Rationale Treatment guidelines recommend a more conservative surgical approach than mastectomy for early stage breast cancer and a stronger emphasis on adjuvant therapy. Registry data at South Australian teaching hospitals have been used to monitor survivals and treatment in relation to these guidelines.Aims and objectives To use registry data to: (1) investigate trends in survival and treatment; and (2) compare treatment with guidelines.Methods Registry data from three teaching hospitals were used to analyse trends in primary courses of treatment of breast (...) cancers during 1977–2003 (n = 4671), using univariate analyses and multiple logistic regression. Disease-specific survivals were analysed using Kaplan–Meier product limit estimates and multivariable Cox proportional hazards regression.Results The 5-year survival was 79.9%, but with a secular increase, reaching 83.6% in 1997–2003. The relative risk of death (95% confidence limits) was 0.74 (0.62, 0.88) for 1997–2003, compared with previous diagnoses, after adjusting for tumour node metastasis stage, grade, age and place of residence. Treatment changes included an increase in conservative surgery (as opposed to mastectomy) from 51.7% in 1977–1990 to 76.8% in 1997–2003 for stage I (P < 0.001) and from 31.1% to 52.2% across these periods for stage II (P < 0.001). Adjuvant radiotherapy also became more common (P < 0.001), with 20.6% of patients receiving this treatment in 1977–1990 compared with 60.7% in 1997–2003. Radiotherapy generally was more prevalent when conservative surgery was provided, although also relatively common in mastectomy patients when tumour diameters exceeded 50 mm or when there were four or more involved nodes. The proportion of patients receiving chemotherapy increased (P < 0.001), from 19.6% in 1977–1990 to 36.9% in 1997–2003, and the proportion having hormone therapy also increased (P < 0.001), from 34.3% to 59.4% between these periods.Conclusions Survivals appear to be increasing and treatment trends are broadly consistent with guideline directions, and the earlier research on which these recommendations were based. (shrink)

[Stephen Yablo] The usual charge against Carnap's internal/external distinction is one of 'guilt by association with analytic/synthetic'. But it can be freed of this association, to become the distinction between statements made within make-believe games and those made outside them-or, rather, a special case of it with some claim to be called the metaphorical/literal distinction. Not even Quine considers figurative speech committal, so this turns the tables somewhat. To determine our ontological commitments, we have to ferret out all traces (...) of nonliterality in our assertions; if there is no sensible project of doing that, there is no sensible project of Quinean ontology. /// [Andre Gallois] I discuss Steve Yablo's defence of Carnap's distinction between internal and external questions. In the first section I set out what I take that distinction, as Carnap draws it, to be, and spell out a central motivation Carnap has for invoking it. In the second section I endorse, and augment, Yablo's response to Quine's arguments against Carnap. In the third section I say why Carnap's application of the distinction between internal and external questions runs into trouble. In the fourth section I spell out what I take to be Yablo's version of Carnap. In the last I say why that version is especially vulnerable to the objection raised in the second. (shrink)

This chapter defends the property dualism argument. The term “semantic premise” mentioned is used to refers to an assumption identified by Brian Loar that antiphysicalist arguments, such as the property dualism argument, tacitly assume that a statement of property identity that links conceptually independent concepts is true only if at least one concept picks out the property it refers to by connoting a contingent property of that property. It is argued that, the property that does the work in explaining the (...) possibility of a posteriori identities need not be a first-order property of the referent in question. On his view, the property dualism argument requires only a weaker semantic premise, which allows that the property in question be a higher order property. A refined version of the property dualism argument is formulated, which uses the weaker premise, and defends the argument against various objections. (shrink)

Postmodernism has evoked great controversy and it continues to do so today, as it disseminates into general discourse. Some see its principles, such as its fundamental resistance to metanarratives, as frighteningly disruptive, while a growing number are reaping the benefits of its innovative perspective. In Political Theory and Postmodernism, Stephen K. White outlines a path through the postmodern problematic by distinguishing two distinct ways of thinking about the meaning of responsibility, one prevalent in modern and the other in postmodern (...) perspectives. Using this as a guide, White explores the work of Heidegger, Foucault, Derrida, Lyotard, and Habermas, as well as 'difference' feminists, with the goal of showing how postmodernism can inform contemporary ethical-political reflection. In his concluding chapter, White examines how this revisioned postmodern perspective might bear on our thinking about justice. (shrink)

Mental causes are threatened from two directions: from below, since they would appear to be screened off by lower-order, e.g., neural states; and from within, since they would also appear to be screened off by intrinsic, e.g., syntactical states. A principle needed to parry the first threat -causes should be proportional to their effects- appears to leave us open to the second; for why should unneeded extrinsic detail be any less offensive to proportionality than excess microstructure? I say that the (...) second threat relies on a perversion of proportionality that would lay waste to all causal relations. (shrink)

The Anthropocene prompts renewed critical reflection on some of the central tenets of modern thought including narratives of ‘progress’, the privileging of the nation state, and the universalist rendering of the human. In this context it is striking that ‘rights’, a quintessentially modern mode of articulating normativity, are often presumed to have an enduring relevance in the contemporary moment, exemplified in renewed recourse to rights in their attribution to parts of the nonhuman world. Our intervention contemplates ways in which the (...) apparent disorientations of the Anthropocene might allow for a generative reorientation of some of these presuppositions. We critically consider the institutional and discursive limitations of rights and the ambivalence of rights language, and argue that the monism that rights so often implies limits the capacity to foster generative encounters between Indigenous and non-Indigenous legal traditions. We develop a critical discourse of obligation, understood here to both precede and exceed the rights-duty correlate so central to modern law. An attentiveness to the priority of obligation, we argue, might allow us to foreground an ethics of encounter between traditions, to examine the limits of modernity’s legal and political imaginary, and to pursue a ‘radical re-storying’ of laws for the Anthropocene. (shrink)

Historical introduction -- Human being -- Identity and human incompletion in Sartre -- Identity and human incompletion in Aquinas -- Human understanding -- The subjective nature of objective understanding in Sartre -- The subjective nature of objective understanding in Aquinas -- Human freedom -- Freedom, choice, and the indetermination of reason in Sartre -- Freedom, choice, and the indetermination of reason in Aquinas -- Human fulfillment -- The possibility of human happiness in Sartre -- The possibility of human happiness in (...) Aquinas. (shrink)

'I think, therefore I am' - Descartes..'Such tricks hath strong imagination..That, if it would but apprehend some joy,..It comprehends some bringer of that joy;..Or in the night, imagining some fear,..How easy is a bush supposed a bear?' - Shakespeare..A unique compendium of key texts of psychology, from Aristotle to cutting-edge neuroscience.

What does it mean to be ethical in psychotherapy? Does adherence to ethical codes and rules make a psychotherapist ethical? This article examines standard ways of thinking about ethics in the field and argues that these ways are inadequate, creating a false dichotomy between the ethical and the clinical, and that they are designed only for formal and contractual relationships, in which psychotherapy is more often personal and affecting. The ethic of care and the approach to ethics of Emmanuel Levinas (...) are presented as additional approaches, along with their challenges to rationality and autonomy. An ethic of listening is then presented, and it is argued that ethics should be not an afterthought, but the primary consideration of clinical utility. (shrink)

What does it mean to be ethical in psychotherapy? Does adherence to ethical codes and rules make a psychotherapist ethical? This article examines standard ways of thinking about ethics in the field and argues that these ways are inadequate, creating a false dichotomy between the ethical and the clinical, and that they are designed only for formal and contractual relationships, in which psychotherapy is more often personal and affecting. The ethic of care and the approach to ethics of Emmanuel Levinas (...) are presented as additional approaches, along with their challenges to rationality and autonomy. An ethic of listening is then presented, and it is argued that ethics should be not an afterthought, but the primary consideration of clinical utility. (shrink)

Hegel's Philosophy of right concerns ideas on justice, moral responsibility, family life, economic activity and the political structure of the state. He shows how human freedom involves living with others in accordance with publicly recognized rights and laws.

In a tribute to the intellectual legacy of Peter Fitzpatrick, this article explores the poiesis of modern law, as a constitutive ambivalence distilled in the affinity between law and literature. Reading with Fitzpatrick, the resolution of the contradictions of this law in myth depends, paradoxically, upon its fundamental irresolution. Reflecting upon the profound significance of his revelation of the mythology of modern law and its scholarly reverberations, I consider the constitutive tensions of this law as exemplified in the relation between (...) praxis and poiesis, the operative function of the former dependent upon the creative unfolding of the latter. The alchemy of autopoiesis, by which law boldly proclaims itself law, is made explicit in the eschatology of its archive and the formation of its sovereign subject in negation. Revealing the literary dimensions of this law, the conceit of autonomy is nonetheless subject to the subversive substitutions of the supplement. Pressing yet further, the autopoiesis of law is found to be enfolded within a generative sympoiesis, constituted by the movement between its apposite dimensions. Ultimately, extending Fitzpatrick’s rendering of the irresolution of modern law as decolonial, I explore the possibilities afforded by a reading of the fundamental mutuality of myths, and the decolonial conviviality of poiesis. (shrink)

Global Media Ethics is the first comprehensive cross-cultural exploration of the conceptual and practical issues facing media ethics in a global world. A team of leading journalism experts investigate the impact of major global trends on responsible journalism. The first full-length, truly global textbook on media ethics; Explores how current global changes in media promote and inhibit responsible journalism; Includes relevant and timely ethical discussions based on major trends in journalism and global media; Questions existing frameworks in media ethics in (...) light of the impact of global media; Contributors are leading experts in global journalism and communication. (shrink)

No progress has been made over the past decade in improving equity of access to higher education for young people from low socio-economic backgrounds. New evidence indicates that both family income and cultural factors explain this situation. The cultural factor is particularly strong for boys from blue collar backgrounds. Current Government equity policy ignores these findings.

Corporate sustainability introduces multiple tensions or paradoxes into organisations which defy traditional approaches such as trading-off contrasting options. We examine an alternative approach: to manage corporate sustainability with a paradoxical lens where contradictory elements are managed concurrently. Drawing on paradox theory, we focus on two specific pathways: to the organisation-wide acceptance of paradox and to paradoxical resolution. Introducing the concept of strategic agility, we argue that strategically agile organisations are better placed to navigate these paradox pathways. Strategic agility comprises three (...) organisational meta-capabilities: strategic sensitivity, collective commitment, and resource fluidity. We propose that strategically agile organisations draw on strategic sensitivity and collective commitment to achieve organisation-wide acceptance of paradox, and collective commitment and resource fluidity to achieve paradoxical resolution. For each of these meta-capabilities, we identify three organisational practices and processes specifically related to corporate sustainability that organisations can leverage in pursuit of strategic agility. We offer a conceptual framework depicting the strategic agility meta-capabilities, and associated practices and processes, which organisations draw on to successfully manage corporate sustainability with a paradoxical lens. (shrink)

Substantial efforts have recently been made to reform the physician-patient relationship, particularly toward replacing the `silent world of doctor and patient' with informed patient participation in medical decision-making. This 'new ethos of patient autonomy' has especially insisted on the routine provision of informed consent for all medical interventions. Stronly supported by most bioethicists and the law, as well as more popular writings and expectations, it still seems clear that informed consent has, at best, been received in a lukewarm fashion by (...) most clinicians, many simply rejecting what they commonly refer to as the `myth of informed consent'. The purpose of this book is to defuse this seemingly intractable controversy by offering an efficient and effective operational model of informed consent. This goal is pursued first by reviewing and evaluating, in detail, the agendas, arguments, and supporting materials of its proponents and detractors. A comprehensive review of empirical studies of informed consent is provided, as well as a detailed reflection on the common clinician experience with attempts at informed consent and the exercise of autonomy by patients. In the end, informed consent is recast as a management tool for pursuing clinically and ethically important goods and values that any clinician should see as meriting pursuit. Concurrently, the model incorporates a flexible, anticipatory approach that recognizes that no static, generic ritual can legitimately pursue the quite variable goods and values that may be at stake with different patients in different situations. Finally, efficiency of provision is addressed by not pursuing the unattainable and ancillary. Throughout, the traditional principle of beneficence is appealed to toward articulating an operational model of informed consent as an intervention that is likely to change outcomes at the bedside for the better. (shrink)

What Is Political Theory? provides students with a comprehensive overview of the current state of the discipline. Ten substantive chapters address the most pressing topics in political theory today, including: - what resources do the classic texts still provide for political theorists? - what areas will political theorists focus on in the future? - can western political theory alone continue to provide a framework for responding to the challenges of modern political life? The authors assess the intellectual challenges to conventional (...) political theory, such as post-structuralism and the scientific study of politics that have revitalized the field in the last 30 years. They also broaden the perspective to take in non-western ideas and to reconceptualize political theory in the light of specifically global challenges. Students and teachers of political theory and political philosophy will find this book invaluable in understanding the factors that have shaped current political theory and which will guide its future development. (shrink)

I examine the (mediated) correspondence between Spinoza and Robert Boyle concerning the latter’s account of fluidity and his experiments on reconstitution of niter in the light of the epistemology and doctrine of method contained in the Treatise on the Emendation of the Intellect. I argue that both the Treatise and the correspondence reveal that for Spinoza, the proper method of science is not experimental, and that he accepted a powerful under-determination thesis. I argue that, in contrast to modern versions, Spinoza’s (...) form of naturalism was a highly rationalist and anti-empirical one. I conclude with a brief account of the value of experience and experimentation for Spinoza’s scientific method. (shrink)

As a practising lawyer and judge, it is the insights gained from Stephen's own experience that give an added practical dimension to this work. As well as his accounts of the history of the branches of the law, Stephen gives several fascinating analyses of famous trials, and explores the relation of madness to crime and the relation of law to ethics, physiology, and mental philosophy. His discussion also includes the subjects of criminal responsibility, offences against the state, the (...) criminal jurisdiction of the Privy Council, libel, Indian criminal law and offences against religion. (shrink)

Philosophical Perspectives on Art presents a series of essays devoted to two of the most fundamental topics in the philosophy of art: the distinctive character of artworks and what is involved in understanding them as art. In Part I, Stephen Davies considers a wide range of questions about the nature and definition of art. Can art be defined, and if so, which definitions are the most plausible? Do we make and consume art because there are evolutionary advantages to doing (...) so? Has art completed the mission that guided its earlier historical development, and if so, what is to become of it now? Should architecture be classified as an art form? -/- Part II turns to the interpretation and appreciation of art. What is the target and purpose of the critic's interpretation? Is interpretation primarily directed at uncovering artists' intended meanings? Can apparently contradictory interpretations of a given piece both be true? Are interpretative evaluations entailed by descriptions of a work's aesthetic and artistic characteristics? In addition to providing fresh answers to these and other central questions in aesthetics, Davies considers the nature and content of metaphor, and the relation between the expressive qualities of a work of art and the emotions of its creator. (shrink)

v. 1. The collective use and evolution of concepts.

Examines the history and inherent flaws of the tests science has used to measure intelligence.

What is it for marks or sounds to have meaning, and what is it for someone to mean something in producing them? Answering these and related questions, Schiffer explores communication, speech acts, convention, and the meaning of linguistic items in this reissue of a seminal work on the foundations of meaning. A new introduction takes account of recent developments and places his theory in a broader context.

Neo-Confucianism is a philosophically sophisticated tradition weaving classical Confucianism together with themes from Buddhism and Daoism. It began in China around the eleventh century CE, played a leading role in East Asian cultures over the last millennium, and has had a profound influence on modern Chinese society. -/- Based on the latest scholarship but presented in accessible language, Neo-Confucianism: A Philosophical Introduction is organized around themes that are central in Neo-Confucian philosophy, including the structure of the cosmos, human nature, ways (...) of knowing, personal cultivation, and approaches to governance. The authors thus accomplish two things at once: they present the Neo-Confucians in their own, distinctive terms; and they enable contemporary readers to grasp what is at stake in the great Neo-Confucian debates. (shrink)

This book develops a theory of how the imagination functions, and how it evolved. The imagination is characterized as an embodied cognitive system. The system draws upon sensory-motor, visual, and linguistic capacities, but it is a flexible, developmental ability, typified by creative improvisation. The imagination is a voluntary simulation system that draws on perceptual, emotional, and conceptual elements, for the purpose of creating works that adaptively investigate external (environmental) and internal (psychological) resources. Beyond the adaptive useful values of this system, (...) imagination also possesses significant intrinsic value (e.g., in the joy of play, and states of wonder). The book argues that imagination is not a late arrival in the evolution of mind, but one of the earliest human abilities. (shrink)

Introduction -- Part I: Willing as practical knowing -- The will and practical judgment -- Fundamental practical judgments : the wish for happiness -- Part II: From presuppositions of judgment to the idea of a categorical imperative -- The formal presuppositions of practical judgment -- Constraints on willing -- Part III: Interpretation -- The categorical imperative -- Applications -- Conclusion.

Stephen Davies presents a fascinating exploration of the idea that art, and our aesthetic sensibilities more generally, should be understood as an element in human evolution. He asks: Do animals have aesthetics? Do our aesthetic preferences have prehistoric roots? Is art universal? What is the biological role of aesthetic and artistic behaviour?

To what extent should parents be allowed to use reproductive technologies to determine the characteristics of their future children? Is there something morally wrong with choosing what their sex will be, or with trying to 'screen out' as much disease and disability as possible before birth? Stephen Wilkinson offers answers to such questions.

FEW HEROES LOWER their sights in the prime of their lives; triumph leads inexorably on, often to destruction. Alexander wept because he had no new worlds to conquer; Napoleon, overextended, sealed his doom in the depth of a Russian winter. But Charles Darwin did not follow the Origin of Species (1859) with a general defense of natural selection or with its evident extension to human evolution (he waited until 1871 to publish The Descent of Man). Instead, he wrote his most (...) obscure work, a book entitled: On the Various Contrivances by Which British and Foreign Orchids Are Fertilized by Insects (1862). (shrink)