The phenomenon of ambivalence is an important one for any philosophy of action. Despite this importance, there is a lack of a fully satisfactory analysis of the phenomenon. Although many contemporary philosophers recognize the phenomenon, and address topics related to it, only Harry Frankfurt has given the phenomenon full treatment in the context of action theory - providing an analysis of how it relates to the structure and freedom of the will. In this paper, I develop objections to Frankfurt's account, (...) all revolving around the charge that his account contains a serious ambiguity between willing and identifying. With such objections in place, I then develop an analysis that avoids the difficulties and ambiguities that Frankfurt's analysis is prey to. I briefly distinguish ambivalence from other types of internal conflict. This paper aims to offer conceptual clarification on the phenomenon of ambivalence, which will then allow for discussions about the normative merits and demerits of ambivalence, the effects of ambivalence on autonomous action, and methods of resolution of ambivalence. (shrink)

"This book is very valuable. Today, there are too many books on the Work that are either deliberately impersonal and as a result are just a re-explaining of basic ideas which are already there in Ouspensky.

An analysis of the identity issues involved in facial allograft transplantation is provided in this paper. The identity issues involved in organ transplantation in general, under both theoretical accounts of personal identity and subjective accounts provided by organ recipients, are examined. It is argued that the identity issues involved in facial allograft transplantation are similar to those involved in organ transplantation in general, but much stronger because the face is so closely linked with personal identity. Recipients of facial allograft transplantation (...) have the potential to feel that their identity is a mix between their own and the donor’s, and the donor’s family is potentially likely to feel that their loved one ‘‘lives on’’. It is also argued that facial allograft transplantation allows the recipients to regain an identity, because they can now be seen in the social world. Moreover, they may regain expressivity, allowing for them to be seen even more by others, and to regain an identity to an even greater extent. Informing both recipients and donors about the role that identity plays in facial allograft transplantation could enhance the consent process for facial allograft transplantation and donation. (shrink)

Although I agree with Sabine Muller’s conclusion that we should first seek to find alternatives to amputation for patients suffering from Body Integrity Identity Disorder (BIID), I disagree with one of the major premises that she uses to argue for her claim. Muller argues that patients with BIID are likely not autonomous when they request that the limb be amputated. Muller’s argument that BIID suffers are not autonomous is flawed because she conflates philosophical conceptions of autonomy with the conception of (...) autonomy that is operative in the context of medicine. (shrink)

"This reviewer had to be restrained from stopping people in the street to urge them to read it: They would learn something of the way science is done,...

This classic, with a new introduction by Madeleine L'Engle, is by turns an entrancing mediation on language a piercing commentary on the nature of art and why so much of what we read, hear, and see falls short and a brilliant examination of the fundamental tenets of Christianity. The Mind of the Maker will be relished by those already in love with Dorothy L. Sayers and those who have not yet met her. A mystery writer, a witty and perceptive (...) theologian, culture critic, and playwright, Dorothy Sayers sheds new,unexpected light on a specific set of statements made in the Christian creeds. She examines anew such ideas as the image of God, the Trinity, free will, and evil, and in these pages a wholly revitalized understanding of them emerges. The author finds the key in the parallels between the creation of God and the human creative process. She continually refers to each in a way that illuminates both. (shrink)

In his paper, ‘Patients, doctors and risk attitudes,’ Nicholas Makins1 argues that healthcare professionals should defer to a patient’s higher-order risk attitudes (ie, the risk attitudes they desire to have or endorse within themselves upon reflection) when making medical decisions. We argue against Makins’ deference to higher-order risk attitudes on the basis that (1) there are significant practical concerns regarding our ability to easily and consistently access and verify the higher-order risk attitudes of patients, (2) there is a lack of (...) a theoretical limit on higher-order risk attitudes (eg, second, third, fourth order), and (3) the consideration of higher-order risk attitudes is actually more paternalistic than Makins suggests because it narrows what counts as an autonomous preference to the limited occasions in which an individual actually reflects on his or her own risk attitude. On the issue of practicality, we can reasonably expect that healthcare professionals would find difficulty eliciting the higher-order risk attitudes of their patients. Take for example the patient who has never expressed his higher-order desire to be more risk adverse and who is not willing nor comfortable expressing this desire. What is the healthcare professional expected to do in this situation? This is even more of a concern for the incapacitated patient, to which Makins seems to imply that …. (shrink)

There has been a long debate on whether demonstratives are directly referential as Kaplan originally argued, or indirectly referential like a definite description. I propose a new analysis of demonstratives that combines intuitions from both direct and indirect approaches. The demonstrative is analyzed as an indirectly referential expression with a binary maximality operator that takes two arguments, where the second argument can be a deictic pointing, an anaphoric index, or a relative clause. Direct reference is encoded not in the meaning (...) of the demonstrative but in the meaning contributed by the pointing gesture, thus capturing both direct and indirect uses. I further propose that some pronouns in English function as demonstratives, realizing the binary structure and competing with the demonstrative. The main advantages of this proposal include (a) deriving the distribution of pronominal and adnominal demonstratives systematically; (b) capturing the unique interaction that demonstratives have with a pointing gesture; and (c) locating English demonstratives against a larger, cross-linguistic picture. (shrink)

This chapter provides the background to the American women philosophers’ works that are introduced and collected in Knowledge, Mind and Reality: An Introduction by Early Twentieth-Century American Women Philosophers. We describe the institutional context which made these works possible and their methodological and theoretical background. We also provide biographies for their authors.

The developmental importance to humans of the human-constructed physical environment, including myriad modified natural objects or manufactured objects, is well recognized. The importance of the physical dimension of the constructed niche has also been recognized in nonhuman animals with respect to dwellings (e.g., beavers’ dams, birds’ nests, and bees’ hives), but has not previously been applied to technical traditions, despite the fact that enduring alterations of the physical environment left by social partners are part of the constructed niche that supports (...) the learning of technical skills through the phenomenon of delayed social facilitation. These alterations aid learning over a longer time scale than the actions themselves. Thus, technical skills that result in enduring physical artifacts, which themselves aid learning the skills, should be both more persistent in a population and more widespread than technical skills that do not share this feature. This perspective gives us a new lens through which to understand the origins of technical traditions in nonhuman animals, and by extension, in human ancestors. Understanding the process by which traditional technical skills are acquired in nonhuman species gives us insight into the ways that the combination of social and physical niche construction can support the evolution of technical aspects of culture from modest beginnings. (shrink)

The history of research on the genetics of intelligence is fraught with social bias. During the eugenics era, the hereditary theory of intelligence justified policies that encouraged the proliferation of favored races and coercively stemmed procreation by disfavored ones. In the 1970s, Berkeley psychologist Arthur Jensen argued that black students’ innate cognitive inferiority limited the efficacy of federal education programs. The 1994 controversial bestseller The Bell Curve, by Richard J. Herrnstein and Charles Murray, rehashed the claim that race and class (...) disparities stem from immutable differences in inherited intelligence, which could not be eliminated through social interventions. Today most scientists studying the genetics of intelligence distance themselves from this history of social bias by arguing that their research need not investigate intellectual differences between social groups. Rather, they argue, examining the heritability of intelligence can be socially neutral and may even help to reduce social inequities. I argue, however, that research on the genetics of intelligence cannot be socially neutral. Even if we divorce the heritability of intelligence from a eugenicist mission, measuring intelligence remains useful only as a gage of individuals’ appropriate positions in society. Research into the genetics of intelligence ultimately helps to determine individuals’ inherited capacity for particular social positions, even when researchers aim to modify the effects of inheritance. (shrink)

The editors of the _Journal of Medical Ethics_ support the call of the UK Health Alliance on Climate for urgent action to ensure that the current Conference of the Parties to the United Nations Framework Convention on Climate Change ‘finally delivers climate justice for Africa and vulnerable countries’. 1 As they note ‘Africa has suffered disproportionately although it has done little to cause the crisis’. The burden of climate change has thus far fallen disproportionately on Global South countries. The monsoon (...) in Pakistan this year killed over 1100 people and the public health implications of the flooding might affect the health of over 5 million people. 2 The South Asian monsoon impacts the lives of a billion people and the flooding associated with wet seasons is likely to occur eight times more frequently in future years than at present. 3 For many pacific islands such as Kiribati,... (shrink)

Questions about when to limit unhelpful treatments are often raised in general medicine but are less commonly considered in psychiatry. Here we describe a survey of U.S. psychiatrists intended to characterize their attitudes about the management of suicidal ideation in patients with severely treatment-refractory illness. Respondents (n = 212) received one of two cases describing a patient with suicidal ideation due to either borderline personality disorder or major depressive disorder. Both patients were described as receiving all guideline-based and plausible emerging (...) treatments. Respondents rated the expected helpfulness and likelihood of recommending each of four types of intervention: hospitalization, additional medication changes, additional neurostimulation, and additional psychotherapy. Across both cases, most respondents said they were likely to provide each intervention, except for additional neurostimulation in borderline personality disorder, while fewer thought each intervention would be helpful. Substantial minorities of respondents indicated that they would provide an intervention they did not think was likely to be helpful. Our results suggest that while most psychiatrists recognize the possibility that some patients are unlikely to be helped by available treatments, many would continue to offer such treatments. (shrink)

The late ancient commentators on Aristotle, most of them Platonists, have been gradually re-emerging on the philosophical and scholarly horizon during the last two or three decades. Their reappearance is not likely to cause any major transformations of the scene, but they are interesting enough in themselves to deserve careful study and they have been influential in the past to the extent that proper understanding of their work sheds light on the subsequent history of the interpretation of Aristotle. This and (...) much more is borne out by Blumenthal's excellent study. A considerable number of ancient commentaries have now appeared in English translations initiated by Richard Sorabji, and books and articles on them have begun to appear as never before. After writing some pioneering works on Plotinus's psychology, in which the relevance of Aristotle for the latter's fundamentally Platonic psychology is much in focus, Blumenthal set out in the 1970s to study the commentators and thus belongs to the pioneers in the contemporary awakening. (shrink)

In a number of influential articles published since 1972, Dorothy Grover has developed the prosentential theory of truth. Brought together and published with a new introduction, these essays are even more impressive as a group than they were as single contributions to philosophy and linguistics. Denying that truth has an explanatory role, the prosentential theory does not address traditional truth issues like belief, meaning, and justification. Instead, it focuses on the grammatical role of the truth predicate and asserts that (...) “it is true” is a prosentence, functioning much as a pronoun does. Grover defends the theory by indicating how it can handle notorious paradoxes like the Liar, as well as by analyzing some English truth-usages. The introduction to the volume surveys traditional theories of truth, including correspondence, pragmatic, and coherence theories. It discusses the essays to come and, finally, considers the implications of the prosentential theory for other theories. Despite the fact that the prosentential theory dismisses the “nature of truth” as a red herring, Grover shows that there are important aspects of traditional truth theories that prosentential theorists have the option of endorsing. (shrink)

Benedict Spinoza is feted as the philosopher par excellence of the popular democratic multitude by Antonio Negri and others. But Spinoza himself expresses a marked ambivalence about the multitude in brief asides, and as for his thoughts on what he calls “the rule of multitude,” that is, democracy, these exist only as meager fragments in his unfinished Tractatus Politicus or Political Treatise. This essay addresses the problem of Spinoza’s multitude. First, I reconstruct a vision of power that is found in (...) the Ethics but that tends to be overlooked in the scholarly literature: power is not just sheer efficacy or imposition of will, but rather involves a capacity for being-affected; I call this the conception of power as sensitivity. The second part of my argument shows how, given Spinoza’s emphatic political naturalism, the conception of power as sensitivity can be extended to his political philosophy to shed light on what Spinoza calls potentia multitudinis, or “the power of the multitude”—a term found solely in the Political Treatise and nowhere else in his oeuvre. This juxtaposition reveals significant qualifications to the liberatory potential of the multitude currently claimed in the scholarly literature. (shrink)

Dystonia is a movement disorder that can have a debilitating impact on motor functions and quality of life. There are 250,000 cases in the United States, most with childhood onset. Due to the limited effectiveness and side effects of available treatments, pediatric deep brain stimulation has emerged as an intervention for refractory dystonia. However, there is limited clinical and neuroethics research in this area of clinical practice. This paper examines whether it is ethically justified to offer pDBS to children with (...) refractory dystonia. Given the favorable risk-benefit profile, it is concluded that offering pDBS is ethically justified for certain etiologies of dystonia, but it is less clear for others. In addition, various ethical and policy concerns are discussed, which need to be addressed to optimize the practice of offering pDBS for dystonia. Strategies are proposed to help address these concerns as pDBS continues to expand. (shrink)

The article argues that Marx’s use of the concept of ideology in The German Ideology is incidental to a sustained critique of how those he described as the German ideologists think and reason about society and history and that this critique is not simply of an idealist theory that represents society and history as determined by consciousness but of methods of reasoning that treat concepts, even of those of political economy, as determinants. His view of how consciousness is determined historically (...) by our social being does not envisage some kind of mechanical transfer of class status to class consciousness. Rather, he works with an epistemology that takes the concepts foundational to political economy as expressions or reflections of the social relations of a mode of production. The difference between ideology and science is the difference between treating those concepts as the primitives of theory and treating them as sites for exploring the social relations that are expressed in them. Thus, the historical rather than further undermining claims to knowledge, provides both the conditions under which knowledge is possible and its limitations. (shrink)

The host actin nucleation machinery is subverted by many bacterial pathogens to facilitate their entry, motility, replication, and survival. The majority of research conducted in the past primarily focused on exploitation of a host actin nucleator, the Arp2/3 complex, by bacterial pathogens. Recently, new studies have begun to explore the role of formins, another family of host actin nucleators, in bacterial pathogenesis. This review provides an overview of recent advances in the study of the exploitation of the Arp2/3 complex and (...) formins by bacterial pathogens. Secreted bacterial effector proteins seem to manipulate the regulation of these actin nucleators or functionally mimic them to drive bacterial entry, motility and survival within host cells. An enhanced understanding of how formins are exploited will provide us with greater insight into how a fundamental eurkaryotic cellular process is utilized by bacteria and will also advance our knowledge of host‐pathogen interactions. (shrink)

The human body is becoming hot property, a resource to be “mined,” “harvested,” patented, and traded commercially for profit as well as scientific and therapeutic advances. Under the new entrepreneurial approach to the body old tensions take on new dimensions—about consent, the fair distribution of tissues and products developed from them, the individual and cultural values represented by the body, and public policy governing the use of organs and tissues.

This study investigated whether musical training and bilingualism are associated with enhancements in specific components of executive function, namely, task switching and dual-task performance. Participants belonging to one of four groups were matched on age and socioeconomic status and administered task switching and dual-task paradigms. Results demonstrated reduced global and local switch costs in musicians compared with non-musicians, suggesting that musical training can contribute to increased efficiency in the ability to shift flexibly between mental sets. On dual-task performance, musicians also (...) outperformed non-musicians. There was neither a cognitive advantage for bilinguals relative to monolinguals, nor an interaction between music and language to suggest additive effects of both types of experience. These findings demonstrate that long-term musical training is associated with improvements in task switching and dual-task performance. (shrink)