Most writing on informed consent in Africa highlights different cultural and social attributes that influence informed consent practices, especially in research settings. This review presents a composite picture of informed consent in Nigeria using empirical studies and legal and regulatory prescriptions, as well as clinical experience. It shows that Nigeria, like most other nations in Africa, is a mixture of sociocultural entities, and, notwithstanding the multitude of factors affecting it, informed consent is evolving along a purely Western model. Empirical studies (...) show that 70–95% of Nigerian patients report giving consent for their surgical treatments. Regulatory prescriptions and adjudicated cases in Nigeria follow the Western model of informed consent. However, adversarial legal proceedings, for a multiplicity of reasons, do not play significant roles in enforcing good medical practice in Nigeria. Gender prejudices are evident, but not a norm. Individual autonomy is recognized even when decisions are made within the family. Consent practices are influenced by the level of education, extended family system, urbanization, religious practices, and health care financing options available. All limitations notwithstanding, consent discussions improved with increasing level of education of the patients, suggesting that improved physician's knowledge and increasing awareness and education of patients can override other influences. Nigerian medical schools should restructure their teaching of medical ethics to improve the knowledge and practices of physicians. More research is needed on the preferences of the Nigerian people regarding informed consent so as to adequately train physicians and positively influence physicians' behaviors. (shrink)

Most writing on informed consent in Africa highlights different cultural and social attributes that influence informed consent practices, especially in research settings. This review presents a composite picture of informed consent in Nigeria using empirical studies and legal and regulatory prescriptions, as well as clinical experience. It shows that Nigeria, like most other nations in Africa, is a mixture of sociocultural entities, and, notwithstanding the multitude of factors affecting it, informed consent is evolving along a purely Western model.Empirical studies show (...) that 70–95% of Nigerian patients report giving consent for their surgical treatments. Regulatory prescriptions and adjudicated cases in Nigeria follow the Western model of informed consent. However, adversarial legal proceedings, for a multiplicity of reasons, do not play significant roles in enforcing good medical practice in Nigeria. Gender prejudices are evident, but not a norm. Individual autonomy is recognized even when decisions are made within the family. Consent practices are influenced by the level of education, extended family system, urbanization, religious practices, and health care financing options available. All limitations notwithstanding, consent discussions improved with increasing level of education of the patients, suggesting that improved physician's knowledge and increasing awareness and education of patients can override other influences.Nigerian medical schools should restructure their teaching of medical ethics to improve the knowledge and practices of physicians. More research is needed on the preferences of the Nigerian people regarding informed consent so as to adequately train physicians and positively influence physicians’ behaviors. (shrink)

Thomas Aquinas famously held that (A) theft is always wrong, and also that (B) it is permissible for a starving man to take the bread he needs, openly or secretly, from another. He reconciled these two positions by claiming that (C) in cases of great need, it is not theft to take someone else’s property when she does not need it herself. On its face, (C) looks like a theoretically costly concession that Aquinas is forced into in order to reconcile (...) (A) and (B). Our first aim is to show that this is not so. We argue that (C) is in fact the only way to accommodate a set of intuitive norms of keeping and taking. Our second aim is to show that (C) has important implications for theories of property more generally: a plausible theory of property must acknowledge a foundational sense of "belong" on which things belong to those who need them. (shrink)

Schopenhauer repeatedly claims that suicide is both foolish and futile. But while many commentators have expressed sympathy for his charge of foolishness, most regard his charge of futility as indefensible even within his own system. In this paper, I offer a defense of Schopenhauer’s futility charge, based on metaphysical and psychological considerations. On the metaphysical front, Schopenhauer’s view implies that psychological connections extend beyond death. Drawing on Parfit’s discussion of personal identity, I argue that those connections have personal significance, such (...) that suicide does not allow one, as Hamlet hopes, simply “not to be.” On the psychological front, I argue that a distinction between agents’ intentions and underlying desires makes room for Schopenhauer to claim that paradigmatic suicidal agents ultimately desire the opposite of what suicide accomplishes. I conclude by showing how the resulting account of futility can buttress the charge of foolishness as well. My interpretation still leaves Schopenhauer vulnerable to certain objections, but shows that his account is significantly more defensible than previous commentators have realized. (shrink)

In the past two decades, much work on Kant has aimed to delimit and evaluate the bedrock assumptions of Kant's mature Critical philosophy. This volume brings together leading Kant scholars to address this issue in conversation with each other, articulating and interrogating Kant's critical assumptions.

As Emmanuel Levinas states in the preface to Existence and Existents, "this study is a preparatory one. It examines . . . the problem of the Good, time, and the relationship with the other [person] as a movement toward the Good." First published in 1947, and written mostly during Levinas's imprisonment during World War II, this work provides the first sketch of his mature thought later developed fully in Totality and Infinity and Otherwise than Being, or Beyond Essence. This (...) new edition marks the first time this important work has been made available in an inexpensive paperback edition. Levinas's project in Existence and Existents is to move from anonymous existence to the emergence of subjectivity; to subjectivity's practice, theory and morality; to its encounter with the alterity of the other person. He is concerned here primarily with the time of the solitary subject; time is the inner structure of subjectivity, of the movement of existing. "Levinas's work," says Alphonso Lingis, "contains not only wholly new analyses of the forms of time of the present, the past, the future but also a new conception of the work of time." Beginning with Existence and Existents, then, it is possible to begin tracing the progressive "alterization" of time as it unfolds across the development of Levinas's entire philosophy. As a "preparatory" study, Existence and Existents introduces the major themes and concerns that occupied Levinas throughout his career. This is essential reading for understanding both Levinas's own philosophy and the developments in philosophical thought in the twentieth century. (shrink)

Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient’s interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians (...) have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. (shrink)

People confront their doctors with three modes of unhealth - disease, illness and sickness. Each is discussed, and the question is asked and answered as to why in this situation people wish to become patients.

Certain questions have recurred throughout the history of philosophy. They are the big questions-about happiness and the good life, the limits of knowledge, the ultimate structure of reality, the nature of consciousness, the relation between causality and free will, the pervasiveness of suffering, and the conditions for a just and flourishing society-that thinkers in different cultures across the ages have formulated in their own terms in an attempt to make sense of their lives and the world around them. The essays (...) in this book turn to the major figures and texts of the Buddhist tradition in order to expand and enrich our thinking on these enduring questions. Examining them from a comparative and cross-cultural perspective demonstrates the value of alternative ways of addressing philosophical problems, showing how different approaches can produce new and unexpected kinds of questions and answers. Engaging with the Buddhist tradition, this book shows, helps return philosophy to its practical as well as theoretical aim: not only understanding the world but also knowing how to live in it. Featuring striking and generative comparisons of Buddhist and Western thought, Philosophy's Big Questions challenges our thinking in fundamental ways and offers readers new conceptual tools, methods, and insights for the pursuit of a good and happy life. (shrink)

Emmanuel Levinas is one of the most important figures of twentieth-century philosophy. Exerting a profound influence upon such thinkers as Derrida, Lyotard, Blanchot, and Irigaray, Levinas's work bridges several major gaps in the evolution of continental philosophy--between modern and postmodern, phenomenology and poststructuralism, ethics and ontology. He is credited with having spurred a revitalized interest in ethics-based philosophy throughout Europe and America. _Entre Nous_ (Between Us) is the culmination of Levinas's philosophy. Published in France a few years before his (...) death, it gathers his most important work and reveals the development of his thought over nearly forty years of committed inquiry. Along with several trenchant interviews published here, these essays engage with issues of suffering, love, religion, culture, justice, human rights, and legal theory. Taken together, they constitute a key to Levinas's ideas on the ethical dimensions of otherness. Working from the phenomenological method of Edmund Husserl and Martin Heidegger, Levinas pushed beyond the limits of their framework to argue that it is ethics, not ontology, that orients philosophy, and that responsibility precedes reasoning. Ethics for Levinas means responsibility in relation to difference. Throughout his work, Levinas returns to the metaphor of the face of the other to discuss how and where responsibility enters our lives and makes philosophy necessary. For Levinas, ethics begins with our face to face interaction with another person--seeing that person not as a reflection of one's self, nor as a threat, but as different and greater than self. Levinas moves the reader to recognize the implications of this interaction: our abiding responsibility for the other, and our concern with the other's suffering and death. Situated at the crossroads of several philosophical schools and approaches, Levinas's work illuminates a host of critical issues and has found resonances among students and scholars of literature, law, religion, and politics. _Entre Nous_ is at once the apotheosis of his work and an accessible introduction to it. In the end, Levinas's urgent meditations upon the face of the other suggest a new foundation upon which to grasp the nature of good and evil in the tangled skein of our lives. (shrink)

In this acclaimed exploration of the search for "authentic" individual identity, Marshall Berman explores the historical experiences and needs out of which this new radicalism arose. Focussing on eighteenth-century Paris, a time and place in which a distinctively modern form of society was just coming into its own, Berman shows how the ideal of authenticity—of a self that could organize the individual's energy and direct it toward his own happiness—articulated eighteenth-century man's deepest responses to this brave new world, and (...) his most ardent hope for a new life in it. Exploring in particular the ideas of Montesquieu and Rousseau, Berman shows how the ideal of authenticity was radically opposed to the bourgeois, capitalistic idea of "self-interest.". (shrink)

The paradoxical logic of transparency and mediation Transparency is the metaphor of our time. Whether in government or corporate governance, finance, technology, health or the media – it is ubiquitous today, and there is hardly a current debate that does not call for more transparency. But what does this word actually stand for and what are the consequences for the life of individuals? Can knowledge from the arts, and its play of visibility and invisibility, tell us something about the paradoxical (...) logics of transparency and mediation? This Obscure Thing Called Transparency gathers contributions by international experts who critically assess the promises and perils of transparency today. (shrink)

Considered the most original thinker in the Italian philosophical tradition, Giambattista Vico has been the object of much scholarly attention but little consensus. In this new interpretation, David L. Marshall examines the entirety of Vico's oeuvre and situates him in the political context of early modern Naples. He demonstrates Vico's significance as a theorist who adapted the discipline of rhetoric to modern conditions. Marshall presents Vico's work as an effort to resolve a contradiction. As a professor of rhetoric (...) at the University of Naples, Vico had a deep investment in the explanatory power of classical rhetorical thought, especially that of Aristotle, Cicero, and Quintilian. Yet as a historian of the failure of Naples as a self-determining political community, he had no illusions about the possibility or worth of democratic and republican systems of government in the post-classical world. As Marshall demonstrates, by jettisoning the assumption that rhetoric only illuminates direct, face-to-face interactions between orator and auditor, Vico reinvented rhetoric for a modern world in which the Greek polis and the Roman res publica are no longer paradigmatic for political thought. (shrink)

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One of the most influential philosophers of our day has selected 16 previously uncollected pieces that are unified by Levinas's project of revising the phenomenological description of the world in light of our experience of other persons.

Internationally renowned as one of the great French philosophers of the twentieth century, the late Emmanuel Levinas remains a pivotal figure across the humanistic disciplines for his insistence--against the grain of Western philosophical tradition--on the primacy of ethics in philosophical investigation. This first English translation of a series of twelve essays known as _Alterity and Transcendence_ offers a unique glimpse of Levinas defining his own place in the history of philosophy. Published by a mature thinker between 1967 and 1989, (...) these works exhibit a refreshingly accessible perspective that seasoned admirers and newcomers will appreciate. In today's world, where religious conceptions of exalted higher powers are constantly called into question by theoretical investigation and by the powerful influence of science and technology on our understanding of the universe, has the notion of transcendence been stripped of its significance? In Levinas's incisive model, transcendence is indeed alive--not in any notion of our relationship to a mysterious, sacred realm but in the idea of our worldly, subjective relationships to others. Without presupposing an intimate knowledge of the history of philosophy, Levinas explores the ways in which Plotinus, Descartes, Husserl, and Heidegger have encountered the question of transcendence. In discourses on the concepts of totality and infinity, he locates his own thinking in the context of pre-Socratic philosophers, Aristotle, Leibniz, Spinoza, Kant, and Descartes. Always centering his discussions on the idea of interpersonal relations as the basis of transcendence, Levinas reflects on the rights of individuals (and how they are inextricably linked to those of others), the concept of peace, and the dialogic nature of philosophy. Finally, in interviews conducted by Christian Chabanis and Angelo Bianchi, Levinas responds to key questions not directly addressed in his writings. Throughout, _Alterity and Transcendence_ reveals a commitment to ethics as first philosophy--obliging modern thinkers to investigate not merely the true but the good. (shrink)

Providing an overview of the intellectual roots of the worldwide environmental movement - from ancient religions and philosophies to modern science and ethics - this book synthesises them into a new philosophy of nature in which to ground ...

What a person is doing often depends on that person’s thought about what they are doing, or about the wider circumstances of their action. For example, whether my killing is murder or manslaughter depends, in part, on whether I understand that what I am doing is killing you, and on whether I understand that my killing is unjustified. Similarly, if I know that the backpack I am taking is yours, then my taking it may be an act of theft; but (...) it is not theft if I simply mistook your backpack for my own. And if I don’t know that in signing a document I’m promising to do some thing, then in signing it I’m not promising to do this at all. -/- According to Elizabeth Anscombe, a central task of philosophical psychology is to articulate this dependency of action on thought. And in a range of papers published during the 1960s, Anscombe sought to elucidate various aspects of this dependency. In this paper we give a systematic overview of how Anscombe understands this dependency, and in the process reveal the conceptual framework underlying Anscombe’s thinking about perception, desire, intention, voluntariness, responsibility, guilt, and sin. (shrink)

Dan Marshall and Josh Parsons note, correctly. that the property of being either a cube or accompanied by a cube is incorrectly classified as intrinsic under the definition we have given unless it turns out to be disjunctive. Whether it is disjunctive, under the definition we gave, turns on certain judgements of the relative naturalness of properties. They doubt the judgements of relative naturalness that would classify their property as disjunctive. We disagree. They also suggest that the whole idea (...) of judging relative naturalness is a dubious business. We reply that, like them or not, such judgements cannot easily be avoided. (shrink)

We have some of our properties purely in virtue of the way we are. (Our mass is an example.) We have other properties in virtue of the way we interact with the world. (Our weight is an example.) The former are the intrinsic properties, the latter are the extrinsic properties. This seems to be an intuitive enough distinction to grasp, and hence the intuitive distinction has made its way into many discussions in philosophy, including discussions in ethics, philosophy of mind, (...) metaphysics, epistemology and philosophy of physics. Unfortunately, when we look more closely at the intuitive distinction, we find reason to suspect that it conflates a few related distinctions, and that each of these distinctions is somewhat resistant to analysis. (shrink)

One of the most influential philosophers of our day has selected 16 previously uncollected pieces that are unified by Levinas's project of revising the phenomenological description of the world in light of our experience of other persons.

PREFACE -/- WHEN first I undertook the study of the theory of Art, many years ago, I was impressed by the emphasis of pleasure attainment in all descriptions of art works, and by the emphatic pleasurableness of my own mental state during the contemplation of artistic productions. -/- My thought being thus turned to the consideration of the relation of æsthetics to hedonics, I was led to make a careful study of the psychology of pleasure and of its correlate pain: (...) the results of this study I here lay before those who may be interested. (shrink)

Organisms' environments are thought to play a fundamental role in determining their fitness and hence in natural selection. Existing intuitive conceptions of environment are sufficient for biological practice. I argue, however, that attempts to produce a general characterization of fitness and natural selection are incomplete without the help of general conceptions of what conditions are included in the environment. Thus there is a "problem of the reference environment"—more particularly, problems of specifying principles which pick out those environmental conditions which determine (...) fitness. I distinguish various reference environment problems and propose solutions to some of them. While there has been a limited amount of work on problems concerning what I call "subenvironments", there appears to be no earlier work on problems of what I call the "whole environment". The first solution I propose for a whole environment problem specifies the overall environment for natural selection on a set of biological types present in a population over a specified period of time. The second specifies an environment relevant to extinction of types in a population; this kind of environment is especially relevant to certain kinds of long-term evolution. (shrink)

I describe a realist, ontologically objective interpretation of probability, "far-flung frequency (FFF) mechanistic probability". FFF mechanistic probability is defined in terms of facts about the causal structure of devices and certain sets of frequencies in the actual world. Though defined partly in terms of frequencies, FFF mechanistic probability avoids many drawbacks of well-known frequency theories and helps causally explain stable frequencies, which will usually be close to the values of mechanistic probabilities. I also argue that it's a virtue rather than (...) a failing of FFF mechanistic probability that it does not define single-case chances, and compare some aspects of my interpretation to a recent interpretation proposed by Strevens. (shrink)

One controversy about the existence of so called evolutionary forces such as natural selection and random genetic drift concerns the sense in which such “forces” can be said to interact. In this paper I explain how natural selection and random drift can interact. In particular, I show how population-level probabilities can be derived from individual-level probabilities, and explain the sense in which natural selection and drift are embodied in these population-level probabilities. I argue that whatever causal character the individual-level probabilities (...) have is then shared by the population-level probabilities, and that natural selection and random drift then have that same causal character. Moreover, natural selection and drift can then be viewed as two aspects of probability distributions over frequencies in populations of organisms. My characterization of population-level probabilities is largely neutral about what interpretation of probability is required, allowing my approach to support various positions on biological probabilities, including those which give biological probabilities one or another sort of causal character. ‡This paper has benefited from feedback on and discussions of this and earlier work. I want to thank André Ariew, Matt Barker, Lindley Darden, Patrick Forber, Nancy Hall, Mohan Matthen, Samir Okasha, Jeremy Pober, Robert Richardson, Alex Rosenberg, Eric Seidel, Denis Walsh, and Bill Wimsatt. †To contact the author, please write to: Department of Philosophy, University of Alabama at Birmingham, HB 414A, 900 13th Street South, Birmingham, AL 35294-1260; e-mail: [email protected]. (shrink)

Citing a lifelong engagement with Marxism, critic and writer Marshall Berman reveals the movement's positive points and suggests a new beginning for Marxism may be on the horizon with its recent 150th anniversary attention.

It has been argued that biological fitness cannot be defined as expected number of offspring in all contexts. Some authors argue that fitness therefore merely satisfies a common schema or that no unified mathematical characterization of fitness is possible. I argue that comparative fitness must be relativized to an evolutionary effect; thus relativized, fitness can be given a unitary mathematical characterization in terms of probabilities of producing offspring and other effects. Such fitnesses will sometimes be defined in terms of probabilities (...) of effects occurring over the long term, but these probabilities nevertheless concern effects occurring over the short term. †To contact the author, please write to: Department of Philosophy, University of Alabama at Birmingham, HB 414A, 900 13th Street South, Birmingham, AL 35294‐1260; e‐mail: [email protected]. (shrink)

Spinoza’s account of reason in the Short Treatise has been largely neglected. That account, I argue, has at least four features which distinguish it from that of the Ethics: in the Short Treatise, (1) reason is more sharply distinguished from the faculty of intuitive knowledge, (2) reason deals with things as though they were ‘outside’ us, (3) reason lacks clarity and distinctness, and (4) reason has no power over many types of passions. I argue that these differences have a unified (...) explanation, consisting of a principle that Spinoza accepts in both works and a central change in his views. The principle is that whatever we find in ourselves has more power over us than anything which comes from outside, and the change is in making the objects of reason common things or common notions. Understanding this, I claim, sheds important light on the psychological and epistemological motivations behind Spinoza's mature doctrines. (shrink)

La philosophie, et en particulier la phénoménologie, se trouve aujourd'hui en France dans une situation pour le moins paradoxale dans son vis-à-vis avec la théologie. Alors que les uns e - accusent les phénoménologues d'un prétendu tournant théologique et que les autres s'en défendent comme si toute théologisation devait entacher leur intégrité, nul ne tente délibérément la traversée en prenant en charge les deux disciplines comme telles. En osant " passer le Rubicon " avec cette conviction que " plus on (...) théologise, mieux on philosophe ", cet ouvrage tente donc de mettre fin à la trop fréquente position de " chiens de faïence " et propose un " choc en retour " de la théologie sur la phénoménologie. Loin des philosophies du " seuil " ou du " saut ", une véritable rencontre des disciplines est ici revendiquée, dans l'assurance qu'elles seront mieux distinguées si elles acceptent d'être davantage assumées. Alea jacta est : " le sort en est jeté ", avec audace et peut-être témérité mais en sachant que nul ne pense s'il ne vient à s'exposer. (shrink)

Ruth Millikan and others advocate theories which attempt to naturalize wide mental content (e.g. beliefs.

This chapter explores a philosophical hypothesis about the nature of (some) probabilities encountered in social sciences. It should be of interest to those with philosophical concerns about the foundations of probability, and to social scientists and philosophers of science who are somewhat puzzled by the nature of probability in social domains. As will become clear below, the chapter is not intended as a contribution to an empirical methodology such as a particular way of applying statistics.