Among philosophers, there are at least two prevalent views about the core concept of intentional action. View I (Adams 1986, 1997; McCann 1986) holds that an agent S intentionally does an action A only if S intends to do A. View II (Bratman 1987; Harman 1976; and Mele 1992) holds that there are cases where S intentionally does A without intending to do A, as long as doing A is foreseen and S is willing to accept A as a consequence (...) of S’s action. Joshua Knobe (2003a) presents intriguing data that may be taken to support the second view.1 Knobe’s data show an asymmetry in folk judgements. People are more inclined to judge that S did A intentionally, even when not intended, if A was perceived as causing a harm (e.g. harming the environment). There is an asymmetry because people are not inclined to see S’s action as intentional, when not intended, if A is perceived as causing a benefit (e.g. helping the environment). In this paper we will discuss Knobe’s results in detail. We will raise the question of whether his ordinary language surveys of folk judgments have accessed core concepts of intentional action. We suspect that instead Knobe’s surveys are tapping into pragmatic aspects of intentional language and its role in moral praise and blame. We will suggest alternative surveys that we plan to conduct to get at this difference, and we will attempt to explain the pragmatic usage of intentional language. (shrink)

In an age of professionalization and specialization, the practice of clinical ethics is facing an identity crisis. Are clinical ethicists moral experts, ethics experts, or merely quasi-lawyers giving legal advice? Are they extensions of the hospital, always working to advance the hospital’s interests? Or is there another option? Since 1998, when the American Society for Bioethics and Humanities first issued its Core Competencies for Healthcare Ethics Consultation, there has been debate about the role of standardization and proceduralism in clinical ethics (...) consultation. Now, as ASBH continues to move forward with its credentialing program, proceduralism in clinical ethics must be critically examined. In this paper, I argue that the proceduralist approach to clinical ethics consultation, as espoused by the ASBH’s call for credentialing, creates a demeaning experience for all parties involved and precludes goods internal to the practice of clinical ethics consultation from being actualized. As a practice embedded in medicine and in institutions such as the hospital, clinical ethics consultation must define and examine its own goods in order to bring about more than a sterile, law-like solution to difficult moral quandaries, as these sterile solutions leave patients, families, and providers unsatisfied, abandoned, and disappointed. Thus, in an effort to push back against this proceduralism in clinical ethics consultation, I will offer a preliminary exploration of what these goods might be. (shrink)

Abstract The aim of this article is to make use of recent research on `political eros ' in order to clarify the connection that Plato establishes between eros and tyranny in Republic IX, specifically by elucidating the intertextuality between Plato's work and the various historical accounts of Alcibiades. An examination of the lexicon used in these accounts will allow us to resolve certain interpretive difficulties that, to my knowledge, no other commentator has elucidated: why does Socrates blame eros for the (...) decline from democracy into tyranny? What does he mean by ` eros ' here, and what link existed between eros and tyranny in the minds of his contemporaries? And finally, who are the mysterious `tyrant-makers' ( turannopoioí , 572e5-6) who, according to Socrates, introduce a destructive eros in the soul of the future tyrant? After a careful examination of the passage from book IX on the genesis of the tyrannical man (focused on the last stage of the metamorphosis, which is concerned with éros túrannos , 572d-573b), I will offer answers to these questions by turning to the writings of Thucydides, Aristophanes and Plutarch while examining the portrait of Alcibiades that Plato paints in the Alcibiades I and Symposium. (shrink)

Arguments for what consent is often appeal to its functions. For instance, some argue that because consent functions to express the consent-giver’s autonomous control over her normative boundaries, consent must consist in a mental state. In this paper, I argue that consent has an often-overlooked function and that its having this function has consequences for our views of what consent is. I argue that consent has a relationship-shaping function: acts of consent can alter and enable personal relationships. This function grounds (...) an argument for the following claim: some acts of consent cannot be morally transformative unless there is uptake, or acceptance, or cooperation, on the recipient’s part. At least some acts of consent need to be “cosigned” by both parties. This rules out what I call “unilateral” conceptions of consent, according to which consent can always be given by the giver alone and nobody else needs to enter the picture. (shrink)

In this article I employ Deleuzian theory in an exploration of men’s and women’s experiences of sexuality and sexual relations when encountering erectile difficulties and/or using sexuopharmaceuticals such as Viagra (sildenafil). I analyse the ways in which accounts of the function of Viagra-assisted erections can be seen to restore or re-establish previous sexual conventions or patterns (in Deleuzian terms, to ‘re-territorialize’ desire in ‘molar’ directions), and the ways in which Viagra use may change or challenge such patterns. Also examined are (...) the alternative stories of those for whom Viagra hasn’t ‘worked’; these accounts demonstrate how the persistence of erectile difficulties produces positive opportunities for experimentation, creativity and transformation in the realm of the erotic. (shrink)

Every day around the country, patients are discharged from hospitals without difficulty, as the interests of the hospital and the patient tend to align: both the hospital and the patient want the patient to leave and go to a setting that will promote the patient’s continued recovery. In some cases, however, this usually routine process does not go quite as smoothly. Patients may not want to leave the hospital, or they may insist on an unsafe discharge plan. In other cases, (...) there may simply be no good place for the patient to go. These complex hospital discharge situations often involve ethical, legal, financial, and practical considerations, but the ethical issues inherent in these dilemmas have received only sporadic attention from clinical ethicists at best, leaving patients, providers, administrators, and caregivers unsure about what to do. When the ethical issues are in fact brought to light, analysis usually proceeds based on a consideration of the principles of autonomy, beneficence, nonmaleficence, and justice. However, principled analysis often fails to present patients and providers with a satisfactory solution, as the principles inevitably conflict. In this paper, I argue that difficult discharges are ethical dilemmas worthy of scholarly attention that goes beyond principlism, and I argue that providers and those involved in discharge planning ought to cultivate what philosopher Alasdair MacIntyre calls “virtues of acknowledged dependence” in order to care for these patients and their families. I first trace the current conversation about difficult discharge and show that the principled approach to resolving discharge dilemmas is not sufficient. I then argue that a new approach is needed, and to that end, I offer practical ways in which MacIntyre’s account of the virtues of acknowledged dependence may help patients, providers, and family members to navigate issues of difficult discharge. (shrink)

In many ways, grief is thought to be outside the realm of bioethics and clinical ethics, and grieving patients or family members may be passed off to grief counselors or therapists. Yet grief can play a particularly poignant role in the ethical encounter, especially in cases of brain death, where the line between life and death has been blurred. Although brain death is legally and medically recognized as death in the United States and elsewhere, the concept has been contentious since (...) its inception in 1968. Yet in most cases, families are not allowed to reject the determination of brain death. Apart from religious exemptions, families have no recourse to reject this controversial determination of death. This paper explores the role of grief in brain death determinations and argues that bioethics has failed to address the complexity of grief in determinations of brain death. Grief ought to have epistemological weight in brain death determinations because of the contested nature of the diagnosis and the unique ways in which grief informs the situation. Thus, I argue that, in some rare cases, reasonable accommodation policies should be expanded to allow for refusals of brain death determinations based on the emotional and moral force of grief. By drawing on ethnographic accounts of grief in other cultures, I problematize the current procedural and linear understandings of grief in brain death determinations, and I conclude by offering a new way in which to understand the case of Jahi McMath. (shrink)

In many ways, grief is thought to be outside the realm of bioethics and clinical ethics, and grieving patients or family members may be passed off to grief counselors or therapists. Yet grief can play a particularly poignant role in the ethical encounter, especially in cases of brain death, where the line between life and death has been blurred. Although brain death is legally and medically recognized as death in the United States and elsewhere, the concept has been contentious since (...) its inception in 1968. Yet in most cases, families are not allowed to reject the determination of brain death. Apart from religious exemptions, families have no recourse to reject this controversial determination of death. This paper explores the role of grief in brain death determinations and argues that bioethics has failed to address the complexity of grief in determinations of brain death. Grief ought to have epistemological weight in brain death determinations because of the contested nature of the diagnosis and the unique ways in which grief informs the situation. Thus, I argue that, in some rare cases, reasonable accommodation policies should be expanded to allow for refusals of brain death determinations based on the emotional and moral force of grief. By drawing on ethnographic accounts of grief in other cultures, I problematize the current procedural and linear understandings of grief in brain death determinations, and I conclude by offering a new way in which to understand the case of Jahi McMath. (shrink)

In many ways, grief is thought to be outside the realm of bioethics and clinical ethics, and grieving patients or family members may be passed off to grief counselors or therapists. Yet grief can play a particularly poignant role in the ethical encounter, especially in cases of brain death, where the line between life and death has been blurred. Although brain death is legally and medically recognized as death in the United States and elsewhere, the concept has been contentious since (...) its inception in 1968. Yet in most cases, families are not allowed to reject the determination of brain death. Apart from religious exemptions, families have no recourse to reject this controversial determination of death. This paper explores the role of grief in brain death determinations and argues that bioethics has failed to address the complexity of grief in determinations of brain death. Grief ought to have epistemological weight in brain death determinations because of the contested nature of the diagnosis and the unique ways in which grief informs the situation. Thus, I argue that, in some rare cases, reasonable accommodation policies should be expanded to allow for refusals of brain death determinations based on the emotional and moral force of grief. By drawing on ethnographic accounts of grief in other cultures, I problematize the current procedural and linear understandings of grief in brain death determinations, and I conclude by offering a new way in which to understand the case of Jahi McMath. (shrink)

Moral distress is prevalent within the neonatal intensive care unit (NICU) and can negatively affect clinicians. Studies have evaluated the causes of moral distress and interventions to mitigate it...

In this paper I shall do three things. Firstly , I shall distinguish between three senses of “imagine”: one in which the word is used to report the occurrence of mental imagery; a second in which “imagined” is used as substantially equivalent to “thought”; and a third in which “imagine” is used as substantially equivalent to “suppose.” Secondly , I shall discuss Hume's thesis about imagination: both because, although this is set out as a plausible generalization about psychology, it nevertheless (...) seems to me that Hume dealt with a central philosophical problem concerning imagination—the relation of descriptions to imagery—in a way that is suggestive and fruitful; and—the main reason for mentioning Hume—because a study of the relation between imagining and imagining will help us to reinterpret his thesis from a mistaken one about psychology into a correct one about logic and language. Thirdly , I shall give thecentral arguments and the conclusion of the chapter on Imagination in The Concept of Mind , and comment on them. (shrink)

In principle Claude Bernard criticizes historical reflection, which he character- izes as a waste of time. But in spite of strong statements condemning it, Bernard makes use of history frequently and in several different ways. The coexistence of this openly antihistorical stance with a use of the historical perspective poses a problem. I will try to show that these two attitudes lead toward a common goal: promoting science. They combine to create a broad strategy that contributed a great deal to (...) the development of scientism in the nineteenth century. Bernard's arguments may be one of the sources of the distrust some scientists still feel toward the history of science. (shrink)

I examine the roles of traditional Native American women with regard to their impact on maintaining appropriate spiritual, cultural, and physical relationships with the natural world and discuss lessons that ecophilosphers might find useful in reexamining their own spiritual, cultural, and physical relationships.

Sophocles's Antigone continues to attract attention for its portrayal of the themes of moral agency and sexual difference. In this paper I argue that the contradictory factors which constitute Antigone's social identity work against the possibility of assessing her actions as either "virtuous" or not. I challenge readings of the play which suggest either that individual moral agency is sexually neutral or that women's action is necessarily and simply in direct opposition to the interests of the public sphere.

I examine the roles of traditional Native American women with regard to their impact on maintaining appropriate spiritual, cultural, and physical relationships with the natural world and discuss lessons that ecophilosphers might find useful in reexamining their own spiritual, cultural, and physical relationships.

Tome I. Politique des savoirs. Science(s) et religion. -- tome II. Pouvoirs : politique intérieure et politique extérieure.

Justice requires that public policy improve the lives of disadvantaged members of society. Dementia is a source of disadvantage, and a growing global public health challenge. This article examines the theoretical and ethical connections between theories of justice and public dementia policy. Disability in general, and dementia in particular, poses important challenges for theories of justice, especially social contract theories. First, the article argues that non-contractarian accounts of justice such as the Capabilities and Disadvantage approaches are better equipped than their (...) contractarian counterparts to analyse issues of justice and dementia. Secondly, using a capabilities framework, I analyse original empirical data from qualitative interviews and discussion groups with health and social care professionals. The article concludes that social connection is a ‘fertile functioning’—a multiplier of advantage that enables people to live well with dementia together—and should therefore be a priority for public dementia policy. (shrink)

These lectures [FN#1: Delivered at the 32nd Anniversary of the Theosophical Society held at Benares, on Dec. 27th, 28th, 29th, and 30th, 1907.] are intended to give an outline of Yoga, in order to prepare the student to take up, for practical purposes, the Yoga sutras of Patanjali, the chief treatise on Yoga. I have on hand, with my friend Bhagavan Das as collaborateur, a translation of these Sutras, with Vyasa's commentary, and a further commentary and elucidation written in the (...) light of Theosophy.[FN#2: These have never been finished or printed.] To prepare the student for the mastering of that more difficult task, these lectures were designed; hence the many references to Patanjali. They may, however, also serve to give to the ordinary lay reader some idea of the Science of sciences, and perhaps to allure a few towards its study. Annie Besant. (shrink)

Informed consent to therapy is the legal doctrine which imposes on a physician the duty to explain the nature and risks of a proposed treatment so the patient can make an informed decision whether to undergo the treatment. The doctrine has spawned tremendous controversy in the legal and medical professions.In this paper I examine the doctrine of informed consent as developed by the courts. The thrust of my criticism is that as the doctrine has been developed, it significantly undercuts individual (...) autonomy. Several modifications are suggested which would provide more support for autonomy interests. (shrink)

Informed consent to therapy is the legal doctrine which imposes on a physician the duty to explain the nature and risks of a proposed treatment so the patient can make an informed decision whether to undergo the treatment. The doctrine has spawned tremendous controversy in the legal and medical professions.In this paper I examine the doctrine of informed consent as developed by the courts. The thrust of my criticism is that as the doctrine has been developed, it significantly undercuts individual (...) autonomy. Several modifications are suggested which would provide more support for autonomy interests. (shrink)

In an earlier paper ("knowledge, Belief, And rationality" "journal of philosophy", Lxxiv, 1977, Pages 217-225), I argued that the relation of knowledge and belief was a normative relation, Not one of entailment. Kenneth stern ("knowledge and rationality" "philosophical studies", Volume 35, 1979, Pages 213-216) attacked my theory. In the present paper I reply to his arguments.

In the coming months and years, the left faces a historic juncture. On the one hand, racist violence is on the rise across the West, and the political class seems intent on mobilising both overt and subtle racism. On the other hand, strategies of anti-racist organising, which have developed on both sides of the Atlantic, have reached a theoretical impasse. I argue that now, more than ever, a serious project of historical and intellectual retrieval is necessary. This article interrogates the (...) theoretical limitations of ‘anti-blackness’ as an analysis of racialised oppression. Through the thought of Frantz Fanon and Steve Biko, among others, I argue that theories of ‘anti-blackness’, specifically those rooted in Afro-pessimism, are predicated on a theoretical shift away from relational social theory to identitarian essentialism which obscures, rather than illuminates, the processes of racialisation which undergird racial oppression. (shrink)

When publishing his first book anonymously at Leyden in 1637, Descartes showed his deep interest in medicine. Part five of the Discourse on Method offers a detailed account of the movement of the heart and discusses Harvey’s discovery of the circulation of blood. We should note that in the margins of the Discourse on Method, William Harvey’s name is mentioned in Latin and so too is the title De motu cordis. Furthermore, in the text, Descartes speaks of “an English physician, (...) who must be praised for having broken the ice” on the circulation of the blood. Harvey is indeed the only author who is mentioned by name in the Discourse, and his name is mentioned with the respect due to a genuine discoverer. These pages in the fifth part of the Discourse offer a totally new way of dealing with medical questions in the first part of the seventeenth century. I will consider here the Descartes-Harvey debate on the cause of the movement of the heart and Descartes’ approbation of Harvey’s discovery of the circulation of the blood. Yet, the medical context of the seventeenth century must be taken into account if we are properly to understand Descartes’ attitude towards Harvey, as well as the medical goals that Descartes had in mind when he attempted to explain the movement of the heart. (shrink)

Rare diseases, defined as having a prevalence inferior to 1/2000, are poorly understood scientifically and medically. Appropriate diagnoses and treatments are scarce, adding to the burden of living with chronic medical conditions. The moral significance of rare disease experiences is often overlooked in qualitative studies conducted with adults living with rare diseases. The concept of morally problematic situations arising from pragmatist ethics shows promise in understanding these experiences. The objectives of this study were to (1) acquire an in-depth understanding of (...) morally problematic situations experienced by adults living with rare diseases in the province of Québec and (2) to develop an integrative model of the concept of morally problematic situations. To this end, an online survey targeting this population was developed through a participatory action research project. Respondents provided 90 long testimonies on the most important morally problematic situations they faced, often in healthcare settings. An integrative model was developed based on various qualitative analyses of these testimonies and relevant literature. The integrative model showcases that morally problematic situations have causes (i.e., contextual and relational factors, personal factors, jeopardized valuations), have affective repercussions (i.e., emotions and feelings, internal tensions), prompt action (i.e., through empowerment strategies leading to the evolution of situations), and elicit outcomes (i.e., factual consequences, residual emotions and feelings, positive or negative resolutions). In sum, this study advances understanding of the moral experiences of adults living with rare diseases while proposing a comprehensive conceptual tool to guide future empirical bioethics research on moral experiences. (shrink)

The inaugural collection in an exciting new exchange between philosophers and geographers, this volume provides interdisciplinary approaches to the environment as space, place, and idea. Never before have philosophers and geographers approached each other's subjects in such a strong spirit of mutual understanding. The result is a concrete exploration of the human-nature relationship that embraces strong normative approaches to environmental problems.

Mastery imagery (i.e., images of being in control and coping in difficult situations) is used to regulate anxiety. The ability to image this content is associated with trait confidence and anxiety, but research examining mastery imagery ability's association with confidence and anxiety in response to a stressful event is scant. The present study examined whether trait mastery imagery ability mediated the relationship between confidence and anxiety, and the subsequent associations on performance in response to an acute psychological stress. Participants (N= (...) 130; 55% male;Mage= 19.94 years;SD= 1.07 years) completed assessments of mastery imagery ability and engaged in a standardized acute psychological stress task. Immediately prior to the task, confidence, cognitive and somatic anxiety intensity, and interpretation of anxiety symptoms regarding the task were assessed. Path analyses supported a model whereby mastery imagery ability mediated the relationship between confidence and cognitive and somatic anxiety interpretation. Greater mastery imagery ability and confidence were both directly associated with better performance on the stress task. Mastery imagery ability may help individuals experience more facilitative anxiety and perform better during stressful tasks. Improving mastery imagery ability by enhancing self-confidence may help individuals successfully cope with anxiety elicited during stressful situations. (shrink)

BackgroundChildhood abuse increases risk for high levels of distress in response to future stressors. Interpersonal social support is protective for health, particularly during stress, and may be particularly beneficial for individuals who experienced childhood abuse.ObjectiveInvestigate whether childhood abuse predicts levels of posttraumatic stress disorder (PTSD) symptoms related to the COVID-19 pandemic, and test whether the perceived availability of social companionship preceding the pandemic moderates this relationship.MethodsDuring Phase 1, adults (N= 120; AgeM[SD] = 19.4 [0.94]) completed a retrospective measure of childhood (...) adversity along with a measure of perceived availability of opportunities for social engagement immediately preceding the pandemic. Two weeks after the COVID-19 pandemic declaration, participants completed the Impact of Event Scale-Revised (IES-R) with respect to the pandemic. Hierarchical linear regression analyses examined the interaction between childhood abuse and the perceived availability of social companionship preceding the pandemic as a predictor of PTSD symptoms.ResultsAdjusting for covariates, the interaction between childhood abuse and perceived availability of others to engage with before the onset of the pandemic was a significant predictor of IES-hyperarousal (β = −0.19,t= −2.06,p= 0.04, ΔR2= 0.032, CI: [−0.31 to −0.01]).ConclusionLevels of perceived opportunities for social companionship before the pandemic associates with levels of hyperarousal related to the pandemic, particularly for individuals who experienced high levels of childhood abuse. More research is needed to understand how to mitigate the higher levels of distress related to the pandemic for these individuals in order to reduce risk for future psychiatric disorders. (shrink)

Intrinsic gait variability, i.e., fluctuations in the regularity of gait patterns between repetitive cycles, is inherent to the sensorimotor system and influenced by factors such as age and pathology. Increased GV is associated with gait impairments in individuals with cerebral palsy and has been mainly studied based on spatiotemporal parameters. The present study aimed to describe kinematic GV in young people with CP and its associations with clinical impairments [i.e., passive range of motion, muscle weakness, reduced selective motor control, and (...) spasticity]. This retrospective study included 177 participants with CP representing 289 clinical gait analyses [n = 172 for unilateral CP vs. 117 for bilateral CP ]. As variability metrics, Root Mean Square Deviation for nine lower-limb kinematic parameters and Gait Standard Deviation – as composite score of the kinematic parameters – were computed for the affected and most affected side, respectively, as defined by clinical scores. GaitSD was then computed for the non/less-affected side for between leg comparisons. Uni- and multivariate linear regressions were subsequently performed on GaitSD of the affected/most affected side with all clinical impairments as independent variables. Highest RMSD were found in the transverse plane, for distal joints in the sagittal plane and for foot progression. GaitSD was not different between uCP and bCP but higher in the non-affected vs. affected side in uCP. GaitSD was associated with age, gait deviation index, muscle weakness, selectivity, and pROM. After adjustment for age and GDI, GaitSD remained associated with muscle weakness and selectivity. Kinematic GV can be expressed as global indicator of variability in young people with CP given the strong correlation of RMSD for lower-limb kinematic parameters. In terms of asymmetry, increased variability of the non-affected vs. affected side may indicate contralateral compensation mechanisms in uCP. Notably muscle weakness and selectivity – but not spasticity – were associated with GaitSD. Further studies need to explore the clinical relevance of kinematic GV in CP to support the interpretation of clinical gait analyses and therapeutic decision-making. (shrink)

A partire dal XX secolo si è fatta strada l’idea che l’istituzione di tribunali penali internazionali sia un fondamentale e necessario contributo al processo di ricostruzione della pace in contesti post-bellici. Attraverso l’imparzialità nell’individuazione delle colpe e nella distribuzione delle pene, i tribunali penali internazionali sarebbero in grado, secondo questa linea interpretativa, di sopire odi e divisioni, di scoraggiare la commissione di ulteriori crimini e di porre così le basi per una nuova convivenza pacifica. Questa fiducia nella funzione pacificatrice del (...) diritto internazionale penale ne ha sostenuto lo sviluppo storico. Sulla base di questa funzione il Consiglio di Sicurezza ha motivato la creazione di tribunali penali internazionali negli anni Novanta. L’atteggiamento del Consiglio di Sicurezza nei confronti del rapporto tra giurisdizioni penali internazionali e pace non si è però mantenuto lineare nel tempo. Il Consiglio di Sicurezza ha infatti mostrato successivamente di nutrire scarsa fiducia nella funzione pacificatrice del diritto internazionale penale e talvolta di ritenere che i procedimenti penali internazionali possano ostacolare il processo di pace. Il saggio indaga questo complesso rapporto e le ambiguità dell'atteggiamento del Consiglio di Sicurezza rispetto ai tribunali penali internazionali. (shrink)

The aim of the paper is to distinguish and explain some imprecise expressions indicated by prof. Anna Jedynak. Moreover the paper is focused on the fundamental disagreement between the author and his critic, which is the meaning of the term "incommensurability".