The aim of this article is to demonstrate the usefulness of qualitative research for studying the ethics of care, bringing to light the lived experience of health care recipients, together with the importance of methods that allow reconstruction of the processes underlying this lived experience. Lived experiences of families being approached for organ donation, parents facing the imminent death of their child and patients being treated using stem cell transplantation are used to illustrate how ethical principles are differentiated, modified or (...) contradicted by the narrative context of persons concerned. The integration of empirical data into ethics will help caregivers in their ethical decision making and may enrich care ethics as a narrative and interpretative field. (shrink)

Much of the time, human beings seem to rely on habits. Habits are learned behaviours directly elicited by context cues, and insensitive to short-term changes in goals: therefore they are sometimes irrational. But even where habitual responses are rational, it can seem as if they are nevertheless not done for reasons. For, on a common understanding of habitual behaviour, agents’ intentions do not play any role in the coming about of such responses. This paper discusses under what conditions we can (...) say that habitual responses are, after all, done for reasons. We show how the idea that habitual behaviour cannot be understood as ‘acting for reasons’ stems from a widely but often implicitly held theoretical framework: the causal theory of action. We then propose an alternative, Anscombean understanding of intentional action, which can account for habitual responses being done for reasons. (shrink)

Recent studies of scientific interaction based on agent-based models suggest that a crucial factor conducive to efficient inquiry is what Zollman has dubbed ‘transient diversity’. It signifies a process in which a community engages in parallel exploration of rivaling theories lasting sufficiently long for the community to identify the best theory and to converge on it. But what exactly generates transient diversity? And is transient diversity a decisive factor when it comes to the efficiency of inquiry? In this paper we (...) examine the impact of different conditions on the efficiency of inquiry, as well as the relation between diversity and efficiency. This includes certain diversity-generating mechanisms previously proposed in the literature, as well as some factors that have so far been neglected. This study is obtained via an argumentation-based ABM. Our results suggest that cautious decision-making does not always have a significant impact on the efficiency of inquiry while different evaluations underlying theory-choice and different social networks do. Moreover, we find a correlation between diversity and a successful performance of agents only under specific conditions, which indicates that transient diversity is sometimes not the primary factor responsible for efficiency. Altogether, when comparing our results to those obtained by structurally different ABMs based on Zollman’s work, the impact of specific factors on efficiency of inquiry, as well as the role of transient diversity in achieving efficiency, appear to be highly dependent on the underlying model. (shrink)

Controversy swept the U.K. in January of 2000 over public disclosure of the fact that a Scottish surgeon named Robert Smith had amputated the limbs of two able-bodied individuals who reportedly suffered from a condition known as apotemnophilia. The patients, both of whom had sought and consented to the surgery, claimed they had desperately desired for years to live as amputees and had been unable, despite considerable efforts, to reconcile themselves psychologically to living with the bodies with which they were (...) born. Both surgeries were successful, and both patients, who had undergone psychiatric evaluation prior to the amputations, subsequently reported having no regrets. In the wake of a wave of sensationalistic stories in the media, the hospital at which the surgeries had been performed, the Falkirk and District Royal Infirmary, banned any future surgeries of the kind. Outraged local politicians promptly announced their intention to pass laws banning the procedure outright. One member of Scottish Parliament declared the surgery obscene and asserted that the whole thing is repugnant and legislation needs to be brought in now to outlaw this. (shrink)

This article focuses on both daily forms of weakness of will as discussed in the philosophical debate and psychopathological phenomena as impairments of decision making. We argue that both descriptions of dysfunctional decision making can be organized within a common theoretical framework that divides the decision making process in three different stages: option generation, option selection, and action initiation. We first discuss our theoretical framework, focusing on option generation as an aspect that has been neglected by previous models. In the (...) main body of this article, we review how both philosophy and neuropsychiatry have provided accounts of dysfunction in each decision-making stage, as well as where these accounts can be integrated. Also, the neural underpinnings of dysfunction in the three different stages are discussed. We conclude by discussing advantages and limitations of our integrative approach. (shrink)

Recent studies of scientific interaction based on agent-based models suggest that a crucial factor conducive to efficient inquiry is what Zollman has dubbed ‘transient diversity’. It signifies a process in which a community engages in parallel exploration of rivaling theories lasting sufficiently long for the community to identify the best theory and to converge on it. But what exactly generates transient diversity? And is transient diversity a decisive factor when it comes to the efficiency of inquiry? In this paper we (...) examine the impact of different conditions on the efficiency of inquiry, as well as the relation between diversity and efficiency. This includes certain diversity-generating mechanisms previously proposed in the literature, as well as some factors that have so far been neglected. This study is obtained via an argumentation-based ABM. Our results suggest that cautious decision-making does not always have a significant impact on the efficiency of inquiry while different evaluations underlying theory-choice and different social networks do. Moreover, we find a correlation between diversity and a successful performance of agents only under specific conditions, which indicates that transient diversity is sometimes not the primary factor responsible for efficiency. Altogether, when comparing our results to those obtained by structurally different ABMs based on Zollman’s work, the impact of specific factors on efficiency of inquiry, as well as the role of transient diversity in achieving efficiency, appear to be highly dependent on the underlying model. (shrink)

Controversy swept the U.K. in January of 2000 over public disclosure of the fact that a Scottish surgeon named Robert Smith had amputated the limbs of two able-bodied individuals who reportedly suffered from a condition known as apotemnophilia. The patients, both of whom had sought and consented to the surgery, claimed they had desperately desired for years to live as amputees and had been unable, despite considerable efforts, to reconcile themselves psychologically to living with the bodies with which they were (...) born. Both surgeries were successful, and both patients, who had undergone psychiatric evaluation prior to the amputations, subsequently reported having no regrets. In the wake of a wave of sensationalistic stories in the media, the hospital at which the surgeries had been performed, the Falkirk and District Royal Infirmary, banned any future surgeries of the kind. Outraged local politicians promptly announced their intention to pass laws banning the procedure outright. One member of Scottish Parliament declared the surgery obscene and asserted that the whole thing is repugnant and legislation needs to be brought in now to outlaw this. (shrink)

Recently, two apparent truisms about self-control have been questioned in both the philosophical and the psychological literature: the idea that exercising self-control involves an agent doing something, and the idea that self-control is a good thing. Both assumptions have come under threat because self-control is increasingly understood as a mental mechanism, and mechanisms cannot possibly be good or active in the required sense. However, I will argue that it is not evident that self-control should be understood as a mechanism, suggesting (...) that we might also argue the other way around: if we have independent reason to hold onto the idea that self-control is inherently good and active, the conclusion might be that self-control cannot be a mechanism. I will show that Aristotle's original analysis of self-control actually offers grounds for both assumptions: he took there to be conceptual connections between self-control and goodness/activity. By examining these connections, I argue that an Aristotelian approach could offer promising leads for a contemporary non-mechanistic understanding of self-control as a normative capacity. (shrink)

This book explores classic philosophical questions regarding the phenomenon of weakness of will or ‘akrasia’: doing A, even though all things considered, you judge it best to do B. Does this phenomenon really exist and if so, how should it be explained? Nacht van Descartes -/- The author provides a historical overview of some traditional answers to these questions and addresses the main question: how does the phenomenon of 'going against your own judgment' relate to the idea that we are (...) rational beings? She elaborates on the notion of rational agency and shows how different types of behaviour express or fail to express our rational agency. This leads to the speculation of what is needed for akratic action to be free action. -/- A novel position is developed, stating that certain widespread philosophical accounts of free action must conclude that 'going against your own judgment' is necessarily unfree. This also requires a reflection on possible implications for moral responsibility. Would it mean that people cannot be held accountable for irrational behaviour? -/- Kalis offers insight on whether everyday irrational behaviour differs from irrational behaviour occurring in the context of psychiatric dysfunction, and develops a view on how we should understand ourselves when we do something other than what we judge best. -/- Written for philosophers, psychologists and psychiatrists interested in issues of irrationality and philosophy of action, this is an indispensable book for both professionals and students interested in interdisciplinary endeavours in the science of mind and behaviour. (shrink)

In part 1 of Enquiry 12, Hume presents a skeptical argument against belief in external existence. The argument involves a perceptual relativity argument that seems to conclude straightaway the double existence of objects and perceptions, where objects cause and resemble perceptions. In Treatise 1.4.2, Hume claimed that the belief in double existence arises from imaginative invention, not reasoning about perceptual relativity. I dissolve this tension by distinguishing the effects of natural instinct and showing that some ofthese effects supplement the Enquiry’s (...) perceptual relativity argument. The Enquiry’s skeptical argument thus reveals the fundamental involvement of natural instinct in any belief in external existence. (shrink)

A well-known typological observation is the dominance of subject-initial word orders, SOV and SVO, across the world's languages. Recent findings from gestural language creation paradigms offer possible explanations for the prevalence of SOV. When asked to gesture transitive events with an animate agent and inanimate patient, gesturers tend to produce SOV order, regardless of their native language biases. Interestingly, when the patient is animate, gesturers shift away from SOV to use of other orders, like SVO and OSV. Two competing hypotheses (...) have been proposed for this switch: the noisy channel account and the role conflict account. We set out to distinguish between these two hypotheses, disentangling event reversibility and patient animacy, by looking at gestural sequences for events with two inanimate participants. We replicated the previous findings of a preference for SOV order when describing animate-inanimate, irreversible events as well as a decrease in the use of SOV when presented with animate-animate, reversible events. Accompanying the drop in SOV, in a novel condition we observed an increase in the use of SVO and OSV orders when describing events involving two animate entities. In sum, we find that the observed avoidance of SOV order in gestural language creation paradigms when the event includes an animate agent and patient is driven by the animacy of the participants rather than the reversibility of the event. We suggest that findings from gestural creation paradigms are not automatically linkable to spoken language typology. (shrink)

Although much recent social science and humanities work has been a revolt against simplification, this volume explores the contrast between simplicity and complexity to reveal that this dichotomy, itself, is too simplistic. John Law and Annemarie Mol have gathered a distinguished panel of contributors to offer—particularly within the field of science studies—approaches to a theory of complexity, and at the same time a theoretical introduction to the topic. Indeed, they examine not only ways of relating to complexity but complexity (...) _in practice._ Individual essays study complexity from a variety of perspectives, addressing market behavior, medical interventions, aeronautical design, the governing of supranational states, ecology, roadbuilding, meteorology, the science of complexity itself, and the psychology of childhood trauma. Other topics include complex wholes in the sciences, moral complexity in seemingly amoral endeavors, and issues relating to the protection of African elephants. With a focus on such concepts as multiplicity, partial connections, and ebbs and flows, the collection includes narratives from Kenya, Great Britain, Papua New Guinea, the Netherlands, France, and the meetings of the European Commission, written by anthropologists, economists, philosophers, psychologists, sociologists, and scholars of science, technology, and society. _Contributors._ Andrew Barry, Steven D. Brown, Michel Callon, Chunglin Kwa, John Law, Nick Lee, Annemarie Mol, Marilyn Strathern, Laurent Thévenot, Charis Thompson. (shrink)

ABSTRACT: In Treatise 1.4.4, on behalf of modern philosophers, Hume described a causal argument that shows that our impressions of secondary qualities do not resemble qualities of objects themselves. However, in their respective arguments, Hume’s philosophical predecessors did not argue causally, but appealed to contrary qualities. I argue that Hume’s presentation was not simply a “gratuitous” stylistic difference, but an important correction of his predecessors in light of his own philosophical discoveries. RÉSUMÉ : Dans le Traité 1.4.4, Hume a présenté (...) au nom des philosophes modernes un argument causal qui démontre que nos impressions des qualités secondaires ne ressemblent pas aux qualités des objets eux-mêmes. Les prédécesseurs de Hume n’ont pourtant pas employé d’argument causal, mais l’argument des qualités contraires. Je soutiens que la présentation qu’en a fait Hume n’est pas simplement à mettre au compte d’une différence stylistique «gratuite» mais est une correction importante dans la foulée de ses propres découvertes philosophiques. (shrink)

This study investigates what professional caregivers working in nursing homes consider to be a good life for residents suffering from dementia. Ten caregivers were interviewed; special attention was paid to the way in which they deal with conflicting values. Transcripts of the interviews were analysed qualitatively according to the method of grounded theory. The results were compared with those from a similar, earlier study on ideals found in mission statements of nursing homes. The concepts that were mentioned by most interviewed (...) participants as important for a good life were ‘peace and quiet’, ‘going along with subjective experience’ and ‘no enforcement: the way the resident wants it’. A considerable overlap was found between the interviews and the mission statements; however, when compared with the mission statements, the interviews put less emphasis on individuality and on giving meaning, and more on offering residents pleasant activities. When faced with conflicting values, caregivers tend to make pragmatic and more or less intuitive decisions. Although this has its merits, it may be desirable to stimulate conscious reflection regarding conflict between different values. (shrink)

Diagnosis plays an important role in how we understand disease, and how medicine confirms its status in contemporary society. However, diagnoses are far less concrete than their taxonomies suggest. This essay presents influenza as a case study in the elusive nature of the diagnosis, and in its complicated realities. Using the metaphor of boundary transgression, it reveals the fluidity of diagnosis and the paradoxes presented by the naturalization of diseases. In order to contain influenza, medicine commits other paradoxical transgressions of (...) boundaries. Lay self-diagnosis, use of the lay expression “flu,” and wide reliance upon the belief in the influenza-like syndrome are used to attempt to cement a concrete notion of influenza. (shrink)

Classification shapes medicine and guides its practice. As clinicians classify symptoms and illnesses, they trigger a range of actions and consequences. The assignment of particular disease labels is linked to both therapeutic and social responses. However, the classifications of medicine, natural though they may seem, contain significant social content, and are arrived at via a number of cultural framing devices (Aronowitz 2008). This article will explore the social intent and construction of classification and their embodiment in medical diagnosis.Effective classification recognizes (...) difference as well as similarity. By classifying, we are putting items together that have more in common with one another than they .. (shrink)

In contemporary moral psychology, an often-heard claim is that knowing how we make moral judgments can help us make better moral judgments. Discussions about moral development and improvement are often framed in terms of the question of which mental processes have a better chance of leading to good moral judgments. However, few studies elaborate on the question of what makes a moral judgment a good moral judgment. This article examines what is needed to answer questions of moral improvement and development. (...) It distinguishes 3 types of claims that are at stake: descriptive claims, metaethical claims, and normative claims. To find out what makes certain moral judgments better than others, one needs to have insight in the psychological processes and capacities underlying moral judgment formation. However, one also needs to address the question of what makes a moral judgment justified, and this in turn requires a view on the nature of moral goodness and on the question of what makes a judgment moral at all. The author discusses possible ways in which philosophical theories in the areas of metaethics and normative ethics can contribute to the answering of such questions. Also, she provides concrete suggestions for doing interdisciplinary research that is able to address those questions in moral psychology that have both normative and descriptive aspects. (shrink)

This piece is a response to Marilyn Strathern's article, “Binary License,” in the Common Knowledge symposium on “comparative relativism.” Arguing that, across noncoherent practices, there is room for different natures, the essay suggests that modes of relating (the briefly invoked example given is of divergent counting practices) do not need a shared conceptual apparatus in order to be combined. What is held in the juxtaposition of acts and practices seems to be the sense in which acts are not affected by (...) how they are described. The main example given is of surgery, and the emphasis placed on how splitting open part of patient's body is never a matter of a point of view. But to know exactly what is going on in the operating theater, we might wish to ask how this act speaks to the act of intellectual bifurcation, splitting open what up to then had been a seamless argument. To know exactly what is going on in the operating theater, we might also wish to ask how this act speaks to persons cutting themselves off from one another. (shrink)

We all know that we have and are our bodies. But might it be possible to leave this common place? In the present article we try to do this by attending to the way we do our bodies. The site where we look for such action is that of handling the hypoglycaemias that sometimes happen to people with diabetes. In this site it appears that the body, active in measuring, feeling and countering hypoglycaemias is not a bounded whole: its boundaries (...) leak. Bits and pieces of the outside get incorporated within the active body; while the centre of some bodily activities is beyond the skin. The body thus enacted is not self-evidently coherent either. There are tensions between the body’s organs; between the control under which we put our bodies and the erratic character of their behaviour; and between the various needs and desires single bodies somehow try to combine. Thus to say that a body is a whole, or so we conclude, skips over a lot of work. One does not hang together as a matter of course: keeping oneself together is something the embodied person needs to do. The person who fails to do so dies. (shrink)

Reasoning with the maximally consistent subsets of the premises is a well-known approach for handling contradictory information. In this paper we consider several variations of this kind of reasoning, for each one we introduce two complementary computational methods that are based on logical argumentation theory. The difference between the two approaches is in their ways of making consequences: one approach is of a declarative nature and is related to Dung-style semantics for abstract argumentation, while the other approach has a more (...) proof-theoretical flavor, extending Gentzen-style sequent calculi. The outcome of this work is a new perspective on reasoning with MCS, which shows a strong link between the latter and argumentation systems, and which can be generalized to some related formalisms. As a by-product of this we obtain soundness and completeness results for the dynamic proof systems with respect to several of Dung’s semantics. In a broader context, we believe that this work helps to better understand and evaluate the role of logic-based instantiations of argumentation frameworks. (shrink)

Autonomous e-coaching systems offer their users suggestions for action, thereby affecting the user's decision-making process. More specifically, the suggestions that these systems make influence the options for action that people actually consider. Surprisingly though, options and the corresponding process of option generation --- a decision-making stage preceding intention formation and action selection --- has received very little attention in the various disciplines studying decision making. We argue that this neglect is unjustified and that it is important, particularly for designers of (...) autonomous e-coaching systems, to understand how human option generation works. The aims of this paper are threefold. The first aim is to generate awareness with designers of autonomous e-coaching systems that these systems do in fact influence their users' options. The second is to show that understanding the interplay between a person's options and the e-coaching system's suggestions is important for improving the effectiveness of the system. The third is that the very same interplay is also crucial for designing e-coaching systems that respect people's autonomy. (shrink)

In public debates about the desirability of force feeding in the Netherlands the inclination of people with dementia to refrain from eating and drinking tends to be either taken as their gut-way of expressing their will, or as a symptom of their disease running its natural course. An ethnographic inquiry into daily care, however, gives a quite different insight in fasting by relating it to common practices of eating and drinking in nursing homes. In a nursing home eating and drinking (...) are important social activities that may be shaped quite differently. And while necessary for survival, food and drink also have other qualities: taste, temperature, texture, smell. Whether we want it or not, in the end we all die. But with different modes of care come different modes of dying and of living. (shrink)