In their 2018 article in the Cambridge Quarterly of Healthcare Ethics, Little, Lipworth, and Kerridge unpack the concept of corruption and clarify the mechanisms that foster corruption and allow it to persist, noting that organizations are “corruptogenic.” To address the “so-what” question, I draw on research about trust and trustworthiness, emphasizing that a person’s well-being and sense of security require trust to be present at both the individual and organizational levels—which is not possible in an environment where corruption and misconduct (...) prevail. I highlight similarities in Little et al.’s framing of corruption to the persistent problem of scientific misconduct in research and publishing. I acknowledge the challenges in stemming corruption in science and medicine and conclude with a discussion about the need to reinvigorate a web of stakeholders to actively engage in professional regulation. (shrink)

This paper addresses the growing problem of retractions in the scientific literature of publications that contain bad data, also called “false science.” While the problem is particularly acute in the biomedical literature because of the life-threatening implications when treatment recommendations and decisions are based on false science, it is relevant for any knowledge domain, including the social sciences, law, and education. Yet current practices for handling retractions are seen as inadequate. We use the metaphor of a virus to illustrate how (...) such studies can spread and contaminate the knowledge system, when they continue to be treated as valid. We suggest drawing from public health models designed to prevent the spread of biological viruses and compare the strengths and weaknesses of the current governance model of professional self-regulation with a proposed public health governance model. The paper concludes by considering the value of adding a triple-helix model that brings industry into the university-state governance mechanisms and incorporates bibliometric capabilities needed for a holistic treatment of the retraction process. (shrink)

Medical Professionals: Conflicts and Quandaries in Medical Practice offers a fresh approach to understanding the role-related conflicts and quandaries that pervade contemporary medical practice. While a focus on professional conflicts is not new in the literature, what is missing is a volume that delves into medical professionals' own experience of the conflicts and quandaries they face, often as a result of inhabiting multiple roles. The volume explores the ways in which these conflicts and quandaries are exacerbated by broader societal forces, (...) including changing scientific and technological paradigms, commercialization, and strengthened consumer movements, which simultaneously expand the scope of roles and responsibilities that medical professionals are expected to fulfill, and make it more difficult to do so. Several empirical chapters analyze data from qualitative interview studies with clinicians and other stakeholders. The studies highlight the burdens on clinicians who are expected to make informed and justified judgments and decisions in the midst of competing pressures; authors describe the methods that clinicians use to address the associated tensions within specific contexts. Two conceptual chapters follow and offer some innovative ways to think about the challenges facing medical professionals as they strive to make sense of the changing landscape within healthcare. The first reflects on the challenges to clinical practice in the midst of shifting and often competing definitions of disease and associated ideologies of care. The second reflects more broadly on the utility of value pluralism as a framework for conceptualizing and working through moral and professional quandaries. The book concludes with a chapter containing suggestions for how members of the medical profession might reframe their thinking about their roles, responsibilities, and decision-making in the midst of inevitable quandaries such as those presented here. This book will be of vital reading for academics, researchers, educators, postgraduate students, and interested health care practitioners and administrators. (shrink)

The pharmaceutical industry has been criticised for pervasive misconduct. These concerns have generally resulted in increasing regulation. While such regulation is no doubt necessary, it tends to assume that everyone working for pharmaceutical companies is equally motivated by commerce, without much understanding of the specific views and experiences of those who work in different parts of the industry. In order to gain a more nuanced picture of the work that goes on in the “medical affairs” departments of pharmaceutical companies, we (...) conducted 15 semi-structured interviews with professionals working in medical departments of companies in Sydney, Australia. We show that this group of pharmaceutical professionals are committed to their responsibilities both to patients, research participants, and the public and to their companies. Despite the discrepancies between these commitments, our participants did not express much cognitive dissonance, and this appeared to stem from their use of two dialectically related strategies, one of which embraces commerce and the other of which resists the commercial imperative. We interpret these findings through the lens of institutional theory and consider their implications for pharmaceutical ethics and governance. (shrink)

Narrative analysis is well established as a means of examining the subjective experience of those who suffer chronic illness and cancer. In a study of perceptions of the outcomes of treatment of cancer of the colon, we have been struck by the consistency with which patients record three particular observations of their subjective experience: the immediate impact of the cancer diagnosis and a persisting identification as a cancer patient, regardless of the time since treatment and of the presence or absence (...) of persistent or recurrent disease; a state of variable alienation from social familiars, expressed as an inability to communicate the nature of the experience of the illness, its diagnosis and treatment; and a persistent sense of boundedness, an awareness of limits to space, empowerment and available time. These subjectivities were experienced in varying degree by all patients in our study. Individual responses to these experiences were complex and variable. The experiences are best understood under the rubric of a category we call “liminality”. We believe that all cancer patients enter and experience liminality as a process which begins with the first manifestations of their malignancy. An initial acute phase of liminality is marked by disorientation, a sense of loss and of loss of control, and a sense of uncertainty. An adaptive, enduring phase of suspended liminality supervenes, in which each patient constructs and reconstructs meaning for their experience by means of narrative. This phase persists, probably for the rest of the cancer patient’s life. The experience of liminality is firmly grounded in the changing and experiencing body that houses both the disease and the self. Insights into the nature of the experience can be gained from the Existentialist philosophers and from the history of attitudes to death. Understanding liminality helps us to understand what it is that patients with cancer seek from the system to which they turn for help. Its explication should therefore be important for those who provide health care, those who educate health care workers and those concerned to study and use outcomes as administrative and policy making instruments. (shrink)

High-dose chemotherapy and autologous stem cell transplantation is used to treat some advanced malignancies. It is a traumatic procedure, with a high complication rate and significant mortality. ASCT patients and their carers draw on many sources of information as they seek to understand the procedure and its consequences. Some seek information from beyond orthodox medicine. Alternative beliefs and practices may conflict with conventional understanding of the theory and practice of ASCT, and ‘contested understandings’ might interfere with patient adherence to the (...) strict and demanding protocols required for successful ASCT.The present study, conducted in Sydney, Australia, examines narrative-style interviews with 10 sequentially recruited ASCT patients and nine of their carers conducted at the time of transplant and three months later. Transcripts were read for instances of mention of alternative advice, and for instances of contested understanding of information relevant to the transplant.Patients and carer pairs expressed closely concordant views about alternative advice. Five pairs were consulting alternative practitioners. Contested understanding was expressed in four domains—understandings of the transplant itself and its underlying theory, of the relationship between the components of the ‘transplant’, of the nature and role of stem cells, and of beliefs about bodily function and life-style. Contested understandings of the transplant treatment were expressed as predominantly personal interpretations of orthodox informationPatients and carers seemed to recognise that alternative and conventional systems were discordant, yet they were able to separate the two, and adhere to each practice without prejudicing their medical treatment. A single case of late, post-transplant repudiation of Western medicine is discussed to emphasise some of the possible determinants of dissonance when it does occur. (shrink)

Concerns are frequently raised about the extent to which formal consent procedures actually lead to “informed” consent. As part of a study of consent to high-risk medical procedures, we analyzed in-depth interviews with 16 health care professionals working in bone-marrow transplantation in Sydney, Australia. We find that these professionals recognize and act on their responsibility to inform and educate patients and that they expect patients to reciprocate these efforts by demonstrably engaging in the education process. This expectation is largely implicit, (...) however, and when it is not met, this can give rise to trouble that can have adverse consequences for patients, physicians, and relationships within the clinic. We revisit the concept of the sick role to formalize this new role expectation, and we argue that “informed” consent is a process that is usually incomplete, despite trappings and assumptions that help to create the illusion of completeness. (shrink)

We examine the link between the growing emphasis on corporate social responsibility at the organizational level and beliefs about social responsibility at work (SRW) expressed by individuals. Drawing from theories of professionalism and diffusion of innovations (including practices and beliefs), we advance hypotheses about beliefs of managers and non-managers in 11 countries at two time periods, and use a unique international data set to test our hypotheses. Our general prediction that managers would score higher than non-managers on a measure of (...) SRW was not supported. However, further analysis revealed a more complex relationship moderated by the contextual factors of time frame and country inequality level. We discuss implications and extensions for future research. (shrink)

We examine the link between the growing emphasis on corporate social responsibility at the organizational level and beliefs about social responsibility at work (SRW) expressed by individuals. Drawing from theories of professionalism and diffusion of innovations (including practices and beliefs), we advance hypotheses about beliefs of managers and non‐managers in 11 countries at two time periods, and use a unique international data set to test our hypotheses. Our general prediction that managers would score higher than non‐managers on a measure of (...) SRW was not supported. However, further analysis revealed a more complex relationship moderated by the contextual factors of time frame and country inequality level. We discuss implications and extensions for future research. (shrink)

This exploratory study assessed the use of functional Near Infrared Spectroscopy (fNIRS) to examine hemodynamic response patterns during sentence processing. Four groups of participants: monolingual English children, bilingual Chinese-English children, bilingual Chinese-English adults and monolingual English adults were given an agent selection syntactic processing task. Bilingual child participants were classified as simultaneous or sequential bilinguals to examine the impact of first language, age of second-language acquisition (AoL2A), and the length of second language experience on behavioral performance and cortical activation. Participants (...) were asked to select the agent of four types of sentences: subject-verb-object (SVO), passive (PAS), subject-extracted relative clause (SR), and object-extracted relative clause (OR) adopted from the “Whatdunit” task by Montgomery et al. (2016). Semantic cues were removed by using inanimate nouns for agents and patients, which constrained participants to make decisions based on syntactic knowledge. Behavioral results showed greater accuracy for canonical SVO and SR sentence types than for noncanonical OR and PAS sentence types, which aligns with prior studies. Neuroimaging results revealed greater hemodynamic responses to relative clauses (i.e., SR and OR sentences) than to simple sentences (SVO and PAS), especially for Chinese-English bilinguals suggesting first-language transfer influencing sentence processing in English. The effects AoL2A and the length of second language experience showed no significant differences between simultaneous and sequential bilinguals or between bilingual adults and children for identifying the correct agent in each sentence. However, neuroimaging results demonstrated greater hemodynamic responses in right dorsolateral prefrontal cortex (DLPFC) and left inferior parietal lobule (IPL) in simultaneous bilinguals compared to sequential bilinguals and greater hemodynamic responses in left and right DLPFC and left IPL among bilingual adults. Different behavioral and neural hemodynamic response patterns afford new insights into the effects of syntactic knowledge on sentence processing. (shrink)

Anonymity is a form of nonidentifiability which I define as noncoordinatability of traits in a given respect. This definition broadens the concept, freeing it from its primary association with naming. I analyze different ways anonymity can be realized. I also discuss some ethical issues, such as privacy, accountability and other values which anonymity may serve or undermine. My theory can also conceptualize anonymity in information systems where, for example, privacy and accountability are at issue.

In an era of fake news, alternative truths and leaked secrets making constant headlines, we are telling stories about ourselves all the time, and we are telling them in so many different ways. From vlogs and blogs to tweets and posts, from photos and gifs to live streams. From instant updates that disappear to rash words that last for ever and data trails that chart every step we take. While people around her shake their heads and mutter bad things about (...) the new levels of day-to-day deceit, Kathleen Wyatt is busy marvelling at how society manages it. How do we do this extraordinary thing - often under the most ordinary of circumstances? How do we convince each other to suspend disbelief? And why do we do it? In this brilliant, wide-ranging study of lies and lying, Wyatt introduces us to a cast of professionals and professional liars - from scientists to investigators, from double agents to journalists, from toddler specialists to a fallen titan of industry - all to help her prove a remarkable thesis: lies hold us together as much as they push us apart and may be vital in a healthy society"--Publisher's description. (shrink)

This book is a complete re-thinking of Aristotle's metaphysical theory of material substances. The view of the author is that the 'substances' are the living things, the organisms: chiefly, the animals. There are three main parts to the book: Part I, a treatment of the concepts of substance and nonsubstance in Aristotle's Categories; Part III, which discusses some important features of biological objects as Aristotelian substances, as analysed in Aristotle's biological treatises and the de Anima; and Part V, which attempts (...) to relate the conception of substance as interpreted so far to that of the Metaphysics itself. The main aim of the study is to recreate in modern imagination a vivid, intuitive understanding of Aristotle's concept of material substance: a certain distinctive concept of what an individual material object is. (shrink)

This book is a re-thinking of Aristotle's metaphysical theory of material substances. The view of the author is that the 'substances' are the living things, the organisms: chiefly, the animals. There are three main parts to the book: Part I, a treatment of the concepts of substance and nonsubstance in Aristotle's Categories; Part III, which discusses some important features of biological objects as Aristotelian substances, as analysed in Aristotle's biological treatises and the de Anima; and Part V, which attempts to (...) relate the conception of substance as interpreted so far to that of the Metaphysics itself. The main aim of the study is to recreate in modern imagination a vivid, intuitive understanding of Aristotle's concept of material substance: a certain distinctive concept of what an individual material object is. (shrink)

Scientists depend on complex computational systems that are often ineliminably opaque, to the detriment of our ability to give scientific explanations and detect artifacts. Some philosophers have s...

A popular approach to defining fictive utterance says that, necessarily, it is intended to produce imagining. I shall argue that this is not falsified by the fact that some fictive utterances are intended to be believed, or are non-accidentally true. That this is so becomes apparent given a proper understanding of the relation of what one imagines to one's belief set. In light of this understanding, I shall then argue that being intended to produce imagining is sufficient for fictive utterance (...) as well. (shrink)

This article examines the complaint that arbitrary algorithmic decisions wrong those whom they affect. It makes three contributions. First, it provides an analysis of what arbitrariness means in this context. Second, it argues that arbitrariness is not of moral concern except when special circumstances apply. However, when the same algorithm or different algorithms based on the same data are used in multiple contexts, a person may be arbitrarily excluded from a broad range of opportunities. The third contribution is to explain (...) why this systemic exclusion is of moral concern and to offer a solution to address it. (shrink)

This book explores the scope and limits of the concept of personDS a vexed question in contemporary philosophy. The author begins by questioning the methodology of thought-experimentation, arguing that it engenders inconclusive and unconvincing results, and that truth is stranger than fiction. She then examines an assortment of real-life conditions, including infancy, insanity andx dementia, dissociated states, and split brains. The popular faith in continuity of consciousness, and the unity of the person is subjected to sustained criticism. The author concludes (...) with a look at different views of the person found in Homer, Aristotle, the post-Cartesians, and contemporary cognitive science. (shrink)

Jaakko Hintikka points out the power of Skolem functions to affect both what there is and what we know. There is a tension in his presupposition that these functions actually extend the realm of logic. He claims to have resolved the tension by “reconstructing constructivism” along epistemological lines, instead of by a typical ontological construction; however, after the collapse of the distinction between first and second order, that resolution is not entirely satisfactory. Still, it does throw light on the conceptual (...) analysis Hintikka proposes. (shrink)

This guide is an exploration of political reality as understood by Eric Voegelin. Voegelin employed the revolutionary concepts found in ancient Greek noetic and Christian pneumatic philosophy that describe political reality and the means to know it. This guide begins with a biographical sketch of Voegelin, the historical milieu that inspired his resistance to "unreality" and terms and symbols he uses to identify the spiritual sickness he believes is destroying Western civilization's traditional basis of order, it then examines Voegelin's theories (...) of consciousness, philosophy and science fundamental to understanding reality. Given the extensive nature and volume of his work, a consolidation and explanation of it is offered, and an example on how to apply it is outlined. Critiques of Voegelin's work are detailed to outline weaknesses in his theories and methods. This guide concludes by defining political reality, how to use Voegelinian techniques to analyze reality, and how to live a life that cultivates the pursuit of human knowledge in keeping with Western philosophic traditions. Book jacket. (shrink)

The concept of a relational self has been prominent in feminism, communitarianism, narrative self theories, and social network theories, and has been important to theorizing about practical dimensions of selfhood. However, it has been largely ignored in traditional philosophical theories of personal identity, which have been dominated by psychological and animal theories of the self. This book offers a systematic treatment of the notion of the self as constituted by social, cultural, political, and biological relations. The author's account incorporates practical (...) concerns and addresses how a relational self has agency, autonomy, responsibility, and continuity through time in the face of change and impairments. This cumulative network model of the self incorporates concepts from work in the American pragmatist and naturalist tradition. The ultimate aim of the book is to bridge traditions that are often disconnected from one another--feminism, personal identity theory, and pragmatism--to develop a unified theory of the self. (shrink)

As philosophers of mind we seem to hold in common no very clear view about the relevance that work in psychology or the neurosciences may or may not have to our own favourite questions—even if we call the subject ‘philosophical psychology’. For example, in the literature we find articles on pain some of which do, some of which don't, rely more or less heavily on, for example, the work of Melzack and Wall; the puzzle cases used so extensively in discussions (...) of personal identity are drawn sometimes from the pleasant exercise of scientific fantasy, at times from surprising reports of scientific fact; and there are those who deny, as well as those who affirm, the importance of the discovery of rapid-eye-movement sleep to the philosophical treatment of dreaming. A general account of the relation between scientific, and philosophical, psychology is long overdue and of the first importance. Here I shall limit myself to just one area where the two seem to connect, discussing one type of neuropsychological research and its relevance to questions in the philosophy of mind and the philosophy of psychology. (shrink)

The topic of this paper is the debate between two accounts of the continuum. On one account the continuum has discrete elements. On the other it has no discrete elements. Each account has its own strengths and weaknesses. The paper introduces several different explications of continuity before stating and discussing an antinomy and some options to resolve it. An assessment follows in which certain astute philosophical views are vetted. If the dispute concerns the reality of the continuum, there seems to (...) be nothing that could further decide the matter. If the dispute concerns our access to the continuum, there are many adequate options. But, in either case, the dispute is not merely verbal. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Elements of Eleatic Ontology' MONTGOMERY FURTH THE TASKOF AN INTERPRETERof Parmenides is to find the simplest, historically most plausible, and philosophically most comprehensible set of assumptions that imply (in a suitably loose sense) the doctrine of 'being' set out in Parmenides' poem. In what follows I offer an interpretation that certainly is simple and that I think should be found comprehensible. Historically, only more cautious claims are possible, (...) for several portions of the general view from which I 'deduce the poem' are not clearly stated in the poem itself; my explanation of this is that they are operating as tac/t assumptions, and indeed that the poem is best thought of as an attempt to force these very assumptions to the surface for formulation and criticism -that the poem is a challenge. To be sure, there are dangers in pretending, as for dramatic purposes I shall, that ideas are definite and explicit which for Parmenides himself must have been tacit or vague--that Parmenides knew what he was doing as clearly as I represent him; I try to avoid them, but the risk must be taken. I even believe that not to take it, in the name of preserving his thought pure from anachronous contamination, actually prevents us from seeing the extent to which he, pioneer, was ahead of his timc the argument works both ways. So let me hedge my historical claim in this way: the view I shall discuss could have been an active-indeed a controlling---element of Eleaticism; to suppose that Parmenides held it not only explains the poem, but also helps explain the subsequent reactions to Eleaticism of Anaxagoras, Democritus, and Plato (though there is not space to elaborate this here). In addition, it brings his thought astonishingly close to some contemporary philosophical preoccupations. In the first of the following sections, I lay down some sketchy but necessary groundwork concerning the early Greek concept of 'being.' Then in Section 2 an interpretation is given of what I take to be the central Parmenidean doctrine, that 'it cannot be said that anything is not.' This section is the lengthiest and most involved, but it also contains all the moves that appear to be important. Of the remaining sections, Section 3 exp]Mn.qthe principle: 'of what is, all that can be said is: it is,' Section 4 deals briefly with the remaining cosmology of "The Way of Truth," and Section 5 considers the question whether Parmenides himself believed the fantastic conclusions of his argument. There is a short postscript on a point of methodology. 1. A Word on 6v If we are to examine Parmenides' reasoning profitably, an indispensable pre1This paper wasprepared while the author was beneficiary of a Grant-in-Aid of Research from the American Council of Learned Societies, hereby gratefully acknowledged. [111] 112 HISTORY OF PHILOSOPHY liminary is to estabhsh at least a provisional reading for the Greek words translated "is" or "it is" (tar,v), "what is" or "being" (Sv,rb 5v), "to be" (alva0. For while it is evident enough that in his poem Parmenides purports to be delivering an insight of the utmost significance concerning rb tbv (as he calls it), still the construction which he puts upon the term and its cognates, and the understanding which he expects of his listener, are not so clear and have been topics of dispute. Especially notable, and often noted, is the fact that Parmenides' discussion of 'being' shows no sign of the conceptual distinction considered elementary nowadays, between the "is" linking subject and predicate and the "is" of existence; and in fact it needs no documentation here that this distinction was not reflected in either ordinary or philosophical Greek idiom until, at least, a much later date than his, the word tare expressing both concepts. Also highly visible in the poem is the abundance of occurrences of tare used absolutely, unaccompanied by any predicate expression. As a result of this last, the poem can create in the contemporary reader the impression that r5 tSv is being used to mean what is in the existential sense only, to mean what there is; indeed some students of the poem conclude not only that Parmenides... (shrink)

The paper discusses the utility of the notion of consciousness for the behavioural and brain sciences. It describes four distinctively different senses of 'conscious', and argues that to cope with the heterogeneous phenomena loosely indicated thereby, these sciences not only do not but should not discuss them in terms of 'consciousness'. It is thus suggested that 'the problem' allegedly posed to scientists by consciousness is unreal; one need neither adopt a realist stance with respect to it, nor include the term (...) and its cognates in the sciences' conceptual apparatus. The paper briefly examines Nagel's [1974] article, since this presents the strongest counter to the thesis proposed. (shrink)

The vast changes in family life-the rise of single, same-sex, and two-paycheck parents-have often been blamed for declining morality and unhappy children. Drawing upon pioneering research with the children of the gender revolution, Kathleen Gerson reveals that it is not a lack of family values, but rigid social and economic forces that make it difficult to live out those values. The Unfinished Revolution makes clear recommendations for a new flexibility at work and at home that benefits families, encourages a (...) thriving economy, and helps women and men integrate love and work. (shrink)

COVID-19 is a highly contagious infection with no proven treatment. Approximately 2.5% of patients need mechanical ventilation while their body fights the infection.1 Once COVID-19 patients reach the point of critical illness where ventilation is necessary, they tend to deteriorate quickly. During the pandemic, patients with other conditions may also present at the hospital needing emergency ventilation. But ventilation of a COVID-19 patient can last for 2–3 weeks. Accordingly, if all ventilators are in use, there will not be time for (...) patients to ‘queue up’ to wait for those who arrived earlier to recover. Those who need a ventilator will die if they do not receive access to one quickly. Many nations now face the prospect that they failed to prepare appropriately for this foreseen risk of pandemic (another issue worthy of legal analysis) and that their populations will need far more ventilators than the health service can supply. For many weeks, the UK has been anticipating a surge of COVID-19 infections that could leave patients queuing in hospitals for ICU care. Luckily, social distancing has ‘flattened the curve’ and this problem might not arise. There is still a degree of risk, however, and other countries will not be so lucky. At some point, during this pandemic or the next, all countries will need to answer hard questions about whether and when scarce ICU resources (such as ventilators, beds and staff) should be either withheld or withdrawn from certain groups of patients solely for the purpose of providing them to others. Attempts to answer these questions can be found in a wide range of ICU triage protocols and ethical guidance documents, many of which embrace the foundational principle of ‘save the most lives’. Unfortunately, this worthwhile goal has generated many suggestions that could violate the law. This article identifies …. (shrink)

In this classic work, often described as "The History of the Rise, Decline, and Fall of the Love Affair," Denis de Rougemont explores the psychology of love from the legend of Tristan and Isolde to Hollywood. At the heart of his ever-relevant inquiry is the inescapable conflict in the West between marriage and passion--the first associated with social and religious responsiblity and the second with anarchic, unappeasable love as celebrated by the troubadours of medieval Provence. These early poets, according to (...) de Rougemont, spoke the words of an Eros-centered theology, and it was through this "heresy" that a European vocabulary of mysticism flourished and that Western literature took on a new direction.Bringing together historical, religious, philosophical, and cultural dimensions, the author traces the evolution of Western romantic love from its literary beginnings as an awe-inspiring secret to its commercialization in the cinema. He seeks to restore the myth of love to its original integrity and concludes with a philosophical perspective on modern marriage. (shrink)