In this paper I argue that it is morally important for doctors to trust patients. Doctors' trust of patients lays the foundation for medical relationships which support the exercise of patient autonomy, and which lead to an enriched understanding of patients' interests. Despite the moral and practical desirability of trust, distrust may occur for reasons relating to the nature of medicine, and the social and cultural context within which medical care is provided. Whilst it may not be possible to trust (...) at will, the conscious adoption of a trusting stance is both possible and warranted as the burdens of misplaced trust fall more heavily upon patients than doctors. (shrink)

_Talking Politics_ is a philosophical examination of some of the basic concepts of political discourse. Its primary focus is on the _ordinary_; on what is said by politicians, in newspapers and by people in pubs, rather than on the works of political theorists. This is a work _of_, but not _on_ political theory. _Talking Politics_ is: * Invaluable as a source of reference for students, and contains a detailed index * Arranged thematically, around topics such as `Nation'. Each entry has (...) copious cross-references and suggestions for further reading A. W. Sparkes is uniquely qualified to write such a book, combining some thirty years' teaching as a philosopher with wide experience of, and a life-long fascination with, politics. His attitude is that of a critical, but uncynical, observer. (shrink)

Software piracy is a damaging and important moral issue, which is widely believed to be unchecked in particular areas of the globe. This cross-cultural study examines differences in morality and behavior toward software piracy in Singapore versus the United States, and reviews the cultural histories of Asia versus the United States to explore why these differences occur. The paper is based upon pilot data collected in the U.S. and Singapore, using a tradeoff analysis methodology and analysis. The data reveal some (...) fascinating interactions between the level of ethical transgression and the rewards or consequences which they produce. (shrink)

This article examines the implicit promises of fairness in evidence based medicine , namely to avoid discrimination through objective processes, and to distribute effective treatments fairly. The relationship between EBM and vulnerable groups is examined. Several aspects of EBM are explored: the way evidence is created , and the way evidence is applied in clinical care and health policy. This analysis suggests that EBM turns our attention away from social and cultural factors that influence health and focuses on a narrow (...) biomedical and individualistic model of health. Those with the greatest burden of ill health are left disenfranchised, as there is little research that is relevant to them, there is poor access to treatments, and attention is diverted away from activities that might have a much greater impact on their health. (shrink)

The aim of the study was to determine the acceptance and perception of Nigerian patients to medical photography. A self-administered questionnaire was distributed among Nigerian patients attending oral and maxillofacial surgery and plastic surgery clinics of 3 tertiary health institutions. Information requested included patients' opinion about consent process, capturing equipment, distribution and accessibility of medical photographs. The use of non-identifiable medical photographs was more acceptable than identifiable to respondents for all purposes (P = 0.003). Most respondents were favourably disposed to (...) photographs being taken for inclusion in the case note, but opposed to identifiable photographs being used for other purposes most especially in medical websites and medical journals. Female respondents preferred non-identifiable medical photographs to identifiable ones (P = 0.001). Most respondents (78%) indicated that their consent be sought for each of the outline needs for medical photography. Half of the respondents indicated that identifiable photographs may have a negative effect on their persons; and the most commonly mentioned effects were social stigmatization, bad publicity and emotional/psychological effects. Most of the respondents preferred the use of hospital-owned camera to personal camera/personal camera-phone for their medical photographs. Most respondents (67.8%) indicated that they would like to be informed about the use of their photographs on every occasion, and 74% indicated that they would like to be informed of the specific journal in which their medical photographs are to be published. In conclusion, non-identifiable rather than identifiable medical photography is acceptable to most patients in the studied Nigerian environment. The use of personal camera/personal camera-phone should be discouraged as its acceptance by respondents is very low. Judicious use of medical photography is therefore advocated to avoid breach of principle of privacy and confidentiality in medical practice. (shrink)

This paper will discuss the behaviour of and in the Homeric poems. These words are allotted a variety of different ‘meanings’ by the lexicographers. For example, LSJ s.v. I. pray, II. vow, III. profess loudly, boast, vaunt; s.v. I. prayer, II. boast, vaunt, or object of boasting, glory; s.v. I. thing prayed for, object of prayer, II. boast, vaunt. I shall, of course, discuss the whole range of these words; but I begin with some observations on ‘prayer’. It may appear (...) at first sight that ‘prayer’ is a simple word, with only one conceivable ‘meaning’, which must have that ‘meaning’ in any language. We might suggest that ‘request addressed to a god’ is an adequate representation of that ‘meaning’, and that when we have rendered by ‘pray’ in what appear to us to be appropriate contexts we have conveyed the full sense of the original. (shrink)

This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable (...) of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health. (shrink)

This provocative but persuasive book is essentially a radical attack upon the Humean conception of causality and the presentation and defense of a counter-theory, closer to everyday experience and pre-Humean traditional views. As formulated by empiricist philosophers, the Humean approach depends on two basic postulates. The philosophical analysis of any non-empirical concept must be a formal explication; any residue elements have to be accounted for in terms of their psychological origins. The world as experienced can be conceived adequately as a (...) logically independent system of things or flux of events, without the unwarranted assumption that individuals persist diachronically. As the grounds for undermining these assumptions, the authors develop a conception of causes as "powerful particulars," i.e., things which have both a nature and powers. So long as the nature remains unchanged the agent in question will continue to behave in this fashion with a natural necessity, stemming from the individual’s nature and specific powers. The opening chapter discusses the problem of conceptual and natural necessity—as distinct from logical necessity which alone is allowed by the Humean empiricists. Natural necessity is the mark of the relationship between real causes and their respective effects, whereas conceptual necessity characterizes the way our statements about such are themselves related. Later the irreducibility of natural necessity is emphasized and its differences from logical entailment spelled out. Chapter two takes up the subject of the "regularity theory and its allies." Characteristic of such are two claims: the empirical content of a causal-relationship statement is exhausted by the actual or hypothetical regularity between independent entities, and the necessity ordinarily attributed to causal production is an illusion, to be accounted for in various ways. Subsequent chapters are devoted to assaulting the pillars of the Humean notion either directly or indirectly through an illuminating and attractive account of their own theory of nature, causal powers, and natural necessity. The final chapter, entitled "Fields of Potential," indulges in speculation about the nature of ultimate entities on the basis of an extended generalization of the notion of the powerful individual, and concludes with a brief account of the historical antecedents of Faraday’s modern field theory and the metaphysical implications of a generalized field theory.—A.B.W. (shrink)

Having argued for an affirmative answer to my question, I consider arguments for a negative answer to it. With the important exception of those arguments in which the Basic Assumption is rejected, I think I can resist each of these. But in the case of arguments in which the Basic Assumption is rejected, I seem to reach an impasse. There is, however, some prospect of reconciliation. This comes in a species of transcendental idealism whereby all our representations are from a (...) ‘transcendent’ point of view and whereby the Basic Argument, though it has to be rejected at that ‘transcendent’ level, can be retained at a ‘non‐transcendent’ level. (shrink)

I begin by raising the question whether there can be ‘absolute representations’ and explain what I mean by this. I define a ‘representation’ as anything, which has content and which, because of its content, is either true or false. I define an ‘absolute’ representation as a representation whose content can be combined with that of any other possible representation ‘by simple addition’. This contrasts with the case of a ‘non‐absolute’ or ‘perspectival’ representation, whose content may not be combinable with that (...) of another representation until the element of perspective has been eliminated. Thus if one person says, ‘I am English,’ and another says, ‘I am German,’ it is not possible for either of those people, nor indeed for anyone else, to combine the contents of their representations by saying, ‘I am English and I am German.’. (shrink)

I argue that both Kant and, in his later work, Wittgenstein indicate the possibility of just such a transcendental‐idealist response to the Basic Argument. I also argue, however, that transcendental idealism, for all its appeal, is incoherent. This is because its attempt to invoke the ‘transcendent’ is an attempt to invoke that which, by definition, cannot be invoked. So, it does not provide an alternative to unregenerate endorsement of the Basic Argument after all.

There remains the problem of accounting for the appeal of transcendental idealism. Transcendental idealists themselves may say that there is nothing wrong with the doctrine, but only with the attempt to express it, the point being that it is inexpressibly true: but I argue that this does not extricate them from the trap of self‐stultification. An importantly different proposal, which I derive from the earlier work of Wittgenstein, is this: while we cannot coherently state that transcendental idealism is true we (...) are shown that transcendental idealism is true, where ‘A is shown that x’ is defined as ‘ A has ineffable knowledge, and when an attempt is made to put that knowledge into words, the result is: x.’ I try to indicate how, provided we can make sense of and, this proposal has the threefold merit of: avoiding self‐stultification; being compatible with the incoherence of transcendental idealism; and providing an account of transcendental idealism's appeal. (shrink)

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) has for decades been a locus of dispute between ardent defenders of its scientific validity and vociferous critics who charge that it covertly cloaks disputed moral and political judgments in scientific language. This essay explores Alasdair MacIntyre's tripartite typology of moral reasoning—"encyclopedia," "genealogy," and "tradition"—as an analytic lens for appreciation and critique of these debates. The DSM opens itself to corrosive neo-Nietzschean "genealogical" critique, such an analysis holds, only (...) insofar as it is interpreted as a presumptively objective and context-independent encyclopedia free of the contingencies of its originating communities. A MacIntyrean tradition-constituted understanding of the DSM, on the other hand, helpfully allows psychiatric nosology to be understood both as "scientific" and, simultaneously, as inextricable from the political and moral interests—and therefore the moral successes and moral failures—of the psychiatric guild from which it arises. (shrink)

The paper begins with a defence of a new definition of privacy as the absence of undocumented personal knowledge. In the middle section, I criticise alternative accounts of privacy. Finally, I show how my definition can be worked into contemporary American Law.

The additional data, perspectives, questions, and criticisms contributed by the commentaries strengthen our view that local cortical processors coordinate their activity with the context in which it occurs using contextual fields and synchronized population codes. We therefore predict that whereas the specialization of function has been the keynote of this century the coordination of function will be the keynote of the next.