De senere år har pleie- og omsorgstjenesten i mange norske kommuner startet med ulike former for etikkarbeid, oftest initiert av KS’ prosjekt “Samarbeid om etisk kompetanseheving”. Hensikten med vår studie var å evaluere innsatsen i de kommunene som deltok i prosjektet fra starten av, med vekt på hvilke tiltak som var iverksatt, hvilke virksomheter dette omfattet, og om tiltakene har fortsatt utover prosjektperioden. Studien har et kvalitativt design. Materialet er hovedsakelig basert på telefonintervjuer med kontaktpersoner for etikksatsingen i 34 kommuner. (...) Det transkriberte materialet er analysert ved kvalitativ innholdsanalyse. Med unntak av fem kommuner som aldri kom i gang med etikkarbeidet, hadde de fleste startet etikkrefleksjon innenfor flere tjenester, oftest i sykehjem og hjemmetjenester. Noen kommuner hadde imidlertid ikke klart å videreføre etikkarbeidet utover en prosjektperiode. Det var stor variasjon både i etikkarbeidets forankring i kommunen, omfang, hyppighet og metoder. Et gjennomgående funn er vektlegging av behovet for etikkkompetanse og oppfølging av dem som skal lede etikkarbeidet. Flertallet av kommunene som fortsatt gjennomfører etikkrefleksjon, tar utgangspunkt i egen praksis, men et mindretall anvender strukturerte metoder. Dersom etikkarbeidet i kommunen skal være levedyktig over tid, bør arbeidet forankres på flere nivåer i organisasjonen, og de som skal lede dette arbeidet, bør få styrket sin kompetanse i etikk og etikkrefleksjon.Nøkkelord: etikk, evaluering, kommunehelsetjenestenEnglish summary: Building ethical competence in Norwegian municipalities: What has been done and what has been sustainable?“Cooperation for building ethics competence” is a national project aimed to stimulate moral reflection and build competence in ethics in community health services in Norway. This article is based on an evaluation of the activities implemented by the first 34 participating municipalities, exploring which measures were implemented, which services and employees were involved, and if the measures are sustainable. The study has a qualitative design, and the data mainly consists of telephone interviews with “key” persons in 34 municipalities. With the exception of five municipalities that never really started ethics work, the majority had implemented ethical reflection in several areas, most often in nursing homes and home care services. There was great variation with regard to the implementation. Many had tried a variety of reflection models, and only a minority of the municipalities were using a structured method of ethical reflection. A consistent finding is the need for more competence; many of those who run ethical reflection are reported to need more competence both in ethics and methods for systematic reflection. There were also great variations in how well the ethics projects were anchored within the municipality. To make ethical interventions sustainable, this study indicates the importance of strong anchoring within the municipality, the need for ethical competence, as well as good methods for structuring ethical reflection. (shrink)

This article examines the involvement of residents and their relatives in end-of-life decisions and care in Norwegian nursing homes. It also explores challenges in these staff—family relationships. The article is based on a nationwide survey examining Norwegian nursing homes’ end-of-life care at ward level. Only a minority of the participant Norwegian nursing home wards ‘usually’ explore residents’ preferences for care and treatment at the end of their life, and few have written procedures on the involvement of family caregivers when their (...) relative is in the terminal phase. According to the respondents, most staff seem to comfort relatives well. However, several challenges were described. The study revealed a need for better procedures in the involvement of residents and relatives in nursing home end-of-life care. The findings emphasize a need to strengthen both the involvement of nursing home physicians and staff communication skills. (shrink)

In many Western countries, studies have demonstrated extensive use of coercion in nursing homes, especially towards patients suffering from dementia. This article examines what kinds of strategies or alternative interventions nursing staff in Norway used when patients resist care and treatment and what conditions the staff considered as necessary to succeed in avoiding the use of coercion. The data are based on interdisciplinary focus group interviews with nursing home staff. The study revealed that the nursing home staff usually spent a (...) lot of time trying a wide range of approaches to avoid the use of coercion. The most common strategies were deflecting and persuasive strategies, limiting choices by conscious use of language, different kinds of flexibility and one-to-one care. According to the staff, their opportunities to use alternative strategies effectively are greatly affected by the nursing home’s resources, by the organization of care and by the staff’s competence. (shrink)

Background: Studies have demonstrated the extensive use of coercion in Norwegian nursing homes, which represents ethical, professional as well as legal challenges to the staff. We have, however, limited knowledge of the experiences and views of nursing home patients and their relatives. Objectives: The aim of this study is to explore the perspectives of nursing home patients and next of kin on the use of coercion; are there situations where the use of coercion can be defended, and if so, under (...) which circumstances? Methods: The data are based on individual interviews with 35 patients living in six nursing homes and seven focus group interviews with 60 relatives. Ethical considerations: Participation was based on written informed consent, and the study was approved by the Regional Committees for Medical and Health Research Ethics. Results: More than half of the patients and the majority of the relatives accepted the use of coercion, trusting the staff to act in the patient’s best interest. However, the acceptance of coercion is strongly related to the patients’ lack of understanding, to prevent health risks and to preserve the patient’s dignity. Conclusion: The majority of nursing home patients and relatives accepted the use of coercion in specific situations, while at the same time they emphasised the need to try alternative strategies first. There is still a need for good qualitative research on the use of coercion in nursing homes, especially with a closer focus on the perspectives and experiences of nursing home patients. (shrink)

Background:Through the Norwegian ethics project, ethics activities have been implemented in the health and care sector in more than 200 municipalities.Objectives:To study outcomes of the ethics activities and examine which factors promote and inhibit significance and sustainability of the activities.Research design:Two online questionnaires about the municipal ethics activities.Participants and research context:A total of 137 municipal contact persons for the ethics project answered the first survey, whereas 217 ethics facilitators responded to the second survey.Ethical considerations:Based on informed consent, the study was (...) approved by the Data Protection Official of the Norwegian Social Science Data Services.Findings:Around half of the respondents found the ethics project to have been highly significant for daily professional practice. Outcomes include better handling of ethical challenges, better employee cooperation, better service quality, and better relations to patients and next of kin. Factors associated with sustainability and/or significance of the activities were sufficient support from stakeholders, sufficient available time, and ethics facilitators having sufficient knowledge and skills in ethics and access to supervision.Discussion:This study shows that ethics initiatives can be both sustainable and significant for practice. There is a need to create regional or national structures for follow-up and develop more comprehensive ethics training for ethics facilitators.Conclusion:It is both possible and potentially important to implement clinical ethics support activities in community health and care services systematically on a large scale. Future ethics initiatives in the community sector should be designed in light of documented promoting and inhibiting factors. (shrink)

Background:To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature.Methods:A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociologicals and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included.Ethical considerations:The review is conducted according to the Vancouver Protocol.Results:There are few studies that study ethical (...) challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good and inflicting harm. In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion.Conclusion:There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress. (shrink)

BackgroundInternationally, clinical ethics support has yet to be implemented systematically in community health and care services. A large-scale Norwegian project attempted to increase ethical competence in community services through facilitating the implementation of ethics support activities in 241 Norwegian municipalities. The article describes the ethics project and the ethics activities that ensued.MethodsThe article first gives an account of the Norwegian ethics project. Then the results of two online questionnaires are reported, characterizing the scope, activities and organization of the ethics activities (...) in the Norwegian municipalities and the ethical topics addressed.ResultsOne hundred and thirty-seven municipal contact persons answered the first survey, whereas 217 ethics facilitators from 48 municipalities responded to the second. The Norwegian ethics project is vast in scope, yet has focused on some institutions and professions whilst seldom reaching others. Patients and next of kin were very seldom involved. Through the ethics project employees discussed many important ethical challenges, in particular related to patient autonomy, competence to consent, and cooperation with next of kin. The “ethics reflection group” was the most common venue for ethics deliberation.ConclusionsThe Norwegian project is the first of its kind and scope, and other countries may learn from the Norwegian experiences. Professionals have discussed central ethical dilemmas, the handling of which arguably makes a difference for patients/users and service quality. The study indicates that large scale implementation of CES structures for the municipal health and care services is complex, yet feasible. (shrink)

Background:Healthcare personnel in the municipal healthcare systems experience many ethical challenges in their everyday work. In Norway, 243 municipalities participated in a national ethics project, aimed to increase ethical competence in municipal healthcare services. In this study, we wanted to map out what participants in ethics reflection groups experienced as promoters or as barriers to successful reflection.Objectives:To examine what the staff experience as promoters or as barriers to successful ethics reflection.Research design:The study has a qualitative design, where 56 participants in (...) municipal healthcare participated in 10 different focus-group interviews.Ethical considerations:The data collection was based on the participants’ informed consent and approved by the Data Protection Official of the Norwegian Centre for Research Data.Results:The informants had different experiences from ethics reflection group. Nevertheless, we found that there were several factors that were consistently mentioned: competence, facilitator’s role, ethics reflection groups organizing, and organizational support were all experienced as promoters and as a significant effect on ethics reflection groups. The absence of such factors would constitute important barriers to successful ethics reflection.Discussion:The results are coincident with other studies, and indicate some conditions that may increase the possibility to succeed with ethics reflection groups. A systematic approach seems to be important, the systematics of the actual reflections, but also in the organization of ethics reflection group at the workplace. Community healthcare is characterized by organizational instabilities as many vacancies, high workloads, and lack of predictability. This can be a hinder for ethics reflection group.Conclusion:Both internal and external factors seem to influence the organization of ethics reflection group. The municipalities’ instabilities challenging this work, and perceived as a clear inhibitor for the development. The participants experienced that the facilitator is the most important success factor for establishing, carrying out, and to succeed with ethics reflection groups. (shrink)

Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. Most participants report (...) positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices. (shrink)

Because of the transfer of responsibility from hospitals to community-based settings, providers in home-based care have more responsibilities and a wider range of tasks and responsibilities than before, often with limited resources. The increased responsibilities and the complexity of tasks and patient groups may lead to several ethical challenges. A systematic search in the databases MEDLINE, CINAHL, and SveMed+ was carried out in February 2019 and August 2020. The research question was translated into a modified PICO worksheet. A total of (...) 40 articles were included. The review is conducted according to the Vancouver Protocol. The main findings from the systematic literature review show that ethical challenges experienced by healthcare and social care providers in home-based care are related to autonomy and balancing ethical principles, decisions regarding intensity of care, challenges related to priority settings, truth-telling, and balancing the professional role. Findings regarding ethical challenges within home-based care are in line with findings from institutional healthcare and social care settings. However, some significant differences from the institutional context are also highlighted. (shrink)

Siden 2007 har HOD og KS satset store ressurser på prosjektet «Samarbeid om etisk kompetanseheving» i kommunale helse- og omsorgstjenester. Hensikten med prosjektet har vært å heve de ansattes etiske kompetanse, og ett av de iverksatte tiltakene har vært å etablere refleksjonsgrupper i etikk. Denne artikkelen er basert på en evaluering av arbeidet i refleksjonsgruppene med fokus på hvordan etikkveilederen, også kalt fasilitator, beskriver arbeidet i gruppene. Hensikten med studien var å utvikle kunnskap om hvordan arbeidet med etikk-refleksjon foregår, samt (...) å diskutere om måten det arbeides på kan forventes å bidra til etisk kompetanseheving blant gruppemedlemmene. Vinteren 2012 gjennomførte vi fokusgruppeintervju i åtte kommuner med ansatte fra ulike deler av den kommunale helse- og omsorgstjenesten, ett intervju i hver kommune, til sammen 33 personer. Data ble analysert og fortolket i tråd med hermeneutisk metode. Resultatene viser at de i refleksjonsgruppene diskuterer alt fra verdier, begreper, fiktive case, dilemmaer til vanskelig situasjoner fra egen praksis. Refleksjonsmetodene varierer i spennet fra fri diskusjon til en strukturert samtale. Fasiltatorenes helsefaglige grunnutdanning og kunnskap om etikk og refleksjon ser ut til å være avgjørende faktorer for om refleksjonsgrupper i etikk mest fungerer som et pusterom, eller blir en læringsarena for etisk kompetanseheving. Resultatene diskuteres i lys av lærings- og refleksjonsteori.Nøkkelord: Etikk, evaluering, fasilitatorer, kommunehelsetjenesten, læring, refleksjonsgrupper English Summary: Ethics reflection groups: Just a “time out” or a learning arena?Since 2007, there has been a nationally prioritised programme aiming to enhance ethics competence in Norwegian community health care. One of many measures has been to establish ethics reflection groups. The purpose of this study was to obtain knowledge about how ethics reflection is carried out and if the reflection strengthens the participants´ competence in ethics. In this article, we focus on how the role of the facilitator, and the objective is to describe and discuss how the facilitator work and facilitate in the groups. We conducted focus group interviews with facilitators from various clinical settings in eight different municipalities. Data were analysed and interpreted according to hermeneutic methodology. The findings show that the discussions in the reflection groups varied from values, concepts and fictional cases to dilemmas and ethically difficult situations from the participants own practice. The methods used varied from free conversation to structured reflection. Competence in ethics and methods of reflection are essential skills facilitators must employ/have to run the groups. We discuss the findings using learning- and reflection theory.Article first published online: 22 MARCH 2016. (shrink)

Mobsters and others engaged in risky forms of social coordination and coercion often communicate by saying something that is overtly innocuous but transmits another message ‘off record’. In both ordinary conversation and political discourse, insinuation and other forms of indirection, like joking, offer significant protection from liability. However, they do not confer blanket immunity: speakers can be held to account for an ‘off record’ message, if the only reasonable interpreta- tions of their utterance involve a commitment to it. Legal liability (...) for speech in the service of criminal behavior displays a similar profile of significant protection from indirection along with potential liability for reasonable interpretations. Specifically, in both ordinary and legal contexts, liability depends on how a reasonable speaker would expect a reasonable hearer to interpret their utterance in the context of utter- ance, rather than on the actual speaker’s claimed communicative intentions. (shrink)

We sley Salmon, in his influential and detailed book, Four Decades of Scientific Explanation, argues that the pragmatic approach to scientific explanation, “construed as the claim that scientific explanation can be explicated entirely in pragmatic terms” (1989, 185) is inadequate. The specific inadequacy ascribed to a pragmatic account is that objective relevance relations cannot be incorporated into such an account. Salmon relies on the arguments given in Kitcher and Salmon (1987) to ground this objection. He also suggests that Peter Railton’s (...) concepts of the ideal explanatory text and explanatory information (Railton 1981) can provide what the pragmatic approach lacks. This suggestion is not a conclusion of course; we read it as the promotion of part of a research program aimed at forging a greater consensus on scientific explanation-an admirable goal. However, we do not see the pragmatic approach as inadequate. We will show that a synthetic account inspired by Salmon’s adaptation of Railton would be equivalent to van Fraassen’s pragmatic account in three respects: accepting or rejecting requests for explanation; the practice of giving scientific explanations; and the evaluation of the goodness of explanations. We include all three under the general rubric of explanatory “practice.” Admittedly these are not the only three features by which an account of explanation might be evaluated. Roughly, we mean to show that a synthetic account cannot do a better job of accounting for the scientific practices which are of importance to the constructive empiricist, and therefore no argument can be presented to the constructive empiricist to convince her that by her own standards the synthetic account is superior. (shrink)

In recent years, the integration of philosophical with scientific theorizing has started to yield new insights. This chapter surveys some recent philosophical and empirical work on the nature and structure of action, on conscious agency, and on our knowledge of actions.

Most of us create and use a panoply of non-sentential representations throughout our ordinary lives: we regularly use maps to navigate, charts to keep track of complex patterns of data, and diagrams to visualize logical and causal relations among states of affairs. But philosophers typically pay little attention to such representations, focusing almost exclusively on language instead. In particular, when theorizing about the mind, many philosophers assume that there is a very tight mapping between language and thought. Some analyze utterances (...) as the outer vocalizations of inner thoughts (e.g. Grice 1957, Devitt 2005), while others treat thought as a form of inner speech (e.g. Sellars 1956/1997, Carruthers 2002). But even philosophers who take no stand on the relative priority of language and thought still tend to individuate mental states in terms of the sentences we use to ascribe them. Indeed, Dummett (1993) claims that it is constitutive of analytic philosophy that it approaches the mind by way of language. In many ways, this linguistic model is salutary. Our thoughts are often intimately intertwined with their linguistic expression, and public language does provide a comparatively tractable proxy for, and a window into, the messier realm of thought. However, an exclusive focus on thought as it is expressed in language threatens to leave other sorts of thought unexplained, or even to blind us to their possibility. In particular, many cognitive ethologists and psychologists find it useful to talk about humans, chimpanzees, birds, rats, and even bees as employing cognitive maps. We need to make sense of this way of talking about minds as well as more familiar sentential descriptions. In what follows, I investigate the theoretical and practical possibility of non-sentential thought. Ultimately, I am most interested in the contours of distinctively human thought: what forms does human thought take, and how do those different forms interact? How does human thought compare with that of other animals? In this essay, however, I focus on a narrower and more basic theoretical question: could thought occur in maps? Many philosophers are convinced that in some important sense, thought per se must be language-like.. (shrink)

Elisabeth Porter's guide to the development of feminist thought on ethics & moral agency surveys feminist debates on the nature of feminist ethics, intimate relationships, professional ethics, politics, sexual politics, abortion and reproductive choices.

A vital and timely contribution to the growing scholarship on the political thought of Alain Badiou.

I take up three puzzles about our emotional and evaluative responses to fiction. First, how can we even have emotional responses to characters and events that we know not to exist, if emotions are as intimately connected to belief and action as they seem to be? One solution to this puzzle claims that we merely imagine having such emotional responses. But this raises the puzzle of why we would ever refuse to follow an author’s instructions to imagine such responses, since (...) we happily imagine many other implausible things. A natural response to this second puzzle is that our responses to fiction are real, and so can’t just be conjured up in response to an author’s demands. However, this simple response is inadequate, because we often respond differently to people and events in fiction than we would if we encountered them in real life. Solving these three puzzles in a consistent way requires the notion of a “perspective” on a fictional world. I sketch an account of this intuitive but frustratingly amorphous notion: perspectives are tools for organizing our thinking, which can in turn alter our emotional and evaluative responses. Cultivating a perspective can be illuminating, entertaining, or corrupting — or all three at once. (shrink)

From antiquity, Galenic physicians extensively discussed the active powers of simple and compound drugs. In their views, simple drugs, that is, single ingredients, acted according to their material qualities and the properties of their substance. As for compound drugs, their efficacy resulted from the mutual interaction of their ingredients and their modes of preparation. In the late Renaissance, Galenic physicians and naturalists, such as Leonhart Fuchs and Pietro Andrea Mattioli, attempted to explain these pharmacological properties or “faculties” at the intersection (...) of medicine, botany, and natural philosophy. This chapter examines the case of the Italian physician and botanist Andrea Cesalpino. His pharmacological treatise De medicamentorum facultatibus [On the Faculties of Drugs, 1593] was particularly significant for its reception of ancient and medieval texts on drug properties, materia medica, and the role of the senses in the knowledge of bodies. (shrink)

Widmer sheds light on a neglected aspect of the Western philosophical tradition. Following an era of Hegelianism, the members of the neo-Kantian "Marburg School," such as Friedrich Albert Lange, Hermann Cohen, Rudolf Stammler, Paul Natorp, and Ernst Cassirer defended socialism or left-wing ideals on Kantian principles. In doing so, Widmer breaks with two mistaken assumptions. First, Widmer demonstrates that the left-Hegelian and Marxist traditions were not the only significant philosophical sources of socialist critique in nineteenth-century Germany, as the left-Kantians identified (...) problems of normativity that the left-Hegelians could not adequately address. Second, Widmer challenges the prevailing assumption that the political philosophies developed in the Marburg School can be comprehensively characterized as a unified school of "ethical socialism." By showing that they varied fundamentally regarding their political views and their philosophical foundations of socialism, Widmer fills a gap in the studies of neo-Kantianism that is long overdue. (shrink)

La période périnatale suscite un bouleversement psychique de la famille où le passé, le présent et le futur s’entremêlent. Quand des traumatismes ont affecté des générations en amont, il est possible qu’un passé non élaboré resurgisse à la naissance d’un enfant. Des organisations défensives délétères se transmettent sans transformation. Une confusion des temps peut s’installer, entre passé et présent, obturant le futur, plongeant la nouvelle famille dans de la désorganisation, faisant apparaître des symptômes. Les autrices proposent un éclairage théorique, puis (...) des vignettes cliniques dont un accompagnement de thérapie familiale psychanalytique périnatale pour permettre à la nouvelle famille de se différencier et de construire un avenir détoxifié et « déconfusionné ». Le développement favorable de l’enfant et une parentalité plus harmonieuse peuvent en découler au bénéfice de tous. (shrink)

On a familiar and prima facie plausible view of metaphor, speakers who speak metaphorically say one thing in order to mean another. A variety of theorists have recently challenged this view; they offer criteria for distinguishing what is said from what is merely meant, and argue that these support classifying metaphor within 'what is said'. I consider four such criteria, and argue that when properly understood, they support the traditional classification instead. I conclude by sketching how we might extract a (...) workable notion of 'what is said' from ordinary intuitions about saying. (shrink)

Traditional theories of sarcasm treat it as a case of a speaker's meaning the opposite of what she says. Recently, 'expressivists' have argued that sarcasm is not a type of speaker meaning at all, but merely the expression of a dissociative attitude toward an evoked thought or perspective. I argue that we should analyze sarcasm in terms of meaning inversion, as the traditional theory does; but that we need to construe 'meaning' more broadly, to include illocutionary force and evaluative attitudes (...) as well as propositional content. I distinguish four subclasses of sarcasm, individuated in terms of the target of inversion. Three of these classes raise serious challenges for a standard implicature analysis. (shrink)

Ten years ago, one of us proposed a dynamic hierarchical model of intentions that brought together philosophical work on intentions and empirical work on motor representations and motor control (Pacherie, 2008). The model distinguished among Distal intentions, Proximal intentions, and Motor intentions operating at different levels of action control (hence the name DPM model). This model specified the representational and functional profiles of each type of intention, as well their local and global dynamics, and the ways in which they interact. (...) A core insight of the model was that action control is the result of integrated, coordinated activity across these levels of intention. Since the proposal of the model, empirical and theoretical works in philosophy and cognitive science have emerged that would seem to support and expand on this central insight. In particular, an updated understanding of the nature of sensorimotor processing and motor representations, as well as of how the different levels of intention and control interface and interact, allows for the further specification and precisification of the original DPM model. (shrink)

Phenomenology has been adapted for use in qualitative health research, where it’s often used as a method for conducting interviews and analyzing interview data. But how can phenomenologists study subjects who cannot accurately reflect upon or report their own experiences, for instance, because of a psychiatric or neurological disorder? For conditions like these, qualitative researchers may gain more insight by conducting observational studies in lieu of, or in conjunction with, interviews. In this article, we introduce a phenomenological approach to conducting (...) this kind of observational research. The approach relies on conceptual grounding to focus a study on specific aspects of the participants’ experiences. Moreover, the approach maintains the openness to novel discoveries that qualitative research requires while also providing a structured framework for data collection and analysis. To illustrate its practical application, we use examples of hemispatial neglect—a neurologic disorder in which patients characteristically lack awareness of their own illness and bodily capacities. However, the approach that we describe can be applied more broadly to the study of complex illness experiences and other experiential alterations. (shrink)

I compare two of Davidson's main discussions of metaphor. I argue, first, that despite some puzzling inconsistencies, the overall thrust of “What Metaphors Mean” is a radical form of noncogitivism, on which speakers of metaphors merely cause their hearers to perceive certain features in the world, but do not claim or implicate that things are any particular way. By contrast, in “A Nice Derangement of Epitaphs,” Davidson endorses a neo‐Gricean account of metaphor as a form of speaker's meaning. However, he (...) also now advocates a radical anticonventionalism about linguistic meaning in general, which threatens to undermine his new view of metaphor. Finally, I articulate and evaluate a neo‐Davidsonian view of metaphor, which retains as much as possible from both papers. (shrink)

I argue that we can reconcile two seemingly incompatible traditions for thinking about concepts. On the one hand, many cognitive scientists assume that the systematic redeployment of representational abilities suffices for having concepts. On the other hand, a long philosophical tradition maintains that language is necessary for genuinely conceptual thought. I argue that on a theoretically useful and empirically plausible concept of 'concept', it is necessary and sufficient for conceptual thought that a thinker be able to entertain many of the (...) potential thoughts produced by recombining her representational abilities apart from a direct confrontation with the states of affairs being represented. Such representational abilities support a cognitive engagement with the world that is flexible, abstract, and active. (shrink)

Metaphors are powerful communicative tools because they produce ”framing effects’. These effects are especially palpable when the metaphor is an insult that denigrates the hearer or someone he cares about. In such cases, just comprehending the metaphor produces a kind of ”complicity’ that cannot easily be undone by denying the speaker’s claim. Several theorists have taken this to show that metaphors are engaged in a different line of work from ordinary communication. Against this, I argue that metaphorical insults are rhetorically (...) powerful because they combine perspectives, presupposition, and pragmatics in the service of speech acts with assertoric force. (shrink)

After a long period of neglect, the phenomenology of action has recently regained its place in the agenda of philosophers and scientists alike. The recent explosion of interest in the topic highlights its complexity. The purpose of this paper is to propose a conceptual framework allowing for a more precise characterization of the many facets of the phenomenology of agency, of how they are related and of their possible sources. The key assumption guiding this attempt is that the processes through (...) which the phenomenology of action is generated and the processes involved in the specification and control of action are strongly interconnected. I argue in favor of a three-tiered dynamic model of intention, link it to an expanded version of the internal model theory of action control and specification, and use this theoretical framework to guide an analysis of the contents, possible sources and temporal course of complementary aspects of the phenomenology of action. (shrink)