Background Parental refusal of routine childhood vaccination remains an ethically contested area. This systematic review sought to explore and characterise the normative arguments made about parental refusal of routine vaccination, with the aim of providing researchers, practitioners, and policymakers with a synthesis of current normative literature. Methods Nine databases covering health and ethics research were searched, and 121 publications identified for the period Jan 1998 to Mar 2022. For articles, source journals were categorised according to Australian Standard Field of Research (...) codes, and normative content was analysed using a framework analytical approach. Results Most of the articles were published in biomedical journals (34%), bioethics journals (21%), and journals that carry both classifications (20%). Two central questions dominated the literature: (1) Whether vaccine refusal is justifiable (which we labelled ‘refusal arguments’); and (2) Whether strategies for dealing with those who reject vaccines are justifiable (‘response arguments’). Refusal arguments relied on principlism, religious frameworks, the rights and obligations of parents, the rights of children, the medico-legal best interests of the child standard, and the potential to cause harm to others. Response arguments were broadly divided into arguments about policy, arguments about how individual physicians should practice regarding vaccine rejectors, and both legal precedents and ethical arguments for vaccinating children against a parent’s will. Policy arguments considered the normative significance of coercion, non-medical or conscientious objections, and possible reciprocal social efforts to offset vaccine refusal. Individual physician practice arguments covered nudging and coercive practices, patient dismissal, and the ethical and professional obligations of physicians. Most of the legal precedents discussed were from the American setting, with some from the United Kingdom. Conclusions This review provides a comprehensive picture of the scope and substance of normative arguments about vaccine refusal and responses to vaccine refusal. It can serve as a platform for future research to extend the current normative literature, better understand the role of cultural context in normative judgements about vaccination, and more comprehensively translate the nuance of ethical arguments into practice and policy. (shrink)

BackgroundIn most Anglophone nations, policy and law increasingly foster an autonomy-based model, raising issues for large numbers of people who fail to fit the paradigm, and indicating problems in translating practical and theoretical understandings of ‘good death’ to policy. Three exemplar populations are frail older people, people with dementia and people with severe traumatic brain injury. We hypothesise that these groups face some over-lapping challenges in securing good end-of-life care linked to their limited agency. To better understand these challenges, we (...) conducted a scoping review and thematic synthesis.MethodsTo capture a range of literature, we followed established scoping review methods. We then used thematic synthesis to describe the broad themes emerging from this literature.ResultsInitial searches generated 22,375 references, and screening yielded 49, highly heterogeneous, studies that met inclusion criteria, encompassing 12 countries and a variety of settings. The thematic synthesis identified three themes: the first concerned the processes of end-of-life decision-making, highlighting the ambiguity of the dominant shared decision-making process, wherein decisions are determined by families or doctors, sometimes explicitly marginalising the antecedent decisions of patients. Despite this marginalisation, however, the patient does play a role both as a social presence and as an active agent, by whose actions the decisions of those with authority are influenced. The second theme examined the tension between predominant notions of a good death as ‘natural’ and the drive to medicalise death through the lens of the experiences and actions of those faced with the actuality of death. The final theme considered the concept of antecedent end-of-life decision-making, its influence on policy and decision-making, and some caveats that arise from the studies.ConclusionsTogether these three themes indicate a number of directions for future research, which are likely to be applicable to other conditions that result in reduced agency. Above all, this review emphasises the need for new concepts and fresh approaches to end of life decision-making that address the needs of the growing population of frail older people, people with dementia and those with severe traumatic brain injury. (shrink)

This entry concerns dualism in the philosophy of mind. The term ‘dualism’ has a variety of uses in the history of thought. In general, the idea is that, for some particular domain, there are two fundamental kinds or categories of things or principles. In theology, for example a ‘dualist’ is someone who believes that Good and Evil — or God and the Devil — are independent and more or less equal forces in the world. Dualism contrasts with monism, which is (...) the theory that there is only one fundamental kind, category of thing or principle; and, rather less commonly, with pluralism, which is the view that there are many kinds or categories. In the philosophy of mind, dualism is the theory that the mental and the physical — or mind and body or mind and brain — are, in some sense, radically different kinds of thing. Because common sense tells us that there are physical bodies, and because there is intellectual pressure towards producing a unified view of the world, one could say that materialist monism is the ‘default option’. Discussion about dualism, therefore, tends to start from the assumption of the reality of the physical world, and then to consider arguments for why the mind cannot be treated as simply part of that world. (shrink)

Arguments for property dualism offer a strong challenge to materialist views, but even if they are regarded as successful, a large task remains, namely, to develop a positive account of the place of non-physical properties in the world -- one that holds some promise of eventual satisfaction regarding the hard problem. After noting some difficulties in current approaches to this task, this paper outlines one possible line of development for a dualistic view. Like all other suggestions for routes to progress (...) in this area, this one is speculative. However, the empirical findings that would support this line of development lie within current epistemic possibility. Moreover, the conceptual changes that would be required are intelligible from our present vantage point, and have parallels in views that are accepted in science and by non-dualist philosophers. (shrink)

Medically unexplained symptoms (MUS) remain recalcitrant to the medical profession, proving less suitable for homogenic treatment with respect to their aetiology, taxonomy and diagnosis. While the majority of existing medical research methods are designed for large scale population data and sufficiently homogenous groups, MUS are characterised by their heterogenic and complex nature. As a result, MUS seem to resist medical scrutiny in a way that other conditions do not. This paper approaches the problem of MUS from a philosophical point of (...) view. The aim is to first consider the epistemological problem of MUS in a wider ontological and phenomenological context, particularly in relation to causation. Second, the paper links current medical practice to certain ontological assumptions. Finally, the outlines of an alternative ontology of causation are offered which place characteristic features of MUS, such as genuine complexity, context-sensitivity, holism and medical uniqueness at the centre of any causal set-up, and not only for MUS. This alternative ontology provides a framework in which to better understand complex medical conditions in relation to both their nature and their associated research activity. (shrink)

This paper addresses the question whether evolutionary principles are compatible with epiphenomenalism, and argues for an affirmative answer. A general summary of epiphenomenalism is provided, along with certain specifications relevant to the issues of this paper. The central argument against compatibility is stated and rebutted. A specially powerful version of the argument, due to William James (1890), is stated. The apparent power of this argument is explained as resulting from a problem about our understanding of pleasure and an equivocation on (...) 'explanation'. Finally, an argument by Plantinga (2004), which applies to beliefs rather than phenomenal qualities, is stated and rebutted. (shrink)

In recent years, a significant number of philosophers from an orthodox analytic background have begun to advocate theories of composite objects, which they say are strikingly similar to Aristotle’s hylomorphism. These theories emphasize the importance of structure, or organization—which they say is closely connected to Aristotle’s notion of form—in defining what it is for a composite to be a genuine object. The reality of these structures is closely connected with the fact that they are held to possess powers, again in (...) what is held to be a broadly Aristotelian sense, and so to be genuinely efficacious. Naturally enough, they want to do all this without espousing the discredited aspects of Aristotelian science. It is the purpose of this essay to cast a skeptical eye on whether this objective can be achieved. (shrink)

Background Professional values are important in promoting healthy work environments, patient satisfaction, and quality of care. Magnet® hospitals are recognized for excellence in nursing care and as such, understanding the relationship between nurses' values and Magnet status is essential as healthcare organizations seek to improve patient outcomes. Research question/aim/objectives The research question is: are there differences in individual values, professional values, and nursing care quality for nurses and nurse managers practicing in Magnet, Magnet journey, and non-Magnet direct patient care settings? (...) Research Design This descriptive cross-sectional study is guided and informed by the conceptual framework of the Professional Values Model including individual values, professional values, and nursing care quality. Participants and research context Convenience sampling of registered nurses and nurse managers, responsible for direct patient care, was utilized in a non-profit healthcare system in the Midwest region of the United States. Ethical Considerations Institutional review board approval was obtained. Participants were informed about the right to self-determine participation and assurance of anonymity. Findings 827 (n = 827) nurses and nurse managers responded to the survey. Significant differences were identified in individual values sub-scale: self-enhancement ( p = 0.38), professional values ( p = 0.037), practice environment: participation in hospital affairs ( p = 0.00), foundations for quality care ( p = 0.016), and resources adequacy ( p = 0.012) and in nurse sensitive HCAHPS questions: nurses explained things understandably ( p = 0.00), got help as soon as wanted ( p = 0.00), and treated with courtesy and respect ( p = 0.00). Discussion/Conclusions Findings indicate that fostering individual and professional values may impact nursing practice, regardless of Magnet designation. Promoting professional values may contribute to improved work environments, enhancing patient satisfaction. Study results offer valuable insights for organizations striving to enhance nursing values, impacting quality of care provided to patients. MeSH Terms Cross-Sectional Studies, Respect, Ethics Committees, Patient Satisfaction, Nurse Administrators, and Personal Satisfaction. (shrink)

This article explores the link between CEOs’ language and hubristic leadership. It is based on the precepts that leaders’ linguistic utterances provide insights into their personality and behaviours; hubris is associated with unethical and potentially destructive leadership behaviours; if it is possible to identify linguistic markers of CEO hubris then these could serve as early warnings sign and help to mitigate the associated risks. Using computational linguistics, we analysed spoken utterances from a sample of hubristic CEOs and compared them with (...) non-hubristic CEOs. We found that hubristic CEOs’ linguistic utterances show systematic and consistent differences from the linguistic utterances of non-hubristic CEOs. Demonstrating how hubristic leadership manifests in CEO language contributes to wider research regarding the diagnosis and prevention of the unethical and potentially destructive effects of hubristic leadership. This research contributes to the wider study of hubris and unethical leadership by applying a novel method for identifying linguistic markers and offers a way of militating against the risk of unethical and destructive CEO behaviours induced or aggravated by hubristic leadership. (shrink)

BackgroundSuicide research aims to contribute to a better understanding of suicidal behaviour and its prevention. However, there are many ethical challenges in this research field, for example, regarding consent and potential risks to participants. While studies to-date have focused on the perspective of the researchers, this study aimed to investigate the views and experiences of members of Human Research Ethics Committees (HRECs) in dealing with suicide-related study applications.MethodsThis qualitative study entailed a thematic analysis using an inductive approach. We conducted semi-structured (...) interviews with a purposive sample (N = 15) of HREC Chairs or their delegates from Australian research-intensive universities. The interview guide included questions regarding the ethical concerns and challenges in suicide-related research raised by HREC members, how they dealt with those challenges and what advice they could give to researchers.ResultsThe analysis identified four main themes: (1) HREC members’ experiences of reviewing suicide-related study applications, (2) HREC members’ perceptions of suicide, suicide research, and study participants, (3) Complexity in HREC members’ decision-making processes, and (4) HREC members’ relationships with researchers.ConclusionsReliance on ethical guidelines and dialogue with researchers are crucial in the assessment of suicide-related study applications. Both researchers and HREC members may benefit from guidance and resources on how to conduct ethically sound suicide-related studies. Developing working relationships will be likely to help HRECs to facilitate high quality, ethical suicide-related research and researchers to conduct such research. (shrink)

Environmental ethicists have frequently criticized ancient Greek philosophy as anti-environmental for a view of philosophy that is counterproductive to environmental ethics and a view of the world that puts nature at the disposal of people. This provocative collection of original essays reexamines the views of nature and ecology found in the thought of Plato, Aristotle, the Stoics, and Plotinus. Recognizing that these thinkers were not confronted with the environmental degradation that threatens contemporary philosophers, the contributors to this book find that (...) the Greeks nevertheless provide an excellent foundation for a sound theory of environmentalism. (shrink)

An ongoing challenge facing emotion researchers is finding appropriate measurement tools. Many of our theories focus on emotion in the context of dynamic interaction, yet many of our most relied-upon measures either interrupt or alter interaction. New research suggests that infrared thermography may be useful as a nonintrusive way to measure emotion. Here we discuss the viability of thermography for studying emotion response and advancing emotion theory.

Abstract: Receptivity is a foundational concept in the analysis of causation given in Gregg Rosenberg’s A Place for Consciousness and it enters, directly or indirectly, into the definitions of a host of other terms in the book. This commentary raises a problem (which I call “the triviality problem”) about how we are to understand receptivity. Search for a solution proceeds by examination of several contexts in which the concept of receptivity is used. Although a satisfactory solution remains elusive, it is (...) hoped that making the problem clear will lead to its eventual resolution. (shrink)

The emotion of anger, when chronic, is especially problematic. Frequent and intense experiences of anger predict quite a few adverse health outcomes and are especially implicated in cardiovascular...

We give a new proof of the subanalyticity of the regular locus of a p-adic subanalytic set, replacing use of an approximation theorem by a more natural argument based on the flatness of certain homomorphisms given by Taylor expansions of strictly convergent power series at a non-standard point of Zmp.

Is believing in "minds" as qualitatively distinct from "bodies" just wrong headed? Did René Descartes set us off on a four hundred year wild goose chase? How should we think about this traditional dichotomy? With Wayne Alt, Alicia Juerrero, and Daniel Robinson.

Receptivity is a foundational concept in the analysis of causation given in Gregg Rosenberg’s A Place for Consciousness and it enters, directly or indirectly, into the definitions of a host of other terms in the book. This commentary raises a problem about how we are to understand receptivity. Search for a solution proceeds by examination of several contexts in which the concept of receptivity is used. Although a satisfactory solution remains elusive, it is hoped that making the problem clear will (...) lead to its eventual resolution. (shrink)

Sigmund Freuds kritikere Frank J. Sulloway, Jeffrey M. Masson og Adolf Grünbaum og argumenterne mod deres kritik.