Antimicrobial resistance (AMR) is a global public health disaster driven largely by antibiotic use in human health care. Doctors considering whether to prescribe antibiotics face an ethical conflict between upholding individual patient health and advancing public health aims. Existing literature mainly examines whether patients awaiting consultations desire or expect to receive antibiotic prescriptions, but does not report views of the wider public regarding conditions under which doctors should prescribe antibiotics. It also does not explore the ethical significance of public views (...) or their sensitivity to awareness of AMR risks or the standpoint (self-interested or impartial) taken by participants. Methods: An online survey was conducted with a sample of the U.S. public (n = 158). Participants were asked to indicate what relative priority should be given to individual patients and society-at-large from various standpoints and in various contexts, including antibiotic prescription. Results: Of the participants, 50.3% thought that doctors should generally prioritize individual patients over society, whereas 32.0% prioritized society over individual patients. When asked in the context of AMR, 39.2% prioritized individuals whereas 45.5% prioritized society. Participants were significantly less willing to prioritize society over individuals when they themselves were the patient, both in general (p = .001) and in relation to AMR specifically (p = .006). Conclusions: Participants’ attitudes were more oriented to society and sensitive to collective responsibility when informed about the social costs of antibiotic use and when considered from a third-person rather than first-person perspective. That is, as participants came closer to taking the perspective of an informed and impartial “ideal observer,” their support for prioritizing society increased. Our findings suggest that, insofar as antibiotic policies and practices should be informed by attitudes that are impartial and well-informed, there is significant support for prioritizing society. (shrink)

In this paper, we draw inferences from the Nobel laureate Amartya Sen’s book, The Idea of Justice to inform the organisational justice literature. The extant societal-level theories of justice tend to emphasise aspects that are analogous to either the procedural or distributive dimensions of organisational justice. The Senian idea of comprehensive justice is different in that it synthesises the procedural- and distributive-related dimensions at the societal-level. We theorise that the Senian notion could be applied at the organisational-level to facilitate outcomes (...) that are actually valued by the workforce. Further, we contend that the emphasis on non-parochialism in the Senian notion of justice makes it particularly relevant to the ethics of multi-national corporations operating in alien cultures. To support our contention, we analyse the lean manufacturing practices of a Japanese MNC operating in India. Our case analysis demonstrates how Senian thinking helps one surface unjust outcomes that would otherwise go unacknowledged. Our analysis also offers tentative support to Senian claims about the capacity of human behaviour to undermine well-designed institutions. Concurring with the Senian view, which favours combating manifest injustice rather than fixating over designing perfectly just institutions, we derive some normative implications to advance the cause of striving for outcomes that are actually valued by the workforce. (shrink)

Nursing has a considerable history of theory development but has consistently struggled to reconcile theoretical reality and practice realities. Many authors have attempted to reconcile what has been called the “theory–practice gap,” but the space where these two realities enmesh has remained problematic and contentious (Aimei, Macau Journal of Nursing, 14, 2015, 13; Factor, Matienzo, & de Guzman, Nurse Education Today, 57, 2017, 82). The idea of the theory–practice gap has a significant history in nursing, but also continues to have (...) a significant presence within nursing literature and mythology up to the present (Aimei, Macau Journal of Nursing, 14, 2015, 13). In this paper, the space between theoretic reality and practice reality, as evidenced by the theory–practice gap, will be examined. A Heideggerian perspective of “dwelling” (Heidegger, 1971, Poetry, language, thought, New York, NY: Harper Colophon) will be used as a guiding discourse to move nursing away from this classic tension between theory and practice, towards a perspective where theory and practice are woven together as part of one reality. (shrink)

In Less Than Nothing, the pinnacle publication of a distinguished career, Slavoj i ek argues that it is imperative that we not simply return to Hegel but that we repeat and exceed his triumphs, overcoming his limitations by being even more ...

The latest book by the Slovenian critic Slavoj Zizek takes the work of French philosopher Gilles Deleuze as the beginning of a dazzling inquiry into the realms of radical politics, philosophy, film (Hitchcock, Fight Club ), and psychoanalysis. Of Organs without Bodies Joan Copjec ( Imagine There's No Woman ) has written: "With all his ususal humor and invention, Zizek -- the acknowledged master of the 180 degree turn -- here takes a trip into "enemy" territory to deliver Deleuze of (...) a marvelously rebellious child, one that seriously challenges Deleuze's other progeny with a surprising but convincing bid for succession. Those who thought Deleuze's forward march into the future would follow a straight path are forced to rethink their stance. From now on all readings of Deleuze will have to take a detour through this important -- even necessary -- book." Eric Santner ( On the Psychopathology of Everyday Life ) describes Organs without Bodies as offering "an entirely new degree of conceptual clarity and political urgency. Through his deep engagement with the logic of Deleuze's project, Zizek opens up new possibilities of thought beyond the terms of the current political debates on globalization, democratization, war on terror. Once again, Zizek has produced an utterly timely and radically untimely meditation." Recently profiled in The New Yorker , and hailed by the Village Voice as "the giant of Ljubljana," Zizek is one of the most provocative and entertaining thinkers at work today. (shrink)

Book synopsis: In this combative major new work, philosophical sharpshooter Slavoj Zizek looks for the kernel of truth in the totalitarian politics of the past. Examining Heidegger's seduction by fascism and Foucault's flirtation with the Iranian Revolution, he suggests that these were the 'right steps in the wrong direction.' On the revolutionary terror of Robespierre, Mao and the bolsheviks, Zizek argues that while these struggles ended in historic failure and horror, there was a valuable core of idealism lost beneath the (...) bloodshed. A redemptive vision has been obscured by the soft, decentralized politics of the liberal-democratic consensus. Faced with the coming ecological crisis, Zizekk argues the case for revolutionary terror and the dictatorship of the proletariat. A return to past ideals is needed despite the risks. In the words of Samuel Beckett: 'Try again. Fail again. Fail better.'. (shrink)

Whenever the membranes of the egg in which the foetus emerges on its way to becoming a new-born are broken, imagine for a moment that something flies off, and that one can do it with an egg as easily as with a man, namely the hommelette, or the lamella. The lamella is something extra-flat, which moves like the amoeba. It is just a little more complicated. But it goes everywhere. And as it is something - I will tell you shortly (...) why - that is related to what the sexed being loses in sexuality, it is, like the amoeba in relation to sexed beings, immortal - because it survives any division, and scissiparous intervention. And it can turn around. Well! This is not very reassuring. But suppose it comes and envelopes your face while you are quietly asleep... I can't see how we would not join battle with a being capable of these properties. But it would not be a very convenient battle. This lamella, this organ, whose characteristic is not to exist, but which is nevertheless an organ - I can give you more details as to its zoological place - is the libido. It is the libido, qua pure life instinct, that is to say, immortal life, irrepressible life, life that has need of no organ, simplified, indestructible life. It is precisely what is subtracted from the living being by virtue of the fact that it is subject to the cycle of sexed reproduction. And it is of this that all the forms of the objet a that can be enumerated are the representatives, the equivalents. Every word has a weight here, in this deceivingly poetic description of the mythic creature called by Lacan "lamella". Lacan imagines lamella as a version of what Freud called "partial object": a weird organ which is magically autonomized, surviving without a body whose organ it should have been, like a hand that wonders around alone in early Surrealist films, or like the smile in Alice in Wonderland that persists alone, even when the Cheshire cat's body is no longer present: "'All right', said the Cat; and this time it vanished quite slowly, beginning with the end of the tail, and ending with the grin, which remained some time after the rest of it had gone. 'Well! I've often seen a cat without a grin', thought Alice; 'but a grin without a cat! It's the most curious thing I ever saw in my life!'" The lamella is an entity of pure surface, without the density of a substance, an infinitely plastic object that can not only incessantly change its form, but can even transpose itself from one to another medium: imagine a "something" that is first heard as a shrilling sound, and then pops up as a monstrously distorted body. A lamella is indivisible, indestructible, and immortal - more precisely, undead in the sense this term has in horror fiction: not the sublime spiritual immortality, but the obscene immortality of the "living dead" which, after every annihilation, re-composes themselves and clumsily goes on. As Lacan puts it in his terms, lamella does not exist, it insists: it is unreal, an entity of pure semblance, a multiplicity of appearances which seem to envelop a central void - its status is purely fantasmatic. This blind indestructible insistence of the libido is what Freud called "death drive," and one should bear in mind that "death drive" is, paradoxically, the Freudian name for its very opposite, for the way immortality appears within psychoanalysis: for an uncanny excess of life, for an "undead" urge which persist beyond the cycle of life and death, of generation and corruption. This is why Freud equates death drive with the so-called "compulsion-to-repeat," an uncanny urge to repeat painful past experiences which seems to outgrow the natural limitations of the organism affected by it and to insist even beyond the organism's death - again, like the living dead in a horror film who just go on. This excess inscribes itself into the human body in the guise of a wound which makes the subject "undead," depriving him of the capacity to die : when this wound is healed, the hero can die in peace. (shrink)

With a new introduction by the author In this deliciously polemical work, a giant of cultural theory immerses himself in the ideas of a giant of French thought.

As a slew of recent work in epistemology has brought out, there is a range of cases where there's a strong temptation to say that prudential and (especially) moral considerations affect what we ought to believe. There are two distinct models of how this can happen. On the first, “reasons pragmatist” model, the relevant prudential and moral considerations constitute distinctively practical reasons for (or against) belief. On the second, “pragmatic encroachment” model, the relevant prudential and moral considerations affect what one (...) is epistemically justified in believing. The pragmatic encroachment model appears to have several advantages over reasons pragmatism, and this has led many recent philosophers to endorse the former. However, in this paper we argue that a version of reasons pragmatism can be (at least largely) saved from these purported disadvantages once paired with an independently plausible permissivism about epistemically justified outright belief. This hybrid view—“permissivist pragmatism”—holds that when there is more than one epistemically permitted doxastic attitude, practical (including moral) considerations can determine which epistemically permitted doxastic attitude one all-things-considered ought to have. This view avoids both the problems faced by simple versions of reasons pragmatism, and those that distinctively attend pragmatic encroachment, while preserving the advantages of each view. (shrink)

Sometimes, learning about the origins of a belief can make it irrational to continue to hold that belief—a phenomenon we call ‘genealogical defeat’. According to explanationist accounts, genealogical defeat occurs when one learns that there is no appropriate explanatory connection between one’s belief and the truth. Flatfooted versions of explanationism have been widely and rightly rejected on the grounds that they would disallow beliefs about the future and other inductively-formed beliefs. After motivating the need for some explanationist account, we raise (...) some problems for recent versions of explanationism. Learning from their failures, we then produce and defend a more resilient explanationism. (shrink)

On Islamic teachings, written by an army officer and educationist from Pakistan.

On the dominant contemporary accounts of how practical considerations affect what we ought to believe, practical considerations either encroach on epistemic rationality by affecting whether a belief is epistemically justified, or constitute distinctively practical reasons for belief which can only affect what we ought to believe by conflicting with epistemic rationality. This paper shows that a promising alternative view can be found in a surprising source: the writings of Søren Kierkegaard. I argue that in light of two of his central (...) epistemological commitments—belief-credence dualism and epistemic permissivism about outright belief—Kierkegaard holds that practical considerations can affect what we ought to believe without either encroaching on or (necessarily) conflicting with epistemic rationality. The central idea is that practical considerations can determine which among the epistemically permitted outright doxastic attitudes one should all-things-considered adopt. In addition to constituting a novel, systematic interpretation of Kierkegaard’s account of how practical considerations affect what we ought to believe, this suggests that Kierkegaard holds a distinctive and underexplored view that constitutes a serious philosophical rival to dominant contemporary views. (shrink)

Kierkegaard’s pseudonym Johannes Climacus famously defines faith as a risky “venture” that requires “holding fast” to “objective uncertainty.” Yet puzzlingly, he emphasizes that faith requires resolute conviction and certainty. Moreover, Climacus claims that all beliefs about contingent propositions about the external world “exclude doubt” and “nullify uncertainty,” but also that uncertainty is “continually present” in these very same beliefs. This paper argues that these apparent contradictions can be resolved by interpreting Climacus as a belief-credence dualist. That is, Climacus holds that (...) beliefs and credences (i.e., degrees of belief) are two irreducibly distinct types of mental states. Beliefs are resolutions that close inquiry, thereby excluding doubt and reflecting subjective certainty by disregarding the possibility of error. Credences, by contrast, reflect assessments of evidential probabilities, thereby encoding a recognition of “objective uncertainty” by acknowledging the possibility of error. In addition to solving a vexing interpretive puzzle and showing how Kierkegaard anticipates contemporary views about the nature of belief and credence, this paper demonstrates that Kierkegaard developed a sophisticated account of the nature of belief, doubt, and certainty that merits serious philosophical consideration. (shrink)

Donald Davidson has made enormous contributions to the philosophy of action, epistemology, semantics and philosophy of mind and today is recognized as one of the most important analytical philosophers of the late twentieth century. _Donald Davidson: Truth, Meaning and Knowledge_ addresses * Davidson's writings on epistemology and theory of language with their implications of ontology and philosophy of mind * the central issue of whether truth is the ultimate goal of enquiry, challenged by contributions from Richard Rorty and Paul Horwich (...) * Davidson's approach to semantics and applied linguistics as addressed by Kirk Ludwig, Gabriel Segal, Peter Pagin, Stephen Neale, Herman Cappelen and Ernie Lepore and Reinaldo Elugardo * Davidson's advances in the philosophy of mind in relation to the views of Williard V. Quine, John McDowell and Peter F. Strawson, in essays by Roger Gibson and Anita Avramides. (shrink)

We study structures equipped with generic predicates and/or automorphisms, and show that in many cases we obtain simple theories. We also show that a bounded PAC field is simple. 1998 Published by Elsevier Science B.V. All rights reserved.

With his characteristic wit, Zizek addresses the burning question of how to reformulate a leftist project in an era of global capitalism and liberal-democratic ...

In this provocative and original work, Slavoj Zizek takes a look at the question of human agency in a postmodern world. From the sinking of the Titanic to Hitchcock's Rear Window, from the operas of Wagner to science fiction, from Alien to the Jewish Joke, the author's acute analyses explore the ideological fantasies of wholeness and exclusion which make up human society. Linking key psychoanalytical and philosophical concepts to social phenomena such as totalitarianism and racism, the book explores the political (...) significance of these fantasies of control. In so doing, The Sublime Object of Ideology represents a powerful contribution to a psychoanalytical theory of ideology, as well as offering persuasive interpretations of a number of contemporary cultural formations. -- Back cover. (shrink)

BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)