Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/UWS more respondents agreed with treatment withdrawal when they considered that VS/UWS patients did not feel pain (77%) as compared to those who thought VS/UWS did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/uws) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/uws more respondents agreed with treatment withdrawal when they considered that VS/uws patients did not feel pain (77%) as compared to those who thought VS/uws did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

Religion and the external world -- Projection, religion, and the external world -- The senses, reason and the imagination -- Realism, meaning and justification : the external world and religious belief -- Modality, projection and realism -- 'Our profound ignorance' : causal realism, and the failure to detect necessity -- Spreading the mind : projection, necessity and realism -- Into the labyrinth : persons, modality, and Hume's undoing -- Value, projection, and realism -- Gilding : projection, value and secondary qualities (...) -- The gold : good, evil, belief and desire -- The golden : relational values, realism and a moral sense. (shrink)

The ultimate goal of the pioneering project outlined in this book is to map our genome--the key to what makes us human--in detail. The Code of Codes is a collective exploration of the substance and possible consequences of th is project in relation to ethics, law, and society.

A first-of-its-kind book that seriously and profoundly examines what it means philosophically to be Latino and where Latinos fit in American society. Offers a fresh perspective and clearer understanding of Latin American thought and culture, rejecting answers based on stereotypes and fear Takes an interdisciplinary approach to the philosophical, social, and political elements of Hispanic/Latino identity, touching upon anthropology, history, cultural studies and sociology, as well as philosophy Written by Jorge J. E. Gracia, one of the most influential thinkers of (...) Hispanic/Latino descent. (shrink)

'To think often, and never to retain it so much as one moment, is a very useless sort of thinking' In An Essay concerning Human Understanding, John Locke sets out his theory of knowledge and how we acquire it. Eschewing doctrines of innate principles and ideas, Locke shows how all our ideas, even the most abstract and complex, are grounded in human experience and attained by sensation of external things or reflection upon our own mental activities. A thorough examination of (...) the communication of ideas through language and the conventions of taking words as signs of ideas paves the way for his penetrating critique of the limitations of ideas and the extent of our knowledge of ourselves, the world, God, and morals. Locke's masterpiece laid the foundation of British empiricism and is of enduring interest to anyone exploring the development of philosophical thought. This sensitive abridgement uses P. H. Nidditch's authoritative text, and together with an illuminating introduction and other features, makes Locke's arguments more accessible. (shrink)

This volume provides a superb introduction to the philosophical, social, and political elements of Hispanic/Latino identity. It is an indispensable tool for anyone interested in issues that concern Hispanics/Latinos, social policy, and the history of thought and culture.

George Berkeley's Principles of Human Knowledge is a crucial text in the history of empiricism and in the history of philosophy more generally. Its central and seemingly astonishing claim is that the physical world cannot exist independently of the perceiving mind. The meaning of this claim, the powerful arguments in its favour, and the system in which it is embedded, are explained in a highly lucid and readable fashion and placed in their historical context. Berkeley's philosophy is, in part, a (...) response to the deep tensions and problems in the new philosophy of the early modern period and the reader is offered an account of this intellectual milieu. The book then follows the order and substance of the Principles whilst drawing on materials from Berkeley's other writings. This volume is the ideal introduction to Berkeley's Principles and will be of great interest to historians of philosophy in general. (shrink)

Institutional ethics committees (IECs) are part of a growing phenomenon in the American health care system. Although a major force driving hospitals to establish IECs is the desire to resolve difficult clinical dilemmas in a quick and systematic way, in this paper we argue that such a goal is naive and, to some extent, misguided. We assess the growing trend of these committees, analyse the theoretical assumptions underlying their establishment, and evaluate their strengths and shortcomings. We show how the 'medical (...) consultation' model is often inappropriately applied to IECs and suggest that IECs must operate under a different framework. Finally, we argue that IECs should be valued for the process they facilitate, and not for the product that they are, often unreasonably, expected to deliver. (shrink)

Surviving Race, Ethnicity, and Nationality is the first book of philosophy that explores race, ethnicity, and nationality together and attempts to present a systematic and unified theory about them with particular emphasis on the metaphysical and epistemological issues that these phenomena raise.

One of the earliest and most influential treatises on the subject of this volume is Aristotle's Categories. Aristotle's title is a form of the Greek verb for speaking against or submitting an accusation in a legal proceeding. By the time of Aristotle, it also meant: to signify or to predicate. Surprisingly, the "predicates" Aristotle talks about include not only bits of language, but also such nonlinguistic items as the color white in a body and the knowledge of grammar in a (...) man's soul. (Categories I/ii) Equally surprising are such details as Aristotle's use of the terms 'homonymy' and 'synonymy' in connection with things talked about rather than words used to talk about them. Judging from the evidence in the Organon, the Metaphysics, and elsewhere, Aristotle was both aware of and able to mark the distinction between using and men tioning words; and so we must conclude that in the Categories, he was not greatly concerned with it. For our purposes, however, it is best to treat the term 'predication' as if it were ambiguous and introduce some jargon to disambiguate it. Code, Modrak, and other authors of the essays which follow use the terms 'linguistic predication' and 'metaphysical predication' for this. (shrink)

Warning research participants and patients about potential risks associated with participation/treatment is a fundamental part of consent. However, such risk warnings might cause negative expectations and subsequent nocebo effects (i.e., negative expectations cause negative outcomes) in participants. Because no existing review documents how past research has quantitatively examined nocebo effects – and negative expectations – arising from consent risk warnings, we conducted a pre-registered scoping review (N = 9). We identified several methodological issues across these studies, which in addition to (...) mixed findings, limit conclusions about whether risk warnings cause nocebo effects. (shrink)

INDIVIDUALITY has given philosophers considerable trouble. There are conflicting views as to how to understand it and even as to its intelligibility in spite of what appears to be its fundamental character in our experience. For, on the one hand, we seem to experience the world in terms of individuals, but when we try to explain what their individuality is we run into difficulties. Indeed, even a view which at first sight appears quite innocuous, defining individuality formally as a feature (...) which characterizes individuals as individuals, is strongly rejected by many. They argue that individuality cannot be a feature at all in the strict sense of the word, since its being a feature would presuppose that something else could share on it or have it, and that seems to contradict the very notion of individuality. At any rate, this is of no concern to us presently since it is an issue which pertains to the ontological status of individuality rather than its intension. It suffices to point out for the moment that there is ample disagreement concerning the proper understanding of individuality. (shrink)

In 1961, at the age of nineteen, Jorge J. E. Gracia escaped from the island of Cuba by passing himself off as a Catholic seminarian. He arrived in the United States with just a few spare belongings and his mother's diamond ring secured in a hole in one of his shoes. With a Diamond in My Shoe tells the story of Gracia's quest for identity--from his early years in Cuba and as a refugee in Miami to his formative role in (...) institutionalizing the field of Latin American philosophy in the US academy. Committed to integrating into Anglo America without forgetting his roots, Gracia reflects on his struggles and successes as an immigrant and academic, bringing a philosopher's eye to bear on his personal and professional development as a leading Latinx scholar. (shrink)

HISPANIC PHILOSOPHY. The notion of Hispanic philosophy is a useful one for trying to understand certain historical phenomena related to the philosophy developed in the Iberian peninsula, the Iberian colonies in the New World, and the countries that those colonies eventually came to form. It is useful for two reasons. First, it focuses attention on the close relations among the philosophers in these geographical areas; and second, other historical denominations and categorizations do not do justice to such relations. This becomes (...) clear when one examines the standard general categorizations according to which the philosophical thought of the mentioned geographical areas is divided and studied: Spanish philosophy, Portuguese philosophy, Catalan philosophy, Latin American philosophy, Spanish-American philosophy, and Ibero-American philosophy. (shrink)

Examines the place of individuation in the work of over 25 scholastic writers from when Arabic and Greek thought began to impact Europe, until scholasticism died out.

THE AUDIENCE IS THE REAL or imaginary group of persons who are in fact acquainted, could be acquainted, or are meant to be acquainted with a given text. Etymologically, the term "audience" refers to a group of listeners. This meaning of the term goes back to a time when the primary form of acquaintance with the work of an author was through the spoken word. From the invention of the printing press, however, until the time when the use of the (...) radio became widespread, written texts were the primary way of learning about an author's work. Although contemporary media have changed this to a certain extent, in science and the humanities it is still true that the audience for an author's work consists largely of readers. For my present purposes, the distinction between readers and listeners is immaterial and, hence, I often refer to an audience as a group of readers, although what I say about it will apply, mutatis mutandis, to listeners as well. (shrink)

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