This integrative review aims to provide a synthesis of research findings of health-care professionals’ knowledge, attitudes and behaviours relating to patient capacity to consent to or refuse treatment within the general hospital setting. Search strategies included relevant health databases, hand searching of key journals, ‘snowballing’ and expert recommendations. The review identified various knowledge gaps and attitudinal dispositions of health-care professionals, which influence their behaviours and decision-making in relation to capacity to consent processes. The findings suggest that there is tension between (...) legal, ethical and professional standards relating to the assessment of capacity and consent within health care. Legislation and policy guidance concerning capacity assessment processes are lacking, and this may contribute to inconsistencies in practice. (shrink)

BackgroundDelirium is highly prevalent in the general hospital patient population, characterized by acute onset, fluctuating levels of consciousness, and global impairment of cognitive functioning. Mental capacity, its assessment and subsequent consent are therefore prominent within this cohort, yet under-explored.AimThis study of patients with delirium sought to determine the processes by which consent to medical treatment was attempted, how capacity was assessed, and any subsequent actions thereafter.MethodA retrospective documentation review of patients identified as having a delirium for the twelve months February (...) 2013 to January 2014 was undertaken. Inclusion and exclusion criteria were used; demographic and descriptive data collected. A total of n=1153 patients were identified with n=310 meeting inclusion criteria.ResultA random sample of one hundred patients were subsequently reviewed. One third of patients had documentation relating to consent, while four patients had documentation relating to capacity. Median delirium duration was three days, with treatment refusal occurring in twenty-two patients and “duty of care” being used as an apparent beneficent related treatment framework in twelve patients.ConclusionsWhile impaired decision-making was indicated, the review was unable to indicate what patient characteristics flag the need for capacity assessment. Documentation relating to consent processes appeared deficient for this cohort. (shrink)

From the ethics perspective, “duty of care” is a difficult and contested term, fraught with misconceptions and apparent misappropriations. However, it is a term that clinicians use frequently as they navigate COVID-19, somehow core to their understanding of themselves and their obligations, but with uncertainty as to how to translate or operationalize this in the context of a pandemic. This paper explores the “duty of care” from a legal perspective, distinguishes it from broader notions of duty on professional and personal (...) levels, and proposes a working taxonomy for practitioners to better understand the concept of “duty” in their response to COVID-19. (shrink)

Australian prisons are overpopulated with people suffering from numerous health problems. COVID-19 presents a significant threat to prisoner health. This article examines the current regulatory responses from Australian state and territory governments to COVID-19 and a recent case which tested the human rights of prisoners during a pandemic.

The doctrine of consent is built upon presumptions of mental capacity. Those presumptions must be tested according to legal rules that may be difficult to apply to COVID-19 patients during emergency presentations. We examine the principles of mental capacity and make recommendations on how to assess the capacity of COVID-19 patients to consent to emergency medical treatment. We term this the CARD approach.

In lieu of an abstract, here is a brief excerpt of the content:THE HISTORICAL CONDITIONING OF CHURCH DOCTRINE* JOHN R. T. LAMONT Winnipeg, Canada I WISH to set out and defend a certain conception of what is involved in accepting the teachings of the Catholic Church. This conception is at odds with some contemporary understandings of the way in which such teachings are historically conditioned. I will argue that these conceptions are mistaken, and state what I think to be (...) the correct understanding of the historical conditioning of dogma. I Possession of the Catholic faith is usually understood to involve belief in the doctrines infallibly taught by the Catholic Church, so that outward profession of, and inward assent to, those doctrines, whether explicit or implicit, is a necessary condition for being a Catholic. I do not intend to discuss which particular doctrines are infallibly taught, or how exactly one determines that a doctrine is infallibly taught. I will simply assume that there are such doctrines, and that it is possible to determine that they are infallibly taught, and go on to ask the question, What does acceptance of these doctrines consist in? (The simpler expression "teachings of the Church" will be used to mean "infallible teachings of the Church" in the rest of this paper.) I propose this answer: • This paper had its origin in the lectures prepared for the author's philosophy of religion course at Chishawasha Seminary, Harare. The author would like to thank Fr. Norman Tanner, S.J., Fr. J.M. R. Tillard, O.P., and his colleagues at the Seminary and the University of Manitoba, for their helpful comments and suggestions. 511 512 JOHN R. T. LAMONT F). To accept the teachings of the Church is to believe that the propositions expressed by the sentences taught by the Church are true. Some comment on F) is necessary in order to make its meaning clear. A) "Propositions" Propositions, according to philosophers and logicians,1 possess the following characteristics. They are i) the bearers of truth or falsity. Whatever can be described as true, or as false, is a proposition. ii) the meanings of meaningful sentences. Different sentences can mean the same thing; for instance, the English sentence "Snow is white" and the French sentence "La neige est blanche" mean the same thing. What these two sentences have in common-what they mean-is a proposition. iii) the objects of cognitive, or propositional, attitudes. Such attitudes include knowing, doubting, wishing, disbelieving, suspending judgment about, expecting. When you know something or disbelieve something, what you know or disbelieve is a proposition. When you hope for something or fear that something might happen, what you hope for or fear is that some proposition might be true. Since the teachings of the Church are things that can be believed or disbelieved, are held to be true (by Catholics) and false (by some non-Catholics), and are expressed by sentences,' it follows that they are propositions.3 B) "Propositions expressed by sentences" Humans communicate propositions to each other by means of sentences. A sentence is a physical object, or a physical happening; ' See, for example, the introduction to Propositions and Attitudes, edited by Nathan Salmon and Scott Soames (Oxford, 1988). I have tried to describe in a previous paper the sort of reasons that have led philosophers to maintain that propositions are the objects of cognitive attitudes such as knowing, believing, or hoping ("The Nature of Revelation," New Blackfriars [July-August 1991]: 335-45). 2 I do not mean to assert here that all the Church's teachings are expressed in sentences, only that the Church does at times express her teachings in sentences (which is undeniable). It is possible for the Church to teach through actions, such as liturgical actions, as well as through sentences. However, since what is taught in such actions will be something that can be known and believed, such teachings will be propositions. 3 The question whether the teachings of the Church are propositions is not the same as the question whether divine revelation is propositional-whether divine revelation consists wholly or partly of propositions communicated by God to humans. I have argued (in "The Nature of Revelation") that revelation is at least partly propositional. However, the THE CONDITIONING... (shrink)

In the twenty-first century, 70.6 percent of Americans self-identify as Christians,1 58 percent of them still segregate themselves by race on Sunday mornings, and white Protestants make up the majority of this 58 percent.2 These facts belie the claim, popularized after Barack Obama's 2008 presidential election, that America is living in a postracial society3 And yet, the role played by religion in white people's lived experiences of race, racism, and white class privilege in the United States tends to be neglected (...) by philosophers and religious studies scholars, except perhaps when considering white supremacist groups such as the Ku Klux Klan.4 Contemporary philosophy is secular in a way that generally excludes and... (shrink)

The concept of ‘accounts’ (Scott and Lyman, 1968) – or linguistic strategies for neutralizing the negative social meanings of norm violation – has a long history in sociology. This work examines British and American women's accounts of cosmetic surgery. In the medical literature, feminist writings and the popular press, aesthetic plastic surgery has been associated with narcissism, psychological instability and self-hatred. Given these negative connotations, cosmetic surgery remains a practice requiring justification even as its popularity increases. Drawing on interview (...) data, I argue that respondents' efforts to account for cosmetic surgery vary according to the ‘repertoires of evaluation’ (Lamont and Thévenot, 2000) made available by their own nation and, particularly, by its healthcare culture. In the market-based US healthcare system, women justify cosmetic surgery by referring to their personal and financial ‘investments’ in physical attractiveness and well-being. Such explanations are less legitimate in Britain, where healthcare is considered a social right rather than a consumer good. In the latter context, women employ narratives that medicalize the pre-surgical body by stressing the physical pain and emotional distress that it caused. (shrink)

Presents wide-ranging and up-to-date interpretations of the Zhuangzi, the Daoist classic and one of the most elusive works ever written.

This study renders the complex corpus of the Guodian texts into a more easily manageable form, incorporating the past several years of scholarly activity on these texts and providing them with a comprehensive introduction along with a complete and well-annotated translation into English.

Zhuang Zi's relation to the Confucian school is reexamined. It is argued that although Zhuang Zi was fond of highlighting the absurdities of the Confucian enterprise, we can nonetheless detect in his writings a great admiration for much of what constituted the central core of the Confucian vision. This essay analyzes Confucius' image of "musical perfection," representing the total concordance of ritual restraints and harmonious freedom; traces the Confucian notion of self-cultivation through Mencius' passage on the "full-flowing energy"; and concludes (...) with an examination of Zhuang Zi's "Butcher Ding" story, showing that while Zhuang Zi's whole concept of self-nurturing is approached from a diametrically opposite angle, he nonetheless ends up celebrating a state of mastery and freedom in many ways identical to Confucius' notion of musical perfection. (shrink)

The debate over what constituted the most effective means of political control—governance through moral suasion or through coercive measures—was one that came to define the main battle lines between the Confucians and their “Legalist” rivals over the course of Warring States period China. While the importance of this debate is by no means new, recently unearthed Warring States manuscripts have done much to help shed new light upon the emergence of this debate: in particular the Chu-region bamboo manuscripts of Guodian (...) 郭店楚墓竹簡, which reveal the extent to which this issue was already at the forefront of Confucian thought by the mid-to-late fourth century bce. This paper discusses how these manuscript texts go about making the argument against coercive order and for rulership through ritual and musical education, which they do, in short, by staking the claim that the latter derive ultimately from human nature itself and, because of this, are the only true and natural means of successfully guiding and controlling it. (shrink)

Traditional sources for understanding of the thought of Confucius, such as the Lunyu 論語 (Analects) and Li ji 禮記 (Book of Ritual), are fraught with uncertainty in terms of dating and reliability. Recently excavated manuscripts from Warring States China, however, have begun to shed new light on the development of Confucian thought and the shaping of Confucius as a narrative figure during the two centuries following his death. This paper surveys and briefly assesses the significance of the relevant texts from (...) two major unearthed corpuses: the Guodian Bamboo Manuscripts of Chu 郭店楚墓竹簡 and the Shanghai Museum Manuscripts of Chu 上海博物館藏戰國楚竹書. These include: “Ziyi,” “Zun deyi,” “Min zhi fumu,” “Zhonggong,” “Zigao,” “Lu bang da han,” “Xiang bang zhi dao,” “Yan Yuan wen yu Kong Zi,” “Junzi wei li,” “Dizi wen,” “Kongzi jian Ji Huanzi,” “Ji Kangzi wen yu Kong Zi,” “Kong Zi shilun,” and “Cong zheng.”. (shrink)

Aside from the Yue Ji 樂記, the “Xiu Wen 修文” chapter of the Shuoyuan 說苑 is perhaps our richest source of pre-Qin and early Han 漢 Confucian musical thought. Though woven together from earlier sources, “Xiu Wen” nonetheless manages to present its own distinctive expression of the role of music and its relationship to the greater system of ritual institutions. This article undertakes an examination of the chapter’s philosophies of ritual and music, focusing especially on the latter, and in the (...) process attempts to demonstrate what is unique about the text in relation to its forerunners in the realm of musical thought. (shrink)

Academic dishonesty is a persistent problem in the American educational system. The present investigation examined how reports of academic cheating related to students' emphasis on their moral identities and their sensitivity to social evaluation. Seventy college students at a large southeastern university completed a battery of surveys. Symptoms of social anxiety were positively correlated with recall of academic cheating. Additionally, relative to students who placed less importance on their moral identities, students who placed more importance on their moral identities recalled (...) significantly fewer instances of cheating. In summary, these findings suggest that students are less likely to cheat on their school work when they place greater emphasis on their moral identity and are less sensitive to social evaluation. Practical interventions to rampant cheating in American schools are discussed. (shrink)

Many of the activities of clinical practice happen to, with or upon vulnerable human beings. For this reason numerous nursing authors draw attention to or claim a significant moral domain in clinical practice. A number of nursing authors also discuss the emotional involvement and/or emotional labour which is often experienced in clinical practice. In this article I explore the importance of emotion for moral perception and moral agency. I suggest that an aspect of being a good nurse is having an (...) emotional sensitivity to other human beings (patients), because this emotional sensitivity allows the nurse to perceive more accurately the context and perspective of the patient. It is thus important to the moral agency of the nurse and to morally sensitive clinical practice. As such education of the emotions should be a feature of the moral education of the nurse. A useful conception of the role of educated emotion in the moral life can be discovered in Aristotelian ethics. (shrink)

This study investigates the role that moral identity, religiosity, and the institutionalization of ethics play in determining the extent of justification of norm violating behavior among business practitioners. Moral justification is where a person, rather than assuming responsibility for an outcome, attempts to legitimize ethically questionable behavior. Results of the study indicate that both the internalization and symbolization dimensions of moral identity as well as intrinsic religiosity and the explicit institutionalization of ethics within the organization are significant determinants of the (...) moral justification of unethical behaviors. (shrink)

Kin selection, reciprocity and group selection are widely regarded as evolutionary mechanisms capable of sustaining altruism among humans andother cooperative species. Our research indicates, however, that these mechanisms are only particular examples of a broader set of evolutionary possibilities.In this paper we present the results of a series of simple replicator simulations, run on variations of the 2–player prisoner's dilemma, designed to illustrate the wide range of scenarios under which altruism proves to be robust under evolutionary pressures. The set of (...) mechanisms we explore is divided into four categories :correlation, group selection, imitation, and punishment. We argue that correlation is the core phenomenon at work in all four categories. (shrink)

Bhimrao Ambedkar is well-known as the architect of the Indian constitution, the document that created the world's largest democracy when it came into effect in 1950. Ambedkar is also famous, or infamous according to some religious partisans, in the Indian political context for his unflagging and often bombastic advocacy on behalf of India's so-called "untouchables." Being a Mahar, an untouchable caste in the Indian state of Maharashtra, Ambedkar knew of the struggles and the religiously underwritten violence that was foisted upon (...) these swaths of Indian society. His struggles in and against the caste system, and the Hindu religious-philosophical system that frequently enabled it, are well documented by... (shrink)

Bhimrao Ambedkar is well known as the architect of independent India’s constitution, the document that created the world’s largest democracy on January 26, 1950. Ambedkar is also famous for his vigorous advocacy on behalf of India’s so-called “untouchables,” those groups of people that reside beneath and outside of the ancient system of hereditary castes in Hinduism. His activism and political efforts secured rights and respect for millions of lower-caste Indians before his death in 1956. Even though Ambedkar was an untouchable, (...) forbidden from learning the ancient language of Sanskrit, he managed to learn English in his early education... (shrink)

I talked to my chair for hours, without it responding—and then I heard its voice, its desire, its rhetoric: sit in me.A new specter of materialist thought, conveniently cloaked in "realism," now haunts philosophy and rhetoric—object-oriented ontology and object-oriented rhetoric.1 Ostensibly, OOO arrives as the logical next step for theories of anti-, extra-, and post-humanism that have, over the past several decades, sought to destabilize the privileged position of human exceptionalism....

We extend the results of Laver on using inverse limits to reflect large cardinals of the form, there exists an elementary embedding Lα → Lα. Using these inverse limit reflection embeddings directly and by broadening the collection of U-representable sets, we prove structural results of L under the assumption that there exists an elementary embedding j : L → L. As a consequence we show the impossibility of a generalized inverse limit X-reflection result for X ⊆ Vλ+1, thus focusing the (...) study of L generalizations on L. (shrink)

The two volumes of Philosophical Essays bring together the most important essays written by one of the world's foremost philosophers of language. Scott Soames has selected thirty-one essays spanning nearly three decades of thinking about linguistic meaning and the philosophical significance of language. A judicious collection of old and new, these volumes include sixteen essays published in the 1980s and 1990s, nine published since 2000, and six new essays. The essays in Volume 1 investigate what linguistic meaning is; how (...) the meaning of a sentence is related to the use we make of it; what we should expect from empirical theories of the meaning of the languages we speak; and how a sound theoretical grasp of the intricate relationship between meaning and use can improve the interpretation of legal texts. The essays in Volume 2 illustrate the significance of linguistic concerns for a broad range of philosophical topics--including the relationship between language and thought; the objects of belief, assertion, and other propositional attitudes; the distinction between metaphysical and epistemic possibility; the nature of necessity, actuality, and possible worlds; the necessary a posteriori and the contingent a priori; truth, vagueness, and partial definition; and skepticism about meaning and mind. The two volumes of Philosophical Essays are essential for anyone working on the philosophy of language. (shrink)

This manuscript reviews and synthesizes most of the major research studies in the area of consumer ethics that have appeared since 1990. It examines both conceptual and empirical works with an objective of encouraging researchers to pursue research in the consumer ethics area. Toward this end, the paper also suggests directions for future research.

This study seeks to understand and critique the growing online trend of “revenge porn,” or the intentional embarrassment of identifiable individuals through the posting of nude images online. This posting of intimate pictures, often done out of motives of revenge for perceived relational scorn, is enhanced by the varying levels of online anonymity. Using the theoretical framework of John Dewey's pragmatism, this study both analyzes this understudied but complex new problem precipitated by the conditions of the online self and establishes (...) the groundwork for the use of pragmatist ethics in other areas of communication ethics. (shrink)

Aristotle's treatment of trade in the Politics book one is usually regarded as especially hostile, and this is put down to snobbery and political prejudice on his part. The Greeks often regarded trade as a degrading thing for a free man to engage in, and it would be surprising if Aristotle's view of trade were entirely unconnected with this Greek sensibility. But there should be something more definite than a loose general affinity if a charge of prejudice is to be (...) taken seriously. A balance of hostile judgements over argued cases to back them up would be some sort of evidence for prejudice, and prima facie evidence against would be anything like a theory from which the hostile judgements followed as conclusions. Theories can be concocted to give the required conclusions, of course, and then we must try to decide how serious the theory is. It comes to this: is there so little in the reasons Aristotle gives for his condemnation of trade that they may be convincingly explained away and belittled as no more than expressions of attitudes? (shrink)

An obstacle to abortion exists in the form of abortion ‘counselling’ that discourages women from terminating their pregnancies. This counselling involves providing information about the procedure that tends to create feelings of guilt, anxiety and strong emotional reactions to the recognizable form of a human fetus. Instances of such counselling that involve false or misleading information are clearly unethical and do not prompt much philosophical reflection, but the prospect of truthful abortion counselling draws attention to a delicate issue for healthcare (...) professionals seeking to respect patient autonomy. This is the fact that even accurate information about abortion procedures can have intimidating effects on women seeking to terminate a pregnancy. Consequently, a dilemma arises regarding the information that one ought to provide to patients considering an abortion: on the one hand, the mere offering of certain types of information can lead to intimidation; on the other hand, withholding information that some patients would consider relevant to their decision-making is objectionably paternalistic on any standard account of the physician-patient relationship. This is an unsettling conclusion for the possibility of setting fixed professional guidelines regarding the counselling offered to women who are considering abortion. Thus, abortion ought to be viewed as an illuminating example of a procedure for which the process of securing informed consent ought to be highly context-sensitive and responsive to the needs of each individual patient. This result underscores the need for health care professionals to cultivate trusting relationships with patients and to develop finely tuned powers of practical judgment. (shrink)

This paper situates the moral domain of practice within the context of a particular description of nursing practice – one that sees human interaction at the heart of that practice. Such a description fits not only with professional rhetoric but also with literature from patients and recent empirical work exploring the nature of nursing practice.Martha Levine in her 1977 description of ethics, within the context of nursing practice, indicated that what was important from an ethical perspective was how we interact (...) with each other, with patients and colleagues, on a daily basis. What enables such interaction to display moral sensitivity, insight into patient need, and a focus on the good for the patient? Of relevance when answering this question is the empirical evidence indicating that professional socialization, as a nurse or a doctor, may dull the individual’s moral sense. If this is the case, cognizance needs to be taken of such evidence when identifying theoretical approaches from mainstream ethics that may provide insight and value for nurse education. It is suggested that such insight and value can be gained from a consideration of the work of Aristotle, Murdoch, and Vetlesen. (shrink)

American democracy, while no stranger to internal conflict, has seemingly reached a boiling point regarding political partisanship. Things have gotten so bad that parties rarely talk to each other on important issues, and shutting down the government over ideological disagreements has become a more or less accepted move. Tom Allen, a former U.S. representative from Maine, paints this provocative picture of how the warring political parties in the U.S. government see each other: “Democrats see Republicans as inattentive to evidence and (...) expertise, unconcerned about Americans struggling to get by, and reflexively opposed to government action to deal with our collective challenges. On the other hand, Republicans see.. (shrink)

ABSTRACTIncreasing attention is being directed at the impact of fake news on democratic societies across the globe. Scholars in a range of fields are attempting to determine who is behind fake news...

ABSTRACT This article explores what the contours of a pragmatist theory of rhetoric would be like in its democratic instantiation. The threat of partisan thought and dogmatism in argument is examined as a threat to the sort of democratic community pragmatists such as John Dewey desired to create. Partisans fail to realize not only their own limitations in pursuing the true and the good but also the fact that solving problems through overly partisan forms of reasoning or argument only creates (...) future obstacles to community life. This provides an extended reading of what Dewey meant by free communication: communication not only free from legal constraints and censorship but also free from the binding habits of thought and interaction that can be identified as “partisan perfect reasoning.”. (shrink)