The COVID‐19 pandemic has placed extraordinary stress on frontline healthcare providers as they encounter significant challenges and risks while caring for patients at the bedside. This study used qualitative research methods to explore nurses and respiratory therapists' experiences providing direct care to COVID‐19 patients during the first surge of the pandemic at a large academic medical center in the Northeastern United States. The purpose of this study was to explore their experiences as related to changes in staffing models and to (...) consider needs for additional support. Twenty semi‐structured interviews were conducted with sixteen nurses and four respiratory therapists via Zoom or by telephone. Interviews were transcribed verbatim, identifiers were removed, and data was coded and analyzed thematically. Five major themes characterize providers' experiences: a fear of the unknown, concerns about infection, perceived professional unpreparedness, isolation and alienation, and inescapable stress and distress. This manuscript analyzes the relationship between these themes and the concept of moral distress and finds that some, but not all, of the challenges that providers faced during this time align with previous definitions of the concept. This points to the possibility of broadening the conceptual parameters of moral distress to account for providers' experiences of treating patients with novel illnesses while encountering institutional and clinical challenges. (shrink)

This anthology concerns limit-decision problems, chiefly as treated in the fourteenth-century Latin West. A central problem taken up concerns the instant of change: in a change from ø to not-ø such that before instant t there is ø and after t not-ø, at t is there ø, or not-ø, or neither, or both? For medieval thinkers, the answer often depended on what kind of item was at issue. They standardly distinguished permanent items, the whole of which exists simultaneously, from successive (...) items, whose parts are non-simultaneous, and gave different type or type answers in the two cases.The papers in... (shrink)

Pour introduire à l’article de Lewis et Langton sur la définition des propriétés intrinsèques, il faut rappeler que les propriétés intrinsèques diffèrent d’autres notions comme les propriétés essentielles, les propriétés monadiques, les propriétés catégoriques, les propriétés qualitatives. Les propriétés intrinsèques sont définies selon David Lewis à partir de la notion plus primitive de propriété « naturelle », ce qu’il a continué à modifier jusqu’à des textes plus récents.

Avec des textes de D. Armstrong, M.Esfeld, K. Fine, D. Lewis, H. Mellot, K. Mulligan, M. Rea, P. Unger, P. van Inwagen, D. Zimmerman. L’ontologie est la partie de la métaphysique qui traite de l’être en général, et non d’un être en particulier, et son domaine d’enquête excède même le monde actuel puisqu’elle porte sur l’ensemble du possible, sur les objets possibles et réels ainsi que sur leurs propriétés ou sur leurs structures ultimes. Ce volume fournit les textes fondamentaux (...) pour réfléchir aux principales notions de l’ontologie contemporaine. Y sont abordés les problèmes de la composition matérielle des objets, de la causalité, de la nature du temps et des relations en général. Les questions de méthode portent sur le lien avec la logique et les sciences tout autant que sur le recours aux catégories conceptuelles et aux intuitions. (shrink)

The phenomenological effects of deep brain stimulation (DBS) on the self of the patient remains poorly understood and under described in the literature, despite growing evidence that a significant number of patients experience postoperative neuropsychiatric changes. To address this lack of phenomenological evidence, we conducted in-depth, semistructured interviews with 17 patients with Parkinson's disease who had undergone DBS. Exploring the subjective character specific to patients' experience of being implanted gives empirical and conceptual understanding of the potential phenomenon of DBS-induced self-estrangement. (...) Our study concluded that (1) the more patients preoperatively felt alienated by their illness, the more they experienced postoperative self-estrangement, and (2) the notion of self-estrangement seems to exist in association with certain common qualitative characters, namely, loss of control, which reflects a deteriorative estrangement, and distorted perception of capacities, which reveals a restorative estrangement. These findings indicate that subjective self-reports help us to understand some aspects of the potential phenomenon of DBS-induced self-estrangement. (shrink)

Optogenetics is being optimistically presented in contemporary media for its unprecedented capacity to control cell behavior through the application of light to genetically modified target cells. As such, optogenetics holds obvious potential for application in a new generation of invasive medical devices by which to potentially provide treatment for neurological and psychiatric conditions such as Parkinson's disease, addiction, schizophrenia, autism and depression. Design of a first-in-human optogenetics experimental trial has already begun for the treatment of blindness. Optogenetics trials involve a (...) combination of highly invasive genetic and electronic interventions that results in irreversible and permanent modifications of an individual's nervous system. Given its novelty, its uncertain benefit to patients, and its unique risk profile of irreversible physiological alteration, optogenetics requires a reassessment of the ethical challenges for protecting human participants in clinical trials, particularly at formative stages of clinical evaluation. This study explores the evolving ethical issues surrounding optogenetics’ potential harm to participants within trial design, especially focusing on whether Phase 1 trials should incorporate efficacy as well as safety endpoints in ways that are fair and respectful to research trial participants. (shrink)

Cet article s’intéresse au problème de la maintenance, c’est-à-dire au moment où les membres d’un collectif social tentent d’assurer dans le temps l’existence de leur collectif en instituant des règles pour réguler leurs comportements. Ce problème se pose avec acuité lorsque certains membres ne respectent pas ces règles communes. Pour maintenir la coopération sociale, les membres peuvent décider d’instituer des règles secondaires visant à sanctionner les transgressions des règles primaires déjà établies. La maintenance d’un collectif peut ainsi reposer sur l’émergence (...) de pouvoirs déontiques qui donnent aux membres l’autorité de légitimement punir et expulser les transgresseurs. Mais d’où viennent ces règles ? On peut penser qu’elles émergent des émotions éprouvées par les membres envers les transgresseurs. Je le démontre à l’aide d’une étude de cas qui établit que, dans le collectif Occupy Geneva, l’institutionnalisation de normes pour punir, exclure et réintégrer les déviants s’ancraient respectivement dans l’indignation, le mépris et le pardon. -/- This article focuses on the problem of maintenance; that is the moment when the members of a social collective attempt to ensure the existence of their collective over time by instituting rules to regulate their behavior. This problem becomes critical when certain members do not respect the common rules. To maintain social cooperation, members can decide to institute secondary rules aimed at sanctioning the transgressions of the already established primary rules. The maintenance of a collective can thus rely on the emergence of deontic powers that give members the authority to legitimately punish and expel transgressors. But where do these rules come from? The hypothesis is that they emerge from the emotions felt by the members towards the transgressors. I show this with the help of a case study, which establishes that the institutionalization of norms allowing the punishment, the exclusion, and the reintegration of deviants within the “Occupy Geneva” collective, was grounded in indignation, contempt, and forgiveness respectively. (shrink)

In an attempt to improve upon Alexander Pruss’s work (The principle of sufficient reason: A reassessment, pp. 240–248, 2006), I (Weaver, Synthese 184(3):299–317, 2012) have argued that if all purely contingent events could be caused and something like a Lewisian analysis of causation is true (per, Lewis’s, Causation as influence, reprinted in: Collins, Hall and paul. Causation and counterfactuals, 2004), then all purely contingent events have causes. I dubbed the derivation of the universality of causation the “Lewisian argument”. The (...) Lewisian argument assumed not a few controversial metaphysical theses, particularly essentialism, an incommunicable-property view of essences (per Plantinga’s, Actualism and possible worlds, reprinted in: Davidson (ed.) Essays in the metaphysics of modality, 2003), and the idea that counterfactual dependence is necessary for causation. There are, of course, substantial objections to such theses. While I think a fight against objections to the Lewisian argument can be won, I develop, in what follows, a much more intuitive argument for the universality of causation which takes as its inspiration a result from Frederic B. Fitch’s work (J Symb Logic 28(2):135–142, 1963) [with credit to who we now know was Alonzo church’s, Referee Reports on Fitch’s Definition of value, in: (Salerno (ed.), New essays on the knowability paradox, 2009)] that if all truths are such that they are knowable, then (counter-intuitively) all truths are known. The resulting Church–Fitch proof for the universality of causation is preferable to the Lewisian argument since it rests upon far weaker formal and metaphysical assumptions than those of the Lewisian argument. (shrink)

On conçoit souvent la jalousie comme une émotion ayant pour objet les relations de proximité (amour, amitié, fratrie, etc.). Elle a généralement mauvaise presse et est typiquement envisagée comme une émotion moralement condamnable, voire comme un vice. Or, la jalousie ne porte pas uniquement sur les relations de proximité : elle peut également porter sur divers biens (prestige, richesses, biens matériels, privilèges, etc.). Par ailleurs, certains auteurs soutiennent que des cas de jalousie pourraient être moralement justifiés, voire que la jalousie (...) pourrait être une vertu. La jalousie paraît également jouer un rôle dans l’institution et le maintien d’institutions visant à perpétuer des inégalités entre les individus jaloux de leurs avantages et ceux qu’ils envisagent comme des concurrents cherchant à les déposséder de leurs biens. De fait, la jalousie paraît utile pour la théorie politique de par les liens qu’elle entretient avec la justice distributive. Cet article propose, dans la première section, une discussion portant sur la nature de la jalousie où elle est contrastée avec l’envie et l’indignation. Dans la seconde section, on se demandera si la jalousie est un vice, ou si elle peut être parfois moralement justifiée, ou même être une vertu. La troisième section traitera les rôles joués par la jalousie collective dans la justice distributive et la fondation et le maintien d’institutions sociales visant à protéger les intérêts des jaloux. Pour le faire, le cas de la jalousie économique, telle que David Hume et Adam Smith la concevaient dans les relations commerciales entre États européens au XVIIIème siècle, est considéré. (shrink)

On se propose d’étudier ici l’unité, la diversité et l’évolution de la pensée de Merleau-Ponty à travers ses deux principaux recueils d’essais, Signes publié en 1960, et Sens et non-sens, paru en 1948, dont l’un annonce l’ouvrage posthume sur Le visible et l’invisible (1964), et l’autre prolonge de l’intérieur la Phénoménologie de la perception (1945). On est ainsi conduit à comprendre comment le problème fondamental de la pensée de Merleau-Ponty autorise la diversité de son œuvre, entre philosophie, sciences humaines et (...) politique, sans espoir de synthèse ou de système, mais conjurant aussi toute dispersion et toute résignation. L’évolution même de cette pensée d’une étape à l’autre en confirme le double héritage, autour d’une intuition centrale et d’une variété irréductible d’expériences. (shrink)

Many criticisms have been made of optimization theory (Laville, 1999a). These objections may be explained by the fact that human rationality is bounded – that decisions are constrained by cognitive limitations (Simon, 1982). In the present paper, I will show that if rationality is bounded, then we must study the processes of decision. My thesis is that cognitive limitations lead to procedural rationality. Although this assertion has already been sustained implicitly by Simon (1959) and explicitly by Mongin (1986), it has (...) not been argued in sufficient depth. (shrink)

Faut-il servir le prince? Ou quel est le rapport du lettré avec le pouvoir? Mencius et Zhuangzi, deux grands penseurs contemporains du IV e siècle avant notre ère, proposent deux réponses différentes. L’un conditionne l’offre et l’autre la refuse radicalement. Pour l’héritier spirituel de Confucius, un prince doit au préalable être doté de la vertu pour qu’on puisse l’aider à réaliser de grandes œuvres. Le rang social, l’un des paramètres qui déterminent les rapports entre un prince et un lettré, n’est (...) pas prioritaire. Selon Zhuangzi, et même s’il relativise à maintes reprises la vie et la mort, servir un prince revient à perdre l’énergie vitale, à risquer inutilement sa vie. Il rejette en effet tout rapport social de contrainte qui prive l’homme de sa liberté. Cette attitude suscitera la critique des confucianistes qui lui reprocheront sa méconnaissance des affaires humaines. Néanmoins, ces deux positions à la fois opposées et complémentaires ont durablement marqué les conceptions politiques des lettrés chinois. (shrink)

The two essays included here are parts of a longer study of temporality, and the genesis of the “religious.” The first part, “Multiple Nows,” depicts a universe in which a present to past relation is establishable from any and every point in consciousness. The resulting perspective differs from that offered by the linear timeline of chronological history. Remembering where I put my glasses is an historicizing act, as fully as is remembering when the Battle of Zama was fought or who (...) won there. On this alternate view of temporality the genesis of the historical perspective is the historicizing subject. The second essay, “The History of a House,” places the observer before an historical structure, then asks where the historicity in the structure is. We discover that the historicity is put there by the observer/subject. This discovery resembles our earlier discovery that historicity is generated by an infinite sequence of nows. The two essays converge on a description of historical cognition as subject-generated. (shrink)

Résumé — Le but de cet article est de montrer que le cœur de la pensée de Simone Weil réside moins dans une philosophie de la nécessité comme telle que dans une philosophie de la rencontre de la nécessité et de l’âme humaine, et de ses effets, du malheur à l’amour, en passant par la vérité. Présente d’emblée, cette pensée connaît cependant deux étapes, comme si l’accent passait de la nécessité à ses effets, étapes que l’on étudie à travers deux (...) textes précis commentés comme les classiques qu’ils devraient être dans la philosophie du XXe siècle en France. C’est aussi par là que Simone Weil rejoint les principaux de ses contemporains, parmi lesquels Camus et Cavaillès, et ainsi le cœur du moment de la Seconde Guerre mondiale, en philosophie comme ailleurs.— This paper intends to show how the core of Simone Weil’s thought is to be found less in a philosophy of necessity as such, than in a philosophy of the encounter between necessity and human soul, and the effects of that encounter, from woe to love, and including truth. However constant, this thought evolves through a difference of accent, as if the stress went from necessity to its effect ; this difference is here studied through the reading of two major writings, which deserve to be considered as XXth Century philosophical classics. It is also through this central thought that Simone Weil meets with such major contemporary philosophical figures as Camus and Cavaillès, and thus with what should be called the moment of the Second World War, in philosophy as elsewhere. (shrink)

This paper analyzes a model of sequential parimutuel betting described as a two-horse race with a finite number of noise bettors and a finite number of strategic and symmetrically informed bettors. For generic objective probabilities that the favorite wins the race, a unique subgame perfect equilibrium is characterized. Additionally, two explanations for the favorite–longshot bias—according to which favorites win more often than the market's estimate of their winning chances imply—are offered. It is shown that this robust anomalous empirical regularity might (...) be due to the presence of transaction costs and/or to strategic bettors' subjective attitude to probabilities. (shrink)

It has long been recognized that the concept of inconsistency is a central part of commonsense reasoning. In this issue, a number of authors have explored the idea of reasoning with maximal consistent subsets of an inconsistent stratified knowledge base. This paradigm, often called “coherent-based reasoning", has resulted in some interesting proposals for para-consistent reasoning, non-monotonic reasoning, and argumentation systems. Unfortunately, coherent-based reasoning is computationally very expensive. This paper harnesses the approach of approximate entailment by Schaerf and Cadoli [SCH 95] (...) to develop the concept of “approximate coherent-based reasoning". To this end, we begin to present a multi-modal propositional logic that incorporates two dual families of modalities: □S and?S defined for each subset S of the set of atomic propositions. The resource parameter S indicates what atoms are taken into account when evaluating formulas. Next, we define resource-bounded consolidation operations that limit and control the generation of maximal consistent subsets of a stratified knowledge base. Then, we present counterparts to existential, universal, and argumentative inference that are prominent in coherence-based approaches. By virtue of modalities □S and?S, these inferences are approximated from below and from above, in an incremental fashion. Based on these features, we show that an anytime view of coherent-based reasoning is tenable. (shrink)