Many philosophers doubt that one can provide any successful explanation of sensory qualities - of how things look, feel, or seem to a perceiving subject. To provide such an explanation, one would need to explain qualitative facts in non-qualitative terms. Attempts to construct such explanations have seemed, in principle, doomed. Austen Clark examines the strategy used in psychophysics, psychometrics, and sensory neurophysiology to explain qualitative facts. He argues that this strategy could succeed: its structure is sound, and it can answer (...) the various philosophical objections lodged against it. On this basis Professor Clark presents an analysis of senosry qualities that offers the possibility of explaining at least some qualia, and he sketches how this scheme might eventually reduce to neurophysiology. If he is correct, we are not doomed to an eternity of mere acquaintance with our qualia. (shrink)

In recent decades there has been increasing demand for and considerable efforts to conduct cross-disciplinary research. However, assessment of research quality in such endeavours still is often based on mono-disciplinary criteria and not seldom carried out by reviewers without strong cross-disciplinary experience. The authors suggest a two-pronged approach to cross-disciplinary research evaluation. One part should comprise an individual review of all the disciplines involved based on their mono-disciplinary sets of criteria. The other part should be a separate evaluation of (...) the cross-disciplinary aspects based on the review of “problem formulation”, “integration and scope of the disciplines”, “parts and the whole”, “practical managerial aspects” and “the applied aspects”. The pros and cons of implementing this approach in a stepwise manner or simultaneously is discussed. It is suggested that funding agencies develop more fair sets of review procedures for cross-disciplinary research and show willingness to allocate extra funds and time to such forms of research that sometimes are regarded as relatively more “risky” than conventional mono-disciplinary types. (shrink)

Some philosophers oppose recent arguments for the Knowledge Norm of Assertion by claiming that assertion, being an act much like any other, will be subject to norms governing acts generally, such as those articulated by Grice for the purpose of successful, cooperative endeavours. But in fact, Grice is a traitor to their cause; or rather, they are his dissenters, not his disciples. Drawing on Grice's unpublished papers, I show that he thought of asserting as a special linguistic act in need (...) of its own norm, and he tied his maxim of Quality to knowledge. I also develop a simple Gricean-inspired argument showing that the Quality maxim is not dependent on the Cooperative Principle. If it is not thus dependent, then the Cooperative Principle cannot be the explanation of, or source of normativity for, the Quality maxim. Thus, leveraging the insights informing the maxim of Quality actually provides the resources for a distinctive positive case that knowledge is the constitutive norm of assertion. (shrink)

With places at nursery school promised for every child above the age of four, this book raises the stakes by looking at the quality of what is provided, and how that compares to what should be provided. Beyond Quality In Early Childhood Education and Care challenges received wisdom and the tendency to reduce philosophical issues of value to purely technical issues of measurement and management. In its place, it offers alternative ways of understanding early childhood, early childhood institutions (...) and pedagogical work. The book places issues of early childhood into a global context and relates them to writers from many fields. Drawing on work with aboriginal peoples in Canada, on the experience of Reggio-Emilia in Italy and on a project in Stockholm inspired by Reggio, the book considers the implications of these alternative ways of understanding, for practice and a reconceptualization of early childhood education and care. (shrink)

In the past years, many students had problems with their finances, especially their expenses for education. Many of the students are affected by the crisis financially, emotionally, and by their wellbeing. That is why the government provides programs that will help the students with their problems with school expenses, and that is through the Tertiary Education Subsidy (TES) of the Commission on Higher Education (CHED). Further, the primary goal of this study is to explore the TES Grantees' lived experiences, challenges, (...) and coping mechanisms. Furthermore, these are the study's findings: (1) The grantees find the TES very helpful regarding finances that will tackle their academic needs, such as tuition fees and school learning materials. (2) Many students value government assistance that motivates them to maintain their grades. (shrink)

What are phenomenal qualities, the qualities of conscious experiences? Are phenomenal qualities subjective, belonging to inner mental episodes of some kind, or should they be seen as objective, belonging in some way to the physical things in the world around us? Are they physical properties at all? And to what extent do experiences represent the things around us, or the states of our own bodies? Fourteen original papers, written by a team of distinguished philosophers and psychologists, explore the ways in (...) which phenomenal qualities fit in with our understanding of mind and reality. This volume offers an indispensable resource for anyone wishing to understand the nature of conscious experience. (shrink)

This paper explores the debate between those philosophers who take (fundamental, perfectly natural) properties to be pure powers and those who take them to be powerful qualities. I first consider two challenges for the view that properties are powerful qualities, which I call, respectively, ‘the clarification challenge’ and ‘the explanatory challenge’. I then examine a number of arguments that aim to show that properties cannot be pure powers and find them all wanting. Finally, I sketch what I take to be (...) the most promising argument against pure powers and for powerful qualities. (shrink)

One powerful argument for dualism is provided by Chalmers: the ‘zombie’ or conceivability argument. This paper aims to establish that if one adopts the ‘Powerful Qualities’ account of properties developed by Martin and Heil, this argument can be resisted at the first premise: the claim that zombies are conceivable is, by the lights of Chalmers’ own account of conceivability, false. The Powerful Qualities account is outlined. Chalmers’ argument, and several distinctions which underlie it, are explained. It is argued that to (...) make sense of the claim that zombies are conceivable, some account of properties must be given. The paper’s central claim is presented and defended from potential responses: given the Powerful Qualities view, zombies are in fact inconceivable. Finally, an error theory is presented, which offers an explanation of why so many have taken the conceivability of zombies to be unproblematic, and the view is briefly contrasted with Russellian monism. (shrink)

I motivate and defend a previously underdeveloped functionalist account of the metaphysics of color, a view that I call ‘quality-space functionalism’ about color. Although other theorists have proposed varieties of color functionalism, this view differs from such accounts insofar as it identifies and individuates colors by their relative locations within a particular kind of so-called ‘quality space’ that reflects creatures’ capacities to discriminate visually among stimuli. My arguments for this view of color are abductive: I propose that (...) class='Hi'>quality-space functionalism best captures our commonsense conception of color, fits with many experimental findings, coheres with the phenomenology of color experience, and avoids many issues for standard theories of color such as color physicalism and color relationalism. (shrink)

This study provides a unified theory of properties, relations, and propositions (PRPs). Two conceptions of PRPs have emerged in the history of philosophy. The author explores both of these traditional conceptions and shows how they can be captured by a single theory.

Quality of life is part of many different discourses and has been used in a variety of meanings ranging from purely descriptive (as in some medical contexts) to distinctly evaluative meanings (as in some social science and political contexts). The paper argues that there are good normative reasons to make the concept as descriptive as possible at least in its medical applications and, furthermore, to reconstruct it in a thoroughgoing subjectivist way, making the reflexive self-evaluation of the subject him- (...) or herself the ultimate standard. Attention is drawn to the fact that only few of the measures of quality of life applied in present-day medicine correspond to these requirements. (shrink)

This chapter explores how far one can go accounting for the moral responsibility implications of several unusual mental conditions using a parsimonious quality-of-will account that relies on the way we talk about moral responsibility in more mundane situations. By contrasting situations involving epistemic irrationality versus cognitive impairment, it becomes clear that the presence of those often (but not always) excuses actions performed by unusual agents. The discussion turns to cases of clinical depression and sketches a way for quality-of-will (...) accounts to approach them. It is also argued that of some of these mental conditions, there is no particular reason to think that they excuse. There is also an argument against regarding the concept "mental disorder" and current DSM categories as critical to agency theory. (shrink)

Philosophers of mind have distinguished (and sometimes conflated) various qualities. This article tries to sort things out.

There is a strong pull to the idea that there is some metaphysically interesting distinction between the fully real, objective, observer‐independent qualities of things as they are in themselves, and the less‐than‐fully‐real, subjective, observer‐dependent qualities of things as they are for us. Call this (putative) distinction the primary/secondary quality distinction. The distinction between primary and secondary qualities is philosophically interesting because it is (a) often quite attractive to draw such a distinction, and (b) incredibly hard to spell it out (...) in any kind of satisfying and sensible way. I attempt such a spelling‐out after first trying to pin down in more detail what we want from the primary/secondary quality distinction, and saying a bit about why that is such a hard thing to get. (shrink)

The odds of encountering a senior citizen selling on the street have increased. The claim that they have no choice but to work and sell on the street, despite the dangers, illnesses, and psychological issues they may face, to provide for their family’s needs is very evident. Therefore, this study explores the quality of life, lived experiences, challenges, and coping mechanisms of senior citizen street vendors in Bulacan, Philippines. The study employed Heideggerian Phenomenology and Interpretative Phenomenological Analysis (IPA). Moreover, (...) the following themes arise (1) Golden years, (2) Socially connected, and (3) Unknown journey. These themes highlighted the experiences and challenges faced by the participants. Moreover, it is highly suggested that local government agencies enhance and strictly monitor the existing program that alleviates mental and physical health concerns and senior citizens' safety and financial assistance. (shrink)

Quality is commonly applied to products and processes, but we can also define human quality in dealing with people. This requires first establishing what treatment is appropriate to the human condition. Through an inquiry into the characteristics that define the human being and what ethical requirements constitute a good treatment, we define “Human Quality Treatment” as dealing with persons in a way appropriate to the human condition, which entails acting with respect for their human dignity and rights, (...) caring for their problems and legitimate interests, and fostering their personal development. With this in mind, we can distinguish between five different levels or degrees of HQT in organizations which can be characterized by the following terms: maltreatment, indifference, justice, care, and development. (shrink)

Richard Kraut presents a new theory of human well-being. Kraut's principal idea, Aristotelian in spirit, is that 'external goods' have at most an indirect bearing on the quality of our lives. A good internal life - one with quality emotional, intellectual, social, and perceptual experiences - is what well-being consists in.

Quality-space theory (QST) explains the nature of the mental qualities distinctive of perceptual states by appeal to their role in perceiving. QST is typically described in terms of the mental qualities that pertain to color. Here we apply QST to the olfactory modalities. Olfaction is in various respects more complex than vision, and so provides a useful test case for QST. To determine whether QST can deal with the challenges olfaction presents, we show how a quality space (QS) (...) could be constructed relying on olfactory perceptible properties and the olfactory mental qualities then defined by appeal to that QS of olfactory perceptible properties. We also consider how to delimit the olfactory QS from other modalities. We further apply QST to the role that experience plays in refining our olfactory discriminative abilities and the occurrence of olfactory mental qualities in non-conscious olfactory states. QST is shown to be fully applicable to and useful for understanding the complex domain of olfaction. (shrink)

Powers are popularly assumed to be distinct from, and dependent upon, inert qualities, mainly because it is believed that qualities have their nature independently of other properties while powers have their nature in virtue of a relation to distinct manifestation property. George Molnar and Alexander Bird, on the other hand, characterize powers as intrinsic and relational. The difficulties of reconciling the characteristics of being intrinsic and at the same time essentially related are illustrated in this paper and it is argued (...) that the reasons for thinking of powers as essentially relational are based on misguided epistemological consideration. Finally, I present a way of thinking of fundamental properties as primitive natures that we can only understand in virtue of what they do but which we should not think of as being ontologically constituted by these doings. According to this view, properties are both qualities and powers. (shrink)

Traditionally, theories of moral responsibility feature only the minimally sufficient conditions for moral responsibility. While these theories are well-suited to account for the threshold of responsibility, it’s less clear how they can address questions about the degree to which agents are responsible. One feature that intuitively affects the degree to which agents are morally responsible is how difficult performing a given action is for them. Recently, philosophers have begun to develop accounts of scalar moral responsibility that make use of this (...) notion of difficulty (Coates and Swenson 2013; Nelkin 2016). In this paper, I argue that these accounts, although innovative, are incomplete. The degree to which agents are morally responsible is determined not only by the difficulties that agents face but also by the quality of the reasons for which they act. (shrink)

The Quality of Thought develops and defends the thesis that thinking is a kind of experience, characterized by a sui generis (“cognitive”) phenomenology, determinates of which are thought contents—what I call the phenomenal intentionality of thought thesis. It draws out the implications of this thesis for issues in philosophy of mind, philosophy of language and metaphysics. The view defended is radically internalist and intensionalist, and thus goes against received doctrines in philosophy of mind (externalism) and language (extensionalism). It also (...) advocates for a metaphysically neutral, non-naturalistic approach to the philosophical study of mind—what I call “Analytic Phenomenology”—in combination with agnosticism about the nature of the relationship between consciousness and physical reality. -/- The book identifies persistent problems with Dretske-inspired causal-informational-teleological theories of conceptual content, and diagnoses them as due to leaving out what it’s like to think a thought—to entertain or grasp a propositional (conceptual) content. It is thus a contribution to the increasingly influential Phenomenal Intentionality Research Program. It includes refutations of classic externalism (Putnam and Burge) and arguments that standard motivations for direct reference theories of names (Kripke), indexicals and demonstratives (Kaplan) are not inevitable, and alternative accounts of their (and their conceptual equivalents’) semantics. It also addresses outstanding challenges to the phenomenal intentionalist view of thought content, including the existence of unconscious thought, the elusiveness of conceptual phenomenology, the matching content problem, phenomenal compositionality, and the determination of conceptual reference. (shrink)

What this book is about -- Theoretical perspectives : modernity and postmodernity, power and ethics -- Constructing early childhood institution : what do we think it is? -- Constructing the early childhood institution : what do we think they are for? -- Beyond the discourse of quality to the discourse of meaning making -- The stockholm project : constructing a pedagogy that speaks in the voice of the child, the pedagogue and the parent -- Pedagogical documentation : a practice (...) for reflection and democracy -- Minority directions in the majority world : threats and possibilities. (shrink)

Difficulty is often treated as blame-mitigating, and even exculpating. But on some occasions difficulty seems to have little or no bearing on our assessments of moral responsibility, and can even exacerbate it. In this paper, I argue that the relevance (and irrelevance) of difficulty with regard to assessments of moral responsibility is best understood via Quality of Will accounts. I look at various ways of characterising difficulty – including via sacrifice, effort, skill and ‘trying’ – and set out to (...) demonstrate that these factors are only blame-mitigating where, and to the extent that, they complicate ascriptions of insufficient concern. Matters become more complex, however, when we turn to difficult circumstances that seem to generate such objectionable attitudes. This is arguably the case with epistemic difficulty and certain instances of moral ignorance. Here I argue that certain difficult circumstances diminish the sense in which false moral beliefs are genuinely revelatory of the agents who hold them. In particular, I draw on the distinction between difficulty that generates objectionable attitudes, and objectionable attitudes that generate difficulty. I argue that the former, but not the latter, can plausibly be viewed as blame mitigating, and that this would apply to (limited) cases of moral ignorance. (shrink)

This study presents a substantial and often radical reinterpretation of some of the central themes of Locke's thought. Professor Alexander concentrates on the Essay Concerning Human Understanding and aims to restore that to its proper historical context. In Part I he gives a clear exposition of some of the scientific theories of Robert Boyle, which, he argues, heavily influenced Locke in employing similar concepts and terminology. Against this background, he goes on in Part II to provide an account of Locke's (...) views on the external world and our knowledge of it. He shows those views to be more consistent and plausible than is generally allowed, demonstrating how they make sense and enable scientific explanations of nature. In examining the views of Locke and Boyle together, the book throws light both on the development of philosophy and the beginnings of modern science, and in particular it makes a considerable and original contribution to our understanding of Locke's philosophy. (shrink)

Secondary qualities have peculiarities which are thought to threaten physicalism. It is argued that these peculiarities are only to be expected in a physicalist universe in virtue of the essential characteristics of a representing device. Any device representing the world such as a camera will have depictional qualities. Secondary qualities are a subset of these.

BackgroundPreprint usage is growing rapidly in the life sciences; however, questions remain on the relative quality of preprints when compared to published articles. An objective dimension of quality that is readily measurable is completeness of reporting, as transparency can improve the reader’s ability to independently interpret data and reproduce findings.MethodsIn this observational study, we initially compared independent samples of articles published in bioRxiv and in PubMed-indexed journals in 2016 using a quality of reporting questionnaire. After that, we (...) performed paired comparisons between preprints from bioRxiv to their own peer-reviewed versions in journals.ResultsPeer-reviewed articles had, on average, higher quality of reporting than preprints, although the difference was small, with absolute differences of 5.0% [95% CI 1.4, 8.6] and 4.7% [95% CI 2.4, 7.0] of reported items in the independent samples and paired sample comparison, respectively. There were larger differences favoring peer-reviewed articles in subjective ratings of how clearly titles and abstracts presented the main findings and how easy it was to locate relevant reporting information. Changes in reporting from preprints to peer-reviewed versions did not correlate with the impact factor of the publication venue or with the time lag from bioRxiv to journal publication.ConclusionsOur results suggest that, on average, publication in a peer-reviewed journal is associated with improvement in quality of reporting. They also show that quality of reporting in preprints in the life sciences is within a similar range as that of peer-reviewed articles, albeit slightly lower on average, supporting the idea that preprints should be considered valid scientific contributions. (shrink)

Logic for Dewey is a normative inquiry into the nature of inquiry itself. Goodman’s grue example is assessed in light of Dewey's vocabulary for logic as presented in his 1938 Logic.

While the term “reactivity” has come to be associated with specific phenomena in the social sciences, having to do with subjects’ awareness of being studied, this paper takes a broader stance on this concept. I argue that reactivity is a ubiquitous feature of the psychological subject matter and that this fact is a precondition of experimental research, while also posing potential problems for the experimenter. The latter are connected to the worry about distorted data and experimental artifacts. But what are (...) experimental artifacts and what is the most productive way of dealing with them? In this paper, I approach these questions by exploring the ways in which experimenters in psychology simultaneously exploit and suppress the reactivity of their subject matter in order to produce experimental data that speak to the question or subject matter at hand. Highlighting the artificiality of experimental data, I raise the question of what distinguishes a genuine experimental result from an experimental artifact. My analysis construes experimental results as the outcomes of inferences from the data that take material background assumptions as auxiliary premises. Artifacts occur when one or more of these background assumptions are false, such that the data do not reliably serve the purposes they were generated for. I conclude by laying out the ways in which my analysis of data quality is relevant to, and informed by, recent debates about the replicability of experimental results. (shrink)

This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life suffers because of (...) disability-focused exclusion or injustice differently from cases where lower quality of life results from laws of nature, resource scarcity, or appropriate tradeoffs. Decisionmakers should ignore quality-of-life losses that result from injustice or exclusion when ignoring them would improve the prospects of individuals with disabilities; in contrast, they should consider quality-of-life losses that are unavoidable or stem from resource scarcity or permissible tradeoffs. On this proposal, while health systems should not amplify existing injustice against individuals with disabilities, they are not required to altogether ignore the potential effects of disability on quality of life. (shrink)

Building on a functionalist framework for decision-making in legal translation, a holistic approach to quality is presented in order to respond to the specificities of this field and overcome the shortcomings of general models of translation quality evaluation. The proposed approach connects legal, contextual, macrotextual and microtextual variables for the definition of the translation adequacy strategy, which guides problem-solving and the rest of the translation process. The same parameters remain traceable between the translation brief and the translation product (...) both in pre-delivery revision and in post-delivery assessment. They are the yardstick for identifying predictable evaluative criteria and competence requirements for translators and quality controllers. The implications of the approach on quality assessment and quality management practices are also discussed. Overall, the model illustrates the potential benefits of enhancing predictability and reducing subjectivity on the basis of specific legal translation methodologies. It supports the need for legal translation expertise in quality evaluation and the relevance of Legal Translation Studies to raising standards in professional practice. (shrink)

Until recently, the powerful qualities view about properties has been effectively identified with the so-called identity theory. Yet, the difficulties that the latter faces (especially concerning the interpretation of its core claim that dispositionality and qualitativity are identical) have led some metaphysicians to propose (at least provisionally) new versions of the powerful qualities view. This paper discusses the prospects of three such versions: the compound view, the higher-order properties theory and the dual aspect account. It is argued that the compound (...) view is in fact property dualism in disguise, while the higher-order properties theory does not by itself provide a metaphysically convincing solution to Armstrong’s dilemma concerning the modal status of the relation between dispositionality and categoricality. Finally, it is argued that it is not clear whether the dual aspect account is distinct from identity theory and pure powerism. (shrink)

This paper identifies four major forms of scholarship in bioethics: empirical research, the articulation of mid-level principles of bioethics, the relating of these principles to fundamental moral theories, and discussions of the bioethical implications of legal principles and health delivery policies. It develops a reflective equilibrium approach to the relation between these four forms of scholarship. It then presents, in light of this approach, criteria for quality research in each of these forms of scholarship in bioethics. Keywords: quality (...) of scholarship, reflective equilibria in bioethics, research in bioethics CiteULike Connotea Del.icio.us What's this? (shrink)

I explore two accounts of properties within a dispositional essentialist (or causal powers) framework, the pure powers view and the powerful qualities view. I first attempt to clarify precisely what the pure powers view is, and then raise objections to it. I then present the powerful qualities view and, in order to avoid a common misconception, offer a restatement of it that I shall call the truthmaker view. I end by briefly defending the truthmaker view against objections.

Many think that properties are powers. However, whilst some claim that properties are pure powers, others claim that properties are powerful qualities. In this paper, I argue that the canonical formulation of the powerful qualities view is no different from the pure powers view. Contrary to appearances, the two positions accept the same view of properties. Thus, the debate between them rests on an illusion. I draw out some consequences of this surprising result for issues over property individuation. Along the (...) way, I argue that all existing objections to the powerful qualities view fail. (shrink)

Ayahuasca, a hallucinogen with profound consciousness- altering properties, has been increasingly utilized in recent studies (e.g., Strassman, 2001; Shanon, 2002a,b). However, other than Shanon's recent work, there has been little attempt to examine the effects of ayahuasca on perceptual, affective and cognitive experience, its relation to fringe consciousness or to pertinent personality variables. Twenty-one volunteers attending a seminar on ayahuasca were administered personality measures and a semi-structured interview about phenomenal qualities of their experience. Ayahuasca ingestion was associated with profound alterations (...) of temporal- spatial experiences including expansive space and slowed time. Ayahuasca use was also associated with positive emotional states, higher levels of fantasy proneness and psychological absorption and a greater openness to mystical experiences. Conversely, quickened time was associated with negative emotionality. The results are discussed within a multi-faceted model of fringe consciousness with a particular emphasis on Hunt's (1995) models of cross-modal translation as the basis for higher-order symbolic cognition and support James' (1890/1950) contention that fringe consciousness is essential to human cognition. (shrink)

As the quality movement in health care now enters its fourth decade, the language of quality is ubiquitous. Practitioners, organizations, and government agencies alike vociferously testify their commitments to quality and accept numerous forms of governance aimed at improving quality of care. Remarkably, the powerful phrase ‘‘quality of care’’ is rarely defined in the health care literature. Instead it operates as an accepted and assumed goal worth pursuing. The status of evidence-based medicine, for instance, hinges (...) on its ability to improve quality of care, and efforts are made by both proponents and detractors to unpack the contents and outcomes of evidence-based practice while the contents of ‘‘quality of care’’ are presumed to be understood. Because the goals of medicine are far from obvious, this paper investigates the neglected term, ‘‘quality of care,’’ in an effort to understand what it is that health care practices are so uncritically assumed to be striving for. Finding lack of consensus on the terminology in the quality literature, I propose that the term operates rhetorically by way of persuasive appeal (and lack of descriptive meaning). Unsatisfied that ‘‘quality of care’’ operates as a mere buzzword in morally contentious debates over resource allocation and duties of care, I implore health care communities to go beyond mere commitments to quality and, instead, to focus attention on the difficult task of specifying what counts as quality care within an economically constrained health care system. (shrink)

The aim of the present paper is to describe three different attempts, which have been made by philosophers, to define what quality of life is; and to spell out some of the difficulties that faces each definition. One, Perfectionism, focuses on the capacities that human beings possess: capacities for friendship, knowledge and creative activity, for instance. It says that the good life consists in the development and use of these capacities. Another account, the Preference Theory, urges that satisfying one's (...) preferences, or desires, is what improves one's quality of life. And a third account, Hedonism, sees life-quality as consisting in the enjoyment of pleasure and the avoidance of pain. The paper describes and evaluates objections to each of these views, thereby displaying their weaknesses and strengths. Since no view comes out as the right one there is a choice to be made. At the end of the paper it is being discussed how well each of the views cohere with different methodologies used in quality of life research. Also it is suggested that considerations about what the research is to be used for are relevant. (shrink)

Quality improvement mechanisms increasingly use outcome measures to evaluate health care providers. This move toward outcome measures is a radical departure from the traditional focus on process measures. More radical still is the proposal to shift from relatively simple and proximal measures of outcome, such as mortality, to complex outcomes, such as quality of life. While the practical, scientific, and ethical issues associated with the use of outcomes such as mortality and morbidity to compare health care providers have (...) been well rehearsed, the specific concerns associated with the use of quality of life measures in quality of care research have received little attention. As with much research on quality of life there is a tendency to assume that the disadvantages are outweighed by the general virtue of “listening” to patients. In this paper we disagree with this assumption and argue that quality of life is a process, not an outcome. (shrink)

Scholars and professional organizations in bioethics describe various approaches to “quality assessment” in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes “quality” in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, in (...) that they represent evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, in this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring disparate, isolated work activities; then, we describe quality assessment in terms of tracking interconnected work activities holistically, across different levels of assessment. We conclude by inviting future efforts in quality improvement to adopt a comprehensive approach to quality assessment into their improvement practices, and offer recommendations for how the field might move in this direction. (shrink)

Drawing on work in psychophysics, psychometrics, and sensory neurophysiology, Clark analyzes the character and defends the integrity of psychophysical explanations of qualitative facts, arguing that the structure of such explanations is sound and potentially successful.