It describes and explains the patient-centered model examining and evaluating qualitative and quantitative research. It comprehensively covers the evolution and the six interactive components of the patient-centered clinical method, taking the reader through the relationships between the patient and doctor and the patient and clinician. All the editors are professors in the Department of Family Medicine at the University of Western Ontario, London, Canada.

Three experiments investigated the processing of the implicature associated with some using a “gumball paradigm.” On each trial, participants saw an image of a gumball machine with an upper chamber with 13 gumballs and an empty lower chamber. Gumballs then dropped to the lower chamber and participants evaluated statements, such as “You got some of the gumballs.” Experiment 1 established that some is less natural for reference to small sets and unpartitioned sets compared to intermediate sets. Partitive some of was (...) less natural than simple some when used with the unpartitioned set. In Experiment 2, including exact number descriptions lowered naturalness ratings for some with small sets but not for intermediate size sets and the unpartitioned set. In Experiment 3, the naturalness ratings from Experiment 2 predicted response times. The results are interpreted as evidence for a Constraint-Based account of scalar implicature processing and against both two-stage, Literal-First models and pragmatic Default models. (shrink)

This paper explains the metaphysical implications of the view that species are individuals (SAI). I first clarify SAI in light of the separate distinctions between individuals and classes, particulars and universals, and abstract and concrete things. I then show why the standard arguments given in defense of SAI are not compelling. Nonetheless, the ontological status of species is linked to the traditional "species problem," in that certain species concepts do entail that species are individuals. I develop the idea that species (...) names are rigid designators and show how this provides additional motivation for SAI. (shrink)

Two ideas shape the epistemology of testimony. One is that testimony provides a unique kind of knowledge. The other is that testimonial knowledge is a social achievement. In traditional terms, those who affirm these ideas are anti-reductionists, and those who deny them are reductionists. There is increasing interest, however, in the possibility of affirming these ideas without embracing anti-reductionism. Thus, Sanford Goldberg uses the idea of epistemic buck-passing to argue that even reductionists can accept the uniqueness of testimonial knowledge, and (...) Jennifer Lackey gives both speaker and hearer an essential role in testimonial justification, rejecting both reductionism and anti-reductionism in favor of what she calls dualism. After distinguishing a weaker and a stronger notion of buck-passing, we show how anti-reductionists can use the stronger notion to motivate their position, and to answer Goldberg’s and Lackey’s challenges. (shrink)

Many nonhuman animals have the emotional capacities to form caring relationships that matter to them, and for their immediate welfare. Drawing from care ethics, we argue that these relationships also matter as objectively valuable states of affairs. They are part of what is good in this world. However, the value of care is precarious in human-animal interactions. Be it in farming, research, wildlife ‘management’, zoos, or pet-keeping, the prevention, disruption, manipulation, and instrumentalization of care in animals by humans is ubiquitous. (...) We criticize a narrow conception of welfare that, in practice, tends to overlook non-experiential forms of harm that occur when we interfere with caring animals. Additionally, we point out wrongs against caring animals that are not just unaccounted for but denied by even an expansive welfare perspective: The instrumentalization of care and caring animals in systems of use can occur as a harmless wrong that an approach purely focused on welfare may, in fact, condone. We should therefore adopt an ethical perspective that goes beyond welfare in our dealings with caring animals. (shrink)

This paper presents and defends an account of the coincidence of biological organisms with mereological sums of their material components. That is, an organism and the sum of its material components are distinct material objects existing in the same place at the same time. Instead of relying on historical or modal differences to show how such coincident entities are distinct, this paper argues that there is a class of physiological properties of biological organisms that their coincident mereological sums do not (...) have. The account answers some of the most pressing objections to coincidence, for example the so-called grounding problem , that material coincidence seems to require that coinciding objects have modal differences that do not supervene on any other properties. (shrink)

En este artículo, presentamos algunos de los factores que inciden en la vulnerabilidad educativa de las personas con discapacidad. Partimos de la discusión sobre lo que entendemos por vulnerabilidad, para posteriormente analizar algunas cuestiones que intervienen en la exclusión de este colectivo y que apuntan tanto al nivel social como a las condiciones de los sistemas educativos.

Taiwan was affected by an outbreak of severe acute respiratory syndrome (SARS) in early 2003. A questionnaire survey was conducted to determine (1) the perceptions of risk of SARS infection in nurses; (2) the proportion of nurses considering leaving their job; and (3) work as well as non-work factors related to nurses' consideration of leaving their job because of the SARS outbreak. Nearly three quarters (71.9%) of the participants believed they were 'at great risk of exposure to SARS', 49.9% felt'an (...) increase in workload', and 32.4% thought that people avoided them because of their job; 7.6% of the nurses not only considered that they should not care for SARS patients but were looking for another job or considering resignation. The main predictors of nurses' consideration of leaving their job were shorter tenure, increased work stress, perceived risk of fatality from SARS, and affected social relationships. The findings are important in view of potential impending threats of pandemics such as avian influenza. (shrink)

Locke is often cited as a precursor to contemporary natural kind realism. However, careful attention to Locke’s arguments show that he was unequivocally a conventionalist about natural kinds. To the extent that contemporary natural kind realists see themselves as following Locke, they misunderstand what he was trying to do. Locke argues that natural kinds require either dubious metaphysical commitments (e.g., to substantial forms or universals), or a question-begging version of essentialism. Contemporary natural kind realists face a similar dilemma, and should (...) not appeal to Locke in their defense. (shrink)

: New genetic technologies continue to emerge that allow us to control the genetic endowment of future children. Increasingly the claim is made that it is morally "irresponsible" for parents to fail to use such technologies when they know their possible children are at risk for a serious genetic disorder. We believe such charges are often unwarranted. Our goal in this article is to offer a careful conceptual analysis of the language of irresponsibility in an effort to encourage more care (...) in its use. Two of our more important sub-claims are: A fair judgment of genetic irresponsibility necessarily requires a thick background description of the specific reproductive choice; and there is no necessary connection between an act's being morally wrong and its being irresponsible. These are distinct judgments requiring distinct justifications. (shrink)

In everyday contexts we do numerous things together. Philosophers of collective intentionality have wondered how we can distinguish parallel cases from cases where we act together. Often their theories argue in favor of one characteristic, feature, or function, that differentiates the two. This feature then distinguishes parallel actions from joint action. The approach in this book is different. Three claims are developed: (1) There are several functions that help human agents coordinate and act together. (2) This entails that joint action (...) should be understood through these different, interrelated, types of coordination. (3) A multidimensional conceptual space, with three levels of control and coordination, will allow us to connect these different forms of coordination and their interdependencies. This allows us to understand the jointness of an action in a more differentiated and encompassing way. This approach has ramifications for several distinctions that are typically understood to be binary, including those between action and mere bodily movement, joint action and parallel action, and action together and not together. (shrink)

In Ethics 1p5, Spinoza asserts that “In Nature there cannot be two or more substances of the same nature or attribute”. This claim serves as a crucial premise in Spinoza’s argument for substance monism, yet Spinoza’s demonstration of the 1p5 claim is surprisingly brief and appears to have obvious difficulties. This paper answers the principle difficulties that have been raised in response to Spinoza’s argument for 1p5. The key to understanding the 1p5 argument lies in a proper understanding of the (...) substance-attribute relationship and the principles of metaphysical individuation that Spinoza accepts. (shrink)

Dichotomous thinking about mental phenomena is abundant in philosophy. One particularly tenacious dichotomy is between “automatic” and “controlled” processes. In this characterization automatic and unintelligent go hand in hand, as do non-automatic and intelligent. Accounts of skillful action have problematized this dichotomous conceptualization and moved towards a more nuanced understanding of human agency. This binary thinking is, however, still abundant in the philosophy of joint action. Habits and skills allow us agentic ways of guiding complex action routines that would otherwise (...) overwhelm our reflective capacities. In this paper, I look at how theories of skill, habit, and know-how in individual action can inform a non-dichotomous account of joint action. I argue that a fuller understanding of joint agency has to understand not only group know-how, but also the role of attention and the highly integrated types of control that allow agents to act together. (shrink)

Dichotomous thinking about mental phenomena is abundant in philosophy. One particularly tenacious dichotomy is between “automatic” and “controlled” processes. In this characterization automatic and unintelligent go hand in hand, as do non-automatic and intelligent. Accounts of skillful action have problematized this dichotomous conceptualization and moved towards a more nuanced understanding of human agency. This binary thinking is, however, still abundant in the philosophy of joint action. Habits and skills allow us agentic ways of guiding complex action routines that would otherwise (...) overwhelm our reflective capacities. In this paper, I look at how theories of skill, habit, and know-how in individual action can inform a non-dichotomous account of joint action. I argue that a fuller understanding of joint agency has to understand not only group know-how, but also the role of attention and the highly integrated types of control that allow agents to act together. (shrink)

The “reproductive suppression hypothesis” states that the strong desire of adolescent girls in our culture to control their weight may reflect the operation of an adaptive mechanism by which ancestral women controlled the timing of their sexual maturation and hence first reproduction, in response to cues about the probable success of reproduction in the current situation. We develop a model based on this hypothesis and explore its behavior and evolutionary and psychological implications across a range of parameter values. We use (...) the process of model development to identify assumptions implicit in the reproductive suppression hypothesis and variables that need to be measured in order to investigate it more fully. In addition, because costs were probably associated with weight control, an important part of this analysis is the specification of situations in which the benefits of adaptive adjustment of the maturation schedule could have outweighed the costs of achieving that adjustment by slowing adolescent weight gain. (shrink)

The article focuses on the study on moral conflicts and ethical relativism. There are few theories in the history ethics that stated that a moral dilemma can not be adhered by to moral requirements. According to philosophy professor David Wong, occurrence of irresolvable moral disagreement is one of the normative problems. On the other hand, the author asserted that single-agent moral conflicts do not necessarily fall under the relativism theory.

I begin with a discussion of the value of privacy and what we lose without it. I then turn to the difficulties of preserving privacy for genetic information and other medical records in the face of advanced information technology. I suggest three alternative public policy approaches to the problem of protecting individual privacy and also preserving databases for genetic research:(1) governmental guidelines and centralized databases, (2) corporate self-regulation, and (3) my hybrid approach. None of these are unproblematic; I discuss strengths (...) and drawbacks of each, emphasizing the importance of protecting the privacy of sensitive medical and genetic information as well as letting information technology flourish to aid patient care, public health and scientific research. (shrink)

High profile breaches of data security in government and other organizations are becoming an increasing concern amongst members of the public. Academic researchers have rarely discussed data security issues as they affect research, and this is especially the case for qualitative social researchers, who are sometimes disinclined to technical solutions. This paper describes 14 guidelines developed to help qualitative researchers improve the security of their digitally-created and stored data. We developed these procedures after the theft of a laptop computer containing (...) highly sensitive data from the home of a fieldworker. This paper introduces the ‘principle of proliferation’: digitally-created and stored files tend to proliferate during the course of a research project by virtue of fact that they can and are copied and shared as research progresses from data collection through to analysis and archive. Our guidelines were designed as concrete strategies that researchers embarking on a project can employ, particularly researchers working in teams, to accommodate this proliferation and reduce it where possible. (shrink)

This paper challenges the assumption that reasons are intrinsic to rational action. A great many actions are not best understood as ones in which the agent acted for reasons--and yet they can be understood as rational, and as open to rational criticism. The relative paucity of explicit reason-giving, practical arguments in daily life presents a general philosophical problem. It reflects the existence of a class of ways in which reason can regulate action, which goes far beyond producing reasons or applying (...) principles. Much practical reasoning takes the form of what H. P. Grice called 'thought-transitions'. These are neither in the form of standard practical arguments, nor can they be so reconstructed without distorting the ways in which an agent thinks. Some actions to which one is led by a thought transition are rational, namely when what Grice called a 'propension' towards a given class of actions--a standing inclination to act in certain ways--would itself stand up to rational evaluation. The paper examines two bases for such endorsement, one local and limited, and one much more speculative, due to Grice himself. (shrink)

Knowledge of others, then, has value; so does immunity from being known. The ability to extend one's knowledge has value; so does the ability to limit other's knowledge of oneself. I have claimed that no interest can count as a right unless it clearly outweighs opposing interests whose presence is logically entailed. I see no way to establish that my interest in not being known, simply as such, outweighs your desire to know about me. I acknowledge the intuitive attractiveness of (...) such a position; but my earlier discussion concluded that the value of privacy is ease, and the value of knowledge is understanding - and it's not obvious that either outweighs the other. Nor is it obvious that the freedom and autonomy which result from the power to limit what others know is more significant than the freedom and autonomy which result from the power to extend one's knowledge. I believe the intuitive attractiveness of the belief that privacy values outweigh knowledge values lies in the entirely correct belief that a society without any privacy would be unpleasant. But a society without mutual knowledge would be impossible.I conclude therefore that there is no right to privacy nor to control over it. Nevertheless, each of these things is a good, and a good made possible (given the presence of other people) by social structures. A desirable society will provide both privacy and control over privacy to some extent. Nothing in my analysis helps determine what the proper extent is, nor what areas of life particularly deserve protection. Those who would argue that privacy and control over it are entailed by respect for persons should, I think, choose instead some particular areas central to being a person, to counting as a person, and then show how one is less likely to exercise one's capacities there fully without privacy or without control over it. Although Gerstein's attempt fails because he inaccurately defines intimacy as a kind of absorption and incorrectly opposes absorption with publicity, I think it is the kind of attempt which must be made. Furthermore, he has probably chosen the right area of life - if anything has a special claim to privacy it is probably the union between people who care for one another. The value of being together alone may be more significant than the value of being alone, if only because words and actions are public while thoughts are not. But I will not try to develop that argument here.In any case both privacy and control over it are social goods; on egalitarian grounds they should, ceteris paribus, be equally available to everyone. This helps explain the “dehumanizing” effect of institutions which provide no privacy at all- prisons and some mental institutions. It is not so much that the inmates are totally known; it is rather that those who know them are not so fully known by them; further, that the staff has a great deal of control over what they disclose of themselves, and the inmates very little. The asymmetry of knowledge in those institutions is one aspect of the asymmetry of power; the completely powerless are likely to feel dehumanized.My analysis also helps account for the wrongness of covert observation. It is not simply that the observer violates the wishes of the observed, for the question is whose wishes trump. The observer is violating the justified expectations of the observed: expectations supported by weighty social conventions. These have more moral weight than simple desires do. The peeping torn is violating a convention which structures the distribution of knowledge, a convention from which he benefits. Without it his own activities might well be impossible. He might be more easily caught; or his victim, less trusting, might choose houses without windows. More deeply, the thrill of what he is doing depends on the existence of the convention. Even morally permissible excitement - the suggestiveness of some clothing- would disappear without conventions about nudity. Presumably, too, there are elements of his own personal life for which he values his privacy. He is on grounds of justice obligated to observe the rule which makes his benefits possible.(Some claims to privacy result from personal predilections, rather than from convention. Parent describes a person who is extremely sensitive about being short, for instance, and does not want his exact height to be common knowledge. Parent, p. 346. The grounds for these claims are obviously different from those I've been discussing. The grounds are the moral obligation not to cause needless pain, or, if the information was given in confidence, to keep one's promises.) Although there is no right to privacy or to control over it as such, there is a right to equality of consideration and to a just distribution of benefits and burdens. To put it another way: there is no natural human right to privacy or to control over it; but a good society will provide some of each, and justice requires that the rules of a good society be observed. This paper was written during Joel Feinberg's 1984 NEH Summer Seminar. I am indebted to NEH for funding, and to Professor Feinberg and the other members of the seminar for helpful comments. (shrink)

Bioethicists appearing in the media have been accused of "shooting from the hip" (Rachels, 1991). The criticism is sometimes justified. We identify some reasons our interactions with the press can have bad results and suggest remedies. In particular we describe a target (fostering better public dialogue), obstacles to hitting the target (such as intrinsic and accidental defects in our knowledge) and suggest some practical ways to surmont those obstacles (including seeking out ways to write or speak at length, rather than (...) in sound bites). We make use of our own research into the way journalists quote bioethicists. We end by suggesting that the profession as a whole look into this question more fully. (shrink)

This paper begins with a discussion of the value of privacy,especially for medical records in an age of advancing technology.I then examine three alternative approaches to protection ofmedical records: reliance on governmental guidelines, the useof corporate self-regulation, and my own third hybrid view onhow to maintain a presumption in favor of privacy with respectto medical information, safeguarding privacy as vigorously andcomprehensively as possible, without sacrificing the benefitsof new information technology in medicine. None of the threemodels I examine are unproblematic, yet (...) it is crucial to weighthe strengths and weaknesses of these alternative approaches. (shrink)

Individuals care about and guard their privacy intensely in many areas. With respect to patient medical records, people are exceedingly concerned about privacy protection, because they recognize that health care generates the most sensitive sorts of personal information. In an age of advancing technology, with the switch from paper medical files to massive computer databases, privacy protection for medical information poses a dramatic challenge. Given high-speed computers and Internet capabilities, as well as other advanced communications technologies, the potential for abuse (...) is much greater than ever before. At every stage in the process of collection and storage, dangers can arise, including entry errors, improper access, exploitation, and unauthorized disclosure. Secondary use and aggregation of data are all far easier, faster, and less expensive, and thus pose additional threats to an individual's control over the disposition of medical information. (shrink)

When two agents of unequal strength compete, the stronger one is expected to always win the competition. This expectation is based on the assumption that evaluation of performance is complete, hence flawless. If, however, the agents are evaluated on the basis of only a small sample of their performance, the weaker agent still stands a chance of winning occasionally. A theoretical analysis indicates that, to increase the chance of this happening the weaker agent ought to give up on enough occasions (...) so that he or she can match the stronger agent on the remaining ones. We model such a competition in a game, present its game‐theoretic solution, and report an experiment, involving 144 individuals, in which we tested whether players (both weak and strong) are actually sensitive to their relative strengths and know how to allocate their resources accordingly. Our results indicate that they do. (shrink)