Allied health professionals play an integral role in providing safe, affordable care to communities in need. Laws that define the permissible scope of practice for these professionals may take full advantage of these providers and may unnecessarily restrict safe and effective care. Nurse practitioners in many states may provide care independent of a physician; research reveals that this care is safe, affordable and accessible. Yet hurdles exist that prevent communities from securing the full benefit of NPs in independent practice. The (...) scope of independent practice for allied dental providers varies greatly across the country, often including stringent supervision requirements. Emerging approaches to allowing allied dental providers to practice independently in certain settings or with dentist supervision via telemedicine and creating the intermediate provider, the dental therapist, may increase access to safe, affordable dental care. Research on the impact of laws that allow broader independent practice by NPs to ferret out the hurdles to full implementation of the spirit of such laws is needed. That research could support expanded independent scope for allied dental providers and other allied health care providers. (shrink)

This case study focuses on some of the ethical issues that arise in community-based participatory research, drawing on an example from practice in the UK. It comprises a case example written by a community researcher, followed by two commentaries, which analyse the case and offer different perspectives on the issues raised from the commentators' experiences in Aotearoa New Zealand and Australia. The case example highlights the challenges faced by volunteer action researchers undertaking research interviews and mentoring on sensitive topics in (...) their local neighbourhoods. It raises questions about: the emotional effects of discussing matters of mental health, well-being and money management on both researchers and research participants; how much researchers should disclose about their own lives; and the nature of the support needs of volunteer community researchers. (shrink)

"Cluster randomized trials," in which groups of patients are randomly assigned to different therapeutic interventions, provide a powerful way of evaluating drugs. CRTs have not been widely used, in good part because of concerns about whether patients must give informed consent to participate in them. A better understanding of how CRTs fit into clinical practice resolves the concerns.

Importance Informed consent is essential to ethical, rigorous research and is important to recruitment and retention in cancer trials.Objective To examine cancer clinical trial (CCT) participants’ perceptions of informed consent processes and variations in perceptions by cancer type.Design and Setting and Participants Cross-sectional survey from mixed-methods study at National Cancer Institute–designated Northeast comprehensive cancer center. Open-ended and forced-choice items addressed: (1) enrollment and informed consent experiences and (2) decision-making processes, including risk-benefit assessment. Eligibility: CCT participant with gastro-intestinal or genitourinary, hematologic-lymphatic (...) malignancies, lung cancer, and breast or gynecological cancer (N = 334).Main Outcome Measures Percentages satisfied with consent process and information provided; and assessing participation’s perceptions of risks/benefits. Multivariable logistic or ordinal regression examined differences by cancer type.Results Most patient-participants felt well informed by the consent process (more than 90% overall and by cancer type) and. most (87.4%) reported that the consent form provided all the information they wanted, although nearly half (44.8%) reported that they read the form somewhat carefully or less. More than half (57.9%) said that talking to research staff (i.e., the consent process) had a greater impact on participation decisions than reading the consent form (2.1%). A third (31.1%) were very sure of joining in research studies before the informed consent process (almost half of lung cancer patients did—47.1%). Most patients personally assessed the risks and benefits before consenting. However, trust in physicians played an important role in the decision to enroll in CCT.Conclusions and Relevance Cancer patients rely less on written features of the informed consent process than on information obtained from the research staff and their own physicians. Research should focus on information and communication strategies that support informed consent from referring physicians, researchers, and others to improve patient risk-benefit assessment and decision-making. (shrink)

With a focus on the areas of theory, literature, culture, society and film, this collection of essays examines, questions and broadens the applicability of Postcolonialism and Islam from a multifaceted and cross-disciplinary perspective.Topics covered include the relationship between Postcolonialism and Orientalism, theoretical perspectives on Postcolonialism and Islam, the position of Islam within postcolonial literature, Muslim identity in British and European contexts, and the role of Islam in colonial and postcolonial cinema in Egypt and India. At a time at which Islam (...) continues to be at the centre of increasingly heated and frenzied political and academic deliberations, Postcolonialism and Islam offers a framework around which the debate on Muslims in the modern world can be centred.Transgressing geographical, disciplinary and theoretical boundaries, this book is an invaluable resource for students of Islamic Studies, Cultural Studies, Sociolgy and Literature. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Gender in The Gay ScienceKathleen Marie HigginsIn his recent novel, When Nietzsche Wept, Irwin Yalom reiterates a common portrait of Nietzsche: a sexist über alles. Much as the quip “Isn’t business ethics a contradiction in terms?” ubiquitously accosts philosophers involved in that subdiscipline, “What’s a nice girl like you doing studying a misogynist like that?” has haunted my career in Nietzsche scholarship. I have never been entirely certain as (...) to whether this ad hominem is more directed at me or at Nietzsche.A sympathetic but jovial colleague played on this ambiguity by remarking, when he heard my topic for this essay, “Yes, that must be an interesting topic for someone who isn’t even shallow.” Yes, Nietzsche did say that women, far from deep, were not even shallow. But does this remark prove him a sexist? Are we even certain what it means?I will attempt to complicate our appraisal of Nietzsche’s alleged sexism by focusing on Book Two of The Gay Science. Considering his passages on women in that book, I will suggest along the way reasons why at least some readings of these as sexist should be rejected. More positively, I will show that these passages urge a reassessment of the relationship between men and women that can be seen as a contribution toward feminist theory (if an unwitting one), and that one of Nietzsche’s intended impacts on his male readers is to initiate a radical revolution in their thinking about women.IThe term “gender” is used advisedly in this context, for Nietzsche made the distinction, common in feminist discussion, between sex (the biological potential to play one role rather than another in [End Page 227] reproduction) and gender (the contingently assigned roles that a society attaches to those who are biologically male or female). Nietzsche urged his readers to recognize the contingency of gender roles and to consider the desirability of changing them.We can hardly begin to consider Nietzsche’s suggestions in these regards, however, without confronting the allegation that Nietzsche was a paradigmatic sexist. Although many of the most important names in Western philosophy have been singled out for feminist censure, Nietzsche is often held up as an exemplar of all that is misogynistic, both in the philosophical tradition and within patriarchy generally. Nietzsche is identified as a misogynist for a variety of reasons. He is seen as an essentialist, an opponent of women’s rights, an enthusiast of masculine virtue, and an advocate of male domination. While none of these attributions may be entirely apt, I agree with Nietzsche’s feminist critics that he was, at least sometimes, too willing to rest content with truisms about women and to vent personal rage in the guise of philosophy.That said, some of the attacks on Nietzsche are both unfair and unfortunate. I am not the only feminist to think so. Maudemarie Clark, Sarah Kofman, Maryanne Bertram, and Deborah Bergoffen have all suggested that certain of Nietzsche’s views offer starting points for feminist theorizing. I will describe some attacks made on Nietzsche by certain other feminists, however, because they represent the popular perspective on Nietzsche (if not that most typical of Nietzsche scholars) and because they indicate certain pitfalls that feminists would do best to avoid.Carol Diethe’s article “Nietzsche and the Woman Question,” for example, criticizes Nietzsche in a number of unwarranted ways. Consider, for example, her complaint that Nietzsche’s conception of the will to power entails an affirmation of the domination of women.If we take his key concept, the will to power, we find that it is so gender based that it practically comes to represent the archetypal phallic symbol. Bernstein describes it as a phenomenon which includes the “will to violate” so that the “feeling of power” (Machtgefühl) is generated, yet when he goes on to mention “Nietzsche’s desire to avoid reducing the will to power to sexuality,” he fails to realize that his own critique has relied heavily on the language of rape and the whole area of male dominance of women which stretches behind words such as “violation.” 1Diethe simply accepts Bernstein’s characterization of Nietzsche’s... (shrink)

Traditional philosophical discussions of knowledge have focused on the epistemic status of full beliefs. In this book, Moss argues that in addition to full beliefs, credences can constitute knowledge. For instance, your .4 credence that it is raining outside can constitute knowledge, in just the same way that your full beliefs can. In addition, you can know that it might be raining, and that if it is raining then it is probably cloudy, where this knowledge is not knowledge of propositions, (...) but of probabilistic contents. -/- The notion of probabilistic content introduced in this book plays a central role not only in epistemology, but in the philosophy of mind and language as well. Just as tradition holds that you believe and assert propositions, you can believe and assert probabilistic contents. Accepting that we can believe, assert, and know probabilistic contents has significant consequences for many philosophical debates, including debates about the relationship between full belief and credence, the semantics of epistemic modals and conditionals, the contents of perceptual experience, peer disagreement, pragmatic encroachment, perceptual dogmatism, and transformative experience. In addition, accepting probabilistic knowledge can help us discredit negative evaluations of female speech, explain why merely statistical evidence is insufficient for legal proof, and identify epistemic norms violated by acts of racial profiling. Hence the central theses of this book not only help us better understand the nature of our own mental states, but also help us better understand the nature of our responsibilities to each other. (shrink)

This paper develops a precise understanding of the thesis of moral encroachment, which states that the epistemic status of an opinion can depend on its moral features. In addition, I raise objections to existing accounts of moral encroachment. For instance, many accounts fail to give sufficient attention to moral encroachment on credences. Also, many accounts focus on moral features that fail to support standard analogies between pragmatic and moral encroachment. Throughout the paper, I discuss racial profiling as a case study, (...) arguing that moral encroachment can help us identify one respect in which racial profiling is epistemically problematic. (shrink)

The Ethics of Need: Agency, Dignity, and Obligation argues for the philosophical importance of the notion of need and for an ethical framework through which we can determine which needs have moral significance. In the volume, Sarah Clark Miller synthesizes insights from Kantian and feminist care ethics to establish that our mutual and inevitable interdependence gives rise to a duty to care for the needs of others. Further, she argues that we are obligated not merely to meet others’ needs (...) but to do so in a manner that expresses "dignifying care," a concept that captures how human interactions can grant or deny equal moral standing and inclusion in a moral community. She illuminates these theoretical developments by examining two cases where urgent needs require a caring and dignifying response: the needs of the elderly and the needs of global strangers. Those working in the areas of feminist theory, women’s studies, aging studies, bioethics, and global studies should find this volume of interest. (shrink)

Anonymity is a form of nonidentifiability which I define as noncoordinatability of traits in a given respect. This definition broadens the concept, freeing it from its primary association with naming. I analyze different ways anonymity can be realized. I also discuss some ethical issues, such as privacy, accountability and other values which anonymity may serve or undermine. My theory can also conceptualize anonymity in information systems where, for example, privacy and accountability are at issue.

An assessment of America's preference for "extra-large" shares examples ranging from mega churches and breast augmentation to landfills and mega-malls, in a cautionary report that reveals some of the consequences of these choices.

This book explores the scope and limits of the concept of personDS a vexed question in contemporary philosophy. The author begins by questioning the methodology of thought-experimentation, arguing that it engenders inconclusive and unconvincing results, and that truth is stranger than fiction. She then examines an assortment of real-life conditions, including infancy, insanity andx dementia, dissociated states, and split brains. The popular faith in continuity of consciousness, and the unity of the person is subjected to sustained criticism. The author concludes (...) with a look at different views of the person found in Homer, Aristotle, the post-Cartesians, and contemporary cognitive science. (shrink)

This article describes a team-taught environmental studies course called Animal Metaphors. Focusing on animal metaphors in literature and film, the course emphasizes various cognitive and perceptual biases that lead humans to place ourselves above and beyond nature, making us more likely to engage in practices destructive to the environment. Whereas the first iteration of the course underscored various ways in which humans are less rational or moral than we imagine, the new iteration shifted more of the focus to what inspires (...) and motivates humans, gives us emotional resilience, and best creates conditions for mental well-being as we cooperate and collaborate. This seemed an appropriate tack to take in an age commonly referred to as the “Anthropocene.” We thus continued to examine our status as evolved animals while also calling more attention to spiritual or ecstatic experience, music, humor, and the uniquely human ability for shared intentionality. (shrink)

Scientists depend on complex computational systems that are often ineliminably opaque, to the detriment of our ability to give scientific explanations and detect artifacts. Some philosophers have s...

Background Researchers are required to determine whether a person has capacity to consent to a research study before they are able to participate. The Mental Capacity Act and accompanying Code of Practice for England and Wales provide some guidance on this process, but researchers have identified that it can be difficult to determine capacity to consent when a person has complex cognitive or communication needs. This study aimed to understand the experiences and opinions of researchers who recruit people with dementia (...) to research projects, to inform the future development of training resources. Methods A mixed method, cross-sectional, electronic survey was circulated via social media and research networks in England and Wales. The survey remained open for ten weeks and included open and closed questions exploring respondents’ confidence in determining capacity in the context of recruiting people with dementia to consent, their views on training and support they have experienced and their suggestions for future training and support needs. Results 60 respondents completed the survey from across England and Wales. Although 75% of respondents had experience of determining capacity to consent with people with dementia to research, only 13% rated themselves as feeling ‘very confident’ in this. Qualitative content analysis of open responses led to the generation of six themes, explaining researchers’ confidence, competence and future training needs in this area: (1) Researcher uncertainties, (2) Lack of time, (3) Balancing information complexity with accessibility, (4) Gatekeepers, (5) Existing enablers and (6) Envisioning future training. Conclusions Researchers would benefit from specific training in undertaking conversations around consent with people with dementia. People with dementia may have fluctuating capacity, and despite support from caregivers, researchers have little practical guidance on methods of determining a person’s ability to understand or appreciate the information they have provided during the consent process. Given the development of large complex trials within dementia research, there is an urgency to develop specific and practical guidance and training for researchers working with people with dementia and their families. (shrink)

A practical judgement is one which enjoys an internal, necessary relation to subsequent action or intention, and which can serve as a sufficient explanation of such action or intention. Does the phenomenon of weakness of will show that deliberation does not characteristically issue in such practical judgements? The author argues that the possibility of akrasia does not threaten the view that we make practical judgements, when the latter thesis is properly understood. Indeed, the author suggests that the alleged possibility of (...) global akrasia actually supports the practical‐judgement model over what she considers its main rival, a kind of ‘Humean externalism’ about practical reason. (shrink)

In an era of fake news, alternative truths and leaked secrets making constant headlines, we are telling stories about ourselves all the time, and we are telling them in so many different ways. From vlogs and blogs to tweets and posts, from photos and gifs to live streams. From instant updates that disappear to rash words that last for ever and data trails that chart every step we take. While people around her shake their heads and mutter bad things about (...) the new levels of day-to-day deceit, Kathleen Wyatt is busy marvelling at how society manages it. How do we do this extraordinary thing - often under the most ordinary of circumstances? How do we convince each other to suspend disbelief? And why do we do it? In this brilliant, wide-ranging study of lies and lying, Wyatt introduces us to a cast of professionals and professional liars - from scientists to investigators, from double agents to journalists, from toddler specialists to a fallen titan of industry - all to help her prove a remarkable thesis: lies hold us together as much as they push us apart and may be vital in a healthy society"--Publisher's description. (shrink)

A popular approach to defining fictive utterance says that, necessarily, it is intended to produce imagining. I shall argue that this is not falsified by the fact that some fictive utterances are intended to be believed, or are non-accidentally true. That this is so becomes apparent given a proper understanding of the relation of what one imagines to one's belief set. In light of this understanding, I shall then argue that being intended to produce imagining is sufficient for fictive utterance (...) as well. (shrink)

I argue that knowledge can be seen as a quality standard that governs our sharing and storing of information. This standard satisfies certain functional needs, namely it allows us to share and store trustworthy information more easily. I argue that this makes knowledge a social kind, similar in important ways to other social kinds like money. This provides us with a way of talking about knowledge without limiting ourselves to the concept of knowledge. I also outline three ways in which (...) this view of knowledge can shed light on familiar epistemological problems: it can explain why knowledge is the norm of assertion, it can help us carve out the harm associated with testimonial injustice, and it can provide us with a clear analysis of the dangers associated with spreading misinformation. (shrink)

Coming to Life: Philosophies of Pregnancy, Childbirth and Mothering is a superlative collection of essays that does what too few scholarly works have dared: it takes seriously the philosophical significance of women’s lived experience. Every woman, regardless of her own reproductive story, is touched by the often restrictive beliefs and norms governing discourses about pregnancy, childbirth and mothering. Thus the concerns of this anthology are relevant to all women and central to any philosophical project that takes women’s lives seriously. In (...) this volume 16 authors- including both established feminists and some of today’s most innovative new scholars- engage in sustained reflection on the experiences of pregnancy, childbirth and mothering, and on the beliefs, customs, and political institutions by which those experiences are informed. Many of the topics in this collection, though familiar, are here taken up in a new way: contributors think beyond the traditional pro-choice/pro-life dichotomy, speak to the manifold nature of mothering by considering the experiences of adoptive mothers and birthmothers, and upend the belief that childrearing practices must be uniform despite psycho-sexual differences in children. Many chapters reveal the radical shortcomings of conventional philosophical wisdom by placing trenchant assumptions about subjectivity, gender, power and virtue in dialogue with women’s experience. The volume is diverse both in its content and in its scholarly approach; certain of the essays are informed by their authors’ own experiences, others draw from extant narratives; many engage such canonical thinkers as Plato, Aristotle, Nietzsche and Heidegger, while others draw from the works of contemporary feminists including Sara Ruddick, Iris Marion Young, Virginia Held, Julia Kristeva and Luce Irigaray. All readers, regardless of their philosophical training and commitments, will find much to appreciate in this volume. (shrink)

This book explores the scope and limits of the concept of personDS a vexed question in contemporary philosophy. The author begins by questioning the methodology of thought-experimentation, arguing that it engenders inconclusive and unconvincing results, and that truth is stranger than fiction. She then examines an assortment of real-life conditions, including infancy, insanity andx dementia, dissociated states, and split brains. The popular faith in continuity of consciousness, and the unity of the person is subjected to sustained criticism. The author concludes (...) with a look at different views of the person found in Homer, Aristotle, the post-Cartesians, and contemporary cognitive science. (shrink)

This article examines the complaint that arbitrary algorithmic decisions wrong those whom they affect. It makes three contributions. First, it provides an analysis of what arbitrariness means in this context. Second, it argues that arbitrariness is not of moral concern except when special circumstances apply. However, when the same algorithm or different algorithms based on the same data are used in multiple contexts, a person may be arbitrarily excluded from a broad range of opportunities. The third contribution is to explain (...) why this systemic exclusion is of moral concern and to offer a solution to address it. (shrink)

The primary aim of this study is to dissolve the mind-body problem. It shows how the ‘problem’ separates into two distinct sets of issues, concerning ontology on the one hand, and explanation on the other, and argues that explanation – whether or not human behaviour can be explained in physical terms – is the more crucial. The author contends that a functionalist methodology in psychology and neurophysiology will prove adequate to explain human behaviour. Defence of this thesis requires: an examination (...) of the mental/physical dichotomy, and its rejection in favour of a distinction between psychological and physical terms; a description and discussion of functionalism in psychology and neurophysiology, showing how the notorious problem of the necessary intensionality of psychological terms may be circumvented; an examination of the role of computer simulation in psycho-physical research; and an explanation of how the phenomena of sentience fit the functional framework. The book concludes that the thesis presented is in all essentials that of Aristotle; Aristotle had no ‘mind-body problem’, and were it not for a subsequent over-obsession with Cartesian scepticism, we need not have had one either. (shrink)

Keith DeRose and Stewart Cohen object to the fallibilist strand of pragmatic invariantism regarding knowledge ascriptions that it is committed to non-cancelable pragmatic implications. I show that this objection points us to an asymmetry about which aspects of the conveyed content of knowledge ascriptions can be canceled: we can cancel those aspects that ascribe a lesser epistemic standing to the subject but not those that ascribe a better or perfect epistemic standing. This situation supports the infallibilist strand of pragmatic invariantism (...) according to which knowledge semantically requires absolute certainty but this claim is often pragmatically weakened: it turns out that exactly those aspects of the conveyed content are cancelable that this view claims are pragmatic. I also argue that attributor contextualism and relativism do not have an alternative explanation of this phenomenon. (shrink)

In this work, Kathleen V. Wider discusses Jean-Paul Sartre's analysis of consciousness in Being and Nothingness in light of recent work by analytic philosophers ...

Introduction: The humanities enrich and transform the practice of medicine. What remains to be seen, however, is how best to integrate humanities into the medical curriculum to optimize both educational and patient-related outcomes. The present study considers the structure of an innovative student-driven humanities curriculum and seeks to understand its strengths and limitations, as well as make recommendations for improvement. Methods: The Penn State College of Medicine, University Park Regional Campus uses an inquiry-based approach to education, whereby students are responsible (...) for creating learning objectives in four core pillars of exploration: Foundational Science, Clinical Science, Health Systems Science, and Health Humanities. This study explores student-derived humanities learning objectives (HLO) across four years of the curriculum. Results: 420 HLOs met criteria for analysis and were coded as instrumental (developing direct clinical skill), non-instrumental (non-skill based), or both. Of these, 125 (30%) were instrumental, 239 (57%) were non-instrumental, and 56 (13%) were coded as both. Most instrumental HLO centered around communication skills. Non-instrumental HLO most commonly focused on bearing witness and critiquing a particular experience within a social and/or political context. Conclusions: Findings from this study contribute to the development of a humanities curriculum in a student-directed learning program. Non-instrumental HLO lacked a theoretical framework to guide student’s investigations to a deeper level of analysis. Student-directed learning offers many strengths, but can be enhanced through external direction from humanities trained faculty, particularly given that many medical students have a limited humanities background. (shrink)

Any good theory of knowledge ascriptions should explain and predict our judgments about their felicity. I argue that any such explanation must take into account a distinction between three ways of using knowledge ascriptions: to suggest acceptance of the embedded proposition, to explain or predict a subject's behavior or attitudes, or to understand the relation of knowledge as such. The contextual effects on our judgments about felicity systematically differ between these three types of uses. Using such a distinction is, in (...) principle, open to both contextualist and pragmatic invariantist accounts of knowledge ascriptions. However, there are some implications pertaining to the use of the “method of cases” in the debate about knowledge ascriptions. (shrink)

Moral error theory is comprised of two parts: a denial of the existence of objective values, and a claim about the ways in which we attempt to make reference to such objective values. John Mackie is sometimes presented as endorsing the view that we necessarily presuppose such objective values in our moral language and thought. In a series of recent papers, though, Victor Moberger (2017), Selim Berker (2019), and Michael Ridge (2020) point out that Mackie does not seem to commit (...) himself to this view. They argue that Mackie thinks this reference to objective values can, and perhaps should, be detached from our moral statements and judgments. In this paper, I argue that Moberger, Berker, and Ridge are right to point out that Mackie stops short of claiming a necessary connection between moral language and a commitment to objective values, but that he does not endorse the contrary claim either. Instead, Mackie stays neutral on the question whether it is possible to assert moral statements or make moral judgments without presupposing objective value. This is because he does not need to take a position on this matter. Mackie only engages with the conceptual analysis of moral language and thought to the extent required to achieve his argumentative goals: he wants to reject revisionary analyses of moral language and to refute the idea that we can assume moral truths to be in alignment with ordinary moral language. (shrink)

Existing discussions of legal proof address a host of apparently disparate questions: What does it take to prove a fact beyond a reasonable doubt? Why is the reasonable doubt standard notoriously elusive, sometimes considered by courts to be impossible to define? Can the standard of proof by a preponderance of the evidence be defined in terms of probability thresholds? Why is statistical evidence often insufficient to meet the burden of proof? -/- This paper defends an account of proof that addresses (...) each of these questions. Where existing theories take a piecemeal approach to these puzzles, my theory develops an insight that unifies them—namely, the thesis that legal proof requires knowledge. Although this thesis may seem radical at first, I answer several common objections to it, and I argue that it does better than several competing accounts when it comes to making sense of our intuitions about what legal proof requires. (shrink)

This paper motivates and develops a novel semantics for several epistemic expressions, including possibility modals and indicative conditionals. The semantics I defend constitutes an alternative to standard truth conditional theories, as it assigns sets of probability spaces as sentential semantic values. I argue that what my theory lacks in conservatism is made up for by its strength. In particular, my semantics accounts for the distinctive behavior of nested epistemic modals, indicative conditionals embedded under probability operators, and instances of constructive dilemma (...) containing epistemic vocabulary. (shrink)