Toward evidence‐based policy decisions: a case study of nursing health human resources in Ontario, CanadaThis paper reflects how health services research ‘evidence’ was used to influence decisions in the province of Ontario, Canada. The process involved interaction among a variety of stakeholders and decision‐makers with researchers to reduce uncertainty and to substantiate emerging service provision issues in the province. The issues presented here focus specifically on an analysis of the nursing situation completed in 1998 for the Minister of Health’s Nursing (...) Task Force, which examined key issues in service delivery. The issues were: restructured work environments; nurse supply and declining enrollments; labour trends and utilization of the nursing workforce; patient acuity and complexity of work environments and the influence on workload; and the paucity of reliable and valid data bases for analysis of nursing’s contribution to the health system. Ontarians can be confident that the Task Force recommendations were born from solid research‐based evidence and now the challenge becomes to monitor the implementation of these resolutions over time. (shrink)

ANGUS J, HODNETT E and O’BRIEN-PALLAS L. Nursing Inquiry 2003; 10: 218–228Implementing evidence-based nursing practice: a tale of two intrapartum nursing unitsDespite concerns that the rise of evidence-based practice threatens to transform nursing practice into a performative exercise disciplined by scientific knowledge, others have found that scientific knowledge is by no means the preeminent source of knowledge within the dynamic settings of health-care. We argue that the contexts within which evidence-based innovations are implemented are as influential in the outcomes (...) as the individual practitioners who attempt these changes. A focused ethnography was done in follow-up to an earlier trial that evaluated the effectiveness of a marketing strategy to encourage the adoption of evidence-based intrapartum nursing practice. Bourdieu's (1990, 1991) concepts of habitus, capital and social field were used in our refinement of the analysis of the ethnographic findings. Nursing leadership, interprofessional struggle with physicians, the characteristics of the community and the physical environment were prominent issues at all of the sites. Detailed descriptions of the sociohistorical context and of the experiences at two sites are presented to illustrate the complexities encountered when implementing innovations. (shrink)

In chapter 3 of Wild Animal Ethics Johannsen argues for a collective obligation based on beneficence to intervene in nature in order to reduce the suffering of wild animals. In the same chapter he claims that the non-identity problem is merely a “theoretical puzzle” which doesn’t affect our reasons for intervention. In this paper I argue that the non-identity problem affects both the strength and the nature of our reasons to intervene. By intervening in nature on a large scale we (...) change which animals come into existence. In doing so, we enable harmful animals to inflict harms on other animals, and we put other animals in harm’s way. The harms that these animals will inflict and endure are foreseeable. Furthermore, since non-human animals aren’t moral agents, harmful animals cannot be morally responsible for their harmful actions. I argue therefore that by causing animals to exist, knowing that they will inflict and suffer harms, we become morally responsible for those harms. By engaging in identity-affecting actions then we take on secondary moral duties towards the animals we have thereby caused to exist, and these secondary moral duties may be extremely demanding, even more so than the initial costs of intervention. Finally, these duties are duties of justice rather than duties of beneficence, and as such are more stringent than purely beneficence-based moral reasons. Furthermore, this conclusion flows naturally from several plausible principles which Johannsen explicitly endorses. (shrink)

The cosmic cycle described in the surviving fragments of Empedocles' poem is the alternation, in endless succession, of Love and Strife. Dr O'Brien's book is primarily an analysis of this elaborate system. It seeks to determine the positions which Love and Strife occupy in the world at different times.

Stobaeus records a placitum where Empedocles says that the world is destroyed by the domination in turn of Love and of Strife. The placitum makes perfectly good sense in the context of Empedocles' belief that Love and Strife produce, in turn, a non-cosmic state of total unity (Love) and of total separation (Strife). But for over two hundred years scholars have been unable to hear that simple message. Sturz (1805) emended the text so as to make it fit the non-cyclical (...) interpretation of Empedocles that he had taken over from the pages of Tiedemann (1791). When Diels included Stobaeus' text in his edition of Aetius, in the "Doxographi graeci" (1879), he failed to remove the emendation, although his own reconstruction of the chapter heading in Aetius made the emendation impossible. Twenty years later, Diels saw the light, and printed Stobaeus' placitum, unemended, in his "Poetarum philosophorum fragmenta" (1901) and in successive editions of his "Fragmente der Vorsokratiker" (from 1903 onwards). But Kranz resurrected the emendation in the "Nachträge" to his sixth edition of the "Fragmente der Vorsokratiker" (1951). The emended placitum is used again by Uvo Hölscher (1965) to support a non-cyclical interpretation of Empedocles and is repeated in the latest collection of the fragments and testimonia (Brad Inwood, 1992). Hölscher fails to appreciate that the text that he uses to support his reconstruction is merely Sturz's translation into Greek of the non-cyclical interpretation of Empedocles proposed by Tiedemann at the end of the eighteenth century. (shrink)

Doctors have an ethical and legal duty to respect patient confidentiality. We consider the basis for this duty, looking particularly at the meaning and value of autonomy in health care. Enabling patients to decide how information about them is disclosed is an important element in autonomy and helps patients engage as active partners in their care.Good quality data is, however, essential for research, education, public health monitoring, and for many other activities essential to provision of health care. We discuss whether (...) it is necessary to choose between individual rights and the wider public interest and conclude that this should only rarely be necessary. The paper makes some recommendations on practical steps which could help ensure that good quality information is available for work which benefits society and the public health, while still enabling patients’ autonomy to be respected. (shrink)

_"The Essential Plotinus_ is a lifesaver. For many years my students in Greek and Roman Religion have depended on it to understand the transition from antiquity to the Middle Ages. The translation is crisp and clear, and the excerpts are just right for an introduction to Plotionus's many-layered view of the world and humankind’s place in it." --F. E. Romer, University of Arizona.

It is suggested that George Cotkin's essay is unpersuasive in its two central claims. Firstly, the evidence is not persuasive that there has been a discernible "moral turn" among historians in the last two decades; rather, it is argued that an engagement with morality has been fairly constant in historical scholarship since its ancient origins. Secondly, it is felt that Cotkin is evasive on whether he wishes historians merely to have opinions about the moralities of others in the past or (...) to be moral agents themselves; the first position is thought to be tenable, the latter probably not. (shrink)

In this chapter I defend a novel view of the relationships among intention for the future, self-control, and co-operation. I argue that when an agent forms an intention for the future she comes to regard herself as criticizable if she does not act in accordance with her intention and as praiseworthy if she does. In forming intentions, then, agents acquire dispositions to have reflexive evaluative attitudes. In contexts where the agent has inclinations that run contrary to her unrescinded intention, these (...) evaluative attitudes help her to resist these inclinations. Intentions have, in other words, a built-in mechanism for self-control. I go on to argue that this mechanism can also function as a mechanism for co-operative behaviour. Sometimes a common species of co-operation just is the exercise of self-controlled behaviour in a social context. If this is on the right track, agents like us are not just equipped to formulate and abide by plans for the future, we are also thereby equipped for exercising self-control and participating in co-operative ventures. (shrink)

ANALOGY has not just to do with the abstruse details and niceties of metaphysics but rather underlies the structure of all metaphysical thought. It is the heart of metaphysics. No system of metaphysics can discard it, without prejudice to the richness and variety of being. Without analogy there is elimination and over-simplification. Metaphysics is far from being a straightforward science; it is highly complex and its method and style of argument are not easy to master. Its field of inquiry is (...) wide. It is the task of the metaphysician to reduce the world of things to an intelligible unity. (shrink)

Niche construction is the process whereby organisms, through their activities and choices, modify their own and each other’s niches. By transforming natural-selection pressures, niche construction generates feedback in evolution at various different levels. Niche-constructing species play important ecological roles by creating habitats and resources used by other species and thereby affecting the flow of energy and matter through ecosystems—a process often referred to as “ecosystem engineering.” An important emphasis of niche construction theory (NCT) is that acquired characters play an evolutionary (...) role through transforming selective environments. This is particularly relevant to human evolution, where our species has engaged in extensive environmental modification through cultural practices. Humans can construct developmental environments that feed back to affect how individuals learn and develop and the diseases to which they are exposed. Here we provide an introduction to NCT and illustrate some of its more important implications for the human sciences. (shrink)

Most models of corporate social responsibility revolve around the controversy as to whether business is a single dimensional entity of profit maximization or a multi-dimensional entity serving greater societal interests. Furthermore, the models are mostly descriptive in nature and are based on the experiences of western countries. There has been little attempt to develop a model that accounts for corporate social responsibility in diverse environments with differing socio-cultural and market settings. In this paper an attempt has been made to fill (...) this gap by developing a two-dimensional model of corporate social responsibility and empirically testing its validity in the context of two dissimilar cultures – Australia and Bangladesh. The two dimensions are the span of corporate responsibility and the range of outcomes of social commitments of businesses. The test results confirm the validity of the two-dimensional model in the two environments. The Factor analysis revealed two leading dimensions. Cluster analysis pointed to two distinctive clusters of managers in both Australia and Bangladesh, one consisting of managers with a broad contemporary concept of social responsibility, and the other with a limited narrow view. The paper concludes that corporate social responsibility is two-dimensional and universal in nature and that differing cultural and market settings in which managers operate may have little impact on the ethical perceptions of corporate managers. (shrink)

How is it that we think and refer in the first-person way? For most philosophers in the analytic tradition, the problem is essentially this: how two apparently conflicting kinds of properties can be reconciled and united as properties of the same entity. What is special about the first person has to be reconciled with what is ordinary about it. The range of responses reduces to four basic options. The orthodox view is optimistic: there really is a way of reconciling these (...) apparently contradictory properties as contained within the same thing. The heretical views are pessimistic and content to be so: there is no such way, and that is because there is simply nothing to reconcile – because there is really nothing special about what is in question; or there is really nothing ordinary about it; or there is really nothing …. (shrink)

Hume is usually taken to have an evidentialist account of testimonial belief: one is justified in believing what someone says if one has empincal evidence that they have been reliable in the past. This account is impartialist: such evidence is required no matter who the person is, or what refotions she may have to you. I, however, argue that Hume has another account of testimony, one grounded in sympathy. This account is partialist, in that empincal evidence is not required in (...) order for one to be justified in believing some of the assertions of one's friends. (shrink)

THIS article concerning Mr. Marshall's open letter to Governor Smith does not pretend to be an answer. It suggests some philosophical considerations on the point at issue. The Editor.

In this paper I want to propose that we see solipsism as arising from certain problems we have about identifying ourselves as subjects in an objective world. The discussion will centre on Wittgenstein.

While new generations of implantable brain computer interface devices are being developed, evidence in the literature about their impact on the patient experience is lagging. In this article, we address this knowledge gap by analysing data from the first-in-human clinical trial to study patients with implanted BCI advisory devices. We explored perceptions of self-change across six patients who volunteered to be implanted with artificially intelligent BCI devices. We used qualitative methodological tools grounded in phenomenology to conduct in-depth, semi-structured interviews. Results (...) show that, on the one hand, BCIs can positively increase a sense of the self and control; on the other hand, they can induce radical distress, feelings of loss of control, and a rupture of patient identity. We conclude by offering suggestions for the proactive creation of preparedness protocols specific to intelligent—predictive and advisory—BCI technologies essential to prevent potential iatrogenic harms. (shrink)

In recent work Irigaray has continued to meditate on the myopic (we might say ‘monadic’) focus of the Western tradition when it comes to its failure to acknowledge sexuate difference. Irigaray has successfully diagnosed the patriarchally over-determined nature of that tradition masquerading behind a façade of objectivity and neutrality in ways that continue to open up interpretive and critical possibilities in terms of reading the canon today. In some of her work, Irigaray levels a powerful challenge against Heidegger’s conception of (...) Dasein and his point of entry into ‘phenomenological ontology’. Thus, Heidegger, the thinker that Irigaray, arguably, engages with most positively in some of her recent work is charged not just with the ‘exsanguination’ of his conception of Dasein, as it were, but with having neutered Dasein in a way that is all too characteristic of the monadic tendencies of the Western tradition and its enduring suppression of sexuate difference. Part of what we will examine in some depth in this section of the book is a blindspot in Heidegger’s account of Dasein which, for all of his insights concerning the social constitution of Dasein, leaves him open to some of the criticisms which Irigaray has successfully levelled against an entire tradition. As part of our efforts to tease these issues out in some detail, we will consider Derrida’s first Geschlecht essay where he looks to exonerate Heidegger from the charge of phallogocentrism (a charge he had levelled against him in a 1982 interview), along with more recent efforts to artificially cross-pollinate between Heidegger, Derrida and Irigaray. We will further examine the problematic ways that Heidegger looks to ‘neutralise’ Dasein in 1928 as well as his attempts in a series of 1930s texts to introduce a distinction between Dasein and the being of the human being. These attempts dovetail with a series of bizarre and illegitimate moves to exclude “whole peoples and races” from the domain of meaningful historical existence in the 1930s in particular. (shrink)

Prediction-based decisions, which are often made by utilizing the tools of machine learning, influence nearly all facets of modern life. Ethical concerns about this widespread practice have given rise to the field of fair machine learning and a number of fairness measures, mathematically precise definitions of fairness that purport to determine whether a given prediction-based decision system is fair. Following Reuben Binns (2017), we take ‘fairness’ in this context to be a placeholder for a variety of normative egalitarian considerations. We (...) explore a few fairness measures to suss out their egalitarian roots and evaluate them, both as formalizations of egalitarian ideas and as assertions of what fairness demands of predictive systems. We pay special attention to a recent and popular fairness measure, counterfactual fairness, which holds that a prediction about an individual is fair if it is the same in the actual world and any counterfactual world where the individual belongs to a different demographic group (cf. Kusner et al. (2018)). (shrink)

One kind of successful communication involves the transmission of knowledge from speaker to hearer. Such testimonial knowledge transmission is usually seen as conforming to three widely held epistemological approaches: reliabilism, impartialism and evidentialism. First, a speaker must be a reliable testifier in order that she transmits knowledge, and reliability is cashed out in terms of her likelihood of speaking the truth. Second, if a certain speaker's testimony has sufficient epistemic weight to be believed by hearer1, then it should also be (...) believed by hearer2. Third, the normative constraint here is evidentially grounded: whether or not a hearer should believe a speaker depends on the evidence the hearer has that the speaker is telling the truth. I argue that there are cases of testimonial knowledge transmission that are incompatible with these three claims. This is when one accepts the testimony of an intimate friend. (shrink)

Stobaeus records a placitum where Empedocles says that the world is destroyed by the domination in turn of Love and of Strife. The placitum makes perfectly good sense in the context of Empedocles' belief that Love and Strife produce, in turn, a non-cosmic state of total unity (Love) and of total separation (Strife). But for over two hundred years scholars have been unable to hear that simple message. Sturz (1805) emended the text so as to make it fit the non-cyclical (...) interpretation of Empedocles that he had taken over from the pages of Tiedemann (1791). When Diels included Stobaeus' text in his edition of Aetius, in the "Doxographi graeci" (1879), he failed to remove the emendation, although his own reconstruction of the chapter heading in Aetius made the emendation impossible. Twenty years later, Diels saw the light, and printed Stobaeus' placitum, unemended, in his "Poetarum philosophorum fragmenta" (1901) and in successive editions of his "Fragmente der Vorsokratiker" (from 1903 onwards). But Kranz resurrected the emendation in the "Nachträge" to his sixth edition of the "Fragmente der Vorsokratiker" (1951). The emended placitum is used again by Uvo Hölscher (1965) to support a non-cyclical interpretation of Empedocles and is repeated in the latest collection of the fragments and testimonia (Brad Inwood, 1992). Hölscher fails to appreciate that the text that he uses to support his reconstruction is merely Sturz's translation into Greek of the non-cyclical interpretation of Empedocles proposed by Tiedemann at the end of the eighteenth century. (shrink)

Increasing societal concerns regarding the potential deleterious effects of future climate change have galvanized efforts to manage the problem both through reduction of greenhouse gases and through development of plans to reduce the impacts of climate change that cannot be avoided. These critical activities require making decisions under conditions of considerable uncertainty regarding future conditions in physical and human systems. As the focus on providing information about future climate for taking actions to cope with climate change, the science of uncertainty (...) of climate change will develop more and more with the needs of decision makers in mind. (shrink)

Stich begins his paper "What is a Theory of Mental Representation?" (1992) by noting that while there is a dizzying range of theories of mental representation in today's philosophical market place, there is very little self-conscious reflection about what a theory of mental representation is supposed to do. This is quite remarkable, he thinks, because if we bother to engage in such reflection, some very surprising conclusions begin to emerge. The most surprising conclusion of all, according to Stich, is that (...) most of the philosophers in this field are undertaking work that is quite futile: It is my contention that most of the players in this very crowded field have no coherent project that could possibly be pursued successfully with the methods they are using. (p.244) Stich readily admits that this is a startling conclusion; so startling, he thinks, that some may even take it as an indication that he has simply "failed to figure out what those who are searching for a theory of mental representation are up to" (p.244). But it is a conclusion that he is willing to stand by, and he sets about it defending it in the body of his paper. Stich, I think, is right about this—I do take his conclusion to indicate that he has failed to figure out what those who are searching for a theory of mental representation are up to. And he has failed to do this largely because he has failed to distinguish between the theory of mind that is implicit in our folk psychology and the mental mechanism that is responsible for our capacity to make folk psychological judgements. When this conflation is undone, so too is the reasoning that takes Stich to his startling conclusion. This is not to say that the conclusion itself is clearly false; it is merely to say that Stich has failed to show that it is true. In what follows I will defend this analysis of Stich's self-conscious reflections on what a theory of mental representation is supposed to do. I will begin with a very brief exposition of Stich's survey of the logical terrain in this part of the philosophical landscape and the line of reasoning that subsequently delivers up the aforementioned conclusion. I will then go on to argue that the latter line of reasoning is fundamentally misdirected because of an error in the former survey. (shrink)

One of the most striking manifestations of schizophrenia is thought insertion. People suffering from this delusion believe they are not the author of thoughts which they nevertheless own as experiences. It seems that a person’s sense of agency and their sense of the boundary between mind and world can come apart. Schizophrenia thus vividly demonstrates that self awareness is a complex construction of the brain. This point is widely appreciated. What is not so widely appreciated is how radically schizophrenia challenges (...) our assumptions about the nature of the self. Most theorists endorse the traditional doctrine of the unity of consciousness, according to which a normal human brain generates a single consciousness at any instant in time. In this paper we argue that phenomenal consciousness at each instant is actually a multiplicity: an aggregate of phenomenal elements, each of which is the product of a distinct consciousness-making mechanism in the brain. We then consider how certain aspects of self might emerge from this manifold substrate, and speculate about the origin of thought insertion. (shrink)

There are various forms of teleological thinking central to debates in the early modern and modern periods, debates in which David Hume (1711–1776) is a key figure. In the first section, we shall introduce three levels at which teleological considerations have been incorporated into philosophical accounts of man and nature, and sketch Hume’s criticisms of these approaches. In the second section, we turn to Hume’s non-teleological ‘science of man’. In the third section, we show how Hume has an account of (...) human flourishing that is not dependent on teleology. In the fourth section, we shall speculate as to the relation between Hume’s account of human nature and contemporary evolutionary accounts of morality and reasoning. (shrink)

Book reviewed in this article: Having Children: Philosophical and Legal Reflections on Parenthood. Edited by Onora O'Neill and William Ruddick.

Lucy O'Brien argues that a satisfactory account of first-person reference and self-knowledge needs to concentrate on our nature as agents. Clearly written, with rigorous discussion of rival views, this book will be of interest to anyone working in the philosophy of mind and action.

We examine the interface of entrepreneurship and society by considering a novel source of gender bias (public opinion) and a novel expression of it (affective evaluations). We posit that women-led teams displaying success will trigger a “penalty for success” bias, and this will be inhibited if the team receives a “stamp of approval” from a gender congruent individual (i.e., an investor who is a man). Analysis from our first study, based on archival data, indicated that other mechanisms might be at (...) play that we could not tease apart in our archival data, so we conducted a follow-up experimental study to further examine our initial findings. Results jointly indicate that women are viewed unfavorably unless either (a) they are validated by success or endorsement from a man, or (b) they fail but are “warm and accommodating” about it. We also find that while men benefit from being validated by success or endorsement of an opposite-gender investor, they do not face a similarly steep penalty absent that validation. (shrink)

This article offers an approach to advance the use of virtue ethics in the training of business managers and leaders, as well as in the education of business students. A thesis is that virtue ethics offers a valuable way to think about how we want to be and what we should strive to become qua businessperson, manager, and leader. The article provides a framework for thinking about virtue ethics in the context of business and leadership, with emphasis on building trust (...) in organizations. It includes a brief summary of Aristotelian virtue ethics, core concepts, and how they apply to management and leadership decision-making. The article concludes with a summary of an approach for teaching a virtue ethics module, which has evolved over the past 20 years. Included are exercises, a survey tool, and a business case as components of the module. The module has been used in corporate training, as well as graduate and undergraduate business education. It is hoped this approach will spur others to explore other ways to bring virtue ethics to business and business education. (shrink)