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 standard foil for recent theories of hope is the belief-desire analysis advocated by Hobbes, Day, Downie, and others. According to this analysis, to hope for S is no more and no less than to desire S while believing S is possible but not certain. Opponents of the belief-desire analysis argue that it fails to capture one or another distinctive feature or function of hope: that hope helps one resist the temptation to despair;2 that hope engages the sophisticated capacities of (...) human agency, such as planning;3 or that hope involves the imagination in ways desire need not.4 Here, I focus on the role of imagination in hope, and discuss its implications for hope’s relation to practical commitment or end-setting. (shrink)

I argue for adopting a conception of obligation that is broader than the conception commonly adopted by moral philosophers. According to this broader conception, the crucial marks of an obligatory action are, first, that the reasons for the obliged party to perform the action include an exclusionary reason and, second, that the obliged party is the appropriate target of blaming reactive attitudes, if they inexcusably fail to perform the obligatory action. An obligation is directed if the exclusionary reason depends on (...) the relationship between the obliged person and the person to whom they owe the obligatory action, and the latter person is positioned to personally blame the obligated person for inexcusably failing to perform the obligatory action. Some direc- ted obligations are not owed as a matter of right, and the person to whom the obligatory action is owed is the only person positioned to blame nonperformance. Other directed obligations are owed as a matter of right, and people who are not part of the relationship grounding the obligation nevertheless are also positioned to (impersonally) blame non-performance. Only the rights-based form of directed obligation has received signifi- cant attention from moral philosophers, yet the former—which is at the heart of what I call “personal bonds”—is a pervasive and significant theme of our ordinary interpersonal lives. (shrink)

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)

The objective of this study was to review the design and delivery of medical ethics education within medical programs across Australia and New Zealand, how current teaching has been informed by the proposed core curriculum published in 2001 by the ATEAM and how it could look moving forward. We conducted a mixed methods study using an online questionnaire consisting of 51 items. This included both binary and open-ended questions to categorise and explore similarities and differences in medical ethics curricula in (...) medical programs accredited by the Australian Medical Council across ANZ. Participants were asked about curriculum design format, duration, goals, assessments, content areas of their own ME curriculum. Convenors from 18 universities responded. The main commonality was that ME curricula were integrated both longitudinally and laterally with other content. There was also commonality in content areas addressed. The goals, format, educators, and assessments of the ME curricula were highly variable. Most respondents described a curriculum which prioritised knowledge and skill development related to ME. Although the core goals of including knowledge, skills, and attitudinal development in ME curricula are still present, there is no uniformity in terms of format, delivery, or assessment across medical programs in ANZ. This is an area for collaborative development. (shrink)

Apologies are strange. They are, in a certain sense, very small. An apology is just a gesture—a set of words, a physical posture, perhaps a gift. But an apology can also be very powerful—this power is implicit in the facts that it can be difficult to offer an apology and that, when we are wronged, we may want an apology very much. More, even we have been severely wronged, we are sometimes willing to forgive or pardon the wrongdoer, if we (...) receive a sincere apology. In this paper, I want to begin to figure out how a mere gesture can be so powerful. The philosophers who discuss apology generally do not go into much detail, and they discuss it almost exclusively in connection with forgiveness. 2 I, too, will discuss apology’s power to provide reason to forgive, but in order to provide the resources to examine another power. Some apologies, I will argue, fail to provide reason to forgive, but nevertheless do provide the recipient a reason to maintain a relationship with the wrongdoer, or to allow the wrongdoer to remain in her community. To be clear: the “powers” I am interested in are reason-giving powers, or powers to make certain beliefs, attitudes, or actions rational. Apologies also, no doubt, have a sort of bare causal power. The sight of a vicious, racist, cruel war criminal on his knees and in tears, sincerely begging forgiveness, may inspire in us pity or even compassion, in spite of what we believe we have reason to feel. “I can’t help but feel sorry for the bastard,” we may say, even while believing that.. (shrink)

How do we encourage patients to be hopeful without exploiting their hope? A medical researcher or a pharmaceutical company can take unfair advantage of someone's hope by much subtler means than simply giving misinformation. Hope shapes deliberation, and therefore can make deliberation better or worse, by the deliberator's own standards of deliberation.

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)

It is a commonplace in both the popular imagination and the philosophical literature that hope has a special kind of motivational force. This commonplace underwrites the conviction that hope alone is capable of bolstering us in despairinducing circumstances, as well as the strategy of appealing to hope in the political realm. In section 1, I argue that, to the contrary, hope’s motivational essence is not special or unique—it is simply that of an endorsed desire. The commonplace is not entirely mistaken, (...) however, because standard ways of expressing hope do have motivational influence that is different in kind from that of desire. In sections 2 through 4, I examine one of these ways of expressing hope, fantasizing, and argue that fantasies can present us with reasons to modify our goals and projects in multiple ways. (shrink)

Pacific Philosophical Quarterly, March 2006. Significant effort has been devoted to locating a good argument for Kant ’s Formula of Humanity. In this paper, I contrast two arguments, based on Kant ’s text, for the Formula of Humanity. The first, which I call the “Valued Ends” argument, is an influential and appealing argument developed most notably by Christine Korsgaard and Allen Wood. Notwithstanding the appeal and influence of this argument, it ultimately fails on several counts. I therefore present as an (...) alternative the “Autonomy” argument, which is largely inspired by the failings of the Valued Ends argument. (shrink)

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)

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)

Recently, there has been a surge of interest in the lexicon. The demand for a fuller and more adequate understanding of lexical meaning required by developments in computational linguistics, artificial intelligence, and cognitive science has stimulated a refocused interest in linguistics, psychology, and philosophy. Different disciplines have studied lexical structure from their own vantage points, and because scholars have only intermittently communicated across disciplines, there has been little recognition that there is a common subject matter. The conference on which this (...) volume is based brought together interested thinkers across the disciplines of linguistics, philosophy, psychology, and computer science to exchange ideas, discuss a range of questions and approaches to the topic, consider alternative research strategies and methodologies, and formulate interdisciplinary hypotheses concerning lexical organization. The essay subjects discussed include: * alternative and complementary conceptions of the structure of the lexicon, * the nature of semantic relations and of polysemy, * the relation between meanings, concepts, and lexical organization, * critiques of truth-semantics and referential theories of meaning, * computational accounts of lexical information and structure, and * the advantages of thinking of the lexicon as ordered. (shrink)

George Lakoff discusses how emotion metaphors reflect the discrete bodily states associated with each emotion. The analysis raises questions about the context for and frequency of use of emotion metaphors and, indeed, emotion labels, per se. An assumption implicit to most theories of emotion is that emotion language is just another channel through which people express ongoing emotion states. Drawing from recent evidence that labeling ongoing emotions reduces their intensity, we propose that a primary function of emotion language is regulatory (...) rather than expressive. (shrink)

A theory of word meaning developed jointly by Adrienne and Keith Lehrer is summarized, which accommodates the empirical facts of natural languages, especially the diversity of types of words. Reference characterizes the application of words to things, events, properties, etc. and sense the relationship among words and linguistic expressions. Although reference and sense are closely connected, neither can be reduced to the other. We use the metaphor of vectors to show how different, sometimes competing forces interact to provide an (...) understanding of what a word in context means. Topics discussed include vagueness, indeterminacy, the role of experts, possible worlds, pragmatic influences, semantic change, semantic networks, fields, and entailments. A formal theory for understanding the relationship of idiolects, dialects, and communal languages is proposed to account for the dynamic interaction of individuals and communities which occurs continuously. (shrink)

In this paper, I outline a Kantian moral psychology and use it to generate an analysis of the emotional attitude, love. At the heart of this moral psychology is a distinction between rational and subrational motives, and the thesis that interpersonal emotional attitudes like love are governed by a norm of respect. I show how an analysis of love that relies on this moral psychology—which I call “the incorporation conception” of love—tightly fits with paradigmatic cases of romantic love, reveals both (...) the continuities and differences between romantic and other forms of love, and also explicates our ambivalence about certain cases. Finally, I argue that this analysis, although it sees love as essentially a bundle of volitions, has the resources to respond to both David Velleman’s and Niko Kolodny’s critiques of volition-based analyses of love. Taken as a whole, the discussion provides an argument for both this analysis of love and the moral psychology it presupposes. (shrink)

What should we make of someone whose beliefs prevent her from accurately understanding her medical needs and care? Should that person still make her own health care decisions? In fact, she probably lacks decision‐making capacity. But that does not mean she is not competent.

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.

The Routledge Handbook of Love in Philosophycollects 39 original chapters from prominent philosophers on the nature, meaning, value, and predicaments of love, presented in a unique framework that highlights the rich variety of methods and traditions used to engage with these subjects. This volume is structured around important realms of human life and activity, each of which receives its own section: I. Family and Friendship II. Romance and Sex III. Politics and Society IV. Animals, Nature, and the Environment V. Art, (...) Faith, and Meaning VI. Rationality and Morality VII. Traditions: Historical and Contemporary. This last section includes chapters treating love as a subject in both Western and non-Western philosophical traditions. The contributions, all appearing in print here for the first time, are written to be accessible and compelling to non-philosophers and philosophers alike; and the volume as a whole encourages professional philosophers, teachers, students, and lay readers to rethink standard constructions of philosophical canons. (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)

In lieu of an abstract, here is a brief excerpt of the content:I Had Never Heard Someone Use That Word BeforeAdrienne Feller NovickThe patient was dying. As the social worker, I had arranged the meeting and sat shoulder to shoulder with the family and the attending physician in the small nondescript room. The family was grief-stricken and asked intelligent questions as they made difficult decisions about end-of-life care for their loved one. The doctor spoke with gentle kindness, acknowledging their difficult (...) decision as he completed the neon pink Medical Orders for Life Sustaining Treatment (MOLST) form and left the room. I was tangled up with emotions; I felt relieved that the meeting had gone smoothly, sad for the patient and family, and in awe of the doctor for his ability to lead the difficult conversation. I stayed behind to ask the family if there was anything I could do to help them. [End Page E4]Before I could speak, the patient's wife turned to me and said, "I am so glad that k--- left the room." (Using a derogatory word for a person of the Jewish faith). My brain began processing the statement. I am a Jewish woman. Did I hear that right? Did she say what I think she said? Should I say something? I froze, and time seemed to stop. She was looking at me expectantly, waiting for a response. Her face reminded me of someone waiting for the other person to return a "high five." I was flooded with emotion. A succession of thoughts ran through my head, everything from being rude in response or getting physical. I did neither. I said nothing. I smiled and left the room feeling like I had been gut-punched.I was in denial. I made excuses for the wife; she was stressed. I kept thinking I must not have heard her correctly and that I was overreacting. I continued to work with the family as though nothing had happened until the patient died five days later. I felt ashamed and never told anyone about what happened. I regretted not saying anything. I replayed the conversation in my mind and felt depressed and angry. Inside I felt complicit for not speaking up, but I had no words. I assumed bias in healthcare was rare. I did nothing.Years later, after I completed a patient visit in the Intensive Care Unit (ICU), I observed a group of surgical residents doing rounds. The attending welcomed me to join this valuable clinical learning experience. As the group approached the next bed, the patient pointed to one resident and loudly said, "I don't want a doctor who looks like that to come near me." I gasped aloud and froze, waiting to see what would happen next. The attending looked directly at the patient and said calmly, "We are all here to help you. That is not an appropriate thing for you to say." Then, he turned to the resident and nodded, directing them to resume their bedside assessment. The patient mumbled something inaudibly and said nothing.To my astonishment, the doctor acknowledged the microaggression (a microaggression is a statement, action, or incident regarded as discrimination), addressed the issue, respectfully supported the resident, created a safe space for everyone on the healthcare team and resumed quality patient care without missing a beat. He modeled a strategy to address patient bias and taught a valuable skill. This was a learning moment for me. It helped me refocus my past experience and provided me with a useful strategy to address bias in the future.As a member of the medical ethics consultation service, I listen, provide support, and aid in challenging communications. I had the opportunity to model the communication strategy I acquired in the ICU. The medical ethics team was consulted for a patient refusing treatment. The patient was disrespectful to healthcare team members, cursing at nurses and residents, using ethnic slurs, and saying he "would rather die than let one of them touch him. I entered the patient's room with the healthcare team, introduced myself, and explained the reason for my visit. The patient defiantly agreed he had used slurs, saying he wanted to go home. I continued, everyone here... (shrink)

Appreciation and gratitude get good press: They are central virtues in many religious and secular ethical frameworks, core in positive psychology research, and they come highly recommended by the self‐improvement set. Generally, appreciation and gratitude feature as good things, in popular consciousness. Of course, on an Aristotelian model, the belief that these are virtues implies they are something people can get right or wrong. This paper examines bad appreciation and bad gratitude, characterizing forms of appreciation and gratitude at the center (...) of some major social norms and practices, and demonstrating that they mask familiar oppressive expectations and power relations. (shrink)

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)

Over the last two decades, legal scholarship has been catching up with the more than century old calls by black Americans for reparations.1 Tax scholar Boris Bittker (in)famously launched the viability of black reparations into legal scholarship with his now classic monograph, The Case for Black Reparations.2 However, it would take more than twenty years for mainstream legal scholarship to take up the robust and wide-ranging set of questions raised by the possibility of reparations for American slavery.3 In the late (...) 1990s private law scholars leapt into the debate, discussing unjust enrichment and torts-based models of black reparations.4 While these scholars made a variety of distinct arguments, collectively, their model rested on the contention that America had wrongfully expropriated the labor of generations of enslaved African Americans and the result had been systemic unjust enrichment, or a species of mass torts. Grounded in various conceptions of corrective justice, these models conceive black reparations as a set of claims that would be litigated through the courts. Over the ensuing two decades, the private law model has become somewhat of an outlier in reparations discussions, largely set aside in favor of broader, more explicitly political approaches. (shrink)

_Ghosts in the Consulting Room: Echoes of Trauma in Psychoanalysis_ is the first of two volumes that delves into the overwhelming, often unmetabolizable feelings related to mourning. The book uses clinical examples of people living in a state of liminality or ongoing melancholia. The authors reflect on the challenges of learning to move forward and embrace life over time, while acknowledging, witnessing and working through the emotional scars of the past. Bringing together a collection of clinical and theoretical papers, _Ghosts (...) in the Consulting Room _features accounts of the unpredictable effects of trauma that emerge within clinical work, often unexpectedly, in ways that surprise both patient and therapist. In the book, distinguished psychoanalysts examine how to work with a variety of ‘ghosts’, as they manifest in transference and countertransference, in work with children and adults, in institutional settings and even in the very founders and foundations of the field of psychoanalysis itself. They explore the dilemma of how to process loss when it is unspeakable and unknowable, often manifesting in silence or gaps in knowledge, and living in strange relations to time and space. This book will be of interest to psychotherapists and psychoanalysts, as well as social workers, family therapists, psychologists, and psychiatrists. It will appeal to those specializing in bereavement and trauma and, on a broader level, to sociologists and historians interested in understanding means of coping with loss and grief on both an individual and larger scale basis. (shrink)

ABSTRACTRecognising a facial expression is more difficult when the expresser's body conveys incongruent affect. Existing research has documented such interference for universally recognisable bodil...