Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

Throughout his life, John Tyler Bonner contributed to major transformations in the fields of developmental and evolutionary biology. He pondered the evolution of complexity and the significance of randomness in evolution, and was instrumental in the formation of evolutionary developmental biology. His contributions were vast, ranging from highly technical scientific articles to numerous books written for a broad audience. This historical vignette gathers reflections by several prominent researchers on the greatness of John Bonner and the implications of his work.

© 2014 Taylor Francis. The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus testing of every client presenting for services in venues where HIV prevalence is high. Because older adults have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent and ever HIV testing in a probability sample of at-risk (...) adults seeking services in needle exchange sites, sexually transmitted disease clinics, and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months or ever. Aging-related disparities in HIV testing exist among clients of these high HIV prevalence venues and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis. (shrink)

"O'Meara masterfully situates Pryzwara in relation to the traditional and contemporary theological, philosophical, ecclesial, cultural, and social contexts within which he wrote." --_William P. Loewe, professor of religious studies, Catholic University of America_ Erich Przywara, S.J. is one of the important Catholic intellectuals of the twentieth century. Yet, in the English-speaking world Przywara remains largely unknown. Few of his sixty books or six hundred articles have been translated. In this engaging new book, Thomas O'Meara offers a comprehensive study of the (...) German Jesuit Erich Przywara and his philosophical theology. Przywara's scholarly contributions were remarkable. He was one of three theologians who introduced the writings of John Henry Cardinal Newman into Germany. From his position at the Jesuit journal in Munich, _Stimmen der Zeit_, he offered an open and broad Catholic perspective on the cultural, philosophical, and theological currents of his time. As one of the first Catholic intellectuals to employ the phenomenologies of Edmund Husserl and Max Scheler, he was also responsible for giving an influential, more theological interpretation of the Spiritual Exercises of Ignatius Loyola. Przywara was also deeply engaged in the ideas and authors of his times. He was the first Catholic dialogue partner of Karl Barth and Paul Tillich. Edmund Husserl was counted among Przywara's friends, and Edith Stein was a close personal and intellectual companion. Through his interactions with important figures of his age and his writings, ranging from speculative systems to liturgical hymns, Przywara was of marked importance in furthering a varied dialogue between German Catholicism and modern culture. Following a foreword by Michael Fahey, S.J., O'Meara presents a chapter on Pryzwara's life and a chronology of his writings. O'Meara then discusses Pryzwara's philosophical theology, his lecture-courses at German universities on Augustine and Aquinas, his philosophy of religion, and his influence on important intellectual contemporaries. O'Meara concludes with an in-depth analysis of Pryzwara's theology, focusing particularly on his Catholic views of person, liturgy, and church. (shrink)

The achievements of the textile industry in Roman Britain are often underestimated as a result of the meagreness of our available evidence. The Edict on maximum prices issued by Diocletian in A.D. 301 shows that British capes commanded high prices on the markets of the Empire, and that in the late third century A.D. British rugs were the best in the world. In view of the competition from the traditional centres of rug manufacture in the East, this is an astonishing (...) achievement. (shrink)

The received translation and interpretation of many of the technical terms current in the textile industry of the Roman Empire are inaccurate, because lexicographers have either fought shy of being precise, or have thought that they recognized in the ancient world technical processes which originated at a much later date. The evidence is often equivocal or insufficient, but may still yield details that have been overlooked. The textile expression scutulatus, to take an example, deserves more attention than Blümner has devoted (...) to it. When it refers to the appearance of a garment, Lewis and Short, s.v. scutulatus, translate ‘diamond or lozenge-shaped, checkered’. It seems worth while to attempt a more precise translation, and, if possible, to estimate the significance in context of the goods so designated. (shrink)

The foundations of law. The digest title, De diversis regulis iuris antiqui, and the general principles of law, by P. Stein. Equity in Chinese customary law, by W. Y. Tsao. Prolegomena to the theory and history of Jewish law, by H. Cohn. Juridical evolution and equity, by J.P. Brutau. Reflections on the sources of the law, by P. Lepaulle. The true nature and province of jurisprudence from the viewpoint of Indian philosophy, by M.J. Sethna. On the functions and aims of (...) the state, by G. Del Veccchio.--Concepts of jurisprudence. Legal language and reality, by K. Olivecrona. The logic of the reasonable as differentiated from the logic of the rational (human reason in the making and the interpretation of the law) by L. Recaséns-Siches. Some refections on status and freedom, by W.G. Friedmann. Law and power and their correlation, by M. Reale. The notion of canonical auctoritas with respect to statute, custom and usage, by B.F. Brown. Two theories of "the institution," by J. Stone. (shrink)

Doctors’ strikes are legally permissible in the UK, with the situation differing in other countries. But are they morally permissible? Doug McConnell and Darren Mann have systematically attempted to dismiss the arguments for the moral impermissibility of doctors’ strikes and creatively attempted to provide further moral justification for them. Unfortunately for striking doctors, they fail to achieve this. Meanwhile, junior doctors’ strikes have continued in the UK through 2023 and have now extended into 2024. In this response, which focuses on (...) the UK situation and specifically junior doctors’ strikes in the National Health Service (NHS) in England, I will demonstrate a central problem with their arguments—namely that they underplay the harms caused by prolonged doctors’ strikes by ignoring the harms to patients with cancer. This weakens their conclusion that strikes are morally permissible in terms of the conditions and thresholds they set. I then provide a psychological critique of their justification for strikes in terms of the interests of the public. It follows that invoking the controversial concept of supererogatory action is ungrounded but also absurd when you consider time-critical cancer care. If those representing striking doctors wish to maintain a modicum of moral respectability, they should mitigate for patients with cancer and negotiate reasonably and with urgency. (shrink)

The Twin Earth thought experiment invites us to consider a liquid that has all of the superficial properties associated with water (clear, potable, etc.) but has entirely different deeper causal properties (composed of “XYZ” rather than of H2O). Although this thought experiment was originally introduced to illuminate questions in the theory of reference, it has also played a crucial role in empirically informed debates within the philosophy of psychology about people’s ordinary natural kind concepts. Those debates have sought to accommodate (...) an apparent fact about ordinary people’s judgments: Intuitively, the Twin Earth liquid is not water. We present results from four experiments showing that people do not, in fact, have this intuition. Instead, people tend to have the intuition that there is a sense in which the liquid is not water but also a sense in which it is water. We explore the implications of this finding for debates about theories of natural kind concepts, arguing that it supports views positing two distinct criteria for membership in natural kind categories – one based on deeper causal properties, the other based on superficial, observable properties. (shrink)

Informal logic has expanded the concept of an 'argument' beyond that presented traditionally by formal logicians-to include arguments as encountered in 'real-life'. Existent definitions of argument structure are argued to be inadequate by failing to fully recognise that, ultimately, arguments have a human source. Accordingly, a new definition is proposed which appeals to relevant cognitive and behavioural factors. The definition retains some traditional concepts, but introduces the term 'supportive' as a modification to 'premiss'. The concept of a 'persuader' is also (...) developed. The definition is argued to capture more fully the intricacies, subtleties and rich diversity of informal arguments. (shrink)

This paper defends traditional political philosophy against the challenges Gaus leverages against it in The Open Society and Its Complexities. Granting Gaus that consensus on the principles of political philosophy is not forthcoming and that complexity undermines many of our most ambitious reform efforts, the paper argues that much work remains for political philosophy as it has been practiced for centuries. This is for three reasons. First, Gaus's own defense of the open society requires resources from the very traditions that (...) he tends to dismiss. Secondly, the kinds of reform Gaus encourages us to focus on in light of complexity presuppose answers to philosophical questions, answers that philosophers have long attempted to provide. Thirdly, not all politically salient philosophical questions are aimed at action guidance. Despite the value in Gaus's analysis, I conclude that political philosophy's future will look, at least in part, like its storied past. (shrink)

This chapter discusses author's view a Thomistic‐like dualism. Next, it lays out the details of his position and he argues that it has certain advantages over physicalist treatments of the human person, and, to a lesser degree, over alternate versions of substance dualism. Then, he responds to some objections against his position. He accepts constituent realism regarding properties (and relations), according to which properties (and relations) are universals that, when exemplified (and they need not be to exist), become constituents of (...) the ordinary particulars that have them. Furthermore, with the Thomistic framework in mind, the chapter offers his view of a human person. Finally, there is the argument that attempts to show that the unity of consciousness cannot be explained if one is a brain, because a brain is just an aggregate of different physical (separable) parts. (shrink)

This chapter contains sections titled: Section One: The Backdrop for Locating Consciousness in a Naturalist Ontology Section Two: The AC Section Three: John Searle and Contingent Correlation Section Four: Timothy O'Connor and Emergent Necessitation Section Five: Colin McGinn and Mysterian “Naturalism” Conclusion Further Reading References.

In their thought-provoking article, Sedlakova and Trachsel (2023) defend the view that the status—both epistemic and ethical—of Conversational Artificial Intelligence (CAI) used in psychotherapy is complicated. While therapeutic CAI seems to be more than a mere tool implementing particular therapeutic techniques, it falls short of being a “digital therapist.” One of the main arguments supporting the latter claim is that even though “the interaction with CAI happens in the course of conversation… the conversation is profoundly different from a conversation with (...) a human therapist” (Sedlakova and Trachsel 2023, 8). In particular, unlike a human therapist, CAI cannot help its users gain new insight and self-understanding (Sedlakova and Trachsel 2023). We agree that currently available therapeutic CAI cannot be considered a “digital therapist,” however, we think that the issue surrounding the acquisition of new self-understanding in the interaction with therapeutic CAI is more complicated than Sedlakova and Trachsel suggest. (shrink)

Growing demand for broadly accessible mental health care, together with the rapid development of new technologies, trigger discussions about the feasibility of psychotherapeutic interventions based on interactions with Conversational Artificial Intelligence (CAI). Many authors argue that while currently available CAI can be a useful supplement for human-delivered psychotherapy, it is not yet capable of delivering fully fledged psychotherapy on its own. The goal of this paper is to investigate what are the most important obstacles on our way to developing CAI (...) systems capable of delivering psychotherapy in the future. To this end, we formulate and discuss three challenges central to this quest. Firstly, we might not be able to develop effective AI-based psychotherapy unless we deepen our understanding of what makes human-delivered psychotherapy effective. Secondly, assuming that it requires building a therapeutic relationship, it is not clear whether psychotherapy can be delivered by non-human agents. Thirdly, conducting psychotherapy might be a problem too complicated for narrow AI, i.e., AI proficient in dealing with only relatively simple and well-delineated tasks. If this is the case, we should not expect CAI to be capable of delivering fully-fledged psychotherapy until the so-called “general” or “human-like” AI is developed. While we believe that all these challenges can ultimately be overcome, we think that being mindful of them is crucial to ensure well-balanced and steady progress on our path to AI-based psychotherapy. (shrink)

While my own philosophical views are largely in keeping with my mentor, Dallas Willard, nevertheless, I find his conception of the human person puzzling, hard to specify precisely, and prima facie contradictory in a few places. Dallas's central goal in formulating his anthropology was to develop a model that shed light on, allowed for deeper insight into, and fostered interest in spiritual formation, especially the role of the body in spiritual maturation. I share this goal, and agree with most of (...) his model. But in what follows, I will make more precise what his views were, try to clear up what, prima facie, seem to be contradictions in his theory, and, finally, recommend an alternative that captures the central concerns Dallas had for his own position. Thus, I will lay out a few general points of Dallas's ontology, provide a description of his philosophical/theological anthropology, along with two problems that seem to be present, and offer a slightly adjusted alternative to his position that accomplishes his main goal in a way with which I believe he would be satisfied. (shrink)

The majority of our linguistic exchanges, such as everyday conversations, are divided into turns; one party usually talks at a time, with only relatively rare occurrences of brief overlaps in which there are two simultaneous speakers. Moreover, conversational turn-taking tends to be very fast. We typically start producing our responses before the previous turn has finished, i.e., before we are confronted with the full content of our interlocutor’s utterance. This raises interesting questions about the nature of linguistic understanding. Philosophical theories (...) typically focus on linguistic understanding characterized either as an ability to grasp the contents of utterances in a given language or as outputs of this ability—mental states of one type or another. In this paper, I supplement these theories by developing an account of the process of understanding. I argue that it enables us to capture the dynamic and temporal aspect of understanding and reconcile philosophical investigations with empirical research on language comprehension. (shrink)

Neologicists have sought to ground mathematical knowledge in abstraction. One especially obstinate problem for this account is the bad company problem. The leading neologicist strategy for resolving this problem is to attempt to sift the good abstraction principles from the bad. This response faces a dilemma: the system of ‘good’ abstraction principles either falls foul of the Scylla of inconsistency or the Charybdis of being unable to recover a modest portion of Zermelo–Fraenkel set theory with its intended generality. This article (...) argues that the bad company problem is due to the ‘static’ character of abstraction on the neologicist's account and develops a ‘dynamic’ account of abstraction that avoids both horns of the dilemma. 1 Introduction2ion Reconstructed3 From Bad to Worse4 Abstraction Reconceived5 Bad Company Made GoodA AppendixA.1SemanticsA.2LogicA.3ConsistencyA.4Strength. (shrink)

It is often suggested that we are equipped with a set of cognitive tools that help us to filter out unreliable testimony. But are these tools effective? I answer this question in two steps. Firstly, I argue that they are not real-time effective. The process of filtering, which takes place simultaneously with or right after language comprehension, does not prevent a particular hearer on a particular occasion from forming beliefs based on false testimony. Secondly, I argue that they are long-term (...) effective. Some hearers sometimes detect false testimony, which increases speakers’ incentives for honesty and stabilizes the practice of human communication in which deception is risky and costly. In short, filtering prevents us from forming a large number of beliefs based on false testimony, not by turning each of us into a high-functioning polygraph but by turning the social environment of human communication into one in which such polygraphs are not required. Finally, I argue that these considerations support strong anti-reductionism about testimonial entitlement. (shrink)