Background: Dementia care at home often involves decisions in which the caregiver must weigh safety concerns with respect for autonomy. These dilemmas can lead to situations where caregivers provide care against the will of persons living with dementia, referred to as involuntary treatment. To prevent this, insight is needed into how family caregivers of persons living with dementia deal with care situations that can lead to involuntary treatment. Objective: To identify and describe family caregivers’ experiences regarding care decisions for situations (...) that can lead to involuntary treatment use in persons living with dementia at home. Research design: A qualitative descriptive interview design. Data were analysed using the Qualitative Analysis Guide of Leuven. Participants and research context: A total of 10 family caregivers providing care for 13 persons living with dementia participated in in-depth semi-structured interviews. Participants were recruited by registered nurses via purposive sampling. Ethical consideration: The study protocol was approved by the Ethics Committee of the University Hospitals Leuven and the Medical Ethical Test Committee Zuyderland. Findings: Family caregivers experience the decision-making process concerning care dilemmas that can lead to involuntary treatment as complicated, stressful and exhausting. Although they consider safety and autonomy as important values, they struggle with finding the right balance between them. Due to the progressive and unpredictable nature of dementia, they are constantly seeking solutions while they adapt to new situations. Family caregivers feel responsible and experience social pressure for the safety of persons living with dementia. They may be blamed if something adverse happens to the persons living with dementia, which increases an already stressful situation. Their experience is influenced by characteristics of the care triad such as practical and emotional support, knowledge, and previous experiences. Discussion and conclusion: To prevent involuntary treatment, professionals need to proactively inform family caregivers, and they need to support each other in dealing with complex care situations. (shrink)

Most of us think of memory in terms of the brain's ability to store and retrieve events, facts, and skills. Philosophers and cognitive scientists seek to understand memory in terms of causation and justification. This article steps back from these considerations to reflect broadly on what memory is. Drawing on the paradigm shift underway in mind sciences, I explore the implications of the emerging understanding of cognition as embodied, embedded, extended, and enacted. This new paradigm undermines epistemological dualism and individualism (...) and makes it possible to view memory as an ecological process. (shrink)

Applying an evolutionary framework, we investigate how a reputation mechanism and a buyer insurance (as used on Internet market platforms such as eBay) interact to promote trustworthiness and trust in markets with moral hazard problems. Our analysis suggests that the costs involved in giving reliable feedback determine the gains from trade that can be obtained in equilibrium. Buyer insurance, on the other hand, can affect the trading dynamics and equilibrium selection. We find that, under reasonable conditions, buyer insurance crowds out (...) trust, and trustworthiness. (shrink)

We have identified a sample of 53 societies outside of the classical Himalayan and Marquesean area that permit polyandrous unions. Our goal is to broadly describe the demographic, social, marital, and economic characteristics of these societies and to evaluate some hypotheses of the causes of polyandry. We demonstrate that although polyandry is rare it is not as rare as commonly believed, is found worldwide, and is most common in egalitarian societies. We also argue that polyandry likely existed during early human (...) history and should be examined from an evolutionary perspective. Our analysis reveals that it may be a predictable response to a high operational sex ratio favoring males and may also be a response to high rates of male mortality and, possibly, male absenteeism. Other factors may contribute, but our within-polyandry sample limits analysis. (shrink)

Big Ideas for Little Kids includes everything a teacher, a parent, or a college student needs to teach philosophy to elementary school children from picture books. Written in a clear and accessible style, the book explains why it is important to allow young children access to philosophy during primary-school education. Wartenberg also gives advice on how to construct a "learner-centered" classroom, in which children discuss philosophical issues with one another as they respond to open-ended questions by saying whether they agree (...) or disagree with what others have said. (shrink)

The aim of this study is to explore how nurses perceive patient participations of patients over 75 years old undergoing hemodialysis treatment in dialysis units, and of their next of kin. Ten nurses told stories about what happened in the dialysis units. These stories were analyzed with critical discourse analysis. Three discursive practices are found: (1) the nurses’ power and control; (2) sharing power with the patient; and (3) transferring power to the next of kin. The first and the predominant (...) discursive practice can be explained with an ideology of paternalism, in which the nurses used biomedical explanations and the ethical principle of benefice to justify their actions. The second can be explained with an ideology of participation, in which the nurses used ethical narratives as a way to let the patients participate in the treatment. The third seemed to involve autonomous decision-making and the ethical principle of autonomy for the next of kin in the difficult end-of-life decisions. (shrink)

PurposeScarce evidence exists regarding end-of-life decision (EOLD) in neurocritically ill patients. We investigated the factors associated with EOLD making, including the group and individual characteristics of involved healthcare professionals, in a multiprofessional neurointensive care unit (NICU) setting.Materials and methodsA prospective, observational pilot study was conducted between 2013 and 2014 in a 10-bed NICU. Factors associated with EOLD in long-term neurocritically ill patients were evaluated using an anonymised survey based on a standardised questionnaire.Results8 (25%) physicians and 24 (75%) nurses participated in (...) the study by providing their ‘treatment decisions’ for 14 patients at several time points. EOLD was ‘made’ 44 (31%) times, while maintenance of life support 98 (69%) times. EOLD patterns were not significantly different between professional groups. The individual characteristics of the professionals (age, gender, religion, personal experience with death of family member and NICU experience) had no significant impact on decisions to forgo or maintain life-sustaining therapy. EOLD was patient-specific (intraclass correlation coefficient: 0.861), with the presence of acute life-threatening disease (OR (95% CI): 18.199 (1.721 to 192.405), p=0.038) and low expected patient quality of life (OR (95% CI): 9.276 (1.131 to 76.099), p=0.016) being significant and independent determinants for withholding or withdrawing life-sustaining treatment.ConclusionsOur findings suggest that EOLD in NICU relies mainly on patient prognosis and not on the characteristics of the healthcare professionals. (shrink)

В статье философия характеризуется на основе дискурсной парадигмы анализа: как текст, интеллектуальная деятельность и коммуникация. Характеризуются два равнозначных аспекта философского дискурса - когнитивный и коммуникативный. Обсуждается феномен философских контроверз, специфика философского спора, выразительные (знаковые) средства философского дискурса, роль мировоззренческого дискурса в современной общественно-политической ситуации в стране.

Because factory-farmed meat production inflicts gratuitous suffering upon animals and wreaks havoc on the environment, there are morally compelling reasons to become vegetarian. Yet industrial plant agriculture causes the death of many field animals, and this leads some to question whether consumers ought to get some of their protein from certain kinds of non factory-farmed meat. Donald Bruckner, for instance, boldly argues that the harm principle implies an obligation to collect and consume roadkill and that strict vegetarianism is thus immoral. (...) But this argument works only if the following claims are true: all humans have access to roadkill, roadkill would go to waste if those who happen upon it don’t themselves consume it, it’s impossible to harvest vegetables without killing animals, the animals who are killed in plant production are all-things-considered harmed by crop farming, and the best arguments for vegetarianism all endorse the harm principle. As I will argue in this paper, each claim is deeply problematic. Consequently, in most cases, humans ought to strictly eat plants and save the roadkill for cats. (shrink)

An adequate theory of rights ought to forbid the harming of animals to promote trivial interests of humans, as is often done in the animal-user industries. But what should the rights view say about situations in which harming some animals is necessary to prevent intolerable injustices to other animals? I develop an account of respectful treatment on which, under certain conditions, it’s justified to intentionally harm some individuals to prevent serious harm to others. This can be compatible with recognizing the (...) inherent value of the ones who are harmed. My theory has important implications for contemporary moral issues in nonhuman animal ethics, such as the development of cultured meat and animal research. (shrink)

In recent discussions, it has been argued that a theory of animal rights is at odds with a liberal abortion policy. In response, Francione (1995) argues that the principles used in the animal rights discourse do not have implications for the abortion debate. I challenge Francione’s conclusion by illustrating that his own framework of animal rights, supplemented by a relational account of moral obligation, can address the moral issue of abortion. I first demonstrate that Francione’s animal rights position, which grounds (...) moral consideration in sentience, is committed to the claim that a sentient fetus has a right to life. I then illustrate that a fully developed account of animal rights that recognizes the special obligations humans have to assist animals when we cause them to be dependent and vulnerable through our voluntary actions or omissions is committed to the following: a woman also has a special obligation to assist a sentient fetus when she causes it to be dependent and vulnerable through her voluntary actions or omissions. From these considerations, it will become evident that a fully developed and consistent animal rights ethic does in fact have implications for the abortion discussion. (shrink)

In The Case for Animal Rights, Tom Regan argues that although all subjects-of-a-life have equal inherent value, there are often differences in the value of lives. According to Regan, lives that have the highest value are lives which have more possible sources of satisfaction. Regan claims that the highest source of satisfaction, which is available to only rational beings, is the satisfaction associated with thinking impartially about moral choices. Since rational beings can bring impartial reasons to bear on decision making, (...) Regan maintains that they have an additional possible source of satisfaction that nonrational beings do not have and, consequently, the lives of rational beings turn out to have greater value.. (shrink)

This grounded study investigated the negotiation of authorship by faculty members, graduate student mentors, and their undergraduate protégés in undergraduate research experiences at a private research university in the northeastern United States. Semi-structured interviews using complementary scripts were conducted separately with 42 participants over a 3 year period to probe their knowledge and understanding of responsible authorship and publication practices and learn how faculty and students entered into authorship decision-making intended to lead to the publication of peer-reviewed technical papers. Herein (...) the theoretical model for the negotiation of authorship developed through the analysis of these interviews is reported. The model identifies critical causal and intervening conditions responsible for the coping strategies faculty and students employ, which, in our study, appear to often produce unfortunate consequences for all involved. The undergraduate student researchers and their graduate student mentors interviewed in this study exhibited a limited understanding of authorship and the requirements for authorship in their research groups. The power differential between faculty and students, the students’ limited epistemic development, the busy-ness of the faculty, and the faculty’s failure to prioritize authorship have been identified as key factors inhibiting both undergraduate and graduate students from developing a deeper understanding of responsible authorship and publication practices. Implications for graduate education and undergraduate research are discussed, and strategies for helping all students to develop a deeper understanding of authorship are identified. (shrink)

The abilities to attribute an action to its proper agent and to understand its meaning when it is produced by someone else are basic aspects of human social communication. Several psychiatric syndromes, such as schizophrenia, seem to lead to a dysfunction of the awareness of one’s own action as well as of recognition of actions performed by other. Such syndromes offer a framework for studying the determinants of agency, the ability to correctly attribute actions to their veridical source. Thirty normal (...) subjects and 30 schizophrenic patients with and without hallucinations and/or delusional experiences were required to execute simple finger and wrist movements, without direct visual control of their hand. The image of either their own hand or an alien hand executing the same or a different movement was presented on a TV-screen in real time. The task for the subjects was to discriminate whether the hand presented on the screen was their own or not. Hallucinating and deluded schizophrenic patients were more impaired in discriminating their own hand from the alien one than the non-hallucinating ones, and tended to misattribute the alien hand to themselves. Results are discussed according to a model of action control. A tentative description of the mechanisms leading to action consciousness is proposed. (shrink)

A collection of Essays over the last 20 years, exploring different dimensions of the philosophical debate on "subjecthood" and "subjectivity" in Modernity, as it was framed by the "Controversy on the subject" from the 1960's, and showing how it is now continued in a "controversy on the Universal.".

Recent discussions in the just war literature suggest that soldiers have a duty to assume certain risks in order to protect the lives of all innocent civilians. I challenge this principle of risk by arguing that it is justified neither as a principle that guides the conduct of combat soldiers, nor as a principle that guides commanders in the US military. I demonstrate that the principle of risk fails on the first account because it requires soldiers both to violate their (...) strict duty of obedience and loyalty and to exceed their special obligations to protect their fellow comrades, the state, the state's constituents and other protected civilians. I then illustrate that the principle of risk fails on the second account since it conflicts with the commander's primary obligation to protect and promote the welfare and lives of his or her soldiers. I conclude by arguing that we cannot reasonably expect soldiers and commanders to adhere to the principle of risk until there is a radical, institutional-level transformation of militaristic goals, values, strategies, policies, warrior codes and expectations of service members in the US Armed Forces. (shrink)

Deeply moved by his experiences in the trenches of the First World War, the Scottish philospher John Macmurray came to challenge the conventions inherited from European traditions of thought and mounted an assault on impersonal philosophies that failed to address needs and emotional reality.

Great advances have been made of late years in the understanding of ancient artillery, but the difference between the παλíντινιν and the εθτινιν seems to remain a riddle still inviting solution. In tentatively accepting the invitation, we are met at the outset by a certain amount of fog due to the fact that ancient guns were classed by two methods which produce a cross division. It will pay us to dispel this fog, or at any rate to find our bearings (...) in it as exactly as may be, before going further. (shrink)

The rise of modern natural sciences was based on the belief that knowledge about nature would increase steadily and that sooner or later it would prove useful for people and society. How these expectations shaped the self-image and the development of the natural sciences is the subject of this book. It turns out that expectations have repeatedly changed: from the universal ideal of utility of the 17th and 18th centuries to the promise of technical progress that is decisive today. The (...) unshakable belief in the usefulness of the natural sciences has always been accompanied by the insight that progress in knowledge can only be guaranteed if research is not based solely on short-term needs. In her story of the modern understanding of science, Désirée Schauz draws a bow from early modern natural research to the natural sciences of the 20th century. With its long-term perspective and its conceptual historical instruments, this book not only makes an important contribution to the modern history of science, but also provides a historically sound basis for current debates on science and innovation policy."-- publisher's website. (shrink)

In my 1993 IJPS paper it was suggested that postmodernist verdicts on ‘the death of philosophy’ relied on a rejection of any ‘substantive’ or ‘metaphysical’ notion of truth. The present paper relates these verdicts to Wittgenstein’s alleged ‘philosophical quietism’. In both cases, for example, there is a rejection of ‘depth’. Various characterisations of Wittgenstein’s position are questioned, including the idea that his quietism consists in showing the impossibility of sceptical challenges to our ‘hinge’ propositions and beliefs. It is then argued, (...) however, that recognition of the groundlessness of beliefs (and practices), far from curing ‘vertigo’ or ‘Angst’, is apt to inspire it. In a final section, I propose that the ‘metaphysical horror’ at the impossibility of articulating grounds for our beliefs can be allayed only by the thought that these answer to a reality that cannot be articulated and must therefore remain a mystery. One role for philosophy might be to cultivate a sense of this mystery and trace its implications for how we should live. (shrink)

In the Caribbean as in many other areas costly biomedical resources and personnel are limited, and more and more people are turning to alternative medicine and folk practitioners for health care. To meet the goal of providing health care for all, research on nonbiomedical therapies is needed, along with legal recognition of folk practitioners to establish standards of practice.