During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by “crisis standards of care,” but they have key differences. We critically appraise one of the most fundamental differences among policies, namely the use of criteria to categorically exclude (...) certain patients from eligibility for otherwise standard medical services. We examine these categorical exclusion criteria from ethical, legal, disability, and implementation perspectives. Focusing our analysis on the most common type of exclusion criteria, which are disease-specific, we conclude that optimal policies for critical care resource allocation and the use of cardiopulmonary resuscitation (CPR) should not use categorical exclusions. We argue that the avoidance of categorical exclusions is often practically feasible, consistent with public health norms, and mitigates discrimination against persons with disabilities. (shrink)

Business Ethics, the Environment &Responsibility, Volume 31, Issue 4, Page 1157-1173, October 2022.

This collection of essays presents a novel interpretation of a signature work of Alexander of Aphrodisias, and of the Stoic philosophy he seeks to refute. It covers all chapters of the work, challenging existing scholarship in significant ways.

We contest two claims: (1) that language, understood as the processing of abstract symbolic forms, is an instrument of cognition and rational thought, and (2) that conventional notions of turn-taking, exchange structure, and move analysis, are satisfactory as a basis for theorizing communication between living, feeling agents. We offer an enkinaesthetic theory describing the reciprocal affective neuro-muscular dynamical flows and tensions of co- agential dialogical sense-making relations. This “enkinaesthetic dialogue” is characterised by a preconceptual experientially recursive temporal dynamics forming the (...) deep extended melodies of relationships in time. An understanding of how those relationships work, when we understand and are ourselves understood, when communication falters and conflict arises, will depend on a grasp of our enkinaesthetic intersubjectivity. (shrink)

Patient competence, defined as the ability to reason, appreciate, understand, and express a choice is rarely discussed in patients with obsessive compulsive disorder, and coercive measures are seldom used. Nevertheless, a psychiatrist of psychologist may doubt whether OCD patients who refuse treatment understand their disease and the consequences of not being treated, which could result in tension between respecting the patient’s autonomy and beneficence. The purpose of this article is to develop a notion of competence that is grounded in clinical (...) practice and corresponds with the experiences of patients with obsessions and/or compulsions. We present a naturalistic case study giving both the patient’s and the therapist’s perspective based on in-depth interviews and a narrative analysis. The case study shows that competence is not merely an assessment by a therapist, but also a co-constructed reality shaped by the experiences and stories of patient and therapist. The patient, a medical student, initially told her story in a restitution narrative, focusing on cognitive rationality. Reconstructing the history of her disease, her story changed into a quest narrative where there was room for emotions, values and moral learning. This fitted well with the therapist’s approach, who used motivational interventions with a view to appealing to the patient’s responsibility to deal with her condition. We conclude that in practice both the patient and therapist used a quest narrative, approaching competence as the potential for practical reasoning to incorporate values and emotions. (shrink)

This volume sheds new light on Alexander of Aphrodisias' On Mixture and Growth as an intelligent and carefully crafted rebuttal of Stoic blending, which Alexander regarded as the closest rival of his own brand of hylomorphism. The authors explore Alexander's dialectical method and determine the precise character of the Stoic theory he attacks. The problematic notions of mutual co-extension and infinite division appear in their proper context, while the successive stages of the process of blending are carefully distinguished from the (...) resulting state of the blend. In this perspective the discussion of growth that closes Alexander's work finds its natural place. (shrink)

In this short paper I will introduce an idea which, I will argue, presents a fundamental additional challenge to the machine consciousness community. The idea takes the questions surrounding phenomenology, qualia and phenomenality one step further into the realm of intersubjectivity but with a twist, and the twist is this: that an agent’s intersubjective experience is deeply felt and necessarily co-affective; it is enkinaesthetic, and only through enkinaesthetic awareness can we establish the affective enfolding which enables first the perturbation, and (...) then the balance and counter-balance, the attunement and co-ordination of whole-body interaction through reciprocal adaptation. (shrink)

In 1976 Raymond Williams commented, ‘Culture is one of the two or three most complicated words in the English language.’ Such implied difficulty has not prevented Bloomsbury Academic, since the 2000s, from publishing around forty series of their well-produced and generously illustrated Cultural Histories, with, according to their website, a further fifty in progress. Each series contains six volumes, each book covering, in theory, the same chronological period (antiquity, the Middle Ages, the Renaissance, the Enlightenment, the age of empire and (...) the modern age), though there is some variation depending on precise topic. The idea is that one can use these books not only to read ‘horizontally’ about a subject across time, but also ‘vertically’ through different subjects in the same period – a idea made easier by the e-texts of the series on Bloomsbury's website. (shrink)

© 2015 Elsevier Inc.Postnatal organogenesis occurs in an immune competent environment and is tightly controlled by interplay between positive and negative regulators. Innate immune cells have beneficial roles in postnatal tissue remodeling, but roles for the adaptive immune system are currently unexplored. Here we show that adaptive immune responses participate in the normal postnatal development of a non-lymphoid epithelial tissue. Since the mammary gland is the only organ developing predominantly after birth, we utilized it as a powerful system to study (...) adaptive immune regulation of organogenesis. We found that antigen-mediated interactions between mammary antigen-presenting cells and interferon-γ -producing CD4+ T helper 1 cells participate in MG postnatal organogenesis as negative regulators, locally orchestrating epithelial rearrangement. IFNγ then affects luminal lineage differentiation. This function of adaptive immune responses, regulating normal development, changes the paradigm for studying players of postnatal organogenesis and provides insights into immune surveillance and cancer transformation. Plaks et al. (shrink)

Phantom limb experiences demonstrate an unexpected degree of fragility inherent in our self-perceptions. This is perhaps most extreme when congenitally absent limbs are experienced as phantoms. Aplasic phantoms highlight fundamental questions about the physiological bases of self-experience and the ontogeny of a physical, embodied sense of the self. Some of the most intriguing of these questions concern the role of mirror neurons in supporting the development of self–other mappings and hence the emergence of phantom experiences of congenitally absent limbs. In (...) this paper, we will examine the hypothesis that aplasic phantom limb experience is the result of an ontogenetic interplay between body schemas and mirror neuron activity and that this interplay is founded on embedding in a social context. Phantom limb experience has been associated with the persistence of subjective experience of a part of the body after deafferentation through surgical or traumatic removal. We maintain that limited association is inconsistent with the extent to which phantom limb experience is reported by aplasic individuals. (shrink)

My aim in this paper is to go some way towards showing that the maintenance of hard and fast dichotomies, like those between mind and body, and the real and the virtual, is untenable, and that technological advance cannot occur with being cognisant of its reciprocal ethical implications. In their place I will present a softer enactivist ontology through which I examine the nature of our engagement with technology in general and with virtual realities in particular. This softer ontology is (...) one to which I will commit Kant, and from which, I will show, certain critical moral and emotional consequences arise. It is my contention that Kant’s logical subject is necessarily embedded in the world and that Kant, himself, would be content with this view as an expression of his inspired response to the ‘‘scandal to philosophy... that the existence of things outside us... must be accepted merely on faith’’ [Bxl]. In keeping with his arguments for the a priori framing of intuition, the a priori structuring of experience through the spontaneous application of the categories, the synthesis of the experiential manifold, and the necessity of a unity of apperception, I will present an enactivist account of agency in the world, and argue that it is our embodied and embedded kinaesthetic engagement in our world which makes possible the syntheses of apprehension, reproduction and recognition, and which, in turn, make possible the activity of the reproductive or creative imagination. (shrink)

It is now generally accepted that human beings are naturally, possibly even essentially, intersubjective. This chapter offers a robust defence of an enhanced and extended intersubjectivity, criticising the paucity of individuating notions of agency and emphasising the community and reciprocity of our affective co-existence with other living organisms and things. I refer to this modified intersubjectivity, which most closely expresses the implicit intricacy of our pre-reflective neuro-muscular experiential entanglement, as ‘enkinaesthesia’. The community and reciprocity of this entanglement is characterised as (...) dialogical, and in this dialogue, as part of our anticipatory preparedness, we have a capacity for intentional transgression, feeling our way with our world but, more particularly, co-feeling our way with the mind and intentions of the other. Thus we are, not so much ‘mind’-reading, as ‘mind’-feeling, and it is through this enkinaesthetic ‘mind’-feeling dialogue that values-realising activity originates and we uncover the deep roots of morality. (shrink)

This paper reports the introduction of electronic handsets, like those used on the television show 'Who Wants To Be A Millionaire?' into the teaching of philosophical logic. Logic lectures can provide quite a formidable challenge for many students, occasionally to the point of making them ill. Our rationale for introducing handsets was threefold: to get the students thinking and talking about the subject in a public environment; to make them feel secure enough to answer questions in the lectures because the (...) system enabled them to do this anonymously; and to build their confidence about their learning by their being able to see how they were progressing in relation to the rest of the students in the class. We have achieved all of these and more. Our experience has revealed that the use of handsets encourages a more dynamic form of student interaction in an environment - the lecture - that can, in the wrong hands, be utterly enervating, but they also provide an opportunity for the lecturer to respond to students' difficulties at the time when they really matter. In this paper, we discuss our case of rapid adoption, our grounds for judging it a success, and what that success seems to have depended on. (shrink)