We agree with van der Pijl et al that the question of how to ensure consent is obtained for procedures which occur during labour and childbirth is vitally important, and worthy of greater attention.1 However, we argue that the modified opt-out approach to consent outlined in their paper may not do enough to protect the choice and agency of birthing people. Moreover, while their approach reflects a pragmatic attempt to facilitate legal clarity and certainty in this context, this is not (...) necessarily responsive to the messy realities of decision-making during labour (and beyond). We outline some of our concerns with their proposals and demonstrate how these illuminate some broader, longstanding tensions around consent and medical law. The authors place significant focus on the particularities of labour, outlining six ways in which maternity care is ‘unlike the usual healthcare setting’ (van der Pijl M et al,1p4). We support the need for attentiveness to these particularities and the problematic nature of consent in this context. Recent scholarly attention on the possible ‘political, ethical and theoretical implications and meanings of birthing embodiment’ (Chadwick R,2p2) has invited more nuanced conversation about consent, agency and decision-making during labour. However, while recognising the embodied particularities of labour, we must also avoid essentialising the differences of labouring bodies and thereby reinforcing exclusionary norms of consent. This points to a long-standing tension in feminist theory between the universal and the particular; between recognising and responding to the powerlessness of individuals without …. (shrink)

Descartes held that practicing mathematics was important for developing the mental faculties necessary for science and a virtuous life. Otherwise, he maintained that the proper uses of mathematics were extremely limited. This article discusses his reasons which include a theory of education, the metaphysics of matter, and a psychologistic theory of deductive reasoning. It is argued that these reasons cohere with his system of philosophy.

We argue that Descartes’s theistic proofs in the ’Meditations’ are much simpler and straightforward than they are traditionally taken to be. In particular, we show how the causal argument of the "Third Meditation" depends on the intuitively innocent principle that nothing comes from nothing, and not on the more controversial principle that the objective reality of an idea must have a cause with at least as much formal reality. We also demonstrate that the so-called ontological "argument" of the "Fifth Meditation" (...) is best understood not as a formal proof but as an axiom, revealed as self-evident by analytic meditation. (shrink)

Psychedelics have been recognized as model interventions for studying altered states of consciousness. However, few empirical studies of the shamanic state of consciousness, which is anecdotally similar to the psychedelic state, exist. We investigated the neural correlates of shamanic trance using high-density electroencephalography (EEG) in 24 shamanic practitioners and 24 healthy controls during rest, shamanic drumming, and classical music listening, followed by an assessment of altered states of consciousness. EEG data were used to assess changes in absolute power, connectivity, signal (...) diversity, and criticality, which were correlated with assessment measures. We also compared assessment scores to those of individuals in a previous study under the influence of psychedelics. Shamanic practitioners were significantly different from controls in several domains of altered states of consciousness, with scores comparable to or exceeding that of healthy volunteers under the influence of psychedelics. Practitioners also displayed increased gamma power during drumming that positively correlated with elementary visual alterations. Furthermore, shamanic practitioners had decreased low alpha and increased low beta connectivity during drumming and classical music and decreased neural signal diversity in the gamma band during drumming that inversely correlated with insightfulness. Finally, criticality in practitioners was increased during drumming in the low and high beta and gamma bands, with increases in the low beta band correlating with complex imagery and elementary visual alterations. These findings suggest that psychedelic drug-induced and non-pharmacologic alterations in consciousness have overlapping phenomenal traits but are distinct states of consciousness, as reflected by the unique brain-related changes during shamanic trance compared to previous literature investigating the psychedelic state. (shrink)

This book is a wide-ranging examination of rationalist thought in philosophy from ancient times to the present day. Written by a superbly qualified cast of philosophers Critically analyses the concept of rationalism Focuses principally on the golden age of rationalism in the seventeenth and early eighteenth centuries Also covers ancient rationalism, nineteenth-century rationalism, and rationalist themes in recent thought Organised chronologically Various philosophical methods and viewpoints are represented.

It has recently been reported that some hospitals in the UK have placed a blanket restriction on the provision of maternal request caesarean sections as a result of the COVID-19 pandemic. Pregnancy and birthing services are obviously facing challenges during the current emergency, but we argue that a blanket ban on MRCS is both inappropriate and disproportionate. In this paper, we highlight the importance of MRCS for pregnant people’s health and autonomy in childbirth and argue that this remains crucial during (...) the current emergency. We consider some potential arguments—based on pregnant people’s health and resource allocation—that might be considered justification for the limitation of such services. We demonstrate, however, that these arguments are not as persuasive as they might appear because there is limited evidence to indicate either that provision of MRCS is always dangerous for pregnant people in the circumstances or would be a substantial burden on a hospital’s ability to respond to the pandemic. Furthermore, we argue that even if MRCS was not a service that hospitals are equipped to offer to all pregnant persons who seek it, the current circumstances cannot justify a blanket ban on an important service and due attention must be paid to individual circumstances. (shrink)

The evolution of modern human life history has involved substantial changes in the overall length of the subadult period, the introduction of a novel early childhood stage, and many changes in the initiation, termination, and character of the other stages. The fossil record is explored for evidence of this evolutionary process, with a special emphasis on middle childhood, which many argue is equivalent to the juvenile stage of African apes. Although the “juvenile” and “middle childhood” stages appear to be the (...) same from a broad comparative perspective, in that they begin with the eruption of the first molar and the achievement of the majority of adult brain size and end with sexual maturity, the detailed differences in the expression of these two stages, and how they relate to the preceding and following stages, suggest that a distinction should be maintained between them to avoid blurring subtle, but important, differences. (shrink)

This paper examines the relationship between modern theories of microeconomics and macroeconomics and, more generally, it evaluates the prospects of theoretically reducing macroeconomics to microeconomics. Many economists have shown strong interest in providing "microfoundations" for macroeconomics and much of their work is germane to the issue of theoretical reduction. Especially relevant is the work that has been done on what is called The Problem of Aggregation. On some accounts, The Problem of Aggregation just is the problem of reducing macroeconomics to (...) microeconomics. I show how to separate these problems and then try to determine to what extent particular kinds of solutions to The Problem of Aggregation succeed in reducing macroeconomics to microeconomics as well. I argue that reduction is not possible by this means given the current state of microeconomics. I also describe how reduction may be possible by means of (dis)aggregation if microeconomics is supplemented in a certain way with the results of experimental research on individual economic agents. (shrink)

This chapter contains section titled: Acknowledgments References and Further Reading.

In this paper I assess the labour ward admission policies introduced by some National Health Service trusts during the COVID-19 pandemic, arguing that these intersected with other policies in a manner which may have coerced birthing people into consenting to vaginal examinations they might have otherwise refused. In order to fully understand the potential severity of these policies, I situate this critique in the historical and contemporary context of the problematic relationship between consent and vaginal examinations. Identifying the legal wrongs (...) associated with performing coerced vaginal examinations, I highlight that the law is inadequately equipped to provide appropriate redress. Further, I illustrate that the issue explored in this paper reflects broader problems which exist with regard to the focus of, and the investment in, the maternity services. (shrink)

This chapter contains sections titled: I II III IV V.

This chapter contains section titled: The Simplicity of Descarteś Proofs and the Relation between Them The Causal Argument The Ontological Argument.

The correspondence between Leibniz and Arnauld was judged by Leibniz himself to be very useful for understanding his philosophy. Historians have concurred in this judgment. Leibniz did not find any philosophy of independent interest in the letters Arnauld sent him. Historians have, for the most part, also concurred in this finding. I shall argue that on one set of issues at least — modal metaphysics and free will — Arnauld accomplished more than facilitating Leibnizian elucidations. He held his own in (...) this dispute. Indeed, were it not for the general sophistication and superior handling of such issues as identity, unity, and the nature of body enjoyed by the Leibnizian system, the Cartesian position on modal metaphysics and free will espoused by Arnauld might have won the day in the eyes of later philosophers. A proper appreciation of the Cartesian framework should also make it of considerable interest to philosophers presently at work on the metaphysics of modality. I shall argue that Descartes and some Cartesians like Arnauld espoused a strongly actualist doctrine. This means they thought that all philosophically interesting uses of possibles were analyzable into facts about actually existing things. (shrink)

I advocate a method that strives to interpret important historical figures in philosophy as presenting philosophical systems of thought. This kind of systematic interpretation, as I shall call it, begins with the supposition that the philosophy being interpreted is itself systematic. This sometimes requires recovering the obscured systematicity. Section I gives a positive characterization of systematic interpretations. Section II notes some of the special obstacles that these interpretations must overcome if they are to be successful. Section III gives a brief (...) sketch of how one might systematically approach Locke’s Essay Concerning Human Understanding. That text is a good test case because Locke professes systematicity, but historians have produced daunting arguments for the conclusion that the text fails to present a coherent system. (shrink)

Those giving birth within modern maternity systems are recognised as facing a number of barriers to person-centred care. In this paper, I argue that in order to best facilitate the conditions for positive change, work needs to be done to provide a more granular articulation of the specific barriers. I then offer a nuanced and contextually aware articulation of one key component of the overall failure to ensure person-centred care: medical authority and the expectation of conformity. Articulating these barriers with (...) increased specificity is valuable, as it creates a stronger foundation from which to challenge existing problems which serve to constrain the autonomy of birthing individuals. The analysis offered in this paper also underscores the need for change at an institutional, rather than individual, level. (shrink)

Neither legalistic gender-neutral categories nor prior feminist theories adequately capture all of the gender dynamics of child sexual abuse. Surveys of 923 young adults, 88 of whom reported sexual contact with adults before they were 16, complemented by intensive follow-up interviews with 18 reporting contact, reveal that gendered constructions of sexuality and dominance make the experience of abuse significantly different for boys and girls. Girls nearly always had contact with men and tended to experience it as harmful abuse. Boys were (...) more likely to have contact with women than with men; they generally interpreted contact with women as consensual, but their contact with men as abusive. Extensions of feminist gender analysis are required to explain these patterns. (shrink)

Good scientific explanations sometimes appear to make use of averages. Using concrete examples from current economic theory, I argue that some confusions about how averages might work in explanations lead to both philosophical and economic problems about the interpretation of the theory. I formulate general conditions on potentially proper uses of averages to refine a notion of average explanation. I then try to show how this notion provides a means for resolving longstanding philosophical problems in economics and other quantitative social (...) sciences. (shrink)

Descartes’s interrelated theories of attributes and conceptual distinction (or rational distinc­tion) are developed. This follows Nolan (1997) in identifying substances and their attributes as they exist apart from the mind’s concepts. This resource is then used to articulate a solution to a famous problem about Descartes’s concept of substance. The key is that the concept of substance is itself to be regarded as an attribute of independently existing things.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Meaning in Spinoza’s MethodAlan Nelson and Noa SheinAaron V. Garrett. Meaning in Spinoza’s Method. New York: Cambridge University Press, 2003. Pp. xii + 240. Cloth, $60.00.This is a book about some fundamental aspects of Spinoza's mature metaphysics. The principal focus is on Part I of the Ethics concerning infinite substance, and on Part V concerning the intuitive knowledge that is the goal of philosophy. Within this focus, Garrett (...) concentrates on Spinoza's method. Garrett explains how he has been influenced by interpretations that stress the structural parallel between the synthetic, geometrical presentation of the Ethics and the relations among the ideas of the well-ordered mind. The Ethics proceeds by deriving propositions concerning substance's modes from definitions of substance and related notions while the mind, insofar as it is free from emotions, intuitively knows things as following from God. Garrett's distinctive thesis, however, is that Spinozistic enlightenment depends on the process of emending the intellect as described in one of Spinoza's earliest works, the Treatise on the Emendation of the Intellect. While this work strongly foreshadows many of Spinoza's mature doctrines, its exposition much more closely resembles the analytic, non-geometric approach of Descartes's Meditations. Spinoza's therapy for the emendation of our "inadequate" ideas closely parallels Descartes's analytic therapy for making what he calls confused ideas "clear and distinct."Garrett is on firm ground in arguing that the process of enlightenment cannot be an unbroken chain of intuitive deductions. For one thing, the definitions and axioms printed in a copy of the Ethics are first sensed by the reader and are not likely to produce immediately the requisite adequate ideas (172). An example of one of Garrett's interesting conclusions is that the definition of God as consisting of an infinity of attributes, the sixth of Part I of the Ethics (1D6), is preliminary and replaced in the process of therapeutic emendation by a definition of God as self caused. It is only after our ideas have become adequate at the end of the process that we are able to fully appreciate 1D6 (171).One might think that Garrett does not go far enough here because his point can be naturally extended. Definitions might assist us in the process of bringing our adequate ideas to light, but our cognitive goal is making these ideas themselves adequate. What then are the ideas we can make most adequate and exactly what distinguishes them from highly refined ideas that are nevertheless more inadequate than these? On one interpretation it is divine essence, that is, the attributes of thought and extension that are individually most adequately conceived after successful therapy. It is tempting to suppose that a single idea of God as both thinking and extended would be more adequate still, but Spinoza holds that our conceptions of these attributes are "really distinct" in a sense analogous to Descartes's(1P10). Spinoza's 1D6 definition of God as a substance consisting of both these attributes (and perhaps other inconceivable ones) thus seems to indicate a subsumption of the attributes we can conceive under the image of some printed or spoken words. Such an idea would be more inadequate than our adequate conceptions of the individual attributes. One is here strongly reminded of Descartes's characterization in Article 63 of the first Part of his Principles of Philosophy, "... we more readily understand extended substance or thinking substance than substance alone."In his seventh and concluding chapter, Garrett tackles the grand problems of intuitive knowledge or knowledge of "the third kind" and the sense in which Spinoza thought a part of the human mind is eternal. The discussion is necessarily complex, but one great advantage of Garrett's treatment is that he realizes intuitive knowledge cannot consist in the explicit deduction of particular things from God. The detailed determination of particular "everyday objects" requires sensory knowledge which is, of course, never perfectly determinate and therefore inherently inadequate. But we can acquire the "second kind" of adequate knowledge by understanding what our minds have in common with other determinate, finite things. This finally enables us to ascend to an appreciation of these... (shrink)

Over the past decade, support for reexamining and reconsidering the U.S. model of ethics review for protocols involving research with humans has grown, particularly for studies involving participants from multiple locales and organizations. The HMO Research Network received an infrastructure-building contract in 2004 that enabled us to evaluate issues in multi-institutional IRB review, examine possible changes, and propose a new model. We conducted key informant interviews and held meetings with IRB personnel, administrators, and researchers, eventually resulting in networkwide agreement to (...) pilot an alternative model of IRB review for minimal-risk, data-only studies that only entailed use of computerized data from our network sites. This article describes the organizational and interpersonal processes that led to the successful establishment of this alternative model, to inform other research consortia considering new multisite review models. (shrink)

The act of drawing a line or uttering a word is often seen as integral to the process of making art. This is especially obvious in music and the visual arts, but applies to literature, performance, and other arts as well. These collected essays, written by scholars from diverse fields, take a historical view of the richness of creation out of nothing (creatio ex nihilo) in order to draw out debates, sometimes implicit and sometimes formally stated, about the production and (...) reproduction of cultural meaning in a period of great change and novelty, between the beginnings of the medieval intellectual tradition and the imprint of the Enlightenment. The authors pose the following questions: Do tradition and creativity conflict with one another, or are they complementary? What are the tensions between composition and live performance? What is the role of the audience in perceiving the object of art? Are such objects fixed or flexible? What about the status of the event? Is the event part of creation, in the sense that it disturbs the still waters of historical continuity? These and other questions build on the foundation of Roland Barthes' concept of Degree Zero, offering new insights into what it means to create"--Back cover. (shrink)

This chapter provides a critical reflection on an ethnographic approach led by a non-Indigenous researcher in partnership with an Indigenous community-controlled health organization, and a team of Indigenous and non-Indigenous supervisors, advisors, critical friends, and mentors. The chapter explores the way the three interrelated principles of Indigenist research informed the study, as a critical reflection of the methodology’s achievement of a decolonizing research agenda. The flow of Maiwah provides a metaphor for the chapter’s diverse authorship. Maiwah’s tributaries, inlets, and banks (...) represent author voices at different points while the one River flowing represents coming together to form a broader collective story of the research that still respects the authors’ individual positioning. Maiwah’s flow also signifies the dialogical approach of the research – “tricky ground” for non-Indigenous researchers seeking to privilege Indigenous voices while remaining accountable to their own White privilege, particularly given that at its most basic level, research requires the “extraction of ideas” from participants. Yet, the flow of Maiwah also shows us the possibilities of research, where in this case, researcher and participants together cocreated new knowledge in support of their agendas. This process enabled both research outcomes and increased research capacity and confidence in the host agency and researcher. On this account, decolonizing research is perhaps more about relationship and devolving control over the process than it is about particular methods, and the respectful negotiation of epistemological meanings and representation of particular knowledges that can result. (shrink)