Medical students' professional identity formation is an adaptive, developmental process. PIF is shaped by values implicit in educational practices and in the culture of the learning environment. In 2003, educational leaders at Harvard Medical School created the Cambridge Integrated Clerkship as a new model of clinical education to support PIF intentionally. The CIC, a longitudinal integrated clerkship, differs in structure, processes, and venues from traditional block rotations, while...

Doxastic voluntarism is the thesis that our beliefs are subject to voluntary control. While there’s some controversy as to what “voluntary control” amounts to (see 1.2), it’s often understood as direct control: the ability to bring about a state of affairs “just like that,” without having to do anything else. Most of us have direct control over, for instance, bringing to mind an image of a pine tree. Can one, in like fashion, voluntarily bring it about that one believes (...) a specific proposition? Doxastic voluntarists hold that, at least in some circumstances—such as when the evidence is ambiguous—we can. Doxastic involuntarists, in contrast, maintain that we cannot. Some involuntarists hold that the concept of belief itself precludes the possibility of believing voluntarily. Others hold that the impossibility of voluntary belief is a contingent psychological fact. Historically, the issue of doxastic voluntarism has been connected to how many think about religious commitment: a prominent view of faith is that it is a voluntary decision to believe. Furthermore, the issue of voluntarism has also been viewed as having bearing on fundamental questions in epistemology. For example, are epistemic norms duties to believe in certain ways? Are there practical or moral reasons to believe? If the answer to either question is “yes,” it seems some measure of voluntary doxastic control is required. -/- In section 1, we expand on the definition of doxastic voluntarism, and survey various kinds of control (e.g. direct, indirect, long-range) and the doxastic attitudes we might control (e.g. outright belief, withholding, credences). In section 2, we discuss a number of historical views on doxastic voluntarism. In section 3, we survey motivations for rejecting doxastic voluntarism. There are two general strategies: arguments that appeal to psychological considerations, and conceptual arguments regarding the nature of belief. In section 4, we survey five approaches to defending voluntarism: those that appeal to epistemic permissivism, doxastic compatibilism, skepticism, one-off considerations, and non-standard views of belief. In section 5, we cover empirical work on doxastic voluntarism. The last two sections discuss two implications of voluntarism. In section 6, we discuss voluntarism’s implications for the ethics of belief, and in section 7, we discuss issues at the intersection of voluntarism and religious faith. (shrink)

Why our workplaces are authoritarian private governments—and why we can’t see it One in four American workers says their workplace is a “dictatorship.” Yet that number almost certainly would be higher if we recognized employers for what they are—private governments with sweeping authoritarian power over our lives. Many employers minutely regulate workers’ speech, clothing, and manners on the job, and employers often extend their authority to the off-duty lives of workers, who can be fired for their political speech, recreational activities, (...) diet, and almost anything else employers care to govern. In this compelling book, Elizabeth Anderson examines why, despite all this, we continue to talk as if free markets make workers free, and she proposes a better way to think about the workplace, opening up space for discovering how workers can enjoy real freedom. (shrink)

Permissivism is the thesis that, for some body of evidence and a proposition p, there is more than one rational doxastic attitude any agent with that evidence can take toward p. Proponents of uniqueness deny permissivism, maintaining that every body of evidence always determines a single rational doxastic attitude. In this paper, we explore the debate between permissivism and uniqueness about evidence, outlining some of the major arguments on each side. We then consider how permissivism can be understood as an (...) underdetermination thesis, and show how this moves the debate forward in fruitful ways: in distinguishing between different types of permissivism, in dispelling classic objections to permissivism, and in shedding light on the relationship between permissivism and evidentialism. (shrink)

“Jesus” constitutes the main element of Christian life. Therefore, Christianity is perceived as a Jesus-centered religion. This perception, from the birth of Jesus to his resurrection, clearly reveals itself both in the Christian faith, Christian worship and Iconography. Because, according to Christians, the birth of Jesus is the beginning of the salvation of mankind. The birth of Jesus, which contains a process, was celebrated as a Christmas Festival in Christianity. Christmas is a combination of the words “Noiono, Noio, Neos” and (...) the concepts “hed, hel, Helios”. These words mean “first day, new day of the month” or “new sun”. Today, Christmas has an important place in Christian life as folkloric. In this component, Santa Claus, pine tree and turkey have an important role. The birth of Jesus was reflected in iconography. The birth scene of Jesus was included in the iconography, and it was one of the icons of the twelve yortou (dodekaorthon). In this context, icons are important (especially for Orthodox Christians). The concept of icon comes from the Greek words “eikon, eikein”. In the iconography the birth of Jesus have the birth of Mary, the visit of Elizabeth, the dream of Joseph and the angel to Joseph, the census, the birth of Jesus, the good news of the shepherds and the worship of Kings. The concepts related to icons within these stages were analyzed. In this article, the importance of birth of Jesus in Christian life and iconography is revealed. Then, the birth of Jesus as a holiday has been discussed. And this birth was interpreted in iconographic terms. (shrink)

I. Causal Thesis: Dispositions have a causal basis. II. Distinctness Thesis: Dispositions are distinct from their causal basis. III. Impotence Thesis: Dispositions are not causally active.

This current study is a pilot project designed to clarify changes in the lived world among people with diagnoses within the schizophrenia spectrum. The Examination of Anomalous World Experience was used to interview ten participants with schizophrenia spectrum disorders and a comparison group of three participants with major depressive disorder. Interviews were analyzed using the descriptive phenomenological method. This analysis revealed two complementary forms of experience unique toszparticipants: Destabilization, the experience that reality and the intersubjective world are less comprehensible, less (...) stable, and generally less real; and Subjectivization, the dominance of one’s internal, subjective experiences in the perception or interpretation of the lived world. Persons with depressive disorders, by contrast, did not experience disruptions of the reality or independence of the world or any significant disruptions of appearance or meaning. These results are consistent with contemporary and classic phenomenological views on anomalous world experience in schizophrenia. (shrink)

What is the work ethic? Does it justify policies that promote the wealth and power of the One Percent at workers' expense? Or does it advance policies that promote workers' dignity and standing? Hijacked explores how the history of political economy has been a contest between these two ideas about whom the work ethic is supposed to serve. Today's neoliberal ideology deploys the work ethic on behalf of the One Percent. However, workers and their advocates have long used the work (...) ethic on behalf of ordinary people. By exposing the ideological roots of contemporary neoliberalism as a perversion of the seventeenth-century Protestant work ethic, Elizabeth Anderson shows how we can reclaim the original goals of the work ethic, and uplift ourselves again. Hijacked persuasively and powerfully demonstrates how ideas inspired by the work ethic informed debates among leading political economists of the past, and how these ideas can help us today. (shrink)

Looking at the philosophical issues raised by food this short and accessible book questions the place food should have in our individual lives. It shows how traditional philosophy and its classic texts can illuminate an everyday subject.

-/- Background: Nurses who provide aggressive care often experience the ethical challenge of needing to preserve the hope of seriously ill patients and their families without providing false hope. -/- Research objectives: The purpose of this inquiry was to explore nurses’ moral competence related to fostering hope in patients and their families within the context of aggressive technological care. A secondary purpose was to understand how this competence is shaped by the social–moral space of nurses’ work in order to capture (...) how competencies may reflect an adaptation to a less than ideal work environment. -/- Research design: A critical qualitative approach was used. -/- Participants: Fifteen graduate nursing students from various practice areas participated. -/- Ethical considerations: After receiving ethics approval from the university, signed informed consent was obtained from participants before they were interviewed. -/- Findings: One overarching theme ‘Mediating the tension between providing false hope and destroying hope within biomedicine’ along with three subthemes, including ‘Reimagining hopeful possibilities’, ‘Exercising caution within the social–moral space of nursing’ and ‘Maintaining nurses’ own hope’, was identified, which represents specific aspects of this moral competency. -/- Discussion: This competency represents a complex, nuanced and multi-layered set of skills in which nurses must be well attuned to the needs and emotions of their patients and families, have the foresight to imagine possible future hopes, be able to acknowledge death, have advanced interpersonal skills, maintain their own hope and ideally have the capacity to challenge those around them when the provision of aggressive care is a form of providing false hope. -/- Conclusion: The articulation of moral competencies may support the development of nursing ethics curricula to prepare future nurses in a way that is sensitive to the characteristics of actual practice settings. (shrink)

We can freely cross disciplinary boundaries, as well as the line between theory and practice, and allow practices to cast their light back on the theory and show us its deficiencies. In short, this approach reorients some much-discussed issues of professional, business, and military ethics and reveals them as variations on one deeply rooted theme. The author does not treat current institutions as final and unalterable. If these arrangements frustrate moral evaluation, she finds that an argument for change. To make (...) intelligent changes, however, we need a clear view of the reasoning that makes them seem natural and inevitable. That is what this book attempts to do. In the process, the author also reexamines the concept of "person." Not all cultures put so much stress on the idea as Western - and particularly American - cultures do. If we wish to keep this emphasis, then here is another argument for change. (shrink)

This commentary responds to the article “What Is the Aim of Pediatric ‘Gender‐Affirming’ Care?,” by Moti Gorin, in the same issue of the journal. Gender‐affirming care is often treated as exceptional and subject to heightened scrutiny. This exceptionalization results in its being held to stricter evidentiary standards than other forms of medical interventions are. But values and value judgments are inextricable from the practice of evidence‐based medicine. For gender‐affirming care, values shape what counts as “strong” evidence, whether the legitimacy of (...) transgender identity is assumed versus treated as something to be investigated, how to characterize the testimonial accounts of trans and gender‐nonconforming patients, and more. We argue that these kinds of questions are part of the practice of medicine, not exceptional to transgender people and gender‐affirming care. However, litigation of evidence for gender‐affirming care in state and national policy underscores the moral urgency of thinking carefully about what values ought to guide evidence. (shrink)

Epistemic paternalism is the practice of interfering with someone’s inquiry, without their consent, for their own epistemic good. In this chapter, I explore the relationship between epistemic paternalism and two other epistemological theses: epistemic permissivism and standpoint epistemology. I argue that examining this relationship is fruitful because it sheds light on a series of cases in which epistemic paternalism is unjustified and brings out notable similarities between epistemic permissivism and standpoint epistemology.

When future generations come to analyze and survey twentieth-century philosophy as a whole, Bertrand Russell’s logic and theory of knowledge is assured a place of prime importance. Yet until this book was first published in 1969 no comprehensive treatment of his epistemology had appeared. Commentators on twentieth-century philosophy at the time assumed that Russell’s important contributions to the theory of knowledge were made before 1921. This book challenges that assumption and draws attention to features of Russell’s later work which were (...) overlooked. The analysis starts with Russell’s earliest views and moves from book to book and article to article through his enormous span of writing on the problems and theory of knowledge. The changes in ideas as he developed the theory are traced, and the study culminates in a statement of his latest views. His work is seen in a continuity in which the changes were part of the development of his mature thought, and the total evaluation and interpretation clarify many of the common misunderstandings of his philosophy. This is naturally of interest to all philosophers, and for students this is the answer to inevitable questions on the nature of Russell’s ideas and their evolution. (shrink)

For much of his career, British political philosopher Michael Oakeshott was identified with Margaret Thatcher’s conservative policies. He has been called by some a guru to the Tories, while others have considered him one of the last proponents of British Idealism. Best known for such books as _Experience and Its Modes_ and _Rationalism in Politics_, Oakeshott has been the subject of numerous studies, but always with an emphasis on his political thought. Elizabeth Campbell Corey now makes the case that (...) Oakeshott’s moral and political philosophies are more informed by religious and aesthetic considerations than has previously been supposed. Hers is the first book-length study of this premise, arguing that Oakeshott’s views on aesthetics, religion, and morality are intimately linked in a creative moral personality that underlies his political theorizing. Corey focuses on a wealth of early material from Oakeshott’s career that has only recently been published, as well as his acclaimed “Tower of Babel” essays, to show that these works illuminate his thinking in ways that could not have been realized prior to their publication. She places Oakeshott squarely in the Augustinian tradition, citing his 1929 essay “Religion and the World,” and then identifies his departure from it. She explores Oakeshott’s recurring theme of “living one’s life in the present”; examines his explicit discussions of religion, aesthetics, and morality; and then considers his political thought in light of this moral vision. She finally compares his idea of Rationalism to Eric Voegelin’s concept of Gnosticism and considers both thinkers’ treatment of Hobbes to delineate their philosophical differences. Through this insightful analysis, Corey shows Oakeshott to be not merely a political philosopher but a thinker with humanistic interests—one who throughout his life was deeply interested in the question of what it means to be human and was moved by art, poetry, and religion while recognizing the necessary evil of political arrangements in order for those activities to flourish. Her work is a major step in a reevaluation of Oakeshott, showing that his conservatism has been greatly misunderstood and that he is more properly regarded as a philosopher whose vision of the human condition, while oftentimes detached and skeptical, is also romantic and inspired. (shrink)

Do terminally ill patients who have exhausted all other available, government-approved treatment options have a constitutional right to experimental treatment that may prolong their lives? On May 2, 2006, a divided panel of the U.S. Court of Appeals for the District of Columbia, in a startling opinion, Abigail Alliance for Better Access to Developmental Drugs v. Von Eschenbach, held “Yes.” The plaintiffs, Abigail Alliance for Better Access to Developmental Drugs and Washington Legal Foundation, sought to enjoin the Food and Drug (...) Administration from refusing to allow the sale of investigational new drugs that had not yet received FDA approval. The terminally ill plaintiffs contended that they quite literally could not wait that long for the drugs. With no other treatment options available, the plaintiffs urged the court to recognize a fundamental, constitutional right to take potentially life-saving or life-prolonging drugs, even though the treatment had not been fully tested through human trials for safety and effectiveness and could not be legally marketed to the public. (shrink)

ABSTRACTIndividual differences in the habitual use of emotion regulation strategies may play a critical role in understanding psychological and biological stress reactivity and recovery in depression and anxiety. This study investigated the relation between the habitual use of different emotion regulation strategies and cortisol reactivity and recovery in healthy control individuals and in individuals diagnosed with social anxiety disorder. The tendency to worry was associated with increased cortisol reactivity to a stressor across the full sample. Rumination was not associated with (...) cortisol reactivity, despite its oft-reported similarities to worry. Worry and rumination, however, were associated with increased cortisol during recovery from the stressor. The only difference between CTL and SAD participants was observed for reappraisal. In the CTL but not in the SAD group, reappraisal predicted recovery, such that an increased tendency to reappraise was associated with greater c... (shrink)

Linking specific nursing actions to outcomes in the healthcare setting is challenging. Patient outcomes are varied and influenced by a myriad of factors, and always involve a wider team than any one nurse. It is difficult to control for a single action or set of actions of a particular nurse. Furthermore, practice is seldom about any ‘one’ action, for one thing leads to another, all within a complex interplay of influencing factors. In this article, we outline a research method which (...) combined Dewey's pragmatism with Gadamer's hermeneutics to explore the consequences of the nurse's use of advanced assessment skills in the acute care setting of medical and surgical wards. This pragmatic hermeneutic methodological approach allowed the complex interplay of influences to be revealed in the unfolding story. Reflection of the nurse brought insights that may otherwise have been passed over. The philosophical notions of Dewey drew attention to the play of ‘means’ and ‘ends’. A hermeneutic approach that calls for ‘thinking’ extends understanding and raises insights that can inform education and practice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 61.3 (2000) 513-530 [Access article in PDF] Hans Blumenberg and Hannah Arendt on the "Unworldly Worldliness" of the Modern Age Elizabeth Brient Introduction In attempting to describe and respond to the dominant ethos of the modern age one is quickly confronted with a startling and seemingly intractable paradox: the age which has defined itself by the very intensity of its "this worldly" (...) orientation is at the same time haunted by an ever growing sense of world loss, of the Unheimlichkeit of modern reality.On the one hand the modern turn away from the transcendent contemplative and religious ideals and values of antiquity and the Middle Ages is evidenced by a profoundly new, active, and indeed constructive approach to the world. Modern science is predicated on an objective stance which demystifies the cosmos and allows for a technological mastery of nature which has improved human life in innumerable ways. The modern conception of the self is grounded in a new conception of the autonomy and dignity of the individual, and modern political theory begins with the notion that society is an artifact to be constructed in the service of the very individuals who constitute the body politic. We are made uneasy by the nagging suspicion that life in this world which we have remade for ourselves is somehow hollow, an artificial construction without depth or solidity, a merely superficial order which threatens to dissolve into meaninglessness. The technological advances made possible by modern science have also brought the atomic bomb, global warming, and acid rain. Power over nature has led to the power to destroy nature. The modern world has seen an unprecedented rise in individual freedom, and yet the autonomy of the individual has all too often given way to the anomie of the individual. Loss of community advances alongside failed experiments in social engineering, and the specter of totalitarianism haunts the modern dream of social and political emancipation. [End Page 513]Paradoxically, then, modern worldliness is attended by an uneasy sense of world alienation. It has become quite common in attempting to give an account for this perplexing state of affairs to speak of a process of secularization in the transition from the medieval to the modern world, a process in which many of the central ideas and principles of the modern age are taken to be secular variations on medieval theological themes. Thus, for example, faith in the progress of science or of history is taken to be a secularized version of belief in divine Providence, the political equality of all individuals under the law is said to be a secular reiteration of the understanding of the equality of all human beings before God, the transcendental subject is exposed as a secular version of the divine or angelic knower, and the communist state and other modern utopias marking the end of history are said to be secularizations of Christian eschatological expectations of the end of the world and the coming reign of God.This reading of the epochal transition explains the worldly character of modern reality in terms of the "immanentization" or secularization of religious attitudes and expectations. It also serves to explain the uncanny sense of worldlessness characteristic of much of modern life. This is because the new secular forms are now revealed either as distorted and impoverished versions of an originally meaningful world view (as for example in Neo-Scholasticism) or as the unfortunate perpetuation or unfolding of an inherently nihilistic tradition (as say Nietzsche, Heidegger, and many contemporary post modernists would have it). But does the secularization thesis as a tool of historical explanation really do justice either to the complex reality of the epochal transition in concrete historical terms or even, and more to the point, to the fundamental character of the supposedly secularized modern ideas?Hans Blumenberg and Hannah Arendt would both no doubt answer emphatically in the negative. Both insist on the genuine novelty of modernity, on the fundamentally unprecedented character of the modern orientation to and in the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesZohar Lederman, Ola Ziara, Rachel Coghlan, Oksana Sulaieva, Anna Shcherbakova, Oleksandr Dudin, Vladyslava Kachkovska, Iryna Dudchenko, Anna Kovchun, Lyudmyla Prystupa, Yuliya Nogovitsyna, Ghaiath Hussein, Kathryn Fausch, P. P. Kyaw, Ayesha Ahmad, Richard W Sams II, Handreen Mohammed Saeed, Artem Riga, Ryan C. Maves, Elizabeth Dotsenko, Irina Deyneka, Eva V. Regel, and Vita Voloshchuk• An Unsettling Affair• How We Keep Caring While Walking Through Our (...) Pain• Adjusting Laboratory Practices to the Challenges of Wartime• Why We Stay• A Semi-Personal Story from a Ukrainian NGO Professional (or a Semi-Professional Story from a Ukrainian Person) Living through the War• When Ethics Survives Where People Do Not: A Story From Darfur• Burma’s Healthcare Under Fire: My Experience as an Exiled Medical Professional• When a Conflict Collapses on a Child: An (Aborted) Medical Evacuation of a Hazara Toddler During the Kabul Airport Blast and the Taliban Takeover• The Vagaries and Vicissitudes of War• Providing Care to a Potential Aggressor: An Ethical Dilemma• One Surgeon’s Experience During Armed Conflict in Ukraine• The Limits of Our Obligations• A Liberating Breath• Soldiers of the Invisible Front: How Ukrainian Therapists Are Fighting for the Mental Health of the Nation Under Fire• Stories of Families with Chronically Ill Pediatric Patients during the War in UkraineCopyright © 2023 Johns Hopkins University Press... (shrink)

One of the possible ways to explain the experience of visual richness is to posit a level of nonconceptual or phenomenal experience. The contents of this level of experience have recently been equated with the contents of sensory memory. It will be argued that sensory memory cannot provide these contents along two broad points. First, the conception of sensory memory relied on by these authors conflates the phenomena of visible and informational persistence, and makes use of an outdated “iconic” model (...) of visual short-term memory. Second, the way in which subjects’ reports are used to show that specific unreported contents are nevertheless experienced on a phenomenal level is questioned, using evidence on gist and high-level categorical perceptual processing. It is concluded that sensory memory, properly understood, cannot provide the kind of visual content required to support a level of richly detailed phenomenal experience, or a pictorial account of perception. Finally, alternative ways of explaining visual richness are suggested. (shrink)

This article provides a broad survey of issues facing rural communities and suggests that medicalization of poverty concepts and interventions need to be tailored to those populations. Rural poverty may be both broader and deeper than in urban areas. Those challenges seem to produce a constellation of health conditions, as rural residents struggle with unemployment and lack of opportunities. Relatedly, rural communities struggle to maintain financially viable hospitals and specialty providers. The article closes by offering a snapshot of rural-specific strategies (...) to address these issues. (shrink)

There are questions about how ethics is best taught to undergraduate business students. There has been a proliferation in the number of stand-alone ethics courses for undergraduate students but research on the effectiveness of integrated versus stand-alone mode of delivery is inconclusive. Christensen et al. :347–368, 2007), in a comprehensive review of ethics, corporate social responsibility and sustainability education, investigated how ethics education has changed over the last 20 years, including the issue of integration of these topics into the core (...) course offerings. We use Brenner and Molander’s :57–71, 1977) situational ethics survey instrument to examine the effect of the mode of delivery of business ethics education on undergraduate student responses. We found a significant difference on mode of delivery. Studies have also found interesting results in respect of the effect of cultural differences and gender on the effectiveness of business ethics instruction. While not the primary focus of this study, we also looked at the influence of gender and culture on students’ responses. Our results indicate significant differences in respect of mode of delivery and culture. In contrast to other studies, we found that gender was not significant. We did test for any interactive effects of gender, culture and mode of delivery. However, no significant differences were found. (shrink)

This article reports on qualitative research conducted in KwaZulu-Natal, South Africa, among researchers and gate-keepers of health facilities in the province. Results suggest disparate but not irreconcilable perceptions of the social value of research in provincial health facilities. This study found that researchers tended to emphasize the contribution of research to the generation of knowledge and to the health of future patients while gate-keepers of health facilities tended to emphasize its contribution to the healthcare system and to current patients. Furthermore, (...) relations between research stakeholders were perceived to be somewhat fragile, making it difficult for stakeholders to achieve consensus about the social value of research, as well as on ways to maximize value. Interventions to negotiate a shared perspective on the social value of research would appear to be warranted, and the findings of this study suggest some focus areas for such intervention. (shrink)

Tigard suggests that the medical community would benefit from continuing to promote notions of individual responsibility and blame in healthcare settings. In particular, he contends that blame will promote systematic improvement, both on the individual and institutional levels, by increasing the likelihood that the blameworthy party will ‘own up’ to his or her mistake and apologise. While we agree that communicating regret and offering a genuine apology are critical steps to take when addressing patient harm, the idea that medical professionals (...) should continue to ‘take the blame’ for medical errors flies in the face of existing science and threatens to do more harm than good. We contrast Dr Tigard’s approach with the current literature on blame to promote an alternative strategy that may help to create lasting change in the face of unfortunate error. (shrink)