BackgroundPatients’ satisfaction arises from their appraisal of experience in hospital services and measuring patients’ satisfaction in hospital has become a global phenomenon. To improve on patients’ satisfaction, radiographers have to imbibe the right ethical attitude in their conduct while discharging duties to patients during radiological examination. The objective of this study is to understand from the patients’ perspective the ethical conduct of radiographers and radiology nurses that constitute factors in patient satisfaction during routine radiological examination. The rationale of the study (...) is to use the findings to improve radiological service delivery and improve on patient satisfaction.MethodsThis is a cross-sectional descriptive study in which 300 respondents in two hospitals were surveyed to ascertain their satisfaction with the ethical conduct of radiographers and services provided by radiology nurses in the department. The data was analyzed using descriptive statistics at 95 % confidence interval for mean scores and Z-values.ResultsThree hundred patients responded to the survey which comprised of 145 patients from the public hospital and 155 patients from the private hospital. Radiographers fell short in some ethical/professional conduct as in informed consent before treatment ; radiographers’ not explaining his/her experience, expectation, knowledge and equipment procedure. However, they did well in some aspects including observation of professional boundaries with patients during treatment and equity in treatment for the patients during the radiological examination. Some services provided by staff members in the department also fell short of patients’ expectation and satisfaction including explanation of what to expect during the exam, whereas they did well in their level of courtesy to patients. There was a significant difference in the satisfaction level experienced by patients at both hospitals in favour of the private hospital.ConclusionsThere is an urgent need for improved ethical/professional conduct of radiographers and general service delivery in the radiology departments of the hospitals where this investigation was carried out to enhance patient satisfaction. Government has to improve the curricular of service providers in radiology service in the university to include ethical/professional conduct and patient/provider relationship. (shrink)

Larmore aims to recover three forms of moral complexity that have often been neglected by moral and political philosophers. First, he argues that virtue is not simply the conscientious adherence to principle. Rather, the exercise of virtue apply. He argues - and this is the second pattern of complexity - that recognizing the value of constitutive ties with shared forms of life does not undermine the liberal ideal of political neutrality toward differing ideals of the good life. Finally Larmore agrues (...) for what he calls the heterogeneity of morality. Moral thinking need not be exclusively deontological or consequentialist, and we should recognize that the ultimate sources of moral value are diverse. The arguments presented here do not attack the possibility of moral theory. But in addressing some of the central issues of moral and political thinking today thay attempt to restore to that thinking greater flexibility and a necessary sensitivity to our common experience. (shrink)

Investigates a complex structure of morality, the demands such morality places on individuals, and the behavioral consequences of the system of right and wrong.

Contract as Promise is a study of the philosophical foundations of contract law in which Professor Fried effectively answers some of the most common assumptions about contract law and strongly proposes a moral basis for it while defending the classical theory of contract. This book provides two purposes regarding the complex legal institution of the contract. The first is the theoretical purpose to demonstrate how contract law can be traced to and is determined by a small number of basic moral (...) principles. At the theory level the author shows that contract law does have an underlying, and unifying structure. The second is a pedagogic purpose to provide for students the underlying structure of contract law. At this level of doctrinal exposition the author shows that structure can be referred to moral principles. Together the two purposes support each other in an effective and comprehensive study of contract law. This second edition retains the original text, and includes a new Preface. It also includes a substantial new essay entitled Contract as Promise in the Light of Subsequent Scholarship--Especially Law and Economics which serves as a retrospective of the work accomplished in the last thirty years, while responding to present and future work in the field. (shrink)

What is political philosophy’s relation to moral philosophy? Does it simply form part of moral philosophy, focusing on the proper application of certain moral truths to political reality? Or must it instead form a more autonomous discipline, drawing its bearings from the specifically political problem of determining the bounds of legitimate coercion? In this essay I work out an answer to these questions by examining both some of the classical views on the nature of political philosophy and, more particularly, some (...) recently published writings by Bernard Williams and G.A. Cohen. (shrink)

Reprint, in paper covers, of the Columbia U. Press edition of 1990. Annotation copyright by Book News, Inc., Portland, OR.

The idea of ‘reversion’ or ‘atavism’ has a peculiar history. For many authors in the latenineteenth and early-twentieth centuries – including Darwin, Galton, Pearson, Weismann, and Spencer, among others – reversion was one of the central phenomena which a theory of heredity ought to explain. By only a few decades later, however, Fisher and others could look back upon reversion as a historical curiosity, a non-problem, or even an impediment to clear theorizing. I explore various reasons that reversion might have (...) appeared to be a central problem for this first group of figures, focusing on their commitment to a variety of conceptual features of evolutionary theory; discuss why reversion might have then ceased to be an interesting phenomenon; and, finally, close with some more general thoughts about the death of scientific problems. (shrink)

Although for the last 50 years, ethicists dealing with human experimentation have focused primarily on the need to protect individual research subjects and vulnerable groups, biomedical research, especially in genetics, now requires the establishment of standards for the protection of communities. We have developed such a strategy, based on five steps. (i) Identification of community characteristics relevant to the biomedical research setting, (ii) delineation of a typology of different types of communities using these characteristics, (iii) determination of the range of (...) possible community protections, (iv) creation of connections between particular protections and one or more community characteristics necessary for its implementation, and (v) synthesis of community characteristics and possible protections to define protections appropriate for each type of community. Depending on the particular community, consent and consultation, consultation alone, or no added protections may be required for research. (shrink)

The institutional review board is the social-oversight mechanism charged with protecting research subjects. Performing this task competently requires that the IRB scrutinize informed-consent procedures, the balance of risks and potential benefits, and subject-selection procedures in research protocols. Unfortunately, it may be said that IRBs are spending too much time editing informed-consent forms and too little time analyzing the risks and potential benefits posed by research. This time mismanagement is clearly reflected in the research ethics literature. A review of articles published (...) between 1979 and 1990 in IRB: A Review of Human Subjects Research, for example, reveals a large number of articles on informed consent and confidentiality and considerably fewer on the assessment of risks and potential harms, study design, and subject-selection procedures. (shrink)

Proponents of the view that social structures are ontologically distinct from the people in whose actions they are immanent have assumed that structures can stand in causal relations to individual practices. Were causality to be no more than Humean concomitance correlations between structure and practices would be unproblematic. But two prominent advocates of the ontological account of structures, Bhaskar and Giddens, have also espoused a powers theory of causality. According to that theory causation is brought about by the activity of (...) particulars, in the social psychological case, individuals of some sort. Consistence would demand that structure be those individuals. But neither Giddens nor Bhaskar wish to reify structure to the extent that would fit it for a role as a powerful particular. If only human beings can be powerful particulars in these contexts, the only way that structures can be real must be as properties of conversational interactions. Human action is social just in so far as people direct themselves to engage well in joint activities with others. (shrink)

The issue of the protection of communities in clinical research first arose 10 years ago in studies conducted in technologically developing countries by scientists from technologically developed nations. The question was, which ethical standards ought to apply, those of the Western investigators or local standards?

Information theory provides a quantitative conceptual framework for understanding the flow of information from the world into and through brains. It focuses our attention on the sets of possible messages a brain's anatomy and physiology enable it to receive. The meanings of the messages arise from the inferences licensed by the brain's processing of them. Different meanings arise at different levels because different representations of the input license different inferences.

Abstract:Therapeutic misconception (TM)—when clinical research participants fail to adequately grasp the difference between participating in a clinical trial and receiving ordinary clinical care—has long been recognized as a significant problem in consent to clinical trials. We suggest that TM does not primarily reflect inadequate disclosure or participants’ incompetence. Instead, TM arises from divergent primary cognitive frames. The researchers’ frame places the clinical trial in the context of scientific designs for assessing intervention efficacy. In contrast, most participants have a cognitive frame (...) that is personal and focused primarily on their medical problems. To illustrate this, we draw on interview material from both clinical researchers and participants in clinical trials. We suggest that reducing TM requires encouraging subjects to adjust their frame, not just add information to their existing frame. What is necessary is ascientific reframingof participation in a clinical trial. (shrink)

Liberalism is a distinctively modern political conception. Only in modern times do we find, as the object of both systematic reflection and widespread allegiance and institutionalization, the idea that the principles of political association, being coercive, should be justifiable to all whom they are to bind. And so only here do we find the idea that these principles should rest, so far as possible, on a core, minimal morality which reasonable people can share, given their expectably divergent religious convictions and (...) conceptions of the meaning of life. No longer does it seem evident—as it did, let us say, before the seventeenth century—that the aim of political association must be to bring man into harmony with God's purposes or to serve some comprehensive vision of the good life. The causes of this transformation are various, and not all of them lie at the level of moral principle. But a change in moral consciousness has certainly been one of the factors involved. As Hegel observed, modern culture is inherently a reflective one: notions of principle are essential to our self-understanding and thus to the stability of the social forms in which we participate. Modern culture has no room for a dichotomy between “in principle” and “in practice.” It is worth determining, then, what new moral conceptions have been responsible for the emergence of modern liberalism. Not only will we thereby better understand how we have become who we are, we will also have a surer grasp of the principles that sustain our political life. (shrink)

Numbers are symbols manipulated in accord with the axioms of arithmetic. They sometimes represent discrete and continuous quantities, but they are often simply names. Brains, including insect brains, represent the rational numbers with a fixed-point data type, consisting of a significand and an exponent, thereby conveying both magnitude and precision.

It has long been recognized that cancer onset and progression represent a type of reversion to an ancestral quasi‐unicellular phenotype. This general concept has been refined into the atavistic model of cancer that attempts to provide a quantitative analysis and testable predictions based on genomic data. Over the past decade, support for the multicellular‐to‐unicellular reversion predicted by the atavism model has come from phylostratigraphy. Here, we propose that cancer onset and progression involve more than a one‐off multicellular‐to‐unicellular reversion, and are (...) better described as a series of reversionary transitions. We make new predictions based on the chronology of the unicellular‐eukaryote‐to‐multicellular‐eukaryote transition. We also make new predictions based on three other evolutionary transitions that occurred in our lineage: eukaryogenesis, oxidative phosphorylation and the transition to adaptive immunity. We propose several modifications to current phylostratigraphy to improve age resolution to test these predictions. Also see the video abstract here: https://youtu.be/3unEu5JYJrQ. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Place and the "Spatial Turn" in Geography and in HistoryCharles W. J. WithersI. IntroductionA few years ago, British Telecom ran a newspaper advertisement in the British press about the benefits—and consequences—of advances in communications technology. Featuring a remote settlement in the north-west Highlands of Scotland, and with the clear implication that such "out-of-the-way places" were now connected to the wider world (as if they had not been before), the (...) advert proclaimed "Geography is History." What the advert signalled to as the "end" of geography in the sense of the social gradients associated with space and distance is what is known, variously, as "time-space convergence" and "time-space distanciation."1 The terms embrace not just the "collapse" of geographical space given technical advances (in travel time and in communications—consequences of what Castells calls "the information age" and "the network society"2), but also the idea that the modern world has become [End Page 637] more homogenized. One place is now much the same as another. Further, given the likelihood of such technical and cultural changes continuing into the future, geographical distinctiveness, evident in the particularity of place, would be a thing of the past: geography would indeed be history. There is, of course, much evidence to the contrary: that, in the face of "globalisation," questions of locality, sense of place and of identity in place matter now more than ever. Even, then, as Francis Fukuyama cautioned against the "death" of liberal democratic politics as The End of History,3 geography—that is, geography understood as questions to do with place, and questions to do with where you are in the world as part of questions about how you are and who you are in the world—has had considerably heightened significance and for some places and people more than others.4These notions of place—as a particular location, and the character or sense of place—are only part of the meanings associated with place in geographical and in historical work. Like space, its regular epistemic dancing partner in geographical ubiquity and metaphysical imprecision, place is a widespread yet complex term. What follows is historiographical in focus and, of necessity, partial in range. I offer a historiographical survey of the term place, principally but not alone within recent work in geography. In more detail, and with reference to one of the strong senses in which place is used, namely that of locale, "the local," or localness, I trace here the connections between place, space, and the idea of the local as evident in recent work in history and in geography, especially within the history and the geography of science. Particular attention is paid in this context to the distinctive features of what we may think of as the "spatial turn" in the history of science by looking at the idea of place and space in recent work in Enlightenment studies. My argument is three-fold. Notions of place and space, much debated by geographers, have been as central a concern for intellectual historians and historians of science as for philosophers and others, but they have been differently expressed. There is, I shall argue, value in looking at these different views in order to understand that whilst place is a commonplace term it is not agreed upon: working with imprecision has been both opportunity and restriction. In relation to work within the history of science and in Enlightenment studies, consideration of the so-called "spatial turn," of place [End Page 638] as social practice and of placing as a process in accounting for the uneven movement of ideas over space and time may help provide some precision and strengthen connections between geography and history.II. Place (In Geography): A Partial HistoriographyPlace is one of the most fundamental concepts in human geography. It is also one of the most problematic.5 Place, or small-scale regional space, features as a subdivision within the Classical tripartite division of cosmography (the earth in relation to other planetary bodies), geography (the earth as a whole) and chorography (parts of the earth or regional geography). So, too, does the distinction between chorography and chronology as... (shrink)

As genetic research increasingly focuses on communities, there have been calls for extending research protections to them. We critically examine guidelines developed to protect aboriginal communities and consider their applicability to other communities. These guidelines are based on a model of researcher-community partnership and span the phases of a research project, from protocol development to publication. The complete list of 23 protections may apply to those few non-aboriginal communities, such as the Amish, that are highly cohesive. Although some protections may (...) be applicable to less-cohesive communities, such as Ashkenazi Jews, analysis suggests substantial problems in extending these guidelines in toto beyond the aboriginal communities for which they were developed. (shrink)

The Belmont Report’s distinction between research and the practice of accepted therapy has led various authors to suggest that these purportedly distinct activities should be governed by different ethical principles. We consider some of the ethical consequences of attempts to separate the two and conclude that separation fails along ontological, ethical, and epistemological dimensions. Clinical practice and clinical research, as with yin and yang, can be thought of as complementary forces interacting to form a dynamic system in which the whole (...) exceeds the sum of its parts. Just as effective clinical practice cannot exist without clinical research, meaningful clinical research requires the context of clinical practice. We defend this thesis by triangulation, that is, by outlining how multiple investigators have reached this conclusion on the basis of varied theoretical and applied approaches. More confidence can be placed in a result if different methods/viewpoints have led to that result. (shrink)

I distinguish between ‘substantival’ and ‘functional’ forms of vitalism in the eighteenth century. Substantival vitalism presupposes the existence of a (substantive) vital force which either plays a causal role in the natural world as studied scientifically, or remains an immaterial, extra-causal entity. Functional vitalism tends to operate ‘post facto’, from the existence of living bodies to the search for explanatory models that will account for their uniquely ‘vital’ properties better than fully mechanistic models can. I discuss representative figures of the (...) Montpellier school (Bordeu, Ménuret, Fouquet) as functional rather than substantival vitalists, and suggest an additional point regarding the reprisal of vitalism(s) in the 20th century, from Driesch to Canguilhem: that in addition to the substantival and functional varieties, we encounter a third species of vitalism, which I term ‘attitudinal’, as it argues for vitalism as a kind of attitude. (shrink)

Intended for the first course in logic, The Power of Logic (POL) is written with the conviction that logic is the most important course that college students take. POL preserves the balance between informal and formal logic. Layman;s direct and accessible writing style, along with his plentiful examples, imaginative exercises, and POL;s accompanying Logic Tutor make this the best text for logic classes today.day.

Implicit bias results from living in a society structured by race. Tamar Gendler has drawn attention to several epistemic costs of implicit bias and concludes that paying some costs is unavoidable. In this paper, we reconstruct Gendler’s argument and argue that the epistemic costs she highlights can be avoided. Though epistemic agents encode discriminatory information from the environment, not all encoded information is activated. Agents can construct local epistemic environments that do not activate biasing representations, effectively avoiding the consequences of (...) activation. We conclude that changing our local environments provides a way to avoid paying implicit bias’s epistemic costs. (shrink)

This paper tackles the problem of the nature of the space of perception. Based both on philosophical arguments and on results obtained from original experimental situations, it attempts to show how space is constituted concretely, before any distinction between the “inner” and the “outer” can be made. It thus sheds light on the presuppositions of the well-known debate between internalism and externalism in the philosophy of mind; it argues in favor of the latter position, but with arguments that are foundationally (...) antecedent to this debate. We call the position we defend enactive externalism. It is based on experimental settings which, in virtue of their minimalism, make it possible both to defend a sensori-motor/enactive theory of perception; and, especially, to inquire into the origin of the space of perception, showing how it is concretely enacted before the controversy between internalism and externalism can even take place. (shrink)

Embodied, embedded, enactive, and extended theorists do not typically focus on the ontological frameworks in which they develop their theories. One exception is 4E theories that embrace New Mechanism. In this paper, we endorse the New Mechanist’s general turn to ontology, but argue that their ontology is not the best on the market for 4E theories. Instead, we advocate for a different ontology: causal powers realism. Causal powers realism posits that psychological manifestations are the product of mental powers, and that (...) mental powers are empirically-discoverable features of individuals that account for the causal work those individuals do. We contend that causal powers realism provides a unifying framework for the central commitments of 4E theories, as well as additional resources for theorizing in a 4E framework. And while New Mechanism offers some of these resources as well, we argue that causal powers realism is ultimately the better of the two. (shrink)

When philosophers undertake to say what it is that makes life worth living, they generally display a procrustean habit of thought which the practice of philosophy itself does much to encourage. As a result, they arrive at an image of the human good that is far more controversial than they suspect. The canonical view among philosophers ancient and modern has been, in essence, that the life lived well is the life lived in accord with a rational plan. To me this (...) conception of the human good seems manifestly wrong. The idea that life should be the object of a plan is false to the human condition. It misses the important truth which Proust, by contrast, discerned and made into one of the organizing themes of his great meditation on disappointment and revelation, A la recherche du temps perdu : The happiness that life affords is less often the good we have reason to pursue than the good that befalls us unexpectedly. (shrink)

Novices sometimes misidentify authorities and end up endorsing false beliefs as a result. In this paper, I suggest that this phenomenon is at least sometimes the result of culturally evolved mechanisms functioning in faulty epistemic contexts. I identify three background conditions which, when satisfied, enable expert-identifying mechanisms to function properly. When any one of them fails, that increases the likelihood of identifying a non-authority as authoritative. Consequently, novices can end up deferring to merely apparent authorities without having failed in any (...) epistemic obligations. (shrink)

In this essay, we defend the design of the Salk polio vaccine trial and try to put some limits on the role schemata should play in designing clinical research studies. Our presentation is structured as a response to de Freitas and Pietrobon who identified the CONSORT statement as a schema that would have, had it existed at the time, ruled out the design of the Salk polio vaccine trial of 1954 in favor of a completely randomized controlled clinical trial. We (...) argue that large-scale public health interventions often require evidence beyond simple efficacy, the limit of what an RCT can provide, and that the design actually adopted for the Salk trial represented a reasonable—albeit imperfect—compromise. This is of more than historical interest in that many contemporary studies are of the scale and scope to require a more pragmatic, rather than explanatory, approach to study design. (shrink)

In this paper, I develop a view about machine autonomy grounded in the theoretical frameworks of 4E cognition and PF Strawson’s reactive attitudes. I begin with critical discussion of White, and conclude that his view is strongly committed to functionalism as it has developed in mainstream analytic philosophy since the 1950s. After suggesting that there is good reason to resist this view by appeal to developments in 4E cognition, I propose an alternative view of machine autonomy. Namely, machines count as (...) autonomous when we members of the moral community adopt reactive attitudes in response to their actions. I distinguish this view from White’s and suggest assets and liabilities of this approach. (shrink)

A study of Lacan’s engagement with the Western philosophical traditions of ethical and political thought in his seventh seminar and later work.

In this paper, I delineate two major problems facing reliabilist approaches in epistemology. I argue that Alvin Goodman's (1986) position fails to solve either problem. I then suggest an alternative reliabilist approach that ties truth-ratio assessments to particular, well-specified cognitive tasks. I claim that a well-specified cognitive task is an empirical hypothesis about a system that involves the specification of input and output types and nomic correlations (including statistical correlations) that underlie the system's performance. On my approach, one characterizes processes (...) by reference to the system's dispositions across the situations consistent with the task. Characterization is best understood as revealing a strategy or a set of strategies for generating outputs from inputs relying on certain nomic correlations associated with the task. (shrink)

Uses interviews with one hundred twenty-five leading male executives to determine how companies can be managed both profitably and ethically.

The existing EELS literature has usefully identified the scope of ethical issues posed by pharmacogenetic and pharmacogenomic research. The time has come for in-depth examination of particular ethical issues. The involvement of racial and ethnic communities in pharmacogenetic and pharmacogenomic research is contentious precisely because it touches upon the science and politics of studying racial and ethnic difference. To date, the ethics literature has not seriously taken account of the fact that such research impinges upon the interests of communities, and (...) that taking such interests seriously requires that we both protect and empower communities in research. We propose a framework that rests upon the recognition that communities are heterogeneous human associations and differing policies are appropriate for differing communities. Community consent and consultation and community consultation alone are neither appropriate nor required for all pharmacogenetic and pharmacogenomic research. Rather, application of these policy protections must take into account particulars of both planned research and the communities involved. (shrink)

The effort to revise the Declaration of Helsinki and the CIOMS Guidelines has sparked a sometimes vitriolic debate centering on the use of placebo controls.