Presently, women receive two-thirds of the prescriptions for psychotropic drugs and Canadian studies have shown that, at any one time, 15–20% of women are taking the drugs. The authors suggest that this difference in prescription rates to men and women is rooted in the unrecognized stresses of women's traditional role and the pervasive sentiment that women who deviate from, or complain about, their traditional role as wife, mother, sex object and self-sacrificing nurturer must be sick. Thus a rationale for the (...) prescription of psychoactive drugs to women has grown up within the framework of the ideology surrounding the institution of the family, and both reflects and reinforces traditional stereotypes about women's status and role. (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)

Against a view currently popular in the literature, it is argued that Kant was not a niıve realist about perceptual experience. Naive realism entails that perceptual experience is object-dependent in a very strong sense. In the first half of the paper, I explain what this claim amounts to and I undermine the evidence that has been marshalled in support of attributing it to Kant. In the second half of the paper, I explore in some detail Kant’s account of hallucination and (...) argue that no such account is available to someone who thinks that veridical perceptual experience is object-dependent in the naive realist sense. Kant’s theory provides for a remarkably sophisticated, bottom-up explanation of the phenomenal character of hallucinatory episodes and is crucial for gaining a proper understanding of his model of the mind and its place in nature. (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)

I discuss three elements of Dennis Schulting’s new book on the transcendental deduction of the pure concepts of the understanding, or categories. First, that Schulting gives a detailed account of the role of each individual category. Second, Schulting’s insistence that the categories nevertheless apply ‘en bloc’. Third, Schulting’s defence of Kant’s so-called reciprocity thesis that subjective unity of consciousness and objectivity in the sense of cognition’s objective purport are necessary conditions for the possibility of one another. I endorse these fascinating (...) but unfashionable claims and sketch my own version of what they amount to, which is quite different to Schulting’s own construal. I point to some fundamental limitations and problems for Schulting’s position and argue that his project needs to be reshaped or at least reconceived in the face of them. Even if Schulting’s argument is sound, it does not provide a deduction, properly speaking, of the categories. (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)

For Kant, the human cognitive faculty has two sub-faculties: sensibility and the understanding. Each has pure forms which are necessary to us as humans: space and time for sensibility; the categories for the understanding. But Kant is careful to leave open the possibility of there being creatures like us, with both sensibility and understanding, who nevertheless have different pure forms of sensibility. They would be finite rational beings and discursive cognizers. But they would not be human. And this raises a (...) question about the pure forms of the understanding. Does Kant leave open the possibility of discursive cognizers who have different categories? Even if other discursive cognizers might not sense like us, must they at least think like us? We argue that textual and systematic considerations do not determine the answers to these questions and examine whether Kant thinks that the issue cannot be decided. Consideration of his wider views on the nature and limits of our knowledge of mind shows that Kant could indeed remain neutral on the issue but that the exact form his neutrality can take is subject to unexpected constraints. The result would be an important difference between what Kant says about discursive cognizers with other forms of sensibility and what he is in a position to say about discursive cognizers with other forms of understanding. Kantian humility here takes on a distinctive character. (shrink)

Predicates of personal taste (fun, tasty) and epistemic modals (might, must) share a similar analytical difficulty in determining whose taste or knowledge is being expressed. Accordingly, they have parallel behavior in attitude reports and in a certain kind of disagreement. On the other hand, they differ in how freely they can be linked to a contextually salient individual, with epistemic modals being much more restricted in this respect. I propose an account of both classes using Lasersohn’s (Linguistics and Philosophy 28: (...) 643–686, 2005) “judge” parameter, at the same time arguing for crucial changes to Lasersohn’s view in order to allow the extension to epistemic modals and address empirical problems faced by his account. (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)

Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...) rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)

This essay considers Kant’s theory of modality in light of a debate in contemporary modal metaphysics and modal logic concerning the Barcan formulas. The comparison provides a new and fruitful perspective on Kant’s complex and sometimes confusing claims about possibility and necessity. Two central Kantian principles provide the starting point for the comparison: that the possible must be grounded in the actual and that existence is not a real predicate. Both are shown to be intimately connected to the Barcan formulas, (...) and Kant’s views on what he distinguishes as three different kinds of modality are then considered in light of this connection. (shrink)

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)

This paper draws out and connects two neglected issues in Kant’s conception of a priori knowledge. Both concern topics that have been important to contemporary epistemology and to formal epistemology in particular: knowability and luminosity. Does Kant commit to some form of knowability principle according to which certain necessary truths are in principle knowable to beings like us? Does Kant commit to some form of luminosity principle according to which, if a subject knows a priori, then they can know that (...) they know a priori? I defend affirmative answers to both of these questions, and by considering the special kind of modality involved in Kant’s conceptions of possible experience and the essential completability of metaphysics, I argue that his combination of knowability and luminosity principles leads Kant into difficulty. (shrink)

Recent trends in the understanding of culture contact, with concepts such as hybridization, cosmopolitanism, and cultural innovation, open up the possibility of a new understanding of human interaction. While the social imaginary is rich with images of conflict resulting from culture contact, images of creativity are far rarer. We propose the creation of an extensive research project to document cultural creativity, starting with obvious examples in the arts, and expanding into all areas of life in order to counteract the present (...) conflictual images and develop a social imaginary with positive “attractor” images that can guide to greater creativity. (shrink)

This paper formalizes part of the cognitive architecture that Kant develops in the Critique of Pure Reason. The central Kantian notion that we formalize is the rule. As we interpret Kant, a rule is not a declarative conditional stating what would be true if such and such conditions hold. Rather, a Kantian rule is a general procedure, represented by a conditional imperative or permissive, indicating which acts must or may be performed, given certain acts that are already being performed. These (...) acts are not propositions; they do not have truth-values. Our formalization is related to the input/ output logics, a family of logics designed to capture relations between elements that need not have truth-values. In this paper, we introduce KL3 as a formalization of Kant’s conception of rules as conditional imperatives and permissives. We explain how it differs from standard input/output logics, geometric logic, and first-order logic, as well as how it translates natural language sentences not well captured by first-order logic. Finally, we show how the various distinctions in Kant’s much-maligned Table of Judgements emerge as the most natural way of dividing up the various types and sub-types of rule in KL3. Our analysis sheds new light on the way in which normative notions play a fundamental role in the conception of logic at the heart of Kant’s theoretical philosophy. (shrink)

In this paper I offer an interpretation of Kant’s theory of perceptual error based on his remarks in the Anthropology. Both hallucination and illusion, I argue, are for Kant species of experience and therefore require the standard co-operation of sensibility and understanding. I develop my account in a conceptualist framework according to which the two canonical classes of non-veridical experience involve error in the basic sense that how they represent the world as being is not how the world is. In (...) hallucination this is due to the misapplication of categories and in illusion to the misapplication of empirical concepts. Yet there is also room in this framework for a distinction in terms of cognitive functionality between the level of experience, which is merely judgementally structured, and that of judgement proper, which involves the free action of a conscious agent. This distinction enables Kant to allow for the otherwise problematic phenomenon of self-aware non-veridicality. (shrink)

We examine pregnant women's experiences with routinised obstetric ultrasound as entailed in their antenatal care during planned pregnancies. This paper highlights the ambiguity of ultrasound technology in the constitution of maternal–foetal connections. Our analysis focusses on Australian women's experiences of the ontological, aesthetic and epistemological ambiguities afforded by ultrasound. We argue that these ambiguities offer possibilities for connecting to the foetus in ways that maintain a kind of unknowability; they afford an openness and ethical responsiveness irrespective of the future of (...) the foetus. This suggests that elucidating women's experience has implications for theorising ethics across maternal–foetal relations and, more specifically, for the ‘moral pioneering’ (Rapp, 2000) that reproductive technologies can demand of women. Moral pioneering cannot be reduced to moments or processes of decision-making; it must allow for greater recognition of the affective commitments entailed in and incited by ultrasound. Furthermore, focussing on experiences of the ambiguity of ultrasound allows for understanding the ways in which affectivity circulates across domains commonly understood as medical or social, public or private. In doing so, it contributes to undermining a series of tensions that currently shape feminist analysis of obstetric ultrasound, often at the expense of the experience of women. (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)

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, ...

A novel solution to the knowability paradox is proposed based on Kant’s transcendental epistemology. The ‘paradox’ refers to a simple argument from the moderate claim that all truths are knowable to the extreme claim that all truths are known. It is significant because anti-realists have wanted to maintain knowability but reject omniscience. The core of the proposed solution is to concede realism about epistemic statements while maintaining anti-realism about non-epistemic statements. Transcendental epistemology supports such a view by providing for a (...) sharp distinction between how we come to understand and apply epistemic versus non-epistemic concepts, the former through our capacity for a special kind of reflective self-knowledge Kant calls ‘transcendental apperception’. The proposal is a version of restriction strategy: it solves the paradox by restricting the anti-realist’s knowability principle. Restriction strategies have been a common response to the paradox but previous versions face serious difficulties: either they result in a knowability principle too weak to do the work anti-realists want it to, or they succumb to modified forms of the paradox, or they are ad hoc. It is argued that restricting knowability to non-epistemic statements by conceding realism about epistemic statements avoids all versions of the paradox, leaves enough for the anti-realist attack on classical logic, and, with the help of transcendental epistemology, is principled in a way that remains compatible with a thoroughly anti-realist outlook. (shrink)

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)

In this paper I return to the question of whether intuition is object-dependent. Kant’s account of the imagination appears to suggest that intuition is not object-dependent. On a recent proposal, however, the imagination is a faculty of merely inner intuition, the inner objects of which exist and are present in the way demanded by object-dependence views, such as Lucy Allais’s relational account. I argue against this proposal on both textual and philosophical grounds. It is inconsistent with what Kant says about (...) how the imagination functions and is ultimately incompatible with the relational account it is supposed to support. Kant’s account of the imagination remains a serious obstacle for the view that intuition is object-dependent. (shrink)