Energy has an ambivalent status in social theory, variously figuring as a driver or an outcome of social and institutional change, or as something that is woven into the fabric of society itself. In this article the authors consider the underlying models on which different approaches depend. One common strategy is to view energy as a resource base, the management and organization of which depends on various intersecting systems: political, economic and technological. This is not the only route to take. (...) The authors develop an alternative approach, viewing energy supply and energy demand as part of the ongoing reproduction of bundles and complexes of social practice. In articulating and comparing these two positions they show how social-theoretical commitments influence the ways in which problems like those of reducing carbon emissions are framed and addressed. Whereas theories of practice highlight basic questions about what energy is for, these issues are routinely and perhaps necessarily obscured by those who see energy as an abstract resource that structures or that is structured by a range of interlocking social systems. (shrink)

Total knee arthroplasty (TKA) is a commonly implemented elective surgical treatment for end-stage osteoarthritis of the knee, demonstrating high success rates when assessed by objective medical outcomes. However, a considerable proportion of TKA patients report significant dissatisfaction postoperatively, related to enduring pain, functional limitations, and diminished quality of life. In this conceptual analysis, we highlight the importance of assessing patient-centred outcomes routinely in clinical practice, as these measures provide important information regarding whether surgery and postoperative rehabilitation interventions have effectively remediated (...) patients’ real-world “quality of life” experiences. We propose a novel precision medicine approach to improving patient-centred TKA outcomes through the development of a multivariate machine-learning model. The primary aim of this model is to predict individual postoperative recovery trajectories. Uniquely, this model will be developed using an interdisciplinary methodology involving non-linear analysis of the unique contributions of a range of preoperative risk and resilience factors to patient-centred TKA outcomes. Of particular importance to the model’s predictive power is the inclusion of a comprehensive assessment of modifiable psychological risk and resilience factors that have demonstrated relationships with TKA and other conditions in some studies. Despite the potential for patient psychological factors to limit recovery, they are typically not routinely assessed preoperatively in this patient group, and thus can be overlooked in rehabilitative referral and intervention decision-making. This represents a research-to-practice gap that may contribute to adverse patient-centred outcomes. Incorporating psychological risk and resilience factors into a multivariate prediction model could improve the detection of patients at risk of sub-optimal outcomes following TKA. This could provide surgeons and rehabilitation providers with a simplified tool to inform postoperative referral and intervention decision-making related to a range of interdisciplinary domains outside their usual purview. The proposed approach could facilitate the development and provision of more targeted rehabilitative interventions on the basis of identified individual needs. The roles of several modifiable psychological risk and resilience factors in recovery are summarised, and intervention options are briefly presented. While focusing on rehabilitation following TKA, we advocate for the broader utilisation of multivariate prediction models to inform individually-tailored interventions targeting a range of health conditions. (shrink)

During the past two decades, several reports have documented substantial support from clinicians, policy-makers, and the general public for the use of advance directives, yet studies continue to find that only a minority of individuals have completed these legal documents. Advance directives are written instructions, such as living wills or durable powers of attorney for health care, which describe an individual's medical treatment wishes in the event that individual becomes incapacitated in the future. The completion and use of advance directives (...) is one of several components of the broader activity of advance care planning, that is, the overall planning and communication of personal wishes concerning future medical care.In December 1991, the federal Patient Self-Determination Act became effective. Promoted as a federal initiative to enhance an individual's control over medical treatment decision making and, therefore, patient autonomy and self-determination, PSDA placed several new requirements on health care organizations receiving Medicare or Medicaid payments. (shrink)

During the past two decades, several reports have documented substantial support from clinicians, policy-makers, and the general public for the use of advance directives, yet studies continue to find that only a minority of individuals have completed these legal documents. Advance directives are written instructions, such as living wills or durable powers of attorney for health care, which describe an individual's medical treatment wishes in the event that individual becomes incapacitated in the future. The completion and use of advance directives (...) is one of several components of the broader activity of advance care planning, that is, the overall planning and communication of personal wishes concerning future medical care.In December 1991, the federal Patient Self-Determination Act became effective. Promoted as a federal initiative to enhance an individual's control over medical treatment decision making and, therefore, patient autonomy and self-determination, PSDA placed several new requirements on health care organizations receiving Medicare or Medicaid payments. (shrink)

Adopting the perspective of another person is an important aspect of social cognition and has been shown to depend on multisensory signals from one’s own body. Recent work suggests that interoceptive signals not only contribute to own-body perception and self-consciousness, but also to empathy. Here we investigated if social cognition – in particular adopting the perspective of another person – can be altered by a systematic manipulation of interoceptive cues and further, if this effect depends on empathic ability. The own-body (...) transformation task – wherein participants are instructed to imagine taking the perspective and position of a virtual body presented on a computer screen – offers an effective way to measure reaction time differences linked to the mental effort of taking an other’s perspective. Here, we adapted the OBT with the flashing of a silhouette surrounding the virtual body, either synchronously or asynchronously with the timing of participants’ heartbeats. We evaluated the impact of this cardio-visual synchrony on reaction times and accuracy rates in the OBT. Empathy was assessed with the empathy quotient questionnaire. Based on previous work using the cardio-visual paradigm, we predicted that synchronous cardio-visual stimulation would increase self-identification with the virtual body and facilitate participants’ ability to adopt the virtual body’s perspective, thereby enhancing performance on the task, particularly in participants with higher empathy scores. We report that participants with high empathy showed significantly better performance during the OBT task during synchronous versus asynchronous cardio-visual stimulation. Moreover, we found a significant positive correlation between empathic ability and the synchrony effect. We conclude that synchronous cardio-visual stimulation between the participant’s body and a virtual body during an OBT task makes it easier to adopt the virtual body’s perspective, presumably based on multisensory integration processes. However, this effect depended on empathic ability, suggesting that empathy, interoception and social perspective taking are inherently linked. (shrink)

Orations of the Fatimid Caliphs: Festival Sermons of the Ismaili Imams. Ed. and tr. Paul E. Walker. Ismaili Texts and Translations Series, vol. 10. London: I. B. Tauris, with the Institute of Ismaili Studies, 2009. Pp. xvii + 162 + 58. £29.50, $51.29.

Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values (...) and responsibilities in situations of moral distress. We also discuss the importance of nurses creating “counterstories” of their work as knowledgeable and trustworthy professionals to repair their damaged moral identities, and, finally, we recommend that efforts toward shifting the goal of health care away from the prolongation of life at all costs to the relief of suffering to diminish the moral distress that is a common response to aggressive care at end-of-life. (shrink)

Walker Percy was both a medical doctor and a serious Catholic—a scientist and a religious believer. He thought, however, that science had become hegemonic in the twentieth century and that it was incapable of answering the most fundamental needs of human beings. He thus leveled a critique of the scientific method and its shortcomings in failing to address the individual person over against the group. In response to these shortcomings Percy postulates a religious understanding of human life, one in (...) which man's life is understood as a pilgrimage or a search. The person who searches may not find the “object” of his search during his earthly life, but it is likely that he will come to a better understanding of himself by means of it. (shrink)

It may be the case that the most challenging moral problem of the twenty‐first century will be the relationship between the individual moral agent and the practices and institutions in which the moral agent is embedded. In this paper, we continue the efforts that one of us, Joan Liaschenko, first called for in 1993, that of using feminist ethics as a lens for viewing the relationship between individual nurses as moral agents and the highly complex institutions in which they do (...) the work of nursing. Feminist ethics, with its emphasis on the inextricable relationship between ethics and politics, provides a useful lens to understand the work of nurses in context. Using Margaret Urban Walker's and Hilde Lindemann's concepts of identity, relationships, values, and moral agency, we argue that health care institutions can be moral communities and profoundly affect the work and identity and, therefore, the moral agency of all who work within those structures, including nurses. Nurses are not only shaped by these organizations but also have the power to shape them. Because moral agency is intimately connected to one's identity, moral identity work is essential for nurses to exercise their moral agency and to foster moral community in health care organizations. We first provide a brief history of nursing's morally problematic relationship with institutions and examine the impact institutional master narratives and corporatism exert today on nurses’ moral identities and agency. We close by emphasizing the significance of ongoing dialogue in creating and sustaining moral communities, repairing moral identities, and strengthening moral agency. (shrink)

Background:While there have been studies exploring moral habitability and its impact on the work environments of nurses in Western countries, little is known about the moral habitability of the work environments of nurses and midwives in resource-constrained settings.Research objective:The purpose of this research was to examine the moral habitability of the work environment of nurses and midwives in Ghana and its influence on their moral agency using the philosophical works of Margaret Urban Walker.Research design and participants:A critical moral ethnography (...) was conducted through the analysis of interviews with 30 nurses and midwives, along with observation, and documentary materials.Ethical considerations:After receiving ethics approval, signed informed consent was obtained from participants before data collection.Results:Five themes were identified: (1) holding onto the values, identities, and responsibilities of being a midwife/nurse; (2) scarcity of resources as limiting capacity to meet caring responsibilities; (3) gender and socio-economic inequities shaping the moral-social context of practice; (4) working with incoherent moral understandings and damaged identities in the context of inter- and intra-professional relationships; and (5) surviving through adversity with renewed commitment and courage.Discussion:The nurses and midwives were found to work in an environment that was morally uninhabitable and dominated by the scarcity of resources, overwhelming and incoherent moral responsibilities, oppressive conditions, and workplace violence. These situations constrained their moral agency and provoked suffering and distress. The nurses and midwives negotiated their practice and navigated through morally uninhabitable work environment by holding onto their moral values and commitments to childbearing women.Conclusion:Creating morally habitable workplaces through the provision of adequate resources and instituting interprofessional practice guidelines and workplace violence prevention policies may promote safe and ethical nursing and midwifery practice. (shrink)

Medical futility is often defined as providing inappropriate treatments that will not improve disease prognosis, alleviate physiological symptoms, or prolong survival. This understanding of medical futility is problematic because it rests on the final outcomes of procedures that are narrow and medically defined. In this article, Walker's `expressivecollaborative' model of morality is used to examine how certain critical care interventions that are considered futile actually have broader social functions surrounding death and dying. By examining cardiopulmonary resuscitation and life-sustaining intensive (...) care measures as moral practices, we show how so-called futile interventions offer ritualistic benefit to patients, families, and health care providers, helping to facilitate the process of dying. This work offers a new perspective on the ethical debate concerning medical futility and provides a means to explore how the social value of treatments may be as important in determining futility as medical scientific criteria. (shrink)

This essay explores small “ordinary” experiences of moral harm as problems of social injustice. Starting with two stories, we first argue against a dominant framework of personal responsibility that assigns responsibility to particular blameworthy agents. Instead we sketch an account of why structural responsibility for social harm must be considered, drawing on the work of Iris Marion Young and Pierre Bourdieu. Finally, drawing on Margaret Walker’s notion of moral repair and Christopher Marshall’s interpretation of the parable of the Good (...) Samaritan, we sketch an account of Christian moral responsibility grounded in restorative justice that seeks to address daily experiences of moral harm through the moral repair work of neighbor-love. (shrink)

For deliberations on the ethical and meta-ethical implications of Alfred North Whitehead's process philosophy, here are abstracts and papers from the Ethics Section of the 6th International Whitehead Conference held at the University of Salzburg in Salzburg, Austria in July 2006. In accordance with the conference schedule, there are three subsections. The subsection on "Metaphysics of Morals and Moral Theory" includes contributions from Franklin I. Gamwell (Does Morality Presuppose God?), John W. Lango (abstract only), Duane Voskuil ("Ethics' Dipolar Necessities and (...) Theistic Implications), and Theodore Walker Jr. ("Neoclassical Cosmology and Matthew 22:36-40). The subsection on "Evaluating Moral Practices" includes contributions from Frederick Ferrè (abstract only), Seung Gap Lee (Hope for the Earth: A Process Eschatological Eco-ethics for South Korea), Mary Elizabeth Mullino Moore (Compassion, Creativity, and Form: The Ethics of Institutions), and George W. Shields (Ruse, Altruism, and Process Philosophy). The subsection on "Ethics and Aesthetic Values" includes contributions from Stephen T. Franklin (abstract only), Brian G. Henning (Is There an Ethics of Creativity?), Mihàly Tòth (Art of Life and the Ethics of Life Forming), and Guorong Yang (Problems and Perspectives in the Emerging of Global Society). (shrink)

We citizens of the 21st century live in a world where division of epistemic labour rules. Most of what we know we learned from the spoken or written word of others, and we depend in endless practical ways on the technological fruits of the dispersed knowledge of others—of which we often know almost nothing—in virtually every moment of our lives. Interest has been growing in recent years amongst philosophers, in the issues in epistemology raised by this fact. One issue concerns (...) the depth and extent of our epistemic dependence on testimony, as we may label this broad epistemic source: Do we have any knowledge at all that is free of epistemic dependence on what we have learned from others? A related question is whether our entitlement to believe what we have learned from others can be explained without invoking any epistemic principles special to testimony. These questions concern, as it were, the macro-epistemology of testimony. In the present discussion I shall focus instead on the micro foundations. Testimony, in our broad sense, can occur through an extensive range of types of spoken and written means of purportedly factual communication, including telephone calls, e-mails and personal letters, lectures and radio broadcasts, newspapers, textbooks and encyclopaedias, personal diaries, and public records of all kinds. But the central paradigm—what started the whole communication thing off—is surely that of face-to-face spoken encounter, when one person tells something to another, thereby intending and hoping to share her knowledge with her audience. I begin by describing the speech act of telling, identifying what takes place in a felicitous act of telling. From the nature of the speech act of telling, we see precisely how it is that knowledge is, when all goes as it should, acquired from teller by trusting hearer, in such an act, and in acts of testimony more broadly. (shrink)

Willie James Jennings contends that the goal of whiteness is the creation and preservation of segregated space. For Jennings, whiteness, as well as upholding perceived notions of white normativity, is a way of being in the world, an imagined reality made real by our movement in physical space which destroys the identity-forming connections between communities and land. In this article I bring together Pope Francis’s reflections on the globalised economy in Laudato Si’ with the critiques of James H. Cone and (...) Jennings to demonstrate the horrific harm of whiteness on marginalised people groups and the land itself. To resist the building project of whiteness, therefore, requires attention to our relationship with land. At this point I turn more readily to the land of England, offering the beginnings of a theology of place given the substantial land holdings of the Church of England. I close by asking whether the Church of England can be trusted to use its land to dismantle whiteness given its troubling colonial history in relation to land use. (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)

What attitude should philosophers take toward their favorite philosophical theories? I argue that the answer is belief and middling to low credence. I begin by discussing why disagreement has motivated the view that we cannot rationally believe our philosophical theories. Then, I show why considerations from disagreement actually better support my view. I provide two additional arguments for my view: the first concerns roles for belief and credence and the second explains why believing one’s philosophical theories is superior to accepting (...) them. I close by addressing objections, including implications my view has for the Lockean thesis, the view that there is a normative connection between belief and high credence. (shrink)

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Traditional theistic arguments conclude that God exists. Pragmatic theistic arguments, by contrast, conclude that you ought to believe in God. The two most famous pragmatic theistic arguments are put forth by Blaise Pascal (1662) and William James (1896). Pragmatic arguments for theism can be summarized as follows: believing in God has significant benefits, and these benefits aren’t available for the unbeliever. Thus, you should believe in, or ‘wager on’, God. This article distinguishes between various kinds of theistic wagers, including finite (...) vs. infinite wagers, premortem vs. postmortem wagers, and doxastic vs. acceptance wagers. Then, we’ll turn to the epistemic-pragmatic distinction, and discusses the nuances of James’ argument, and how views like epistemic permissivism and epistemic consequentialism provide unique “hybrid” wagers. Finally, we’ll cover outstanding objections and responses. (shrink)

The author argues that uploading does preserve personal identity, at least identity of a certain sort. The fact that we are assuming that computers are capable of embodying all the same type of properties necessary for personal identity means that we can make use of the equivalency thesis. There are two reasons for invoking the equivalency thesis. The first is so that we are not misled by a new form of racism: substratism. The second is that it makes directly relevant (...) an enormous amount of philosophical effort that has gone into exploring the possibility of carbonto‐ carbon transfers. He examines an alternative explanation to somaticism for why people might be reluctant to use Parfit's Teletransporter, namely, fear of the unknown. Finally, the author talks about the type/token (TT) account of personal identity and then see whether the no‐branching argument has any traction against it. (shrink)

Recent defenses of same-sex marriage and polygamy have invoked the liberal doctrines of neutrality and public reason. Such reasoning is generally sound but does not go far enough. This paper traces the full implications of political liberalism for marriage. I argue that the constraints of public reason, applied to marriage law, entail ‘minimal marriage’, the most extensive set of state-determined restrictions on marriage compatible with political liberalism. Minimal marriage sets no principled restrictions on the sex or number of spouses and (...) the nature and purpose of their caring relationships, nor on which marital rights are exchanged, and whether they are exchanged reciprocally or asymmetrically. Minimal marriage supports adult care networks, urban tribes, friendships, and other forms of relationships as well as ‘traditional’ marriages. I provide a publically justifiable rationale for a legal framework supporting non-dependent caring relationships between adults. The argument is that caring relationships are primary goods, and that liberal justice accordingly requires legal frameworks supporting caring relationships. Minimal marriage is one such framework. (shrink)

Mark Walker argues for Skeptical-Dogmatism-the view that we should disbelieve our cherished philosophical views, such as beliefs about what makes for a good life, religious beliefs, and political beliefs. To not disbelieve one's preferred views in these contested matters is hubristic.

There are reasons to be skeptical of the claim that philosophy and science are making progress toward the complete truth of the universe and our place in it. I discuss two different kinds of skeptical worries about justifying contemporary philosophical and scientific beliefs. Widespread philosophical disagreement leads to a suspicion that most philosophers are probably wrong. In science there is more agreement, but science has not justified some of its basic assumptions including the use of Occam's Razor for theory selection. (...) Worse, noetic skepticism questions whether humans even have the cognitive capacity for understanding the complete truth. We do not believe that children or apes have that capacity, so the question naturally arises within both philosophy and science as to whether we have reason to believe that adult humans are adequately equipped. Finally, I propose a scientific experiment to put this type of skepticism to the test. (shrink)

In this project I am concerned with the extent to which conceptual engineering happens in domains outside of philosophy, and if so, what that might look like. Specifically, I’ll argue that...

This chapter puts to rest for all of eternity the self-undermining charge against conciliationism.

Fast‐forward two hundred years to the opening sequence of Alien: Resurrection where United Systems Military (USM) science officers aboard the Auriga are toying with her DNA—salvaged from frozen blood samples on Fiorina 161—to try to create a cloned version of the alien queen that was growing inside her at the time of her death. The absurd is what links the two— Ripley's desire to make some sense out of her troubling existence and the fact that the world is unable to (...) offer her any such sense. French essayist, Albert Camus, repeatedly stresses this point in different, sometimes rather poetic, ways throughout his classic essay, “The Myth of Sisyphus”. Ripley‐8 has one messed‐up and confusing life. When Camus talks about philosophical suicide, he is really talking about an irrational “leap of faith”. Ripley and Call are both artificial creations living a similar sort of existence. (shrink)

This book moves away from the frameworks that have traditionally guided ethical decision-making in the Western clinical setting, towards an inclusive, non-coercive and, reflective dialogic approach to moral decision-making. Inspired in part by Jürgen Habermas's discourse theory of morality and principles of communicative action, the book offers a proportionist approach as a way of balancing out the wisdom in traditional frameworks, set in the actual reality of the clinical situation at hand. Putting this approach into practice requires having a conversation, (...) a dialogue or a discourse, with collaboration amongst all the stakeholders. The aim of the dialogue is to reach consensus in the decision, via mutual understanding of the values held by the patient and others whom they see as significant. This book aims to underscore the moral philosophical foundations for having a meaningful conversation. Life and Death Decision in the Clinical Setting is especially relevant in our contemporary era, characterised medically by an ever-increasing armamentarium of life-sustaining technology, but also by increasing multiculturalism, a multiplicity of faiths, and increasing value pluralism. (shrink)

This chapter offers a complete account of Aristotle’s underexplored treatment of the virtue of wittiness (eutrapelia) in Nicomachean Ethics IV.8. It addresses the following questions: (1) What, according to Aristotle, is this virtue and what is its structure? (2) How do Aristotle’s moral psychological views inform Aristotle’s account, and how might Aristotle’s discussions of other, more familiar virtues, enable us to understand wittiness better? In particular, what passions does the virtue of wittiness concern, and how might the virtue (and its (...) attendant vices) be related to the virtue of temperance (and its attendant vices)? (3) How does wittiness, as an ethical virtue, benefit its possessor? (4) How can Aristotle resolve some key tensions that his introducing a virtue of wittiness apparently generates for his ethics? In addition to exploring these questions, this chapter challenges some commonly accepted accounts of Aristotle’s views on the nature of the laughable. (shrink)