One of the fundamental aims of nursing is to safeguard or promote patients' "quality of life." Perspectives on Quality of Life examines existing ways of defining the concept and argues that nurses need to adopt a fresh approach, which more accurately reflects patients' concerns and helps them to develop practical ways of promoting the well-being of people in their care. Part One provides an analysis of statistical approaches to quality of life, including social indicators, the Quality Adjusted Life Year (QALY), (...) and the medical outcomes literature. Part Two proposes an alternative, qualitative approach to organizing care, which respects the patients' choice and individuality. Part three presents the findings of new research into the quality of life of older people in hospital wards. (shrink)

A paper was published in 2003 discussing the ethics of nurses participating in executions by inserting the intravenous line for lethal injections and providing care until death. This paper was circulated on an international email list of senior nurses and academics to engender discussion. From that discussion, several people agreed to contribute to a paper expressing their own thoughts and feelings about the ethics of nurses participating in executions in countries where capital punishment is legal. While a range of opinions (...) were presented, these opinions fell into two main themes. The first of these included reflections on the philosophical obligations of nurses as caregivers who support those in times of great need, including condemned prisoners at the end of life. The second theme encompassed the notion that no nurse ever should participate in the active taking of life, in line with the codes of ethics of various nursing organisations. This range of opinions suggests the complexity of this issue and the need for further public discussion. (shrink)

According to the Requirement of Total Evidence, when assessing the credibility of hypotheses, we should endeavor to take into account all of the relevant evidence at our disposal instead of just some proper part of that evidence. In "The Fine-Tuning Argument and the Requirement of Total Evidence," Peter Fisher Epstein offers two alleged counterexamples to this requirement. I show that, on at least one very natural interpretation of the requirement, his alleged counterexamples are not genuine. I close by explaining (...) why this conclusion is important. (shrink)

Kai Draper’s War and Individual Rights: The Foundations of Just War Theory seeks to “give birth to an alternative approach” to traditional just war theory. This review seeks to analyse and evaluate this alternative approach. Draper’s approach to just war theory differs from other approaches in three ways. First, it is “highly individualistic.” Second, Draper’s approach avoids reliance upon the principle of double effect. Third, this approach is “largely rights-based”—it seeks “to understand the ethics of war mostly (...) by way of understanding certain fundamental moral rights”. This review will argue that Draper succeeds in offering an alternative to traditional just war theory that is both rights-based and capable of dispensing with the needless complexities of the principle of double effect. However this review will argue that Draper falls short of his ultimate goal of refuting Rousseau’s claim that war is “a relationship between State and State, in which individuals are enemies only by accident”. (shrink)

Peter Draper has offered a critique of concept analysis in nursing, suggesting that many concept analysis studies can be regarded as low‐grade literature reviews. Although I will argue en passant that he was right, defending Draper is not my main concern in this paper. Instead, I undertake a close reading of a single study, and identify a series of puzzles about what it says. The puzzles pertain to the distinction between concept and phenomenon; the function of definition; (...) discriminating between the concept of interest and other concepts; how defining attributes are derived; in what sense concept analysis clarifies the concept; whether concept analysis can adjudicate current debates; the role of model cases. The point is to show how a precise and detailed interrogation of this kind sets an agenda of questions which can be asked about other examples of the same genre. The approach gives rise to concerns about the politics of reading in the current academic environment, and I refer to these concerns briefly at the end. (shrink)

Scientific debates about the nature of light have nothing to do with the philosophical problem of evil if you focus on the subject matter of those debates, but quite a bit to do with it if you focus on the structure of the reasoning in those debates. Some theories of light have been shown to be improbable, at least other evidence held equal, by comparing them to incompatible theories, both with respect to how well they fit certain data and (at (...) least implicitly) with respect to how probable they are intrinsically. Similarly, (a popular form of) theism can be shown to be improbable, at least other evidence held equal, by comparing it to the incompatible theory that physical reality is the source of mental reality. This theory of “source physicalism” fits a variety of data about good and evil much better than theism does. Further, primarily because of its modesty, source physicalism is many times more probable intrinsically than theism. It follows that, other evidence held equal, theism is very probably false. (shrink)

Climate change is reshaping patterns of displacement around the world. Extreme weather events destroy homes, environmental degradation threatens the viability of livelihoods, sea level rise and coastal erosion force communities to relocate, and risks to food and resource security magnify the sources of political instability. Climate displacement—the displacement of people driven at least in part by the impacts of climate change—is a pressing moral challenge that is incumbent upon us to address. -/- This book develops a political theory of climate (...) displacement. Most work on climate displacement has tended to take an idealized ‘climate refugee’ as its focus. But focusing on the figure of the climate refugee obscures the complexity and heterogeneity of climate displacement. Instead, this book takes the empirical dynamics of climate displacement as its starting point. It examines the moral and political problems raised by the interaction of climate change and displacement in five domains: community relocation, territorial sovereignty, labour migration, refugee movement, and internal displacement. In each context, climate displacement raises distinct questions, which this book explores on their own terms. At the same time, this book treats climate displacement as a unified phenomenon by examining the overarching questions of responsibility and fairness that it raises. The result is an empirically grounded political theory that both maps the conceptual terrain of climate displacement and charts a course for meeting the moral challenge that it raises. (shrink)

The situation of internally displaced persons has long been a matter of international concern. This volume develops a distinctive research agenda for the political philosophy of internal displacement, and highlights the salience of the phenomenon for debates on migration, refugees, territorial rights, state sovereignty, and climate change.

This article focuses on questions about evil which are both theological and doxastic, and more specifically alethic – i.e., questions about whether what we know about evil can be used to establish the falsity or probable falsity of the belief or proposition that God exists. Such a focus is natural for agnostics. More generally, it is natural for anyone who is engaged in genuine inquiry about whether or not God exists. A specific concept of God is employed – it is (...) assumed that to assert that God exists, or that ‘theism’ is true, is to assert that there exists a supernatural person who created the natural world and who is perfect in power, perfect in knowledge, and perfect in moral goodness. This is obviously a narrow sense of the words ‘God’ and ‘theism’, but it is common in the philosophical literature. The article also uses a common strategy to investigate alethic problems of evil: it constructs and evaluates a variety of ‘arguments from evil’ for the conclusion that God does not exist or that His existence is improbable. (shrink)

As I write this, in November 1971, people are dying in East Bengal from lack of food, shelter, and medical caxc. The suffering and death that are occurring there now axe not inevitable, 1101; unavoidable in any fatalistic sense of the term. Constant poverty, a cyclone, and a civil war have turned at least nine million people into destitute refugees; nevertheless, it is not beyond Lhe capacity of the richer nations to give enough assistance to reduce any further suffering to (...) very small proportions. The decisions arid actions of human beings can prevent this kind of suffering. Unfortunately, human beings have not made the necessary decisions. At the individual level, people have, with very few exceptions, not responded to the situation in any signihczmt way. Generally speaking, people have not given large sums to relief funds; they have not written t0 their parliamentaxy representatives demanding increased government assistance; they have not demonstrated in the streets, held symbolic fasts, or done anything else directed toward providing thc refugees with the means to satisfy their essential needs. At thc government level, no govcrmmcnt has given the sort of massive aid that would enable the refugees to survive fm: more than a few days. Britain, for instance, has given rather more than most countries. It has, to date, given £14,750,000. For comparative purposes, B1~itain’s share of thc nonreccverabla development costs of the Anglo-French Concorde project is already in excess of £275,000,000, and on present estimates will reach £440,000,¤00. The implication is that the British government values a supersonic transport more than thirty times as.. (shrink)

This paper discusses the views of 17 healthcare practitioners involved with transplantation on the ethics of live liver donations . Donations between emotionally related donor and recipients increased the acceptability of an LLD compared with those between strangers. Most healthcare professionals disapproved of altruistic stranger donations, considering them to entail an unacceptable degree of risk taking. Participants tended to emphasise the need to balance the harms of proceeding against those of not proceeding, rather than calculating the harm-to-benefits ratio of donor (...) versus recipient. Participants’ views suggested that a complex process of negotiation is required, which respects the autonomy of donor, recipient and HCP. Although they considered that, of the three, donor autonomy is of primary importance, they also placed considerable weight on their own autonomy. Our participants suggest that their opinions about acceptable risk taking were more objective than those of the recipient or donor and were therefore given greater weight. However, it was clear that more subjective values were also influential. Processes used in live kidney donation were thought to be a good model for LLD, but our participants stressed that there is a danger that patients may underestimate the risks involved in LLD if it is too closely associated with LKD. (shrink)

Medical student learning is dependent on an unwritten agreement between patients and the medical profession, in which students “practise” upon real patients in order that, when they are doctors, those same patients will benefit from the doctors’ skills. Given the increasing propensity for patients to refuse to take part in such learning, there is a danger that doctors will qualify without being truly competent. As patients, we must all ask ourselves, when asked to take part in medical teaching: if this (...) student/trainee doesn’t learn now, on me and under supervision, how will the person be truly competent next time, when this is for real, and the patient might be me or my loved one?We argue that a new and more explicit agreement is needed, in which the default should be that all patients are willing to help in the education of medical students, while we ensure that all such students are already competent in simulation before first practising upon real patients. (shrink)

This paper argues that a set of questioning attitudes are among the foundations of human and animal minds. While both verbal questioning and states of curiosity are generally explained in terms of metacognitive desires for knowledge or true belief, I argue that each is better explained by a prelinguistic sui generis type of mental attitude of questioning. I review a range of considerations in support of such a proposal and improve on previous characterizations of the nature of these attitudes. I (...) then broaden their explanatory scope to include a number of forms of exploratory search. The paper has three main goals: to characterize the nature of the questioning attitudes, outlining their causal role and type of content; to argue that they are fundamental components of the mind, being widespread among animals and not constructed during ontogeny out of other attitudes; and to suggest that they explain a great deal more behavior than one might think. (shrink)

We propose a solution to the problem of logical omniscience in what we take to be its fundamental version: as concerning arbitrary agents and the knowledge attitude per se. Our logic of knowledge is a spin-off from a general theory of thick content, whereby the content of a sentence has two components: an intension, taking care of truth conditions; and a topic, taking care of subject matter. We present a list of plausible logical validities and invalidities for the logic of (...) knowledge per se for arbitrary agents, and isolate three explanatory factors for them: the topic-sensitivity of content; the fragmentation of knowledge states; the defeasibility of knowledge acquisition. We then present a novel dynamic epistemic logic that yields precisely the desired validities and invalidities, for which we provide expressivity and completeness results. We contrast this with related systems and address possible objections. (shrink)

In this article we distinguish between philosophical bioethics (PB), descriptive policy orientated bioethics (DPOB) and normative policy oriented bioethics (NPOB). We argue that finding an appropriate methodology for combining empirical data and moral theory depends on what the aims of the research endeavour are, and that, for the most part, this combination is only required for NPOB. After briefly discussing the debate around the is/ought problem, and suggesting that both sides of this debate are misunderstanding one another (i.e. one side (...) treats it as a conceptual problem, whilst the other treats it as an empirical claim), we outline and defend a methodological approach to NPOB based on work we have carried out on a project exploring the normative foundations of paternal rights and responsibilities. We suggest that given the prominent role already played by moral intuition in moral theory, one appropriate way to integrate empirical data and philosophical bioethics is to utilize empirically gathered lay intuition as the foundation for ethical reasoning in NPOB. The method we propose involves a modification of a long-established tradition on non-intervention in qualitative data gathering, combined with a form of reflective equilibrium where the demands of theory and data are given equal weight and a pragmatic compromise reached. (shrink)

This paper offers an ethical framework for the development of robots as home companions that are intended to address the isolation and reduced physical functioning of frail older people with capacity, especially those living alone in a noninstitutional setting. Our ethical framework gives autonomy priority in a list of purposes served by assistive technology in general, and carebots in particular. It first introduces the notion of “presence” and draws a distinction between humanoid multi-function robots and non-humanoid robots to suggest that (...) the former provide a more sophisticated presence than the latter. It then looks at the difference between lower-tech assistive technological support for older people and its benefits, and contrasts these with what robots can offer. This provides some context for the ethical assessment of robotic assistive technology. We then consider what might need to be added to presence to produce care from a companion robot that deals with older people’s reduced functioning and isolation. Finally, we outline and explain our ethical framework. We discuss how it combines sometimes conflicting values that the design of a carebot might incorporate, if informed by an analysis of the different roles that can be served by a companion robot. (shrink)

Narrative thinking -- Narrative thinking about one's past -- Grief : a case study -- Narrative thinking about one's future -- Self-forgiveness : a case study -- The narrative sense of self -- Narrative, truth, life, and fiction.

What is ethics? Where do moral standards come from? Are they based on emotions, reason, or some innate sense of right and wrong? For many scientists, the key lies entirely in biology---especially in Darwinian theories of evolution and self-preservation. But if evolution is a struggle for survival, why are we still capable of altruism? In his classic study The Expanding Circle, Peter Singer argues that altruism began as a genetically based drive to protect one's kin and community members but (...) has developed into a consciously chosen ethic with an expanding circle of moral concern. Drawing on philosophy and evolutionary psychology, he demonstrates that human ethics cannot be explained by biology alone. Rather, it is our capacity for reasoning that makes moral progress possible. In a new afterword, Singer takes stock of his argument in light or recent research on the evolution of morality.--Publisher's description. (shrink)

Single-premise epistemic closure is the principle that: if one is in an evidential position to know that P where P entails Q, then one is in an evidential position to know that Q. In this paper, I defend the viability of opposition to closure. A key task for such an opponent is to precisely formulate a restricted closure principle that remains true to the motivations for abandoning unrestricted closure but does not endorse particularly egregious instances of closure violation. I focus (...) on two brands of epistemic theory that naturally incorporate closure restrictions. The first type holds that the truth value of a knowledge ascription is relative to a relevant question. The second holds that the truth value of a knowledge ascription is relative to a relevant topic. For each approach, I offer a formalization of a leading theory from the literature and use this formalization to evaluate the theory’s adequacy in terms of a precise set of desiderata. I conclude that neither theory succeeds in meeting these desiderata, casting doubt on the viability of the underlying approaches. Finally, I offer a novel variant of the topic-sensitive approach that fares better. (shrink)

This chapter provides an introduction to higher-order metaphysics as well as to the contributions to this volume. We discuss five topics, corresponding to the five parts of this volume, and summarize the contributions to each part. First, we motivate the usefulness of higher-order quantification in metaphysics using a number of examples, and discuss the question of how such quantifiers should be interpreted. We provide a brief introduction to the most common forms of higher-order logics used in metaphysics, and indicate a (...) number of questions which can be raised in such systems using logical vocabulary alone. Using a further example, we return to applications of higher-order logics in metaphysics. We also mention key developments in the history of higher-order logic as it pertains to metaphysics. Finally, we mention certain arguments which have been raised against the use of higher-order logic, and some ways of responding to them. (shrink)

Introduction These essays have been written over a period of about ten years and have already been published separately in various places. ...

The phenomenon of contract cheating presents, potentially, a serious threat to the quality and standards of Higher Education around the world. There have been suggestions, cited below, to tackle the problem using legal means, but we find that current laws are not fit for this purpose. In this article we present a proposal for a specific new law to target contract cheating, which could be enacted in most jurisdictions.We test our proposed new law against a number of issues that would (...) need to be considered before any legal approach could be successful; would changing the legal status of contract cheating make it less likely to happen? Could this be achieved in a specific way? If so, who should actually be prosecuted and what offence are they committing? Would it actually address the causes of contract cheating? We suggest some answers to these questions, but then also identify a number of unintended potential consequences. We therefore additionally consider whether a legal approach is possible or even desirable.We conclude that a legal approach to contract cheating is possible, and, on balance, appropriate. Using UK law as an example, we offer a specific suggestion to lawmakers, around the world, for how this might be achieved, and conclude that the most successful approach would be to focus largely on a law targeting the providers of contract cheating, in particular commercial services. (shrink)

Since its original publication in 1975, this groundbreaking work has awakened millions of people to the existence of "speciesism"—our systematic disregard of nonhuman animals—inspiring a worldwide movement to transform our attitudes to animals and eliminate the cruelty we inflict on them. In Animal Liberation, author Peter Singer exposes the chilling realities of today’s "factory farms" and product-testing procedures—destroying the spurious justifications behind them, and offering alternatives to what has become a profound environmental and social as well as moral issue. (...) An important and persuasive appeal to conscience, fairness, decency, and justice, it is essential reading for the supporter and the skeptic alike. (shrink)

In Europe, telecare is the use of remote monitoring technology to enable vulnerable people to live independently in their own homes. The technology includes electronic tags and sensors that transmit information about the user's location and patterns of behavior in the user's home to an external hub, where it can trigger an intervention in an emergency. Telecare users in the United Kingdom sometimes report their unease about being monitored by a ?Big Brother,? and the same kind of electronic tags that (...) alert telecare hubs to the movements of someone with dementia who is ?wandering? are worn by terrorist suspects who have been placed under house arrest. For these and other reasons, such as ordinary privacy concerns, telecare is sometimes regarded as an objectionable extension of a ?surveillance state.? In this article, we defend the use of telecare against the charge that it is Orwellian. In the United States, the conception of telecare primarily as telemedicine, and the fact that it is not typically a government responsibility, make a supposed connection with a surveillance state even more doubtful than in Europe. The main objection, we argue, to telecare is not its intrusiveness, but the danger of its deepening the isolation of those who use it. There are ways of organizing telecare so that the independence and privacy of users are enhanced, but personal isolation may be harder to address. As telecare is a means of reducing the cost of publicly provided social and health care, and the need to reduce public spending is growing, the correlative problem of isolation must be addressed alongside the goal of promoting independence. (shrink)

First published in 1987. Routledge is an imprint of Taylor & Francis, an informa company.

Bioethics, Volume 35, Issue 7, Page 623-633, September 2021.

We created Justice: The Game, an educational, role-immersion game designed to be used in philosophy courses. We seek to describe Justice in sufficent detail so that it is understandable to readers not already familiar with role-immersion pedagogy. We hope some instructors will be sufficiently interested in using the game. In addition to describing the game we also evaluate it, thereby highlighting the pedagogical potential of role-immersion games designed to teach political philosophy. We analyze the game by drawing on our observations (...) as designers and playtesters of Justice, along with feedback from students obtained in focus-groups conducted shortly after playtesting ended. We present evidence that Justice, compared to conventional instructional methods alone, plausibly enhances student learning of philosophical skills and content by requiring them to practice those skills and put their content-area knowledge to use in a highly-motivating and engaging context. (shrink)

I lay out the framework for my theory of sensory imagination in “Imagining as a guide to possibility.” Sensory imagining involves mental imagery , and crucially, in describing the content of imagining, I distinguish between qualitative content and assigned content. Qualitative content derives from the mental image itself; for visual imaginings, it is what is “pictured.” For example, visually imagine the Philadelphia Eagles defeating the Pittsburgh Steelers to win their first Super Bowl. You picture the greenness of the field and (...) the football’s brown oblong shape. Some of what you imagine isn’t explicitly pictured, however. That it is Sunday, that it is the Super Bowl: these facts are assigned. (shrink)

Political decisions have the potential to greatly impact our lives. Think of decisions in relation to abortion or climate change, for example. This makes political legitimacy an important normative concern. But what makes political decisions legitimate? Are they legitimate in virtue of having support from the citizens? Democratic conceptions of political legitimacy answer in the affirmative. Such conceptions righly highlight that legitimate political decision-making must be sensitive to disagreements among the citizens. But what if democratic decisions fail to track what (...) there is most reason to do? What if a democratically elected government fails to take measures necessary to protect its population from threats related to climate change? Peter argues that the legitimacy of political decisions doesn't just depend on respect for the citizens' will; and defends a novel hybrid conception of political legitimacy, called the Epistemic Accountability conception. According to this conception, political legitimacy also depends on how political decision-making responds to evidence for what there is most reason to do. Grounds for Political Legitmacy starts with an overview of the main ways in which philosophers have thought about political legitimacy, and identifies the epistemic accountability conception as an overlooked alternative. It then develops the epistemic accountability conception of political legitimacy and discusses its implications for legitimate political decision-making. Considering the norms that should govern political debate, it examines the role of experts in politics, and probes the responsibilities of democratically elected political leaders and as well as of citizens. (shrink)

COVID-19 continues to dominate 2020 and is likely to be a feature of our lives for some time to come. Given this, how should health systems respond ethically to the persistent challenges of responding to the ongoing impact of the pandemic? Relatedly, what ethical values should underpin the resetting of health services after the initial wave, knowing that local spikes and further waves now seem inevitable? In this editorial, we outline some of the ethical challenges confronting those running health services (...) as they try to resume non-COVID-related services, and the downstream ethical implications these have for healthcare professionals’ day-to-day decision making. This is a phase of recovery, resumption and renewal; a form of reset for health services.1 This reset phase will define the ‘new normal' for healthcare delivery, and it offers an opportunity to reimagine and change services for the better. There are difficulties, however, healthcare systems are already weakened by austerity and the first wave of COVID-19 and remain under stress as the pandemic continues. The reset period is operating alongside, rather than at the end, of the pandemic and this creates difficult ethical choices. ### Balancing the greater good with individual care Pandemics—and public health emergencies more generally—reinforce approaches to ethics that emphasise or derive from the interests of communities, rather than those grounded in the claims of the autonomous individual. The response has been to draw on more public health focused ethics, ‘if demand outstrips the ability to deliver to existing standards, more strictly utilitarian considerations will have to be applied, and decisions about how to meet the individual's need will give way to decisions about how to maximise overall benefit’.2 Alongside this, effective …. (shrink)