This study assessed the attitudes and needs of physicians and health professional staff at a tertiary care hospital in Canada regarding the introduction of physician assisted dying (PAD) during 2015–16. This research aimed to develop an understanding of the wishes, concerns and hopes of stakeholders related to handling requests for PAD; to determine what supports/structures/resources health care professionals (HCP) require in order to ensure high quality and compassionate care for patients requesting PAD, and a supportive environment for all healthcare providers (...) across the moral spectrum. This study constituted a mixed methods design with a qualitative descriptive approach for the study’s qualitative component. A total of 303 HCPs working in a tertiary care hospital completed an online survey and 64 HCPs working in hospital units with high mortality rates participated in 8 focus group discussions. Both focus group and survey data coalesced around several themes to support the implementation of PAD following the decriminalization of this practice: the importance of high quality care; honoring moral diversity; supporting values (such as autonomy, privacy, beneficence); and developing resources, including collaboration with palliative care, education, policies and a specialized team. This study provided the foundational evidence to support the development of the PAD program described in other papers in this collection, and can be a model for gathering evidence from stakeholders to inform the implementation of PAD in any healthcare organization. (shrink)

Following an initial study of the needs of healthcare providers (HCP) regarding the introduction of Medical Assistance in Dying (MAiD), and the subsequent development of an assisted dying program, this study sought to determine the efficacy and impact of MAiD services following the first two years of implementation. The first of three aims of this research was to understand if the needs, concerns and hopes of stakeholders related to patient requests for MAiD were addressed appropriately. Assessing how HCPs and families (...) perceived the quality of MAiD services, and determining if the program successfully accommodated the diverse needs and perspectives of HCPs, rounded out this quality evaluation. This research implemented a mixed-methods design incorporative of an online survey with Likert scale and open-ended questions, as well as focus groups and interviews with staff and physicians, and interviews with MAiD-involved family members. There were 356 online surveys, as well as 39 participants in six focus groups with HCP, as well as fourteen interviews with MAiD-involved family members. Participants indicated that high-quality MAiD care could only be provided with enabling resources such as policies and guidelines to ensure safe, evidence-based, standardized care, as well as a specialized, trained MAiD team. Both focus group and survey data from HCPs suggest the infrastructure developed by the hospital was effective in delivering high-quality MAiD care that supports the diverse needs of various stakeholders. This study may serve as a model for evaluating the impact and quality of services when novel and ethically-contentious clinical practices are introduced to healthcare organizations. (shrink)

BackgroundUse of modified texture diets—thickening of liquids and modifying the texture of foods—in the hope of preventing aspiration, pneumonia and choking, has become central to the current management of dysphagia. The effectiveness of this intervention has been questioned. We examine requirements for a valid informed consent process for this approach and whether the need for informed consent for this treatment is always understood or applied by practitioners.Main textValid informed consent requires provision of accurate and balanced information, and that agreement is (...) given freely by someone who knows they have a choice. Current evidence, including surveys of practitioners and patients in different settings, suggests that practice in this area is often inadequate. This may be due to patients’ communication difficulties but also poor communication—and no real attempt to obtain consent—by practitioners before people are ‘put on’ modified texture diets. Even where discussion occurs, recommendations may be influenced by professional misconceptions about the efficacy of this treatment, which in turn may poison the well for the informed consent process. Patients cannot make appropriate decisions for themselves if the information provided is flawed and unbalanced. The voluntariness of patients’ decisions is also questionable if they are told ‘you must’, when ‘you might consider’ is more appropriate. Where the decision-making capacity of patients is in question, inappropriate judgements and recommendations may be made by substitute decision makers and courts unless based on accurate information.ConclusionResearch is required to examine the informed consent processes in different settings, but there is ample reason to suggest that current practice in this area is suboptimal. Staff need to reflect on their current practice regarding use of modified texture diets with an awareness of the current evidence and through the ‘lens’ of informed consent. Education is required for staff to clarify the importance of, and requirements for, valid informed consent and for decision making that reflects people’s preferences and values. (shrink)

According to Xenophon, the hetaira "gratified" her patron as a philos, participating in an aristocratic network of gift exchange , while the pornê, as her name signified, trafficked in sex as a commodity. Recent writers on Greek prostitution have acknowledged that hetaira vs. pornê may be as much a discursive opposition as a real difference in status, but still, very little attention has been paid to the period of the "invention" of this binary. Hetaira meaning "courtesan" first occurs in Herodotus (...) and does not exist in Homer: hence, the conceptual category of the hetaira is an invention of the archaic period. What needs generated the constitution of this category? And what conceptual "work" was the opposition hetaira-pornê doing in Greek culture in the period of its inception? This paper addresses these questions through a reading of fragments of archaic lyric-predominantly those of Anakreon-as well as consideration of Attic vase painting. I suggest that the hetaira-pornê opposition participates in the overarching tension between the aristocratic symposium and the public sphere in archaic Greece. Oswyn Murray has suggested that the symposium constitutes itself as a kind of anti-city with its own rules and conventions. Part of the discursive exclusion of the public sphere is the complete suppression of the city's monetarized economy from the domain of the aristocratic symposium, and it is this impulse to mystify economic relations for sex that generates the category of the hetaira within a framework of gift exchange. But if the motives for this discursive invention are economic, they are also political: the hetaira affirms and embodies the circulation of charis within a privileged elite, while the pornê figures the debased and promiscuous exchanges of the agora. (shrink)

In our article, “The Faces of Reason and Its Critics”, Dialogue 25/1, 105–118, Elizabeth Trott and I said that, in his presidential address to the Canadian Philosophical Association, Francis Sparshott “mysteriously seemed to have confused … John Clark Murray … with John Macmurray”. In footnote 6, we reported Martyn Estall's theory that there might, indeed, have been no confusion because Sparshott probably did mean Macmurray who was being “promoted” at Queen's at the time. Professor Sparshott reports that Professor Estall's (...) surmise is the correct solution to the “mystery”. He also reminds us that, when he came to Canada in 1950 he was at University College, Toronto. Later, from 1955 onwards, he was John Irving's colleague at Victoria College. (shrink)

One of the first books to address what has come to be known as the philosophy of cosmology, Universes asks, "Why does the universe exist?", arguing that the universe is "fine tuned for producing life." For example, if the universe's early expansion speed had been smaller by one part in a million, then it would have recollapsed rapidly; with an equivalently tiny speed increase, no galaxies would have formed. Either way, this universe would have been lifeless.

Excellence in sport performance is normally taken to be a matter of superior performance of physical movements or quantitative outcomes of movements. This paper considers whether a wider conception can be afforded by certain kinds of nature based sport. The interplay between technical skill and aesthetic experience in nature based sports is explored, and the extent to which it contributes to a distinction between different sport-based approaches to natural environments. The potential for aesthetic appreciation of environmental engagement is found to (...) be strongly dependent on whether or not environmental engagement is exploited for the end of producing a quantifiable result or enhancing technical skill. It is also argued that an existential rather than spectatorial attitude to aesthetic experience is offered by specifically nature oriented sport. Aesthetic experience achieved in this way is therefore neither passive nor detached, but extends Berleant's concept of participatory environmental aesthetics and underpins both an alternate (wide) conception of excellence in sport activity and a richer experience of aesthetic engagement than more objectivised standpoints. (shrink)

Mind wandering is typically operationalized as task-unrelated thought. Some argue for the need to distinguish between unintentional and intentional mind wandering, where an agent voluntarily shifts attention from task-related to task-unrelated thoughts. We reveal an inconsistency between the standard, task-unrelated thought definition of mind wandering and the occurrence of intentional mind wandering (together with plausible assumptions about tasks and intentions). This suggests that either the standard definition of mind wandering should be rejected or that intentional mind wandering is an incoherent (...) category. Solving this puzzle is critical for advancing theoretical frameworks of mind wandering. (shrink)

From this post-reflective point of view, the book argues for an intimate relationship between cognition, sensorimotor embodiment, and the integrative character ...

The central argument that Leslie Smith makes in this study is that reasoning by mathematical induction develops during childhood. The basis for this claim is a study conducted with children aged five to seven years in school years one and two.

We sometimes fail unwittingly to do things that we ought to do. And we are, from time to time, culpable for these unwitting omissions. We provide an outline of a theory of responsibility for unwitting omissions. We emphasize two distinctive ideas: (i) many unwitting omissions can be understood as failures of appropriate vigilance, and; (ii) the sort of self-control implicated in these failures of appropriate vigilance is valuable. We argue that the norms that govern vigilance and the value of self-control (...) explain culpability for unwitting omissions. (shrink)

Ducks lay eggs' is a true sentence, and `ducks are female' is a false one. Similarly, `mosquitoes carry the West Nile virus' is obviously true, whereas `mosquitoes don't carry the West Nile virus' is patently false. This is so despite the egg-laying ducks' being a subset of the female ones and despite the number of mosquitoes that don't carry the virus being ninety-nine times the number that do. Puzzling facts such as these have made generic sentences defy adequate semantic treatment. (...) However complex the truth conditions of generics appear to be, though, young children grasp generics more quickly and readily than seemingly simpler quantifiers such as `all' and `some'. I present an account of generics that not only illuminates the strange truth conditions of generics, but also explains how young children find them so comparatively easy to acquire. I then argue that generics give voice to our most cognitively primitive generalizations and that this hypothesis accounts for a variety of facts ranging from acquisition patterns to cross-linguistic data concerning the phonological articulation of operators. I go on to develop an account of the nature of these cognitively fundamental generalizations and argue that this account explains the strange truth-conditional behavior of generics. (shrink)

Confabulation is typically understood to be dysfunctional. But this understanding neglects the phenomenon’s potential benefits. In fact, we think that the benefits of non-clinical confabulation provide a better foundation for a general account of confabulation. In this paper, we start from these benefits to develop a social teleological account of confabulation. Central to our account is the idea that confabulation manifests a kind of willful ignorance. By understanding confabulation in this way, we can provide principled explanations for the difference between (...) clinical and non-clinical cases of confabulation and the extent to which confabulation is rational. (shrink)

Leslie Stephen (1832–1904) was a writer, philosopher and literary critic whose work was published widely in the nineteenth century. As a young man Stephen was ordained deacon, but he later became agnostic and much of his work reflects his interest in challenging popular religion. This two-volume work, first published in 1876, is no exception: it focuses on the eighteenth-century deist controversy and its effects, as well as the reactions to what Stephen saw as a revolution in thought. Comprehensive and (...) full of detailed analysis, this is an important work in the history of ideas. Volume 2 focuses on eighteenth-century moral philosophy, political philosophy and literature, and on the literary and religious reactions to the revolution in thought. Utilitarianism is discussed at length, as well as the work of thinkers such as Shaftesbury, Mandeville, Burke and Adam Smith. (shrink)

This edition is not an OCR or a photocopy. It is a new edition.

This book is not aimed at exhuming Kant, but resurrecting him. It is inspired by the Critique of Pure Reason , yet is not about it: perhaps over-ambitiously, it tries to delineate not Kant's metaphysics of experience but the truth of the matter. The author shows rather than says where he agrees and disagrees with the first Critique , in so far as he understood that profound but obscure, over-systematic yet carelessly written, inspiring and infuriating, magnificent but flawed masterpiece. The (...) book attempts a highly systematic presentation, in which the very form of the work reflects the content of the arguments. Kant is often derided for the extent to which he allows his penchant for architectonic structure to distort his insights, but it is argued that he had the right instinct in assuming that there must be some systematic way in which the necessary conditions for experience fit together. The contemporary trend in analytical philosophy seems to be towards ever more specialized, jargon-infested work, and there is a need to draw things together into a wider view that can be more generally appreciated. (shrink)

One popular theory of moral responsibility locates responsible agency in exercises of control. These control-based theories often appeal to tracing to explain responsibility in cases where some agent is intuitively responsible for bringing about some outcome despite lacking direct control over that outcome’s obtaining. Some question whether control-based theories are committed to utilizing tracing to explain responsibility in certain cases. I argue that reflecting on certain kinds of negligence shows that tracing plays an ineliminable role in any adequate control-based theory (...) of responsibility. (shrink)

Sir Leslie Stephen (1832–1904), the founding editor of the Dictionary of National Biography, and a writer on philosophy, ethics, and literature, was educated at Eton, King's College London and Trinity College, Cambridge, where he remained as a fellow and a tutor for a number of years. Though a sickly child, he later became a keen and successful mountaineer, taking part in first ascents of nine peaks in the Alps. In 1871 he became editor of the Cornhill Magazine. During his (...) eleven-year tenure, he wrote two successful books on ethics, including The Science of Ethics in 1892, which was widely adopted as a standard textbook. This two-volume work, which was first published in 1896, brings together the lectures he gave to various ethical societies, mostly in London. Both volumes examine the ethical issues surrounding a range of topics including politics, morality, duty, and crime and punishment. (shrink)

According to the attentional resources account, mind wandering (or “task-unrelated thought”) is thought to compete with a focal task for attentional resources. Here, we tested two key predictions of this account: First, that mind wandering should not interfere with performance on a task that does not require attentional resources; second, that as task requirements become automatized, performance should improve and depth of mind wandering should increase. Here, we used a serial reaction time task with implicit- and explicit-learning groups to test (...) these predictions. Providing novel evidence for the attentional resource account’s first prediction, results indicated that depth of mind wandering was negatively associated with learning in the explicit, but not the implicit, group, indicating that mind wandering is associated with impaired explicit, but not implicit, learning. Corroborating the attention resource account’s second prediction, we also found that, overall, performance improved while at the same time depth of mind wandering increased. From an implicit learning perspective, these results are consistent with the claim that explicit learning is impaired under attentional load, but implicit learning is not. (shrink)

Rooted in the field of cathedral studies, this paper draws into dialogue three bodies of knowledge: Edward Bailey’s notion of implicit religion that, among other things, highlights the continuing traction of the Christian tradition and Christian practice within secular societies; David Walker’s notion of the multiple ways through which in secular societies people may relate to the Christian tradition as embodied within the Anglican Church and John Fisher’s notion of spiritual wellbeing as conceptualised in relational terms. Against this conceptual background, (...) this paper draws on data provided by 1234 participants attending one of the Christmas Eve carol services in Liverpool Cathedral to explore the perceived impact of attendance on the spiritual health of people who do not believe in God and yet feel that Liverpool Cathedral is their cathedral, and it is this sense of belonging that brings them back at Christmas time.Contribution: Situated within the science of cathedral studies, this paper links in an original way three fields of discourse: Edward Bailey’s notion of implicit religion, David Walker’s notion of the four ways of belonging to God facilitated by the Anglican Church and John Fisher’s conceptualisation and operationalisation of the notion of spiritual wellbeing. The hypothesis developed from this original integration of theoretical perspectives is then tested empirically on data provided by 404 participants at carol services who do not believe in God. (shrink)

(Re)presentations of evil in media, philosophy and literature -- The dangerous ones : when evil was a woman -- Space/times of evil : political life and social worlds.

This research addresses the question of whether men and women in sales differ in their ethical attitudes and decision making. The study asked 209 subjects to respond to 20 ethical scenarios, half of which were "relational" and half "non-relational." The study concludes (1) that there are significant ethical differences between the sexes in situations that involve relational issues, but not in non-relational situations, and (2) that gender-based ethical differences change with age and years of experience. The implications of these finding (...) for sales organizations are discussed. (shrink)

Over three previous editions, Ten Theories of Human Nature has been a remarkably popular introduction to some of the most influential developments in Western and Eastern thought. This thoroughly revised fourth edition features substantial new chapters on Aristotle and on evolutionary theories of human nature; the latter centers on Edward O. Wilson but also outlines the ideas of Emile Durkheim, B. F. Skinner, Nikolaas Tinbergen, Konrad Lorenz, Noam Chomsky, and recent evolutionary psychology. This edition also includes a rewritten introduction that (...) invites readers (even if inclined toward fundamentalism, or to cultural relativism) to careful, critical thought about human nature; a useful new section that summarizes the history of ideas from the Stoics to the Enlightenment; and a new conclusion that suggests a way to synthesize the various theories. Lucid and accessible, Ten Theories of Human Nature, 4/e, compresses into a small space the essence of such ancient traditions as Confucianism, Hinduism, and the Old and New Testaments as well as the theories of Plato, Immanuel Kant, Karl Marx, Sigmund Freud, and Jean-Paul Sartre. The authors juxtapose the ideas of these and other thinkers and traditions in a way that helps readers understand how humanity has struggled to comprehend its nature. To encourage readers to think critically for themselves and to underscore the similarities and differences between the many theories, the book examines each one on four points--the nature of the universe, the nature of humanity, the diagnosis of the ills of humanity, and the proposed cure for these problems. Ideal for introductory courses in human nature, philosophy, religious studies, and intellectual history, Ten Theories of Human Nature, 4/e, will engage and motivate students and other readers to consider how we can understand and improve both ourselves and human society. (shrink)

The standard story about self-control states that self-control is limited, aversive, and that the function of self-control is to resist impulses or temptation. Several cases are provided that challenge this standard story. An alternative, future-oriented account of self-control is defended, where the function of self-control is to manage interference that arises from overlapping information processing pathways. This provides a computationally tractable account of self-control rooted in one’s being vigilant. Self-control manifests the maintenance dimension of vigilance. This not only provides an (...) attractive alternative to the standard story about self-control, but also indicates how the future-oriented aspects of self-control are more fundamental than the present-oriented aspects. (shrink)

Research on the folk psychology of free will suggests that people believe free will is incompatible with determinism and that human decision-making cannot be exhaustively characterized by physical processes. Some suggest that certain elements of Western cultural history, especially Christianity, have helped to entrench these beliefs in the folk conceptual economy. Thus, on the basis of this explanation, one should expect to find three things: (1) a significant correlation between belief in dualism and belief in free will, (2) that people (...) with predominantly incompatibilist commitments are likely to exhibit stronger dualist beliefs than people with predominantly compatibilist commitments, and (3) people who self-identify as Christians are more likely to be dualists and incompatibilists than people who do not self-identify as Christians. We present the results of two studies (n = 378) that challenge two of these expectations. While we do find a significant correlation between belief in dualism and belief in free will, we found no significant difference in dualist tendencies between compatibilists and incompatibilists. Moreover, we found that self-identifying as Christian did not significantly predict preference for a particular metaphysical conception of free will. This calls into question assumptions about the relationship between beliefs about free will, dualism, and Christianity. (shrink)

In ‘Discrimination Against the Dying’, Phillip Reed argues that terminally ill patients are subjected to a distinct form of discrimination called ‘terminalism’. One of Reed’s primary examples of terminalism is right to try laws, which offer terminally ill patients the option to request medications that are not FDA-approved and without IRB involvement. In this analysis, we consider additional contextual factors about right to try, suggesting that it may not neatly count as an exemplar of terminalism. When pursued with appropriate protocols (...) and oversight, right to try has the potential to broaden treatment opportunities for the terminally ill by bypassing FDA and IRB restrictions, functioning as a less stringent alternative to expanded access for patients with limited time and dwindling options. Reed acknowledges that differential treatment of patients is not inherently unjust. For instance, Reed praises expanded access laws that grant patients with severe or life-threatening diseases access to treatment options otherwise unavailable. Patients not afflicted by severe illness or who have found success with standard treatment options are unlikely to face discrimination for inability to access nonessential treatment. Conversely, availability of these treatments for the terminally ill could enhance their well-being and prolong their lifespan. It is also significant to highlight important …. (shrink)

Drawing on philosophy, psychology, sociology, politics, biology, and theology, Stevenson introduces readers to the endlessly fascinating subject of human nature. He outlines background theories of the universe, basic approaches to human nature, diagnoses of what is wrong with humankind and prescriptions for putting it right while offering clear, critical analyses of the ideas of Plato, Christianity, Karl Marx, Freud, Sartre, Skinner, and Lorenz. Including completely revised and updated bibliographies, the second edition also provides a new interdisciplinary final chapter suggesting areas (...) of further inquiry. (shrink)

This book has a wonderful introduction and afterword by Marjorie Hewitt Suchocki. From beginning to end, this tri-authored work offers an integrated treatment of process theology, pneumology, and ecclesiology for the benefit of local Christian congregations.Among the three voices at work in this book, John Cobb provides an important primer on Whitehead's views of possibilities, experience, and relationships. Opening each of the book's three parts, Cobb both lays the groundwork and provides a strong framing for pneumology on the basis of (...) Whiteheadian thought. The frame for the Spirit is a broad one, calling for diversity and spontaneity. Lest the spiritual become too ethereal, Cobb reminds us of Whitehead's emphasis on experience and responsiveness to the world around us. Our freedom involves a self-determination that actualizes our own happiness and our contribution to others (111). Cobb's sections build a frame for the sections written by Epperly and Nancarrow, and they also encourage continued reading of Whitehead. (However, the book's lack of an index or a resource page for this kind of growth is a shortcoming.)Epperly offers in each of the book's three sections efforts at honing the concept of spirituality. As a concept, spirituality is in danger of a vacuousness that has no leverage in the life experience of the practitioner. Epperly does not succumb. He explicates important conduits of the spirit: embodiment, imagination, affirmative awareness, and compassion. Epperly provides a definition of spirituality as an adventurous journey of compassion. Spirituality is less a state of being and more of an exploration or a becoming as one relates to the surrounding world. He works the definition of spirituality with a prism-like beauty over the course of the three sections, integrating important persons from various cultures and inviting the reader to imagine their own spiritual past and potential future contributions.In each of the three sections, Nancarrow brings ecclesiology into the mix, thus making the book an essential for pastors who care about the pragmatics of process in the community of a local congregation. Nancarrow's chapters might be best characterized as how-to chapters helping church folk revisit the routines of liturgy, small groups, and the sacrament of communion. He encourages specific practices to engage liturgy, freshen perception, and potentially awaken hearts that can grow dull in rote practices of worship. Discernment and group work receives step-by-step attention. It is not lost on the reader that Nancarrow means to connect the care of facilitation in groups to the group's experience of the Spirit's call. Quite deftly, he closes the book with attention to the sacrament of communion in which “imagination, intellect, will, memory, emotion, sensation, and physicality are all engaged” (137).In short, The Call of the Spirit does more than talk about the Spirit. The book provides a philosophy and theology for practicing into the Spirit and helping others do the same. The authors believe in the readers’ intellect, deep-seated compassion, and commitment to the communities from which the adventure might play out in the most profound ways. (shrink)

In _The Global and the Local: An Environmental Ethics Casebook_, Dale Murray presents fifty-one compelling case studies. By interweaving theoretical considerations into case studies, Murray illuminates a comprehensive range of the most pressing environmental issues facing our biosphere.