According to some views, natural language suffers from underdeterminacy, but thought doesn’t. According to the underdeterminacy claim, sentence types underdetermine the truth-conditions of sentence tokens. In particular, the semantics of a predicate type seems to underdetermine the satisfaction conditions of its tokens. By contrast, mental representation-types are supposed to determine the truth-conditions of its tokens. In this paper I critically examine these mixed views. First, I argue that the arguments supporting the indispensability of including in one’s theory mental representations that (...) are free of the underdeterminacy exhibited by natural language are not sound. As a result, the possibility that mental representation-types are as underdetermined as natural language sentence-types has not been ruled out. Second, I argue that Carston’s ad hoc concept-types are as underdetermined as word-types. I finish by arguing that mental representations are also underdetermined in a second sense—mental representation-tokens only determine a partial function from possible worlds to truth-values. (shrink)

According to contextualists, communication has to do with pragmatically adjusted content, not with conventional meaning. This pragmatic content is sometimes identified with speaker meaning or with the thought the speaker intends to express. I will argue that given the sociolinguistic role of utterance content—the fact it provides reasons for action, liabilities and entitlements—locutionary content should not be modelled as a variety of speaker meaning.

One way to silence the powerless, Langton has taught us, is to pre-emptively disable their ability to do things with words. In this paper I argue that speakers can be silenced in a different way. You can let them speak, and obscure the meaning of their words afterwards. My aim is to investigate this form of silencing, that I call retroactive distortion. In a retroactive distortion, the meaning of the words of a speaker is distorted by the effect of a (...) subsequent speech act by a different speaker. After introducing this notion, I explore some reasons why retroactive distortions can be difficult to challenge and argue that, besides constituting a communicative injustice, they can eliminate topics from public consideration and therefore erode public debate. (shrink)

ABSTRACT Truth-conditions are systematically determined when they are the output of an algorithmic procedure that takes as input a set of semantic and contextual features. Truth-conditional sceptics have cast doubts on the thesis that truth-conditions are systematic in this sense. Against this form of scepticism, Schoubye and Stokke : 759–793) and Dobler : 451–474.) have provided systematic analyses of utterance truth-conditions. My aim is to argue that these theories are not immune to the kind of objections raised by truth-conditional sceptics. (...) In particular, I argue that the use of Questions Under Discussion and ways of being is problematic. (shrink)

Pragmatic modulation makes contextual information necessary for interpretation. This poses a problem for homophonic reports and inter-contextual communication in general: of co-situated interlocutors, we can expect some common ground, but non-co-situated interpreters lack access to the context of utterance. Here I argue that we can nonetheless share modulated contents via homophonic reports. First, occasion-unspecific information is often sufficient for the recovery of modulated content. Second, interpreters can recover what is said with different degrees of accuracy. Homophonic reports and inter-contextual communication (...) are often successful because the reporting context does not demand full accuracy. (shrink)

McGowan has provided a linguistic mechanism that explains how speech can constitute harm. Her idea is that utterances routinely enact s-norms about what is permissible in a given context. My aim is to argue that these s-norms are sensitive to the conversational standing of the speaker. In particular, I claim that the strength of the norm enacted depends on the standing of the speaker. In some cases, the speaker might even lack the standing required to enact new s-norms.

In this paper, we propose an account of metaphor identification on the basis of contextual coherence. In doing so, we build on previous work by Nicholas Asher and Alex Lascarides that appeals to rhetorical relations in order to explain discourse structure and the constraints on the interpretation of metaphor that follow from it. Applying this general idea to our problem, we will show that rhetorical relations are sometimes insufficient and sometimes inadequate for deciding whether a given utterance is a case (...) of metaphor. They are insufficient, since rhetorical relations fall short at times of providing a basis for disambiguating between literal and metaphorical interpretations. In such cases, contextual information other than previous discourse needs to enter the picture. To this effect, we bring the idea of external consistency into play. Beyond that, though, we will argue that rhetorical relations are sometimes inadequate to account for coherence, if conceived as relations among sentences only. The reason is that extra-linguistic elements of the situation in which the sentence is uttered may be crucial for getting at the preferred interpretation. To account for these cases, we allow rhetorical relations to connect both with previous discourse and with extra-linguistic situations. In our final refinement of the notion of contextual coherence, we forfeit any appeal to rhetorical relations in favour of Questions Under Discussion (QUD). We defend the view that this account does not only explain the same sort of cases. What is more, it solves the issue of metaphor identification in impoverished contexts. (shrink)

Many sentences can be interpreted both as a metaphor and as a literal claim, depending on the context. The aim of this paper is to show that there are discourse-based systematic constraints on the identification of an utterance as metaphorical, literal, or both (as in the case of twice-apt metaphors), from a normative point of view. We claim that the key is contextual coherence. In order to substantiate this claim, we introduce a novel notion of context as a rich and (...) heterogeneous body of information, including previous discourse, elements coming from the surroundings of the utterance, background information, and Questions Under Discussion (QUD) issued from these three sources. We then define contextual coherence as a relation between what we call the minimal paraphrase of the metaphor and the context, and argue that for an interpretation to be coherent two conditions must be met. First, the minimal paraphrase must address some question in the QUD stack. Second, it must be externally consistent, i.e. consistent with the available contextual information. Finally, we argue that an approach based on contextual coherence is better suited to deal with twice-true and twice-apt metaphors than traditional approaches based on semantic deviance or pragmatic lack of fit. (shrink)

The present article is the third part of a trilogy of papers, devoted to analysing the influence of semantic Platonism on contemporary philosophy of language. In Part I (Picazo 2021), the discussion was set out by examining a number of typical traces of Platonism in semantic theory since Frege. In Part II (Picazo 2021a), additional illustrations of such traces were provided, taken from a collection of recent commissioned essays on the philosophy of language (Schantz 2012). The present part (...) is devoted to providing yet additional illustrations of such traces, taken from a collection of classic essays on the subject: the book Modern Philosophy of Language, edited by Maria Baghramian in 1998. We shall, thus, describe a number of examples in which the influence of semantic Platonism on these essays can be felt. Prominent among these examples are the confusion between sentences and propositions (and related confusions), the avoidant attitude with respect to basic aspects of linguistic meaning, the overuse of analytic methodology for semantic research, the adoption of a background Platonic metaphysics of meanings and the overreaction against semantic Platonism and germane views, witnessing an inverse influence (‘by opposition’) from these views. (shrink)

Slurs are derogatory terms targeting individuals and groups of individuals on the basis of race, nationality, religion, gender or sexual orientation. The aim of my paper is to propose an account of appropriated uses of slurs – i.e. uses by targeted groups of their own slurs for non-derogatory purposes, as in the appropriation of ‘nigger’ by the African-American community, or the appropriation of ‘queer’ by the homosexual community. In my proposal appropriated uses are conceived as echoic, in Relevance Theory terms: (...) in-groups echo derogatory uses in ways and contexts that make manifest the dissociation from the offensive contents. I will show that the echoic strategy has interesting advantages over alternative theories, and especially over Anderson and Lepore’s deflationary strategy. (shrink)

What distinguishes evils from ordinary wrongs? Is hatred a necessarily evil? Are some evils unforgivable? Are there evils we should tolerate? What can make evils hard to recognize? Are evils inevitable? How can we best respond to and live with evils? Claudia Card offers a secular theory of evil that responds to these questions and more. Evils, according to her theory, have two fundamental components. One component is reasonably foreseeable intolerable harm -- harm that makes a life indecent and (...) impossible or that makes a death indecent. The other component is culpable wrongdoing. Atrocities, such as genocides, slavery, war rape, torture, and severe child abuse, are Card's paradigms because in them these key elements are writ large. Atrocities deserve more attention than secular philosophers have so far paid them. They are distinguished from ordinary wrongs not by the psychological states of evildoers but by the seriousness of the harm that is done. Evildoers need not be sadistic:they may simply be negligent or unscrupulous in pursuing their goals. Card's theory represents a compromise between classic utilitarian and stoic alternatives (including Kant's theory of radical evil). Utilitarians tend to reduce evils to their harms; Stoics tend to reduce evils to the wickedness of perpetrators: Card accepts neither reduction. She also responds to Nietzsche's challenges about the worth of the concept of evil, and she uses her theory to argue that evils are more important than merely unjust inequalities. She applies the theory in explorations of war rape and violence against intimates. She also takes up what Primo Levi called "the gray zone", where victims become complicit in perpetrating on others evils that threaten to engulf themselves. While most past accounts of evil have focused on perpetrators, Card begins instead from the position of the victims, but then considers more generally how to respond to -- and live with -- evils, as victims, as perpetrators, and as those who have become both. (shrink)

Greenwood (2019) casts doubts upon whether a certain view about social groups (the view that social groups persist throughout changes in their membership, by virtue of the maintenance of their structure or function) is a fundamental metaphysical truth about social groups, rather than a theoretical truth about some or many social groups. In this note, I introduce a distinction between absolute and relative metaphysics, and argue that there are no 'fundamental metaphysical truths‘ (as Greenwood conceives of them) at all. If (...) there is one thing that should not persist here, it is absolute metaphysics. (shrink)

Jaques provides a general theory that gives a dynamic scientific foundation for the understanding of all living behavior.

The 'More-than-Human' reader brings together texts by writers across a wide array of disciplines that reflect on the state of post-anthropocentric thinking today. Focusing on the ecologies and technologies of climate injustice and inequalities, as well as the destructive structures lurking within anthropocentrism, More-than-Human proposes complex entanglements, frictions, and reparative attention across species and beings. Thinking past the centrality of the human subject, the texts that compose this reader begin to imagine networks of ethics and responsibility emerging not from the (...) ideologies of old, but from the messy and complex liveliness around us, and underfoot. (shrink)

The article introduces the problematics of the classical two-valued logic on which Western thought is generally based, outlining that under the conditions of its logical assumptions the subject I is situated in a world that it cannot address. In this context, the article outlines a short history of cybernetics and the shift from first- to second-order cybernetics. The basic principles of Gordon Pask’s 1976 Conversation Theory are introduced. It is argued that this second-order theory grants agency to others through a (...) re-conception of living beings as You logically transcending the I. The key principles of Conversation Theory are set in relation to the poetic forms of discourse that played a key role in art as well as philosophical thinking in China in the past. Second-order thinking, the article argues, is essentially poetic. It foregoes prediction in favour of the potentiality of encountering tomorrow’s delights. (shrink)

The editorial introduces issue 21.1 of Technoetic Arts via a critical reflection on the artificial intelligence hype (AI hype) that emerged in 2022. Tracing the history of the critique of Large Language Models, the editorial underscores that there are substantial ethical challenges related to bias in the training data, copyright issues, as well as ecological challeges which the technology industry has consistently downplayed over the years. -/- The editorial highlights the distinction between the current AI technology’s reliance on extensive pre-existing (...) human-generated data for pattern recognition and the performative process inherent in art practice. Patterns of creative output can be replicated without a thorough understanding of underlying concepts. In contrast, the performative process of art practice, as explored through the conceptual frameworks of creativity by Noam Chomsky, Charles Sanders Peirce, and Roger T. Ames and with reference to an earlier publication of the editorial’s author, creates concepts and continually ‘strives to extend itself towards the unknown.’ -/- Following this introductory section, the editorial provides an overview of the ten articles featured in this issue of Technoetic Arts. The first four texts engage with emerging technologies from various perspectives in art and design. The subsequent six articles, part of a special section titled 'Perspectives from Chandigarh,' reflect a quest for meaningful existence within colonial, patriarchal, and biopolitical structures that frame everyday practices of exclusion and oppression. (shrink)

Statements such as “X is beautiful but I don’t like how it looks” or “I like how X looks but it is not beautiful” sound contradictory. How contradictory they sound might however depend on the object X and on the aesthetic adjective being used (“beautiful”, “elegant”, “dynamic”, etc.). In our study, the first sentence was estimated to be more contradictory than the latter: If we describe something as beautiful, we often intend to evaluate its appearance, whereas it is less counterintuitive (...) to appreciate an appearance without finding it beautiful. Furthermore, statements including “beautiful” appeared more contradictory than those including “elegant” and “dynamic”, pointing to its greater evaluative component. When related to artworks, sentences could appear less contradictory due to readers’ consideration of the divergence between conventional beauty and art-related sensory pleasures that can even include negative valence. Such ambivalence might be more frequent in art-objects than in other artefacts. Indeed, in our study, sentences referring to artworks were estimated to be less contradictory compared to sentences referring to other artefacts. Meanwhile, an additional small group of graphic design students showed a less clear difference between art-related and non-art-related sentences. We discuss the potential influence of art experience and interest as well as theoretical and methodological challenges like the conceptualization of beauty. (shrink)

Addressing studying as a distinct educational concept and phenomenon in its own right, the essays in this volume consider study and studying from a range of perspectives. Countering dominant educational discourses, which place a heavy emphasis on learning and instruction, the contributors explore questions such as: What does it mean to study something? How is studying something different from being taught about it, or learning something about it? What does the difficulty demanded by study mean for the one who studies (...) and for the teacher? What mode of existence does study induce? The book highlights the significance of study not only, or even primarily, for its educational outcome, but as a human activity. (shrink)

In this paper I draw a distinction between a special and a general version of the Gettier problem. I argue that the special problem is partially a logical problem, as well as an epistemological one, and I show that it is very easy to solve. This is interesting, since most of the Gettier-style examples that appear in the literature fall under the special problem, and hence as they stand they too are very easy to solve.

In recent times, phenomena of conversational asymmetry have become a lively object of study for linguists, philosophers of language and moral philosophers—under various labels: illocutionary disablement and silencing, discursive injustice :440–457, 2014; Lance and Kukla in Ethics 123:456–478, 2013), illocutionary distortion. The common idea is that members of underprivileged groups sometimes have trouble performing particular speech acts that they are entitled to perform: in certain contexts, their performative potential is somehow undermined, and their capacity to do things with words is (...) distorted or even annulled. In this paper I will assess this idea, focusing on Rebecca Kukla’s and Rae Langton’s accounts; in particular, I will criticize the role the notion of uptake plays in their accounts, and claim that it may ultimately undermine the very idea of discursive injustice. While, according to Kukla and Langton, members of disadvantaged groups are victims of a kind of uptake failure, leading to illocutionary disablement and even silencing, in the account I present they are victims of a kind of communicative disablement. My overall aim is to develop a notion of discursive injustice that is more plausible and more effective for our broader purposes of criticising the structures of power and oppression. (shrink)

Clinical Ethics Consultation (CEC) has grown significantly in the last decade, and efforts are being made to professionalize the practice. The American Society for Bioethics and Humanities (ASBH) has been instrumental in this process, having published the _Code of Ethics and Professional Responsibilities for Healthcare Ethics Consultants_ and founded and endorsed the creation of the _Healthcare Ethics Consultant Certified (HCEC) Certification Commission._ The ASBH also published “core competencies” for healthcare ethics consultants and has delineated a clear identity and role of (...) such consultants distinct from that other healthcare professionals. In addition, more enter the field armed with advanced degrees (MA and PhD) or certification in clinical ethics consultation. While some have questioned the trend toward professionalization, the momentum is clearly in its favor. This paper explores three questions: Does the professionalization of healthcare ethics consultation expose those engaged in the field to the types of liability claims faced by professionals in other fields? What specific liabilities could affect a healthcare ethics consultant? And finally, what should healthcare ethics consultants do to protect themselves against liability claims? We conclude that while the risk of liability remains low, those engaged in the field should accept that risk just as part of their status as professionals and, like those in allied professions, seek appropriate protection in the form of liability insurance. (shrink)

Health-care goods are goods with peculiar properties, and where they are scarce, societies face potentially explosive distributional conflicts. Animated public and academic debates on the necessity and possible justice of limit-setting in health care have taken place in the last decades and have recently taken a turn toward procedural rather than substantial criteria for justice. This article argues that the most influential account of procedural justice in health-care rationing, presented by Daniels and Sabin, is indeterminate where concrete properties of rationing (...) institutions are concerned. Such properties inscribe substantial norms into institutions. These norms can derive validity only from democratic majority decisions, which must be seen as an instance of pure procedural justice. We therefore have to move the discussion to a meta-level and ask how concrete properties of institutions are being chosen. I suggest four criteria for sufficiently democratic institutional design choice and conclude that as institutional properties are likely to have effects on the resulting distribution of health care, design choices should be empirically informed and taken both democratically and deliberately. (shrink)

Das ethische Prinzip des Respekts vor der Autonomie des Patienten/Probanden hat in der modernen Medizin mittlerweile weltweit Bedeutung erlangt. Die Betonung der Autonomie des Patienten und Probanden in allen in der letzten Zeit verabschiedeten internationalen Deklarationen gibt dieser Tendenz unmissverständlich Ausdruck. Doch wenngleich diese Entwicklung unstrittig positiv ist, wirft sie dennoch eine Reihe von Fragen auf, die mit der Kodifizierung, Interpretation, Reichweite und Anwendung dieses universalen Prinzips verbunden sind. Die Antworten auf diese Fragen entscheiden darüber, ob Autonomie als hilfreiches, emanzipatorisches (...) oder als überforderndes, gar hegemoniales Prinzip begriffen wird. Diese normativen Probleme werden anhand von Beispielen aus der globalen Medizinethik verdeutlicht. Was in modernen Gesellschaften als Autonomie bezeichnet und für die Praxis fruchtbar gemacht wird, ist als ein soziales Konstrukt zu verstehen, nicht im Sinne einer Schimäre, sondern im Sinne einer soziokulturellen Leistung, die auf komplexen, historisch gewachsenen und kulturell geprägten Interaktionen von Gesellschaften, Institutionen und Individuen beruht. (shrink)

Following the traces of Margaret Mead’s statement that emphasized that the first photographic images of the Earth from space presented notions of fragility, the article contextualizes the recent critique of the dominant representation of the Earth as a globe that emerged in conjunction with the discourse on the Anthropocene. It analyses the globe as an image and the sentiments that accompanied it since the first photographs of our planet from space were published in 1968. The article outlines how the cultural (...) meaning of the whole Earth representation changed in parallel with the appropriation of the image by the large technological enterprises that emerged from America’s counterculture. It returns to the possibility of a coexistence of ‘views from within’ and ‘views from without’ following a detour with Gregory Bateson via Bali and proposes a Cybernetics of Grace as a practice of resistance against pure exteriority. The article concludes by linking the Cybernetics of Grace with the second-order conversations of Gordon Pask. (shrink)

The present article is the first of a trilogy of papers, devoted to analysing the influence of semantic Platonism on contemporary philosophy of language. In the present article, I lay out the discussion by contrasting semantic Platonism with two other views of linguistic meaning: the socio-environmental conception of meaning and semantic anti-representationalism. Then, I identify six points in which the impregnation of semantic theory with Platonism can be particularly felt, resulting in shortcomings and inaccuracies of various kinds. These points are (...) the following: the limitations of regarding logico-philosophical analysis as the only working methodology; the tendency to avoid investigating a number of aspects of linguistic meaning; the recurring confusion between sentences, statements, and propositions; the weakness of transcendent assumptions about meaning; the weakness of meaning assumptions adopted on the basis of pure intuition; and inconsistencies caused by some over-eager attempts to escape semantic Platonism. (shrink)

The opportunities to become a good person are not the same for everyone. Modern European ethical theory, especially Kantian ethics, assumes the same virtues are accessible to all who are capable of rational choice. Character development, however, is affected by circumstances, such as those of wealth and socially constructed categories of gender, race, and sexual orientation, which introduce factors beyond the control of individuals. Implications of these influences for morality have, since the work of Williams and Nagel in the seventies, (...) raised questions in philosophy about the concept of moral luck. In The Unnatural Lottery, Claudia Card examines how luck enters into moral character and considers how some of those who are oppressed can develop responsibility. Luck is often best appreciated by those who have known relatively bad luck and have been unable to escape steady comparison of their lot with those of others. The author takes as her paradigms the luck of middle and lower classes of women who face violence and exploitation, of lesbians who face continuing pressure to hide or self-destruct, of culturally Christian whites who have ethnic privilege, and of adult survivors of child abuse. How have such people been affected by luck in who they are and can become, the good lives available to them, the evils they may be liable to embody? Other philosophers have explored the luck of those who begin from privileged positions and then suffer reversals of fortune. Claudia Card focuses on the more common cases of those who begin from socially disadvantaged positions, and she considers some who find their good luck troubling when its source is the unnatural lottery of social injustice. (shrink)

Das ethische Prinzip des Respekts vor der Autonomie des Patienten/Probanden hat in der modernen Medizin mittlerweile weltweit Bedeutung erlangt. Die Betonung der Autonomie des Patienten und Probanden in allen in der letzten Zeit verabschiedeten internationalen Deklarationen gibt dieser Tendenz unmissverständlich Ausdruck. Doch wenngleich diese Entwicklung unstrittig positiv ist, wirft sie dennoch eine Reihe von Fragen auf, die mit der Kodifizierung, Interpretation, Reichweite und Anwendung dieses universalen Prinzips verbunden sind. Die Antworten auf diese Fragen entscheiden darüber, ob Autonomie als hilfreiches, emanzipatorisches (...) oder als überforderndes, gar hegemoniales Prinzip begriffen wird. Diese normativen Probleme werden anhand von Beispielen aus der globalen Medizinethik verdeutlicht. Was in modernen Gesellschaften als Autonomie bezeichnet und für die Praxis fruchtbar gemacht wird, ist als ein soziales Konstrukt zu verstehen, nicht im Sinne einer Schimäre, sondern im Sinne einer soziokulturellen Leistung, die auf komplexen, historisch gewachsenen und kulturell geprägten Interaktionen von Gesellschaften, Institutionen und Individuen beruht. (shrink)

This article discusses whether it is rational and valuable to have hope in the face of the climate crisis. The aim is to explore a distinctive Kantian perspective characterized by three main elements. First, hope is not seen primarily as a means of sustaining action, but action is viewed as a condition for rational hope. Second, the value of certain ‘fundamental’ hopes is not merely instrumental but derives from their constitutive role in our practical identity. Here, I focus on Kantian (...) hope in the compatibility of our fundamental ends, happiness and morality. Third, the rationality of such a hope presupposes trust – in particular, trust that our conceptions of morality and the good life are sufficiently flexible to adapt to drastically new circumstances. (shrink)

The starting point of this paper is the idea that linguistic representation is the result of a global process: a process of interaction of a community of cognitive-linguistic agents, with one another and with the environment. I maintain that the study of truth, meaning and related notions should be addressed without losing perspective of this process, and I oppose the ‘static’ or ‘analytic’ approach, which is fundamentally based on our own knowledge of the conventional meaning of words and sentences, and (...) the ability of using them that we have as competent speakers. I argue that the analytic perspective is responsible for five recurring difficulties in truthmaker theory: (1) the lack of attention to the difference of explanatory role between the distinct notions proposed as primary truthbearer; (2) the adscription of purely extra-linguistic truthmakers to ‘synthetic truths’, ignoring the contribution of the linguistic factor; (3) the adscription of purely linguistic truthmakers to ‘logical’ and ‘analytic truths’, ignoring the contribution of the worldly factor; (4) the difficulties in the search for minimal truthmakers; (5) the problems in the treatment of ‘negative facts’ and of other ‘logically complex facts’. I do not provide an account of how to solve these difficulties, but I do show how the ‘process model’ helps to clear up confusion regarding them. (shrink)

The present article is the second part of a trilogy of papers, devoted to analysing the influence of semantic Platonism on contemporary philosophy of language. In Part I (Picazo 2021), the discussion was set out by examining a number of typical traces of Platonism in semantic theory since Frege. In a subsequent paper that shall be published elsewere, additional illustrations of such traces will be provided, taken from a collection of classic texts in the philosophy of language, also from (...) Frege onwards (Baghramian 1998). Then, the present paper is devoted to providing yet additional illustrations of those traces, but this time taken from a collection of recent commissioned essays on the subject: the book Prospects for Meaning, edited by Richard Schantz in 2012. We shall, thus, describe a considerable number of examples in which the influence of semantic Platonism on these essays can be felt. Prominent among these examples are the adhesion to pseudo-Platonism in the form of semantic mentalism; the typical limitations of avoidant and trivializing semantic accounts; the confinement to logico-philosophical analysis as the only methodology for semantic research; the excesses committed by some radical semantic anti-representationalists and some radical semantic biologists; and the adhesion to hardcore semantic Platonism itself. (shrink)

What distinguishes evils from ordinary wrongs? Are some evils unforgivable? How should we respond to evils? Card offers a secular theory of evil--representing a compromise between classic utilitarian and stoic approaches--that responds to these and other questions.

This article considers the question ‘What makes hope rational?’ We take Adrienne Martin’s recent incorporation analysis of hope as representative of a tradition that views the rationality of hope as a matter of instrumental reasons. Against this tradition, we argue that an important subset of hope, ‘fundamental hope’, is not governed by instrumental rationality. Rather, people have reason to endorse or reject such hope in virtue of the contribution of the relevant attitudes to the integrity of their practical identity, which (...) makes the relevant hope not instrumentally but intrinsically valuable. This argument also allows for a new analysis of the reasons people have to abandon hope and for a better understanding of non-fundamental, ‘prosaic’ hopes. (shrink)

ObjectivePhysical and mental well-being are threatened by climate change. Since hospitals in high-income countries contribute significantly to climate change through their greenhouse gas (GHG) emissions, the medical ethics imperative of ‘do no harm’ imposes a responsibility on hospitals to decarbonise. We investigated hospital stakeholders’ perceptions of hospitals’ GHG emissions sources and the sense of responsibility for reducing GHG emissions in a hospital.MethodsWe conducted 29 semistructured qualitative expert interviews at one of Germany’s largest hospitals, Heidelberg University Hospital. Five patients, 12 clinical (...) and 12 administrative employees on different levels were selected using purposive maximum variation sampling. Interviews were transcribed verbatim and analysed using the framework approach.ResultsConcerning GHG emissions, hospital stakeholders perceived energy and waste as most relevant emission sources followed by mobility. Climate change mitigation in general was considered as important. However, in their role as patients or employees, hospital stakeholders felt less responsible for climate change mitigation. They saw providing best possible medical care to be the top priority in hospitals and were often concerned that patients’ health could be jeopardised by climate change mitigation measures.ConclusionPerceptions of most important emission sources did not coincide with those in literature, highlighting the need to inform stakeholders, for instance, about pharmaceuticals as important emission source. A frequently perceived conflict between reducing emissions and providing high-quality medical care could be eased, if reducing emissions would not only be justified as a contribution to mitigation, but also as a contribution to preventing ill health—a basic principle of medical ethics. (shrink)