In this article, we report findings from a qualitative study that explored how the relatives of intensive care unit patients experienced the nurses’ role and relationship with them in the end-of-life decision-making processes. In all, 27 relatives of 21 deceased patients were interviewed about their experiences in this challenging ethical issue. The findings reveal that despite bedside experiences of care, compassion and comfort, the nurses were perceived as vague and evasive in their communication, and the relatives missed a long-term perspective (...) in the dialogue. Few experienced that nurses participated in meetings with doctors and relatives. The ethical consequences imply increased loneliness and uncertainty, and the experience that the relatives themselves have the responsibility of obtaining information and understanding their role in the decision-making process. The relatives therefore felt that the nurses could have been more involved in the process. (shrink)

Does action always arise out of desire? G. F. Schueler examines this hotly debated topic in philosophy of action and moral philosophy, arguing that once two senses of "desire" are distinguished - roughly, genuine desires and pro attitudes - apparently plausible explanations of action in terms of the agent's desires can be seen to be mistaken. Desire probes a fundamental issue in philosophy of mind, the nature of desires and how, if at all, they motivate and justify our actions. At (...) least since Hume argued that reason "is and of right ought to be the slave of the passions," many philosophers have held that desires play an essential role both in practical reason and in the explanation of intentional action. G. F. Schueler looks at contemporary accounts of both roles in various belief-desire models of reasons and explanation and argues that the usual belief-desire accounts need to be replaced. Schueler contends that the plausibility of the standard belief-desire accounts rests largely on a failure to distinguish "desires proper," like a craving for sushi, from so-called "pro attitudes," which may take the form of beliefs and other cognitive states as well as desires proper. Schueler's "deliberative model" of practical reasoning suggests a different view of the place of desire in practical reason and the explanation of action. He holds that we can arrive at an intention to act by weighing the relevant considerations and that these may not include desires proper at all. (shrink)

Listening to someone from some distance in a crowded room you may experience the following phenomenon: when looking at them speak, you may both hear and see where the source of the sounds is; but when your eyes are turned elsewhere, you may no longer be able to detect exactly where the voice must be coming from. With your eyes again fixed on the speaker, and the movement of her lips a clear sense of the source of the sound will (...) return. This ‘ventriloquist’ effect reflects the ways in which visual cognition can dominate auditory perception. And this phenomenological observation is one what you can verify or disconfirm in your own case just by the slightest reflection on what it is like for you to listen to someone with or without visual contact with them. (shrink)

People act for reasons. That is how we understand ourselves. But what is it to act for a reason? This is what Fred Schueler investigates. He rejects the dominant view that the beliefs and desires that constitute our reasons for acting simply cause us to act as we do, and argues instead for a view centred on practical deliberation--our ability to evaluate the reasons we accept. Schueler's account of 'reasons explanations' emphasizes the relation between reasons and purposes, and the fact (...) that the reasons for an action are not always good reasons. (shrink)

In this paper I will argue that the latter group [of Non-Humeans] is correct. My argument focuses on practical deliberation and has two parts. I will discuss two different problems that arise for the Humean Theory and suggest that while taken individually each problem appears to have a solution, for each problem the solution Humeans offer precludes solving the other problem. I will suggest that to see these difficulties we must take seriously the thought that we can only understand an (...) agent’s reasons for her action by looking at her actual or possible practical deliberation. (shrink)

Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the (...) underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the "moral fiction" that donors are dead when vital organs are procured. (shrink)

A common objection to sense-datum theories of perception is that they cannot give an adequate account of the fact that introspection indicates that our sensory experiences are directed on, or are about, the mind-independent entities in the world around us, that our sense experience is transparent to the world. In this paper I point out that the main force of this claim is to point out an explanatory challenge to sense-datum theories.

The disjunctive theory of perception claims that we should understand statements about how things appear to a perceiver to be equivalent to statements of a disjunction that either one is perceiving such and such or one is suffering an illusion (or hallucination); and that such statements are not to be viewed as introducing a report of a distinctive mental event or state common to these various disjoint situations. When Michael Hinton first introduced the idea, he suggested that the burden of (...) proof or disproof lay with his opponent, that what was needed was to show that our talk of how things look or appear to one.. (shrink)

SummaryIntense, sustained nursing lengthens inter-birth intervals and is causally linked with low natural fertility. However, in traditional settings, the effects of such nursing on fertility are difficult to disentangle from those of nutrition. Results from an prospective, direct observational study of reproductive function in well-nourished Amele women who nurse intensively and persistently but who also have high fertility are here presented. Endocrine measures show that ovarian activity resumes by median 11·0 months postpartum. Median duration of postpartum amenorrhoea is 11·3 months, (...) time to next conception is 19·0 months, and the inter-birth interval is 28·0 months. Average life time fertility is 6·8. High fertility in Amele women is due both to refractoriness of reproductive function to suckling stimuli, and to maintenance of equivalent age-specific fertility rates across the reproductive life span. (shrink)

Disjunctivism about perceptual appearances, as I conceive of it, is a theory which seeks to preserve a naïve realist conception of veridical perception in the light of the challenge from the argument from hallucination. The naïve realist claims that some sensory experiences are relations to mind-independent objects. That is to say, taking experiences to be episodes or events, the naïve realist supposes that some such episodes have as constituents mind-independent objects. In turn, the disjunctivist claims that in a case of (...) veridical perception like this very kind of experience that you now have, the experiential episode you enjoy is of a kind which could not be occurring were you having an hallucination. The common strategy of arguments from hallucination set out to show that certain things are true of hallucinations, and hence must be true of perceptions. For example, it is argued that hallucinations must have non-physical objects of awareness, or that such states are not relations to anything at all, but are at best seeming relations to objects. In insisting that veridical perceptual experience is of a distinct kind from hallucination, the disjunctivist denies that any of these conceptions of hallucination challenges our conception of veridical perceptions as relations to mind-independent objects. More specifically, I assume that the disjunctivist advocates naïve realism because they think that this position best articulates how sensory experience seems to us to be just through reflection. If the disjunctivist is correct in this contention, then anyone who accepts the conclusion of the argument from hallucination must also accept that the nature of sensory experience is other than it seems to us to be. In turn, one may complain that any such error theory is liable to lead to sceptical consequences. A Humean scepticism about the senses launches a challenge about our knowledge of the world through questioning the conception we have of what sense experience is, and how it can provide knowledge of the world. (shrink)

This book offers the first comprehensive introduction to wave scattering in nonstationary materials. G. F. Roach's aim is to provide an accessible, self-contained resource for newcomers to this important field of research that has applications across a broad range of areas, including radar, sonar, diagnostics in engineering and manufacturing, geophysical prospecting, and ultrasonic medicine such as sonograms. New methods in recent years have been developed to assess the structure and properties of materials and surfaces. When light, sound, or some other (...) wave energy is directed at the material in question, "imperfections" in the resulting echo can reveal a tremendous amount of valuable diagnostic information. The mathematics behind such analysis is sophisticated and complex. However, while problems involving stationary materials are quite well understood, there is still much to learn about those in which the material is moving or changes over time. These so-called non-autonomous problems are the subject of this fascinating book. Roach develops practical strategies, techniques, and solutions for mathematicians and applied scientists working in or seeking entry into the field of modern scattering theory and its applications. Wave Scattering by Time-Dependent Perturbations is destined to become a classic in this rapidly evolving area of inquiry. (shrink)

International medical travel occurs when patients cross national borders to purchase medical goods and services. On occasion, physicians in home countries will be the last point of domestic contact for patients seeking healthcare information before they travel abroad for care. When this is the case, physicians have a unique opportunity to inform patients about their options and help guide them towards ethical practices. This opportunity brings to the fore an important question: What role should physicians in more-developed home countries play (...) in promoting or constraining international medical travel towards less-developed destination countries? In our view, critical attention to the decision spaces of patients—defined by the personal circumstances, socio-cultural cues, and legal constraints that inform decision-making—is a useful starting point for evaluating the proper response of physicians to various forms of international medical travel. (shrink)