In this chapter, we seek to offer a fresh perspective on whether or not doctors should be “licensed to kill”. As that phrase indicates, we metaphorically refer to the adventures of fictional spy James Bond, although we hope, in doing so, that readers will not think that we are belittling the serious topic with which the chapter is concerned. Having surveyed some of the familiar arguments for and against allowing medically-assisted dying, we advance a new proposal, which seeks to strike (...) a compromise between such arguments. Our exploratory model builds on an analogy with armed response police units as they operate in England, and specifically with situations in which such officers are found to have killed someone in the course of their duties. Rather than confer immunity prospectively (as proponents of assisted dying often seek) or deny immunity completely (as opponents insist), our policy would provide a potential retrospective excuse. (shrink)

The definition of metabolic syndrome has been, and still is, extremely controversial. My purpose is not to give a solution to the associated debate but to argue that the controversy is at least partially due to the different ‘causal content’ of the various definitions: their theoretical validity and practical utility can be evaluated by reconstructing or making explicit the underlying causal structure. I will therefore propose to distinguish the alternative definitions according to the kinds of causal content they carry: definitions (...) grounded on associations, definitions presupposing a causal model built upon statistical associations, and definitions grounded on underlying mechanisms. I suggest that analysing definitions according to their causal content can be helpful in evaluating alternative definitions of some diseases. I want to show how the controversy over MetS suggests a distinction among three kinds of definitions based on how explicitly they characterise the syndrome in causal terms, and on the type of causality involved. I will call ‘type 1 definitions’ those definitions that are purely associative; ‘type 2 definitions’ the definitions based on statistical associations, plus generic medical and causal knowledge; and ‘type 3 definitions’ the definitions based on mechanisms. These kinds of definitions, although different, can be related to each other. A definition with more specific causal content may be useful in the evaluation of definitions characterised by a lower degree of causal specificity. Moreover, the identification of the type of causality involved is of help to constitute a good criterion for choosing among different definitions of a pathological entity. In section I introduce the controversy about MetS, in section I propose some remarks about medical definitions and their ‘causal import’, and in section I suggest that the different attitudes towards the definition of MetS are relevant to evaluate their explicative power. (shrink)

In this paper we discuss the influence of war as a metaphor in the context of the COVID-19 pandemic. After an introduction on the traditional analysis of the war metaphor, we address the social consequences of using this metaphor, a topic that has been widely debated with regard to public communication in the context of COVID-19. We pay particular attention to a theory that many intellectuals have raised: the possibility that the use of the metaphor in this context is harmful (...) to a democratic society because it may lead citizens to accept limited civil liberties and authoritarian policies. After presenting the extensive literature on the use of the war metaphor before and during the COVID-19 pandemic, in the final section of the paper, we analyse experimental evidence of the effects of this metaphor. In the conclusion, we hint at open questions and suggest that the current evidence does not support claims of direct liberticidal influence. (shrink)

Cet article examine le rôle joué par la notion d'intelligence dans la poésie de Xénophane et de Parménide. L'auteur soutient que ces deux philosophes, en modifiant les attributs traditionnels du noos humain et divin, répondent aux problèmes posés par le pessimisme gnoséologique de la tradition poétique archaïque, dans laquelle les mortels sont inéluctablement condamnés à l'ignorance. Comme le montre le cas d'Hésiode, même l'inspiration divine ne garantit pas d'acquérir la connaissance, parce que la divinité peut communiquer, à son gré, le (...) vrai ou le faux et que le poète est dépourvu de moyens pour établir la validité de la révélation. Chez Xénophane en revanche, la régularité de l'ordre naturel fondé sur l'immuable noos du dieu offre aux hommes la possibilité effective d'améliorer leur compréhension du monde, tandis que dans le poème de Parménide, la déduction des attributs de l'Être donne aux mortels l'accès à cette vérité qui était auparavant une prérogative exclusive des dieux. (shrink)

Philosophical works on actual causation make wide use of thought experiments. The principal aim of this paper is to show how thought experiments are used in the contemporary debate over actual causation and to discuss their role in relation to formal approaches in terms of causal models. I claim that a recourse to thought experiments is not something old fashioned or superseded by abstract models, but it is useful to interpret abstract models themselves and to use our intuitions to judge (...) the results of the model. Recent research on actual causation has stressed the importance of integrating formal models with some notion of normality; I suggest that thought experiments can be useful in eliciting intuitions where normality is not intended in a statistical sense. The first expository part gives a short presentation of the notion of actual causation, summarising some typical problems of counterfactual approaches and how they are treated in causal and structural models. The second part focuses on the problems of model isomorphism and criticises some radical ideas opposing the role of thought experiments, claiming that they may also be of use in evaluating formal models. (shrink)

Philosophical works on actual causation make wide use of thought experiments. The principal aim of this paper is to show how thought experiments are used in the contemporary debate over actual causation and to discuss their role in relation to formal approaches in terms of causal models. I claim that a recourse to thought experiments is not something old fashioned or superseded by abstract models, but it is useful to interpret abstract models themselves and to use our intuitions to judge (...) the results of the model. Recent research on actual causation has stressed the importance of integrating formal models with some notion of normality; I suggest that thought experiments can be useful in eliciting intuitions where normality is not intended in a statistical sense. The first expository part gives a short presentation of the notion of actual causation, summarising some typical problems of counterfactual approaches and how they are treated in causal and structural models. The second part focuses on the problems of model isomorphism and criticises some radical ideas opposing the role of thought experiments, claiming that they may also be of use in evaluating formal models. (shrink)

Philosophical works on actual causation make wide use of thought experiments. The principal aim of this paper is to show how thought experiments are used in the contemporary debate over actual causation and to discuss their role in relation to formal approaches in terms of causal models. I claim that a recourse to thought experiments is not something old fashioned or superseded by abstract models, but it is useful to interpret abstract models themselves and to use our intuitions to judge (...) the results of the model. Recent research on actual causation has stressed the importance of integrating formal models with some notion of normality; I suggest that thought experiments can be useful in eliciting intuitions where normality is not intended in a statistical sense. The first expository part gives a short presentation of the notion of actual causation, summarising some typical problems of counterfactual approaches and how they are treated in causal and structural models. The second part focuses on the problems of model isomorphism and criticises some radical ideas opposing the role of thought experiments, claiming that they may also be of use in evaluating formal models. (shrink)

In this paper, we will analyse the language used by a group of Tourism ESP students on WhatsApp. The data will be analysed from different perspectives: a) the grammatical mistakes made, and b) the students´ degree of adaptation to the most common linguistic features in text messages. The results indicate that these students continue to make some basic grammatical mistakes they should have already overcome. Moreover, many linguistic features of text messages were encountered in their interventions such as punctuation overuse (...) and deletion and overuse of sounds. Finally, they insert many emojis in their messages to express different meanings. (shrink)

Caracterizar a demanda de atendimento psicológico e compreender a experiência dos profissionais que atuaram na pandemia do COVID-19, em uma plataforma de atendimento psicológico on-line. Realizou-se uma análise documental e entrevista semiestruturada com 20 psicólogos que atuaram no mínimo 6 meses na plataforma entre mar/2020 à dez/2022, em que foram atendidos um total 15.963 pacientes. Dentre as demandas, prevaleceram ideação suicida com planejamento, ansiedade e depressão. O perfil prevalente dos pacientes atendidos na pandemia corresponde à literatura, em períodos não pandêmicos, (...) bem como a prevalência de sintomas ansiosos e depressivos. Porém, destacou o surgimento do alto número de pacientes com ideação suicida, o que sugere um agravamento dos transtornos mentais, despertado pela pandemia, além de uma dificuldade comum aos entrevistados, relacionada a clareza dos critérios clínicos utilizados para determinação da gravidade dos casos. Os psicólogos apontaram dificuldades no manejo destes casos graves, intensificados pelo impacto emocional pandêmico também sentido por eles, junto ao despreparo para sua atuação online, as percebendo como limitações. Apesar do despreparo, a alta demanda incitou os profissionais aderirem as especificidades da modalidade. Estes relataram ter buscado aporte teórico e apoio emocional para manterem os recursos internos, cognitivos e emocionais, necessários ao setting terapêutico. Pode-se concluir que os resultados evidenciaram a importância de se refletir sobre os critérios de avaliação clínica utilizados para compreensão da severidade dos casos, sem deixar de considerar os recursos internos dos pacientes relativos à sua capacidade de sofrer, os quais podem ser identificados quando mantida a capacidade de rêverie do profissional. (shrink)

O autor, na multiplicidade de seus aspectos, detém-se em considerações sobre o Estado, mas não se limita à perspectiva dos escritos tradicionais de Teoria Geral. Recolhe momentos de sua configuração histórica, de partes relevantes de sua fisionomia jurídica e, de modo particular, emite reflexões filosóficas sobre a morfologia estrutural e o sentido ético dessa entidade. O enfoque, porém, dista de ser mero tangenciar o assunto, porquanto insere, a cada passo, proposições que exprimem sua opinião pessoal e a ideologia de quem (...) anuncia mas, sobretudo, realiza com coerência e determinação, uma pauta de condutas orientada por valores definidos e estáveis. (shrink)

With a new introduction by the author In this deliciously polemical work, a giant of cultural theory immerses himself in the ideas of a giant of French thought.

Ernesto Laclau and Chantal Mouffe have attempted to save the concept of ?hegemony? from its economistic and essentialist Marxist roots by incorporating the linguistic influences of post?structuralist theory. Their major Marxist detractors criticise their trajectory as a ?descent into discourse? ? a decay from well?grounded, material reality into the idealistic and problematic realm of language and discourse. Both sides of the debate seem to agree on one thing: the line from Marxism to post?Marxism is the line from the economy to (...) language, from ?reality? to discourse. This article focuses on Gramsci?s writings on language to argue against both sides of this debate. It illustrates how language is central to Gramsci?s historical materialism and that he does not oppose it to materiality. It argues that Gramsci adopted the very term hegemony substantially from his university studies in linguistics ? the debates from which Ferdinand de Saussure also developed structuralism. For Gramsci, such linguistic issues were directly related to the ?questione della lingua? and Italian unification. Moreover, language lies at the centre of Gramsci?s understanding of the relationship between coercion and consent. This not only troubles Laclau & Mouffe?s reading of Gramsci, but it illuminates a more productive conception of hegemony that can address recent debates around post?structuralism and the use of ?hegemony? to analyse globalisation and an increasingly technological and electronic world. (shrink)

Reflective function is defined as an individual’s ability to understand human behavior in terms of underlying mental states including thoughts, feelings, desires, beliefs, and intentions. More specifically, the capacity of parents to keep their child’s mental states in mind is referred to as parental RF. RF has been linked to adult mental health and parental RF to children’s mental health and development. The gold standard measure of RF is the interview-based Reflective Functioning Scale applied to the Parent Development Interview or (...) Adult Attachment Interview, which while well validated, is time-and labor-intensive to administer. Given the increasing need for reliable, valid, and rapid RF assessment in wide-ranging settings, two alternative measures were considered including the Reflective Function Questionnaire and Parental Reflective Function Questionnaire. We determined the convergent validity of these measures in comparison with the PDI-rated RFS. A sample of mothers and fathers was drawn from a sub-study of the ongoing Alberta Pregnancy Outcomes and Nutrition longitudinal cohort when their children were 42–60 months of age. Pearson correlations and multiple linear regression was conducted, followed by splitting the sample to compute Cohen’s kappas measures of agreement. Two subscales of the PRFQ correlated significantly with the gold standard PDI-rated RFS, providing evidence for convergent validity. As a brief multidimensional measure of parental RF, the PRFQ offers an alternative for measurement of RF in large-scale studies of parental development and child health. (shrink)

Despite the increased prevalence of bioethics research that seeks to use empirical data to answer normative research questions, there is no consensus as to what an appropriate methodology for this would be. This review aims to search the literature, present and critically discuss published Empirical Bioethics methodologies.

Aims:The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress.Background:Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon.Design:Systematic literature review and narrative synthesis (November (...) 2015–March 2016).Data sources:Ovid MEDLINE®In-Process & Other Non-Indexed Citations 1946–Present, PsycINFO®1967–Present, CINAHL®Plus 1937–Present, EMBASE 1974–24 February 2016, British Nursing Index 1994–Present, Social Care Online, Social Policy and Practice Database (1890–Present), ERIC (EBSCO) 1966–Present and Education Abstracts.Review methods:Literature relating to moral distress was systematically retrieved and subjected to relevance assessment. Narrative synthesis was the overarching framework that guided quality assessment, data analysis and synthesis.Results:In all, 152 papers underwent initial data extraction and 34 were chosen for inclusion in the narrative synthesis based on both quality and relevance. Analysis revealed different proposed conditions for the occurrence of moral distress: moral judgement, psychological and physical effects, moral dilemmas, moral uncertainty, external and internal constraints and threats to moral integrity.Conclusion:We suggest the combination of (1) the experience of a moral event, (2) the experience of ‘psychological distress’ and (3) a direct causal relation between (1) and (2) together are necessary and sufficient conditions for moral distress. (shrink)

Attempts to conduct systematic reviews of ethical arguments in bioethics are fundamentally misguided. All areas of enquiry need thorough and informative literature reviews, and efforts to bring transparency and systematic methods to bioethics are to be welcomed. Nevertheless, the raw materials of bioethical articles are not suited to methods of systematic review. The eclecticism of philosophy may lead to suspicion of philosophical methods in bioethics. Because bioethics aims to influence medical and scientific practice it is tempting to adopt scientific language (...) and methods. One manifestation is the increasing innovation in, and use of, systematic reviews of ethical arguments in bioethics. Yet bioethics, as a broadly philosophical area of enquiry, is unsuited to systematic review. Bioethical arguments are evaluative, so notions of quality and bias are inapplicable. Bioethical argument is conceptual rather than numerical, and the classification of concepts is itself a process of argument that cannot aspire to neutrality. Any ‘systematic review’ of ethical arguments in bioethics thus falls short of that name. Furthermore, labels matter. Although the bioethics research community may find that adopting the language and the outward methods of clinical science offers apparent prospects of credibility, policy influence and funding, we argue that such misdirection carries risks and is unlikely to pay dividends in the long term. Bioethical sources are amenable to the review methods of the social sciences, and it is on these methods that specific methods of bioethics literature review should be built. (shrink)

This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...) ‘integrating’ empirical methods and ethical argument as a standard for research practice within empirical bioethics. (shrink)

In Less Than Nothing, the pinnacle publication of a distinguished career, Slavoj i ek argues that it is imperative that we not simply return to Hegel but that we repeat and exceed his triumphs, overcoming his limitations by being even more ...

In this monograph on Luce Irigay, Kelly Ives explores the French thinker's ideas on the politics of sexual difference.

Austerity, by its very nature, imposes constraints by limiting the options for action available to us because certain courses of action are too costly or insufficiently cost effective. In the context of healthcare, the constraints imposed by austerity come in various forms; ranging from the availability of certain treatments being reduced or withdrawn completely, to reductions in staffing that mean healthcare professionals must ration the time they make available to each patient. As austerity has taken hold, across the United Kingdom (...) and Europe, it is important to consider the wider effects of the constraints that it imposes in healthcare. Within this paper, we focus specifically on one theorised effect—moral distress. We differentiate between avoidable and unavoidable ethical challenges within healthcare and argue that austerity creates additional avoidable ethical problems that exacerbate clinicians’ moral distress. We suggest that moral resilience is a suitable response to clinician moral distress caused by unavoidable ethical challenges but additional responses are required to address those that are created due to austerity. We encourage clinicians to engage in critical resilience and activism to address problems created by austerity and we highlight the responsibility of institutions to support healthcare professionals in such challenging times. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.