We reflect, using a vignette, on conceptual tensions and the value judgements that lie behind difficult decisions about whether or not the older person with dementia should return home or move into long-term care following hospital admission. The paper seeks, first, to expose some of the difficulties arising from the assessment of residence capacity, particularly around the nature of evaluative judgements and conceptual tensions inherent in the legal approach to capacity. Secondly, we consider the assessment of best interests around place (...) of residence, which demonstrates significant conceptual tensions. In addition, ‘best interests’ raise issues around the perception of risk and the perceptions of the family and crucially involve the notions of autonomy and trust. Finally, we not only gesture at some practical considerations based on insights from values-based medicine, but also make the suggestion that we require tighter functional assessments of residence capacity coupled with broader judgements about best interests. (shrink)

BackgroundConcerns about decision making related to resuscitation have led to two important challenges in the courts resulting in new legal precedents for decision-making practice. Systematic research investigating the experiences of doctors involved in decisions about resuscitation in light of the recent changes in law remains lacking.AimTo analyse the practice of resuscitation decision making on hospital wards from the perspectives of doctors.DesignThe data presented in this paper were collected as part of a wider research study of end-of-life care in an acute (...) hospital setting. Data collection comprised ethnographic non-participant observation on two acute hospital wards and individual interviews with patients, relatives and healthcare professionals caring for patients thought to be approaching the end of life. Data were analysed using a constructivist grounded theory approach.ResultsDiscussions and decision making about resuscitation present many challenges for those involved on acute medical wards. The data highlight the potential for multiple interpretations of legal precedents, creating misunderstandings that may impact patient care in less positive ways.ConclusionsThis paper provides unique insights into how doctors respond to the changing medico-legal culture and the subsequent effects on patient care. It demonstrates how the juridification of medical practice can occur. It highlights the potential benefit of a structure to support clinicians, patients and relatives in discussing and navigating decisions around care at the end of life in line with the patient’s wishes and preferences. Recommendations for future research are made and legal ramifications are discussed. (shrink)

Aristotle's defense of Dunamis -- Power and potentiality -- Rational and nonrational powers -- The priority of actuality -- Ontological hierarchy, normativity, and gender.

Two recent reports of mice homozygously deleted for cyclin D1 provide unequivocal evidence that the critical G1 cyclin, cyclin D1, is by itself rate‐limiting for growth in some mammalian tissues(1,2). Cyclin D1 knockout mice are small and exhibit behavioral abnormalities. Specific hypoplasias of retinal and mammary tissues suggest an unusual dependence on cyclin D1 function for tissue growth in those organs. The odd coincidences that cyclin D1 functions as the retinoblastoma gene kinase, together with associations between increased cyclin D1 expression (...) and breast cancer, suggest, but do not prove, a special function of cyclin D1 in those tissues. (shrink)

With Hegel’s metaphysics attracting renewed attention, it is time to address a long-standing criticism: Scholars from Marx to Popper and Habermas have worried that Hegel’s metaphysics has anti-individualist and authoritarian implications, which are particularly pronounced in his Philosophy of History, since Hegel identifies historical progress with reason imposing itself on individuals. Rather than proposing an alternative non-metaphysical conception of reason, as Pippin or Brandom have done, this article argues that critics are broadly right in their metaphysical reading of Hegel’s central (...) concepts. However, they are mistaken about what Hegel’s approach entails, when one examines the specific types of states discussed by the philosopher in his Philosophy of History. Even on a traditional metaphysical reading, Hegel is not only non-authoritarian; he also makes a powerful argument concerning freedom, whereupon the freest society involves collective oversight and the shaping of social structures so as to ensure that they benefit everybody. (shrink)

This article discusses an interpretation of Kant's conception of transcendental subjectivity, which manages to avoid many of the concerns that have been raised by analytic interpreters over this doctrine. It is an interpretation put forward by selected C19 and early C20 neo-Kantian writers. The article starts out by offering a neo-Kantian interpretation of the object as something that is constituted by the categories and that serves as a standard of truth within a theory of judgment. The second part explicates transcendental (...) subjectivity as the system of categories, which is self-referential and constitutes objects, in order to then evaluate this conception by means of a comparison with Hegel's absolute subject. Rather than delineating the differences between neo-Kantian writers, the article systematically expounds a shared project, which consists in providing the ultimate foundation for judgments by means of an anti-psychologist and non-metaphysical interpretation of transcendental subjectivity. (shrink)

The neo-Kantian Hermann Cohen is famously anti-empiricist in that he denies that sensations can make a definable contribution to knowledge. However, in the second edition of Kant’s Theory of Experience (1885), Cohen considers a proposition that contrasts with both his other work and that of his followers: a Kantian who studies scientific claims to truth—and the grounds on which they are made—cannot limit himself to studying mathematics and logical principles, but needs to also investigate underlying presuppositions about the empirical element (...) of science. Due to his subjectivist approach, Cohen argues, Kant not only failed to explain how scientific observation and experiments are possible, but also misconceived the role of the ideas, particularly the idea of a system of nature. (shrink)

Many interpreters argue that irrational acts of exchange can count as rational and civic-minded for Hegel—even though, admittedly, the persons who are exchanging their property are usually unaware of this fact. While I do not want to deny that property exchange can count as rational in terms of ‘mutual recognition’ as interpreters claim, this proposition raises an important question: What about the irrationality and arbitrariness that individuals as property owners and persons consciously enjoy? Are they mere vestiges of nature in (...) Hegel’s system, or do they constitute a simple yet valid form of freedom that is not only a part of Hegel’s rational system of right, but its necessary starting point? I will argue the latter: The arbitrary, purely egoist self-definition of property owners is the simplest possible type of freedom for Hegel, which he dissects in order to show how the very arbitrary self-definition implicitly relies on an identity between persons, and hence foreshadows the more social forms of freedom Hegel will discuss later in his book. I make this argument by highlighting Hegel’s references to his discussion of atoms and freedom in his Logic of Being. (shrink)

Garrett Cullity contends that fairness is appropriate impartiality (See Cullity (2004) Chapters 8 and 10 and Cullity (2008)). Cullity deploys his account of fairness as a means of limiting the extreme moral demand to make sacrifices in order to aid others that was posed by Peter Singer in his seminal article ‘Famine, Affluence and Morality’. My paper is founded upon the combination of (1) the observation that the idea that fairness consists in appropriate impartiality is very vague and (2) the (...) fact that psychological studies show the self-serving bias is especially likely to infect one’s judgements when the ideas involved are vague. I argue that Cullity’s solution to extreme moral demandingness is threatened by these findings. I then comment on whether some other theories of fairness are vulnerable to the same objection. (shrink)

This engaging introduction to the fundamental issues of philosophy will prompt students to think actively about questions such as: Does God exist? Do we have souls? Does human life have meaning? Is there a real difference between right and wrong? and many others. The twelve chapters focus on these key philosophical questions and possible answers to them, and include readings by famous thinkers on each issue.

While Hegel's metaphysics was long reviled, it has garnered more interest in recent years, with even the so-called non-metaphysical Hegelians starting to explicitly discuss Hegel’s metaphysical commitments. This brings up the old question: what are the social-philosophical implications of Hegel’s metaphysics? This chapter provides a unique answer to this question by contrasting the former non-metaphysical reading (as developed by Robert Pippin) with a traditional way of interpreting Hegel’s metaphysics and social philosophy, whose lineage includes not Wittgenstein, Sellars, or Brandom, but (...) rather Schelling, Marx, and Adorno. After discussing the two varieties of metaphysics (Sections 1–3), I will argue that a traditional metaphysical Hegel is more realist when it comes to assessing the power of social structures (Section 4), focused on structural freedom rather than agency (Sections 5 and 6), and more empowering for and lenient towards individuals who can make their interests count and are free to be irrational and egoist (Section 7). (shrink)

Patients have to be respected with dignity as the masters of their own lives. The problem, however, is that autonomy may become so dominant and the fundamental value of caring in professional nursing that the patient’s dignity is affected. The aim of this article is to point out some of the issues with the interplay between autonomy, also called self-management and dignity. Given voice to the patient perspective the background is provided by cases from research conducted through qualitative interviews with (...) patients and expanded by summarizing empirical research concerning the interplay between autonomy and dignity. The search strategy and the research question gave five empirical research papers and three theoretical studies and concept analyses. A concise overview of the relevant research contains information about all the major elements of the studies. The background research and an interpretative summary address new issues to be taken into account in dignity conserving care. (shrink)

This paper argues that close personal relationships play an important role in our judgments about what is fair. I start with an explanation of leading theories of fairness, highlighting the potential for further work on the grounds of fairness. Next, I offer an account of close personal relationships as having the ability to generate legitimate and reasonable expectations of one or other party to a judgment about fairness, or both. I show how and when close personal relationships can ground fairness.

Picking up on Marx’s and Hegel’s analyses of human beings as social and individual, the article shows that what is at stake is not merely the possibility of individuality, but also the correct conception of the universal good. Both Marx and Hegel suppose that individuals must be social or political as individuals, which means, at least in Hegel’s case, that particular interests must form part of the universal good. The good and the rational is not something that requires sacrificing one’s (...) interests for the community or denying one’s particular character so as to become an equal rational agent. Very much to the contrary, the rational or the common good is nothing but the harmonious structuring of particular interests. While Section I introduces Marx’s and Hegel’s conceptions of individual and social beings, Sections II and III discuss their respective views of individuality, and Sections IV and V discuss the notion of a universal good containing individual interests. (shrink)

Animals do a wide range of work in our society, but they are rarely recognized as workers or accorded any labour rights, and their working conditions are often oppressive and exploitative. Drawing on law, ethics, and labour studies, the essays in this volume explore the potential and dangers of animal labour.

This study focuses on how moral aspects of purpose shape collaborative processes. It does so by analyzing the unfolding of 21 relationships between four nonprofits and their funders using a framework based on French pragmatist sociology to help uncover the deeply held, ideological and moral beliefs that underscore assumptions about what the overarching purpose of a collaborative effort is or should be. This study contributes to the literature on single and cross-sectoral collaboration by showing that the way partners handle and (...) reconcile differences about purpose is related to the forms of agreement likely to be achieved. It also suggests that certain forms of agreement are inherently more enduring than others. Taken as a whole, this study provides some plausible explanations as to why so many collaborations fail despite their seeming benefits for all the parties involved. (shrink)

Although it is clear in Schelling's Freiheitsschrift that he takes an agent's atemporal choice between good and evil to be central to understanding human freedom, there is no consensus in the literature and no adequate account of how to understand this choice. Further, the literature fails to render intelligible how existential freedom is possible in the light of this atemporal choice. I demonstrate that, despite their differences, the dominant accounts in the literature are all guilty of these failings and argue (...) that this is due to their misunderstanding of Schelling's conception of the relationship between essence and form. After outlining what I take Schelling's account of this relationship to be, I return to the Freiheitsschrift to demonstrate that with this account in mind we can make intelligible Schelling's claims about the agent's atemporal act, and the possibility of existential freedom on his account. (shrink)

As some see it, an impasse has been reached on the mind- body problem between mainstream physicalism and mainstream dualism. So lately another view has been gaining popularity, a view that might be called the 'Russellian theory of mind' (RTM) since it is inspired by some ideas once put forth by Bertrand Russell. Most versions of RTM are panpsychist, but there is at least one version that rejects panpsychism and styles itself as physicalism, and neutral monism is also a possibility. (...) In this paper I will attempt to sort out these different versions with a view to determining which, if any, have a chance of breaking the perceived impasse. The unsurprising conclusion will be that there are a lot of challenges ahead for the RTM theorist. The surprising conclusion will be that it's not clear that pan- psychist RTM holds an advantage over the other versions in this regard. (shrink)

ABSTRACT When does a state of affairs constitute a harm to someone? Comparative accounts say that being worse off constitutes harm. The temporal version of the comparative account is seldom taken seriously, due to apparently fatal counterexamples. I defend the temporal version against these counterexamples, and show that it is in fact more plausible than the prominent counterfactual version of the account. Non-comparative accounts say that being badly off constitutes harm. However, neither the temporal comparative account nor the non-comparative account (...) can correctly classify all harms. I argue that we should combine them into a hybrid account of harm. The hybrid account is extensionally adequate and presents a unified view on the nature of harm. (shrink)

Anyone who is a color eliminativist‐i.e., believes that the physical world is colorless‐must explain how our sense experience of color can be so systematically illusory. As it turns out, it is difficult to do this without committing oneself to dualism. In this paper I explore the options available to the color eliminativist in this regard, and argue that his/her prospects are more promising, though still far from certain, if s/he adopts the position that sense experience is strictly intentional.

Patients in around 20 countries worldwide are now offered online access to at least some of their medical records. Access includes test results, medication lists, referral information, and/or the very words written by clinicians (so-called ‘open notes’). In this paper, I discuss the possibility of one unintended negative consequence of patient access to their clinical notes—the potential to increase ‘nocebo effects’. A growing body of research shows that nocebo effects arise by engaging perceptual and cognitive processes that influence negative expectancies, (...) and as a consequence, adverse health effects. Studies show that increased awareness about the side effects of medications, the framing of information and the socioemotional context of care can increase the risk of nocebo effects. Connecting research into the nocebo effect with open notes provides preliminary support for the hypothesis that patient access to clinical notes might be a forum for facilitating unwanted nocebo effects. Furthermore, current findings indicate that we might expect to see systematic differences in how nocebo effects are experienced among different patient populations. The ethical implications of the tension between transparency and the potential for harm are discussed, with an emphasis on what open notes might mean for justice and equity in clinical care for a range of already marginalised patient populations. I argue that to resolve these challenges does not thereby justify ‘closed notes’, and conclude with suggestions for how health systems and clinicians might adapt to this innovation to reduce the risk of potential nocebo effects arising via this novel route. (shrink)

Evans’ 1968 ANALOGY system was the first computer model of analogy. This paper demonstrates that the structure mapping model of analogy, when combined with high‐level visual processing and qualitative representations, can solve the same kinds of geometric analogy problems as were solved by ANALOGY. Importantly, the bulk of the computations are not particular to the model of this task but are general purpose: We use our existing sketch understanding system, CogSketch, to compute visual structure that is used by our existing (...) analogical matcher, Structure Mapping Engine (SME). We show how SME can be used to facilitate high‐level visual matching, proposing a role for structural alignment in mental rotation. We show how second‐order analogies over differences computed via analogies between pictures provide a more elegant model of the geometric analogy task. We compare our model against human data on a set of problems, showing that the model aligns well with both the answers chosen by people and the reaction times required to choose the answers. (shrink)

In a criminal trial, a judge or jury needs to reason about what happened based on the available evidence, often including statistical evidence. While a probabilistic approach is suitable for analysing the statistical evidence, a judge or jury may be more inclined to use a narrative or argumentative approach when considering the case as a whole. In this paper we propose a combination of two approaches, combining Bayesian networks with scenarios. Whereas a Bayesian network is a popular tool for analysing (...) parts of a case, constructing and understanding a network for an entire case is not straightforward. We propose an explanation method for understanding a Bayesian network in terms of scenarios. This method builds on a previously proposed construction method, which we slightly adapt with the use of scenario schemes for the purpose of explaining. The resulting structure is explained in terms of scenarios, scenario quality and evidential support. A probabilistic interpretation of scenario quality is provided using the concept of scenario schemes. Finally, the method is evaluated by means of a case study. (shrink)

This article discusses anglophone readings of G. W. F. Hegel against the backdrop of German-language scholarship. The article starts by differentiating types of metaphysics (I). Following a taxonomy introduced by Paul Redding, I then discuss Charles Taylor’s Christian-mystical (II), the so-called »non-metaphysical« (III) and the »revised metaphysical« reading (IV). Terry Pinkard’s work serves as an example of (III) and Stephen Houlgate’s as an example of (IV). I highlight problematic aspects of each reading that concern: the meaning of »reason in the (...) world« (II), the anti-relativist clout of Hegel’s philosophy (III) and the difference between the development of logical concepts and the empirical origin of the world and human thinking (IV). The text ends (V) by pointing to the social implications of each type of reading. (shrink)

« If there was one development we did not predict it was that, as well as getting larger, corpora would also get smaller! » McEnery et Wilson (2001 : 191) Doit-on qualifier de « petit corpus » tout corpus qui n’est pas grand? Et d’ailleurs, pourquoi faudrait-il se poser la question? Celle-ci peut paraître triviale mais elle signale un moment particulier des sciences du langage. L’informatique a permis l’établissement de grands corpus et le traitement d’impressionnantes quantités de données...

The core argument of this article is that Adorno adopts the distinction between an abstract and a concrete universal from Hegel and criticizes Hegel, on that basis, as abstract. The first two parts of the article outline that both thinkers take the abstract universal to be the form of a false type of knowledge and society, and the concrete universal to be a positive aim. However, as the third part argues, Adorno rejects how the concrete universal is understood in Hegel’s (...) philosophy and formulates a different conception of it. The fourth part questions if Adorno manages to overcome the problems he identifies in Hegel or whether they are inherent to the programme of dialectics both endorse. (shrink)

Researchers have begun to use response times to emotion items as an indirect measure of emotional clarity. Our first aim was to scrutinise the properties of this RT measure in more detail than previously. To be able to provide recommendations as to whether emotional intensity – as a possible confound – should be controlled for, we investigated the specific form of the relation between emotional intensity and RTs to emotion items. In particular, we assumed an inverted U-shaped relation at the (...) item level. Moreover, we analysed the RT measure’s convergent validity with respect to individuals’ confidence in their emotion ratings. As a second aim, we compared the predictive validity of emotional clarity measures with respect to daily emotion regulation. The results of three experience sampling studies showed that the association between emotional intensity and RT followed an inverted U shape. RT was in part related to confidence. Emotional clarity measures were unrelated to reappraisal. There was some evidence that lower emotional clarity was related to a greater use of suppression. The findings highlight that emotional intensity and squared emotional intensity should be controlled for when using the RT measure of emotional clarity in future research. (shrink)

Not so long ago, the idea that analytic philosophers would be taking panpsychism seriously would have been hard to believe. That is because in its early, logical positivist, stage, the analytic movement earned the reputation of being militantly anti-metaphysical. But analytic philosophy has come a long way since the heyday of logical positivism; and, in fact, the dialectic of recent debates on the mind–body problem among analytic philosophers has pushed many of them in the direction of panpsychism. In this paper, (...) I want to explain how this has come about and take a look at some of the versions of panpsychism that have emerged. This will involve running through a quick history of debates on the mind–body problem since about 1960, focusing on how panpsychism has been proposed as a promising, though not unproblematic, way of breaking an apparent impasse that has emerged between more standard physicalist and dualist theories of mind. Along the way, I will also have occasion to comment on the prospects of panpsychism as a respectable scientific theory and how a number of scientists stand on this. (shrink)

In many countries, including patients are legally entitled to request copies of their clinical notes. However, this process remains time-consuming and burdensome, and it remains unclear how much of the medical record must be made available. Online access to notes offers a way to overcome these challenges and in around 10 countries worldwide, via secure web-based portals, many patients are now able to read at least some of the narrative reports written by clinicians. However, even in countries that have implemented (...) the practice many clinicians have resisted the idea remaining doubtful of the value of opening notes, and anticipating patients will be confused or anxious by what they read. Against this scepticism, a growing body of qualitative and quantitative research reveals that patients derive multiple benefits from reading their notes. We address the contrasting perceptions of this practice innovation, and claim that the divergent views of patients and clinicians can be explained as a case of epistemic injustice. Using a range of evidence, we argue that patients are vulnerable to epistemic injustice. Nonetheless, we conclude that the marginalisation of patients’ access to their health information exemplifies a form of epistemic exclusion, one with practical and ethical consequences including for patient safety. (shrink)

In many countries, including patients are legally entitled to request copies of their clinical notes. However, this process remains time-consuming and burdensome, and it remains unclear how much of the medical record must be made available. Online access to notes offers a way to overcome these challenges and in around 10 countries worldwide, via secure web-based portals, many patients are now able to read at least some of the narrative reports written by clinicians (‘open notes’). However, even in countries that (...) have implemented the practice many clinicians have resisted the idea remaining doubtful of the value of opening notes, and anticipating patients will be confused or anxious by what they read. Against this scepticism, a growing body of qualitative and quantitative research reveals that patients derive multiple benefits from reading their notes. We address the contrasting perceptions of this practice innovation, and claim that the divergent views of patients and clinicians can be explained as a case of epistemic injustice. Using a range of evidence, we argue that patients are vulnerable to (oftentimes, non-intentional) epistemic injustice. Nonetheless, we conclude that the marginalisation of patients’ access to their health information exemplifies a form of epistemic exclusion, one with practical and ethical consequences including for patient safety. (shrink)

David Hume is widely regarded as the greatest English thinker in the history of philosophy. His contributions to a huge range of philosophical debates are as important and influential now as they were in the eighteenth century. This book provides an introduction to the ideas of this hugely significant thinker.

In a criminal trial, evidence is used to draw conclusions about what happened concerning a supposed crime. Traditionally, the three main approaches to modeling reasoning with evidence are argumentative, narrative and probabilistic approaches. Integrating these three approaches could arguably enhance the communication between an expert and a judge or jury. In previous work, techniques were proposed to represent narratives in a Bayesian network and to use narratives as a basis for systematizing the construction of a Bayesian network for a legal (...) case. In this paper, these techniques are combined to form a design method for constructing a Bayesian network based on narratives. This design method is evaluated by means of an extensive case study concerning the notorious Dutch case of the Anjum murders. (shrink)

The doctor-patient relationship is built on an implicit covenant of trust, yet it was not until the post-World War Two era that respect for patient autonomy emerged as an article of mainstream medical ethics. Unlike their medical forebears, physicians today are expected to furnish patients with adequate information about diagnoses, prognoses and treatments. Against these dicta there has been ongoing debate over whether placebos pose a threat to patient autonomy. A key premise underlying medical ethics discussion is the notion that (...) the placebo effect necessitates patient deception. Indeed, the American Medical Association guidelines imply that placebo treatment necessary entails a form of deception. As a consequence of this assumption, the fulcrum of debate on the use of placebo treatment has hinged on whether that deception is ever justified. Recently performed experiments with open-label transparently prescribed placebos have begun to challenge the notion that deception is necessary in eliciting the placebo effect and such effects necessarily involve a binary distinction between autonomy and beneficence. In this article we focus on the content of disclosures in distinctive open-label, transparently disclosed placebo studies and inquire whether they might be said to invoke deception in clinical contexts, and if so, whether the deception is unethical. We find that open placebos may be said to involve equivocation over how placebos work. However, drawing on surveys of patient attitudes we suggest that this equivocation appears to be acceptable to patients. We conclude that open placebos fulfil current American Medical Association guidelines for placebo use, and propose future research directions for harnessing the placebo effect ethically. (shrink)

Many people believe that we have moral duties towards those we bring into existence in the short term: our children. Many people also believe that we have moral duties towards those we bring into existence in the long term: future generations. In this article, I explore how these beliefs are connected. I argue that the present generation is morally responsible for future generations in virtue of bringing them into existence. This responsibility entails moral duties to ensure that future people have (...) adequate life prospects. These duties are held directly towards future generations. I argue that this direct argument can overcome challenges that indirect arguments, which justify moral duties concerning future generations via moral duties towards present children, face. The upshot is that considerations from procreative ethics help to illustrate that the present generation stands in a morally relevant special relationship to future generations, a fact that is often overlooked in intergenerational ethics. (shrink)

A popular defense of physicalist theories of consciousness against anti-physicalist arguments invokes the existence of ‘phenomenal concepts’. These are concepts that designate conscious experiences from a first person perspective, and hence differ from physicalistic concepts; but not in a way that precludes co-referentiality with them. On one version of this strategy phenomenal concepts are seen as (1) type demonstratives that have (2) no mode of presentation. However, 2 is possible without 1-call this the ‘bare recognitional concept’ view-and I will argue (...) that this avoids certain recent criticisms while retaining the virtue of finessing the ‘mode of presentation’ problem for phenomenal concepts. But construing phenomenal concepts this way seems to not do justice to the phenomenology of conscious experience. In this paper I examine whether or not this impression can be borne out by a good argument. As it turns out, it is harder to do so than one might think. It can be done, but it involves somewhat more convoluted reasoning than one might have supposed necessary. Having shown that, I will end with a few brief remarks on what my argument means for attempts to preserve a physicalist account of consciousness. (shrink)