Here we describe how more important findings were obtained in a delirium study by using an informal assessment of mental capacity, and, in those who lacked capacity, obtaining consent later when or if capacity returned or a proxy was found. From a total of 233 patients 23 patients lacked capacity as judged by our informal capacity judgment and 210 did not. Of those who lacked capacity, 13 agreed to enter in the study. Six of them regained capacity later. When these (...) 13 participants were excluded from analysis, significant findings were no longer evident. These results show that by the inclusion of subjects who lacked capacity the results of analyses of the condition from whish they suffer are altered. We suggest that this approach to the study of delirium is more ethical than the usual system of strict exclusion of people who lack capacity to give consent and for whom assent is not available. (shrink)

Legal frameworks are in place to protect those who lack the capacity to consent to research, such as the Mental Capacity Act in the UK. Assent is sought instead from a proxy, usually a relative. However, the same legislation may, perversely, affect the welfare of those who lack capacity and of others by hindering the process of recruitment into otherwise potentially beneficial research. In addition, the onus of responsibility is moved from those who know most about the study (ie, the (...) scientific community) to those who know less (the proxies). In this paper, we describe the characteristics of a sample at different stages of the recruitment process of an influenza vaccine-based randomised control trial in elderly care home residents (the FEVER study). 62% (602/968) of potential subjects lacked capacity but only 29% (80/277) of those actually randomised. Older age, being female and living in an Elderly Mentally Ill care home were the only variables associated with lacking capacity. Considering this was a study based in a care home setting where the prevalence of dementia approximates 80%, the trial, like many others, was thus significantly biased. We believe that difficulties seeking proxy assent contributed significantly to this problem. Further thought should be given to how assent to enter research for those who lack capacity should be provided, and we suggest avenues for further discussion such as independent risk/benefit expert panels. (shrink)

This article explores three ways in which physics may involve counterpossible reasoning. The first way arises when evaluating false theories: to say what the world would be like if the theory were true, we need to evaluate counterfactuals with physically impossible antecedents. The second way relates to the role of counterfactuals in characterizing causal structure: to say what causes what in physics, we need to make reference to physically impossible scenarios. The third way is novel: to model metaphysical dependence in (...) physics, we need to consider counterfactual consequences of metaphysical impossibilities. Physics accordingly bears substantial and surprising counterpossible commitments. (shrink)

Quantum physics is believed to be the fundamental theory underlying our understanding of the physical universe. However, it is based on concepts and principles that have always been difficult to understand and controversial in their interpretation. This book aims to explain these issues using a minimum of technical language and mathematics. After a brief introduction to the ideas of quantum physics, the problems of interpretation are identified and explained. The rest of the book surveys, describes and criticises a range of (...) suggestions that have been made with the aim of resolving these problems; these include the traditional, or 'Copenhagen' interpretation, the possible role of the conscious mind in measurement, and the postulate of parallel universes. This new edition has been revised throughout to take into account developments in this field over the past fifteen years, including the idea of 'consistent histories' to which a completely new chapter is devoted. (shrink)

Kierkegaard and Philosophy makes many of the most important papers on Kierkegaard available in one place for the first time. These seventeen essays, written over a period of over twenty years, have all been substantially revised or specially prepared for this collection, with a new introduction by the author. In the first part, Alastair Hannay concentrates on Kierkegaard's central philosophical writings, offering closely text-based accounts of the slient concepts Kierkegaard uses. The second part shows the relevance of other thinkers' (...) treatments of shared themes, pointing our where they differ from Kierkegaard. The concluding chapter provides a reason Kierkegaard himself would give for disagreeing with those who claim his texts are infinitely interpretable. Written by the world's foremost Kierkegaard scholar and translator, Kierkegaard and Philosophy is an indispensible resource for all students of Kierkegaard's work. (shrink)

From very early on, Western philosophers have been obsessed with the understanding of a relatively few works of philosophy which have played a disproportionately large and fundamental role in developing the Western philosophical canon, dominating the curriculum in the past and in the present; there is no indication that they will not do so in the future.Uses and Abuses of the Classics examines the various ways in which the different periods of the history of philosophy have approached these texts. The (...) editors have chosen for analysis some of the major philosophers from periods of the history of philosophy in which the interpretation of the classics has been particularly significant.Contributions to this book include entries on: Aristotle's reading of Plato; Averroes on Aristotle; Nietzsche on the Beginnings of Western Philosophy; and Thomas Aquinas's Commentary on Aristotle's Metaphysics. (shrink)

First Published in 2004. Routledge is an imprint of Taylor & Francis, an informa company.

Externalism in the philosophy of mind has been thought by many to pose a serious threat to the claim that subjects are in general authoritative with regard to certain of their own intentional states.¹ In a series of papers, Tyler Burge (1985_a_, 1985_b_, 1988, 1996) has argued that the distinctive entitlement or right that subjects have to self- knowledge in certain cases is compatible with externalism, since that entitlement is environmentally neutral, neutral with respect to the issue of the individuation (...) dependence of subjects' intentional states on factors beyond their bodies. His reason is that whereas externalism—the view that certain intentional states of persons are individuation-dependent on objects and/or phenomena external to their bodies—is a metaphysical thesis, authoritative self-knowledge is an epistemological matter. This being so, there is no reason to suppose that the two need conflict with one another. (shrink)

Deftly quilting themes of Latin American and feminist liberation theologies with those of philosophers such as Immanuel Kant and John Rawls, Alastair V. Campbell displays our rich interconnectedness and our moral responsibilities to one another. Suggesting that many American citizens are oppressed by our current health-care system, he contends that prior to questions of health-care allocation are questions of what we mean as a society by the term health--and how that term is inextricably linked to personal and social freedom (...) and liberation. In the forceful final chapter of the book, Campbell articulates ethical standards for just health-care delivery in the United States--standards that, above all, take account of deep religious faith and concern for one's neighbor. Health as Liberation is a critical analysis of justice and modern health care, and of a society's moral obligations to its citizens. (shrink)

This book equips readers with a sound understanding of the value-base of mental health care and provides them with the skills and knowledge to demystify complex values in decision-making in order to reach outcomes which are focused on the needs of service users. Engaging case examples and exercises link theory and practice throughout.

There is a systematic and suggestive analogy between grounding and causation. In my view, this analogy is no coincidence. Grounding and causation are alike because grounding is a type of causation: metaphysical causation. In this paper I defend the identification of grounding with metaphysical causation, drawing on the causation literature to explore systematic connections between grounding and metaphysical dependence counterfactuals, and I outline a non-reductive counterfactual theory of grounding along interventionist lines.

This book defends a radical new theory of contingency as a physical phenomenon. Drawing on the many-worlds approach to quantum theory and cutting-edge metaphysics and philosophy of science, it argues that quantum theories are best understood as telling us about the space of genuine possibilities, rather than as telling us solely about actuality. When quantum physics is taken seriously in the way first proposed by Hugh Everett III, it provides the resources for a new systematic metaphysical framework encompassing possibility, necessity, (...) actuality, chance, counterfactuals, and a host of related modal notions. -/- Rationalist metaphysicians argue that the metaphysics of modality is strictly prior to any scientific investigation; metaphysics establishes which worlds are possible, and physics merely checks which of these worlds is actual. Naturalistic metaphysicians respond that science may discover new possibilities and new impossibilities. This book's quantum theory of contingency takes naturalistic metaphysics one step further, allowing that science may discover what it is to be possible. As electromagnetism revealed the nature of light, as acoustics revealed the nature of sound, as statistical mechanics revealed the nature of heat, so quantum physics reveals the nature of contingency. (shrink)

‘Introspection’ is a term used by philosophers to refer to a special method or means by which one comes to know certain of one's own mental states; specifically, one's current conscious states. It derives from the Latin ‘spicere’, meaning ‘look’, and ‘intra’, meaning ‘within’; introspection is a process of looking inward. Introspectionist accounts of self-knowledge fall within the broader domain of theories of self-knowledge, understood as views about the nature of and basis for one's knowledge of one's own mental states, (...) including one's beliefs, desires, conscious thinkings, and sensations. Theories of self-knowledge are motivated by the apparent need to account for a number of striking features of at least some such knowledge, which ordinary empirical knowledge, including knowledge of the mental states of others, is typically thought to lack. (shrink)

This collection of essays explores the conflictual history and future implications of two important traditions of twentieth-century European thought: the ...

Media outlets, industry researchers, and policy-makers are today busily extolling new robotic advances that promise to transform agriculture, bringing us ever closer to self-farming farms. Yet such techno-optimist discourse ignores the cautionary lessons of past attempts to mechanize farms. Adapting the Social Construction of Technology framework, we trace the history of efforts to replace human labor with machine labor on fruit, nut, and vegetable farms in California between 1945 and 1980—a place and time during which a post-WWII culture of faith (...) in the beneficence of technoscience applications to agriculture reached an apex. The degree to which and forms whereby mechanization gains momentum hinges on whether, how, and among whom a technological frame for mimicking human capabilities and supplanting workers coalesces. These frames, we find, vary considerably across crops, reflecting complex interactions of biology, farmer and farm worker behavior, industry supply chains, agricultural research and development, financial flows, and beliefs about labor, race, gender, and immigration. To tease out these complex dynamics, we draw directly from archival evidence to follow the development of cultivation and harvest machines through four cases spanning a spectrum of outcomes—tomatoes, nuts, peaches, and lettuce. In comparing across these cases, we find that although agricultural engineers, scientists, and their boosters framed mechanization as a triumphal narrative of progress in ‘human vs. nature’ conflicts, this techno-optimist rhetoric camouflaged deeper ‘human vs. human’ conflicts, particularly among agribusiness, farmers, and farm workers. We conclude with several insights that this historical study brings to the study of agricultural automation today. (shrink)

The evolutionary framework suggested by Müller & Schumann (M&S) can be extended further by considering drug-taking in terms of Niche Construction Theory (NCT). It is suggested here that genetic and environmental components of addiction are modified by cultural acceptance of the advantages of non-addicted drug taking and the legitimate supply of performance-enhancing drugs. This may then reduce the prevalence of addiction.

This article examines an omission in the study of discretionary time that bears on proposals currently being evaluated in this part of political philosophy. Specifically, this is the tendency in many jobs for work time to bleed into what is meant to be protected or discretionary time. I refer to this phenomenon as the relative proximity of labour and capital, which has become more prevalent in the labour market due to increased use of mobile communications technology. Ignored by the literature (...) is the fact that whether a job exhibits a high degree of proximity of labour and capital will influence workers' access to their discretionary time entitlements, including policies such as workplace flexibility and the four-day week. To account for this, I provide a descriptive and normative account of the proximity of labour and capital, in response to which I propose a remedial policy that provides workers with greater autonomy over how and when they take up their discretionary time entitlements. (shrink)

This paper outlines a non-reductive counterfactual account of grounding along interventionist lines, and uses the account to argue that taking grounding seriously requires ascribing non-trivial truth-conditions to a range of counterpossible counterfactuals. This result allows for a diagnosis of a route to scepticism about grounding, as deriving at least in part from scepticism about non-trivial counterpossible truth and falsity.

This volume explores the ethical dimensions of a wide selection of philosophical and theological topics in Aquinas's texts.

Explores the complexity of truth and the ways that people take advantage of this complexity to use and abuse neutral truths to suit their own agendas in politics, business, the media, and everyday life. -- Provided by publisher.

This collection contains twenty-one thought-provoking essays on the controversies surrounding the moral and legal distinctions between euthanasia and "letting die." Since public awareness of this issue has increased this second edition includes nine entirely new essays which bring the treatment of the subject up-to-date. The urgency of this issue can be gauged in recent developments such as the legalization of physician-assisted suicide in the Netherlands, "how-to" manuals topping the bestseller charts in the United States, and the many headlines devoted to (...) Dr. Jack Kevorkian, who has assisted dozens of patients to die. The essays address the range of questions involved in this issue pertaining especially to the fields of medical ethics, public policymaking, and social philosophy. The discussions consider the decisions facing medical and public policymakers, how those decisions will affect the elderly and terminally ill, and the medical and legal ramifications for patients in a permanently vegetative state, as well as issues of parent/infant rights. The book is divided into two sections. The first, "Euthanasia and the Termination of Life-Prolonging Treatment" includes an examination of the 1976 Karen Quinlan Supreme Court decision and selections from the 1990 Supreme Court decision in the case of Nancy Cruzan. Featured are articles by law professor George Fletcher and philosophers Michael Tooley, James Rachels, and Bonnie Steinbock, with new articles by Rachels, and Thomas Sullivan. The second section, "Philosophical Considerations," probes more deeply into the theoretical issues raised by the killing/letting die controversy, illustrating exceptionally well the dispute between two rival theories of ethics, consequentialism and deontology. It also includes a corpus of the standard thought on the debate by Jonathan Bennet, Daniel Dinello, Jeffrie Murphy, John Harris, Philipa Foot, Richard Trammell, and N. Ann Davis, and adds articles new to this edition by Bennett, Foot, Warren Quinn, Jeff McMahan, and Judith Lichtenberg. (shrink)