Across the world, healthcare providers must wrestle with the twin ogres of finite resources and infinite demand. Successful healthcare delivery creates its own legacy of need. For example, a renal failure patient may now be given a greatly extended life by means of dialysis or organ transplantation. In the process, the healthcare provider has created a permanent demand for services during that extended life. It has been estimated that the recurrent cost of maintaining a patient on hemodialysis for 1 year (...) in the United Kingdom is in the region of £20,000. (shrink)

‘A logical theory may be tested by its capacity for dealing with puzzles, and it is a wholesome plan, in thinking about logic, to stock the mind with as many puzzles as possible, since these serve much the same purpose as is served by experiments in physical science.’ This paper is an attempt to follow Russell’s advice by using a puzzle about the contingent a priori to test and explore certain theories of reference and modality. No one could claim that (...) the puzzle is of any great philosophical importance by itself, but to understand it, one has to get clear about certain aspects of the theory of reference; and to solve it, one has to think a little more deeply than one is perhaps accustomed about what it means to say that a statement is contingent or necessary. (shrink)

BackgroundIn the Netherlands, patients have the legal right to make a request for euthanasia to their physician. However, it is not clear what it means in a moral sense for a physician to receive a request for euthanasia. The aim of this study is to explore the moral values of physicians regarding requests for euthanasia. MethodsSemi-structured interviews were conducted with nine primary healthcare physicians involved in decision-making about euthanasia. The data were inductively analyzed which lead to the emergence of themes, (...) one of which was about values regarding end-of-life decisions.ResultsFour clusters of values related to euthanasia requests are described: values related to 1) the patient; 2) the family; 3) the physician; and 4) life and death. The data show that the participants value patient autonomy as a necessary but not sufficient condition for meeting a euthanasia request. A good relationship with the patient and the family are important. For the physician, the values physician autonomy, responsibility, understanding the patient and relief of suffering play a role. Life as an intrinsic good and a peaceful death are also important values.ConclusionThis study shows that next to patient autonomy and the relationship with the patient and the family, it is important for the participants to act in accordance with their professional values and to do justice to values related to life and death. The awareness of going against the intrinsic value of life is crucial, even if performing euthanasia may result in a feeling of relief or gratitude afterwards. (shrink)

The phrase ‘trading zone’ is often used to denote any kind of interdisciplinary partnership in which two or more perspectives are combined and a new, shared language develops. In this paper we distinguish between different types of trading zone by asking whether the collaboration is co-operative or coerced and whether the end-state is a heterogeneous or homogeneous culture. In so doing, we find that the voluntary development of a new language community—what we call an inter-language trading zone—represents only one of (...) four possible configurations. In developing this argument we show how different modes of collaboration result in different kinds of trading zone, how different kinds of trading zone may be ‘nested’ inside each other and discuss how a single collaboration might move between different kinds of trading zone over time. One implication of our analysis is that interactional expertise is a central component of at least one class of trading zone.Keywords: Trading zones; Interactional expertise; Interdisciplinarity; Creole. (shrink)

Health care is transitioning from genetics to genomics, in which single-gene testing for diagnosis is being replaced by multi-gene panels, genome-wide sequencing, and other multi-genic tests for disease diagnosis, prediction, prognosis, and treatment. This health care transition is spurring a new set of increased or novel liability risks for health care providers and test laboratories. This article describes this transition in both medical care and liability, and addresses 11 areas of potential increased or novel liability risk, offering recommendations to both (...) health care and legal actors to address and manage those liability risks. (shrink)

'If' is one of the most important words in the English language, being used to express hypothetical thought. The use of conditional terms such as 'if' distinguishes human intelligence from that of all other animals. In this volume, Jonathan Evans and David Over present a new theoretical approach to understanding conditionals. The book draws on studies from the psychology of judgement and decision making, as well as philosophical logic.

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

Most of the papers presented at a conference held at Oxford in August 1982.

It is occasionally tempting, after climbing a mountain, to use the elevation one has gained to dash up to the top of a connected peak which does not have sufficient interest to induce one to climb so high for its sake alone. It is in this spirit that I turn to Geach's Latin Prose theory of relative clauses. The matter itself is of no very great moment, and some new ground will have to be covered in dealing with Geach's arguments. (...) Nevertheless we shall primarily be applying the theory constructed in the body of the paper, and when one is in a position to expose bad arguments relatively rapidly, it is perhaps a good idea not to leave them unchallenged, especially when they appear to be gaining currency. (shrink)

Drawing on findings in psychology, neuroscience, and utilising the perspective of cognitive linguistics, this work argues that our experience of time may...

Bioethicists’ attraction to principlism is rooted in a Western view of how matters that affect the public ought to be deliberated and decided: their resolution ought to be so structured and constrained that it can be understood and verified even by those at a remove from the circumstances of the problem. That view of deliberation, itself fostered by the Western view of government, has encouraged principlism to spread from its source in human subjects research into other areas of bioethics discourse.

While functioning quite well for many years, the bioethics profession is in crisis. John H. Evans closely examines the history of the bioethics profession, and based on the sociological reasons the profession evolved as it did, proposes a radical solution to the crisis.

The phenomenon known as matching bias consists of a tendency to see cases as relevant in logical reasoning tasks when the lexical content of a case matches that of a propositional rule, normally a conditional, which applies to that case. Matching is demonstrated by use of the negations paradigm that is by using conditionals in which the presence and absence of negative components is systematically varied. The phenomenon was first published in 1972 and the present paper reviews the history of (...) research and theorising on the problem in the subsequent 25 years. Theories of matching bias considered include those based on several broad frameworks including the heuristic-analytic theory, the mental models theory, the theory of optimal data selection, and relevance theory as well as the specific processing-negations account. The ability of these theories to account for a range of phenomena is considered, including the effects of linguistic form, realistic content, and explicit negation on the matching bias effect. Of particular importance are recent findings showing that the bias is observable on a wider range of linguistic forms than has generally been thought, and that it is almost entirely dependent on the use of implicit negation in the logical cases to which rules are applied. The reasons for the general suppression of matching when realistic content is used are, however, unclear and a need for further research is identified here. It is concluded that matching bias is a highly robust effect which is closely connected with the problem of understanding implicit negation. Most of the theories in the literature are unable to account for at least some of the major phenomena discovered in research on the bias. The accounts that fare best are those that posit local effects of negation, including the heuristic-analytic and processing negations theories. (shrink)

I suggest that we can read Marx in the light of recent analytic, neo-Hegelian thought. I summarize the Pittsburgh School philosophers’ claims about the myth of the given, the claim that human experience is conceptual all the way out, and that we live in a space of reasons. I show how Hegel has been read in those terms, and then apply that reading of Hegel to Marx’s argument that capital is akin to what Hegel called Geist, or spirit. We can (...) understand capitalism as a space of reasons that is contradictory: while the space of reasons is supposed to make human freedom possible, our space of reasons makes freedom impossible. Reading Marx in this way is helpful, because it avoids the flaws of analytical Marxism, existentialism and structuralism. However, it raises a large problem of its own: Can the theory of the space of reasons be applied to a society that is not free of alienation? I argue that it can, but only in ways that would not satisfy the analytic neo-Hegelians themselves. (shrink)

‘Interactional expertise’ is developed through linguistic interaction without full scale practical immersion in a culture. Interactional expertise is the medium of communication in peer review in science, in review committees, and in interdisciplinary projects. It is also the medium of specialist journalists and of interpretative methods in the social sciences. We describe imitation game experiments designed to make concrete the idea of interactional expertise. The experiments show that the linguistic performance of those well socialized in the language of a specialist (...) group is indistinguishable from those with full blown practical socialization but distinguishable from those who are not well socialized. The imitation game can also be used to indicate whether an individual can enter an esoteric domain and master the interactional expertise, a skill required by interpretative sociologists of science, anthropologists, ethnographers, and the like.Keywords: Expertise; Interactional expertise; Imitation game; Turing test; Colour blindness; Interpretative methods. (shrink)

This book is an explanation and defence of a veiw of faith and reason that is found in the writings of Kierkegaard, a view often termed as fideism. The author distinguishes indefensible forms of fideism that involve a rejection of reason from a fideism that requires that reason becomeself-critical. An understanding of the limits of reason requires both an understanding of faith as above reason, as in Aquinas and Kant, and also as against what is taken as rational by most (...) human beings.The fiedeistic view of faith as involving a critique of reason is illustrated by concrete discussions of three traditional topics in the philosophy of religion: knowledge of God's existence, the problem of evil and the question as to how someone could know that a particular religion could be basedon a revelation from God.The book presents a careful distinction between different kinds of fideism, with a critical rejection of some kinds and a defence of others. The author shows that fideism does not have to be understood as a rejection of reason, rather as a critique of the limits of reason. (shrink)

Achieving genuine engagement and understanding between communities with radically divergent worldviews is challenging. If there is no common ground on which to stand and have a discussion, the likely outcomes of an apparent intercultural disagreement are a stalemate, or the (sometimes colonialist) imposition of a single worldview, or a kind of relativistic tolerance that falls short of genuine engagement. In this paper, we suggest a way forward that takes as its starting point the philosophical discussion of deep disagreement, using the (...) example of taniwha (powerful water beings that must be treated with respect) to outline a strategy for building intercultural understanding and enabling constructive intercultural dialogue. (shrink)

In the United States, lay-adults with a range of educational backgrounds often conceptualize species change within a non-Darwinian adaptationist framework, or reject such ideas altogether, opting instead for creationist accounts in which species are viewed as immutable. In this study, such findings were investigated further by examining the relationship between religious belief, scientific expertise, and ecological reasoning in 132 college-educated adults from 6 religious backgrounds in a Midwestern city. Fundamentalist and non-fundamentalist religious beliefs were differentially related to concepts of evolution, (...) adaptation, and extinction. Biological expertise and creationism were significantly and differentially related to the endorsement of the Darwinian concept of common descent. Yet, creationists were more likely to reject macroevolutionary than microevolutionary concepts. Overall, the greater the taxonomic distance between species, the less likely were participants to agree that species-pairs had common ancestors. It is argued that lay adults from contemporary industrialized societies adopt a view of evolution in which species adapt to novel environments, but remain the same "kind" despite changes. Therefore, extinction is considered unlikely and the relations between micro- and macroevolution misconstrued. Lay-adults' species concepts appear to be an amalgam of a common-sense understanding of species and of evolutionary ideas, modified but not transformed by religious and scientific beliefs. Finally, it is argued that the development of scientific expertise does not involve the radical transformation of ingrained worldviews. Rather, scientists select specializations that are compatible with their existing philosophies, then consciously apply the constructs of their disciplines in order to transcend their common-sense folk beliefs. (shrink)

M. Oaksford and N. Chater presented a Bayesian analysis of the Wason selection task in which they proposed that people choose cards in order to maximize expected information gain as measured by reduction in uncertainty in the Shannon-Weaver information theory sense. It is argued that the EIG measure is both psychologically implausible and normatively inadequate as a measure of epistemic utility. The article is also concerned with the descriptive account of findings in the selection task literature offered by Oaksford and (...) Chater. First, it is shown that their analysis data reported in the recent article of K. N. Kirby is unsound; second, an EIG analysis is presented of the experiments of P. Pollard and J. St. B. T. Evans that provides a strong empirical disconfirmation of the theory. (shrink)

Essentially everyone agrees that the outlawing of slavery, or the beginning of women’s suffrage, or the defeat of Nazism constitute paradigmatic examples of moral progress in human history. But this consensus belies a deep division about the nature of moral progress more generally, a consequence of the foundational differences among and within normative traditions regarding the nature and scope of the ‘moral’ in moral progress. This essay proposes that philosophers might nonetheless converge on a working definition of moral progress by (...) identifying a proxy property that reliably tracks moral progress, but which does not purport to be coextensive with the philosophically-relevant property. The aim of this essay is to identify this proxy property with emerging empirical measures of population welfare, and to show why this indicator of moral progress can garner overlapping consensus from a variety of normative traditions. (shrink)

A compelling account of Kierkegaard's ethical views, seeing him against the backdrop of nineteenth-century European society but showing the relevance of his thought for the twenty-first century. Kierkegaard's view of morality as grounded in God's command to love our neighbours as ourselves has clear advantages over contemporary secular rivals.

The purpose of medical humanities is to improve the delivery of effective health care through a better understanding of disease in society, and in the individual. The interfaces between the science of medicine and the arts, philosophy, sociology and law interpret causes and effects of disease. The field of medical ethics is the most prominent offspring of this wider debate, yet the context of disease in the life of the individual and of society is profound and far-reaching. The influences of (...) medicine on the humanities and vice versa are all around, yet only recently have they been recognised in the wider world of health care. How can you encapsulate the essence of medical humanities and teach it to health professionals? Medical Humanities is designed to fill the need for a clear, well illustrated text that both provides the principles for the individual reader, and encourages discussion. The issues are explored in four main sections. Based on a highly successful seminar, and with contributions from leading writers, thinkers, and teachers, this book provides a comprehensive and authoritative reference for what is becoming a professional requirement in medicine. It will be invaluable for clinicians and students alike. (shrink)

I argue that the problem of normative foundations is insoluble. I discuss how and why the apparent problem arose, particularly within the Frankfurt School. Then, I describe various theories of normative foundations and the criticisms that such theories have faced, such as ethno- and andro-centrism, imperialism, and the failure to fulfill their own aims. I make my main argument by way of an analogy: theories of knowledge have wrestled with the question of whether a “given”’ could act as a certain (...) foundation for knowledge. The conclusion is often that no given can function in that way, because the given, which supposedly does not require justification, is therefore necessarily unable to justify knowledge. For similar reasons, I argue, nothing can function as a normative foundation for a critical social theory, because any such normative foundation would have to both stand in no need of normative justification but also justify normative social criticism. I conclude by suggesting that more recent critical theory that does not focus on normative foundations can be understood as justifying their critique by appeal to what people do actually want, rather than what they should rationally want. (shrink)

Florijn analyzes the ruling of the Court of Appeal in the Heringa case, focusing on the role of patient autonomy in physician assisted death (Florijn 2022). His analysis of the case shows that in Dutch euthanasia law patient autonomy as self-determination is limited by the reciprocal physician-patient relationship. Yet, it also gives an unbalanced view of the Dutch euthanasia regulation and its ethical foundation. By focusing on patient autonomy, the importance of unbearable and irremediable suffering as a prerequisite for euthanasia (...) becomes less visible. The requirement of irremediable suffering means that only a physician is allowed to perform euthanasia, since medical expertise is needed to establish whether there are still treatment options to alleviate suffering. We will discuss the importance of suffering, and its consequences for the “tired of life” debate. (shrink)

Providing information to consumers in the form of food labels about modern systems of animal farming is believed to be crucial for increasing their awareness of animal suffering and for promoting technological change towards more welfare-friendly forms of husbandry (CIWF, 2007). In this paper we want to explore whether and how food labels carrying information about the lives of animals are used by consumers while shopping for meat and other animal foods. In order to achieve this, we draw upon a (...) series of focus group discussions that were held in Italy as part of a large EU funded project (Welfare Quality®). In the focus group discussions we addressed how, when or if, claims made about the lives of animals on food labels intervened in what the participants bought and ate. We contend that such labels bring the lives of animals to the forefront and act as new ‘subjectifiers’ (Latour, 2005: 212) that offer a new tool for becoming an ‘ethically competent consumer’, who cares about the lives of animals while shopping for food. However, this offer is not always easily accommodated within existing competences and previous commitments, as it requires a reassessment of existing, and often intimate, practices of shopping, cooking and eating. We argue that new labels carrying welfare claims, with their intention of increasing market transparency, produce two contrasting outcomes: they open new spaces of action, which offer an opportunity for investing in new competences and for engaging with animal welfare issues, in short, they allow an ‘ethically competent consumer’ to emerge, but they also produce another outcome, or a collateral casualty (Bauman, 2007), namely the ethically non-competent consumer. ‘In daily matters, be competent’ (From How to live ethically, the Tao Te Ching). (shrink)