George Du Maurier’s best-selling novel, Trilby (1894), is as important because of its defiance of social and cultural norms as it is for its apparent compliance with them. Trilby is a fiction that, like its eponymous heroine, attempts to negotiate the perilously fine line between the highbrow and the lowbrow, or to put it another way, between fine art and political commentary on one side, and pornography and sensationalism on the other. This article examines the way that Du Maurier engages (...) his readership in this textual tease – his seduction of the reader – by suggesting the possibility of a peep show where everything that Victorian respectability abhors may be on display, and then his narratological dressing of the text, to ensure that where there is sexual non-conformity there is also moralism, and where there is social confrontation there is also historical distance. Understanding the textual appeal of Trilby as a character, the artist’s model who enchanted the fin-de-siècle reading public, is essential to appreciating how the discourses of pornography and fine art interact and have consequently evolved. This article therefore examines why Trilby succeeded with the Victorians where other, similarly sexually active heroines – such as Thomas Hardy’s Sue Bridehead – failed. Trilby the novel and Trilby the woman are both broken down by their author into manageable parts, a pornographic fetishistic technique that simultaneously eroticises, and makes more palatable, the textual and the physical bodies. (shrink)

Psychedelics have been recognized as model interventions for studying altered states of consciousness. However, few empirical studies of the shamanic state of consciousness, which is anecdotally similar to the psychedelic state, exist. We investigated the neural correlates of shamanic trance using high-density electroencephalography (EEG) in 24 shamanic practitioners and 24 healthy controls during rest, shamanic drumming, and classical music listening, followed by an assessment of altered states of consciousness. EEG data were used to assess changes in absolute power, connectivity, signal (...) diversity, and criticality, which were correlated with assessment measures. We also compared assessment scores to those of individuals in a previous study under the influence of psychedelics. Shamanic practitioners were significantly different from controls in several domains of altered states of consciousness, with scores comparable to or exceeding that of healthy volunteers under the influence of psychedelics. Practitioners also displayed increased gamma power during drumming that positively correlated with elementary visual alterations. Furthermore, shamanic practitioners had decreased low alpha and increased low beta connectivity during drumming and classical music and decreased neural signal diversity in the gamma band during drumming that inversely correlated with insightfulness. Finally, criticality in practitioners was increased during drumming in the low and high beta and gamma bands, with increases in the low beta band correlating with complex imagery and elementary visual alterations. These findings suggest that psychedelic drug-induced and non-pharmacologic alterations in consciousness have overlapping phenomenal traits but are distinct states of consciousness, as reflected by the unique brain-related changes during shamanic trance compared to previous literature investigating the psychedelic state. (shrink)

By definition, pain is a sensory and emotional experience that is felt in a particular part of the body. The precise relationship between somatic events at the site where pain is experienced, and central processing giving rise to the mental experience of pain remains the subject of debate, but there is little disagreement in scholarly circles that both aspects of pain are critical to its experience. Recent experimental work, however, suggests a public view that is at odds with this conceptualisation. (...) By demonstrating that the public does not necessarily endorse central tenets of the “mental” view of pain (subjectivity, privacy, and incorrigibility), experimental philosophers have argued that the public holds a more “body-centric” view than most clinicians and scholars. Such a discrepancy would have important implications for how the public interacts with pain science and clinical care. In response, we tested the hypothesis that the public is capable of a more “mind-centric” view of pain. Using a series of vignettes, we demonstrate that in situations which highlight mental aspects of pain the public can, and does, recognize pain as a mental phenomenon. We also demonstrate that the public view is subject to context effects, by showing that the public’s view is modified when situations emphasizing mental and somatic aspects of pain are presented together. (shrink)

Terminal kidney patients are faced with lower quality of life, restricted diets and higher morbidity and mortality rates while waiting for deceased donor kidney transplantation. Fortunately, living kidney donation has proven to be a better treatment alternative (e.g. in terms of waiting time and graft survival rates). We observed an inequality in the number of living kidney transplantations performed between the non-European and the European patients in our center. Such inequality has been also observed elsewhere in this field and it (...) has been suggested that this inequality relates to, among other things, attitude differences towards donation based on religious beliefs. In this qualitative research we investigated whether religion might indeed (partly) be the explanation of the inequalities in living donor kidney transplants (LDKT) among non-European patients. Fifty patients participated in focus group discussions and in-depth interviews. The interviews were conducted following the focus group method and analyzed in line with Grounded Theory. The qualitative data analyses were performed in Atlas.ti. We found that religion is not perceived as an obstacle to living donation and that religion actually promotes helping and saving the life of a person. Issues such as integrity of the body were not seen as barriers to LDKT. We observed also that there are still uncertainties and a lack of awareness about the position of religion regarding living organ donation within communities, confusion due to varying interpretations of Holy Scriptures and misconceptions regarding the process of donation. Faith leaders play an important educational role and their opinion is influential. This study has identified modifiable factors which may contribute to the ethnic disparity in our living donation program. We argue that we need to strive for more clarity and awareness regarding the stance of religion on the issue of living donation in the local community. Faith leaders could be key figures in increasing awareness and alleviating uncertainty regarding living donation and transplantation. (shrink)

Since at least Hume and Kant, philosophers working on the nature of aesthetic judgment have generally agreed that common sense does not treat aesthetic judgments in the same way as typical expressions of subjective preferences—rather, it endows them with intersubjective validity, the property of being right or wrong regardless of disagreement. Moreover, this apparent intersubjective validity has been taken to constitute one of the main explananda for philosophical accounts of aesthetic judgment. But is it really the case that most people (...) spontaneously treat aesthetic judgments as having intersubjective validity? In this paper, we report the results of a cross‐cultural study with over 2,000 respondents spanning 19 countries. Despite significant geographical variations, these results suggest that most people do not treat their own aesthetic judgments as having intersubjective validity. We conclude by discussing the implications of our findings for theories of aesthetic judgment and the purpose of aesthetics in general. (shrink)

According to standard philosophical and clinical understandings, pain is an essentially mental phenomenon. In a challenge to this standard conception, a recent burst of empirical work in experimental philosophy, such as that by Justin Sytsma and Kevin Reuter, purports to show that people ordinarily conceive of pain as an essentially bodily phenomenon—specifically, a quality of bodily disturbance. In response to this bodily view, other recent experimental studies have provided evidence that the ordinary concept of pain is more complex than previously (...) assumed: rather than tracking only bodily or only mental aspects of pain, the ordinary concept of pain can actually track either of these aspects. The polyeidic analysis of the folk concept of pain, as proposed by Emma Borg et al., captures this complexity. Whereas previous empirical support for the polyeidic view has focused on the context-sensitivity of the folk concept of pain, here we discuss individual differences in people’s ‘pain priors’—namely, their standing tendencies to think of pain in relatively mind-centric or body-centric ways. We describe a preliminary empirical study and present a small number of findings, which will be explored further in future work. The results we discuss are part of a larger programme of work which seeks to integrate philosophical pain research into clinical practice. For example, we hypothesise that variations in how patients with chronic pain are thinking about pain could help predict their responses to treatment. (shrink)

In The Age of Culpability, Gideon Yaffe argues that all minors who commit crimes should be treated more leniently by the criminal law than similarly situated adults. This core intuition – that “kid...

This work reviews and critically evaluates contemporary American Catholic moral theological reflections, both non-magisterial and magisterial, from 1975 to the present. It also considers relevant reflections from papal and papally related literature, and from the older tradition. It examines the following: criteria used in distinguishing between "ordinary" and "extraordinary" means, e.g., benefit and burden; miscellaneous elements employed in regard to these means, e.g., treatment and care; definitions given for these means. Based on the results of the foregoing, it proposes original (...) working definitions of these two main types of means. ;This work confirms the need, already recognized by some moral theologians, for a broad foundational criterion on which to base contemporary definitions of and distinctions between "ordinary" and "extraordinary" means. It finds the criteria offered thus far to be suggestive but flawed. Accordingly, its own working definitions are grounded in a foundational criterion of "integral human fulfillment in Jesus," a concept taken from the fundamental moral theological system developed by Germain Grisez. (shrink)

This paper argues that there are no necessary and sufficient conditions for the identity through time of material objects where those conditions have a kind of empirical content necessary for them to function as criteria for identity through time. Taking Eli Hirsch’s program in The Concept of Identity as representative of attempts to formulate conditions which are logically necessary and sufficient and which also function as criteria guiding our tracing of objects’ careers through time, I argue (a) that, when such (...) programs are constructed in a way sensitive to the criteria we actually use, they fall prey to conceivable counterexamples and (b) that, when such programs are tightened to avoid logically possible counterexamples, they fail to capture the identity criteria implicit in our ordinary experience. The paper argues that our identity criteria are incomplete and informal and that our individuative practice is partially determined by the kind of interest we have in the object(s) being traced. The relationship between this view and two versions of relative identity is also discussed. (shrink)

The concept of “difference” forms the core of contemporary attacks on “liberal legalism” and is central to proposals for replacing it. Critics charge that liberal law quashes difference because it grounds political equality and individual rights in the assumption that all persons share certain “samenesses,” such as rationality or autonomy. In the words of the philosopher Iris Marion Young, “liberal individualism denies difference by positing the self as a solid, self-sufficient unity, not defined by or in need of anything or (...) anyone other than itself.” The claim is that this “sameness”-based vision of equality is in fact an exercise of power, reflecting a highly specific model of personhood that was constructed by and for a white male elite and ensures its continued social dominance. Liberalism's critics conclude that the achievement of social justice will be possible only when sameness-based conceptions of equality are rejected. (shrink)

The concept of “difference” forms the core of contemporary attacks on “liberal legalism” and is central to proposals for replacing it. Critics charge that liberal law quashes difference because it grounds political equality and individual rights in the assumption that all persons share certain “samenesses,” such as rationality or autonomy. In the words of the philosopher Iris Marion Young, “liberal individualism denies difference by positing the self as a solid, self-sufficient unity, not defined by or in need of anything or (...) anyone other than itself.” The claim is that this “sameness”-based vision of equality is in fact an exercise of power, reflecting a highly specific model of personhood that was constructed by and for a white male elite and ensures its continued social dominance. Liberalism's critics conclude that the achievement of social justice will be possible only when sameness-based conceptions of equality are rejected. (shrink)

This paper argues that there are no necessary and sufficient conditions for the identity through time of material objects where those conditions have a kind of empirical content necessary for them to function as criteria for identity through time. Taking Eli Hirsch’s program in The Concept of Identity as representative of attempts to formulate conditions which are logically necessary and sufficient and which also function as criteria guiding our tracing of objects’ careers through time, I argue (a) that, when such (...) programs are constructed in a way sensitive to the criteria we actually use, they fall prey to conceivable counterexamples and (b) that, when such programs are tightened to avoid logically possible counterexamples, they fail to capture the identity criteria implicit in our ordinary experience. The paper argues that our identity criteria are incomplete and informal and that our individuative practice is partially determined by the kind of interest we have in the object(s) being traced. The relationship between this view and two versions of relative identity is also discussed. (shrink)

Polybios’ famous description of Philip V of Macedon as “the darling of the Greeks” (ἐρώμενος … τῶν Ἑλλήνων) comes about at a critical moment in the historian’s narrative of the king’s life: it appears at the end of a summary extolling all of the good characteristics and deeds Philip exhibited and achieved in his early years, when he had inspired great hopes of future magnanimity amongst his Greek allies (4.27.9, 77; 7.11); and just before the king takes a sudden turn (...) for the worse in 215 BC, when he incites revolution in the allied city of Messene and attempts to impose a Macedonian garrison on its citadel. This article sets out to break new ground not only in the study of the Macedonian king, but also in the study of the literary aspects of Polybios’ work, by exploring this statement in more depth and arguing that it retained its significance beyond the structural demarcation of Philip’s change. The imagery that such a title inherently possessed and conveyed helped to define and deepen understanding of the relationship between Philip and his Greek allies in his early years by evoking implicit connotations within the audience. (shrink)

Rights of Women attracted much UK media attention in late 2014 by bringing a judicial review that challenged the reduced provisions for family law legal aid available for victims of domestic violence: R v The Lord Chancellor and Secretary of State for Justice [2015] EWHC 35. In June 2015, within Rights of Women’s 40th anniversary year, Hannah Camplin interviewed the organisation’s Director Emma Scott about the decision to bring the judicial review, the advantages and challenges of the judicial review (...) process, and the experience of strategic litigation within the context of Rights of Women’s long history of campaigning for women’s rights. What emerged is a portrait of a feminist organisation in 2015, and, in a fast changing political and financial landscape, the dual importance of collaborative working and the need for flexibility in service provision and campaigning tools. (shrink)

In cases where the best interests of the child are disputed or finely balanced, Clinical Ethics Committees (CECs) can provide a valuable source of advice to clinicians and trusts on the pertinent ethical dimensions. Recent judicial cases have criticised the lack of formalised guidance and inconsistency in the involvement of parents in CEC deliberations. In Manchester University NHS FT v Verden [2022], Arbuthnot J set out important procedural guidance as to how parental involvement in CEC deliberations might be managed. She (...) also confirmed substantive guidance on the role of parental views in determining the child’s best interests. We agree that it is good practice to ensure that the patient voice is heard in ethics processes, but how that is achieved is controversial. Surely it is best that what matters most to a patient and their family, whether facts or values, is conveyed directly to those considering the moral issues involved, rather than via a prism of another party. The approach suggested in theVerdencase has much in common with the process used by our CEC. In this article, we commend Arbuthnot J’s approach, provide an example of its effective operation and consider what it might mean for ethics processes. (shrink)

The pace of change and, indeed, the sheer number of clinical ethics committees has accelerated during the COVID-19 pandemic. Committees were formed to support healthcare professionals and to operationalise, interpret and compensate for gaps in national and professional guidance. But as the role of clinical ethics support becomes more prominent and visible, it becomes ever more important to address gaps in the support structure and misconceptions as to role and remit. The recent case of Great Ormond Street Hospital for Children (...) NHS Foundation Trust v MX, FX and X, [21]–[23] and [58]) has highlighted the importance of patient/family representation at clinical ethics committee meetings. The court viewed these meetings as making decisions about such treatment. We argue that this misunderstands the role of ethics support, with treatment decisions remaining with the clinical team and those providing their consent. The considered review by clinical ethics committees of the moral issues surrounding complex treatment decisions is not a matter of determining a single ethical course of action. In this article, we consider current legal understandings of clinical ethics committees, explore current concepts of ethics support and suggest how they may evolve, considering the various mechanisms of the inclusion of patients and their representatives in ethics meetings which is not standard in the UK. (shrink)

This historical study aims to explain how the transition from student nurse service to fully qualified “graduate nurse” service in the United States in the 20th century affected assumptions about fundamental patient care in hospital wards and provide historical context for current apprenticeship programs. Through analysis of documents from 1920 when student nurse service, a nurse apprentice model, was the norm to 1960 when the nurse apprentice model was waning in favor of registered nurse service, this study found that the (...) replacement of student nurses with registered nurses led to weakened standardization of fundamental bedside care and the introduction of large numbers of unlicensed nursing assistants. While student nurses could perform all the functions of fully qualified graduate nurses, nursing assistants could not, resulting in a separation of fundamental nursing care from the professional nurse role and changes in assumptions and attitudes toward fundamental care. These changes had a negative effect on fundamental nursing care. New apprenticeship programs provide opportunities for improvement. (shrink)

The aim of this investigation is to discuss the merits of the three radically divergent views as to the nature and function of the categories held by Kant, Ward and Alexander.

In EN II.1, Aristotle claims that our nature is inadequate for moral virtue. We are not, he says, in the same relation to virtue as a stone falling to earth; moral excellence is neither by nature nor contrary to our nature but reached by habituation . Other texts such as Pol. I.13 and Pol. VII.12 about natural capacities, as well as those like Phys. II.1 and Meta. V.4 about physis in general, complicate the picture concerning the bases for moral excellence (...) in EN. This essay considers the range of applications of physis, focusing on the practical works, so as to examine the extent to which Aristotle thinks moral and political nature is amenable to external determinants such as cultural education. (shrink)

In the United Kingdom, the question of how much information is required to be given to patients about the benefits and risks of proposed treatment remains extant. Issues about whether healthcare resources can accommodate extended shared decision-making processes are yet to be resolved. COVID-19 has now stepped into this arena of uncertainty, adding more complexity. U.K. public health responses to the pandemic raise important questions about professional standards regarding how the obtaining and recording of consent might change or be maintained (...) in such emergency conditions, particularly in settings where equipment, medicines, and appropriately trained or specialized staff are in short supply. Such conditions have important implications for the professional capacity and knowledge available to discuss the risks and benefits of and alternatives to proposed treatment with patients. The government’s drive to expedite the recruitment to wards of medical students nearing the end of their studies, as well as inviting retired practitioners back into practice, raises questions about the ability of such healthcare providers to engage fully in shared decision-making.This article explores whether the legal duty on healthcare practitioners to disclose the material risks of a proposed medical treatment to a patient should be upheld during pandemic conditions or whether the pre-eminence of patient autonomy should be partly sacrificed in such exceptional circumstances. We argue that measures to protect public health and to respect autonomous decision-making are not mutually exclusive and that there are good reasons to maintain professional standards in obtaining consent to treatment even during acute pressures on public health systems. (shrink)

A large proportion of hospital inpatients are affected by cognitive impairment, posing challenges in the provision of their care in busy, fast-paced acute wards. Signs and symbols, known as visual identifiers, are employed in many U.K. hospitals with the intention of helping healthcare professionals identify and respond to the needs of these patients. Although widely considered useful, these tools are used inconsistently, have not been subject to full evaluation, and attract criticism for acting as a shorthand for a routinized response. (...) In order for visual identifiers to be used effectively in acute care settings, thorough consideration must be given to the ethical and legal issues that are engaged in this context, and their potential benefits and harms must be weighed and balanced. This paper proposes a set of legal and ethical principles that can be used to guide the implementation of visual identifiers. Together, these principles provide a framework applicable in the design and implementation phases to systematically identify relevant considerations arising from the use of these tools. We outline some tensions that arise between principles and conclude that selecting a preferred moral framework could help to guide decision-making, as does clarity around the purpose and objectives of the identifier. (shrink)

The post-Civil War American natural history craze spawned a new institution -- the natural history dealer -- that has failed to receive the historical attention it deserves. The individuals who created these enterprises simultaneously helped to promote and hoped to profit from the burgeoning interest in both scientific and popular specimen collecting. At a time when other employment and educational prospects in natural history were severely limited, hundreds of dealers across the nation provided encouragement, specimens, publication outlets, training opportunities, and (...) jobs for naturalists of all motivations and levels of expertise. This paper explores the crucial role that specimen dealers played in the larger natural history community. After briefly examining the development of local taxidermy shops in the mid-nineteenth century, it then traces the history of four large natural history dealerships established in the United States during the latter half of the century: Ward's Natural History Establishment, Frank Blake Webster's Naturalists' Supply Depot, Southwick & Jencks' Natural History Store, and Frank H. Lattin & Co. By the early twentieth century, changing tastes in interior design, the growth of the Audubon movement, and the dramatic expansion of alternate training and job opportunities for naturalists led many specimen dealers either to shift their emphasis or to shut their doors. (shrink)