Mr. F. is a fifty‐year‐old father of two school‐aged daughters. Six years ago, he received a double lung transplant because he was suffering from interstitial lung disease, a fatal illness that causes suffocation by progressive scarring of the lungs. He is now experiencing chronic rejection of the transplant and is being considered to receive another. Without it, he is expected to survive only a year and a half. With it, his prognosis will improve, but the numbers are still not good. (...) Three years after his lung transplant, Mr. F. stopped attending his office visits. For a period of sixteen months he went without the studies and attention essential to posttransplant care. He stopped performing the required daily self‐monitoring of his lung function about eight months after his transplant, but he has maintained a regular exercise regimen. While lost to follow‐up, he continued to take his immunosuppressant medications, but he stopped taking medicine to control his high blood pressure because of its expense. (shrink)

Shame appeals may be both relevant to and make possible argumentation with reluctant addressees. I propose a normative pragmatic model of practical reasoning involved in shame appeals and show that its explanatory power exceeds that of a more traditional account of an underlying practical inference structure. I also illustrate that analyzing the formal propriety of shame appeals offers a more complete explanation of their normative pragmatic force than an application of rules for dialogue types.

Medical ethics committees are increasingly called on to assist doctors, patients, and families in resolving difficult ethics issues. Although committees are becoming more sophisticated in the substance of medical ethics, little attention has been given to the processes these committees use to facilitate decision-making. In 1990, the National Institute for Dispute Resolution in Washington, D.C., provided a planning grant from its Innovation Fund to the Institute of Public Law of the University of New Mexico School of Law to look at (...) what ethics committees can learn from facilitation and mediation techniques. The study's thesis was that, if adapted for use by medical ethics committees, facilitation and mediation techniques can be helpful to those bodies in case review consultations and in other internal committee processes. This article reports on that project. (shrink)

This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be permitted (...) access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

ABSTRACT This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be (...) permitted access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

Contents: "Analysis of Claude Bernard's Introduction to the Study of Experimental Medicine," "Two Unpublished Chapters from She Came to Stay," "Pyrrhus and Cineas," "A Review of The Phenomenology of Perception by Maurice Merleau-Ponty," "Moral Idealism and Political Realism," "Existentialism and Popular Wisdom," "Jean-Paul Sartre," "An Eye for an Eye," "Literature and Metaphysics," "Introduction to an Ethics of Ambiguity," "An Existentialist Looks at Americans," and "What is Existentialism?".

This article analyzes U.S. court cases involving reproductive technologies in terms of their implications for reproductive choice, mothers' versus fathers' rights, definitions and evaluations of parenting, and the nuclear family structure. The analysis reveals that the courts have tended not to recognize how social conditions shape women's reproductive choices, to promote fathers' rights more than mothers' rights, to ignore the social relationships that constitute childbearing and child rearing and value men's over women's biological contribution to these processes, to reflect certain (...) assumptions about the proper roles of mothers and fathers, and to privilege the nuclear family. The implications of developing reproductive technology policy for an understanding of the relationships among gender, reproductive technologies, and the state are considered, and recommendations for the equitable regulation of these technologies are offered. (shrink)

Although it has been given qualified approval by a number of philosophers of education, the so-called ‘therapeutic turn’ in education has been the subject of criticism by several commentators on post-compulsory and adult learning over the last few years. A key feature of this alleged development in recent educational policy is said to be the replacement of the traditional goals of knowledge and understanding with personal and social objectives concerned with enhancing and developing confidence and self-esteem in learners. After offering (...) some critical observations on these developments, I suggest that there are some educationally justifiable goals underpinning what has been described as a therapeutic turn. Whilst accepting that ‘self-esteem’ and cognate concepts cannot provide a general end or universal aim of education, the therapeutic function is more valuable and significant than is generally acknowledged. This claim is justified by an examination of the concept of ‘mindfulness’ that, it is argued, can be an immensely powerful and valuable notion, which is integrally connected with the centrally transformative and developmental nature of learning and educational activity at all levels. (shrink)

Indigenous nurse scholars across nations colonised by Europeans articulate the need for accomplices (as opposed to mere performative allies) to work alongside them and support their ongoing struggle for health equity and respect and to prioritise and promote culturally safe healthcare. Although cultural safety is now being mandated in nursing codes of practice as a strategy to address racism in healthcare, it is important that white nurse educators have a comprehensive understanding about cultural safety and the pedagogical skills needed to (...) teach it to undergraduate nurses. We open this article with stories of our journeys as two white nurses in becoming accomplices and working alongside Indigenous Peoples, as patients and colleagues. Our lived experience of the inertia of healthcare and education organisations to address systemic and institutional resistance to the practice of cultural safety underpins the intention of this article. We understand that delivering this challenging and complex topic effectively and respectfully is best achieved when Indigenous and white educators work together at the cultural interface. Doing so requires commitment from white nurses and power holders within universities and healthcare institutions. A decolonising approach to nurse education at individual and institutional levels is fundamental to support and grow the work that needs to be done to reduce health inequity and increase cultural safety. White nurse accomplices can play an important role in teaching future nurses the importance of critical reflection and aiming to reduce power imbalances and racism within healthcare environments. Reducing power imbalances in healthcare environments and decolonising nursing practice is the strength of a cultural safety framework. (shrink)

This book focuses on material culture as a subject of philosophical inquiry and promotes the philosophical study of material culture by articulating some of the central and difficult issues raised by this topic and providing innovative solutions to them, most notably an account of improvised action and a non-intentionalist account of function in material culture. Preston argues that material culture essentially involves activities of production and use; she therefore adopts an action-theoretic foundation for a philosophy of material culture. Part 1 (...) illustrates this foundation through a critique, revision, and extension of existing philosophical theories of action. Part 2 investigates a salient feature of material culture itself—its functionality. A basic account of function in material culture is constructed by revising and extending existing theories of biological function to fit the cultural case. Here the adjustments are for the most part necessitated by special features of function in material culture. These two parts of the project are held together by a trio of overarching themes: the relationship between individual and society, the problem of centralized control, and creativity. (shrink)

According to accounts of the Passion, Christ cries out from the cross, “My God, my God, why have you forsaken me?” The cry, I argue, manifests that Christ lacks a belief that God is with him. Given the standard view of faith—belief that p is required for faith that p—it would follow that Christ lost his faith that God is with him just before he died. In this paper, I challenge the standard view by looking at the cognitive requirement of (...) faith. Although faith that p requires some positive cognitive orientation toward p, that orientation need not be belief. I show that reliance is an alternative stance that fulfills the cognitive requirement of faith. Reliance aims at providing sensible guidance for action that is in accord with one’s values/ends. Thinking of the cognitive component of Christ’s faith in terms of reliance makes sense of the doubt manifested in his cry. (shrink)

Since the establishment of the National Council for Vocational Qualfications (NCVQ) in 1986, the influence of the competence-based approach, which underpins National Vocational Qualifications (NVQs), has spread beyond its original remit and now extends into schools and higher education. Competence strategies are criticised for their conceptual imprecision and their behaviourist, foundation. More significantly, it is argued that the competence approach displays confusion and incoherence in its interpretation and use of the ideas of ‘knowledge’ and ‘understanding’, and so should be challenged (...) and resisted by educators committed to these values. (shrink)

Attempts by David Bridges and others to justify certain models of competence-based education and training (CBET) are criticised on the grounds that they do not challenge the behaviouristic nature of the functional analysis system which underpins CBET. Competence strategies serve to de-skill and de-professionalise teaching and other public-service occupations by their technicist and reductionist approach to human values and knowledge. Educators committed to liberal values should eschew competence strategies in favour of learning theories inspired by the experiential tradition.

It has become commonplace to say that with the advent of technologies like synthetic biology the line between artifacts and living organisms, policed by metaphysicians since antiquity, is beginning to blur. But that line began to blur 10,000 years ago when plants and animals were first domesticated; and has been thoroughly blurred at least since agriculture became the dominant human subsistence pattern many millennia ago. Synthetic biology is ultimately only a late and unexceptional offshoot of this prehistoric development. From this (...) perspective, then, synthetic biology is a red herring, distracting us from more thorough philosophical consideration of the most truly revolutionary human practice—agriculture. In the first section of this paper I will make this case with regard to ontology, arguing that synthetic biology crosses no ontological lines that were not crossed already in the Neolithic. In the second section I will construct a parallel case with regard to cognition, arguing that synthetic biology as biological engineering represents no cognitive advance over what was required for domestication and the new agricultural subsistence pattern it grounds. In the final section I will make the case with regard to human existence, arguing that synthetic biology, even if wildly successful, is not in a position to cause significant existential change in what it is to be human over and above the massive existential change caused by the transition to agriculture. I conclude that a longer historical perspective casts new light on some important issues in philosophy of technology and environmental philosophy. (shrink)

Attempts by David Bridges and others to justify certain models of competence-based education and training (CBET) are criticised on the grounds that they do not challenge the behaviouristic nature of the functional analysis system which underpins CBET. Competence strategies serve to de-skill and de-professionalise teaching and other public-service occupations by their technicist and reductionist approach to human values and knowledge. Educators committed to liberal values should eschew competence strategies in favour of learning theories inspired by the experiential tradition.

Corporate Philanthropy is multi-dimensional, differs between sectors and involves both individual and organisational decision-making to achieve business and social goals. However, the CP literature characteristically focuses on strategic decisions made by business leaders and ignores the role of employees, especially those in lower status and lower paid positions. To redress this imbalance, we conducted a qualitative study of employees’ involvement in CP processes in ten workplaces in the South East of England to identify whether and how they are involved in (...) CP decision-making and to capture their perspective on the nature of CP and the benefits generated by such activities. We specifically chose to study workplaces where employees are involved in the actual execution of the CP strategy, prioritising companies with a visible presence on the high street. The results illustrate the benefits of involving employees in CP decision-making, which we argue derives in part from the ‘liminal-like states’ that typify CP activities organised by shop floor staff, involving the temporary overturning of hierarchies, humanising of workplaces and opportunities for lower level staff to prioritise their personal philanthropic preferences and signal their charitable identity to colleagues and customers. Whilst the data also suggest that CP decision-making remains predominantly top-down and driven by profit-oriented goals, we conclude that employees should be involved in choosing charitable causes as well as in designing and implementing workplace fundraising, in order to maximise the advantages of CP for the company and for wider society. (shrink)

_Wittgenstein's Art of Investigation_ is one of the first to focus on and provide an original and detailed analysis of Wittgenstein's grammatical investigations. Beth Sarkey offers us new insight into the historical context and influences on method which will help students understand the intricacies and depth of his work.

Function theorists routinely speculate that a viable function theory will be equally applicable to biological traits and artifacts. However, artifact function has received only the most cursory scrutiny in its own right. Closer scrutiny reveals that only a pluralist theory comprising two distinct notions of function--proper function and system function--will serve as an adequate general theory. The first section describes these two notions of function. The second section shows why both notions are necessary, by showing that attempts to do away (...) with one of them fail. This demonstration draws on examples from the artifactual realm to motivate major points of the argument. The third section is an outline of artifact function. It confirms the conclusions of the second section, and also begins the task of describing some of the special features of artifact function needing accommodation within the general theory. (shrink)

_Wittgenstein's Art of Investigation_ is one of the first to focus on and provide an original and detailed analysis of Wittgenstein's grammatical investigations. Beth Sarkey offers us new insight into the historical context and influences on method which will help students understand the intricacies and depth of his work.

This article explores the organization of instructional corrections in pre-clinical dental education. The students are practising manual skills using a simulator and tutors are inspecting and evaluating their progress. Simulators and simulation are critical to the organization of contemporary healthcare training, and the academic literature that explores forms of simulation in healthcare tends to consider the ‘fidelity’ of systems and the extent to which they match the clinical situations that they are designed to mimic. In contrast, this article considers how (...) tutors and students explicitly attend to matters of realism in the course of instructional sequences. We highlight the ways in which tutors routinely invoke ‘real life’ in instructional corrections and we discuss how these sequences reveal the work that tutors undertake to compensate for the ‘chronic insufficiency’ of the simulator. We show how tutors emphasize the reasoned character of manual bodily skills, reasons linked to the complexities and contingencies of clinical practice. To explore these issues and concerns, the article draws on the analysis of audio-visual data of everyday instruction. (shrink)

To address growing concerns about academic integrity, college students (n?=?758) at honor system and non-honor system institutions were presented with eight scenarios to determine the influence of an honor system on their perceptions of and responses to academic dishonesty. Main effects for honor code status emerged. Students from traditional honor system schools considered the behaviors to be more dishonest, and were more likely to respond that they would report the incident when compared to students attending modified and non-honor system institutions. (...) Findings suggest traditional honor systems, with specific rules and regulations in place, are more effective at cultivating academic integrity among students; modified honor systems may not be as effective as previous research suggests. (shrink)

A paradigm case of demanding involves making utterances designed to influence addressees to accede.1 It would be incoherent to say, "I demand that you do x, but I am not saying that you ought to do x," or "I demand that you do x, although I am fully aware that you cannot do x." The extraordinary nature of demanding may be gleaned from anomalous utterances such as "employees may demand time off by notifying scheduling managers at least one month in (...) advance" and "faculty members may demand an extension of the tenure clock in writing to the provost." Demanding is less anomalous in protest rhetoric and in fact an important strategy for marginalized groups who are "criticized for not handling conflicts and controversies... (shrink)

That women tend to see harassment where men see harmless fun or normal gendered interaction is one of the more robust findings in sexual harassment research. Using in-depth interviews with employed men and women, this article argues that these differences may be partially explained by the performative requirements of masculinity. The ambiguous practice of “girl watching” is centered, and the production of its meaning analyzed. The data suggest that men's refusal to see their behavior as harassing may be partially explained (...) through the objectification and attenuated empathy that the production of masculine identities may require. Thus, some forms of harassment and their interpretations may more accurately be seen as acts of ignoring than states of ignorance. Implications for anti-sexual harassment policies and training are explored. (shrink)

The year is 1901. Two minor celebrities from opposite corners of the globe share an evening meal in Chicago. Both are politically left-leaning, both are evolutionists of a sort, both are concerned with the plight of the poor in the face of the escalation of the Industrial Revolution. The Russian man has been giving a series of lectures to the people of Chicago; he is staying at the American woman's settlement house-Hull House. They are Jane Addams, Chicago's activist social worker (...) and Petr Kropotkin, Russian nobleman by birth, anarchist in politics, and naturalist by inclination. Each awaits publication of their first full-length book concerning politics and moral development: Democracy and Social Ethics (1902) on .. (shrink)

Extending her earlier work on a theory of human rights in her 1993 Operative Rights, Singer (emerita, American philosophy presumably, City U. of New York) critiques philosophies from Rousseau to Kymlicka in clarifying her views--influenced by Dewey and Mead (George Herbert, not Margaret)--and applying them to such issues as multiculturalism, minority rights, and conflict resolution. The analysis pivots on her concept of "a normative community" rather than natural rights. Annotation copyrighted by Book News, Inc., Portland, OR.

Presents a portrait of Alamaba rivers, from their origins in the Appalachian highlands to their confluence with the Gulf of Mexico, and promotes the stewardship and preservation of these natural regions.

Broadly speaking, it seems plausible to say that fear appeals are designed to induce action—to generate persuasive force for addressees to act in order to avoid a fearful outcome (Walton 2000, 1-2, 20, 22, 143; Witte 1994, 113; Witte 1992, 329). Because a fear appeal is a kind of argument about harmful consequences, and because arguments about harmful consequences are commonplace in deliberations, fear appeals are practically inevitable in civic discourse. And, as some scholars have recently confirmed, making fear appeals (...) may be appropriate in civic discourse (Walton 2000, 139; Pfau 2007, 228). The challenge is to explain how they generate persuasive force—how they reasonably pressure addressees to act as the .. (shrink)

Book reviewed in this article:K. H. Lawson, Philosophical Issues in the Education of Adults.

Book reviewed in this article:K. H. Lawson, Philosophical Issues in the Education of Adults.

There is increasing interest in artifacts among philosophers. The leading edge is the metaphysics of artifacts and artifact kinds. However, an important question has been neglected. What is the ontological status of the category ‘artifact’ itself? Dan Sperber (2007) argues against its theoretical integrity for the purposes of naturalistic social sciences. In Section 2, I lay out Sperber’s argument, which is based on the observed continuum between natural objects and artifacts. I also review the implicit support for this continuum argument (...) in the philosophical literature on artifacts. In Section 3, I diagnose the fatal weakness affecting continuum-based arguments about categories. They fail to take into account recent thinking about classification in philosophy of science, which has been forced to accommodate continua in biology. In Section 4, I focus specifically on the species problem in philosophy of biology, and on pluralism about species concepts as a response to it. I then identify an analogous artifact problem, and argue that pluralism about artifact concepts is an appropriate and defensible response here as well. Finally, in Section 5, I show that just as species pluralism leads to skepticism about the species category, so artifact pluralism leads to skepticism about the artifact category. I thus arrive at Sperber’s conclusion by an alternate route that does not run afoul of the weakness affecting continuum-based arguments about categories. (shrink)

Tool use rivals language as an important domain of cognitive phenomena, and so as a source of insight into the nature of cognition in general. But the favoured current definition of tool use is inadequate because it does not carve the phenomena of interest at the joints. Heidegger's notion of equipment provides a more adequate theoretical framework. But Heidegger's account leads directly to a non-individualist view of the nature of cognition. Thus non-individualism is supported by concrete considerations about the nature (...) of tools and tool use. (shrink)

How do social actors get addressees to stop retreating to metadiscussions that derail ground-level discussions, and why do they expect the strategies to work? The question is of both theoretical and practical interest, especially with regard to ground-level discussions of systemic sexism and racism derailed by qualifying “not all men” and “not all white people” perform the sexist or racist actions that are the topic of discussion. I use a normative pragmatic approach to analyze two exemplary messages designed to halt (...) retreats to metadiscussions about using “not all men” and “not all white people” qualifiers in discussions of systemic sexism and racism. I find that social actors use strategies that may at first glance appear to be out of bounds in an ideal critical discussion—e.g., demanding, shouting, cussing, sarcasm, name-calling—to cultivate a context where using not-all qualifiers becomes increasingly costly. The strategies are designed to get addressees to recognize that using not-all qualifiers is not an epistemic correction of a hasty generalization or ethical intervention to halt promulgation of stereotypes about men and white people. Instead, the strategies display that using not-all qualifiers is a fallible sign of willful hermeneutical ignorance, willful ignorance, and an attempt to reassert a measure of social dominance. These findings affirm the need to investigate the various strategies and normative materials social actors actually bring to bear to regulate disagreement. (shrink)