Background Older patients in emergency care often have complex needs and may have limited ability to make their voices heard. Hence, there are ethical challenges for healthcare professionals in establishing a trustful relationship to determine the patient’s preferences and then decide and act based on these preferences. With this comes further challenges regarding how the patient’s autonomy can be protected and promoted. Aim To describe nurses’ experiences of dealing with older patients’ autonomy when cared for in emergency departments (EDs). Research (...) design This study adopted reflective lifeworld theory and a phenomenological design. Participants and research context A total of 13 open-ended interviews were performed with nurses working at two EDs in Sweden. Ethical considerations The study was reviewed by the Ethical Advisory Board in South East Sweden and conducted according to the Declaration of Helsinki. All participants gave consent. Findings Nurses’ experiences of dealing with older patients’ autonomy in EDs are characterized by moving in a conflicting uphill struggle, indicating obscure thoughts on how patient autonomy can be protected in an ethically challenging context. The phenomenon is further described with its meaning constituents: ‘Being hampered by prioritization under stress’, ‘Balancing paternalism and patient autonomy’, ‘Making decisions without consent in the patient’s best interests’ and ‘Being trapped by notions of legitimate care needs’. Conclusion Stressful work conditions and lacking organizational strategies in EDs contribute to nurses maintaining unjustified paternalistic care, regardless of the patient’s ability and medical condition, and questioning who has legitimacy for participating in decisions about care. The nurses’ protection and promotion of older patients’ autonomy is dependent on the opportunity, ability and willingness to create a patient relationship where the patient’s voice and preferences are valued as important. Consequently, strategies are needed to improve patient autonomy in EDs based on the idea of ‘relational autonomy’. (shrink)

Clinicians at quaternary centers see part of their mission as providing hope when others cannot. They tend to see sicker patients with more complex disease processes. Part of this mission is offering longshot treatment modalities that are unlikely to achieve their stated goal, but conceivably could. When patients embark on such a treatment plan, it may fail. Often treatment toward an initial goal continues beyond the point at which such a goal is feasible. We explore the progression of care from (...) longshot to fantasy using two pediatric cases. This progression may be differentiated into four distinct stages of care related to the potential of achieving the initial goals of care. Physicians are often ill prepared for the progression of treatments from a longshot hope to an unfeasible and, therefore, typically unjustified intervention. We present a structured approach to guide clinicians at referral institutions where these situations may be common. The transition of care from “longshot” to “fantasy” is an inherent part of quaternary care for the sickest of patients that has been underexplored. Physicians are often poorly equipped to approach that transition. We advocate this approach to the shift from longshot to fantasy with the belief that such a structured method will have multiple benefits, including: reduced suffering for the patient; decreased emotional burden on patient and family; decreased provider moral distress; increased likelihood of seeking high quality palliative care earlier; and provision of honest and straightforward information to patients and their families. (shrink)

The object of this paper is to examine half and full connexive extensions of the basic regular conditional logic CR. Extensions of this system are of interest because it is among the strongest well-known systems of conditional logic that can be augmented with connexive theses without inconsistency resulting. These connexive extensions are characterized axiomatically and their relations to one another are examined proof-theoretically. Subsequently, algebraic semantics are given and soundness, completeness, and decidability are proved for each system. The semantics is (...) also used to establish independence results. Finally, a deontic interpretation of one of the systems is examined and defended. (shrink)

Conditional logics have traditionally been intended to formalize various intuitively correct modes of reasoning involving conditional expressions in natural language. Although conditional logics have by now been thoroughly studied in a classical context, they have yet to be systematically examined in an intuitionistic context, despite compelling philosophical and technical reasons to do so. This paper addresses this gap by thoroughly examining the basic intuitionistic conditional logic ICK, the intuitionistic counterpart of Chellas’ important classical system CK. I give ICK both worlds (...) semantics and algebraic semantics, and prove that these are equivalent. I give a Gödel-type embedding of ICK into CK and a Glivenko-type embedding of CK into ICK. I axiomatize ICK and prove soundness, completeness, and decidability results. Finally, I discuss extending ICK. (shrink)

Conditional logics were originally developed for the purpose of modeling intuitively correct modes of reasoning involving conditional—especially counterfactual—expressions in natural language. While the debate over the logic of conditionals is as old as propositional logic, it was the development of worlds semantics for modal logic in the past century that catalyzed the rapid maturation of the field. Moreover, like modal logic, conditional logic has subsequently found a wide array of uses, from the traditional (e.g. counterfactuals) to the exotic (e.g. conditional (...) obligation). Despite the close connections between conditional and modal logic, both the technical development and philosophical exploitation of the latter has outstripped that of the former, with the result that noticeable lacunae exist in the literature on conditional logic. My dissertation addresses a number of these underdeveloped frontiers, producing new technical insights and philosophical applications. -/- I contribute to the solution of a problem posed by Priest of finding sound and complete labeled tableaux for systems of conditional logic from Lewis' V-family. To develop these tableaux, I draw on previous work on labeled tableaux for modal and conditional logic; errors and shortcomings in recent work on this problem are identified and corrected. While modal logic has by now been thoroughly studied in non-classical contexts, e.g. intuitionistic and relevant logic, the literature on conditional logic is still overwhelmingly classical. Another contribution of my dissertation is a thorough analysis of intuitionistic conditional logic, in which I utilize both algebraic and worlds semantics, and investigate how several novel embedding results might shed light on the philosophical interpretation of both intuitionistic logic and conditional logic extensions thereof. -/- My dissertation examines deontic and connexive conditional logic as well as the underappreciated history of connexive notions in the analysis of conditional obligation. The possibility of interpreting deontic modal logics in such systems (via embedding results) serves as an important theoretical guide. A philosophically motivated proscription on impossible obligations is shown to correspond to, and justify, certain (weak) connexive theses. Finally, I contribute to the intensifying debate over counterpossibles, counterfactuals with impossible antecedents, and take—in contrast to Lewis and Williamson—a non-vacuous line. Thus, in my view, a counterpossible like "If there had been a counterexample to the law of the excluded middle, Brouwer would not have been vindicated" is false, not (vacuously) true, although it has an impossible antecedent. I exploit impossible (non-normal) worlds—originally developed to model non-normal modal logics—to provide non-vacuous semantics for counterpossibles. I buttress the case for non-vacuous semantics by making recourse to both novel technical results and theoretical considerations. (shrink)

This essay focuses on Husserl’s conception of the natural attitude, which, I argue, is one of his most important contributions to contemporary phenomenology. I offer a critical exploration of this concept’s productive explanatory potential for feminist theory, critical race theory, queer theory, and disability studies. In the process, I draw attention to the rich, multi-faceted, and ever-changing social world that can be brought to life through this particular phenomenological concept. One of the most striking features of the natural attitude, as (...) Husserl describes it, is that it is not natural at all, but rather, is a developmental phenomenon that is acquired through, and profoundly influenced by, specific socio-cultural practices. To de-naturalize the natural attitude, then, is to recognize that the natural attitude is not fixed or innate but relative to a particular time period and culture, and therefore always capable of being changed. (shrink)

"A collection of essays on the early modern English writer, proto-feminist, and rhetorician Mary Astell. Includes discussions on human nature, equality, rationality, power, freedom, friendship, marriage, and education"--Provided by publisher.

If the Libyan intervention goes well, it will put teeth in the fledgling RtoP doctrine. Yet, if it goes badly, critics will redouble their opposition, and future decisions will be made more difficult. Libya suggests that we can say no more Holocausts, Cambodias, and Rwandas--and occasionally mean it.

Subset Spaces were introduced by L. Moss and R. Parikh in [8]. These spaces model the reasoning about knowledge of changing states.In [2] a kind of subset space called intersection space was considered and the question about the existence of a set of axioms that is complete for the logic of intersection spaces was addressed. In [9] the first author introduced the class of directed spaces and proved that any set of axioms for directed frames also characterizes intersection spaces.We give (...) here a complete axiomatization for directed spaces. We also show that it is not possible to reduce this set of axioms to a finite set. (shrink)

Most of the surveys that were undertaken in the 19th century, particularly in France, among workers, were conducted essentially from viewpoints of social legislation, philanthropy, or were even animated by a bias against the labor movement. Marx, however, in the survey that he initiated in 1880, not only wanted to deliver information on working and living conditions of the workers to the public, but tried to clarify by the questionnaires the thoughts of the workers themselves on their own situation and (...) its social causes. The questionnaire containing about one hundred different questions utilizes, therefore, in adapting itself to the labor movement of the time and the character of the workers' education, the relevant categories of the Marxian theory of society.As an appendix, the essay contains a german translation of the questionnaire itself.Les enquêtes sur la situation sociale des ouvriers organisées dans le cours du xixe siècle en Angleterre et surtout en France, étaient entreprises avec des intentions de politique sociale ou de philanthropie ou même d’hostilité contre le mouvement ouvrier. Elles n’avaient souvent qu’un intérêt déterminé, limité à la mise au jour de l’état des choses réeL Au contraire, lorsque Marx organise en 1880 une enquête par questionnaires,, il ne veut pas seulement donner à l’opinion publique des informations précises sur les conditions de travail et de vie des ouvriers français ; le questionnaire qui, pour la première fois, s’adresse exclusivement aux ouvriers, eux-mêmes doit aussi servir à éclairer la classe ouvrière elle-même sur sa situation réelle et les causes sociales de sa misère. Aussi le questionnaire détaillé, qui comprend 100 questions, utilise-t-il les catégories essentielles de la théorie marxiste de la société de manière adaptée à l’état du mouvement ouvrier et à l’éducation de la classe ouvrière à cette époque.On a reproduit, en appendice de l’article, une traduction allemande du questionnaire. (shrink)

This volume addresses the issues of the Third Age--that time after retirement when financial stability and reduced obligations to others, together, allow for freedom--and good health makes it possible to enjoy that freedom. How, in this special time of life, is meaning and purpose to be found? And what alternatives are available? These difficult questions are responded to by scholars in the field of aging, some themselves in the Third Age.

Why, despite well-established and well-publicized intergovernmental processes that date back to the early 1970s, have we been unable to put in place effective mechanisms to combat climate change? Why, despite the existence of extensive global human rights machinery, do we live in a world where mass kidnapping, rape, torture, and murder continue to blight the lives of so many? Why, despite a great deal of effort on the part of intergovernmental organizations and nonstate actors, have we been unable to make (...) much of a difference to the lives of the ultra-poor and attenuate the very worst aspects of growing global inequalities? Most fundamentally, why have the current international system and the outcomes that it has produced remained so inadequate in the postwar period? (shrink)

The main object of this article is to give two novel proofs of the admissibility of Ackermann’s rule (γ) for the propositional relevant logic R. The results are established as corollaries of cut elimination for systems of tableaux for R. Cut elimination, in turn, is established both nonconstructively (as a corollary of completeness) and constructively (using Gentzen-like methods). The extensibility of the techniques is demonstrated by showing that (γ) is admissible for RQ* (R with constant domain quantifiers). The status of (...) the admissibility of (γ) for RQ* was, to the best of the author’s knowledge, an open problem. Further extensions of these results will be explored in the sequel(s). (shrink)

This commentary examines the interpretation of Parmenides developed by Rose Cherubin in her paper, “Parmenides, Liars, and Mortal Incompleteness.” First, I discuss the tensions Cherubin identifies between the definitions and presuppositions of justice, necessity, fate, and the other requisites of inquiry. Second, I critically assess Cherubin’s attribution of a sort of liar paradox to Parmenides. Finally, I argue that Cherubin’s handling of the Doxa, the section of Parmenides’ poem that deals with mortal opinion and cosmology, is unsatisfactory. I suggest that (...) her reading may contradict the text in denying that the Doxa contains truths. (shrink)

This is the first complete English translation of Hasdai Crescas's Light of the Lord, a seminal work of medieval Jewish philosophy. Crescas challenges the Aristotelian underpinnings of medieval thought, introduces alternative physical and metaphysical theories, and presents service to the God of love and benefaction as the goal for humankind.

This edited book brings together research work in the field of constructive semantics with scholarship on the phenomenological foundations of logic and mathematics. It addresses one of the central issues in the epistemology and philosophy of mathematics, namely the relationship between phenomenological meaning constitution and constructive semantics. Contributing authors explore deep structural connections and fundamental differences between phenomenology and constructivism. Papers are drawn from contributions to a prestigious workshop held at the University of Friedrichshafen. Readers will discover insight into structural (...) connections between the phenomenological concept of meaning constitution and constructivist concepts of meaning. Discussion ranges from more specific conceptualizations in the philosophy of logic and mathematics to more general considerations in epistemology, inferential semantics and phenomenology. Questions such as a possible phenomenological understanding of the relationship between structural rules and particle rules in dialogical logic are explored. Significant aspects of both phenomenology and dialectics, and dialectics and constructivism emerge. Graduates and researchers of philosophy, especially logic, as well as scholars of mathematics will all find something of interest in the expert insights presented in this volume. (shrink)

Traditional pedagogical approaches to the Platonic forms pose problems that can be best addressed by presenting students two rival interpretations: one that understands the forms in terms of definitions, and another in terms of ideals. The second, if not the first interpretation, models, for students of even a relativistic stripe, how one can conceive the existence of thought-objects about which no consensus exists. It also serves to illustrate how knowledge of such thought-objects may be attained nonetheless. This approach is to (...) be preferred, therefore, to traditional approaches that tend to reinforce, rather than counteract, relativism in students. (shrink)