The physician-researcher conflict of interest has thus far eluded satisfactory solution. Most attempts to deal with it focus on improving informed consent. But those attempts are not successful and may even make things worse. Research subjects are already voluntarily undertaking the risks of research — we should not ask them to go it alone — to undergo medical “treatment” without medical “care.” The only effective solution is that in much clinical research, each research subject should have a doctor independent from (...) the research study. (shrink)

The physician-researcher conflict of interest, a long-standing and widely recognized ethical challenge of clinical research, has thus far eluded satisfactory solution. The conflict is fairly straightforward. Medical research and medical therapy are distinct pursuits; the former is aimed at producing generalizable knowledge for the benefit of future patients, whereas the latter is aimed at addressing the individualized medical needs of a particular patient. When the physician-researcher combines these pursuits, he or she serves two masters and cannot — no matter how (...) well-intentioned — avoid the risk of compromising the duties owed in one of the professional roles assumed. Because of the necessary rigidity of a research protocol, the more demanding of the two masters is frequently the research.The problem of the physician-researcher conflict has been evident since the first attempts to regulate human research in the United States. Otto E. Guttentag, a physician at the University of California School of Medicine in San Francisco, addressed the conflict in a 1953Sciencemagazine article. (shrink)

Virginia Woolf, in A Room of One’s Own, asked why there were no women writers before 1800. If she had been thinking about philosophers instead of writers in the traditional women’s areas of plays and fiction, she might have asked why there were no women philosophers at all, for I suspect that most people would find it very hard to name a woman philosopher before the present day. To help her in answering her question, she invented a fictional character, Judith (...) Shakespeare, a sister to William Shakespeare. The conditions of Judith’s life made it impossible for her to write, and so Woolf speculated that the women who would have been writers did not lead the kinds of lives that permitted them to realize their talents. Woolf’s image of Judith Shakespeare is a very powerful one but her speculation is only half right. There undoubtedly were many women in the past who would have been talented writers or philosophers if their lives had been different, but Judith Shakespeare’s image can also blot out our knowledge of women who, contrary to Woolf’s speculation, did exist and did write. Indeed, we know now there were even women who wrote philosophy. These women were in many ways exceptional, for Woolf is quite right that most women did not live either with enough privacy or with enough income to allow them to write. Often, they were members of the aristocracy, whose position enabled them to behave eccentrically, sometimes to be able to demand privacy, and sometimes to be able to invite contacts with leading intellectuals. Quite often, these women were childless, which in an age before birth control made them exceptions to the general rule, and at a time when many women were bearing their last child in their forties, was the only thing that could have given them private time. Nevertheless, research in the last ten or fifteen years has uncovered the work of quite a number of these women: for example, Princess Elizabeth of Bohemia, the Electress Sophie, Queen Christina of Sweden, Queen Sophie Charlotte of Prussia, Anne, Lady Conway, Mary Astell, Damaris, Lady Masham, Catharine Trotter Cockburn, Emilie du Chatelet, Catherine Macaulay, Lady Mary Shepherd, and many more. Woolf’s question then comes up again in a slightly different form. Why is it that the work of these women was for so long unknown? Why do so many people even today remain ignorant of the existence of women philosophers before the present day? I am not going to answer this question directly; in fact, I suspect it has multiple answers. Instead, I am going to present a case study from amongst all the cases of all of these women. I hope by considering the history of this woman, and, in particular, considering the way in which she was read, it will be possible to gain some insights into the ways in which women have failed to be incorporated into philosophical history. The woman I am going to discuss is Lady Mary Shepherd. Mary Shepherd actually falls outside of Woolf’s target date of 1800, since she flourished in the first half of the nineteenth century, but this merely reflects my point about the greater ignorance that prevails about women in philosophy. (shrink)

Ann Margaret Sharp, American philosopher of education, believed that friends could, in fact, be quite critical of one another. Writing in her essay, “What is a Community of Inquiry,” she states,... but children know that the group has taken on a great significance for them: each one’s happiness means as much to each of them as their own. They truly care for each other as persons, and this care enables them to converse in ways they never have before. They (...) can engage in inquiry without fear of rebuff or humiliation. They can try out ideas that they never would have thought of expressing before just to see what happens.I am grateful to the friends of Sharp who spent time in pursuit of understanding her work and its... (shrink)

In this article, we offer a perspective into howCanadian doctoral nursing students’ writing capacity is mentored and, as a result, we argue is disciplined. We do this by sharing our own disciplinary and interdisciplinary experiences of writing with, for and about nurses. We locate our experiences within a broader discourse that suggests doctoral (nursing) students be prepared as stewards of the (nursing) discipline. We draw attention to tensions and effects of writing within (nursing) disciplinary boundaries. We argue that traditional approaches (...) to developing nurses’ writing capacity in doctoral programs both shepherds and excludes emerging scholarly voices, and we present some examples to illustrate this dual role. We ask our nurse colleagues to consider for whom nurses write, offering an argument that nurses’ writing must ultimately improve patient care and thus would benefit from multiple voices in writing. (shrink)

In 1827, Lady Mary Shepherd published Essays on the Perception of an External Universe, which offers both an argument for the existence of a world of external bodies existing outside our minds and a criticism of Berkeley's argument for idealism in A Treatise Concerning the Principles of Human Knowledge. In this paper, I evaluate Margaret Atherton's criticisms of Shepherd's case against Berkeley, and provide reasons for thinking that, although Shepherd's particular criticisms of Berkeley do not succeed, (...) she correctly identifies an important problem to which Berkeley's reasoning is subject. (shrink)

This chapter examines the epistemologies of Margaret Cavendish, Mary Astell, and Mary Shepherd. Cavendish argues that minds come to have knowledge via two routes: sensory perception and reason. For Cavendish, these two faculties of knowledge differ not in kind but in degree: they work to produce ideas in the same way, but ideas that come from reason are less trustworthy than those from the senses. While Astell also acknowledges a distinction between sense perception and reason as faculties of (...) cognition, she claims that ideas that come from the senses cannot properly be called knowledge. In contrast, reason traffics in ideas that are wholly non-sensory and allow for a level of certainty that counts as knowledge in the strict sense. Shepherd locates a position that lies in between that of Cavendish and Astell. Like Astell, Shepherd argues that we have limited knowledge from sense perception, and we have absolutely certain knowledge of some things through a non-sensory faculty of reason – for example, that changes in a body cannot occur without a cause, and that things cannot be annihilated or come from nothing. However, for Shepherd, the scope of human knowledge is quite limited. (shrink)

Many think that a specific aspect of phenomenal consciousness – valenced or affective experience – is essential to consciousness’s moral significance (valence sentientism). They hold that valenced experience is necessary for well-being, or moral status, or psychological intrinsic value (or all three). Some think that phenomenal consciousness generally is necessary for non-derivative moral significance (broad sentientism). Few think that consciousness is unnecessary for moral significance (non-necessitarianism). In this paper I consider the prospects for these views. I first consider the prospects (...) for valence sentientism in light of Vulcans, beings who are conscious but without affect or valence of any sort. I think Vulcans pressure us to accept broad sentientism. But I argue that a consideration of explanations for broad sentientism opens up possible explanations for non-necessitarianism about the moral significance of consciousness. That is, once one leans away from valence sentientism because of Vulcans, one should feel pressure to accept a view on which consciousness is not necessary for well-being, moral status, or psychological intrinsic value. (shrink)

Why does a wine glass break when you drop it, whereas a steel goblet does not? The answer may seem obvious: glass, unlike steel, is fragile. This is an explanation in terms of a power or disposition: the glass breaks because it possesses a particular power, namely fragility. Seemingly simple, such intrinsic dispositions or powers have fascinated philosophers for centuries. A power's central task is explaining why a thing changes in the ways that it does, rather than in other ways: (...) powers should explain why an acorn turns into an oak tree, not a sunflower, or why fire burns wood, and wood can catch fire. -/- This volume examines the twists and turns of the fascinating history of a difficult philosophical concept, focusing on the metaphysical sense of "powers"--that is, the powers that are invoked in the explanation of natural changes and activities. Scholars probe the views of thinkers from antiquity to the present day: Anaxagoras, Plato, the Stoics, Abelard, Anselm, Henry of Ghent, Gottfried Wilhelm Leibniz, Margaret Cavendish, Mary Shepherd, Immanuel Kant, Georg Wilhelm Friedrich Hegel, and numerous others. In addition, the volume contains four short reflection essays that examine the concept of powers from the perspective of disciplines other than philosophy, namely history of music, West African religions, history of chemistry, and history of art. -/- The history of philosophy brims with controversies surrounding the concept of power, and these controversies have not diminished--particularly as potentialities or powers see a revival in contemporary analytic metaphysics. Hence, telling the history of philosophical theories of powers means exploring the trajectory of a concept whose importance to the past and present of philosophy can hardly be overstated. (shrink)

The extensive involvement of nonconscious processes in human behaviour has led some to suggest that consciousness is much less important for the control of action than we might think. In this article I push against this trend, developing an understanding of conscious control that is sensitive to our best models of overt action control. Further, I assess the cogency of various zombie challenges—challenges that seek to demote the importance of conscious control for human agency. I argue that though nonconscious contributions (...) to action control are evidently robust, these challenges are overblown. (shrink)

We argue that any strong version of a knowledge condition on intentional action, the practical knowledge principle, on which knowledge of what I am doing (under some description: call it A-ing) is necessary for that A-ing to qualify as an intentional action, is false. Our argument involves a new kind of case, one that centers the agent’s control appropriately and thus improves upon Davidson’s well-known carbon copier case. After discussing this case, offering an initial argument against the knowledge condition, and (...) discussing recent treatments that cover nearby ground, we consider several objections. One we consider at some length maintains that although contemplative knowledge may be disconnected from intentional action, specifically practical knowledge of the sort Anscombe elucidated escapes our argument. We demonstrate that this is not so. Our argument illuminates an important truth, often overlooked in discussions of the knowledge-intentional action relationship: intentional action and knowledge have different levels of permissiveness regarding failure in similar circumstances. (shrink)

My topic is the intelligent guidance of action. In this paper I offer an empirically grounded case for four ideas: that [a] cognitive processes of practical reasoning play a key role in the intelligent guidance of action, [b] these processes could not do so without significant enabling work done by both perception and the motor system, [c] the work done by perceptual and motor systems can be characterized as the generation of information specialized for action guidance, which in turn suggests (...) that [d] the cognitive processes of practical reasoning that play a key role in the guidance of intelligent action are not the abstract, syllogistic ones philosophers often treat as the paradigm of practical reasoning. Rather, these cognitive processes are constrained by, and work well with, the specialized concepts outputted by perception and the feedback outputted by sensorimotor processes. (shrink)

I argue that the neural realizers of experiences of trying are not distinct from the neural realizers of actual trying . I then ask how experiences of trying might relate to the perceptual experiences one has while acting. First, I assess recent zombie action arguments regarding conscious visual experience, and I argue that contrary to what some have claimed, conscious visual experience plays a causal role for action control in some circumstances. Second, I propose a multimodal account of the experience (...) of acting. According to this account, the experience of acting is a temporally extended, co-conscious collection of agentive and perceptual experiences, functionally integrated and structured both by multimodal perceptual processing as well as by what an agent is, at the time, trying to do. (shrink)

Anne Margaret Baxley offers a systematic interpretation of Kant's theory of virtue, whose most distinctive features have not been properly understood. She explores the rich moral psychology in Kant's later and less widely read works on ethics, and argues that the key to understanding his account of virtue is the concept of autocracy, a form of moral self-government in which reason rules over sensibility. Although certain aspects of Kant's theory bear comparison to more familiar Aristotelian claims about virtue, Baxley (...) contends that its most important aspects combine to produce something different - a distinctively modern, egalitarian conception of virtue which is an important and overlooked alternative to the more traditional Greek views which have dominated contemporary virtue ethics. (shrink)

Necessarily, if S lacks the ability to exercise control, S is not an agent. If S is not an agent, S cannot act intentionally, responsibly, or rationally, nor can S possess or exercise free will. In spite of the obvious importance of control, however, no general account of control exists. In this paper I reflect on the nature of control itself. I develop accounts of control ’s exercise and control ’s possession that illuminate what it is for degrees of control (...) —that is, the degree of control an agent possesses or exercises in a given circumstance—to vary. Finally, I demonstrate the usefulness of the account on offer by showing how it generates a solution to a long-standing problem for causalist theories of action, namely, the problem of deviant causation. (shrink)

Common-sense folk psychology and mainstream philosophy of action agree about decisions: these are under an agent's direct control, and are thus intentional actions for which agents can be held responsible. I begin this paper by presenting a problem for this view. In short, since the content of the motivational attitudes that drive deliberation and decision remains open-ended until the moment of decision, it is unclear how agents can be thought to exercise control over what they decide at the moment of (...) deciding. I note that this problem might motivate a non-actional view of deciding?a view that decisions are not actions, but are instead passive events of intention acquisition. For without an understanding of how an agent might exercise control over what is decided at the moment of deciding, we lack a good reason for maintaining commitment to an actional view of deciding. However, I then offer the required account of how agents exercise control over decisions at the moment of deciding. Crucial to this account is an understanding of the relation of practical deliberation to deciding, an understanding of skilled deliberative activity, and the role of attention in the mental action of deciding. (shrink)

In this paper, I offer evidence that folk views of free will and moral responsibility accord a central place to consciousness. In sections 2 and 3, I contrast action production via conscious states and processes with action in concordance with an agent's long-standing and endorsed motivations, values, and character traits. Results indicate that conscious action production is considered much more important for free will than is concordance with motivations, values, and character traits. In section 4, I contrast the absence of (...) consciousness with the presence of consciousness in behaviorally identical agents. Most participants attribute free will to conscious agents, but not to nonconscious agents. Focusing in particular on two leading views of free will and moral responsibility, namely, Deep Self and Reasons-Responsive Views, I argue that these results present philosophers of mind and action with the following explanatory burden: develop a substantive theory of the connection between consciousness on the on.. (shrink)

Theories of perception are at the core of many of the most renowned seventeenth and eighteenth century European philosophical systems. Work on perception is less common in the writings of women philosophers of this period, and yet, like their male peers, early modern women philosophers are responsible for innovative accounts of our perceptual relation with the natural world. With special attention to the work of Margaret Cavendish and Mary Shepherd, this essay explores some notable features of theories of (...) perception developed by women between the mid-seventeenth and the early nineteenth centuries with the aim of elucidating how women’s contributions to this cardinal area of early modern study expanded the diversity of views on offer. (shrink)

An ongoing crisis in Australian agriculture resulting from climate crises including drought, decreasing irrigation water, more recent catastrophic flooding, and an uncertain policy environment is reshaping gender relations in the intimate sphere of the farm family. Drawing on research conducted in the Murray-Darling Basin area of Australia we ask the question: Does extreme hardship/climate crises change highly inequitable gender relations in agriculture? As farm income declines, Australian farm women are more likely to be working off farm for critical family income (...) while men continue to work on farm often in circumstances of damaged landscapes, rising debt, and limited production. This paper examines the way gender relations are being renegotiated in a time of significant climate crisis. Our research suggests that climate crises have indeed led to changes in gender relations and that some changes are unexpected. Whereas one would logically assume that women’s enhanced economic contribution would increase their power in gender negotiations, we argue that this does not necessarily occur because their contribution is viewed as a farm survival strategy. Men are committed to prioritizing the farm and view women’s income generating work as critical to this purpose and yet, paradoxically, long for a return to traditional farm roles. We find that women are actively resisting traditional gender relations by reshaping a role for themselves beyond the farm—in the process moving physically and mentally away from a farm family ideology, questioning gender inequalities, and by extension their relationships. (shrink)

In this interesting paper, Lavazza and Massimini draw attention to a subset of the ethical issues surrounding the development and potential uses of cerebral organoids. This subset concerns the possibility that cerebral organoids may one day develop phenomenal consciousness, and thereby qualify as conscious subjects—that there may one day be something it is like to be an advanced cerebral organoid. This possibility may feel outlandish. But as Lavazza and Massimini demonstrate, the science of organoids is moving fast, and I agree (...) that the ethical issues now deserve careful scrutiny. The ethical issues are not entirely separate from epistemological issues concerning how certain we could ever be (a) that an organoid is conscious or (b) that regarding any conscious state or process, an organoid is capable of tokening that state or undergoing that process. Lavazza and Massimini’s approach is theory-based—they claim that ‘we need a general theory of consciousness that attempts to explain what experience is and what type of physical systems can have it’. I am not convinced, however, that a theory of consciousness is what we need. Nor am I convinced that detecting the presence of consciousness is the most important moral issue. Let me say a word regarding theories of consciousness first. In general, to the extent that pervasive disagreement characterises expert discussion of some phenomenon P, one should modify one’s credence downward regarding any theory of the nature of P. In my view, this is the case regarding expert discussion of consciousness. Although most philosophers are confident that consciousness is an entirely physical phenomenon, a …. (shrink)

It is well known that the nature of consciousness is elusive, and that attempts to understand it generate problems in metaphysics, philosophy of mind, psychology, and neuroscience. Less appreciated are the important – even if still elusive – connections between consciousness and issues in ethics. In this chapter we consider three such connections. First, we consider the relevance of consciousness for questions surrounding an entity’s moral status. Second, we consider the relevance of consciousness for questions surrounding moral responsibility for action. (...) Third, we consider the relevance of consciousness for the acquisition of moral knowledge. (shrink)

What are the folk-conceptual connections between free will and consciousness? In this paper I present results which indicate that consciousness plays central roles in folk conceptions of free will. When conscious states cause behavior, people tend to judge that the agent acted freely. And when unconscious states cause behavior, people tend to judge that the agent did not act freely. Further, these studies contribute to recent experimental work on folk philosophical affiliation, which analyzes folk responses to determine whether folk views (...) are consistent with the view that free will and determinism are incompatible (incompatibilism) or with the opposite view (compatibilism). Conscious causation of behavior tends to elicit pro-free will judgments, even when the causation takes place deterministically. Thus, when controlling for consciousness, many folk seem to be compatibilists. However, participants who disagree with the deterministic or cognitive scientific descriptions given of human behavior tend to give incompatibilist responses. (shrink)

Recent work in cognitive science suggests that conscious thought plays a much less central role in the production of human behavior than most think. Partially on the basis of this work, Peter Carruthers has advanced the claim that humans never consciously decide to act. This claim is of independent interest for action theory, and its potential truth poses a problem for theories of free will and autonomy, which often take our capacity to consciously decide to be of central importance. In (...) this article, I examine the nature of conscious deciding and I argue that Carruthers fails to establish the claim that humans never consciously decide to act. (shrink)

Globalization, international policymanipulations such as the US farm bill, andnational policy responses have received a greatdeal of media coverage in recent times. Theseinternational and national events are having amajor impact on agricultural production inAustralia. There is some suggestion that theyare, in fact, responsible for a downturn in thefortunes of agriculture. Yet, it is more likelythat these issues are acting to continue andexacerbate a trend towards reduced viabilityfor farm families evident in economic andsocial trends since at least the 1950s.Nevertheless, globalization and (...) Australia's policy responses have left farm families morevulnerable in the global world. What then do weknow about their impact at farm gate level?Just who is doing the farming in Australia inthe 21st century and how are these peopleresponding to major world politics? This paperwill focus on the social aspects ofagricultural production in Australia notingsocial trends and drawing attention to thechanging social relations of agriculture. Thedominance of farm families, the role ofcorporate agriculture, ethnic diversity, theimportance of women, and the practice of farmtransfers will be canvassed in this paper. (shrink)

I offer an account of the experience of acting that demonstrates how agentive aspects of experience associated with the execution of intentions are richly integrated with perceptual aspects associated with parts of action taking place in the publicly observable world. On the view I elucidate, the experience of acting is often both an engagement with the world and a type of intimate acquaintance with it. In conscious action the agent consciously intervenes in the world and consciously experiences the world she (...) is changing. In section one, I discuss extant accounts of the experience of acting, noting deficiencies. In sections two and three, I develop my own account, drawing on Casey O’Callaghan’s work on multi-modal perception. In the conclusion, I discuss ramifications for psychology and philosophy. (shrink)

Brain–computer interfaces are a form of technology that read a user’s neural signals to perform a task, often with the aim of inferring user intention. They demonstrate potential in a wide range of clinical, commercial, and personal applications. But BCIs are not always simple to operate, and even with training some BCI users do not operate their systems as intended. Many researchers have described this phenomenon as “BCI illiteracy,” and a body of research has emerged aiming to characterize, predict, and (...) solve this perceived problem. However, BCI illiteracy is an inadequate concept for explaining difficulty that users face in operating BCI systems. BCI illiteracy is a methodologically weak concept; furthermore, it relies on the flawed assumption that BCI users possess physiological or functional traits that prevent proficient performance during BCI use. Alternative concepts to BCI illiteracy may offer better outcomes for prospective users and may avoid the conceptual pitfalls that BCI illiteracy brings to the BCI research process. (shrink)

Here, I review work from three lines of research in cognitive science often taken to threaten free will and moral responsibility. This work concerns conscious deciding, the experience of acting, and the role of largely unnoticed situational influences on behavior. Whether this work in fact threatens free will and moral responsibility depends on how we ought to interpret it, and depends as well on the nature of free and responsible behavior. I discuss different ways this work has been interpreted and (...) argue that though work on conscious deciding and the experience of acting presents no real threat, work on situational influences is more difficult to dismiss. This work may present a real threat, and it may require us to revise our commonsense understanding of free and responsible behavior. But this work may also present ways to augment free and responsible behavior. Determining whether and how advancing science threatens, enhances, or simply describes free will is an ongoing task for scientists and philosophers alike. (shrink)

In this paper I explore the relationship between skill and sensitivity to reasons for action. I want to know to what degree we can explain the fact that the skilled agent is very good at performing a cluster of actions within some domain in terms of the fact that the skilled agent has a refined sensitivity to the reasons for action common to the cluster. The picture is a little bit complex. While skill can be partially explained by sensitivity to (...) reasons – a sensitivity often produced by rational practice – the skilled human agent, because imperfect, must navigate a trade-off between full sensitivity and a capacity to succeed. (shrink)

Economies - and the government institutions that support them - reflect a moral and political choice, a choice we can make and remake. Since the dawn of industrialization and democratization in the late eighteenth century, there has been a succession of political economic frameworks, reflecting changes in technology, knowledge, trade, global connections, political power, and the expansion of citizenship. The challenges of today reveal the need for a new moral political economy that recognizes the politics in political economy. It also (...) requires the redesign of our social, economic, and governing institutions based on assumptions about humans as social beings rather than narrow self-serving individualists. This Element makes some progress toward building a new moral political economy by offering both a theory of change and some principles for institutional design. (shrink)

The flow construct has been influential within positive psychology, sport psychology, the science of consciousness, the philosophy of agency, and popular culture. In spite of its longstanding influence, it remains unclear [a] how the constituents of the flow state ‘hang together’—how they relate to each other causally and functionally—[b] in what sense flow is an ‘optimal experience,’ and [c] how best to describe the unique phenomenology of the flow state. As a result, difficulties persist for a clear understanding of the (...) flow state’s structure and function. After explicating the standard view of the flow construct, I articulate several basic questions regarding its nature and functional roles, and I argue that these questions are best answered by integrating flow within broader streams of research on the dynamics of thought, on cognitive control resource allocation, and on creative thought. (shrink)

It is natural to think that at root, agents are beings that act. Agents do more than this, however – agents omit to act. Sometimes agents do so intentionally. How should we understand intentional omission? Recent accounts of intentional omission have given causation a central theoretical role. The move is well-motivated. If some form of causalism about intentional omission can successfully exploit similarities between action and omission, it might inherit the broad support causalism about intentional action enjoys. In this paper (...) I consider the prospects for causalism about intentional omission. I examine two recent proposals: one Carolina Sartorio (2009) defends, and one Randolph Clarke (2010a) defends. I argue these versions fail, and for a similar reason. Reflection on the function of intention for agency brings this reason to light, and motivates a novel causalism about intentional omission. On the account I go on to defend necessarily, an agent J intentionally omits to A only if an intention of J’s with relevant content (or the intention’s acquisition) causes in J a disposition not to A. Though the causal work done by intentions to omit differs in some cases from the causal work done by intentions to act, it turns out that causalism about intentional behavior (i.e., about action and omission) is viable. (shrink)

In this paper I consider an argument for the possibility of intending at will, and its relationship to an argument about the possibility of believing at will. I argue that although we have good reason to think we sometimes intend at will, we lack good reason to think this in the case of believing. Instead of believing at will, agents like us often suppose at will.

Embedded pragmatic clinical trials (PCTs), like other types of randomized comparative-effectiveness research (CER) studies, are sometimes conducted without informed consent. Indeed, authors of both...

Sarah Angelina Acland is one of the most important photographers of the late Victorian and early Edwardian periods. Daughter of the Regius Professor of Medicine at Oxford, she was photographed by Lewis Carroll as a child, along with her close friend Ina Liddell, sister of Alice of Wonderland fame. The critic John Ruskin taught her art and she also knew many of the Pre-Raphaelites, holding Rossetti's palette for him as he painted the Oxford Union murals. At the age of nineteen (...) she met the photographer Julia Margaret Cameron, whose influence is evident in her early work.Following in the footsteps of Cameron and Carroll Miss Acland first came to attention as a portraitist, photographing the illustrious visitors to her Oxford home. In 1899 she then turned to the challenge of colour photography, becoming, through work with the 'Sanger Shepherd process', the leading colour photographer of the day. Her colour photographs were regarded as the finest that had ever been seen by her contemporaries, several years before the release of the Lumière Autochrome system, which she also practised.This volume provides an introduction to Miss Acland's photography, illustrating more than 200 examples of her work, from portraits to picturesque views of the landscape and gardens of Madeira. Some fifty specimens of the photographic art and science of her peers from Bodleian collections are also reproduced for the first time, including four unrecorded child portraits by Carroll. Detailed descriptions accompany the images, explaining their interest and significance. The photographs not only shed important light on the history of photography in the period, but also offer a fascinating insight into the lives of a pre-eminent English family and their circle of friends. (shrink)

: I focus on Uriah Kriegel’s account of conative phenomenology. I agree with Kriegel’s argument that some conative phenomenology is primitive in that some conative phenomenal properties cannot be reduced to another kind of property. I disagree, however, with Kriegel’s specific characterization of the properties in question. Kriegel argues that the experience of deciding-and-then-trying is the core of conative phenomenology. I argue, however, that the experiences of trying and acting better occupy this place. Further, I suggest that the attitudinal component (...) of the experiences of trying and acting is not, as Kriegel suggests, best characterized in terms of commitment to the rightness or goodness of the objects of experience. Rather, I argue that the attitudinal component is best characterized in imperatival terms. Keywords : Agentive Phenomenology; Deciding; Trying; Imperatives Kriegel e la fenomenologia dell’azione Riassunto : In questo testo mi concentrerò sulla descrizione della fenomenologia conativa di Kriegel. Mentre condivido la tesi di Kriegel, secondo cui parte della fenomenologia conativa è primitiva, nel senso che parte delle proprietà fenomeniche conative non possono essere ridotte ad altri tipi di proprietà, debbo tuttavia dissentire riguardo la specifica caratterizzazione data da Kriegel delle proprietà in questione. Kriegel ritiene che l’esperienza del decidere-e-poi-sforzarsi sia il nucleo della fenomenologia conativa. Io direi tuttavia che le esperienze dello sforzo e dell’azione occupano meglio questa posizione. Inoltre, suggerirei che la componente relativa all’atteggiamento delle esperienze dello sforzo e dell’azione non sia descrivibile al meglio, come suggerisce Kriegel, in termini di impegno legato all’adeguatezza o all’integrità dell’oggetto d’esperienza. Direi piuttosto che la componente dell’atteggiamento sia meglio descrivibile in termini imperativi.. Parole chiave : Fenomenologia dell’agentività; Atto della decisione; Atto dello sforzo; Imperativi. (shrink)

This paper evaluates four recent randomized clinical trials in which the informed consent of participants was either not sought at all, or else was conducted with critical information missing from the consent documents. As these studies have been taking place, various proposals to conduct randomized clinical trials without consent have been appearing in the medical literature. Some of the explanations offered for why it is appropriate to bypass consent or disclosure requirements appear to represent a fundamental misunderstanding of applicable government (...) regulations and even the research enterprise. Others are the result of conceptual disagreements about the importance and application of traditional research ethics norms to ‘comparative effectiveness research’ and modern research environments. Common among these explanations, however, is a failure to appreciate when a research intervention, rather than merely an observation or review of data, is taking place. Review committees and investigators are failing to see, or choosing to ignore, interventions in the lives of research subjects. When these studies have come to light, government agencies with oversight authority have done little or backed down. Prestigious medical journals have published research results knowing that the required consent was not obtained, or they have stood by the published studies even after the inadequacy of consent is discovered. This article critically examines this erosion of consent in theory and practice and calls for restoring the requirement of informed consent to its proper place as a priority in human subjects research. (shrink)

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)

Society is failing in its moral obligation to improve the standard of healthcare provided to vulnerable populations, such as people who lack decision making capacity, by a misguided paternalism that seeks to protect them by excluding them from medical research. Uncertainties surround the basis on which decisions about research participation is made under dual regulatory regimes, which adds further complexity. Vulnerable individuals’ exclusion from research as a result of such regulation risks condemning such populations to poor quality care as a (...) result of ‘evidence biased’ medicine. This paper explores the research regulation provisions for proxy decision making for those unable to provide informed consent for themselves, and the subsequent legal and practical difficulties for decision-makers. There are two separate regulatory regimes governing research involving adults who lack capacity to consent in England and Wales. The Mental Capacity Act 2005 governs how incapacitated adults can be involved in research, however clinical trials of medicinal products are separately regulated by the Medicines for Human Use Regulations 2004. There are significant differences under these dual regimes in the provisions for those lacking capacity to participate in medical research. The level of risk permitted differs, with a greater requirement for justification for participation in a clinical trial than other types of research. Who acts as proxy decision maker, how much information is provided to the person lacking capacity, and whether they retain the power of veto also significantly differs. The development of two separate regulatory regimes has resulted in significant differences between the provisions for clinical trials and other forms of research, and from usual medical practice. The resulting uncertainty has reinforced the tendency of those approving and conducting research to exclude adults lacking capacity to avoid difficult decisions about seeking consent for their participation. Future developments, such as the incoming EU Regulations, may address some of these differences, however the justification and level of risk permitted requires review to ensure that requirements are appropriate and proportionate to the burdens and risks for the individual, and also to the benefits for the wider population represented. (shrink)

People who are unable to make decisions about participating in research rely on proxies to make a decision based on their wishes and preferences. However, patients rarely discuss their preferences about research and proxies find it challenging to determine what their wishes would be. While the process of informed consent has traditionally been the focus of research to improve consent decisions, the more conceptually complex area of what constitutes ‘good’ proxy decision-making for research has remained unexplored. Interventions are needed to (...) improve and support proxy decision-making for research but are hampered by a lack of understanding about what constitutes decision quality in this context. A global increase in conditions associated with cognitive impairment such as dementia has led to an urgent need for more research into these conditions. The COVID-19 pandemic and subsequent necessity to conduct research with large numbers of critically ill patients has made this need even more pressing. Much of the empirical research centres on the desire to improve decision accuracy, despite growing evidence that authenticity is more reflective of the aim of proxy decisions and concerns about the methodological flaws in authenticity-focused studies. Such studies also fail to take account of the impact of decision-making on proxies, or the considerable body of research on improving the quality of healthcare decisions. This paper reports a concept synthesis of the literature that was conducted to develop the first conceptualisation of ‘good’ proxy decisions about research participation. Elements of decision quality were identified across three stages of decision-making: proxy preparedness for decision-making which includes knowledge and understanding, and values clarification and preference elicitation; the role of uncertainty, decisional conflict, satisfaction and regret in the decision-making process; and preference linked outcomes and their effect. This conceptualisation provides an essential first step towards the future development of interventions to enhance the quality of proxy decision-making and ensure proxy decisions represent patients’ values and preferences. (shrink)

First, what are the psychological roots of our concept of free will? Second, how might progress on the first question contribute to progress regarding normative debates about the proper concept of free will? In sections two and three I address the first question. Section two discusses recent work in the experimental philosophy of free will, and motivates the study I report in section three. Section four reflects on the second question in light of the reported results. To preview, the results (...) suggest that the psychological structure of our concept of free will is sensitive to three independent features: Liberty, Ensurance, and Consciousness. I argue this supports the view that our concept is incompatibilist more than the view that our concept is compatibilist, and I discuss two proposals regarding the normative upshot. On one proposal, these results might be taken to offer some support to incompatibilism about the proper concept. A second proposal, however, makes room for a much different upshot. (shrink)