Informed consent is an essential step in helping patients be aware of consequences of their treatment decisions. With surgery, it is vitally important for patients to understand the risks and benefits of the procedure and decide accordingly. We explored whether a written IC form was provided to patients; whether they read and signed it; whether they communicated orally with the physician; whether these communications influenced patient decisions. Adult postsurgical patients in nine general hospitals of Italy’s Campania Region were interviewed via (...) a structured questionnaire between the second and seventh day after the surgery at the end of the first surgical follow up visit. Physicians who were independent from the surgical team administered the questionnaire. The written IC form was given to 84.5% of those interviewed. All recipients of the form signed it, either personally or through a delegate; however, 13.9% did not know/remember having done so; 51.8% said that they read it thoroughly. Of those who reported to have read it, 90.9% judged it to be clear. Of those receiving the written consent form, 52.0% had gotten it the day before the surgery at the earliest 41.1% received it some hours or immediately before the procedure. The written IC form was explained to 65.6% of the patients, and 93.9% of them received further oral information that deemed understandable. Most attention was given to the diagnosis and the type of surgical procedure, which was communicated respectively to 92.8 and 88.2% of the patients. Almost one in two patients believed that the information provided some emotional relief, while 23.2% experienced increased anxiety. Younger patients and patients with higher levels of education were more likely to read the written IC form. The written IC form is not sufficient in assuring patients and making them fully aware of choices they made for their health; pre-operative information that was delivered orally better served the patients’ needs. To improve the quality of communication we suggest enhancing physicians’ communication skills and for them to use structured conversation to ensure that individuals are completely informed before undergoing their procedures. (shrink)

For decades American sociologists maintained that due to the elimination of their ancestral heritage under slavery, African-American shad no ethnic culture. Social segregation was due to poverty rather than racial prejudice. Social theorist Robert Blauner contests this view. The theory that black culture is only a lower class life-style is flawed because it ignores the culture-producing effects of racism which is the basis for a distinctive African-American culture. Following Blauner, this paper argues that racism is a more complex phenomenon than (...) discrimination because it asserts a type of inferiority that is not diminished by economic participation in the dominant culture. Racism encourages recurring social separations that set limits to assimilation. This paper also draws upon the work of Davis, Hacker and Winant to demonstrate how the bipolar construction of racial identity characteristic of racial relations in the United States precludes full social assimilation. (shrink)

For decades American sociologists maintained that due to the elimination of their ancestral heritage under slavery, African-American shad no ethnic culture. Social segregation was due to poverty rather than racial prejudice. Social theorist Robert Blauner contests this view. The theory that black culture is only a lower class life-style is flawed because it ignores the culture-producing effects of racism which is the basis for a distinctive African-American culture. Following Blauner, this paper argues that racism is a more complex phenomenon than (...) discrimination because it asserts a type of inferiority that is not diminished by economic participation in the dominant culture. Racism encourages recurring social separations that set limits to assimilation. This paper also draws upon the work of Davis, Hacker and Winant to demonstrate how the bipolar construction of racial identity characteristic of racial relations in the United States precludes full social assimilation. (shrink)

Global governance has become a topic of interest to many contemporary political theorists. Issues arising from the nature of global markets and multinational corporations can no longer be locally contained. These developments signal the decline of the nation state and therewith the end of the liberal moral and political theory that justified national institutions. The alternative possible orders appear bleak, including anarchy, hegemonic power or the most horrific of all specters, the liberty crushing “world state.” Kant’s cosmopolitan theory of justice (...) can provide a third way between nationalism and its bleak alternatives, providing a measureof global governance upheld by nations without recourse to a world state. My thesis is that a juridical society of states is necessarily founded upon cosmopolitan right having universal jurisdiction and that the implementation of the norms of hospitality underlying cosmopolitan right requires global institutions based upon democratic representation and accountability. (shrink)

Global governance has become a topic of interest to many contemporary political theorists. Issues arising from the nature of global markets and multinational corporations can no longer be locally contained. These developments signal the decline of the nation state and therewith the end of the liberal moral and political theory that justified national institutions. The alternative possible orders appear bleak, including anarchy, hegemonic power or the most horrific of all specters, the liberty crushing “world state.” Kant’s cosmopolitan theory of justice (...) can provide a third way between nationalism and its bleak alternatives, providing a measureof global governance upheld by nations without recourse to a world state. My thesis is that a juridical society of states is necessarily founded upon cosmopolitan right having universal jurisdiction and that the implementation of the norms of hospitality underlying cosmopolitan right requires global institutions based upon democratic representation and accountability. (shrink)

Global governance has become a topic of interest to many contemporary political theorists. Issues arising from the nature of global markets and multinational corporations can no longer be locally contained. These developments signal the decline of the nation state and therewith the end of the liberal moral and political theory that justified national institutions. The alternative possible orders appear bleak, including anarchy, hegemonic power or the most horrific of all specters, the liberty crushing “world state.” Kant’s cosmopolitan theory of justice (...) can provide a third way between nationalism and its bleak alternatives, providing a measureof global governance upheld by nations without recourse to a world state. My thesis is that a juridical society of states is necessarily founded upon cosmopolitan right having universal jurisdiction and that the implementation of the norms of hospitality underlying cosmopolitan right requires global institutions based upon democratic representation and accountability. (shrink)

In this paper I argue that Kant's concept of cosmopolitan right is the philosophical basis for contemporary international human rights. The law of world citizenship or cosmopolitan right is necessary in order to secure hospitable interactions between individuals and states. Such interactions in turn create an international civil culture or "cosmopolitan condition" which 1 is the source of the further specification and eventual codification of human rights. Human rights, I conclude, are universal because of their international significance and scope and (...) are inherently linked to cosmopolitan values. (shrink)

In this paper I argue that Kant's concept of cosmopolitan right is the philosophical basis for contemporary international human rights. The law of world citizenship or cosmopolitan right is necessary in order to secure hospitable interactions between individuals and states. Such interactions in turn create an international civil culture or "cosmopolitan condition" which 1 is the source of the further specification and eventual codification of human rights. Human rights, I conclude, are universal because of their international significance and scope and (...) are inherently linked to cosmopolitan values. (shrink)

In contrast with his major ethical works, Kant’s writings on history are replete with the theme of the social character of moral development and the interdependence of individual and community. I argue that historical-moral progress is an important part of Kant’s comprehensive ethical theory. However, in order to link the moral goals of humanity with the moral goals of individuals, judgement must have a dimension that can apprehend the purposiveness of those human achievements which are social in their significance and (...) socially transmitted. In other words, such achievements transcend individual intention. The ‘historical signs’ of such moral purposiveness provide moral orientation through the conflicting claims that arise within and between complex and historically evolving human communities. I explore the role of disinterested judgement in providing this orientation and in marking the moral disposition of the species. (shrink)

This paper traces the evolution of the international concept of a human right to culture from a general and individual right of participation in the public life of a state (1966, Article 27 of the IC of Civil and Political Rights), to a group right to a cultural identity (1992 Declaration on the rights of persons belonging to national or ethnic, religious or linguistic minorities). I argue that the original generic formulation of the human right to culture reflected the nineteenth-century (...) ideal of one-nation, one culture which had proved inadequate from the beginning even in Europe and wrecked havoc upon newly evolving nations in previously colonized territories. International Human Rights doctrine has had to evolve in response to the confl icts that have erupted within multi-ethnic states. In this paper I will consider and defend the argument of William Kymlicka that culture is a necessary context for the exercise of meaningful choices and therefore, within limits, deserves protection within liberal regimes. I argue that providing political support for cultural identities in the form of group rights need not imply a right of secession and can support a robust conception of multicultural citizenship. I analyze the philosophical significance of cultural identity for human dignity and democratic participation in multicultural contexts and conclude that group rights are neither “collectivist” nor “individualist” but a necessary and significant byproduct of the fundamental human right to free association. (shrink)

Communication is an integral part of nursing practice—with patients and their relatives, other nurses and members of the healthcare team, and ancillary staff. Through interaction with the ‘other’, language and silence creates and recreates social realities. Acceptance, rejection or modification of social realities depends on what is expressed and by whom. Narratives that are offered can tell of some experiences and not others. Some nurses choose to be silent while others are silenced. In nursing situations recognising and allowing silence to (...) speak is a challenging but uniquely personal experience that embraces reflection in and on experiences, practice and self as a person and a professional. If enabled and truly heard, silence can speak more loudly than the hubbub of daily practice, allowing us to collectively question and challenge inherent assumptions and biases as professionals, and as a profession. Through a microcosm of Newly Graduated Nurses' lived experiences of nursing situations and expressions of silence individuals' discomfort and private efforts to ascribe meaning to experiences are reflected on. Returning to silence is to return to a constant process of professional transformation that can enable ways of knowing and being that can reform our profession from within and enable us to cast off shackles that bind us to a shameful cultural underbelly. (shrink)

What is the nature of the fundamental relation we have to ourselves that makes each of us a self? To answer this question, Charles Larmore develops a systematic theory of the self, challenging the widespread view that the self’s defining relation to itself is to have an immediate knowledge of its own thoughts. On the contrary, Larmore maintains, our essential relation to ourselves is practical, as is clear when we consider the nature of belief and desire. For to believe or (...) desire something consists in committing ourselves to thinking and acting in accord with the presumed truth of our belief or the presumed value of what we desire. Larmore develops this conception with frequent reference to such classic authors as Montaigne, Stendhal, and Proust and by comparing it to other views of the self in contemporary philosophy. He also discusses the important ethical consequences of his theory of the self, arguing that it allows us to better grasp what it means to be ourselves and why self-understanding often involves self-creation. Winner of the Académie Française’s Grand Prix de Philosophie, _The Practices of the Self_ is that rare kind of lucid yet rigorous work that transcends disciplinary boundaries. (shrink)

In many ways set theory lies at the heart of modern mathematics, and it does powerful work both philosophical and mathematical – as a foundation for the subject. However, certain philosophical problems raise serious doubts about our acceptance of the axioms of set theory. In a detailed and original reassessment of these axioms, Sharon Berry uses a potentialist approach to develop a unified determinate conception of set-theoretic truth that vindicates many of our intuitive expectations regarding set theory. Berry further (...) defends her approach against a number of possible objections, and she shows how a notion of logical possibility that is useful in formulating Potentialist set theory connects in important ways with philosophy of language, metametaphysics and philosophy of science. Her book will appeal to readers with interests in the philosophy of set theory, modal logic, and the role of mathematics in the sciences. (shrink)

In Science as Social Knowledge, Helen Longino offers a contextual analysis of evidential relevance. She claims that this "contextual empiricism" reconciles the objectivity of science with the claim that science is socially constructed. I argue that while her account does offer key insights into the role that values play in science, her claim that science is nonetheless objective is problematic.

In this book Sharon Krause argues that moral and political deliberation must incorporate passions, even as she insists on the value of impartiality.

Contemporary realist theories of value claim to be compatible with natural science. In this paper, I call this claim into question by arguing that Darwinian considerations pose a dilemma for these theories. The main thrust of my argument is this. Evolutionary forces have played a tremendous role in shaping the content of human evaluative attitudes. The challenge for realist theories of value is to explain the relation between these evolutionary influences on our evaluative attitudes, on the one hand, and the (...) independent evaluative truths that realism posits, on the other. Realism, I argue, can give no satisfactory account of this relation. On the one hand, the realist may claim that there is no relation between evolutionary influences on our evaluative attitudes and independent evaluative truths. But this claim leads to the implausible skeptical result that most of our evaluative judgements are off track due to the distorting pressure of Darwinian forces. The realist’s other option is to claim that there is a relation between evolutionary influences and independent evaluative truths, namely that natural selection favored ancestors who were able to grasp those truths. But this account, I argue, is unacceptable on scientific grounds. Either way, then, realist theories of value prove unable to accommodate the fact that Darwinian forces have deeply influenced the content of human values. After responding to three objections, the third of which leads me to argue against a realist understanding of the disvalue of pain, I conclude by sketching how antirealism is able to sidestep the dilemma I have presented. Antirealist theories of value are able to offer an alternative account of the relation between evolutionary forces and evaluative facts —
an account that allows us to reconcile our understanding of evaluative truth with our understanding of the many non-rational causes that have played a role in shaping our evaluative judgements. (shrink)

On e recent change in the Society of Professional journalists Code of Ethics emphasizes that journalists should consider minimizing harm to society. This emphnsis follows more than a decade of thinking by educators who have called for teaching journalism students moral philosophy and moral reasoning decision making models-models that generally examine potential harm that surrounds newsroom decisions. This study, a quasi-experiment, examines pretest and posttest results of 210 students in 9 sections of n mass media ethics class taught over 6 (...) different semesters. After taking the course, which emphasized moral reasoning, students were more likely to make decisions that minimized harm, while gaining certainty in their answers. Diflerences between news-editorial and public relntions students are noted. Essays written by the students support the finding that education in moral reasoning can be effective in the development ofstudent journalists and their sense ofresponsibility to society. (shrink)

New biotechnologies have propelled the question of what it means to be human - or posthuman - to the forefront of societal and scientific consideration. This volume provides an accessible, critical overview of the main approaches in the debate on posthumanism, and argues that they do not adequately address the question of what it means to be human in an age of biotechnology. Not because they belong to rival political camps, but because they are grounded in a humanist ontology that (...) presupposes a radical separation between human subjects and technological objects. The volume offers a comprehensive mapping of posthumanist discourse divided into four broad approaches-two humanist-based approaches: dystopic and liberal posthumanism, and two non-humanist approaches: radical and methodological posthumanism. The author compares and contrasts these models via an exploration of key issues, from human enhancement, to eugenics, to new configurations of biopower, questioning what role technology plays in defining the boundaries of the human, the subject and nature for each. Building on the contributions and limitations of radical and methodological posthumanism, the author develops a novel perspective, mediated posthumanism, that brings together insights in the philosophy of technology, the sociology of biomedicine, and Michel Foucault's work on ethical subject constitution. In this framework, technology is neither a neutral tool nor a force that alienates humanity from itself, but something that is always already part of the experience of being human, and subjectivity is viewed as an emergent property that is constantly being shaped and transformed by its engagements with biotechnologies. Mediated posthumanism becomes a tool for identifying novel ethical modes of human experience that are richer and more multifaceted than current posthumanist perspectives allow for. The book will be essential reading for students and scholars working on ethics and technology, philosophy of technology, poststructuralism, technology and the body, and medical ethics. (shrink)

The lottery paradox has been discussed widely. The standard solution to the lottery paradox is that a ticket holder is justified in believing each ticket will lose but the ticket holder is also justified in believing not all of the tickets will lose. If the standard solution is true, then we get the paradoxical result that it is possible for a person to have a justified set of beliefs that she knows is inconsistent. In this paper, I argue that the (...) best solution to the paradox is that a ticket holder is not justified in believing any of the tickets are losers. My solution avoids the paradoxical result of the standard solution. The solution I defend has been hastily rejected by other philosophers because it appears to lead to skepticism. I defend my solution from the threat of skepticism and give two arguments in favor of my conclusion that the ticket holder in the original lottery case is not justified in believing that his ticket will lose. (shrink)

For the past 15 years, scholars in education have focused on Levinas’s work largely in terms of his understanding of alterity, of the self-Other relation, of ethics as ‘first philosophy’ and the significance these concepts have on rethinking educational theory and practice. What I do in this paper, by way of method, is to start from a slightly different place, from the assertion that there is indeed something ‘new’ to be explored in Levinas’s philosophy – both in terms of ideas (...) to be found within his work, and also in terms of the demands educational ideas and practices place on his work from without. That is, how does the actual, lived specificity of educational encounters occasion a different set of questions than one would otherwise pose if thinking only from within the discipline of philosophy, or from a purely theoretical point of view? In light of this, this paper explores Levinas’s ideas of sensibility, materiality, and embodiment. I see these not simply as supports for his ethical thought, but as the very core of incarnation without which his ethics makes no sense. I propose that these ideas are quintessentially pedagogical aspects of his thought – that is, they are always already rooted in a relational context of change and alteration of the subject. (shrink)

Robert Nozick's experience machine thought experiment is often considered a decisive refutation of hedonism. I argue that the conclusions we draw from Nozick's thought experiment ought to be informed by considerations concerning the operation of our intuitions about value. First, I argue that, in order to show that practical hedonistic reasons are not causing our negative reaction to the experience machine, we must not merely stipulate their irrelevance (since our intuitions are not always responsive to stipulation) but fill in the (...) concrete details that would make them irrelevant. If we do this, we may see our feelings about the experience machine becoming less negative. Second, I argue that, even if our feelings about the experience machine do not perfectly track hedonistic reasons, there are various reasons to doubt the reliability of our anti-hedonistic intuitions. And finally, I argue that, since in the actual world seeing certain things besides pleasure as ends in themselves may best serve hedonistic ends, hedonism may justify our taking these other things to be intrinsically valuable, thus again making the existence of our seemingly anti-hedonistic intuitions far from straightforward evidence for the falsity of hedonism. (shrink)

This article offers a reading of the philosophies of Emmanuel Levinas and Theravada Buddhism across and through their differences in order to rethink an education that is committed to ‘negative capability’ and the sensibility to uncertainty that this entails. In fleshing this out, I first explore Buddhist ideas of impermanence, suffering and non-self, known as the three marks of existence, from the perspective of Theravada Buddhism. I explore in particular vipassana meditation's insistence on openness to the transient nature of experience (...) and self, and the notion of ‘encounter’ that is implied therein. I then interweave this with Levinas's notion of an ethics of alterity. I argue that taken in tandem, both provide the condition through which another kind of ethical sensibility can be developed—that is, one that is attuned to our encounters with the world. In conclusion, the article reflects on how this sensibility as ‘negative capability’ can re-inform an ethics of educational practices, which are by nature themselves necessarily involved with change and uncertainty. (shrink)

Case study research was once the primary methodology of research in political science. The shift to other methodologies in recent decades suggests has led to a devaluing of these approaches. This article explores six roles for case studies in the social sciences and argues that an understanding of the multiple aims of research supports a methodological pluralism that includes case study research.

The concept of social structure is crucial in social analysis, yet sociologists' use of the term is often ambiguous and misleading. Contributing to the ambiguity is a tendency to imply the meaning of "social structure" either by opposing it to agency or by contrasting it to culture, thus reducing "structure" to pure constraint and suggesting that "culture" is not structured. Even more damaging is the tendency to conflate these two contrasts. To add to the confusion, these contrasts are often mapped (...) inappropriately onto other dichotomies prevalent in social theorizing, including material versus ideal, external versus internal, static versus active, and objective versus subjective, to produce a conceptual prism in which structure, agency, and culture are all poorly understood. This article attempts to disentangle these concepts from the aforementioned system of contrasts, to specify the connections between structure and agency, and to make a case for the inclusion of culture in the sociological conception of social structure. (shrink)

In this paper, I will attempt to develop and defend a common form of intuitive resistance to the companions in guilt argument. I will argue that one can reasonably believe there are promising solutions to the access problem for mathematical realism that don’t translate to moral realism. In particular, I will suggest that the structuralist project of accounting for mathematical knowledge in terms of some form of logical knowledge offers significant hope of success while no analogous approach offers such hope (...) for moral realism. (shrink)

Introduction to cluster of papers on feminist standpoint theory.

Most agree that when it comes to so-called 'first-order' normative ethics and political philosophy, constructivist views are a powerful family of positions. When it comes to metaethics, however, there is serious disagreement about what, if anything, constructivism has to contribute. In this paper I argue that constructivist views in ethics include not just a family of substantive normative positions, but also a distinct and highly attractive metaethical view. I argue that the widely accepted 'proceduralist characterization' of constructivism in ethics is (...) inadequate, and I propose what I call the 'practical standpoint characterization' in its place. I then offer a general taxonomy of constructivist positions in ethics. Since constructivism's standing as a family of substantive normative positions is relatively uncontested, I devote the remainder of the paper to addressing skeptics' worries about the distinctiveness of constructivism understood as a metaethical view. I compare and contrast constructivism with three other standard metaethical positions with which it is often confused or mistakenly thought to be compatible: realism; naturalist reductions in terms of an ideal response; and expressivism. In discussing the contrast with expressivism, I explain the sense in which, according to the constructivist, the distinction between substantive normative ethics and metaethics breaks down. I conclude by distinguishing between two importantly different debates about the mind-dependence of value. I argue that a failure to make this distinction is part of what explains why the possibility of constructivism as a metaethical view is often overlooked. (shrink)

Feminist philosophy of science appears to present problems for the ideal of value-free science. These difficulties also challenge a traditional understanding of the objectivity of science. However, feminist philosophers of science have good reasons for desiring to retain some concept of objectivity. The present essay considers several recent and influential feminist approaches to the role of social and political values in science, with particular focus on feminist empiricism and feminist standpoint theory. The similarities and difference, as well as the strengths (...) and weaknesses of these approaches are explored. The essay concludes with suggestions for future research in the area of feminist epistemology and philosophy of science. (shrink)

In this article, I discuss a trivialization worry for Hartry Field’s official formulation of the access problem for mathematical realists, which was pointed out by Øystein Linnebo. I argue that various attempted reformulations of the Benacerraf problem fail to block trivialization, but that access worriers can better defend themselves by sticking closer to Hartry Field’s initial informal characterization of the access problem in terms of general epistemic norms of coincidence avoidance.

This volume contains essays that examine the optical works of Giambattista Della Porta, an Italian natural philosopher during the Scientific Revolution. Coverage also explores the science and technology of early modern optics. Della Porta's groundbreaking book, Magia Naturalis, includes a prototype of the camera. Yet, because of his obsession with magic, Della Porta's scientific achievements are often forgotten. As the contributors argue, his work inspired such great minds as Johanes Kepler and Francis Bacon. After reading this book, researchers, historians, and (...) students will have a better appreciation of this influential scientist. They will also gain a greater understanding of an important period in the history of optics. Readers will learn about Della Porta's experimental method, a process governed by the protocols, aims, and theoretical assumptions of natural magic. Coverage also discusses the material properties and limitations of optical technology in the early 17th century, based on a recently discovered Dutch spyglass. It also demonstrates how diagrams were instrumental in the discovery of the sine law of refraction. In addition, the book includes an in-depth analysis of previously untranslated Latin sources. This makes the material useful to historians of optics unfamiliar with the language. More than 70 illustrations complement the text. (shrink)

Social inclusion/exclusion involves just/unjust social relations and social structures enabling or constraining opportunities for participation and health. In this paper, social inclusion/exclusion is explored as a dialectic. Three discourses – discourses on recognition, capabilities, and equality and citizenship – are identified within Canadian literature. Each discourse highlights a different view of the injustices leading to social exclusion and the conditions supporting inclusion and social justice. An Integrated Framework for Social Justice that incorporates the three discourses is developed and used to (...) critique the dominant focus on distributive justice within foundational Canadian nursing documents. We propose a broader conceptualization of social (in)justice that includes both relational and structural dimensions. Opportunities for multilevel interventions to promote social justice are identified. This framework is congruent with nursing's moral imperative to promote health equity and with the multiple roles played by nurses to promote social justice in everyday practice. (shrink)

In this article, I discuss a trivialization worry for Hartry Field’s official formulation of the access problem for mathematical realists, which was pointed out by Øystein Linnebo (and has recently been made much of by Justin Clarke-Doane). I argue that various attempted reformulations of the Benacerraf problem fail to block trivialization, but that access worriers can better defend themselves by sticking closer to Hartry Field’s initial informal characterization of the access problem in terms of (something like) general epistemic norms of (...) coincidence avoidance. (shrink)