This paper is particularly concerned with shame, sometimes considered the ‘master emotion’, and its possible role in affecting the consent process, specifically where that shame relates to the issue of diminished health literacy. We suggest that the absence of exploration of affective issues in general during the consent process is problematic, as emotions commonly impact upon our decision-making process. Experiencing shame in the healthcare environment can have a significant influence on choices related to health and healthcare, and may lead to (...) discussions of possibilities and alternatives being closed off. In the case of impaired health literacy we suggest that it obstructs the narrowing of the epistemic gap between clinician and patient normally achieved through communication and information provision. Health literacy shame prevents acknowledgement of this barrier. The consequence is that it may render consent less effective than it otherwise might have been in protecting the person's autonomy. We propose that the absence of consideration of health literacy shame during the consent process diminishes the possibility of the patient exerting full control over their choices, and thus bodily integrity. (shrink)

This innovative text is psychologically informed, both in its diagnosis of inferential errors, and in teaching students how to watch out for and work around their natural intellectual blind spots. It also incorporates insights from epistemology and philosophy of science that are indispensable for learning how to evaluate premises. The result is a hands-on primer for real world critical thinking. The authors bring a fresh approach to the traditional challenges of a critical thinking course: effectively explaining the nature of validity, (...) assessing deductive arguments, reconstructing, identifying and diagramming arguments, and causal and probabilistic inference. Additionally, they discuss in detail, important, frequently neglected topics, including testimony, including the evaluation of news and other information sources, the nature and credibility of science, rhetoric, and dialectical argumentation. The treatment of probability uses frequency trees and a frequency approach more generally, and argument reconstruction is taught using argument maps; these methods have been shown to improve students’ reasoning and argument evaluation. (shrink)

In her interesting paper on cross-jurisdictional legal approaches to brain death, Ariane Lewis considers whether informed consent is required for DNC testing in the UK, and proposes that it is not...

Canada has recently published a new Clinical Practice Guideline on the diagnosis and management of brain death. It states that consent is not necessary to carry out the interventions required to make the diagnosis. A supporting article not only sets out the arguments for this but also contends that ‘UK laws similarly carve out an exception, excusing clinicians from a prima facie duty to get consent’. This is supplemented by the claim that recent court decisions in the UK similarly confirm (...) that consent is not required, referencing two judgements inBattersbee. We disagree with the authors’ interpretation of the law on consent in the UK and argue that there is nothing inBattersbeeto support the conclusion that consent to testing is not necessary. Where there is a disagreement about testing for brain death in the UK, court authorisation is required. (shrink)

In the context of critically ill children, Baines contended that the best interests test was neither objective nor coherent, and thus of little applicability in making end-of-life decisions. In reply, Bridgeman attempted to refute these claims through legal analysis and contended that the doctrine allowed for responsive, fact-specific, context-sensitive and prudential reasoning. This paper is a response to Bridgeman, and argues that an examination of case law reveals the subjective and value-laden nature of the test. Courts must make decisions in (...) contested cases, but there is no reason to hold that a judge can divine the best interests of a critically ill child better than either parents or medical staff. This paper analyses a number of cases where judicial decisions appear at odds with the child's best interests, and argues that as the outcome depends upon the value system of the decision-maker the test is unhelpful in contested end-of-life cases. (shrink)

The decision of the House of Lords in Gillick v West Norfolk Area Health Authority carved out a safe space for competent minors to confidentially access sexual and reproductive health care and advice in the UK. Ireland is one of the few common law jurisdictions that has not endorsed Gillick or a similar mature minor doctrine, nor has it securely legislated for the right to consent of those aged 16 and 17 years. The legal lacuna created by this deficiency has (...) left young persons in Ireland seeking sexual and reproductive healthcare, and the clinicians who provide this, in a challenging place. While this void has been partially filled with policy statements by bodies such as the Irish College of General Practitioners and the Health Service Executive, nonetheless the legal shortcomings leave both a sense of insecurity, and real world difficulties for adolescents seeking to access to sexual and reproductive healthcare. (shrink)

The reality of current clinical practice in the UK is that where a patient’s family refuses to agree to testing for brain stem death (BD), such cases will ultimately end up in court. This situation is true of both adults and children and reinforced by recent legal cases. While recourse to the courts might be regrettable in such tragic cases, if public trust in the medical diagnosis of BD is to be maintained all aspects of the process must be conducted (...) in a way that is transparent and open to scrutiny. This is not an ‘ineffective expenditure’ of resources, but an essential element of a human rights-compliant legal system. (shrink)

The Health (Regulation of Termination of Pregnancy) Act 2018 was commenced on 01/01/2019 in Ireland. The Act provides for legal termination of pregnancy under defined circumstances including for any reason at < 12 weeks gestation; and where two doctors agree there is ‘a condition affecting the foetus that is likely to lead to the death of the foetus either before, or within 28 days of, birth’. As such, abortion for congenital anomaly (CA) can occur at a number of time points, (...) depending on the adjudged severity. Infants born with CAs frequently require significant medical intervention and account for a high proportion of admissions to paediatric intensive care units (PICUs). The purpose of this paper was to evaluate the number of infants with CAs admitted to an Irish PICU in the period before and after the implementation of the Act. All PICU admissions < 1 month of age to a single Irish paediatric hospital between 2012 and 2021 were analysed. CAs were recorded, and the periods before and after the commencement of the Act compared. We found a difference in admissions involving CAs, particularly those related to congenital heart disease involving single ventricle anatomy. It is plausible that this difference was as a result of improved access to abortion services following the implementation of the Act. This article explores the legal conditions related to the abortion of a foetus with a CA in Ireland, and the possible impact of the Independent Review of the Operation of the Health ( Regulation of Termination of Pregnancy) Act 2018. (shrink)

In 2010, President Obama instructed the Presidential Commission for the Study of Bioethical Issues to enquire into research carried out by the US Public Health Service in Guatemala between 1946 and 1948. These studies entailed the deliberate inoculation of unconsenting prisoners, mental asylum patients and soldiers, with venereal disease. There was also evidence of deception and secrecy. The Commission’s report describes the research as heinous, egregious, unconscionable and unjustifiable, and identified those responsible as morally blameworthy. However, this article argues that (...) the Commission was deficient in its historical analysis, and failed to appreciate particular disease and temporal factors that might cast the research in a slightly different light. This is not to exculpate the researchers, but rather to critique the Commission’s analysis. The straightforward narrative woven by the Commission does not accurately reflect the muddy ethical waters of the time, nor the utilitarian ethos that pervaded particular research agendas. The creation of a facile story denies to us a proper understanding of why events unfolded as they did, and as a consequence a potential lack of comprehension of those elements that might prevent unethical and harmful research practices from being conducted in the future. (shrink)

While research on children is supported by many professional guidelines, international declarations and domestic legislation, when it is undertaken on children with no possibility of direct benefit it rests on shaky moral foundations. A number of authors have suggested that research enrolment is in the child's best interests, or that they have a moral duty or societal obligation to participate. However, these arguments are unpersuasive. Rather, I will propose in this paper that research participation by children seems most reasonable when (...) considered as an act of solidarity; a form of identification with, and provision of practical assistance to, those who are less well off. This is an articulation of the view that many children, and their parents, seem to take seriously the suffering of others, and wish to assist in advancing other children's wellbeing. Perhaps, by fostering an environment in which children are encouraged to take solidarity seriously, participation in research which holds out substantial hope of benefit to those less well off would come to be perceived as a behavioural norm rather than an exceptional practice. (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

Introduction of O2 to Earth's early biosphere stimulated remarkable evolutionary adaptations, and a wide range of electron acceptors allowed diverse, energy-yielding metabolic pathways. Enzymatic reduction of O2 yielded a several-fold increase in energy production, enabling evolution of multi-cellular animal life. However, utilization of O2 also presented major challenges as O2 and many of its derived reactive oxygen species are highly toxic, possibly impeding multicellular evolution after the Great Oxidation Event. Remarkably, ROS, and especially hydrogen peroxide, seem to play a major (...) part in early diversification and further development of cellular respiration and other oxygenic pathways, thus becoming an intricate part of evolution of complex life. Hence, although harnessing of chemical and thermo-dynamic properties of O2 for aerobic metabolism is generally considered to be an evolutionary milestone, the ability to use ROS for cell signaling and regulation may have been the first true breakthrough in development of complex life. The importance of Earth's oxygen cycle and reactive oxygen species produced on the evolution of complex life. The ability to detoxify oxygen species is not a trait that emerged as a response to increased O2 levels but rather crucial adaptation to the early Earth's weakly oxic microenvironments. (shrink)

A short discussion piece arguing that the neuropsychological phenomenon of double dissociations is most revealing of underlying cognitive architecture because of the capacities that are spared, more than the capacities that are lost.

We present a novel methodology for calculating the improvements obtained in successive versions of biomedical ontologies. The theory takes into account changes both in reality itself and in our understanding of this reality. The successful application of the theory rests on the willingness of ontology authors to document changes they make by following a number of simple rules. The theory provides a pathway by which ontology authoring can become a science rather than an art, following principles analogous to those that (...) have fostered the growth of modern evidence-based medicine. Although in this paper we focus on ontologies, the methodology can be generalized to other sorts of terminology-based artifacts, including Electronic Patient Records. (shrink)

In this accessible book, Barry Hallen discusses the major ideas, figures, and schools of thought in African philosophy. While drawing out critical issues in the formation of African philosophy, Hallen focuses on the recent scholarship, current issues, and relevant debates that have made African philosophy an important key to understanding the rich and complex cultural heritage of Africa. Hallen builds upon Africa's connections with Western philosophical traditions and explores African contributions to cultural universalism, cultural relativism, phenomenology, hermeneutics, and Marxism. (...) Hallen also examines African challenges to Western conceptions of philosophy by taking on questions such as whether philosophy can exist in cultures that are significantly based in oral traditions and what may or may not constitute philosophical texts. Among the figures whose work is discussed are Ptah-hotep, Zar'a Ya'aqob, Anton Wilhelm Amo, Paulin Hountondji, V. Y. Mudimbe, Oyeronke Oyewumi, Kwame Anthony Appiah, and Kwasi Wiredu. This clearly written, highly readable, and concise work will be essential for students and scholars of African philosophy as well as readers with a wide range of interests in African studies. (shrink)

I defend a moderate (neither extremely conservative nor extremely liberal) view about the contents of perception. I develop an account of perceptual kinds as perceptual similarity classes, which are convex regions in similarity space. Different perceivers will enjoy different perceptual kinds. I argue that for any property P, a perceptual state of O can represent something as P only if P is coextensive with some perceptual kind for O. 'Dog' and 'chair' will be perceptual kinds for most normal people, 'blackpool (...) warbler' for the expert birdwatcher but not for the rest of us, 'dangerous', 'familiar', or 'meaning that the cat is on the mat' for none of us. (shrink)

Although known as the founder of modern utilitarianism and the source of analytical jurisprudence, Bentham today is infrequently read but often caricatured. The present book offers a reinterpretation of Bentham's main philosophical doctrines, his principle of utility and his analysis of law, philosophical doctrines, as they are developed in Bentham's most important works. A new reading is also given to his theory of law, which suggests Bentham's insight, originality, and continued interest for philosophers and legal theorists. First published in 1973, (...) this revised edition contains a new Preface, a revised Bibliography, and two new Indexes, one of Names and one of Subjects, which together replace the original index. (shrink)

Barry Schein proposes combining a second-order treatment of plurals with DonaldDavidson's suggestion that there are positions for reference to events in ordinary predicates inorder to account for several of the more puzzling features of ...

Acceptance of Humean Supervenience and thereductive Humean analyses that entail it leadsto a litany of inadequately explained conflictswith our intuitions regarding laws andpossibilities. However, the non-reductiveHumeanism developed here, on which law claimsare understood as normative rather than factstating, can accommodate those intuitions. Rational constraints on such norms provide aset of consistency relations that ground asemantics formulated in terms offactual-normative worlds, solving theFrege-Geach problem of construing unassertedcontexts. This set of factual-normative worldsincludes exactly the intuitive sets ofnomologically possible worlds associated witheach possible (...) set of laws. The extension ofthe semantics to counterfactual and subjunctiveconditionals is sketched. Potential objectionsinvolving subjectivity, mind-dependence, andnon-factuality are discussed. (shrink)

Psychologists have recently turned their attention to the nature of the recognition involved in judgment of familiarity. It has been suggested that, apart from judging a stimulus to be familiar when one is able to recall a context in which it was previously perceived, subjects are also able to judge that something is familiar merely on the basis of its faster perceptual processing.

This article considers the implications for film analysis of the presence or absence of a manual crank. More specifically, it looks at the 16 mm Time and Motion Study Projector as used in behavioral research in the 1960s and 1970s. The controversial concept of ‘interactional synchrony’, or the dance-like coordination of people in conversation, emerged from the use of this hand-turned projector. William S. Condon developed the concept along with the technique of microanalysis. Starting with the projector manufactured by Bell (...) & Howell, he made numerous improvements to facilitate observation—‘sweeping’ over segments of very short duration to discover the rhythmic synchrony of all filmed participants. It led him to a theory of ‘process’ in communication, and in the reception of speech in particular. People always ‘danced’ to the tune of their own voice, and their listeners ‘danced’ to the tune of the speaker—at intervals of one-sixth or one-eighth of a second. This also led Condon to an epistemology of discovery derived partly from philosophy but mostly from his machinery. The universe, he said, is a ‘continuum of order’ whose structures are preserved through translations of order: of thought into speech, speech into vibrations, vibrations into neurons, and back into behavior. The only exceptions are people with disabilities, like the autistics Condon studied from the 1970s onward. But the very distinction of normal and pathological was epiphenomenal to his scanning technique; it was rooted in material and formal qualities of film and of the projector whose crank he turned often. (shrink)

Whether we're buying a pair of jeans, ordering a cup of coffee, selecting a long-distance carrier, applying to college, choosing a doctor, or setting up a 401(k), everyday decisions ; both big and small ; have become increasingly complex due to the overwhelming abundance of choice with which we are presented. As Americans, we assume that more choice means better options and greater satisfaction. But beware of excessive choice: choice overload can make you question the decisions you make before you (...) even make them, it can set you up for unrealistically high expectations, and it can make you blame yourself for any and all failures. In the long run, this can lead to decision-making paralysis, anxiety, and perpetual stress. And, in a culture that tells us that there is no excuse for falling short of perfection when your options are limitless, too much choice can lead to clinical depression. In The Paradox of Choice, Barry Schwartz explains at what point choice ; the hallmark of individual freedom and self-determination that we so cherish ; becomes detrimental to our psychological and emotional well-being. In accessible, engaging, and anecdotal prose, Schwartz shows how the dramatic explosion in choice ; from the mundane to the profound challenges of balancing career, family, and individual needs ; has paradoxically become a problem instead of a solution. Schwartz also shows how our obsession with choice encourages us to seek that which makes us feel worse. By synthesizing current research in the social sciences, Schwartz makes the counter intuitive case that eliminating choices can greatly reduce the stress, anxiety, and busyness of our lives. He offers eleven practical steps on how to limit choices to a manageable number, have the discipline to focus on those that are important and ignore the rest, and ultimately derive greater satisfaction from the choices you have to make."--provided by publisher. (shrink)

In American legal journals over the last decade there were hundreds of pages of articles worrying over threats to justice and freedom arising from the power to withhold benefits. Government officials have tremendous discretion to offer or withhold foreign aid, ration-books, government contracts and jobs, welfare subsidies, public housing, tariff protection, academic grants, alien resident status, paroles, or exemption from conscription or combat, from arrest or prosecution or imprisonment. Right-wing economists have worried about welfare-state emphasis on administrative discretion rather than (...) the rule of law. And left-wing economists have worried about the rich man's power to intimidate the poor man by threatening to cut off his productive work. (shrink)

In the nearly 30 years since Premack and Woodruff famously asked, “Does the chimpanzee have a theory of mind?”, the question of exactly how much non-human primates understand about the mental lives of others has had an unusually dramatic history. As little as ten years ago it appeared that the answer would be a simple one, with early investigations of non-human primates’ mentalistic abilities yielding a steady stream of negative findings. Indeed, by the mid-1990s even very cautious researchers were ready (...) to flatly assert that Theory of Mind was a uniquely human capacity. Recently, however, an exciting new theoretical perspective on primate social cognition has arisen, and with it the distinct possibility that our evolutionary relatives may understand far more of the social world than we previously believed. In this paper we review new theory and evidence suggesting that non-human primates may indeed represent the mental states of others, at least within the domains for which their distinctive social ecology has prepared them. Having asserted that Premack and Woodruff's original question can be answered with a qualified yes, we then consider the new questions that arise in its place, particularly how and why our own Theory of Mind became more domain-general than that of other primates. (shrink)

Difficult to know and impossible to forget, Ludwig Wittgenstein is remembered as the greatest philosopher of the twentieth century. He published only one book in his lifetime - a masterpiece that moulded the evolution of philosophy and baffled his teachers. Spanning most of his life, from his early encounters with Bertrand Russell in Cambridge to a final trip to New York via the Russian Front, Wittgenstein: The Crooked Roads tracks the journeys of a tortured soul. William Lyons, Professor Emeritus (...) of Philosophy, Trinity College, Dublin, has written a moving and philosophically acute journey through successive decades of Wittgenstein's career. The play received its world premiere on 19 April 2011 at the Riverside Studios. (shrink)

The explanatory role of natural selection is one of the long-term debates in evolutionary biology. Nevertheless, the consensus has been slippery because conceptual confusions and the absence of a unified, formal causal model that integrates different explanatory scopes of natural selection. In this study we attempt to examine two questions: (i) What can the theory of natural selection explain? and (ii) Is there a causal or explanatory model that integrates all natural selection explananda? For the first question, we argue that (...) five explananda have been assigned to the theory of natural selection and that four of them may be actually considered explananda of natural selection. For the second question, we claim that a probabilistic conception of causality and the statistical relevance concept of explanation are both good models for understanding the explanatory role of natural selection. We review the biological and philosophical disputes about the explanatory role of natural selection and formalize some explananda in probabilistic terms using classical results from population genetics. Most of these explananda have been discussed in philosophical terms but some of them have been mixed up and confused. We analyze and set the limits of these problems. (shrink)

Faced with the paradox of undermining futures, Humeans have resigned themselves to accounts of chance that severely conflict with our intuitions. However, such resignation is premature: The problem is Humean supervenience (HS), not Humeanism. This paper develops a projectivist Humeanism on which chance claims are understood as normative, rather than fact stating. Rationality constraints on the cotenability of norms and factual claims ground a factual-normative worlds semantics that, in addition to solving the Frege-Geach problem, delivers the intuitive set of possibilia (...) for each chance law. Hence, the account does not entail HS, and the paradox does not arise. A confirmation theory is developed, and the 'principal principle' is justified. (shrink)