Medical Humanities the journal started life in 2000 as a special edition of the JME. However, the intellectual taproots of the medical humanities as a field of enquiry can be traced to two developments: calls made in the 1920s for the development of multidisciplinary perspectives on the sciences that shed historical light on their assumptions, methods and practices; refusals to assimilate all medical phenomena to a biomedical worldview. Medical humanities the term stems from a desire to situate the significance of (...) medicine as a product of culture. But despite growing usage over half a century the term defies a unifying encapsulation and continues to conjure up a multitude of discourse communities, including scholars working at the interfaces of health and humanities, arts and health, and medical education and bioethics. The field is intellectually capacious and polymorphous, forming and reforming around critical new research questions and teaching tasks spanning disciplines. (shrink)

Bioethics case reports generally treat aspects of moral fathomability, characterised and addressed in different ways. This paper reads the case as a textual model of scenarios and draws attention to its structure, narrative shape, linguistic register, and the effects of tone and temporality on reader expectation and responsiveness. Such textual elements of case composition reflect authorial purpose and influence the interpretation, including moral and ethical interpretation, of bioethics cases.

In this paper, we reflect upon shame and humiliation as threats to personal and professional integrity and moral agency within contemporary health care. A personal narrative, written by a nurse about a particular shift in a British National Health Service Accident and Emergency Department, is provided as a case study. This is critically reflected and commented upon in dialogue with insights into the nature of shame and humiliation. It is suggested that Accident and Emergency is a locus that is latently (...) prone to dynamics of shame and humiliation, a potential exacerbated within a culture subject to externally‐determined time targets that are enforced by a top‐down system of surveillance and management. The result is that nurses may lose their sense of professional competence and responsibility, moral agency, and integrity, to their own personal detriment, as well as to the detriment of patients with whom they work. Insofar as examining a small part of a whole may suggest insights into the operation and ethos of a very large system, this very particular case study narrative/reflection has some important implications and lessons for the wider organization and provision of health care in Britain and beyond. (shrink)

Volume 20, Issue 7, July 2020, Page W17-W19.

The first part of the book, dedicated to 'Rhetorical and Epistemological Aspects of Science Writing', addresses how scientific pursuits and methods feed into multi-level texts that generate responses within science, society, and culture.

Traditionally, medical professionals have taken a paternalistic stance towards their patients and have relied on a traditional approach to medical ethics. In recent years, in Britain, however, a new ‘managerialism’ has developed in the National Health Service (the NHS). This stresses consumerism and greater patient choice and is changing the relationship between doctors and patients. This paper draws out the implications for patients. It describes the ethical characteristics of the two conflicting approaches and argues the need to stress again the (...) view of the patient as an individual person. (shrink)

Brian Leftow offers a theist theory of necessity and possibility, and a new sort of argument for God's existence. He argues that necessities of logic and mathematics are determined by God's nature, but that it is events in God's mind - his imagination and choice - that account for necessary truths about concrete creatures.

Value pluralists believe in multiple dimensions of value. What does betterness along a dimension have to do with being better overall? Any systematic answer begins with the Strong Pareto principle: one thing is overall better than another if it is better along one dimension and at least as good along all others. We defend Strong Pareto from recent counterexamples and use our discussion to develop a novel view of dimensions of value, one which puts Strong Pareto on firmer footing. We (...) conclude by defending Dimensionalism, the hypothesis that overall value relations are determined solely by how things compare along value dimensions. These are first steps towards a more systematic value pluralism. (shrink)

Brian Hedden defends a radical view about the relationship between rationality, personal identity, and time. On the standard view, personal identity over time plays a central role in thinking about rationality, because there are rational norms for how a person's attitudes and actions at one time should fit with her attitudes and actions at other times. But these norms are problematic. They make what you rationally ought to believe or do depend on facts about your past that aren't part (...) of your current perspective on the world, and they make rationality depend on controversial, murky metaphysical facts about what binds different instantaneous snapshots into a single person extended in time. Hedden takes a different approach, treating the relationship between different time-slices of the same person as no different from the relationship between different people. On his account, the locus of rationality is the time-slice rather than the temporally extended agent. This impersonal, time-slice-centric approach to rationality yields a unified approach to the rationality of beliefs, preferences, and actions where what rationality demands of you is solely determined by your evidence, with no special weight given to your past beliefs or actions. (shrink)

I advocate Time-Slice Rationality, the thesis that the relationship between two time-slices of the same person is not importantly different, for purposes of rational evaluation, from the relationship between time-slices of distinct persons. The locus of rationality, so to speak, is the time-slice rather than the temporally extended agent. This claim is motivated by consideration of puzzle cases for personal identity over time and by a very moderate form of internalism about rationality. Time-Slice Rationality conflicts with two proposed principles of (...) rationality, Conditionalization and Reflection. Conditionalization is a diachronic norm saying how your current degrees of belief should fit with your old ones, while Reflection is a norm enjoining you to defer to the degrees of belief that you expect to have in the future. But they are independently problematic and should be replaced by improved, time-slice-centric principles. Conditionalization should be replaced by a synchronic norm saying what degrees of belief you ought to have given your current evidence and Reflection should be replaced by a norm which instructs you to defer to the degrees of belief of agents you take to be experts. These replacement principles do all the work that the old principles were supposed to do while avoiding their problems. In this way, Time-Slice Rationality puts the theory of rationality on firmer foundations and yields better norms than alternative, non-time-slice-centric approaches. (shrink)

A textbook on modal logic, intended for readers already acquainted with the elements of formal logic, containing nearly 500 exercises. Brian F. Chellas provides a systematic introduction to the principal ideas and results in contemporary treatments of modality, including theorems on completeness and decidability. Illustrative chapters focus on deontic logic and conditionality. Modality is a rapidly expanding branch of logic, and familiarity with the subject is now regarded as a necessary part of every philosopher's technical equipment. Chellas here offers (...) an up-to-date and reliable guide essential for the student. (shrink)

"Brian Orend's The Morality of War promises to become the single most comprehensive and important book on just war for this generation. It moves far beyond the review of the standard just war categories to deal comprehensively with the new challenges of the conflict with terrorism. It thoughtfully reviews every major military conflict of the past few decades, mining them for implications of the evolving tradition of just war thinking. It concludes with a critical engagement with the major alternatives (...) to just war thinking: pacifism and 'realism.' It is, in short, the most comprehensive and thoughtful assessment of all aspects of just war since Michael Walzer's classic Just and Unjust Wars." - Martin L. Cook, United States Air Force Academy. (shrink)

Authors have a lot of leeway with regard to what they can make true in their story. In general, if the author says that p is true in the fiction we’re reading, we believe that p is true in that fiction. And if we’re playing along with the fictional game, we imagine that, along with everything else in the story, p is true. But there are exceptions to these general principles. Many authors, most notably Kendall Walton and Tamar Szabó Gendler, (...) have discussed apparent counterexamples when p is “morally deviant”. Many other statements that are conceptually impossible also seem to be counterexamples. In this paper I do four things. I survey the range of counterexamples, or at least putative counterexamples, to the principles. Then I look to explanations of the counterexamples. I argue, following Gendler, that the explanation cannot simply be that morally deviant claims are impossible. I argue that the distinctive attitudes we have towards moral propositions cannot explain the counterexamples, since some of the examples don’t involve moral concepts. And I put forward a proposed explanation that turns on the role of ‘higher-level concepts’, concepts that if they are satisfied are satisfied in virtue of more fundamental facts about the world, in fiction, and in imagination. (shrink)

We live in a world of crowds and corporations, artworks and artifacts, legislatures and languages, money and markets. These are all social objects — they are made, at least in part, by people and by communities. But what exactly are these things? How are they made, and what is the role of people in making them? In The Ant Trap, Brian Epstein rewrites our understanding of the nature of the social world and the foundations of the social sciences. Epstein (...) explains and challenges the three prevailing traditions about how the social world is made. One tradition takes the social world to be built out of people, much as traffic is built out of cars. A second tradition also takes people to be the building blocks of the social world, but focuses on thoughts and attitudes we have toward one another. And a third tradition takes the social world to be a collective projection onto the physical world. Epstein shows that these share critical flaws. Most fundamentally, all three traditions overestimate the role of people in building the social world: they are overly anthropocentric. Epstein starts from scratch, bringing the resources of contemporary metaphysics to bear. In the place of traditional theories, he introduces a model based on a new distinction between the grounds and the anchors of social facts. Epstein illustrates the model with a study of the nature of law, and shows how to interpret the prevailing traditions about the social world. Then he turns to social groups, and to what it means for a group to take an action or have an intention. Contrary to the overwhelming consensus, these often depend on more than the actions and intentions of group members. (shrink)

A counterpossible is a counterfactual whose antecedent is impossible. The vacuity thesis says all counterpossibles are true solely because their antecedents are impossible. Recently, some have rejected the vacuity thesis by citing purported non-vacuous counterpossibles in science. One limitation of this work, however, is that it is not grounded in experimental data. Do scientists actually reason non-vacuously about counterpossibles? If so, what is their basis for doing so? We presented biologists (N = 86) with two counterfactual formulations of a well-known (...) model in biology, the antecedents of which contain what many philosophers would characterize as a metaphysical impossibility. Participants consistently judged one counterfactual to be true, the other to be false, and they explained that they formed these judgments based on what they perceived to be the mathematical relationship between the antecedent and consequent. Moreover, we found no relationship between participants’ judgments about the (im)possibility of the antecedent and whether they judged a counterfactual to be true or false. These are the first experimental results on counterpossibles in science with which we are familiar. We present a modal semantics that can capture these judgments, and we deal with a host of potential objections that a defender of the vacuity thesis might make. (shrink)

A theoretical and sociological exploration of the relationship between law and society, this book constructs an approach to law that integrates legal theory with sociological approaches to law. Law is generally understood to be a mirror of society--a reflection of its customs and morals--that functions to maintain social order. Focusing on this common understanding, the book conducts a survey of Western legal and social theories about law and its relationship within society, engaging in a theoretical and empirical critique of this (...) common understanding. (shrink)

This review note surveys some important aspects of a recent publication by Amos Edelheit, A Philosopher at the Crossroads: Giovanni Pico della Mirandola’s Encounter with Scholastic Philosophy. While focus over the last decades has been placed on Pico’s thought in relation to Jewish Kabbalah and mysticism, Edelheit hopes to emphasize the importance of the scholastic tradition (or, rather, the pluriform and various tradition of late medieval and Renaissance scholasticism) in Pico’s thought, and the ways in which this intellectual context places (...) this unique Renaissance thinker at a sort of ‘crossroads’. Beyond providing a brief overview of the three main parts of the text, this note examines more closely Edelheit’s study of Pico’s 900 Theses and the methodological approach which involves a reconstruction of the dialectical context for each thesis. The Latin scholastics are real conversational partners for Pico: he is versed in the 13th-century scholastic sources, is certainly familiar with contemporaneous scholastic thought, and is able to employ scholastic methods and terminology within his wider philosophical project. While scholastic philosophy was very much alive at the end of the fifteenth century, Pico’s new and inclusive approach to philosophy and the history of philosophy, never eschewing the Latin masters, departs from both scholastic and humanist trends. (shrink)

In the first full-length analysis of Wittgenstein's Remarks on Frazer's Golden Bough, Brian R. Clack presents a fresh and innovative interpretation of Wittgenstein's conception of religion. While previous commentators have tended to sideline the Remarks on Frazer, Clack shows how the key to Wittgenstein's thought on religion lies in these remarks on primitive magico-religious observances. This book shows that Wittgenstein neither embraces expressivism, as it is generally assumed, nor straightforwardly denies instrumentalism. Focusing instead on Wittgenstein's suggestion that magic is (...) somehow akin to metaphysics, a view of ritual as the spontaneous expression of human beings is presented. (shrink)

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

ABSTRACT Quine insisted that the satisfaction of an open modalised formula by an object depends on how that object is described. Kripke's ‘objectual’ interpretation of quantified modal logic, whereby variables are rigid, is commonly thought to avoid these Quinean worries. Yet there remain residual Quinean worries for epistemic modality. Theorists have recently been toying with assignment-shifting treatments of epistemic contexts. On such views an epistemic operator ends up binding all the variables in its scope. One might worry that this yields (...) the undesirable result that any attempt to ‘quantify in’ to an epistemic environment is blocked. If quantifying into the relevant constructions is vacuous, then such views would seem hopelessly misguided and empirically inadequate. But a famous alternative to Kripke's semantics, namely Lewis' counterpart semantics, also faces this worry since it also treats the boxes and diamonds as assignment-shifting devices. As I'll demonstrate, the mere fact that a variable is bound is no obstacle to binding it. This provides a helpful lesson for those modelling de re epistemic contexts with assignment sensitivity, and perhaps leads the way toward the proper treatment of binding in both metaphysical and epistemic contexts: Kripke for metaphysical modality, Lewis for epistemic modality. (shrink)

In this chapter, we introduce the notion of “moral neuroenhancement,” offering a novel definition as well as spelling out three conditions under which we expect that such neuroenhancement would be most likely to be permissible (or even desirable). Furthermore, we draw a distinction between first-order moral capacities, which we suggest are less promising targets for neurointervention, and second-order moral capacities, which we suggest are more promising. We conclude by discussing concerns that moral neuroenhancement might restrict freedom or otherwise “misfire,” and (...) argue that these concerns are not as damning as they may seem at first. (shrink)

Almost every country today contains adherents of different religions and different secular conceptions of the good life. Is there any alternative to a power struggle among them, leading most probably to either civil war or repression? The argument of this book is that justice as impartiality offers a solution. According to the theory of justice as impartiality, principles of justice are those principles that provide a reasonable basis for the unforced assent of those subject to them. The object of this (...) book is to set the theory out, explain its rationale, and respond to a variety of criticism that have been made of it. As the second volume of his work-in-progress, A Treatise on Social Justice, this work lies at the heart of a thriving academic debate which the author has played a key role in shaping. (shrink)

All major western countries today contain groups that differ in their religious beliefs, customary practices or ideas about the right way in which to live. How should public policy respond to this diversity? In this important new work, Brian Barry challenges the currently orthodox answer and develops a powerful restatement of an egalitarian liberalism for the twenty-first century. Until recently it was assumed without much question that cultural diversity could best be accommodated by leaving cultural minorities free to associate (...) in pursuit of their distinctive ends within the limits imposed by a common framework of laws. This solution is rejected by an influential school of political theorists, among whom some of the best known are William Galston, Will Kymlicka, Bhikhu Parekh, Charles Taylor and Iris Marion Young. According to them, this 'difference-blind' conception of liberal equality fails to deliver either liberty or equal treatment. In its place, they propose that the state should 'recognize' group identities, by granting groups exemptions from certain laws, publicly 'affirming' their value, and by providing them with special privileges or subsidies. In Culture and Equality, Barry offers an incisive critique of these arguments and suggests that theorists of multiculturism tend to misdiagnose the problems of minority groups. Often, these are not rooted in culture, and multiculturalist policies may actually stand in the way of universalistic measures that would be genuinely beneficial. (shrink)

Pt. I. Zeno and the metaphysics of quantity. Zeno's paradox of measure -- Tractarian nominalism -- Logical atoms and combinatorial possibility -- Strict coherence, sigma coherence, and the metaphysics of quantity -- pt. II. Coherent degrees of belief. Higher-order degrees of belief -- A mistake in dynamic coherence arguments? -- Dynamic coherence and probability kinematics -- Updating, supposing, and MAXENT -- The structure of radical probabilism -- Diachronic coherence and radical probabilism -- pt. III. Induction. Carnapian inductive logic for Markov (...) chains -- Carnapian inductive logic and Bayesian statistics -- Bayesian projectability. (shrink)

Almost entirely ignored in the linguistic theorising on names and descriptions is a hybrid form of expression which, like definite descriptions, begin with 'the' but which, like proper names, are capitalised and seem to lack descriptive content. These are expressions such as the following, 'the Holy Roman Empire', 'the Mississippi River', or 'the Space Needle'. Such capitalised descriptions are ubiquitous in natural language, but to which linguistic categories do they belong? Are they simply proper names? Or are they definite descriptions (...) with unique orthography? Or are they something else entirely? This paper assesses two obvious assimilation strategies: (i) assimilation to proper names and (ii) assimilation to definite descriptions. It is argued that both of these strategies face major difficulties. The primary goal is to lay the groundwork for a linguistic analysis of capitalised descriptions. Yet, the hope is that clearing the ground on capitalised descriptions may reveal useful insights for the on-going research into the semantics and syntax of their lower-case or 'the'-less relatives. (shrink)

The question of what makes someone the same person through time and change has long been a preoccupation of philosophers. In recent years, the question of what makes ordinary or lay people judge that someone is—or isn’t—the same person has caught the interest of experimental psychologists. These latter, empirically oriented researchers have sought to understand the cognitive processes and eliciting factors that shape ordinary people’s judgments about personal identity and the self. Still more recently, practitioners within an emerging discipline, experimental (...) philosophical bioethics or “bioxphi”—the focus of this chapter—have adopted a similar aim and employed similar methodologies, but with two distinctive features: (a) a special concern for enhanced ecological validity in the examples and populations studied; and (b) an interest in contributing to substantive normative debates within the wider field of bioethics. Our aim in this chapter is to sample illustrative work on personal identity in bioxphi, explore how it relates to studies in psychology covering similar terrain, and draw out the implications of this work for matters of bioethical concern. In pursuing these issues, we highlight recent work in bioxphi that includes the perceived validity of advance directives following neurodegeneration, the right of psychologically altered study participants to withdraw from research, how drug addiction may cause one to be regarded by others as “a completely different person,” the effect of deep-brain stimulation on perceptions of the self, and the potential influence of moral enhancement interventions on intuitive impressions of a person’s character. (shrink)

This chapter provides a general overview of the issues surrounding so-called semantic monsters. In section 1, I outline the basics of Kaplan’s framework and spell out how and why the topic of “monsters” arises within that framework. In Section 2, I distinguish four notions of a monster that are discussed in the literature, and show why, although they can pull apart in different frameworks or with different assumptions, they all coincide within Kaplan’s framework. In Section 3, I discuss one notion (...) that has spun off into the linguistics literature, namely “indexical shift”. In Section 4, I emphasize the connection between monsters and the compositionality of asserted content in Kaplan’s original discussion. Section 5 discusses monsters and the more general idea of re-interpretation or meaning-shift. Section 6 closes with a brief survey of where monsters may dwell, and pointers to avenues for future research. (shrink)

In the face of a perceived lack of widespread understanding of the theoretical issues underlying the development, dissemination and implementation of clinical guidelines, the Royal College of General Practitioners Guidelines Group developed a 2-day course aimed at teaching the theory in these areas. The course was targeted at potential opinion formers and ran on six occasions. Postal questionnaire assessment of the course revealed high levels of satisfaction with all aspects of the course and high levels of reported use of the (...) knowledge gained. Further developments of the course are discussed. (shrink)

This essay investigates whether or not we should think that the things we say are identical to the things our sentences mean. It is argued that these theoretical notions should be distinguished, since assertoric content does not respect the compositionality principle. As a paradigmatic example, Kaplan's formal language LD is shown to exemplify a failure of compositionality. It is demonstrated that by respecting the theoretical distinction between the objects of assertion and compositional values certain conflicts between compositionality and contextualism are (...) avoided. This includes the conflict between eternalism and the semantics of tense, the embedding problems for contextualism about epistemic modals and taste claims, and the conflict between direct reference and the semantics of bound pronouns (and monstrous operators). After presenting the theoretical picture which distinguishes assertoric content from compositional semantic value, some objections to the picture are addressed. In so doing, the objection from King (2003) stemming from apparent complications with the interaction of temporal expressions and attitude reports is assessed and shown to be non-threatening. (shrink)

There are very few medical ethics courses in British medical schools which are a formal part of the clinical curriculum. Such a programme is described in the following, along with the way in which the long-term curriculum committee of the University College and Middlesex Hospital Joint Medical School was persuaded to make it compulsory for first-year students. Pedagogical lessons which have been learned in its planning and implementation are outlined and teaching materials are included concerning student and course assessment which (...) should be useful for others engaged in similar work. Finally, some of the institutional obstacles facing such attempts are discussed, particularly problems concerning timetabling, different types of opposition and the consequent importance of building alliances among clinical teaching staff. (shrink)