Traditionally, physicians and parents made decisions about children’s health care based on western practices. More recently, with legal and ethical development of informed consent and recognition for decision making, children are becoming active participants in their care. The extent to which this is happening is however blurred by lack of clarity about what children — of diverse levels of cognitive development — are capable of understanding. Moreover, when there are multiple surrogate decision makers, parental and professional conflict can arise concerning (...) children’s ‘best interest’. Giving children a voice and offering choice promotes their dignity and quality of life. Nevertheless, it also presents with many challenges. Case studies using pseudonyms and changed situational identities are used in this article to illuminate the complexity of ethical challenges facing nurses in end-of-life care with children and families. (shrink)

ObjectiveHead and neck cancer treatments are known to significantly affect functionality and appearance, leading to an increased risk for body image disturbances. Yet, few longitudinal studies exist to examine body image in these patients. Based on a conceptual model, the current study aimed to determine, in patients newly diagnosed with HNC: the prevalence, level, and course of body image concerns; correlates of upon cancer diagnosis body image concerns; predictors of immediate post-treatment body image concerns; and association between body image concerns (...) and levels of anxiety, depression, suicidal ideation, support, and alcohol and drug misuse.MethodsTwo hundred and twenty-three, newly diagnosed with a primary HNC were assessed using structured clinical interviews and psychometric measures at three, and 6 months after diagnosis. Primary outcome was 3-month, as it was most salient to body image disturbance. Multiple linear regression analyses were conducted on the potential body image predictors, based on the model.ResultsSixty-eight percent of patients with HNC presented some level of body image concerns. Body image concerns at baseline and post-treatment were significantly related and significantly increased from pre- to post-treatment. Immediately post-treatment, 89% presented some level of body image concerns. Correlates of body image concerns in patients with HNC at baseline included: physical symptom burden, difficulties with communication and eating, coping with the cancer diagnosis using denial, suicidal ideation, and having had a past anxiety diagnosis. When controlling for sociodemographic and medical variables, body image concerns in patients with HNC in the immediate post-treatment were predicted by: baseline body image, physical symptom burden, and neuroticism.ConclusionThis longitudinal study helps identify patients more susceptible to experience body image disturbance following head and neck cancer. Clinicians ought to pay special attention to body image concerns upon cancer diagnosis, physical symptom burden, and neuroticism, and may want to target these factors in future preventive interventions. (shrink)

This paper argues that efforts to understand historically remote patterns of thought are driven away from their original meaning if the investigation focuses on reconstruction of concepts , instead of cognitive ‘complexes’. My paper draws on research by Jan Assmann, Jean-Jacques Glassner, Keimpe Algra, Alex Purves, Nicholas Wyatt, and others on the cultures of Ancient Greece, Israel, Egypt, Mesopotamia, and Etruria through comparative analyses of the semantic fields of spatial and temporal terms, and how these terms are shaped by (...) their relation to the sphere of the sacred. It shows that there are three super-ordinate timeframes - the cyclical, the linear and the static - each of which is composed of lower-order cycles (days, lunar months, and seasons). These timeframes reflect their cultures’ ideas about the nature, scope and power of the gods, and structure the common point-of-view about the present, the past and eternity. There are also super-ordinate spatial frames which reflect their cultures’ ideas about the heavens and which structure both the sacred precinct and the profane field of action and exchange. Close analysis of texts that use words such as eternity, forever, past, present, and future, for example, do not reveal that there is anything like a general abstract concept of time in virtue of which some thing or event can be said to be in time or to have its own time. Archaic patterns of thought do not differ from our “ modern ” patterns in having different concepts, but in not having anything like concepts at all. (shrink)

Traditionally, perceptual experiences—for example, the experience of seeing a cat—were thought to have two quite distinct components. When one sees a cat, one’s experience is “about” the cat: this is the representational or intentional component of the experience. One’s experience also has phenomenal character: this is the sensational component of the experience. Although the intentional and sensational components at least typically go together, in principle they might come apart: the intentional component could be present without the sensational component or vice (...) versa. (shrink)

Although decision‐making algorithms are not new to medicine, the availability of vast stores of medical data, gains in computing power, and breakthroughs in machine learning are accelerating the pace of their development, expanding the range of questions they can address, and increasing their predictive power. In many cases, however, the most powerful machine learning techniques purchase diagnostic or predictive accuracy at the expense of our ability to access “the knowledge within the machine.” Without an explanation in terms of reasons or (...) a rationale for particular decisions in individual cases, some commentators regard ceding medical decision‐making to black box systems as contravening the profound moral responsibilities of clinicians. I argue, however, that opaque decisions are more common in medicine than critics realize. Moreover, as Aristotle noted over two millennia ago, when our knowledge of causal systems is incomplete and precarious—as it often is in medicine—the ability to explain how results are produced can be less important than the ability to produce such results and empirically verify their accuracy. (shrink)

From very early on, Western philosophers have been obsessed with the understanding of a relatively few works of philosophy which have played a disproportionately large and fundamental role in developing the Western philosophical canon, dominating the curriculum in the past and in the present; there is no indication that they will not do so in the future.Uses and Abuses of the Classics examines the various ways in which the different periods of the history of philosophy have approached these texts. The (...) editors have chosen for analysis some of the major philosophers from periods of the history of philosophy in which the interpretation of the classics has been particularly significant.Contributions to this book include entries on: Aristotle's reading of Plato; Averroes on Aristotle; Nietzsche on the Beginnings of Western Philosophy; and Thomas Aquinas's Commentary on Aristotle's Metaphysics. (shrink)

Intentionalism about demonstratives is the view that the referent of a demonstrative is determined solely by the speaker's intentions. Intentionalists can disagree about the nature of these intentions, but are united in rejecting the relevance of other factors, such as the speaker's gestures, her gaze, and any facts about the addressee or the audience. In this paper, I formulate a particular version of this view, and I defend it against six objections, old and new.

Externalism in the philosophy of mind has been thought by many to pose a serious threat to the claim that subjects are in general authoritative with regard to certain of their own intentional states.¹ In a series of papers, Tyler Burge (1985_a_, 1985_b_, 1988, 1996) has argued that the distinctive entitlement or right that subjects have to self- knowledge in certain cases is compatible with externalism, since that entitlement is environmentally neutral, neutral with respect to the issue of the individuation (...) dependence of subjects' intentional states on factors beyond their bodies. His reason is that whereas externalism—the view that certain intentional states of persons are individuation-dependent on objects and/or phenomena external to their bodies—is a metaphysical thesis, authoritative self-knowledge is an epistemological matter. This being so, there is no reason to suppose that the two need conflict with one another. (shrink)

It has become an intellectual commonplace to claim that we have entered the era of 'postmodernity'. Three themes are embraced in this claim the poststructurist critique by Foucault, Derrida and others of the philosophical heritage of the Enlightenment the supposed impasse of High Modern art and its replacement by new artistic forms and the alleged emergence of 'post-industrial' societies whose structures are beyond the ken of Marx and other theorists of industrial capitalism. Against Postmodernism takes issue with all these themes. (...) It challenges the idealist irrationalism of post-structuralism. It questions the existence of any radical break separating allegedly Postmodern from Modern art. And it denies that recent socio-economic developments represent any fundamental shift from classical patterns of capital accumulation. Drawing on philosophy and history, Against Postmodernism takes issue also with some of the most forthright critics of postmodernism -- Jurgen Habermas and Fredric Jameson, for example. But it is most distinctive in that it offers a historical reading of the theories of such currently fashionable thinkers as Baudrillard and Lyotard. Postmodernism, Alex Callinios argues, reflects the disappointed revolutionary generation of '68, and the incorporation of many of its members into the porfessional and managerial 'new middle class'. It is best read as a symptom of political frustration and social mobility rather than as a significant intellectual or cultural phenomenon in its own right. (shrink)

This collection of essays explores the conflictual history and future implications of two important traditions of twentieth-century European thought: the ...

Common principles for resource allocation in health care can prioritize the alleviation of small health burdens over lifesaving treatment. I argue that there is some evidence that these principles are at odds with a sizable share of public opinion, which holds that saving a life should take priority over any number of cures for minor ailments. I propose two possible explanations for this opinion, one debunking and one vindicatory. I also outline how well-designed surveys and moral inquiry could help decide (...) between them. Finally, I consider how priority-setting principles could be adjusted if the view that saving a life always trumps alleviating small burdens were vindicated. (shrink)

Philosopher Ludwig Wittgenstein had an enormous influence on twentieth-century philosophy even though only one of his works, the famous Tractatus Logico-Philosophicus, was published in his lifetime. Beyond this publication the impact of his thought was mainly conveyed to a small circle of students through his lectures at Cambridge University. Fortunately, many of his ideas have survived in both the dictations that were subsequently published, and the notes taken by his students, among them Alice Ambrose and the late Margaret Macdonald, (...) from 1932 to 1935. These notes, now edited by Professor Ambrose, are here published, and they shed much light on Wittgenstein's philosophical development. Among the topics considered are the meaning of a word and its relation to common usage, rules of grammar and their relation to fact, the grammar of first person statements, language games, and the nature of philosophy. This volume is indispensable to any serious discussion of Wittgenstein's work. (shrink)

This essay surveys the varieties of disjunctivism about perceptual experience. Disjunctivism comes in two main flavours, metaphysical and epistemological.

This paper introduces a symposium on Equality versus Priority. It explains how cases involving risk are key to distinguishing these views and discusses a 'social egalitarian' critique of both 'telic egalitarians' and 'telic prioritarians'.

One very popular framework in contemporary epistemology is Bayesian. The central epistemic state is subjective confidence, or credence. Traditional epistemic states like belief and knowledge tend to be sidelined, or even dispensed with entirely. Credences are often introduced as familiar mental states, merely in need of a special label for the purposes of epistemology. But whether they are implicitly recognized by the folk or posits of a sophisticated scientific psychology, they do not appear to fit well with perception, as is (...) often noted. -/- This paper investigates the tension between probabilistic cognition and non-probabilistic perception. The tension is real, and the solution—to adapt a phrase from Quine and Goodman—is to renounce credences altogether. (shrink)

It seems possible to see a star that no longer exists. Yet it also seems right to say that what no longer exists cannot be seen. We therefore face a puzzle, the traditional answer to which involves abandoning naïve realism in favour of a sense datum view. In this article, however, I offer a novel exploration of the puzzle within a naïve realist framework. As will emerge, the best option for naïve realists is to embrace an eternalist view of time, (...) and claim that in the relevant case, one sees a still existent star‐stage located somewhere in the distant past. (shrink)

When A utters a declarative sentence in a context to B, typically A can mean a proposition by the sentence, the sentence in context literally expresses a proposition, there are propositions A and B can agree the sentence literally expressed, and B can acquire knowledge from this testimonial exchange. In recent work on linguistic communication, each of these four platitudes has been challenged, and on the same basis: viz. on the ground that exactly which proposition the sentence expressed in context (...) is not discernible given the information provided by the context. I argue that, even if this is true, there will be propositional parts of the proposition expressed by the sentence in context which can be identified and that, consequently, the partial understanding afforded by the existence of such identifiable parts undermines the soundness of the arguments against the platitudes. (shrink)

Darwin in Argentina -- Conflicting Systems -- Francisco Javier Muniz (1795-1871) -- Hermann Burmeister (1807-1891) -- Francisco P. Moreno (1852-1919) -- Domingo F. Sarmiento (1811-1888) -- Eduardo Holmberg (1852-1937) -- Florentino Ameghino (1854-1911) -- Jose Ingenieros (1877-1925) -- Carlos Octavio Bunge (1875-1918).

There are at least two different aspects of our rational evaluation of agents’ doxastic attitudes. First, we evaluate these attitudes according to whether they are supported by one’s evidence (substantive rationality). Second, we evaluate these attitudes according to how well they cohere with one another (structural rationality). In previous work, I’ve argued that substantive and structural rationality really are distinct, sui generis, kinds of rationality – call this view ‘dualism’, as opposed to ‘monism’, about rationality – by arguing that the (...) requirements of substantive and structural rationality can come into conflict. In this paper, I push the dialectic on this issue forward in two main ways. First, I argue that the most promising ways of resisting the diagnosis of my cases as conflicts still end up undermining monism in different ways. Second, supposing for the sake of argument that we should understand the cases as conflicts, I address the question of what we should do when such conflicts arise. I argue that, at least in a prominent kind of conflict case, the coherence requirements take precedence over the evidential requirements. (shrink)

Endre Begby’s Prejudice: A Study in Non-Ideal Epistemology engages a wide range of issues of enduring interest to epistemologists, applied ethicists, and anyone concerned with how knowledge and justice intersect. Topics include stereotypes and generics, evidence and epistemic justification, epistemic injustice, ethical-epistemic dilemmas, moral encroachment, and the relations between blame and accountability. Begby applies his views about these topics to an equally wide range of pressing social questions, such as conspiracy theories, misinformation, algorithmic bias, discrimination, and criminal justice. Through it (...) all, the book’s central thesis is that prejudices can be epistemically rational, a corrective against what Begby takes to be the received view that prejudices are always and everywhere bad. However, Begby’s arguments do not engage consistently with relevant empirical literatures, misrepresent the positions of his interlocutors, and rehearse ideas already well-established across a range of intellectual traditions. (shrink)

This volume explores the ethical dimensions of a wide selection of philosophical and theological topics in Aquinas's texts.

This fascinating and thought-provoking book provides much-needed philosophical background for counselors, therapists, and healthcare workers looking for broader, deeper foundations in the struggle to help and make sense of others. While examining the best among 20th century philosophy it shows the wealth of inspiration of earlier centuries, and demonstrates with remarkable clarity the way in which the ideas of, and the relations between, these philosophers can inspire, inform, and underpin much of counseling and psychotherapy.

Explores the complexity of truth and the ways that people take advantage of this complexity to use and abuse neutral truths to suit their own agendas in politics, business, the media, and everyday life. -- Provided by publisher.

I defend Fricker’s virtue-theoretic proposals for grappling with epistemic injustice, arguing that her account is both empirically oriented and plausible. I agree with Fricker that an integral component of what we ought to do in the face of pervasive epistemic injustice is working to cultivate epistemic habits that aim to consistently neutralize the effects of such prejudices on their credibility estimates. But Fricker does not claim that her specific proposals constitute the only means through which individuals and institutions should combat (...) epistemic injustice. I therefore build on Fricker’s account by beginning to sketch a fuller picture of the structure of cultivating epistemic virtue. Virtue cultivation must, I argue, occur on two broad but interrelated fronts: first, the direct retraining of more automatic and unreflective patterns of thinking, feeling, and reacting to epistemic social reality, and second, the cultivation of more reflective, metacognitive virtues, such as the ability to swiftly identify contexts in which our first-order epistemic intuitions are likely astray. Although I articulate a range of individual-level obligations, my account is not individualistic. With Fricker, I argue that individual self-transformation is a necessary but not sufficient component of the struggle for epistemic justice. Accordingly, I sketch several ways in which individual virtue cultivation must be a socially and institutionally embedded process. Moreover, I argue that this process is ongoing. While most individuals cannot actually achieve such moral-epistemic ideals, many can (and therefore should try to) get much closer than they already are. (shrink)

The Existentialist Reader is a comprehensive anthology of classic philosophical writings from eight key existentialist thinkers: Sartre, Camus, Heidegger, de Beauvoir, Jaspers, Marcel, Merleau-Ponty, and Ortega y Gasset. These substantial and carefully selected readings consider the distinctive concerns of existentialism: absurdity, anxiety, alienation, death. A comprehensive introduction by Paul S. MacDonald illuminates the existentialist quest for individual freedom and authentic human experience with insight into the historical and intellectual background of these major figures. The Existentialist Reader is a valuable (...) guide to the provocative theories that shook the philosophical world in the 1930s and continue to profoundly shape the way we think about ourselves. (shrink)

Epistemologists typically assume that the acquisition of knowledge from testimony is not threatened at the stage at which audiences interpret what proposition a speaker has asserted. Attention is instead typically paid to the epistemic status of a belief formed on the basis of testimony that it is assumed has the same content as the speaker’s assertion. Andrew Peet has pioneered an account of how linguistic context sensitivity can threaten the assumption. His account locates the threat in contexts in which an (...) audience’s evidence under-determines which proposition a speaker is asserting. I argue that Peet’s epistemic uncertainty account of the threat is mistaken and I propose an alternative. The alternative locates the threat in contexts that provide factors that give audiences a mistaken psychological certainty or confidence that a speaker has asserted a proposition she has not. (shrink)

This entry discusses the relationship between disability and well‐being. Disabilities are commonly thought to be unfortunate, but whether this is true is unclear, and, if it is true, it is unclear why it is true. The entry first explains the disability paradox, which is the apparent discrepancy between the level of well‐being that disabled people self‐report, and the level of well‐being that nondisabled people predict disabled people to have. It then turns to an argument that says that disabilities must be (...) bad, because it is wrong to cause them in others. Later sections discuss whether disabilities might be intrinsically bad or even bad by definition. The final section addresses the claim that disabilities are bad only because society discriminates against people with disabilities. (shrink)

The terminology surrounding the dispute between higher-order and first-order theories of consciousness is piled so high that it sometimes obscures the view. When the debris is cleared away, there is a real prospect.

Millar has written a valuable monograph on perceptual knowledge. Knowing By Perceiving is careful and detailed, at times laborious, delivering many insights. Oc.

Does immorality necessarily involve irrationality? The question is often taken to be among the deepest in moral philosophy. But apparently deep questions sometimes admit of deflationary answers. In this case we can make way for a deflationary answer by appealing to dualism about rationality, according to which there are two fundamentally distinct notions of rationality: structural rationality and substantive rationality. I have defended dualism elsewhere. Here, I’ll argue that it allows us to embrace a sensible – I will not say (...) boring – moderate view about the relationship between immorality and irrationality: roughly, that immorality involves substantive irrationality, but not structural irrationality. I defend this moderate view, and argue that many of the arguments for less moderate views turn either on missing the distinction between substantive and structural rationality, or on misconstruing it. (shrink)