Existing regulation of end-of-life care is flawed. Problems include poorly-designed laws, policies, ethical codes, training, and funding programs, which often are neither effective nor helpful in guiding decision-making. This leads to adverse outcomes for patients, families, health professionals, and the health system as a whole. A key factor contributing to the harms of current regulation is a siloed approach to regulating end-of-life care. Existing approaches to regulation, and research into how that regulation could be improved, have tended to focus on (...) a single regulatory instrument (e.g., just law or just ethical codes). As a result, there has been a failure to capture holistically the various forces that guide end-of-life care. This article proposes a response to address this, identifying “regulatory space” theory as a candidate to provide the much-needed holistic insight into improving regulation of end-of-life care. The article concludes with practical implications of this approach for regulators and researchers. (shrink)

Background Voluntary assisted dying became lawful in Victoria, the first Australian state to permit this practice, in 2019 via the Voluntary Assisted Dying Act 2017 (Vic). While conscientious objection by individual health professionals is protected by the Victorian legislation, objections by institutions are governed by policy. No research has been conducted in Victoria, and very little research conducted internationally, on how institutional objection is experienced by patients seeking assisted dying. Methods 28 semi-structured interviews were conducted with 32 family caregivers and (...) one patient about the experience of 28 patients who sought assisted dying. Participants were interviewed during August-November 2021. Data from the 17 interviews (all with family caregivers) which reported institutional objection were analysed thematically. Results Participants reported institutional objection affecting eligibility assessments, medication access, and taking the medication or having it administered. Institutional objection occurred across health settings and was sometimes communicated obliquely. These objections resulted in delays, transfers, and choices between progressing an assisted dying application and receiving palliative or other care. Participants also reported objections causing adverse emotional experiences and distrust of objecting institutions. Six mediating influences on institutional objections were identified: staff views within objecting institutions; support of external medical practitioners and pharmacists providing assisted dying services; nature of a patient’s illness; progression or state of a patient’s illness; patient’s geographical location; and the capability and assertiveness of a patient and/or caregiver. Conclusions Institutional objection to assisted dying is much-debated yet empirically understudied. This research found that in Victoria, objections were regularly reported by participants and adversely affected access to assisted dying and the wider end-of-life experience for patients and caregivers. This barrier arises in an assisted dying system that is already procedurally challenging, particularly given the limited window patients have to apply. Better regulation may be needed as Victoria’s existing policy approach appears to preference institutional positions over patient’s choice given existing power dynamics. (shrink)

In jurisdictions where voluntary assisted dying is legal, eligibility assessments, prescription and administration of a VAD substance are commonly performed by senior doctors. Junior doctors’ involvement is limited to a range of more peripheral aspects of patient care relating to VAD. In the Australian state of Victoria, where VAD has been legal since June 2019, all health professionals have a right under the legislation to conscientiously object to involvement in the VAD process, including provision of information about VAD. While this (...) protection appears categorical and straightforward, conscientious objection to VAD-related care is ethically complex for junior doctors for reasons that are specific to this group of clinicians. For junior doctors wishing to exercise a conscientious objection to VAD, their dependence on their senior colleagues for career progression creates unique risks and burdens. In a context where senior colleagues are supportive of VAD, the junior doctor’s subordinate position in the medical hierarchy exposes them to potential significant harms: compromising their moral integrity by participating, or compromising their career progression by objecting. In jurisdictions intending to provide all health professionals with meaningful conscientious objection protection in relation to VAD, strong specific support for junior doctors is needed through local institutional policies and culture. There are no data in this work. (shrink)

ObjectiveTo increase knowledge of how doctors perceive futile treatments and scarcity of resources at the end of life. In particular, their perceptions about whether and how resource limitations influence end-of-life decision making. This study builds on previous work that found some doctors include resource limitations in their understanding of the concept of futility.SettingThree tertiary hospitals in metropolitan Brisbane, Australia.DesignQualitative study using in-depth, semistructured, face-to-face interviews. Ninety-six doctors were interviewed in 11 medical specialties. Transcripts of the interviews were analysed using thematic (...) analysis.ResultsDoctors’ perceptions of whether resource limitations were relevant to their practice varied, and doctors were more comfortable with explicit rather than implicit rationing. Several doctors incorporated resource limitations into their definition of futility. For some, availability of resources was one factor of many in assessing futility, secondary to patient considerations, but a few doctors indicated that the concept of futility concealed rationing. Doctors experienced moral distress due to the resource implications of providing futile treatment and the lack of administrative supports for bedside rationing.ConclusionsDoctors’ ability to distinguish between futility and rationing would be enhanced through regulatory support for explicit rationing and strategies to support doctors’ role in rationing at the bedside. Medical policies should address the distinction between resource limitations and futility to promote legitimacy in end-of-life decision making. (shrink)

BackgroundThis paper investigates the content of Australian policies that address withholding or withdrawing life-sustaining treatment to analyse the guidance they provide to doctors about the allocation of resources.MethodsAll publicly available non-institutional policies on withholding and withdrawing life-sustaining treatment were identified, including codes of conduct and government and professional organization guidelines. The policies that referred to resource allocation were isolated and analysed using qualitative thematic analysis. Eight Australian policies addressed both withholding and withdrawing life-sustaining treatment and resource allocation.ResultsFour resource-related themes were (...) identified: doctors’ ethical duties to consider resource allocation; balancing ethical obligations to patient and society; fair process and transparent resource allocation; and legal guidance on distributive justice as a rationale to limit life-sustaining treatment.ConclusionOf the policies that addressed resource allocation, this review found broad agreement about the existence of doctors’ duties to consider the stewardship of scarce resources in decision-making. However, there was disparity in the guidance about how to reconcile competing duties to patient and society. There is a need to better address the difficult and confronting issue of the role of scarce resources in decisions about life-sustaining treatment. (shrink)

Background Victoria was the first Australian state to legalize voluntary assisted dying (elsewhere known as physician-assisted suicide and euthanasia). Some institutions indicated they would not participate in voluntary assisted dying. The Victorian government issued policy approaches for institutions to consider Objective To describe and analyse publicly available policy documents articulating an institutional objection to voluntary assisted dying in Victoria. Methods Policies were identified using a range of strategies, and those disclosing and discussing the nature of an institutional objection were thematically (...) analysed using the framework method. Results The study identified fifteen policies from nine policymakers and developed four themes: (1) extent of refusal to participate in VAD, (2) justification for refusal to provide VAD, (3) responding to requests for VAD, and (4) appeals to state-sanctioned regulatory mechanisms. While institutional objections were stated clearly, there was very little practical detail in most documents to enable patients to effectively navigate objections in practice. Conclusion This study demonstrates that despite having clear governance pathways developed by centralized bodies (namely, the Victorian government and Catholic Health Australia), many institutions’ public-facing policies do not reflect this guidance. Since VAD is contentious, laws governing institutional objection could provide greater clarity and regulatory force than policies alone to better balance the interests of patients and non-participating institutions. (shrink)

Background In June 2016, Canada legalized medical assistance in dying (MAiD). From the outset, some healthcare institutions (including faith-based and non-faith-based hospitals, hospices, and residential aged care facilities) have refused to allow aspects of MAiD onsite, resulting in patient transfers for MAiD assessments and provision. There have been media reports highlighting the negative consequences of these “institutional objections”, however, very little research has examined their nature and impact. Methods This study reports on findings from 48 semi-structured qualitative interviews conducted with (...) MAiD assessors and providers, MAiD team members (working to coordinate care and lead MAiD programs in institutions and health authorities), and family caregivers on their experiences with institutional objection. Participants were recruited from the Canadian provinces of British Columbia, Ontario, and Nova Scotia. Data were analyzed using inductive thematic analysis. Results Themes identified were: (1) basis for institutional objection (with objections commonly rooted in religious values and a particular philosophy of palliative care); (2) scope of objection (demonstrating a wide range of practices objected to); (3) lack of transparency regarding institutional position; (4) impacts on patients; (5) impacts on health practitioners; and (6) catalysts for change. Participants reported that many institutions’ objections had softened over time, lessening barriers to MAiD access and adverse impacts on patients and health practitioners. Participants attributed this positive change to a range of catalysts including advocacy by health practitioners and family members, policymaking by local health authorities, education, and relationship building. Nevertheless, some institutions, particularly faith-based ones, retained strong objections to MAiD, resulting in forced transfers and negative emotional and psychological impacts on patients, family members, and health practitioners. Conclusions This paper adds to the limited evidence base about the impacts of institutional objection and can inform practical and regulatory solutions in Canada and abroad. Reform is needed to minimize the negative impacts on patients, their caregivers, and health practitioners involved in MAiD practice. (shrink)

BackgroundJunior medical doctors have a key role in discussions and decisions about treatment and end-of-life care for people with dementia in hospital. Little is known about junior doctors’ decision-making processes when treating people with dementia who have advance care directives, or the factors that influence their decisions. To describe among junior doctors in relation to two hypothetical vignettes involving patients with dementia: their legal compliance and decision-making process related to treatment decisions; the factors influencing their clinical decision-making; and the factors (...) associated with accurate responses to one hypothetical vignette. MethodA cross-sectional survey of junior doctors, including trainees, interns, registrars and residents, on clinical rotation in five public hospitals located in one Australian state. The anonymous, investigator-developed survey was conducted between August 2018 and June 2019. Two hypothetical vignettes describing patients with dementia presenting to hospital with an ACD and either: bacterial pneumonia; or suspected stroke were presented in the survey. Participants were asked to indicate whether they would commence treatment, given the ACD instructions described in each vignette.ResultsOverall, 116 junior doctors responded. In Vignette 1, 58% of respondents selected the legally compliant option. Participants who chose the legally compliant option perceived ‘following patient wishes’ and ‘legal requirements to follow ACDs’ as equally important reasons for complying with the ACD. The most common reason for not selecting the legally compliant option in Vignette 1 was the ‘ACD is relevant in my decision-making process, but other factors are more relevant’. In Vignette 2, 72% of respondents indicated they would commence treatment and 18% selected they would not commence treatment.. Similar reasons influenced participant decision-making in Vignette 2, a less legally certain scenario.ConclusionsThere are critical gaps in junior doctors’ compliance with the law as it relates to the implementation of ACDs. Despite there being differences in relation to the legal answer and its certainty, clinical and ethical factors guided decision-making over and above the law in both vignettes. More education and training to guide junior doctors’ clinical decision-making and ensure compliance with the law is required. (shrink)

Burial rites are very common among many Africa communities. In the African context, burials are not the end of life but rather the beginning of another life in the land of the ancestors. In spite of the importance of the African funeral rites, the missional role of the church in mourning and the burial of the dead in the African communities, the COVID-19 pandemic led protocols and restrictions placed a huge challenge on the African religious and cultural practices.Contribution: In the (...) light of the above-named challenges, the article discusses the religious-cultural effect of the pandemic with special focus on the African liturgical and missiological challenges in the context of the COVID-19 restrictions on funerals and burial rites. (shrink)

This commentary focuses on two aspects of eye movement behaviour that E-Z Reader 7 currently makes no attempt to explain: the influence of higher order psycholinguistic processes on fixation durations, and orthographic influences on initial and refixation locations on words. From our understanding of the current version of the model, it is not clear how it may be readily modified to account for existing empirical data.

Gray takes an information-processing paradigm as his departure point, invoking a comparator as part of the system. He concludes that consciousness is to be found “in” the comparator but is unable to point to how the comparison takes place. Thus, the comparator turns out not to be an entity arising out of brain research per se, but out of the logic of the paradigm. In this way, Gray both reinvents dualism and remains trapped in the language game of his own (...) model – ending up dealing with the unknowable. (shrink)

A fluent and accurate new translation of the dialogue that, all of Plato's works, has seemed to speak most directly to the interests of contemporary analytical philosophers. White's extensive introduction explores the dialogue's center themes, its connection with related discussions in other dialogues, and its implication for the interpretation of Plato's metaphysics.

Working parents in are struggling to balance the demands of their occupation with those of childcare and homeschooling during the COVID-19 pandemic. Moreover, studies show that women are shouldering more of the burden and reporting greater levels of psychological distress, anxiety, and depression relative to men. However, research has yet to show that increases in psychological symptoms are linked to changes in stress during the pandemic. Herein, we conduct a small-N study to explore the associations between stress and psychological symptoms (...) during the pandemic among mothers using structural equation modeling, namely latent change score models. Thirty-three mothers completed questionnaires reporting current anxious and depressive symptoms, as well as stressful life experiences prior to-versus during the pandemic. Women endorsed significantly more stressful events during the pandemic, relative to the pre-pandemic period. Additionally, 58% of mothers scored as moderate-to-high risk for developing a stress-related physical illness in the near future because of their pandemic-level stress. Depressive symptoms were associated with the degree of change in life stress, whereas anxiety symptoms were more related to pre-pandemic levels of stress. The present study preliminarily sheds light on the nuanced antecedents to mothers’ experiences of anxious and depressive symptoms during the COVID-19 pandemic. Although further work is needed in larger, more diverse samples of mothers, this study highlights the potential need for appropriate policies, and prevention and intervention programs to ameliorate the effects of pandemics on mothers’ mental health. (shrink)

Do the ethical features of an artwork bear on its aesthetic value? This movie endorses misogyny, that song is a civil rights anthem, the clay constituting this statue was extracted with underpaid labor—are facts like these the proper bases for aesthetic evaluation? I argue that this debate has suffered from a false presupposition: that if the answer is yes (for at least some such ethical features), such considerations feature as pro tanto contributions to an artwork's overall aesthetic value, i.e., as (...) merits or flaws which make something have more or less overall aesthetic value. As the case of ethically laden, aesthetic evaluation makes clear, however, good aesthetic judgement is irreducibly multi-dimensional, e.g., "the movie has an engaging soundtrack, tasteful camera work, and takes a misogynistically prurient perspective on its female lead.'' Such a "non-summative" judgement refuses to reduce those various dimensions of aesthetic value to a single aggregate aesthetic evaluation, like "it's a 6/10" or "it's a pretty good movie!" I defend both the modest claim that such non-summative evaluations are not mistaken and the extremist claim that summative (i.e., unidimensional) aesthetic evaluation is defective by considering other domains of normative assessment in which summing seems inappropriate, notably including evaluations of people's character. (shrink)

In the study of expertise, few debates come as big as that between constructivists and realists. This chapter discusses the signal debate between realists and constructivists about expertise. It sets out a view that includes aspects of both the constructivist and realist position to show that insights from what is often considered to be rival camps can be incorporated in a position that does justice to both. The chapter argues that, while expertise is real, there are two distinct social dimensions (...) to the concept of expertise. It attempts to demonstrate two distinct ways in which expertise has a social dimension. First, the chapter develops an account according to which 'is an expert' is a triadic predicate. Second, it considers the fact that attributions of expertise are often done by institutions, i.e. by medical boards certifying doctors, etc. Both dimensions can be acknowledged without undermining the basic case for realism about expertise. (shrink)

However, the barriers and facilitators of such changes - law reform perspectives - have been virtually ignored. Why do so many attempts to change the law fail but others are successful? International Perspectives on End-of-Life Law Reform aims to address this question by drawing on ten case studies of end-of-life law reform from the United Kingdom, the United States, Canada, the Netherlands, Belgium and Australia. Written by leading end-of-life scholars, the book's chapters blend perspectives from law, medicine, bioethics and sociology (...) to examine sustained reform efforts to permit assisted dying and change the law about withholding and withdrawing life-sustaining treatment. Findings from this book not only shed light on changing end-of-life law but also provide insight more generally into how and why law reform succeeds in complex and controversial social policy areas. (shrink)

_From the Introduction:_ "Stoic philosophy, of which Epictetus (c. a.d. 50–130) is a representative, began as a recognizable movement around 300 b.c. Its founder was Zeno of Cytium (not to be confused with Zeno of Elea, who discovered the famous paradoxes). He was born in Cyprus about 336 b.c., but all of his philosophical activity took place in Athens. For more than 500 years Stoicism was one of the most influential and fruitful philosophical movements in the Graeco-Roman world. The works (...) of the earlier Stoics survive only in fragmentary quotations from other authors, but from the Renaissance until well into the nineteenth century, Stoic ethical thought was one of the most important ancient influences on European ethics, particularly because of the descriptions of it by Cicero, through surviving works by the Stoics Seneca, Marcus Aurelius, and also Epictetus--and also because of the effect that it had had in antiquity, and continued to have into the nineteenth century, on Christian ethical views. Nowadays an undergraduate or graduate student learning about ancient philosophy in a university course may well hear only about Plato and Aristotle, along perhaps with the presocratics; but in the history of Western thought and education this situation is somewhat atypical, and in most periods a comparable student would have learned as much or more about Stoicism, as well as two other major ancient philosophical movements, Epicureanism and Scepticism. In spite of this lack of explicit acquaintance with Stoic philosophers and their works, however, most students will recognize in Epictetus various ideas that are familiar through their effects on other thinkers, notably Spinoza, in our intellectual tradition.". (shrink)

The present article addresses the logic of the sphere, or the Sphere Model of Consciousness developed by Patrizio Paoletti over three decades of research. M.E.D. Ed., 2002; Flussi, territori, luogo II. M.E.D. Ed., 2002; Fare il punto nave. M.E.D. Ed., 2005; In: Proceedings conference at Leslie and Susan Gonda Multidisciplinary Brain Research Center. Bar Ilan University. Faculty of Neuroscience, Israel, 2007; Osservazione—Quaderni di Pedagogia per il Terzo Millennio, Ed. 3P, 2011; Mediazione—Quaderni di Pedagogia per il Terzo Millennio, Ed. 3P, 2011). (...) The SMC model has been experimentally applied in the educational field and lies at the base of neuroscientific and psychoeducational research conducted by the Paoletti Foundation. In recent years, it has been studied by several researchers in the field of neuroscience. Following a logical-mathematical introduction regarding the properties of the spherical shape, we illustrate for the first time the structuring of the model and its neural foundations. We emphasize the central space of the sphere, defined by the geometric model and highlight its descriptive and heuristic properties in relation to the study of consciousness. Finally, we present educational applications of the model, particularly with respect to the center of the sphere, defined in the current context as the “place of pre-existence.”. (shrink)

The present article addresses the logic of the sphere, or the Sphere Model of Consciousness developed by Patrizio Paoletti over three decades of research. M.E.D. Ed., 2002; Flussi, territori, luogo II. M.E.D. Ed., 2002; Fare il punto nave. M.E.D. Ed., 2005; In: Proceedings conference at Leslie and Susan Gonda Multidisciplinary Brain Research Center. Bar Ilan University. Faculty of Neuroscience, Israel, 2007; Osservazione—Quaderni di Pedagogia per il Terzo Millennio, Ed. 3P, 2011; Mediazione—Quaderni di Pedagogia per il Terzo Millennio, Ed. 3P, 2011). (...) The SMC model has been experimentally applied in the educational field and lies at the base of neuroscientific and psychoeducational research conducted by the Paoletti Foundation. In recent years, it has been studied by several researchers in the field of neuroscience. Following a logical-mathematical introduction regarding the properties of the spherical shape, we illustrate for the first time the structuring of the model and its neural foundations. We emphasize the central space of the sphere, defined by the geometric model and highlight its descriptive and heuristic properties in relation to the study of consciousness. Finally, we present educational applications of the model, particularly with respect to the center of the sphere, defined in the current context as the “place of pre-existence.”. (shrink)

A popular response to the Exclusion Argument for physicalism maintains that mental events depend on their physical bases in such a way that the causation of a physical effect by a mental event and its physical base needn’t generate any problematic form of causal overdetermination, even if mental events are numerically distinct from and irreducible to their physical bases. This paper presents and defends a form of dualism that implements this response by using a dispositional essentialist view of properties to (...) argue that the psychophysical laws linking mental events to their physical bases are metaphysically necessary. I show the advantages of such a position over an alternative form of dualism that merely places more “modal weight” on psychophysical laws than on physical laws. The position is then defended against the objection that it is inconsistent with dualism. Lastly, some suggestions are made as to how dualists might clarify the contribution that mental causes make to their physical effects. (shrink)

The Exclusion Argument for physicalism maintains that since (1) every physical effect has a sufficient physical cause, and (2) cases of causal overdetermination are rare, it follows that if (3) mental events cause physical events as frequently as they seem to, then (4) mental events must be physical in nature. In defence of (1), it is sometimes said that (1) is supported if not entailed by conservation laws. Against this, I argue that conservation laws do not lend sufficient support to (...) (1) to render its denial ‘unscientific’, and that those who accept (3) and deny (4) may consequently respond to the Exclusion Argument by denying (1) without thereby setting themselves at odds with current science. I also argue that conservation laws are compatible with (3) and the negation of (4), and that one can therefore accept conservation laws and (3) while denying both (1) and (4). (shrink)

This paper argues for a theory of phenomenal intentionality (herein referred to as ‘Structuralism’), according to which perceptual experiences only possess intentional content when their phenomenal components are appropriately related to one another. This paper responds to the objections (i) that Structuralism cannot explain why some experiences have content while others do not, or (ii) why contentful experiences have the specific contents that they have. Against (i), I argue that to possess content, an experience must present itself as an experience (...) of something distinct from itself, and that only experiences whose components are suitably structured satisfy this requirement. Against (ii), I argue that Structuralists can provide a deeper explanation of perceptual content than other theories of phenomenal intentionality by showing how the content-determining relations among our experiences depend on the selection pressures under which our perceptual systems developed. (shrink)

This paper proposes an analysis of statements about universals according to which such statements assert nothing more than that the evidence we’d take to confirm them obtains, where this evidence is understood to consist solely of patterns in the behavior of particulars that cannot be explained by other regularities in the way things behave. On this analysis, to say that a universal exists is simply to say that there is such a pattern in the behavior of certain particulars, and for (...) any predicate F that is presumed to correspond to a universal, to say that a particular is F is simply to say that its behavior exhibits a pattern of this sort. I argue that there is no theoretical work that we want postulations and ascriptions of universals to do that they’d be unfit for if analyzed in this way, and consequently that there is no reason to treat such statements as asserting anything more than what the proposed analysis suggests. (shrink)

Chalmers’ meta-problem of consciousness is the problem of explaining “problem reports”; i.e. reports to the effect that phenomenal consciousness has the various features that give rise to the hard problem. Chalmers suggests that solving the meta-problem will likely “shed significant light on the hard problem.” Against this, I argue that work on the meta-problem will likely fail to make the hard problem any easier. For each of the main stances on the hard problem can provide an account of problem reports, (...) and we have no way of deciding which of these accounts gives the correct explanation of an individual’s problem reports without presupposing a stance on the hard problem. We thus cannot determine which of the available solutions to the meta-problem is correct without having already solved the hard problem. (shrink)

Ecological research and conservation practice frequently raise difficult and varied ethical questions for scientific investigators and managers, including duties to public welfare, nonhuman individuals (i.e., animals and plants), populations, and ecosystems. The field of environmental ethics has contributed much to the understanding of general duties and values to nature, but it has not developed the resources to address the diverse and often unique practical concerns of ecological researchers and managers in the field, lab, and conservation facility. The emerging field of (...) “ecological ethics” is a practical or scientific ethics that offers a superior approach to the ethical dilemmas of the ecologist and conservation manager. Even though ecological ethics necessarily draws from the principles and commitments of mainstream environmental ethics, it is normatively pluralistic, including as well the frameworks of animal, research, and professional ethics. It is also methodologically pragmatic, focused on the practical problems of researchers and managers and informed by these problems in turn. The ecological ethics model offers environmental scientists and practitioners a useful analytical tool for identifying, clarifying, and harmonizing values and positions in challenging ecological research and management situations. Just as bioethics provides a critical intellectual and problem-solving service to the biomedical community, ecological ethics can help inform and improve ethical decision making in the ecology and conservation communities. (shrink)

Setting aside all exclusion-style worries about the redundancy of postulating additional, non-physical mental causes for effects that can already be explained in purely physical terms, dualists who treat mental properties as supervening on physical properties still face a further problem: in cases of mental-to-mental causation, they cannot avoid positing an implausibly coincidental coordination in the timing of the distinct causal processes terminating, respectively, in the mental effect and its physical base. I argue that this problem arises regardless of whether one (...) treats the mental cause as causing both the mental effect and its physical base, or whether one treats the latter as having instead been caused by some physical state, and that the problem also does not depend on which theory of causation one adopts. A third option of treating the mental cause and its physical base as producing the mental effect and its physical base by a single causal process that they both contribute to is found to come up short as well. (shrink)

Over several decades, ethics and law have been applied to medical education and practice in a way that reflects the continuation during the twentieth century of the strong distinction between facts and values. We explain the development of applied ethics and applied medical law and report selected results that reflect this applied model from an empirical project examining doctors’ decisions on withdrawing/withholding treatment from patients who lack decision-making capacity. The model is critiqued, and an alternative “constitutive” model is supported on (...) the basis that medicine, medical law, and medical ethics exemplify the inevitable entanglement of facts and values. The model requires that ethics and law be taught across the medical education curriculum and integrated with the basic and clinical sciences and that they be perceived as an integral component of medical evidence and practice. Law, in particular, would rank as equal in normative authority to the relevant clinical scientific “facts” of the case, with graduating doctors having as strong a basic command of each category as the other. The normalization of legal knowledge as part of the clinician’s evidence base to be utilized in practice may provide adequate consolation for clinicians who may initially resent further perceived incursions on their traditional independence and discretion. (shrink)

Theories of phenomenal intentionality have been claimed to resolve certain worries about the indeterminacy of mental content that rival, externalist theories face. Thus far, however, such claims have been largely programmatic. This paper aims to improve on prior arguments in favor of phenomenal intentionality by using attention and Gestalt principles as specific examples of factors that influence the phenomenal character of perceptual experience in ways that thereby help determine perceptual content. Some reasons are then offered for rejecting an alternative interpretation (...) of these examples, according to which the phenomenal effects of attention and Gestalt principles play no role in the determination of perceptual content. (shrink)

Kotzee and Smit explain why, if unicorns don't exist, then they could not possibly have existed. In fact, even if horned horses were discovered somewhere, they would not necessarily be unicorns. The key to understanding why this is so lies in understanding how so-called natural kind terms function.

This article argues that standard causal and functionalist definitions of realization fail to account for the realization of entities that cannot be individuated in causal or functional terms. By modifying such definitions to require that realizers also logically suffice for any historical properties of the entities they realize, one can provide for the realization of entities whose resistance to causal/functional individuation stems from their possession of individuative historical properties. But if qualia cannot be causally or functionally individuated, then qualia can (...) be physically realized only if the thesis that all things are physical or physically realized is insufficient for physicalism. (shrink)

J P White; Teacher Accountability and School Autonomy, Journal of Philosophy of Education, Volume 10, Issue 1, 30 May 2006, Pages 58–78, https://doi.org/10.1111.

A step by step, passage by passage analysis of the complete Republic. White shows how the argument of the book is articulated, the important interconnections among its elements, and the coherent and carefully developed train of though which motivates its complex philosophical reasoning. In his extensive introduction, White describes Plato's aims, introduces the argument, and discusses the major philosophical and ethical theories embodied in the Republic. He then summarizes each of its ten books and provides substantial explanatory and (...) interpretive notes. (shrink)

"A complete and unified account of Plato's epistemology... scholarly, historically sensitive, and philosophically sophisticated. Above all it is sensible.... White's strength is that he places Plato's preoccupation in careful historical perspective, without belittling the intrinsic difficulties of the problems he tackled.... White's project is to find a continuous argument running through Plato's various attacks on epistemological problems. No summary can do justice to his remarkable success." --Ronald B. De Sousa, University of Toronto, in Phoenix.

Philosophy & Public Affairs, Volume 50, Issue 1, Page 6-49, Winter 2022.