Spain is one of the most advanced European countries in terms of the legislative and administrative development of ADs. Article 11 of Law 41/2002, concerning Patient Autonomy, regulates ‘advance directives’ and has prompted various Autonomous Regions to develop legislation in this area. Nevertheless, whilst the variety of legislations in different territories presents advantages, the disparity of criteria also presents problems.Despite significant legislative development, only 23,000 Spanish citizens have filled in an AD. Clearly, AD use is confined to a minority. Several (...) surveys, however, show that the Spanish population views these documents in a positive light. Thus, we must analyse this discrepancy between attitude and practice. A similar situation exists amongst health professionals. Whilst they generally feel that the use of ADs is positive and necessary, they are frequently unwilling to employ them.Bioethical literature and research on ADs has significantly increased in Spain over the last six years. It is likely that this trend will continue in the foreseeable future; but more resources and effort are required if ADs are to become consolidated. (shrink)

This paper evaluates the content of the syllabi of postgraduate courses on public health ethics within accredited schools and programs of public health in the United States in order to gain an awareness of the topics addressed within these courses. Methods: Data was gathered via the analysis of syllabi of courses on PHE. In 2012, information was requested by e-mail from the 48 schools and 86 PH programs accredited by the U.S. Council on Education for Public Health for 2012. The (...) “Epidemiology and PHE Syllabi” project of the University of Miami also was consulted. A table of topics was drawn up in order to carry out content analysis of the documents. Results: Data was obtained from 25 schools and 36 accredited programs ; 36 syllabi were gathered and 75 different topics were found. Of these, 38 topics were addressed in six or more syllabi and can be grouped as follows: foundations of PHE; autonomy and its limits; infectious disease control; justice; research ethics; health education and promotion; environmental and occupational health; screening; genetics; privacy and confidentiality; and community-based practice and vulnerable populations. Conclusions: The analyzed syllabi show high variability in curricular content. The debate with regard to whether a core curriculum on PHE should be established is ongoing. The results of this work might be of interest for schools and programs of PH in other countries or regions of the world in order to develop or ameliorate their own PHE syllabi. (shrink)

Objective: To measure the stability of life-sustaining treatment preferences amongst older people and analyse the factors that influence stability. Design: Longitudinal cohort study. Setting: Primary care centres, Granada (Spain). Eighty-five persons age 65 years or older. Participants filled out a questionnaire with six contexts of illness (LSPQ-e). They had to decide whether or not to receive treatment. Participants completed the questionnaire at baseline and 18 months later. Results: 86 percent of the patients did not change preferences. Sex, age, marital status, (...) hospitalisation, and self-perception of health and pain did not affect preferences. Morbidity and the death of a relative did. Conclusion: Stability of preferences of older persons in relation to end-of-life decisions seems to be more probable than instability. Some factors, such as the death of a relative or the increase in morbidity, can change preferences. These findings have implications for advance directives (ADs) and advance care planning. (shrink)

The accuracy of proxies when they interpret advance directives or apply substituted decision-making criteria has been called into question. It therefore became important to know if the Andalusian Advance Directive Form (AADF) can help to increase the accuracy of proxies' predictions. The aim of this research was to compare the effect of the AADF on the accuracy of proxies' predictions about patients' preferences with that gained from informative and deliberative sessions about end-of-life decision making. A total of 171 pairs of (...) patients and their proxies were randomized to three groups. The control group's answers to the Life Sustaining Preferences Questionnaire (LSPQ) were compared with their proxies' answers to the same questionnaire. In one intervention group, the patients had already completed the AADF and given it to their proxies, who used it to guide their own answers to the LSPQ. In the second intervention (discussion) group, both patients and proxies attended two educative sessions guided by trained nurses and later filled in the LSPQ. Comparisons of accuracy and other variables showed a strong association with the discussion group. The findings show that promoting communication between patients and their proxies improves the accuracy of proxies' predictions much more than isolated use of the AADF form. (shrink)

The aim of this study is to assess the knowledge, attitudes and experiences of Spanish nurses in relation to euthanasia and physician-assisted suicide. In an online questionnaire completed by 390 nurses from Andalusia, 59.1% adequately identified a euthanasia situation and 64.1% a situation involving physician-assisted suicide. Around 69% were aware that both practices were illegal in Spain, while 21.4% had received requests for euthanasia and a further 7.8% for assisted suicide. A total of 22.6% believed that cases of euthanasia had (...) occurred in Spain and 11.4% believed the same for assisted suicide. There was greater support (70%) for legalisation of euthanasia than for assisted suicide (65%), combined with a greater predisposition towards carrying out euthanasia (54%), if it were to be legalised, than participating in assisted suicide (47.3%). Nurses in Andalusia should be offered more education about issues pertaining to the end of life, and extensive research into this area should be undertaken. (shrink)

Principles of procreative beneficence (PPBs) hold that parents have good reasons to select the child with the best life prospects. Sparrow (2010) claims that PPBs imply that we should select only female children, unlesswe attach normative significance to “normal” human capacities. We argue that this claim fails on both empirical and logical grounds. Empirically, Sparrow’s argument for greater female wellbeing rests on a selective reading of the evidence and the incorrect assumption that an advantage for females would persist even when (...) a serious gender imbalance is obtained. Logically, PPBs cite only pro tanto reasons and allow that the good of an individual child could be outweighed by other morally relevant considerations, such as those which take collectively suboptimal outcomes into account. There is thus no need to attach value to the “normal.”. (shrink)

Human decisions are increasingly supported by decision support systems (DSS). Humans are required to remain “on the loop,” by monitoring and approving/rejecting machine recommendations. However, use of DSS can lead to overreliance on machines, reducing human oversight. This paper proposes “reflection machines” (RM) to increase meaningful human control. An RM provides a medical expert not with suggestions for a decision, but with questions that stimulate reflection about decisions. It can refer to data points or suggest counterarguments that are less compatible (...) with the planned decision. RMs think against the proposed decision in order to increase human resistance against automation complacency. Building on preliminary research, this paper will (1) make a case for deriving a set of design requirements for RMs from EU regulations, (2) suggest a way how RMs could support decision-making, (3) describe the possibility of how a prototype of an RM could apply to the medical domain of chronic low back pain, and (4) highlight the importance of exploring an RM’s functionality and the experiences of users working with it. (shrink)

Cancer is a singular cellular state, the emergence of which destabilises the homeostasis reached through the evolution to multicellularity. We present the idea that the onset of the cellular disobedience to the metazoan functional and structural architecture, known as the cancer phenotype, is triggered by changes in the cell's external environment that occur with ageing: what ensues is a breach of the social contract of multicellular life characteristic of metazoans. By integrating old ideas with new evidence, we propose that with (...) ageing the environmental information that maintains a multicellular organisation is eroded, rewiring internal processes of the cell, and resulting in an internal shift towards an ancestral condition resulting in the pseudo‐multicellular cancer phenotype. Once that phenotype emerges, a new local social contract is built, different from the homeostatic one, leading to tumour formation and the foundation of a novel local ecosystem. (shrink)

This study compares the balance of newspaper and television news coverage about migration in two countries that were differently affected by the so-called “refugee crisis” in 2015 in terms of the geopolitical involvement and numbers of migrants being admitted. Based on a broad consensus among political elites, Germany left its borders open and received about one million migrants mainly from Syria during 2015. In contrast, the conservative British government was heavily attacked by oppositional parties for closing Britain’s borders and, thus, (...) restricting immigration. These different initial situations led to remarkable differences between the news coverage in both countries. In line with news value theory, German media outlets reported much more on migration than did their British counterparts. In line with indexing theory, German news coverage consonantly reflected the consensual view of German political elites, while British news media reported along their general editorial lines. (shrink)

Un tipo de prolepsis, utilizado frecuentemente en Argonáuticas, es el discurso-programa en el cual un personaje anticipa la narración posterior. De esta manera funciona el relato de Fineo como guía de navegación para los Argonautas. Con el ineludible modelo de los relatos de viajes de Odisea, esta narración interna guarda una relación especular con la obra que la contiene y conlleva una cuasi-identificación entre narrador interno y narrador principal. Este artículo tiene como objetivo el análisis de los niveles narrativos en (...) este relato, para mostrar el modo en que esa técnica anticipatoria funciona en el poema en un nivel metaliterario. One type of prolepsis, frequently used in the Argonautica, is the programmatic speech in which a character anticipates the subsequent story. In this manner works the story of Phineus as navigation guidance for the Argonauts. With the inevitable model of travel stories of Odyssey, this internal narrative keeps a mirror-relationship with the work that contains it and carries a quasi-identification between internal narrator and main narrator. This article aims to analyze the narrative levels in this story, to show how this anticipatory technique works in the poem on a metaliterary level. (shrink)

El presente artículo aborda las connotaciones y los fundamentos de la paráfrasis cum canere vellem en Serv. Ecl. 6. 3. El análisis del sentido del verbo volo en este contexto y la confrontación del pasaje con Serv. Ecl. 6. 5 revelan que Servio interpreta la frase cum canerem reges et proelia como referencia a un temprano empeño de Virgilio en componer poesía épica, del que pronto desistió. Esta interpretación está condicionada por la idea de que la secuencia cronológica Églogas - (...) Geórgicas - Eneida tiene un correlato jerárquico, idea que se funda en noticias biográficas y en la teoría de la tripertita varietas. This paper focuses on the connotations and grounds of the paraphrase cum canere vellem in Serv. Ecl. 6. 3. The analysis of the sense of verb volo within this context, as well as the confrontation between that passage and Serv. Ecl. 6. 5, show that Servius interprets the clause cum canerem reges et proelia as a reference to Virgil's early endeavor to compose an epic poem, from which he shortly desisted. This interpretation is conditioned by the idea that the chronological sequence Eclogues - Georgics - Aeneid has a hierarchical correlate, an idea which is founded on biographical information and the theory of tripertita varietas. (shrink)

We say that a sentence A is a permissive consequence of a set X of premises whenever, if all the premises of X hold up to some standard, then A holds to some weaker standard. In this paper, we focus on a three-valued version of this notion, which we call strict-to-tolerant consequence, and discuss its fruitfulness toward a unified treatment of the paradoxes of vagueness and self-referential truth. For vagueness, st-consequence supports the principle of tolerance; for truth, it supports the (...) requisite of transparency. Permissive consequence is non-transitive, however, but this feature is argued to be an essential component to the understanding of paradoxical reasoning in cases involving vagueness or self-reference. (shrink)

This bestselling dictionary is written by one of the leading philosophers of our time, and it is widely recognized as the best dictionary of its kind. Comprehensive and authoritative, it covers every aspect of philosophy from Aristotle to Zen. With clear and concise definitions, it provides lively and accessible coverage of not only Western philosophical traditions, but also themes from Chinese, Indian, Islamic, and Jewish philosophy. New entries on philosophy of economics, social theory, neuroscience, philosophy of the mind, and moral (...) conceptions, bring this authoritative third edition up to date. It is the ideal introduction to philosophy for anyone with an interest in the subject, and it is an indispensable work of reference for students and teachers. (shrink)

RésuméAu cœur de la théorie de Sophia Moreau sur la discrimination répréhensible réside le devoir moral de traiter les autres comme des êtres égaux. Cet essai soulève quelques questions sur les contours de ce devoir et suggère des moyens de renforcer la théorie. En particulier, il suggère d'intégrer une vision cosmopolite de la portée de ce devoir, d’éclairer les caractéristiques à la base du statut moral égal des personnes afin d'en identifier les fondements, ainsi que d'identifier certaines considérations relatives à (...) des intérêts d'importance afin d'en préciser le contenu. La relation entre la théorie de Moreau et le discours sur les droits humains est également brièvement examinée, et une discussion plus approfondie de ce dernier est recommandée. (shrink)

The relationship of part to whole is one of the most fundamental there is; this is the first and only full-length study of this concept. This book shows that mereology, the formal theory of part and whole, is essential to ontology. Peter Simons surveys and criticizes previous theories, especially the standard extensional view, and proposes a more adequate account which encompasses both temporal and modal considerations in detail. 'Parts could easily be the standard book on mereology for the next twenty (...) or thirty years.' Timothy Williamson, Grazer Philosophische Studien. (shrink)

I show that frequentism, as an explanation of probability in classical statistical mechanics, can be extended in a natural way to a decoherent quantum history space, the analogue of a classical phase space. The result is a form of finite frequentism, in which Gibbs’ concept of an infinite ensemble of gases is replaced by the quantum state expressed as a superposition of a finite number of decohering microstates. It is a form of finite and actual frequentism (as opposed to hypothetical (...) frequentism) insofar as all the microstates exist, in keeping with the decoherence-based Everett interpretation, and some versions of pilot-wave theory. (shrink)

Here at last is a coherent, unintimidating introduction to the challenging and fascinating landscape of Western philosophy. Written expressly for "anyone who believes there are big questions out there, but does not know how to approach them," Think provides a sound framework for exploring the most basic themes of philosophy, and for understanding how major philosophers have tackled the questions that have pressed themselves most forcefully on human consciousness. Simon Blackburn, author of the best-selling Oxford Dictionary of Philosophy, begins by (...) making a convincing case for the relevance of philosophy and goes on to give the reader a sense of how the great historical figures such as Plato, Hume, Kant, Descartes, and others have approached its central themes. In a lively and accessible style, Blackburn approaches the nature of human reflection and how we think, or can think, about knowledge, fate, ethics, identity, God, reason, and truth. Each chapter explains a major issue, and gives the reader a self-contained guide through the problems that the philosophers have studied. Because the text approaches these issues from the gound up, the untrained reader will emerge from its pages able to explore other philosophies with greater pleasure and understanding and be able to think--philosophically--for him or herself. Philosophy is often dismissed as a purely academic discipline with no relation to the "real" world non-philosophers are compelled to inhabit. Think dispels this myth and offers a springboard for all those who want to learn how the basic techniques of thinking shape virtually every aspect of our existence. (shrink)

1.Los bienes invisibles -- 2. Tareas del espíritu.

El presente artículo pretende invitar al estudio del impacto que tuvo _El Evangelio en Triumpho_ de Olavide sobre el pensamiento decimonónico. Con ese fin propone, en primer lugar, leerlo captando en sus rasgos esenciales el valor alegórico de sus personajes en sus relaciones. A continuación, señala qué aspectos de esa lectura habrían influido de manera más marcada en las obras de Maistre y Saint-Simon, con las que abarca las dos tendencias post-revolucionarias de entender la historia, catecóntica y quiliástica. Finalmente, presenta (...) la unidad milenarista de la obra de Olavide, ajena a aquellas interpretaciones precisamente por su ortodoxia, apuntando, como lectura alternativa a la francesa, la que sugiere Dostoyevski en _El Gran Inquisidor_. (shrink)

In a recent paper, Barrio, Tajer and Rosenblatt establish a correspondence between metainferences holding in the strict-tolerant logic of transparent truth ST+ and inferences holding in the logic of paradox LP+. They argue that LP+ is ST+’s external logic and they question whether ST+’s solution to the semantic paradoxes is fundamentally different from LP+’s. Here we establish that by parity of reasoning, ST+ can be related to LP+’s dual logic K3+. We clarify the distinction between internal and external logic and (...) argue that while ST+’s nonclassicality can be granted, its self-dual character does not tie it to LP+ more closely than to K3+. (shrink)

Supervaluationism is a well known theory of vagueness. Subvaluationism is a less well known theory of vagueness. But these theories cannot be taken apart, for they are in a relation of duality that can be made precise. This paper provides an introduction to the subvaluationist theory of vagueness in connection to its dual, supervaluationism. A survey on the supervaluationist theory can be found in the Compass paper of Keefe (2008); our presentation of the theory in this paper will be short (...) to get rapidly into the logical issues. This paper is relatively self-contained. A modest background on propositional modal logic is, though not strictly necessary, advisable. The reader might find useful the Compass papers Kracht (2011) and Negri (2011) (though these papers cover issues of more complexity than what is demanded to follow this paper). (shrink)

Gravity and Grace was the first ever publication by the remarkable thinker and activist, Simone Weil. In it Gustave Thibon, the priest to whom she had entrusted her notebooks before her untimely death, compiled in one remarkable volume a compendium of her writings that have become a source of spiritual guidance and wisdom for countless individuals.

Michel Janssen and Harvey Brown have driven a prominent recent debate concerning the direction of an alleged arrow of explanation between Minkowski spacetime and Lorentz invariance of dynamical laws in special relativity. In this article, I critically assess this controversy with the aim of clarifying the explanatory foundations of the theory. First, I show that two assumptions shared by the parties—that the dispute is independent of issues concerning spacetime ontology, and that there is an urgent need for a constructive interpretation (...) of special relativity—are problematic and negatively affect the debate. Second, I argue that the whole discussion relies on a misleading conception of the link between Minkowski spacetime structure and Lorentz invari-ance, a misconception that in turn sheds more shadows than light on our understand-ing of the explanatory nature and power of Einstein’s theory. I state that the arrow connecting Lorentz invariance and Minkowski spacetime is not explanatory and uni-directional, but analytic and bidirectional, and that this analytic arrow grounds the chronogeometric explanations of physical phenomena that special relativity offers. (shrink)

Frost's article advocates for universal models of reading and critiques recent models that concentrate in what has been described as “cracking the orthographic code.” Although the challenge to develop models that can account for word recognition beyond Indo-European languages is welcomed, we argue that reading models should also be constrained by general principles of visual processing and object recognition.

To what degree can language be acquired from linguistic input alone? This question has vexed scholars for millennia and is still a major focus of debate in the cognitive science of language. The complexity of human language has hampered progress because studies of language–especially those involving computational modeling–have only been able to deal with small fragments of our linguistic skills. We suggest that the most recent generation of Large Language Models (LLMs) might finally provide the computational tools to determine empirically (...) how much of the human language ability can be acquired from linguistic experience. LLMs are sophisticated deep learning architectures trained on vast amounts of natural language data, enabling them to perform an impressive range of linguistic tasks. We argue that, despite their clear semantic and pragmatic limitations, LLMs have already demonstrated that human-like grammatical language can be acquired without the need for a built-in grammar. Thus, while there is still much to learn about how humans acquire and use language, LLMs provide full-fledged computational models for cognitive scientists to empirically evaluate just how far statistical learning might take us in explaining the full complexity of human language. (shrink)

In this paper we investigate a semantics for first-order logic originally proposed by R. van Rooij to account for the idea that vague predicates are tolerant, that is, for the principle that if x is P, then y should be P whenever y is similar enough to x. The semantics, which makes use of indifference relations to model similarity, rests on the interaction of three notions of truth: the classical notion, and two dual notions simultaneously defined in terms of it, (...) which we call tolerant truth and strict truth. We characterize the space of consequence relations definable in terms of those and discuss the kind of solution this gives to the sorites paradox. We discuss some applications of the framework to the pragmatics and psycholinguistics of vague predicates, in particular regarding judgments about borderline cases. (shrink)

In a previous paper (see ‘Tolerant, Classical, Strict’, henceforth TCS) we investigated a semantic framework to deal with the idea that vague predicates are tolerant, namely that small changes do not affect the applicability of a vague predicate even if large changes do. Our approach there rests on two main ideas. First, given a classical extension of a predicate, we can define a strict and a tolerant extension depending on an indifference relation associated to that predicate. Second, we can use (...) these notions of satisfaction to define mixed consequence relations that capture non-transitive tolerant reasoning. Although we gave some empirical motivation for the use of strict and tolerant extensions, making use of them commits us to the view that sentences of the form ‘ p∨¬p ’ and ‘ p∧¬p ’ are not automatically valid or unsatisfiable, respectively. Some philosophers might take this commitment as a negative outcome of our previous proposal. We think, however, that the general ideas underlying our previous approach to vagueness can be implemented in a variety of ways. This paper explores the possibility of defining mixed notions of consequence in the more classical super/sub-valuationist setting and examines to what extent any of these notions captures non-transitive tolerant reasoning. (shrink)

One way in which we might approach the challenge posed by the Sorites Paradox is considering that Sorites-susceptible predicates have several candidate extensions, or several ways in which these expressions can be made precise. For example, a candidate extension for the predicate ‘is a baby’ is the set of humans of less than two years, but also the set of those less than two years and one second, and of those less than two years and two seconds. In this chapter (...) we present and discuss two theories for vague predicates based on this idea: supervaluationism and subvaluationism. The chapter is structured in three parts. The first presents the super- and subvaluationist theories: their similarities and differences in the semantics, the resulting logics with their most characteristic features. The second reviews the super- and subvaluationist solutions to the Sorites Paradox and provides discussion on several controversies surrounding these theories. The third part introduces proof procedures for s’valuationist logics. (shrink)

This is a book about the religious life of the Greeks from the eighth century BC to the fifth century AD, looked at in the context of a variety of different cities and periods. Simon Price does not describe some abstract and self-contained system of religion or myths but examines local practices and ideas in the light of general Greek ideas, relating them for example, to gender roles and to cultural and political life (including Attic tragedy and the trial of (...) Socrates). He also lays emphasis on the reactions to Greek religions of ancient thinkers - Greek, Roman, Jewish and Christian. The evidence drawn on is of all kinds: literary texts, which are translated throughout; inscriptions, including an appendix of newly translated Greek inscriptions; and archaeology, which is highlighted in the numerous illustrations. (shrink)

Topics in Cognitive Science, Volume 14, Issue 3, Page 634-645, July 2022.

This paper presents and defends a way to add a transparent truth predicate to classical logic, such that and A are everywhere intersubstitutable, where all T-biconditionals hold, and where truth can be made compositional. A key feature of our framework, called STTT (for Strict-Tolerant Transparent Truth), is that it supports a non-transitive relation of consequence. At the same time, it can be seen that the only failures of transitivity STTT allows for arise in paradoxical cases.

In this clear introduction to ethics Simon Blackburn tackles the major moral questions surrounding birth, death, happiness, desire and freedom, showing us how ...

Nietzsche famously attacked traditional morality, and propounded a controversial ethics of 'life-enhancement'. Simon May presents a radically new view of Nietzsche's thought, which is shown to be both revolutionary and conservative, and to have much to offer us today after the demise of old values and the 'death of God'.

When we speak about different interpretations of quantum mechanics it is suggested that there is one single quantum theory that can be interpreted in different ways. However, after an explicit characterization of what it is to interpret quantum mechanics, the right diagnosis is that we have a case of predictively equivalent rival theories. I extract some lessons regarding the resulting underdetermination of theory choice. Issues about theoretical identity, theoretical and methodological pluralism, and the prospects for a realist stance towards quantum (...) theory can be properly addressed once we recognize that interpretations of quantum mechanics are rival theories. (shrink)

This paper is concerned with the claim that supervaluationist consequence is not classical for a language including an operator for definiteness. Although there is some sense in which this claim is uncontroversial, there is a sense in which the claim must be qualified. In particular I defend Keefe's position according to which supervaluationism is classical except when the inference from phi to Dphi is involved. The paper provides a precise content to this claim showing that we might provide complete (and (...) sound) systems of deduction for supervaluationist consequence in which proofs are completely classical with the exception of a single last step (involving the above mentioned inference). (shrink)

According to a popular narrative, in 1932 von Neumann introduced a theorem that intended to be a proof of the impossibility of hidden variables in quantum mechanics. However, the narrative goes, Bell later spotted a flaw that allegedly shows its irrelevance. Bell’s widely accepted criticism has been challenged by Bub and Dieks: they claim that the proof shows that viable hidden variables theories cannot be theories in Hilbert space. Bub’s and Dieks’ reassessment has been in turn challenged by Mermin and (...) Schack. Hereby I critically assess their reply, with the aim of bringing further clarification concerning the meaning, scope and relevance of von Neumann’s theorem. I show that despite Mermin and Schack’s response, Bub’s and Dieks’ reassessment is quite correct, and that this reading gets strongly reinforced when we carefully consider the connection between von Neumann’s proof and Gleason’s theorem. (shrink)