Background There are numerous ethical challenges that can impact patients and families in the health care setting. This paper reports on the results of a study conducted with a panel of clinical bioethicists in Toronto, Ontario, Canada, the purpose of which was to identify the top ethical challenges facing patients and their families in health care. A modified Delphi study was conducted with twelve clinical bioethicist members of the Clinical Ethics Group of the University of Toronto Joint Centre for Bioethics. (...) The panel was asked the question, what do you think are the top ten ethical challenges that Canadians may face in health care? The panel was asked to rank the top ten ethical challenges throughout the Delphi process and consensus was reached after three rounds. Discussion The top challenge ranked by the group was disagreement between patients/families and health care professionals about treatment decisions. The second highest ranked challenge was waiting lists. The third ranked challenge was access to needed resources for the aged, chronically ill, and mentally ill. Summary Although many of the challenges listed by the panel have received significant public attention, there has been very little attention paid to the top ranked challenge. We propose several steps that can be taken to help address this key challenge. (shrink)

My strategy is to examine a recent trend in philosophical discussions of responsibility, a trend that tries, but I think ultimately fails, to give an acceptable analysis of the conditions of responsibility. It fails due to what at first appear to be deep and irresolvable metaphysical problems. It is here that I suggest that the condition of sanity comes to the rescue. What at first appears to be an impossible requirement for responsibility---the requirement that the responsible agent have created her- (...) or himself---turns out to be the vastly more mundane and non controversial requirement that the responsible agent must, in a fairly standard sense, be sane. (shrink)

The “lone” clinical bioethicist working in a large, multisite hospital faces considerable challenges. While attempting to build ethics capacity and sustain a demanding range of responsibilities, he or she must also achieve an acceptable level of integration, sustainability, and accountability within a complex organisational structure. In an effort to address such inherent demands and to create a platform towards better evaluation and effectiveness, the Clinical Ethics Group at the Joint Centre for Bioethics at the University of Toronto is implementing the (...) Hub and Spokes Strategy at seven hospitals. The goal of the Hub and Spokes Strategy is to foster an ethical climate and strengthen ethics capacity broadly throughout healthcare settings as well as create models in clinical bioethics that are excellent and effective. (shrink)

Bioethics has paid surprisingly little attention to the special problems faced by women and to feminist analyses of current health care issues other than ...

Background Dynamic consent has been proposed as a process through which participants and patients can gain more control over how their data and samples, donated for biomedical research, are used, resulting in greater trust in researchers. It is also a way to respond to evolving data protection frameworks and new legislation. Others argue that the broad consent currently used in biobank research is ethically robust. Little empirical research with cohort study participants has been published. This research investigated the participants’ opinions (...) of adding a dynamic consent interface to their existing study. Methods Adult participants in the Extended Cohort for E-health, Environment and DNA longitudinal cohort study who are members of the EXCEED Public and Participant Engagement Group were recruited. Four focus groups were conducted and analysed for thematic content. Discussion topics were derived from a review of the current literature on dynamic consent. Results Participants were in favour of many aspects of a dynamic consent interface, such as being able to update their information, add additional data to their records and choose withdrawal options. They were supportive provided it was simple to use and not intrusive. Participants expressed a markedly high level of trust in the study and its investigators and were unanimously happy with their current participation. No strong support was found for adding a dynamic consent interface to EXCEED. Conclusions Trust in the study researchers was the strongest theme found. Openness and good data security were needed to retain their trust. While happy to discuss dynamic consent, participants were satisfied with the current study arrangements. There were indications that changing the study might unnecessarily disturb their trust. This raised the question of whether there are contexts where dynamic consent is more appropriate than others. This study was limited by the small number of participants who were committed to the study and biased towards it. More research is needed to fully understand the potential impact of adding a dynamic consent interface to an existing cohort study. (shrink)

The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration -- Clients (...) with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)

Only human beings have a rich conceptual repertoire with concepts like tort, entropy, Abelian group, mannerism, icon and deconstruction. How have humans constructed these concepts? And once they have been constructed by adults, how do children acquire them? While primarily focusing on the second question, in The Origin of Concepts , Susan Carey shows that the answers to both overlap substantially. Carey begins by characterizing the innate starting point for conceptual development, namely systems of core cognition. Representations of core (...) cognition are the output of dedicated input analyzers, as with perceptual representations, but these core representations differ from perceptual representations in having more abstract contents and richer functional roles. Carey argues that the key to understanding cognitive development lies in recognizing conceptual discontinuities in which new representational systems emerge that have more expressive power than core cognition and are also incommensurate with core cognition and other earlier representational systems. Finally, Carey fleshes out Quinian bootstrapping, a learning mechanism that has been repeatedly sketched in the literature on the history and philosophy of science. She demonstrates that Quinian bootstrapping is a major mechanism in the construction of new representational resources over the course of childrens cognitive development. Carey shows how developmental cognitive science resolves aspects of long-standing philosophical debates about the existence, nature, content, and format of innate knowledge. She also shows that understanding the processes of conceptual development in children illuminates the historical process by which concepts are constructed, and transforms the way we think about philosophical problems about the nature of concepts and the relations between language and thought. (shrink)

Deep ethical interpretivism has been the standard view of the nature of sport in the philosophy of sport for the past seventeen years or so. On this account excellence assumes the role of the foundational, ethical goal that justice assumes in Ronald Dworkin’s interpretivist model of law. However, since excellence in sports is not an ethical value, and since it should not be regarded as an ultimate goal, the case for the traditional account fails. It should be replaced by the (...) shallow interpretivist model that I begin to sketch out and defend here. (shrink)

In this important book, Susan Hurley sheds new light on consciousness by examining its relationships to action from various angles. She assesses the role of agency in the unity of a conscious perspective, and argues that perception and action are more deeply interdependent than we usually assume. A standard view conceives perception as input from world to mind and action as output from mind to world, with the serious business of thought in between. Hurley criticizes this picture, and considers (...) how the interdependence of perceptual experience and agency at the personal level (of mental contents and norms) may emerge from the subpersonal level (of underlying causal processes and complex dynamic feedback systems). Her two-level view has wide implications, for topics that include self-consciousness, the modularity of mind, and the relations of mind to world. The self no longer lurks hidden somewhere between perceptual input and behavioral output, but reappears out in the open, embodied and embedded in its environment. Hurley traces these themes from Kantian and Wittgensteinian arguments through to intriguing recent work in neuropsychology and in dynamic systems approaches to the mind, providing a bridge from mainstream philosophy to work in other disciplines. Consciousness in Action is unique in the range of philosophical and scientific work it draws on, and in the deep criticism it offers of centuries-old habits of thought. (shrink)

ABSTRACTBernard Suits and other formalists endorse both the logical incompatibility thesis and the view that rule-breakings resulting in penalties can be a legitimate part of a game. This is what Fred D’Agostino calls ‘the problem of penalties’. In this paper, I reject both Suits’ and D’Agostino’s responses to the problem and argue instead that the solution is to abandon Suits’ view that the constitutive rules of all games are alike. Whereas the logical incompatibility thesis applies to games in which players’ (...) actions are perfectly controlled, it does not apply to sports. This insight not only justifies the rejection of formalism as a theory about the nature of sport but it also helps explain the greater normative complexity of sports, which in turn leads to the idea that in sports ‘cheating’ should be interpreted as a genus. (shrink)

BackgroundThere are numerous ethical challenges that can impact patients and families in the health care setting. This paper reports on the results of a study conducted with a panel of clinical bioethicists in Toronto, Ontario, Canada, the purpose of which was to identify the top ethical challenges facing patients and their families in health care. A modified Delphi study was conducted with twelve clinical bioethicist members of the Clinical Ethics Group of the University of Toronto Joint Centre for Bioethics. The (...) panel was asked the question, what do you think are the top ten ethical challenges that Canadians may face in health care? The panel was asked to rank the top ten ethical challenges throughout the Delphi process and consensus was reached after three rounds.DiscussionThe top challenge ranked by the group was disagreement between patients/families and health care professionals about treatment decisions. The second highest ranked challenge was waiting lists. The third ranked challenge was access to needed resources for the aged, chronically ill, and mentally ill.SummaryAlthough many of the challenges listed by the panel have received significant public attention, there has been very little attention paid to the top ranked challenge. We propose several steps that can be taken to help address this key challenge. (shrink)

Previous research has demonstrated that self-involvement enhances the memorability of information encountered in the past. The emergence of this effect, however, is dependent on guided evaluative processing and the explicit association of items with self. It remains to be seen, therefore, whether self-memory effects would emerge in task contexts characterized by incidental-encoding and minimal self-involvement. Integrating insights from work on source monitoring and action recognition, we hypothesized that the effects of self-involvement on memory function may be moderated by the extent (...) to which encoding experiences entail volitional processing. The results of three experiments supported this prediction. Despite the adoption of an incidental task context and stimulus materials that were inconsequential to participants, the act of selection enhanced the memorability and accessibility of information. The implications of these findings for contemporary treatments of self are considered. (shrink)

Bernard Suits and other formalists endorse both the logical incompatibility thesis and the view that rule-breakings resulting in penalties can be a legitimate part of a game. This is what Fred D’Ag...

My main goal here is to develop a functional analysis of cheating and corruption in sports, and to differentiate cheating within the broader category of corruption. Whereas officials can act corruptly, they cannot cheat. In contrast, sports participants, since they occupy two roles, can do both. I argue that although acts of cheating are acts of corruption, not all corrupt acts by competitors are acts of cheating. I also respond to some skeptical challenges and criticisms of the concept of ‘cheating’ (...) by providing some opposing arguments and a provisional definition. I argue that cheating in sports occurs in the context of a complex institutional practice. It transpires due to some failing in the efforts and/or limitations of sports officials to prohibit it. In central cases it consists in both the functional and ethical violation of the constitutional norms of a sport in the service of obtaining unearned victory for the cheater. (shrink)

In this paper, I defend a general theory of competition and contrast it with a corresponding general theory of cooperation. I then use this analysis to critique mutualism. Building on the work of Arthur Applbaum and Joseph Heath I develop an alternative adversarial model of competitive sport, one that helps explain and is partly justified by shallow interpretivism, and argue that this model helps shows that the claim that mutualism provides us with the most defensible ethical ideal of sport is (...) false. By replacing that view with an understanding of sporting adversarial ethics we can appreciate that the ethics of sport are more complex than has been commonly recognized. (shrink)

ABSTRACTIn this article, I begin to develop and defend a reformed concept of ‘cheating’ as ‘wrongful competitive norm violating’. I then use this to reject Oliver Leaman’s view that cheating is som...

ABSTRACTIn this article, I begin to develop and defend a reformed concept of ‘cheating’ as ‘wrongful competitive norm violating’. I then use this to reject Oliver Leaman’s view that cheating is som...

In this article I develop my argument for a shallow interpretivist theory of sport by showing that whereas it applies to all oppositional sports, the standard theory of sport for the past twenty ye...

The nature/nurture debate is not dead. Dichotomous views of development still underlie many fundamental debates in the biological and social sciences. Developmental systems theory offers a new conceptual framework with which to resolve such debates. DST views ontogeny as contingent cycles of interaction among a varied set of developmental resources, no one of which controls the process. These factors include DNA, cellular and organismic structure, and social and ecological interactions. DST has excited interest from a wide range of researchers, from (...) molecular biologists to anthropologists, because of its ability to integrate evolutionary theory and other disciplines without falling into traditional oppositions. The book provides historical background to DST, recent theoretical findings on the mechanisms of heredity, applications of the DST framework to behavioral development, implications of DST for the philosophy of biology, and critical reactions to DST. (shrink)

A theory of conceptual development must specify the innate representational primitives, must characterize the ways in which the initial state differs from the adult state, and must characterize the processes through which one is transformed into the other. The Origin of Concepts (henceforth TOOC) defends three theses. With respect to the initial state, the innate stock of primitives is not limited to sensory, perceptual, or sensorimotor representations; rather, there are also innate conceptual representations. With respect to developmental change, conceptual development (...) consists of episodes of qualitative change, resulting in systems of representation that are more powerful than, and sometimes incommensurable with, those from which they are built. With respect to a learning mechanism that achieves conceptual discontinuity, I offer Quinian bootstrapping. TOOC concludes with a discussion of how an understanding of conceptual development constrains a theory of concepts. (shrink)

The idea that cheaters cannot (really) win in sports persists among philosophers, mainly due to the lingering influence of Bernard Suits’ logical incompatibility thesis. In this article I explain why the thesis does not apply to sports. I argue that the question whether cheating can be prohibited in sports is empirical rather than analytic, as is the case for games subject to the thesis. Thus, sports rules do not make cheating impossible and since game officials cannot always detect cheating and (...) punish cheaters, cheating is a part of sports and cheaters sometimes win. Even if advances in technology made it impossible for cheaters to evade detection, since in-game officials will never know whether their attempts to provide restorative justice to those victimized by acts of cheating are successful, and since cheaters exploit this fact, it follows that not only is cheating a part of sports, but it always will be. (shrink)

Regional planning for improved agricultural capacity to supply produce, legumes, and whole grains has the potential to improve population health as well as the local food economy. This case study of Waterloo Region (WR), Canada, had two objectives. First, we estimate the quantity of locally grown vegetables, fruits, legumes, and whole grains needed to help meet the Region of Waterloo population’s optimal nutritional requirements currently and in 2026. Secondly, we estimate how much of these healthy food requirements for the WR (...) population could realistically be produced through local agriculture by the year 2026. Results show that a shift of approximately 10% of currently cropped hectares to the production of key nutritious foods would be both agriculturally feasible and nutritionally significant to the growing population. We supplement our findings with some agronomic considerations and community-level strategies that would inform and support such change. The methodology of this study could be applied to other regions: more such analyses would create a broader picture of the diverse qualitative and quantitative agricultural shifts that could synchronize optimal land use with dietary recommendations, thus informing coordinated policy and planning. (shrink)

In this book, Susan Mendus seeks to address these important questions to assess whether this apparent tension between morality and politics is real and, if so, ...

Throughout, the emerging theory of aspect is extensively compared with alternative theories, and the book concludes with general reflections on the semantic ...

The Republic’s political discussion begins with the construction of two contrasting cities: a ‘healthy’ city and a ‘city with a fever’; one defined by environmentally sustainable subsistence practices and the other by ‘luxurious’ over consumption that exceeds the carrying capacity of its land. Plato’s characters proceed to cure the inflamed city of its fever, resulting in the delineation of the ideal political constitution, the Kallipolis, which recovers the virtues of the original, healthy city in an altered form. This paper develops (...) an ecological reading of the Republic, highlighting Plato’s optimism regarding humans’ ability to limit their material consumption in accordance with the limits of the natural world. The conventional interpretation of the Republic’s first city, known as ‘the city of pigs’, is reconsidered in light of new socio-ecological research on traditional resource management systems. (shrink)

To what extent can animal behaviour be described as rational? What does it even mean to describe behaviour as rational? -/- This book focuses on one of the major debates in science today - how closely does mental processing in animals resemble mental processing in humans. It addresses the question of whether and to what extent non-human animals are rational, that is, whether any animal behaviour can be regarded as the result of a rational thought processes. It does this with (...) attention to three key questions, which recur throughout the book and which have both empirical and philosophical aspects: What kinds of behavioural tasks can animals successfully perform? What if any mental processes must be postulated to explain their performance at these tasks? What properties must processes have to count as rational? The book is distinctive in pursuing these questions not only in relation to our closest relatives, the primates, whose intelligence usually gets the most attention, but also in relation to birds and dolphins, where striking results are also being obtained. -/- Some chapters focus on a particular species. They describe some of the extraordinary and complex behaviour of these species - using tools in novel ways to solve foraging problems, for example, or behaving in novel ways to solve complex social problems - and ask whether such behaviour should be explained in rational or merely mechanistic terms. Other chapters address more theoretical issues and ask, for example, what it means for behaviour to be rational, and whether rationality can be understood in the absence of language. -/- The book includes many of the world's leading figures doing empirical work on rationality in primates, dolphins, and birds, as well as distinguished philosophers of mind and science. The book includes an editors' introduction which summarises the philosophical and empirical work presented, and draws together the issues discussed by the contributors. (shrink)

I ARGUE THAT WE RECEIVE PLEASURE FROM TRAGEDIES BECAUSE WE ARE PLEASED TO FIND OURSELVES RESPONDING IN AN UNPLEASANT WAY TO HUMAN SUFFERING AND INJUSTICE. THE PLEASURE IS THUS A METARESPONSE, AND REFLECTS FEELINGS WHICH ARE AT THE BASIS OF MORALITY. THIS HELPS EXPLAIN WHY TRAGEDY IS SUPPOSED TO BE A HIGHER ART FORM THAN COMEDY, AND PROVIDES A NEW WAY OF SEEING THE RELATIONSHIP BETWEEN THE MORALITY OF AN ARTWORK AND ITS VALUE.

This work examines the evolution of law and legal method, and challenges the law's claim to neutrality by examining its role in creating and reproducing inequality between the sexes. It considers many of the current debates, and in each, the law is stated with reference to recent developments in statute and judicial decisions in the UK and other jurisdictions. The author illustrates how each issue is shaped by the current political climate and, where relevant, by the European Court. Reference is (...) also made to US and Australian case law. The book should be of interest to students studying women and the law, family law, criminal law and jurisprudcence, as well as those on criminology and sociology courses. It should also be useful to family and criminal practitioners. (shrink)