Surgical devices are often marketed before there is good evidence of their safety and effectiveness. Our paper discusses the ethical issues associated with the early marketing and use of new surgical devices from the perspectives of the six groups most concerned. Health Canada, which is responsible for licensing new surgical devices, should amend their requirements to include rigorous clinical trials that provide data on effectiveness and safety for each new product before it is marketed. Industry should comply with all Health (...) Canada requirements to obtain licenses for new products. Until Health Canada requires effectiveness and safety data, industry should cooperate with physicians in appropriate studies before releasing new products and should make balanced presentations of all the available evidence. Surgeons should, before using a new surgical device, assess the evidence on its effectiveness and safety and ensure they are properly trained and competent in using the device. Surgeons should provide their patients with an evaluation of the available evidence and inform them about possible complications and the surgeon's level of experience with the new device. Patients, who should be given an honest evaluation of the available evidence, possible complications, and the surgeon's experience, should be encouraged to evaluate the evidence and information to their own satisfaction to ensure that fully informed consent is given. Health institutions, responsible for regulating practice within their walls, should review new devices for safety, effectiveness, and economic impacts, before allowing their use. They should also limit the use of new surgical devices to surgeons trained and competent in the new technology. Professional societies should provide guidance on the early adoption of new surgical devices and technologies. We urge all those involved in the development, licensing, and use of new surgical devices to aim for higher ethical standards to protect the health and safety of patients requiring surgery. The lowest acceptable ethical standard would require device manufacturers to provide surgeons with accurate and timely information on the efficacy and safety of their products, allowing surgeons and patients to evaluate the evidence (and the significance of information not yet available) before surgery. (shrink)

Dr. Elisabeth Kübler-Ross is credited as one of the first clinicians to formalize recommendations for working with patients with advanced medical illnesses. In her seminal book, On Death and Dying,...

Human clinical research has become a huge economic enterprise (Morin et al. 2002; Noah 2002). Because the human subject at the center can be so easily marginalized, many commentators recommend spec...

If the 1960’s did not see a resurgence of belief in God, they at least witnessed a renewed interest in him, stimulated by die writings of Harvey Cox, John Robinson and the so-called death-of-God theologians. These were concerned with the phenomenon of the ‘absence of God’, so called because, for all the difference he seemed to make in the day-to-day business of nations and cultures, God might just as well not exist. Whatever knowledge gaps may previously have existed have (...) already been plugged either in fact or in principle, and this without any explanation involving a God. The universe no longer seems to point beyond itself, but seems, on the contrary, pretty clearly self-sufficient. In such circumstances the ground has been cut from under anyone wanting to say that God exists. And if the claim continues to be made, it is from a philosophical viewpoint quite gratuitous. (shrink)

Attempts to look without preconception at the part of the text usually thought to contain Wittgenstein's main argument against the existence of a private language.

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)

Discusses Quine's views on the impossibility of taking up a vantage point outside conceptual schemes. It explores issues in Quine's theory of language, among which are the theory of the inscrutability of reference and the doctrine of ‘being at home’ in our language.

Examines Searle's theory of intentionality. The author argues that the three reasons given by Searle in support of his hypothesis of a background, which underlies our intentional states, are inconclusive at best.

Disputes the attribution to Wittgenstein of a ‘conventionalist’ account of necessity. Conventionalism can seem appropriate given Wittgenstein's denial that there is anything in a person's understanding of the premises and rules he or she accepts, which can ‘force’ him or her to accept a particular conclusion. This conventionalist interpretation is resisted.

Tries to ravel out Wittgenstein's dictum that meaning is used in an attempt to forestall Kripke's ‘sceptic’, who draws the conclusion that there is no such thing as meaning on the grounds that mental objects cannot be brought to bear on the question of what a person means, and that mere conformity to linguistic practice is not sufficient for the determination of meaning. It is argued that the indeterminacy or problematic nature of meaning with respect to a certain class of (...) facts does not entail that meaning is indeterminate or problematic. (shrink)

_Stream of Consciousness_ is about the phenomenology of conscious experience. Barry Dainton shows us that stream of consciousness is not a mosaic of discrete fragments of experience, but rather an interconnected flowing whole. Through a deep probing into the nature of awareness, introspection, phenomenal space and time consciousness, Dainton offers a truly original understanding of the nature of consciousness.

theories. What was Freud thinking, when, and why and what were the major influences which shaped his ideas? We follow the inner movement of his theory construction, its meaning and coherence, as well as his conceptual logic and personal directions concerning his evolving views of the reciprocal interactions between mind and body, the motivational force of instinctual drives, and the dominant role of sexuality rooted in evolutionary biology in human development, behaviour, and the creation of neurotic disturbances. We follow Freud's (...) construction and sequential reconstructions of his theoretical models concerning the nature, dynamics, and principles of unconscious mental functioning, including his changing concepts on the nature and purpose of dreams. We trace his changing views on the role of deferred action of early childhood experiences and the determining role of unconscious fantasy, psychic reality, in the formation of adult character structure and neuroses. Through such historical analysis this book provides grounding for a meaningful understanding of Freud's familiar concepts: id, ego, superego, and the Oedipus complex. We explore what these concepts meant to Freud, why he conceived them, and what functions they served in his theory of mind. This is the perfect book for students and trainees wanting to learn more about the development of Freud's ideas, as well as for established psychoanalysts and psychotherapists interested in expanding their knowledge of Freud's theories. (shrink)

Takes up the idea that meaning and intentional phenomena in general are indeterminate or underdetermined with respect to physical facts. What notion of physicalism is, then, needed to make physicalism a tenable thesis? The emerging characterization of physicalism—as the thesis that physical predicates are sufficient for a description of things as they are ‘fundamentally’—raises another version of the problem of indeterminacy of meaning with respect to a certain class of facts.

In this accomplished, comprehensive and accessible book Barry Smart explores these questions. The book examines the social and economic processes which have shaped and continue to shape life today. It also provides exemplary critical assessments of the various `modern' and `postmodern' thinkers who have sought to explain these processes. Judicious in its judgements and superbly informed, the text is a major contribution to the debate on Modernity and Postmodernity.

In this new book, David Harvey seeks to determine what is meant by the term in its different contexts and to identify how accurate and useful it is as a description of contemporary experience.

This chapter contains sections titled: Critical Thinking Critiques of Reason The Fundamental Reply to All Critiques of Reason.

A critique of reflective equilibrium as an account of epistemic justification.

This introduction to the second international conference on Formal Ontology and Information Systems presents a brief history of ontology as a discipline spanning the boundaries of philosophy and information science. We sketch some of the reasons for the growth of ontology in the information science field, and offer a preliminary stocktaking of how the term ‘ontology’ is currently used. We conclude by suggesting some grounds for optimism as concerns the future collaboration between philosophical ontologists and information scientists.

Barry Taylor's book mounts a major new argument against one of the fundamental tenets of much contemporary philosophy, the idea that we can make sense of reality as existing objectively, independently of our capacities to come to know it. He concludes that there is no defensible notion of truth which preserves the theses of traditional realism, nor any extant position sufficiently true to the ideals of that doctrine to inherit its title. In presenting his case Taylor engages with many (...) key works of contemporary metaphysics, semantics, and philosophical logic, so his book will be of interest to a broad spectrum of scholars and students. (shrink)

This essay introduces a running symposium on the work of Richard Rorty and its legacy fifteen years after his passing. The arc of Rorty's thought defines a trajectory through American pragmatism, tracing a variation unimagined until he expressed it. His work raised Anglophone philosophers’ interest in American pragmatism as never before and also focused the interest of the whole world on American pragmatism as never before, even though the result was to define a pragmatism saturated with nominalism and suppressing the (...) most original qualities of the sources that he celebrated. (shrink)

First Published in 1992. Routledge is an imprint of Taylor & Francis, an informa company.

Indigenous cultures of North America confronted a problem of knowledge different from that of canonical European philosophy. The European problem is to identify and overcome obstacles to the perfection of knowledge as science, while the Indigenous problem is to conserve a legacy of practice fused with a territory. Complicating the difference is that one of these traditions violently colonized the other, and with colonization the Indigenous problem changes. The old problem of inter-generational stability cannot be separated from the post-colonial problem (...) of sovereignty in the land where the knowledge makes sense. I differentiate the question of the value of knowledge (Part 1), and its content (Part 2). The qualities these epistemologies favor define what I callceremonial knowledge, that is, knowledge that sustains a ceremonial community. The question of content considers the interdisciplinary research of Indigenous and Traditional Ecological Knowledge, as well as the issue of epistemic decolonization. (shrink)

The philosophical issues raised by perception make it one of the central topics in the philosophical tradition. Debate about the nature of perceptual knowledge and the objects of perception comprises a thread that runs through the history of philosophy. In some historical periods the major issues have been predominantly epistemological and related to scepticism, but an adequate understanding of perception is important more widely, especially for metaphysics and the philosophy of mind. For this reason Barry Maund provides an account (...) of the major issues in the philosophy of perception that highlights the importance of a good theory of perception in a range of philosophical fields, while also seeking to be sensitive to the historical dimension of the subject. The work presents chapters on forms of natural realism; theories of perceptual experience; representationalism; the argument from illusion; phenomenological senses; types of perceptual content; the representationalist/intentionalist thesis; and adverbialist accounts of perceptual experience. The ideas of, among others, Austin, Dretske, Heidegger, Millikan, Putnam and Robinson are considered and the reader is given a philosophical framework within which to consider the issues. (shrink)