BackgroundUse of modified texture diets—thickening of liquids and modifying the texture of foods—in the hope of preventing aspiration, pneumonia and choking, has become central to the current management of dysphagia. The effectiveness of this intervention has been questioned. We examine requirements for a valid informed consent process for this approach and whether the need for informed consent for this treatment is always understood or applied by practitioners.Main textValid informed consent requires provision of accurate and balanced information, and that agreement is (...) given freely by someone who knows they have a choice. Current evidence, including surveys of practitioners and patients in different settings, suggests that practice in this area is often inadequate. This may be due to patients’ communication difficulties but also poor communication—and no real attempt to obtain consent—by practitioners before people are ‘put on’ modified texture diets. Even where discussion occurs, recommendations may be influenced by professional misconceptions about the efficacy of this treatment, which in turn may poison the well for the informed consent process. Patients cannot make appropriate decisions for themselves if the information provided is flawed and unbalanced. The voluntariness of patients’ decisions is also questionable if they are told ‘you must’, when ‘you might consider’ is more appropriate. Where the decision-making capacity of patients is in question, inappropriate judgements and recommendations may be made by substitute decision makers and courts unless based on accurate information.ConclusionResearch is required to examine the informed consent processes in different settings, but there is ample reason to suggest that current practice in this area is suboptimal. Staff need to reflect on their current practice regarding use of modified texture diets with an awareness of the current evidence and through the ‘lens’ of informed consent. Education is required for staff to clarify the importance of, and requirements for, valid informed consent and for decision making that reflects people’s preferences and values. (shrink)

Anxiety disorders represent the most common class of mental illness. In fact, approximately one-third of adults report clinically significant symptoms of anxiety (Kessler et al., 2012), of which sy...

Innovative modes of collaboration between archaeologists and Indigenous communities are taking shape in a great many contexts, in the process transforming conventional research practice. While critics object that these partnerships cannot but compromise the objectivity of archaeological science, many of the archaeologists involved argue that their research is substantially enriched by them. I counter objections raised by internal critics and crystalized in philosophical terms by Boghossian, disentangling several different kinds of pluralism evident in these projects and offering an analysis of (...) why they are epistemically productive when they succeed. My central thesis is that they illustrate the virtues of epistemic inclusion central to proceduralist accounts of objectivity, but I draw on the resources of feminist standpoint theory to motivate the extension of these social -cognitive norms beyond the confines of the scientific community. (shrink)

Linguists, biological anthropologists, and cognitive scientists come together in this book to explore the origins and early evolution of phonology, syntax, and semantics. They consider the nature of pre- and proto-linguistic communication, the internal and external triggers that led to its transformation into language, and whether and how language may be considered to have evolved after its inception. Evidence is drawn from many domains, including computer simulations of language emergence, the songs of finches, problem-solving abilities in monkeys, sign language, and (...) the structure of languages today. (shrink)

I argue that understanding why p involves a kind of intellectual know how and differsfrom both knowledge that p and knowledge why p (as they are standardly understood).I argue that understanding, in this sense, is valuable.

Intentional collective action -- Collective moral responsibility -- Collective guilt -- Individual responsibility for (and in) collective wrongs -- Collective obligation, individual obligation, and individual moral responsibility -- Individual moral responsibility in wrongful social practice.

Recently, the theory theory has led to much interesting research. However, this is the first book to look at the theory in extensive detail and to systematically contrast it with other theories.

Traditional accounts of the emergence of professional biology have privileged not only metropolis over province, but research over teaching and laboratory over museum. This paper seeks to supplement earlier studies of the ‘transformation of biology’ in the late nineteenth century by exploring in detail the developments within three biology departments in Northern English civic colleges. By outlining changes in the teaching practices, research topics and the accommodation of the departments, the authors demonstrate both locally contingent factors in their development and (...) continuities with existing traditions in natural history. The appointment of Arthur Milnes Marshall in preference to Louis Miall to the new zoology chair in Manchester in 1879 casts light on contemporary views of the laboratory and museum as ‘equal though different’. The transformation in biology, in Northern England at least, was shaped more by such local institutional changes than by a phoenix-like rise of the laboratory from the ashes of the museum—more by the rhetorical construction of a professional academic community than any dramatic shift in sites. In this period the biology laboratory supplemented, rather than eclipsed, the museum, and the dichotomy between the ‘naturalist’ and the ‘experimentalist’ was far from clear-cut. (shrink)

Standpoint theory is an explicitly political as well as social epistemology. It’s distinctive features are commitment to understand the social locations that shape the epistemic capacities and resources of individuals in structural terms, and a recognition that those who are marginalized within hierarchically structured systems of social differentiation are often epistemically advantaged. In some crucial domains they know more and know better as a contingent function of their situated experience and knowledge. This “inversion thesis” counters the alignment of social with (...) epistemic privilege. (shrink)

Although many of the congenital syndromes that used to be lethal no longer are, they are still routinely referred to as “lethal anomalies.” But the label is not only inaccurate, it is also dangerous: by portraying as a medical determination what is in fact a judgment about the child's quality of life, it wrests from the parents a decision that only the parents can make.

Psychological factors have long been associated with the onset, maintenance and exacerbation of many cutaneous disorders (Newell, 2000, p. 8; Papadopoulos, Bor & Legg, 1999, p. 107). Chronic cutaneous disease is often visible to others so that social factors in coping and adjustment are thus highly relevant (Papadopoulos, et al., 1999, p. 107). Psychological factors tend, however, to be overlooked in the dermatological treatment domain when the skin problem is not regarded as life threatening (MacGregor, 1990 as cited in Papadopoulos, (...) et al., 1999, p. 113). In 2004, at a meeting of the Editorial Board of Dermatology Nursing, the need for studies presenting the patient’s perspective on living with a skin disease was discussed. It was thought that qualitative exploration of the patient’s experience of cutaneous disease would provide medical and mental health care professionals with valuable insights and important information to help improve dermatology patient care (Hill, 2004, p. 399). More specifically, Papadopoulos et al. (1999, p. 122) posit that qualitative exploration of dermatological patients’ lived experience might help provide insight into the efficacy of coping strategies, the need for psychological counsel, and also the need for a more holistic understanding of this patient population rather than maintaining a dichotomous focus on either the mind or the body. Research in the field is currently characterised by (a) a predominance of quantitative studies, the design of which results in inevitable loss of in-depth information regarding the experiential world of sufferers of cutaneous disease (Hill, 2004, p. 399; Papadopoulos, et al., 1999, p. 122), and (b) a dearth of studies investigating the impact of disfiguring skin conditions on the self-concept. In order to address this lack, and simultaneously to contribute towards mapping the psychodermatological terrain in need of qualitative exploration, this paper attempts to integrate the findings of relevant studies in the fields of both dermatology and psychology, with specific focus on women suffering from psoriasis, a common chronic disorder of the skin, and the impact of this on the various dimensions of self. The primary aim of this paper is, however, to prompt qualitative - and, in particular, phenomenological - research in the area of body disfigurement and selfconcept in order to elucidate the lived experiences of people afflicted with disfiguring dermatological conditions, and as such to promote necessary change in the therapeutic domain. Indo-Pacific Journal of Phenomenology , Volume 6, Edition 1 May 2006. (shrink)

This paper argues that Spinoza does not take extension in space to be a fundamental property of physical things. This means that when Spinoza calls either substance or a mode “an Extended thing”, he does not mean that it is a thing extended in three dimensions. The argument proceeds by showing, first, that Spinoza does not associate extension in space with substance, and second, that finite bodies, or physical things, are not understood through the intellect when they are conceived as (...) extended in space. I conclude by articulating some suggestions about where we should go from here in trying to understand Spinoza’s account of the attribute of extension and of the physical world. (shrink)

We propose that children employ specialized cognitive systems that allow them to recover an accurate “causal map” of the world: an abstract, coherent, learned representation of the causal relations among events. This kind of knowledge can be perspicuously understood in terms of the formalism of directed graphical causal models, or “Bayes nets”. Children’s causal learning and inference may involve computations similar to those for learning causal Bayes nets and for predicting with them. Experimental results suggest that 2- to 4-year-old children (...) construct new causal maps and that their learning is consistent with the Bayes net formalism. (shrink)

According to policy makers, telemedicine offers “huge opportunities to improve the quality and accessibility of health services.” It is defined as diagnosis, treatment, and monitoring, with doctors and patients separated by space but mediated through information and communication technologies. This mediation is explored through an ethnography of a U.K. teledermatology clinic. Diagnostic image transfer enables medicine at a distance, as patients are removed from knowledge generation by concentrating their identities into images. Yet that form of identity allows images and the (...) expert gaze to be brought into potentially lifesaving proximity. Following Latour’s thread, images must be captured and then mobilized to the knowledge base, where they must be stabilized into standard diagnoses, then combined with different images, waiting lists, skin lesions, dermatologists, paper records, and beds, so that ultimately, outcomes are produced. This huge task requires new knowledges and a widening of agency that, if unacknowledged, may see telemedicine projects continue to founder. (shrink)

This is a bold and controversial feminist, philosophical critique of postmodernism. Whilst providing a brief and accessible introduction to postmodernist feminist thought, _Enlightened Women_ is also a unique defence of realism and enlightenment philosophy. The first half of the book covers an analysis of some of the most influential postmodernist theorists, such as _Luce Irigaray_ and _Judith Butler_. In the second half Alison Assiter advocates a return to modernism in feminism. She argues, against the current orthodoxy, that there can (...) be a distinction between "sex" and "gender". For students trying to pick their way through the maze of literature in the area of postmodernist feminism, _Enlightened Women_ is a concise guide to contemporary thought - as well as a radical contribution to the debate. (shrink)

In this paper we consider the prospects for an account of good argument that takes the character of the arguer into consideration. We conclude that although there is much to be gained by identifying the virtues of the good arguer and by considering the ways in which these virtues can be developed in ourselves and in others, virtue argumentation theory does not offer a plausible alternative definition of good argument.

This study examines business students’ ethical awareness for two virtues needed to maintain academic integrity, respect, and responsibility. Using the multidimensional ethics survey, five dimensions were measured for six scenarios representing student behaviors using Information Technology . The results indicate that students are ethically aware in respect situations, but are more neutral in responsibility situations. Of the five ethical dimensions, moral equity and relativism appear to be the strongest influences in academic integrity scenarios utilizing IT. This study provides guidance for (...) business professors in their pursuit of ethical excellence in the classroom and for researchers in search of greater understanding of ethical judgments of students. (shrink)

This chapter explores the suggestion that early attachment underpins the human capacity for empathy, and that empathy, in turn, is a condition of moral competence. We are disposed by nature to seek intimacy with our human conspecifics: the securely attached child learns that, whatever perils the world may hold, his well-being is shielded within the private sphere of personal intimacy. But why should secure attachment also favour—as it does—recognition of moral obligations towards those with whom we have no special standing (...) and share no personal destiny—recognition that the claims of persons as such merit our attention and regard? One answer to this question looks beyond the fact of secure attachment to a further psychological capacity, our capacity for empathy: secure attachment promotes susceptibility to empathy, and an appropriate susceptibility to empathy is a condition of basic moral competence. The chapter proposes that the deeper and more persisting significance of empathy to morality can be understood from a developmental perspective. Looking to mentalization-based attachment theory allows us to understand how empathic mirroring enters into our earliest intimate, interactions with other persons, securing our default commitment to recognizing their reality as bound up with our own. In this way, empathy constitutes one of the natural foundations on which the more complex architecture of moral experience is constructed. Attachment theory helps us to understand the indispensable role empathy plays at the beginning of the circuitous road to virtue. (shrink)

We standardly evaluate counterfactuals and abilities in temporally asymmetric terms—by keeping the past fixed and holding the future open. Only future events depend counterfactually on what happens now. Past events do not. Conversely, past events are relevant to what abilities one has now in a way that future events are not. Lewis, Sider and others continue to evaluate counterfactuals and abilities in temporally asymmetric terms, even in cases of backwards time travel. I’ll argue that we need more temporally neutral methods. (...) The past shouldn’t always be held fixed, because backwards time travel requires backwards counterfactual dependence. Future events should sometimes be held fixed, because they’re in the causal history of the past, and agents have evidence of them independently of their decisions now. We need temporally neutral methods to maintain connections between causation, counterfactuals and evidence, and if counterfactuals are used to explain the temporal asymmetry of causation. (shrink)

The book makes a new contribution to the contemporary debates on nihilism and the sacred. Drawing on an original interpretation of Richard Rorty’s writings, it challenges the orthodox treatment of nihilism as a malaise that human beings must overcome. Instead, nihilism should be framed as a problem for human culture to outgrow through pragmatism.

John Fischer and Mark Ravizza defend in this book a painstakingly constructed analysis of what they take to be a core condition of moral responsibility: the notion of guidance control. The volume usefully collects in one place ideas and arguments the authors have previously published in singly or jointly authored works on this and related topics, as well as various refinements to those views and some suggestive discussions that aim to show how their account of guidance control might fit into (...) a more comprehensive account of moral responsibility. (shrink)

Causes always seem to come prior to their effects. What might explain this asymmetry? Causation's temporal asymmetry isn't straightforwardly due to a temporal asymmetry in the laws of nature—the laws are, by and large, temporally symmetric. Nor does the asymmetry appear due to an asymmetry in time itself. This Element examines recent empirical attempts to explain the temporal asymmetry of causation: statistical mechanical accounts, agency accounts and fork asymmetry accounts. None of these accounts are complete yet and a full explanation (...) of the temporal asymmetry of causation will likely require contributions from all three programs. (shrink)

A number of modern theologians have concluded that the rise of natural science makes it necessary to give up the idea that God acts in particular ways to affect the course of events in the world. I reply to this claim, taking up the challenge to explain what might be meant by a ”special’ act of God. There are several ways to conceive of such acts, including the possibility that God might determine what is left determinable in the structures of (...) nature, e.g., at the quantum level. I address objections to this view, and consider metaphysical puzzles that it presents. (shrink)

In recent years several proposals to view reasoning with legal cases as theory construction have been advanced. The most detailed of these is that of Bench-Capon and Sartor, which uses facts, rules, values and preferences to build a theory designed to explain the decisions in a set of cases. In this paper we describe CATE (CAse Theory Editor), a tool intended to support the construction of theories as described by Bench-Capon and Sartor, and which produces executable code corresponding to a (...) theory. CATE has been used in a series of experiments intended to explore a number of issues relating to such theories, including how the theories should be constructed, how sets of values should be compared, and the representation of cases using structured values as opposed to factors. (shrink)

Analysis of online mathematics forums can help reveal how explanation is used by mathematicians; we contend that this use of explanation may help to provide an informal conceptualization of simplicity. We extracted six conjectures from recent philosophical work on the occurrence and characteristics of explanation in mathematics. We then tested these conjectures against a corpus derived from online mathematical discussions. To this end, we employed two techniques, one based on indicator terms, the other on a random sample of comments lacking (...) such indicators. Our findings suggest that explanation is widespread in mathematical practice and that it occurs not only in proofs but also in other mathematical contexts. Our work also provides further evidence for the utility of empirical methods in addressing philosophical problems. (shrink)

There are temporal asymmetries in our attitudes towards the past and future. For example, we judge that a given amount of work is worth twice as much if it is described as taking place in the future, compared to the past :796–801, 2008). Does this temporal value asymmetry support a tensed metaphysics? By getting clear on the asymmetry’s features, I’ll argue that it doesn’t. To support a tensed metaphysics, the value asymmetry would need to not vary with temporal distance, apply (...) equally to events concerning oneself and others, and be rational and judged to be so. But evidence suggests the value asymmetry lacks these features. There are, moreover, independent arguments against its rationality. The asymmetry’s features suggest instead that it arises as an emotion-driven generalisation from a temporal bias concerning our future actions. This explanation points towards mechanisms that can play a role in explaining other instances where we generalise about the past and future, and why we’re tempted towards metaphysical pictures of time. (shrink)

There are significant problems involved in determining the ontology of quantum field theory. An ontology involving particles seems to be ruled out due to the problem of defining localized position operators, issues involving interactions in QFT, and, perhaps, the appearance of unitarily inequivalent representations. While this might imply that fields are the most natural ontology for QFT, the wavefunctional interpretation of QFT has significant drawbacks. A modified field ontology is examined where determinables are assigned to open bounded regions of spacetime (...) instead of spacetime points. (shrink)

Human beings pose a problem for Descartes’ metaphysics. They seem to be more than a mere sum of their mental and bodily parts; human beings, Descartes insists, are unions of mind and body. But what does that union amount to? In the first, negative, part of this paper I argue that, by Descartes’ own lights, there is no way for us to answer this question if we are looking for a proper metaphysics of the union. Metaphysics is the job of (...) the intellect; it involves understanding. On Descartes’ considered view, we don’t understand the union; we feel it through the internal senses. In the second, positive, part of the paper I argue that, while Descartes does not give a properly metaphysical account of the union, he does provide a rich phenomenology of it that is of both theoretical and practical interest. Along the way, I suggest a phenomenological reading of a number of important passages that scholars have interpreted as Descartes’ attempt to provide a metaphysics of the union. (shrink)

Understanding causal structure is a central task of human cognition. Causal learning underpins the development of our concepts and categories, our intuitive theories, and our capacities for planning, imagination and inference. During the last few years, there has been an interdisciplinary revolution in our understanding of learning and reasoning: Researchers in philosophy, psychology, and computation have discovered new mechanisms for learning the causal structure of the world. This new work provides a rigorous, formal basis for theory theories of concepts and (...) cognitive development, and moreover, the causal learning mechanisms it has uncovered go dramatically beyond the traditional mechanisms of both nativist theories, such as modularity theories, and empiricist ones, such as association or connectionism. (shrink)

The Beloved Self is about the holy grail of moral philosophy, an argument against egoism that proves that we all have reasons to be moral. Part One introduces three different versions of egoism. Part Two looks at attempts to prove that egoism is false, and shows that even the more modest arguments that do not try to answer the egoist in her own terms seem to fail. But in part Three, Hills defends morality and develops a new problem for egoism, (...) an epistemological problem. She shows that it is not epistemically rational to believe the most plausible versions of egoism. The first part of the book will be most relevant to those interested in moral theory, as it contains detailed discussions of recent interpretations of virtue ethics and especially of Kant's moral theory. The second and third part of the book turn to epistemology, particularly moral epistemology, and include an account of the relationship between knowledge and action, a new theory of moral understanding, and a discussion of the epistemically rational response to various kinds of disagreement. Hills also defends a new account of virtue and of morally worthy action. (shrink)