While doctors generally enjoy considerable status, some believe that this is increasingly threatened by consumerism, managerialism, and competition from other health professions. Research into doctors’ perceptions of the changes occurring in medicine has provided some insights into how they perceive and respond to these changes but has generally failed to distinguish clearly between concerns about “status,” related to the entitlements associated with one’s position in a social hierarchy, and concerns about “respect,” related to being held in high regard for one’s (...) moral qualities. In this article we explore doctors’ perceptions of the degree to which they are respected and their explanations for, and responses to, instances of perceived lack of respect. We conclude that doctors’ concerns about loss of respect need to be clearly distinguished from concerns about loss of status and that medical students need to be prepared for a changing social field in which others’ respect cannot be taken for granted. (shrink)

Rationale, aims and objectives: Bioethics and professionalism are standard subjects in medical training programmes, and these curricula reflect particular representations of meaning and practice. It is important that these curricula cohere with the actual concerns of practicing clinicians so that students are prepared for real-world practice. We aimed to identify ethical and professional concerns that do not appear to be adequately addressed in standard curricula by comparing ethics curricula with themes that emerged from a qualitative study of medical practitioners. Method: (...) Curriculum analysis: Thirty-two prominent ethics and professionalism curricula were identified through a database search and were analysed thematically. Qualitative study: In-depth, semi-structured interviews were conducted with 20 medical practitioners. Participants were invited to reflect upon their perceptions of the ways in which values matter in their practices and their educational experiences. The themes emerging from the two studies were compared and contrasted. Results: While representations of meaning and value in ethics and professionalism curricula overlap with the preoccupations of practicing clinicians, there are significant aspects of ‘real-world’ clinical practice that are largely ignored. These fell into two broad domains: ‘sociological’ concerns about enculturation, bureaucracy, intra-professional relationships, and public perceptions of medicine; and epistemic concerns about making good decisions, balancing different kinds of knowledge, and practising within the bounds of professional protocols. Conclusions: Our findings support the view that philosophy and sociology should be included in medical school and specialty training curricula. Curricula should be reframed to introduce students to habits of thought that recognize the need for critical reflection on the social processes in which they are embedded, and on the philosophical assumptions that underpin their practice. (shrink)

This book develops a theory of existential security. It demonstrates that the publics of virtually all advanced industrial societies have been moving toward more secular orientations during the past half century, but also that the world as a whole now has more people with traditional religious views than ever before. This second edition expands the theory and provides new and updated evidence from a broad perspective and in a wide range of countries. This confirms that religiosity persists most strongly among (...) vulnerable populations, especially in poorer nations and in failed states. Conversely, a systematic erosion of religious practices, values and beliefs has occurred among the more prosperous strata in rich nations. (shrink)

This thesis argues that the concept of contingency plays a central role in Althusser's recasting of Marxist philosophy and in his attempt to free the Marxist conception of history from concepts such as teleology, necessity and origin. It is critically placed both against those readings that see the emergence of the problematic of contingency only in the late Althusserm and to the most recent attempts to establish a straightforward continuity in Althusser's work. Drawing on published and unplublished material and covering (...) the entirety of Althusser's philosophical itinerary, the thesis seeks both to unearth the latent presence of this problematic, and its various implications, at each stage in the development of his work. It seeks to clarify, in a systematic way, the conceptual consequences of Althusser's commitment to contingency to the received understanding of his conceptions of structural change, ideology and political action. In particular, it argues that the standpoint of contingency allows us to locate in Althusser's 'Structural Marxism' the emergence of a 'logic of irruption' and structurally under-determined development of becoming. By emphasising this logic of contingency, it then seeks to produce a more nuanced assessment of his theory of ideology through the introduction of the concept of 'overinterpellation'. It finally attempts to distinguish two moments in the emergence of a materialism of contingency, first political and then philosophical; the problematic coexistence of these two aspects helps to account for the unstable charactoer of Althusser's late philosophical project. (shrink)

The metaphor of inscription on the body and the constitution of the body through those inscriptions have been widely used in recent attempts to theorize the body. Michel Foucault calls the body the ‘inscribed surface of events’ (Foucault, 1984: 83) and Elizabeth Grosz argues that the ‘female (or male) body can no longer be regarded as a fixed, concrete substance, a pre-cultural given. It has a determinate form only by being socially inscribed’ (Grosz, 1987: 2). The body becomes plastic, inscribed (...) with gender and cultural standards. While Foucault assumes the existence of a pre-inscriptive body, many theorists reject that idea and argue that ‘there is no recourse to a body that has not always already been interpreted by cultural meanings’ (Butler, 1990: 8). The constitution of the body rests in its inscription; the body becomes the text which is written upon it and from which it is indistinguishable. Starting from Catherine Belsey's suggestion that to ‘give the metaphor literal significance … is to … isolate it for contemplation’ (Belsey, 1988: 100), I discuss this metaphor of inscription, using cosmetic surgery as one literal example. While some theorists reject the pre-inscriptive body, the popular discourses advocating changing one's body assume unproblematically the existence of a body prior to these ‘elective’ procedures and reinforce the mind/body dualism which recent theory has sought so insistently to reject. I examine how popular discourses of body modification enforce a disciplinary regime (in Foucault's sense) and impose degrees of both literal and figurative inscription. Juxtaposing these two perspectives, I explore how both discourses efface the materiality of the body and the social contexts within which bodies are experienced and constructed. While the rhetoric surrounding cosmetic surgery denies the physical process and the economic constraints, so theories of the body which stress the body's plasticity also deny the materiality of that process and the cultural and social contexts within which the body is always placed. (shrink)

Thinking about ethics -- Philosophical ethics -- Why not do wrong? -- Is the ethical a human construct or a factual realm? -- Do you just do what is right or do you try to predict the outcomes? -- Natural law and virtue ethics -- Ethics and the bible -- Learning from the wisdom of the world -- Humanism : do we need god to realize that people just matter? -- Ethical dilemmas -- Dilemmas in bed -- Dilemmas in business (...) -- Dilemmas in medicine -- Dilemmas involving violence and power -- Dilemmas in government and leadership -- Dilemmas and the future : the environment, animals, and plants -- Dilemmas in the cyber world -- Making a decision -- Becoming a morally serious person -- Taking an ethical position. (shrink)

Background In April 2019, our hospital transitioned to an electronic patient record system and patient portal. MyGOSH enables young people aged 12 years or older and their parents to access results, documentation, appointments, and to communicate with their care team. Aims A focus group was conducted to explore the ethical and legal considerations of young people and their parents using a patient portal from the perspective of hospital Ethics Committee members. Participants and research context Members of the hospital Paediatric Bioethics (...) Centre were recruited. Written informed consent was provided by all participants. Research design The focus group discussion was recorded, transcribed verbatim and analysed using thematic analysis. Ethical considerations Health Research Authority Research Ethics Committee Approval was granted by London Southeast REC. Results Four themes, and sub-themes, were identified: granting access – complexities of assessing competence/capacity, exclusion from MyGOSH due to non-disclosure of diagnosis, and truth-telling; inequalities resulting in inequities – complexities of inequity in access; responding to change – providing support and managing expectations; engagement, empowerment and understanding – data safety, empowering young people to take ownership of their health data, a one-size fits all system may not meet the needs of all families, and early engagement with young people/parents. Discussion Giving families portal access can increase engagement, empowering them to be more involved in care, yet poses challenges for all. Complexities exist in the assessment for portal access, and supporting and managing user expectations whilst providing an equitable service. Conclusions Ongoing support is required for all stakeholders following patient portal implementation to navigate the ethical and legal complexities, and to promote equity and portal utility for patient benefit. (shrink)

I explore the view that metaphysics is essentially imaginative. I argue that the central goal of metaphysics on this view is understanding, not truth. Metaphysics-as-essentially-imaginative provides novel answers to challenges to both the value and epistemic status of metaphysics.

There is widespread concern that the nature of mass politics changed during the late twentieth century, and indeed changed largely for the worse, in most post-industrial societies. The standard arguments are familiar and widely rehearsed. You can hear them echoed everyday, whether in simple or sophisticated versions, in the press, scattered in political speeches, and published in academe. Some arguments are cast in strictly empirical terms, but many popular accounts have strongly normative overtones.The intellectual roots lie in the classics of (...) political sociology from the late 1950s and mid-1960s, captured perhaps just as the era of traditional party campaigns was passing, notably the work of Maurice Duverger on mass-branch political parties and Stein Rokkan and Seymour Martin Lipset on social cleavages and electoral behaviour.The standard view emphasizes the consequences of the significant shift from direct party-oriented linkages between citizens and the state towards indirect media-oriented linkages in representative democracies. In the traditional model of election campaigns that characterized the ‘golden age’ of West European party politics, running from the expansion of the mass franchise in the late nineteenth century until at least the mid-twentieth century, party loyalists characteristically selected parliamentary representatives based on long-standing social cleavages and stable ideological cues.The core cleavages of class, religion, region, and language gave a collective meaning to party support and united people with shared identities and social roots who strived for broadly similar political ideals. As illustrated in Figure 1, in traditional campaigns political leaders communicated with grass-roots party loyalists via elected representatives and core party activists, using direct face-to-face channels of persuasion, organization and mobilization, such as local meetings, party newsletters, candidate pamphlets, doorstep canvassing, and town-hall speeches, supplemented by partisan newspapers.Collective organizations and traditional interest groups such as unions and churches, local cooperatives, community groups, and workers’ clubs, mobilized many citizens at the margins of political power and linked their interests to political parties. Support by party loyalists was regarded as a sign of trust in the ability of elected leaders to translate their programmatic principles into concrete policy actions. (shrink)

Can parties such as the Swedish Democrats, the Jobbik Movement for a Better Hungary, the UK Independence Party and the Italian Lega Nord all be classified consistently as part of the same family? Part I of this study summarizes the conceptual framework arguing that the traditional post-war Left-Right cleavage in the electorate and party competition has faded, overlaid by divisions over authoritarian-libertarianism and populism-pluralism. Building on this, part II discusses the pros and cons of alternative methods for gathering evidence useful (...) to classify party positions. Part III describes how these are measured in this study, using Chapel Hill Expert Survey data in 2014 and 2017, and how they are mapped on a multidimensional issue space. Part IV compares European political parties on these scales – including Authoritarian-Populist parties – across a wide range of European countries. The conclusion in part V draws together the main findings and considers their implications. (shrink)

Logical realism is the view that there is logical structure in the world. I argue that, if logical realism is true, then we are deeply ignorant of that logical structure: either we can’t know which of our logical concepts accurately capture it, or none of our logical concepts accurately capture it at all. I don’t suggest abandoning logical realism, but instead discuss how realists should adjust their methodology in the face of this ignorance.

Many philosophers take purportedly logical cases of ground ) to be obvious cases, and indeed such cases have been used to motivate the existence of and importance of ground. I argue against this. I do so by motivating two kinds of semantic determination relations. Intuitions of logical ground track these semantic relations. Moreover, our knowledge of semantics for first order logic can explain why we have such intuitions. And, I argue, neither semantic relation can be a species of ground even (...) on a quite broad conception of what ground is. Hence, without a positive argument for taking so-called ‘logical ground’ to be something distinct from a semantic determination relation, we should cease treating logical cases as cases of ground. (shrink)

Abstract‘Logical Realism’ is taken to mean many different things. I argue that if reality has a privileged structure, then a view I call metaphysical logical realism is true. The view says that, first, there is ‘One True Logic’; second, that the One True Logic is made true by the mind‐and‐language‐independent world; and third, that the mind‐and‐language‐independent world makes it the case that the One True Logic is better than any other logic at capturing the structure of reality. Along the way, (...) I discuss a few alternatives, and clarify two distinct kinds of metaphysical logical realism. (shrink)

The Dobbs v. Jackson Women’s Health Organization Supreme Court decision not only upended constitutional protections for abortion in the United States but also bolstered legislative and cultural int...

Objectives During the COVID-19 pandemic, healthcare resources including staff were diverted from paediatric services to support COVID-positive adult patients. Hospital visiting restrictions and reductions in face-to-face paediatric care were also enforced. We investigated the impact of service changes during the first wave of the pandemic on children and young people (CYP), to inform recommendations for maintaining their care during future pandemics. Design A multi-centre service evaluation was performed through a survey of consultant paediatricians working within the North Thames Paediatric Network, (...) a group of paediatric services in London. We investigated six areas: redeployment, visiting restrictions, patient safety, vulnerable children, virtual care and ethical issues. Results Survey responses were received from 47 paediatricians across six National Health Service Trusts. Children's right to health was largely believed to be compromised by the prioritisation of adults during the pandemic (81%; n = 33). Sub-optimal paediatric care due to redeployment (61%; n = 28) and the impact of visiting restrictions on CYP's mental health (79%; n = 37) were reported. Decreased hospital attendances of CYP were associated with parental fear of COVID-19 infection-risks (96%; n = 45) and government ‘stay at home’ advice (89%; n = 42). Reductions in face-to-face care were noted to have disadvantaged those with complex needs, disabilities and safeguarding concerns. Conclusion Consultant paediatricians perceived that paediatric care was compromised during the first wave of the pandemic, resulting in harm to children. This harm must be minimised in subsequent pandemics. Recommendations for future practice which were developed from our findings are provided, including maintaining face-to-face care for vulnerable children. (shrink)

I argue that, in order for us to be justified in believing that two theories are metaphysically equivalent, we must be able to conceive of them as unified into a single theory, which says nothing over and above either of them. I propose one natural way of precisifying this condition, and show that the quantifier variantist cannot meet it. I suggest that the quantifier variantist cannot meet the more general condition either, and argue that this gives the metaphysical realist a (...) way to rule out theses like quantifier variance without appealing to fundamentality, grounding, or "levels" of reality. (shrink)

The deductive system in Boole's Laws of Thought (LT) involves both an algebra, which we call proto-Boolean, and a "general method in Logic" making use of that algebra. Our object is to elucidate these two components of Boole's system, to prove his principal results, and to draw some conclusions not explicit in LT. We also discuss some examples of incoherence in LT; these mask the genius of Boole's design and account for much of the puzzled and disparaging commentary LT has (...) received. Our evaluation of Boole's logical system does not differ substantially from that advanced in Hailperin's exhaustive study, Boole's Logic and Probability. Unlike the latter work, however, we make direct use of the polynomials native to LT rather than appealing to formalisms such as multisets and rings. (shrink)

In this paper we argue that one-way quantum computation can be seen as a form of phase transition with the available information about the solution of the computation being the order parameter. We draw a number of striking analogies between standard thermodynamical quantities such as energy, temperature, work, and corresponding computational quantities such as the amount of entanglement, time, potential capacity for computation, respectively. Aside from being intuitively pleasing, this picture allows us to make novel conjectures, such as an estimate (...) of the necessary critical time to finish a computation and a proposal of suitable architectures for universal one-way computation in 1D. (shrink)

In 1952, Quine showed that the problem of reducing a propositional formula to a simplest normal equivalent can be solved in two steps, viz., (i) express the given formula, Φ, equivalently as the disjunction of all its prime implicants, and (ii) find all non-redundant disjunctions of the latter that are equivalent to Φ (Quine 1952). However, it seems not generally known that an ingenious form of the same two-step process was published by Hugh McColl in 1878.

A basic way of evaluating metaphysical theories is to ask whether they give satisfying answers to the questions they set out to resolve. I propose an account of “third-order” virtue that tells us what it takes for certain kinds of metaphysical theories to do so. We should think of these theories as recipes. I identify three good-making features of recipes and show that they translate to third-order theoretical virtues. I apply the view to two theories—mereological universalism and plenitudinous platonism—and draw (...) out their third-order virtues and vices. One lesson is that there is an important difference between essentially and non-essentially third-order vicious theories. I also argue that if a theory is essentially third-order vicious, it cannot be assessed for more standard “second-order” theoretical virtues and vices, like parsimony. This motivates the idea that third-order virtues are distinct from second-order ones. Finally, I suggest that the relationship between truth, progress, and third-order virtue is more complex than it seems. (shrink)

Do Morals Matter? is an accessible and informed guide to contemporary ethical issues that reflects upon the intersection of religion and morality. An informal yet informed guide through the key ethical issues we are facing today, from moral decision making in business and medicine, to the uncertainty of war and terrorism, and the condition of our environment. Reflects on religion’s intersection with morality, exploring the challenge of pluralism in major world religions, and the question of Humanism and God’s role in (...) ethics. Considers the forecast of future situations that will be affected by today’s ethical decisions. Questions what accounts for the variances in ethical beliefs in different cultures, and how we properly reassess our conceptions of ethical standards as new issues arise. Written by the internationally regarded Ian Markham, Dean of Hartford Seminary and author of numerous books on world religions and ethics. (shrink)

Chaos theory is beginning to find applications in the field of medicine. The theory of chaos should be introduced to students to help them as they make the transition from learning the scientific literature to actually applying this newly acquired knowledge in clinical situations. Chaos theory will give the students a powerful conceptual framework from which they can better understand the limits of predictability in clinical situations. Failure to understand the limits of predictability in chaotic natural systems will invariably lead (...) to frustration in both patients and physicians. (shrink)

Celebrated performer Giulio Caccini's life as a court musician throws light on the ways in which the soloist formulated and reformulated his/her own identity in order to fit within each of the spaces used for music. Tracing the documented performances associated with Caccini, one can map them onto a continuum of spaces from the most public to the most private. Caccini's successful passage into the more intimate spaces required him to re-form himself as the inheritor of the century-old tradition of (...) the intimate vocal improvvisatori, a stylistic and physical transformation that was, in a sense, his life's work. This performative conception of his musical work is a potent reminder of the ambiguous status of solo song at the beginning of the Seicento, perched between the abstract space of the printed score and the traditional space of the court chamber. (shrink)

Yet many in the USA and Europe are not familiar with his important work; this book seeks to rectify that gap.In Globalization, Ethics and Islam, Jewish, ...