Dilemmas about resuscitation and life-prolonging treatment for severely compromised infants have become increasingly complex as skills in neonatal care have developed. Quality of life and resource issues necessarily influence management. Our Institute of Medical Ethics working party, on whose behalf this paper is written, recognises that the ultimate responsibility for the final decision rests with the doctor in clinical charge of the infant. However, we advocate a team approach to decision-making, emphasising the important role of parents and nurses in the (...) process. Assessing the relative burdens and benefits can be troubling, but doctors and parents need to retain a measure of discretion; legislation which would determine action in all cases is inappropriate. Caution should be exercised in involving committees in decision-making and, where they exist, their remit should remain to advise rather than to decide. Support for families who bear the consequences of their decisions is often inadequate, and facilitating access to such services is part of the wider responsibilities of the intensive care team. The authors believe that allowing death by withholding or withdrawing treatment is legitimate, where those closely involved in the care of the infant together deem the burdens to be unacceptable without compensating benefits for the infant. As part of the process accurate and careful recording is essential. (shrink)

Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

Though we often “fear the worst”, worrying that unexpectedly bad things will happen, there are times when we “hope for the best”, imagining that unexpectedly good things will happen, too. The paper explores how the valence of the current situation influences people's imagining of unexpected future events when participants were instructed to think of “something unexpected”. In Experiment 1, participants (N = 127) were asked to report unexpected events to everyday scenarios under different instructional conditions (e.g., asked for “good” or (...) “bad” unexpected events), and manifested a strong negativity bias in response to non-valenced instructions (i.e., being asked to “think of the unexpected” with no valence given). They mainly reported quite “predictable” unexpected outcomes that were negative; however, a post-test (N = 31) showed that the scenarios used were predominantly positive. In Experiment 2 (N = 257), when participants were instructed to think of “something unexpected and bizarre”, under the same instructional manipulations as Experiment 1, this negativity bias was replicated. In Experiment 3, using a design in which positive/negative materials were matched (verified by a pre-test, N = 60), it was found that when participants (N = 102) were given negative scenarios, they reported more positive events than they do when they are given positive scenarios. Though responding still retained an overwhelming negative bias, this result provided some evidence for a weaker valence-countering strategy; that is, where a negative scenario can lead to positive unexpected events being mentioned, and a positive scenario leads to negative unexpected events being reported. The implications of these results for people's projections of unexpected futures in their everyday lives is discussed. (shrink)

In her ground-breaking and highly influential book Transformative Experience, L.A. Paul makes two claims: (1) one cannot evaluate and compare certain experiential outcomes (e.g. being a parent and being a non-parent) unless one can grasp what these outcomes are like; and (2) one can evaluate and compare certain intuitively horrible outcomes (e.g. being eaten alive by sharks) as bad and worse than certain other outcomes even if one cannot grasp what these intuitively horrible outcomes are like. We argue that the (...) conjunction of these two claims leads to an implausible discontinuity in the evaluability of outcomes. One implication of positing such a discontinuity is that evaluative comparisons of outcomes will not be proportionally sensitive to variation in the underlying features of these outcomes. This puts pressure on Paul to abandon either (1) or (2). But (1) is central to her view and (2) is very hard to deny. We call this the Shark Problem. (shrink)

In a series of articles Christopher Cowie has provided what he calls a ‘Master Argument’ against the Companions in Guilt (CG) defence of moral objectivity. In what follows I defend the CG strategy against Cowie. I show, firstly, that epistemic judgements are relevantly similar to moral judgements, and secondly, that it is not possible coherently to deny the existence of irreducible and categorically normative epistemic reasons. My argument for the second of these claims exploits an analogy between the thesis that (...) epistemic norms are non-categorical and G.E. Moore’s paradox concerning first personal belief ascriptions. I argue that the absurdity of the assertion “I have evidence that p but no reason to believe it” shows that the norms of belief are categorical. I then consider the counter-argument that this categoricity is a ‘conceptual’ rather than an ‘objective’ requirement. By drawing on the work of Hilary Putnam and Charles Travis, I show that this counter-argument is unsuccessful. Putnam is one of the original proponents of the Companions in Guilt strategy. Thus, by supporting the CG argument through appeal to other Putnamian theses, I show that its insights can only fully be appreciated in the context of broader metaphysical and semantic lessons. (shrink)

There is no agreement about the supplement at the end of the first line. almost certainly refers to marriage, discussion of which is postponed till something becomes black or turns dark. Theiler's hardly fits thecontext, and Burkert's with the sense ‘when the grapes ripen’ is not convincing. A metaphorical sense for ‘grapes’ is preferable, e.g. or, better,,, ‘when youwill be old enough to marry’; but the phrase comes with a jolt in the absence of any preparation or immediate follow-up: in (...) the passages of Philodemus andHorace quoted as parallel by Ebert-Luppes the metaphor is not simply a singleword but is extended over two or three lines. (shrink)

Although theory refers to organizational culture as an important variable in corrupt organizations, only little empirical research has addressed the characteristics of a corrupt organizational culture. Besides some characteristics that go hand in hand with unethical behavior and other features of corrupt organizations, we are still not able to describe a corrupt organizational culture in terms of its underlying assumptions, values, and norms. With a qualitative approach, we studied similarities of organizational culture across different corrupt organizations. In this study, we (...) performed content analysis on interviews of 14 independent experts about their experience with corrupt organizations. With this approach, we gained insights about different corrupt organizations spanning different branches (e.g., government, foreign trade, pharmacy, sports, building industry). We found that corrupt organizations perceive themselves to fight in a war, which leads to their taken-for-granted assumption that “the end justifies the means”. This assumption inspires many values and norms of the organizational culture. An important value in a corrupt organization is “security”, and an important norm is punishment of deviant (i.e., non-corrupt) behavior. Furthermore, managers and employees differ in their perception of organizational culture. While the management endorses values, such as success, results, and performance, and implements these values in their norms of goal setting, employees make use of rationalization strategies and endorse values of security and team spirit. (shrink)

_If you were free in doing something and morally responsible for it, you could have done otherwise. That_ _has seemed a pretty firm proposition among the old, new, clear, unclear and other propositions in the_ _philosophical discussion of freedom and determinism. If you were free in what you did, there was an_ _alternative. It is also at least natural to think that if determinism is true, you can never do otherwise than_ _you do. G. E. Moore, that Cambridge reasoner in (...) whose shadow Wittgenstein ought to be standing,_ _considered the matter. He pointed out that even if determinism is true, there remains a sense in which you_ _can still do otherwise than you do: you will do otherwise if you so choose. That, on reflection, is consistent_ _with determinism. The doctrine of the compatibility of freedom and determinism is saved. Joseph Keim_ _Campbell, strong philosopher at Washington State University, provides the latest thinking on this seemingly_ _unavoidable dispute. You do not have to agree that either compatibilism or incompatibilism must be true in_ _order to appreciate the carefulness of his reasoning in this piece of ongoing American philosophy. It_ _requires and repays attention._. (shrink)

I set out two theses. The first is Lynn Robertson’s: (a) spatial awareness is a cause of object perception. A natural counterpoint is: (b) spatial awareness is a cause of your ability to make accurate verbal reports about a perceived object. Zenon Pylyshyn has criticized both. I argue that nonetheless, the burden of the evidence supports both (a) and (b). Finally, I argue conscious visual perception of an object has a different causal role to both: (i) non-conscious perception of the (...) object, and (ii) experience, e.g. hallucination, that may be subjectively indiscriminable from, but is not, perception of the object. (shrink)

I compare two kinds of holism about values: G.E. Moore's 'organic unities', and Jonathan Dancy's 'value holism'. I propose a simple formal model for representing evaluations of parts and wholes. I then define two conditions, additivism and invariabilism, which together imply a third, atomism. Since atomism is absurd, we must reject one of the former two conditions. This is where Moore and Dancy part company: whereas Moore rejects additivism, Dancy rejects invariabilism. I argue that Moore's view is more plausible. Invariabilism (...) ought to be retained because (a) it eliminates the needless multiplication of values inherent in variable evaluations, and (b) it preserves a certain necessary connection between values and reasons, which Dancy himself endorses. (shrink)

Professor Boring is best known for his work in the history of psychology and for good reason: his History of Experimental Psychology and his Sensation and Perception in the History of Experimental Psychology are truly impressive works. However, he has also written numerous articles in the philosophy of science, the psychology of scientific discovery, and the sociology of scientific production, but unfortunately this material has not heretofore been readily accessible. This deficiency, however, has been corrected efficiently by the recent publication (...) of Boring's History, Psychology, and Science: Selected Papers, edited by Robert I. Watson and Donald T. Campbell. The essays in this book represent the whole range of Boring's interests and make essential reading for any serious student of the philosophy of science. Of especial value to philosophers are the essays listed under the titles “The Scientific Method” and “The Mind-Body Problem.” Since the groupings overlap, however, the following essays in other categories are also crucial: “The Nature and History of Experimental Control,” “William James and the Psychology of the Present,” and “The Influence of Evolutionary Theory Upon American Psychological Thought.” All of these essays are interesting but the ones on operationism and theory in psychology, and the one on evolutionary notions in American psychology, are classics and worth very careful consideration and comment. (shrink)

Like number representation, basic arithmetic seems to be a natural candidate for abstract instantiation in the brain. To investigate this, researchers have examined effects of numeral format on elementary arithmetic (e.g., 4+5 vs. four+five). Different numeral formats often recruit distinct processes for arithmetic, reinforcing the conclusion that number processing is not necessarily abstracted away from numeral format.

There is no agreement about the supplement at the end of the first line. almost certainly refers to marriage, discussion of which is postponed till something becomes black or turns dark. Theiler's hardly fits thecontext, and Burkert's with the sense ‘when the grapes ripen’ is not convincing. A metaphorical sense for ‘grapes’ is preferable, e.g. or, better, , , ‘when youwill be old enough to marry’; but the phrase comes with a jolt in the absence of any preparation or immediate (...) follow-up: in the passages of Philodemus andHorace quoted as parallel by Ebert-Luppes the metaphor is not simply a singleword but is extended over two or three lines. (shrink)

MOHAMMED SA, WALTERS KL, LAMARR J, EVANS‐CAMPBELL T and FRYBERG S. Nursing Inquiry 2012; 19: 116–127 [Epub ahead of print]Finding middle ground: negotiating university and tribal community interests in community‐based participatory researchCommunity‐based participatory research (CBPR) has been hailed as an alternative approach to one‐sided research endeavors that have traditionally been conducted on communities as opposed to with them. Although CBPR engenders numerous relationship strengths, through its emphasis on co‐sharing, mutual benefit, and community capacity building, it is often challenging as (...) well. In this article, we describe some of the challenges of implementing CBPR in a research project designed to prevent cardiovascular disease among an indigenous community in the Pacific Northwest of the United States and how we addressed them. Specifically, we highlight the process of collaboratively constructing a Research Protocol/Data Sharing Agreement and qualitative interview guide that addressed the concerns of both university and tribal community constituents. Establishing these two items was a process of negotiation that required: (i) balancing of individual, occupational, research, and community interests; (ii) definition of terminology (e.g., ownership of data); and (iii) extensive consideration of how to best protect research participants. Finding middle ground in CBPR requires research partners to examine and articulate their own assumptions and expectations, and nurture a relationship based on compromise to effectively meet the needs of each group. (shrink)

In C.Q. XXVII. 178–181 Mr. S. G. Owen has raised some interesting questions, but it may be doubted whether he has in every case discovered the correct solution. Panntalia 30, 6: quaeque sine exemplo in nece functa uiri. Mr. Owen's pronece removes the hiatus, but I think has no other merit. The sense ‘a death for a death,’ even if not necessarily or best represented by repetition of the same term, is at least not happily represented by such combination of (...) euphemism with dysphemism; ‘in place of the slaughter of her husband, she finished her days.’ Read funere, and you get an expression characteristic of this school; Paulinus of Pella applied it to death; patris de funere functi 236, ‘of my father's death,’ i.e. funere defuncti, cf. 241 defuncti patris. But Paulinus of Nola applied it also to a vicarious death, Christus … morte mea functus, carm. 31, 191 . Both were pupils of Ausonius. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Pathology of the Mind: Disorder Versus DisabilityRichard G. T. Gipps (bio)Keywordsorder, disorder, ability, disability, mental illnessAlfredo Gaete (2008) describes mental disorders as impairments in intentionality, phenomenal consciousness, and intelligence that cause harm to the affected person. I found persuasive Gaete’s claim that the concept of ‘mental disorder’ is best understood as nontheoretical and nontechnical. I also find compelling his argument that a previous contribution of my own—which relied in (...) part on specifying different senses of ‘disorder’ in psychological, physiological, and social cases—was misguided. Further, his suggestion that we ought at least to attempt analysis in terms of necessary and sufficient conditions before we seek out less definitive characterizations (in terms of family resemblances) also persuades me, although I find myself less sanguine than he about the general possibility of achieving such analyses.One of Gaete’s principal claims is that mental disorder is helpfully understood in terms of an absence of a capacity—that is, as a disability. There are two related objections—or two aspects of the same objection—that I would like to offer the author with respect to this claim. These may well not be conclusive, but will I hope at least function as foils against which the author can usefully sharpen his argument. One objection suggests that there is a viable distinction between the concepts of mental disorder and mental disability, as commonly used in clinical contexts, which the account offered seems unable to respect. The second suggests that the account may not be able to theorize what is argued to be the essential contribution of the concepts of order and disorder (as opposed to ability and disability) to the everyday concept of mental disorder. Accordingly, it questions the power of a disability approach such as Gaete’s to capture the essential nature of mental disorder.In his paper, Gaete classifies mental retardation and developmental, or (what in the United Kingdom are known as) learning, disabilities (autism, etc.) as cases of mental disorder. I found this surprising because it is not common linguistic practice in the psychological circles in which I operate. It would also seem to make a nonsense of commonly accepted ideas like: “Mental disorders are more likely to occur in patients with developmental disabilities (e.g., in autism, Asperger, or Down syndrome) than in the general population.” (For an example, see Campbell and Malone [1991]). On Gaete’s classification, it would appear that people with autism eo ipso have a mental disorder, and [End Page 341] hence the commonly accepted idea would need to be interpreted as merely a statement about comorbidities of different disorders of the same general (i.e., mental) type. But that is not, I believe, how the term is commonly used, and Gaete’s suggestion must therefore be treated as revisionary rather than descriptively analytical.One way of reconstructing a rationale underlying the distinction between mental disabilities and mental disorders is as follows. A developmental disability involves a failure of (certain aspects of) the mind to grow and reach an expected level or type of organization. A mental disorder by contrast involves a disturbance or disorganization (not simply an impoverishment) within the mind at whichever level of organization it has reached. As the mind develops, and reaches new levels or types of organization, the forms which mental disorders may take accordingly change.Autism and schizophrenia provide helpful illustrations of this distinction. Autism represents a failure of (among other things) the social mind to develop in childhood. The person with moderate to severe autism may attain at best a very shaky grasp on the realities of other minds and social conventions. That is, the degree of mental structure they obtain—their social competencies or capacities—will likely remain limited. It is this fundamental deficit that marks out the disability, and not the social anxieties or other such disturbances that can beset the autistic person.Schizophrenia, by contrast, tends to occur at late adolescence, when the individual has developed higher levels of—albeit often fragile—mental structure. Yet it is not the fragility of such mental structure, but rather the disruptions that can occur within such structures as have developed, that mark them out... (shrink)

The greatest philosopher of the twentieth century may not have been Wittgenstein, or Russell, or Quine (and he certainly wasn’t Heidegger), but he may have been a somewhat obscure and conservative Australian named David Stove (1927-94). If he wasn’t the greatest philosopher of the century, Stove was certainly the funniest and most dazzling defender of common sense to be numbered among the ranks of last century’s thinkers, better even—by far—than G. E. Moore and J. L. Austin. The twentieth century was (...) not a period in which philosophers distinguished themselves as essayists, or even as capable of writing interestingly on any subject outside their speciality (or even within it). Stove, though, was an essayist, polemicist, and wit of the highest order, rather like a super-intelligent H. L. Mencken. A heavyweight admirer was once led to write that “Reading Stove is like watching Fred Astaire dance. You don’t wish you were Fred Astaire, you are just glad to have been around to see him in action.”. (shrink)

An inspection into the contemporary theory of knowledge shows that a new methodological stance, that is, the so called evolutionary epistemology or, equivalently, evolutionary theory of knowledge, which is a version of “naturalistic” turn has been established. This stance tends to consider various philosophical problems from concrete scientific positions and by means of scientific knowledge. This interdisciplinary enterprise has determined as its purposes the researches of biological preconditions of human knowledge and the explanation of its features on the basis of (...) the modern synthetic theory of evolution.The paper discusses the ideas of K. Lorenz, G. Vollmer, D.T. Campbell, H.R. Maturana, F.J. Varela. Especially, the paper concerns the thesis that the reality cognizable by man is the reality designed, created during his personally involved communicative activity. In this perspective, the question “What is the object of knowledge?” becomes inappropriate. The reliability of knowledge consists in being able to behave adequately in individual enterprising and in co-operation with other subjects. (shrink)

By the courtesy of the editors I have been allowed to see Mr. A. Y. Campbell's “observations on two emendations of Ausonius suggested by me in C.Q. XXVII. 178 ff. Meanwhile I have learned from Mr. E. Harrison, of Trinity College, Cambridge, that, in the Cambridge Philological Society's Proceedings, 1924, p. 27, since Alcestis is meant, cp. Juv. 6, 652 spectant subeuntem fata mariti / Alcestim et, similis si permutatio detur, morte viri cupiant animam servare catellae, he had already (...) proposed to ‘read pro nece functa viri,’ thus anticipating my pro nece and Mr. Campbell's funere. As the Cambridge Phil. Soc. Proc. are inaccessible to me and are not to be discovered in theBodleian Library, I was ignorant of Mr. Harrison's proposal. I am glad that we concur. (shrink)

This book is a collection of essays in honor of Radoslav A. Tsanoff, Chairman of the Department of Philosophy at Rice University for forty years. Besides a tribute to Tsanoff written by J. S. Fulton, there are ten essays written by distinguished philosophers, each considering a topic in his field of interest. Virgil Aldrich discusses the importance of language in an essay entitled "Self-Consciousness." An examination of the new in art and an attempt to explicate its value and rationale is (...) presented by Van Meter Ames; illustrative material is drawn from such sources as contemporary film, pop art and chance music. In "Social Science and Social Norms" Clifford Barrett discusses the relevance of facts and norms in systematic considerations of social scientists. C. P. Snow's concept of two cultures is examined by A. Cornelius Benjamin in "Philosophy and the Cultures." Other essays presented are "Philosophy and Common Sense" by George Boas, "Conscience and Conscientiousness" by A. Campbell Garnett, "Criteria for Ideas of God" by C. Hartshorne, and "Sovereignty and the Idea of Republic" by C. W. Hendel. Charles Morris examines the common themes of the pragmatic movement, discussing such fields as epistemology, axiology and cosmology, and such philosophers as Peirce, Dewey, Mead and Lewis. In the concluding essay G. R. Morrow discusses Plato's views about a God and the many gods of the Greek pantheon. This book is a loose collection of papers, lacking any single theme or determinate relation between the essays presented; each essay, however, is competently handled and is interesting in its own right.—E. M. (shrink)

An inspection into the contemporary theory of knowledge shows that a new methodological stance, that is, the so called evolutionary epistemology or, equivalently, evolutionary theory of knowledge, which is a version of “naturalistic” turn has been established. This stance tends to consider various philosophical problems from concrete scientific positions and by means of scientific knowledge. This interdisciplinary enterprise has determined as its purposes the researches of biological preconditions of human knowledge and the explanation of its features on the basis of (...) the modern synthetic theory of evolution.The paper discusses the ideas of K. Lorenz, G. Vollmer, D.T. Campbell, H.R. Maturana, F.J. Varela. Especially, the paper concerns the thesis that the reality cognizable by man is the reality designed, created during his personally involved communicative activity. In this perspective, the question “What is the object of knowledge?” becomes inappropriate. The reliability of knowledge consists in being able to behave adequately in individual enterprising and in co-operation with other subjects. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

Despite the periodic table having been discovered by chemists half a century before the discovery of electronic structure, modern designs are invariably based on physicists’ definition of periods. This table is a chemists’ table, reverting to the phenomenal periods that led to the table’s discovery. In doing so, the position of hydrogen is clarified.

_Zettel, _ an en face bilingual edition, collects fragments from Wittgenstein's work between 1929 and 1948 on issues of the mind, mathematics, and language.