is accurate while...

What exactly is hope and how does it influence our decisions? In How We Hope, Adrienne Martin presents a novel account of hope, the motivational resources it presupposes, and its function in our practical lives. She contends that hoping for an outcome means treating certain feelings, plans, and imaginings as justified, and that hope thereby involves sophisticated reflective and conceptual capacities. Martin develops this original perspective on hope--what she calls the "incorporation analysis"--in contrast to the two dominant philosophical conceptions (...) of hope: the orthodox definition, where hoping for an outcome is simply desiring it while thinking it possible, and agent-centered views, where hoping for an outcome is setting oneself to pursue it. In exploring how hope influences our decisions, she establishes that it is not always a positive motivational force and can render us complacent. She also examines the relationship between hope and faith, both religious and secular, and identifies a previously unnoted form of hope: normative or interpersonal hope. When we place normative hope in people, we relate to them as responsible agents and aspire for them to overcome challenges arising from situation or character. Demonstrating that hope merits rigorous philosophical investigation, both in its own right and in virtue of what it reveals about the nature of human emotion and motivation, How We Hope offers an original, sustained look at a largely neglected topic in philosophy. (shrink)

The concept of humoral control--the direction of bodily processes by complex organic fluids--has gained ascendancy in recent decades, and enlisted the interest of more than humoral specialists.

In cases of identity crowding, a subject consciously sees items in a figure, even though they are presented too closely together for her to shift attention to each item. Block uses such cases to challenge the view that attention is necessary for consciousness. I argue that in identity crowding cases, subjects really do attend to the items. Specifically, they attend to the figure as a global object that contains the individual items as parts. To support this view, I provide evidence (...) that attention can be directed to a global object or a local object. My response helps to defend the view that attention is necessary for conscious perception. (shrink)

This article defends a theory of diffuse attention and distinguishes it from focal attention. My view is motivated by evidence from psychology and neuroscience, which suggests that we can deploy visual selective attention in at least two ways: by focusing on a small number of items, or by diffusing attention over a group of items taken as a whole. I argue that diffuse attention is selective and can be object‐based. It enables a subject to select an object to guide behavior, (...) albeit in a different way than focusing does. (shrink)

People with disabilities use more medical care and see health professionals more often than do those of the same age, ethnic group, or economic class who do not have impairments. An indisputable medical goal is.

Attention seems to raise a problem for pure representationalism, the view that phenomenal content supervenes on representational content. The problem is that shifts of attention sometimes seem to bring about a change in phenomenal content without a change in representational content. I argue that the representationalist can meet this challenge, but that doing so requires a new view of the representational content of perception. On this new view, the representational content of perception is always relative to a way of attending. (...) I call this the attention-indexed view of perceptual content. (shrink)

Put relationship-centered communication at the forefront of care Today, physicians face a hypercompetitive marketplace in which they must meet unique and complex patient needs as efficiently as possible. But in a culture prioritizing clinical outcomes above all, there can be a tendency to lose sight of one of the most critical aspects of providing effective care: the communication skills that build and foster physician-patient relationships. Studies have shown that good communication between doctors and patients and among all caregivers who interface (...) with patients directly results in better clinical outcomes, reduced costs, greater patient satisfaction, and lower rates of physician burnout. In Communication the Cleveland Clinic Way, Dr. Adrienne Boissy and her team tell the story of how Cleveland Clinic created and applied the R.E.D.E. to Communicate: Foundations of Healthcare program, making the world-renowned hospital system a leader in relationship-centered care. They provide a step-by-step guide for healthcare leaders and decision-makers to design, develop, and implement communication skills training in their own institutions. Learn how to: • Craft an effective, colleague-supported communication skills program to include veteran physicians, residents, and medical students • Leverage creative program design and data transparency to engage and facilitate staff physicians and advanced care providers • Identify common misperceptions and myths in healthcare communication and respond to them successfully • Cultivate a true sense of empathy—with patients and fellow caregivers alike—while maintaining professionalism In a field where difficult conversations and stressful relationships are commonplace, clinicians need a structured approach to enable them to deliver the best care possible. Communication the Cleveland Clinic Way is the blueprint for establishing a relationship-centered program that will improve patient experience, reinvigorate doctors’ passion for their work, and elevate any organization. (shrink)

Ce bref texte en forme de manifeste rappelle que les mouvements de transformation sociale dirigés vers davantage de justice sont d’autant plus forts que leurs membres reconnaissent avec lucidité et compassion leurs propres implications dans les mécanismes générateurs de violences. Plutôt que des gestes de condamnation et d’annulation ( cancel ), ce sont donc des attitudes d’écoute, de soutien et de solidarité active qui sont requis.

It is gratifying that thoughtful philosophers and bioethicists like Mahowald and Nelson are continuing to address the objections to prenatal testing that have been made by disability scholars and advocates. But it is frustrating to see those objections presented in ways that reflect the doubts of those who reject them more than the intentions of those who make them, in ways that make those objections appear censorious toward pregnant women and prospective parents or naïve about nonverbal expression. We recognize that (...) disability critics share the responsibility for these misunderstandings, that their objections to prenatal disability testing have not always been made as clearly or consistently as they might have been. We therefore welcome this opportunity for clarification and rebuttal. Briefly, we will argue against Mahowald that it is not apparent how prospective parents could have a duty to potential offspring requiring them to prevent the birth of any child expected to have a life worth living. And we will remind Nelson that our primary concern is with the perpetuation of stigma; that even if any reason for abortion can be framed in terms of a trait of the fetus to be aborted, only certain reasons for abortion are based on the rejection of future children because of stigmatized traits. (shrink)

In this paper, we critically appraise institutions for people with disabilities, from residential facilities to outpatient clinics to social organizations. While recognizing that a just and inclusive society would reject virtually all segregated institutional arrangements, we argue that in contemporary American society, some people with disabilities may have needs that at this time can best be met by institutional arrangements. We propose ways of reforming institutions to make them less isolating, coercive, and stigmatizing, and to provide forms of social support (...) the larger society denies many people with disabilities. Although these reforms far fall far short of abolition, they draw heavily on the work of disability scholars and advocates who call for the complete replacement of institutional arrangements with systems of supported living. The consideration of non-ideal-solutions is useful not only in reforming existing institutional arrangements, but in bringing disability scholarship and advocacy to bear on bioethics, which has paid little attention to institutions for people with disabilities. We intend this paper to redress the neglect within mainstream bioethics of the complex ethical problems posed by institutions. (shrink)

Dans cette réflexion surgie des premières expériences de la pandémie du Covid-19, l’autrice met en écho nos peurs et nos réactions face aux dangers de la maladie et face aux actes de violence. Les condamnations sommaires et instantanées auxquelles les militant·es se livrent sur les réseaux sociaux reproduisent partiellement des dynamiques de lynchage dont il faut apprendre à davantage se méfier. Avec la distance de l’abstentiel, il est parfois plus facile de dénoncer ( call-out ) les mauvais comportements, que d’interpeler (...) et d’inclure ( call-in ) celleux qui ont fait du mal. Comment croire les survivant·es tout en restant abolitionnistes? Comment croire les survivant·es tout en pratiquant une justice transformatrice? (shrink)

This article addresses an issue overlooked in most of the literature on judicial review: the legitimacy of judicial review of a constitution's federal and structural provisions. Debates about the legitimacy of judicial review—at least as conducted throughout the Commonwealth—are usually focussed on rights. These debates appear to assume that the power of courts like the Australian High Court and the Canadian Supreme Court to interpret and enforce federal and structural provisions is unproblematic. This article tests that assumption and concludes that (...) those who hold democracy-based objections to constitutional rights should seriously reconsider, and perhaps oppose, federal and structural judicial review as well. (shrink)

The advent of new antiretroviral medicines means that the effects of HIV can now be curbed, but only one in twenty infected people have so far benefited. For those living in developing countries, the new treatments are practically unattainable. Governments, UNAIDS and pharmaceutical companies recognise this only too well and have rethought established assumption in order to try and overcome the challenges posed by cost, inadequate health services and unreliable local supply of medicines.

Classical neo-Darwinian explanations do not fully account for changes in biological forms, and new theories have emerged, primarily in maths and physics, that offer new approaches to the problem of the origin of life and phenomena of order in evolution. This volume focuses on the role of closure at various hierarchical levels as the catalyst between self-organization and selection. Participants addressed special areas of the closure problem such as autopoiesis and autocatalysis and function and selection, and semiosis. Presentations on physical (...) and mathematical modelling are included. The book seeks to clarify the role closure plays in explaining the emergence, development and evolution of structurally stable systems at the thermodynamic, chemical and biochemical, biological, psychological and cultural levels. (shrink)

Spinoza’s attitude toward nonhuman animals is uncharacteristically cruel. This essay elaborates upon this ostensible idiosyncrasy in reference to Hasana Sharp’s commendable desire to revitalize a basis for animal ethics from within the bounds of his system. Despite our favoring an ethics beginning from animal affect, this essay argues that an animal ethic adequate to the demands of our historical moment cannot be developed from within the confines of strict adherence to Spinoza’s system—and this is not yet to speak of a (...) more robust animal ethics which would advocate actual care and compassion for the animals themselves. We argue that on the assumption of Spinoza’s ontological biocentrism, in the presence of Spinozist determinism and the absence of an axiological biocentrism, an anthropocentric axiology necessarily follows. Any Spinozist animal ethic must fall back, therefore, upon appeals to the maximization of human pleasure and power; hence Spinoza’s ruthless injunction to “use (the animals) at our pleasure.” These are the very ontological and ethical assumptions which have incited human self-exaltation in the modern period, in pursuit of power and pleasure even despite the destructive long-term consequences for all the living. We suggest that an adequate animal ethic would require either an abandonment of Spinoza’s ontological biocentrism or the adoption of an axiological biocentrism. (shrink)

Перевод статьи: Davies T., Chandler R. Online deliberation design: Choices, criteria, and evidence // Democracy in motion: Evaluating the practice and impact of deliberative civic engagement / Nabatchi T., Weiksner M., Gastil J., Leighninger M. (eds.). -- Oxford: Oxford univ. press, 2013. -- P. 103-131. А. Кулик. -/- Вниманию читателей предлагается обзор эмпирических исследований в области дизайна онлайн-форумов, предназначенных для вовлечения граждан в делиберацию. Размерности дизайна определены для различных характеристик делиберации: назначения, целевой аудитории, разобщенности участников в пространстве и во (...) времени, среды коммуникации и организации делиберативного процесса. После краткого обзора критериев оценки вариантов дизайна рассматриваются эмпирические данные, соотносящиеся с каждым из вариантов. Эффективность онлайн-делиберации зависит от того, насколько условия коммуникации соотносятся с заданиями делиберации. Компромиссы, как, например, между анонимным или идентифицируемым участием, предполагают различные дизайны в зависимости от цели делиберации и состава участников. Выводы исследования получены на материале существующих технологий и могут измениться по мере коэволюции технологий и пользователей. (shrink)