After 40 years of attributing high rates of physician career dissatisfaction, attrition, alcoholism, divorce and suicide to ‘burnout’, there is growing recognition that these outcomes may instead be caused by moral injury. This has led to a debate about the relative diagnostic merits of these two terms, a recognition that interventions designed to treat burnout may be ineffective, and much perplexity about how—if at all—this changes anything. The current research seeks to develop the construct of moral injury outside military contexts, (...) generate more robust validity tests and more fully describe and measure the experiences of persons exposed to moral harms. Absent from the literature is a mechanism through which to move from the collective moral injury experience of physicians to a systematic change in the structure of medical practice. To address this, after providing a brief history, definitions and contrasts between burnout, moral distress and moral injury, we review the interplay of moral and ethical codes in the context of moral injury. We conclude by suggesting that professional associations can potentially prevent moral injury by providing protections for physicians within their codes of ethics. There are no data in this work. (shrink)

There is an increasingly widespread belief, both within and outside the discipline, that modern economics is irrelevant to the understanding of the real world. Economics and Reality traces this irrelevance to the failure of economists to match their methods with their subject, showing that formal, mathematical models are unsuitable to the social realities economists purport to address. Tony Lawson examines the various ways in which mainstream economics is rooted in positivist philosophy and examines the problems this causes. It focuses (...) on human agency, social structure and their interaction and explores how the understanding of this social phenomena can be used to transform the nature of economic practice. Economics and Reality concludes by showing how this newly transformed economics might set about shaping economic policy. (shrink)

Book synopsis: For the Pre-Socratic philosophers the soul was the source of movement and sensation, while for Plato it was the seat of being, metaphysically distinct from the body that it was forced temporarily to inhabit. Plato's student Aristotle was determined to test the truth of both these beliefs against the emerging sciences of logic and biology. His examination of the huge variety of living organisms - the enormous range of their behaviour, their powers and their perceptual sophistication - convinced (...) him of the inadequacy both of a materialist reduction and of a Platonic sublimation of the soul. In De Anima, he sought to set out his theory of the soul as the ultimate reality of embodied form and produced both a masterpiece of philosophical insight and a psychology of perennially fascinating subtlety. (shrink)

Book synopsis: Aristotle's probing inquiry into some of the fundamental problems of philosophy, The Metaphysics is one of the classical Greek foundation-stones of western thought, translated from the with an introduction by Hugh Lawson-Tancred in Penguin Classics. The Metaphysics presents Aristotle's mature rejection of both the Platonic theory that what we perceive is just a pale reflection of reality and the hard-headed view that all processes are ultimately material. He argued instead that the reality or substance of things lies (...) in their concrete forms, and in so doing he probed some of the deepest questions of philosophy: What is existence? How is change possible? And are there certain things that must exist for anything else to exist at all? The seminal notions discussed in The Metaphysics - of 'substance' and associated concepts of matter and form, essence and accident, potentiality and actuality - have had a profound and enduring influence, and laid the foundations for one of the central branches of Western philosophy. Hugh Lawson-Tancred's lucid translation is accompanied by a stimulating introduction in which he highlights the central themes of one of philosophy's supreme masterpieces. Aristotle (384-22 BC) studied at the Academy of Plato for 20 years and then established his own school and research institute, 'The Lyceum'. His writings, which were of extraordinary range, profoundly affected the whole course of ancient and medieval philosophy and are still eagerly studied and debated by philosophers today. (shrink)

Contemporary literature in philosophy of action seems to be divided overthe place of action in the natural causal world. I think that a disagreementabout ontology underlies the division. I argue here that human action isproperly understood only by reference to a category of process or activity,where this is not a category of particulars.

The question that will be the focus of this paper is this: what is the significance of disagreement between those who are epistemic peers? There are two answers to this question found in the recent literature. On the one hand, there are those who hold that one can continue to rationally believe that p despite the fact that one’s epistemic peer explicitly believes that not-p. I shall call those who hold this view nonconformists. In contrast, there are those who hold (...) that one cannot continue to rationally believe that p when one is faced with an epistemic peer who explicitly believes that not-p. I shall call those who hold this view conformists. Inthis paper, I shall argue that neither nonconformism nor conformism provides a plausible account of the epistemic significance of peer disagreement. I shall then develop my justificationist account of peer disagreement’s epistemic significance. Whereas current views maintain that disagreement, by itself, either simply does or does not possess epistemic power, my account holds that its epistemic power, or lack thereof, is explainable in terms of its interaction with other features,particularly the degree of justified confidence with which the belief in question is held and the presence of information that one possesses about one’s own epistemic situation. (shrink)

Testimony is an invaluable source of knowledge. We rely on the reports of those around us for everything from the ingredients in our food and medicine to the identity of our family members. Recent years have seen an explosion of interest in the epistemology of testimony. Despite the multitude of views offered, a single thesis is nearly universally accepted: testimonial knowledge is acquired through the process of transmission from speaker to hearer. In this book, Jennifer Lackey shows that this (...) thesis is false and, hence, that the literature on testimony has been shaped at its core by a view that is fundamentally misguided. She then defends a detailed alternative to this conception of testimony: whereas the views currently dominant focus on the epistemic status of what speakers believe, Lackey advances a theory that instead centers on what speakers say. The upshot is that, strictly speaking, we do not learn from one another's beliefs - we learn from one another's words. Once this shift in focus is in place, Lackey goes on to argue that, though positive reasons are necessary for testimonial knowledge, testimony itself is an irreducible epistemic source. This leads to the development of a theory that gives proper credence to testimony's epistemologically dual nature: both the speaker and the hearer must make a positive epistemic contribution to testimonial knowledge. The resulting view not only reveals that testimony has the capacity to generate knowledge, but it also gives appropriate weight to our nature as both socially indebted and individually rational creatures. The approach found in this book will, then, represent a radical departure from the views currently dominating the epistemology of testimony, and thus is intended to reshape our understanding of the deep and ubiquitous reliance we have on the testimony of those around us. (shrink)

This essay explores the speech act of dogwhistling (sometimes referred to as ‘using coded language’). Dogwhistles may be overt or covert, and within each of these categories may be intentional or unintentional. Dogwhistles are a powerful form of political speech, allowing people to be manipulated in ways they would resist if the manipulation was carried outmore openly—often drawing on racist attitudes that are consciously rejected. If philosophers focus only on content expressed or otherwise consciously conveyed they may miss what is (...) most powerful and pernicious in the speech of political culture. This essay is a call to start paying attention to these more covert speech acts, and a first attempt at beginning to theorize them. It argues that dogwhistles present a complex and interesting case for the philosopher of language, and explores their implications for democratic politics. (shrink)

I read Dr Cherniack’s article regarding do not resuscitate orders with interest.1 One of the problems with DNR orders is the patients’ assumption that if there is no DNR order they will survive resuscitative efforts. This of course is far from the truth. In my hospital these orders have been modified to “do not attempt to resuscitate” orders. One cannot be truly autonomous without being informed. Long term survival, as measured only by being alive, following inhouse cardiac arrest, is about (...) 15% over all age groups.2 In sick elderly patients over 70 years of age who survive a cardiac arrest, the subsequent hospital mortality approaches 100%. This fact, and concerns about harm, influence physicians’ attitudes, …. (shrink)

Intuitively, there is a difference between knowledge and mere belief. Contemporary philosophical work on the nature of this difference has focused on scenarios known as “Gettier cases.” Designed as counterexamples to the classical theory that knowledge is justified true belief, these cases feature agents who arrive at true beliefs in ways which seem reasonable or justified, while nevertheless seeming to lack knowledge. Prior empirical investigation of these cases has raised questions about whether lay people generally share philosophers’ intuitions about these (...) cases, or whether lay intuitions vary depending on individual factors (e.g. ethnicity) or factors related to specific types of Gettier cases (e.g. cases that include apparent evidence). We report an experiment on lay attributions of knowledge and justification for a wide range of Gettier Cases and for a related class of controversial cases known as Skeptical Pressure cases, which are also thought by philosophers to elicit intuitive denials of knowledge. Although participants rated true beliefs in Gettier and Skeptical Pressure cases as being justified, they were significantly less likely to attribute knowledge for these cases than for matched true belief cases. This pattern of response was consistent across different variations of Gettier cases and did not vary by ethnicity or gender, although attributions of justification were found to be positively related to measures of empathy. These findings therefore suggest that across demographic groups, laypeople share similar epistemic concepts with philosophers, recognizing a difference between knowledge and justified true belief. (shrink)

Civil society organizations (CSOs) have significantly impacted on the politics of health research and the field of bioethics. In the globalHIVepidemic,CSOs have served a pivotal stakeholder role. The dire need for development of new prevention technologies has raised critical challenges for the ethical engagement of community stakeholders inHIVresearch. This study explored the perspectives ofCSOrepresentatives involved inHIVprevention trials (HPTs) on the impact of premature trial closures on stakeholder engagement. Fourteen respondents fromSouthAfrican and internationalCSOs representing activist and advocacy groups, community mobilisation initiatives, (...) and human and legal rights groups were purposively sampled based on involvement inHPTs. Interviews were conducted fromFebruary‐May 2010. Descriptive analysis was undertaken across interviews and key themes were developed inductively.CSOrepresentatives largely described positive outcomes of recent microbicide andHIVvaccine trial terminations, particularly inSouthAfrica, which they attributed to improvements in stakeholder engagement. Ongoing challenges to community engagement included the need for principled justifications for selective stakeholder engagement at strategic time‐points, as well as the need for legitimate alternatives toCABs as mechanisms for engagement. Key issues forCSOs in relation to research were also raised. (shrink)

Once symbolized by a burning armchair, experimental philosophy has in recent years shifted away from its original hostility to traditional methods. Starting with a brief historical review of the experimentalist challenge to traditional philosophical practice, this chapter looks at research undercutting that challenge, and at ways in which experimental work has evolved to complement and strengthen traditional approaches to philosophical questions.

Lawson provides a comprehensive look at the history of western thought, the evolution of science and its attempts to provide us with a "theory of everything" and an evaluation of the relativist multiple truths. He discusses why this scientific mind-set no longer works and why relativist truths are no longer sustainable. He then offers a new theory to help us better understand ourselves and our world.

Reagan, Lawson This article will argue that a Humanist future is a technoprogressive one. It will first give an overview of the emerging third dimension of 21st century politics, that of biopolitics. It will define the broad differences between the transhumanist and bioconservative movements. Then it will turn to the two main ideologically competing strands of the transhumanist movement: that of right wing 'Libertarian Transhumanism' and left wing 'Technoprogressivism'.

Introduction -- Elucidating complexity theories -- Complexity in the natural sciences -- Complexity in social theory -- Towards transdisciplinarity -- Complexity in philosophy: complexification and the limits to knowledge -- Complexity in ethics -- Earth in the anthropocene -- Complexity and climate change -- American dreams, ecological nightmares and new visions -- Complexity and sustainability: wicked problems, gordian knots and synergistic solutions -- Conclusion.

Book synopsis: This is the first volume of a two-volume introduction to and guide through philosophy. It is intended to orientate, assist, and stimulate the reader at every stage in the study of the subject. Eleven extended essays have been specially commissioned from leading philosophers; each surveys a major area of the subject and offers an accessible but sophisticated account of the main debates. An extended introduction maps out the philosophical terrain and explains how the different subjects relate to each (...) other. The first part of the book deals with the foundations of philosophical enquiry: epistemology; philosophical logic; methodology; metaphysics; and the philosophy of mind. The second part offers four historical chapters, two on ancient and two on modern philosophy, introducing great thinkers from the past, explaining and discussing their ideas, and showing the value of studying them today. The third part comprises two chapters devoted to questions of value, in ethics and aesthetics. Full annotated bibliographies are provided at the ends of chapters to serve as guides to further reading. This is real philosophy, not simplified philosophy; it will be accessible for the beginner but equally valuable for the third-year student. Deep and challenging questions are not shirked; the reader will be given a sense of involvement in the practice of philosophy today. (shrink)

This paper provide the first extended discussion in the philosophical literature of the epistemic significance of the phenomenon of “being known” and the relationship it has to reparations that are distinctively epistemic. Drawing on a framework provided by the United Nations of the “right to know,” it is argued that victims of gross violations and injustices not only have the right to know what happened, but also the right to be known—to be a giver of knowledge to others about their (...) own experiences. It is shown that such victims can suffer epistemic wrongs by being rendered invisible, vilified or demonized, or systematically distorted, and that these ways of not being known demand epistemic reparations. While there are traditional reparations that are epistemic in nature, such as memorialization and education, it is argued that there is a prior and arguably more important epistemic reparation—knowing victims of gross violations and injustices in the sense of bearing witness. The paper concludes with a sketch of an epistemological picture to underwrite this notion of epistemic reparations, one that significantly expands the traditional picture by including epistemic duties that are imperfect in nature and concern actions in addition to beliefs. (shrink)

Jennifer Hornsby offers here detailed discussions of ontology, human agency, and everyday psychological explanation. In her distinctive view of questions about the mind's place in nature she argues for a particular position in philosophy of mind: naive naturalism.

In this collection of original essays, international scholars put Asian traditions, such as Hinduism, Buddhism, Daoism, and Confucianism, into conversation with one or more contemporary feminist philosophies, founding a new mode of inquiry that attends to diverse voices and the complex global relationships that define our world. -/- These cross-cultural meditations focus on the liberation of persons from suffering, oppression, illusion, harmful conventions and desires, and other impediments to full personhood by deploying a methodology that traverses multiple philosophical styles, historical (...) texts, and frames of reference. Hailing from the discipline of philosophy in addition to Asian, gender, and religious studies, the contributors offer a fresh take on the classic concerns of free will, consciousness, knowledge, objectivity, sexual difference, embodiment, selfhood, the state, morality, and hermeneutics. One of the first anthologies to embody the practice of feminist comparative philosophy, this collection creatively and effectively engages with global, cultural, and gender differences within the realms of scholarly inquiry and theory construction. -/- http://cup.columbia.edu/book/978-0-231-16624-9/asian-and-feminist-philosophies-in-dialogue. (shrink)

A disjunctivist conception of acting for reasons is introduced by way of showing that a view of acting for reasons must give a place to knowledge. Two principal claims are made. 1. This conception has a rôle analogous to that of the disjunctive conception that John McDowell recommends in thinking about perception; and when the two disjunctivist conceptions are treated as counterparts, they can be shown to have work to do in combination. 2. This conception of acting for reasons safeguards (...) the connection between considerations that move us to act in particular ways and considerations that favour our acting in particular ways. (shrink)

How, in a secular world, should we resolve ethically controversial and troubling issues relating to health care? Should we, as some argue, make a clean sweep, getting rid of the Hippocratic ethic, such vestiges of it as remain? Jennifer Jackson seeks to answer these significant questions, establishing new foundations for a traditional and secular ethic which would not require a radical and problematic overhaul of the old. These new foundations rest on familiar observations of human nature and human needs. (...) Jackson presents morality as a loose anatomy of constituent virtues that are related in different ways to how we fare in life, and suggests that in order to address problems in medical ethics, a virtues-based approach is needed. Throughout, attention is paid to the role of philosophy in medical ethics, and how it can be used to clarify key notions and distinctions that underlie current debates and controversial issues. By reinstating such concepts as justice, cardinal virtue, and moral duty, Jackson lays the groundwork for an ethics of health care that makes headway toward resolving seeming dilemmas in medical ethics today. This penetrating and accessible book will be invaluable to students of sociology and health care, as well as those who are interested in the ethical uncertainties faced by the medical world. (shrink)

Do epistemic intuitions tell us anything about knowledge? Stich has argued that we respond to cases according to our contingent cultural programming, and not in a manner that tends to reveal anything significant about knowledge itself. I’ve argued that a cross-culturally universal capacity for mindreading produces the intuitive sense that the subject of a case has or lacks knowledge. This paper responds to Stich’s charge that mindreading is cross-culturally varied in a way that will strip epistemic intuitions of their evidential (...) value. I argue that existing work on cross-cultural variation in mindreading favors my position over Stich’s. (shrink)

To what extent should we trust our natural instincts about knowledge? The question has special urgency for epistemologists who want to draw evidential support for their theories from certain intuitive epistemic assessments while discounting others as misleading. This paper focuses on the viability of endorsing the legitimacy of Gettier intuitions while resisting the intuitive pull of skepticism – a combination of moves that most mainstream epistemologists find appealing. Awkwardly enough, the “good” Gettier intuitions and the “bad” skeptical intuitions seem to (...) be equally strong. This chapter argues that it is not a coincidence that these two types of intuition register with equal force: they are generated by a common mechanism. However, the input to this mechanism is interestingly different in the two types of case, and different in a way that can support the mainstream view that Gettier cases tell us something about knowledge where skeptical intuitions involve systematic error. (shrink)

In this article I explore various facets of Nozick’s famous thought experiment involving the experience machine. Nozick’s original target is hedonism—the view that the only intrinsic prudential value is pleasure. But the argument, if successful, undermines any experientialist theory, i.e. any theory that limits intrinsic prudential value to mental states. I first highlight problems arising from the way Nozick sets up the thought experiment. He asks us to imagine choosing whether or not to enter the machine and uses our choice (...) (or rather the choice he assumes most people will have) as evidence against experientialist theories. But for this strategy to succeed it must be possible to distinguish between self-interested and non-self-interested reasons for declining to enter the machine, and there is no obvious way to do this without begging the question against the hedonist. In successive sections I then (a) consider a common misconception of Nozick’s conclusion (that he thinks machine life is the worst life), (b) consider different intuitions about what is important to well-being but missing from machine life, and finally (c) explain what “the experience requirement” is, and describe its relationship to debates about experientialist theories. (shrink)

Testimony is a vital and ubiquitous source of knowledge. Were we to refrain from accepting the testimony of others, our lives would be impoverished in startling and debilitating ways. Despite the vital role that testimony occupies in our epistemic lives, traditional epistemological theories have focused primarily on other sources, such as sense perception, memory, and reason, with relatively little attention devoted specifically to testimony. In recent years, however, the epistemic significance of testimony has been more fully appreciated. I shall here (...) focus on two questions that have received the most attention in recent work in the epistemology of testimony. First, is testimonial knowledge acquired only by being transmitted from speaker to hearer? Second, must a hearer have positive reasons to justifiedly accept a speaker's testimony? (shrink)

Curiosity is evident in humans of all sorts from early infancy, and it has also been said to appear in a wide range of other animals, including monkeys, birds, rats, and octopuses. The classical definition of curiosity as an intrinsic desire for knowledge may seem inapplicable to animal curiosity: one might wonder how and indeed whether a rat could have such a fancy desire. Even if rats must learn many things to survive, one might expect their learning must be driven (...) by simpler incentives, such as hunger. One might also wonder what proximal signals could guide animals towards knowledge itself, or how something as abstract as knowledge could ever be a motivational target for an unreflective animal. Taking a cue from recent work in reinforcement learning, I argue that surprise functions as a reward signal for the curious animal, and then show how this amounts to a desire for knowledge gain, where knowledge is conceived of as a cognitive adaptation to reality. This adaptation results in a mental state whose existence depends essentially on the truth of its contents, a factive mental state. Curious creatures benefit from an interaction between the prediction-error correction processes of basic learning and the active surprise-seeking force of their curiosity. This internally adversarial interaction accelerates knowledge gain in ways that are very helpful for agents with the restrictions of biological creatures, in environments with the complexity of our natural world. (shrink)

'This book not only revises the interpretation of Dewey's ethics but also has relevance to recent discussions about the possibility of naturalistic, ...

Timothy Murphy argues in his article “In Defense of Irreligious Bioethics” (2012) that the role of religion in normative bioethics should be limited and that a viable means for limiting its role (o...

Despite the conceptual problems in identifying the placebo effect, an increasing number of multidisciplinary inquiries rest on the assumption that there is a distinct class of effects, placebo effects. In this chapter, I argue against this assumption. I present cases and characterizations of the placebo effect as offered in the literature, and argue that the latter are subject to insurmountable problems. Moreover, I argue that identification of placebo effects as such is not useful for the three main purposes offered in (...) the literature. I then offer suggestions for why it may remain intuitive that some effects are placebo effects and close by noting the potential benefits of ultimately explaining away these intuitions. (shrink)

Lawson and McCauley have argued that non-cultural regularities in how actions are conceptualized inform and constrain participants' understandings of religious rituals. This theory of ritual competence generates three predictions: 1) People with little or no knowledge of any given ritual system will have intuitions about the potential effectiveness of a ritual given minimal information about the structure of the ritual. 2) The representation of superhuman agency in the action structure will be considered the most important factor contributing to effectiveness. (...) 3) Having an appropriate intentional agent initiate the action will be considered relatively more important than any specific action to be performed. These three predictions were tested in two experiments with 128 North American Protestant college students who rated the probability of various fictitious rituals to be effective in bringing about a specified consequence. Results support Lawson and McCauley's predictions and suggest that expectations regarding ordinary social actions apply to religious rituals. (shrink)

This chapter explores radical personal change and its relationship to well-being, welfare, or prudential value. Many theorists of welfare are committed to what is here called the future-based reasons view (FBR), which holds (1) that the best prudential choice in a situation is determined by which possible future has the greatest net welfare value for the subject and (2) what determines facts about future welfare are facts about the subject and the world at that future time. Although some cases of (...) radical change are intuitively prudentially good, many cases of really radical change are not. Yet FBR has trouble explaining this. Many people instinctively reach for the notion of identity to solve this problem—arguing that really radical change cannot be good because it alters who someone is. Yet, as the chapter argues, there are reasons to doubt that appeals to identity are appropriate. The chapter ends with the suggestion that prudential facts may explain why and when retaining identity matters, rather than the other way around, and points to a possible way forward for a theorist of welfare committed to FBR. (shrink)

Michael Bergmann’s important new book on scepticism is attractively systematic and thorough. He places familiar ideas under an exceptionally bright spotlight, e.

Because knowledge entails true belief, it is can be hard to explain why a given action is naturally seen as driven by one of these states as opposed to the other. A simpler and more radical characterization of knowledge helps to solve this problem while also shedding some light on what is special about social learning.

Why do we find agents less blameworthy when they face mitigating circumstances, and what does this show about philosophical theories of moral responsibility? We present novel evidence that the tendency to mitigate the blameworthiness of agents is driven both by the perception that they are less normatively competent—in particular, less able to know that what they are doing is wrong—and by the perception that their behavior is less attributable to their deep selves. Consequently, we argue that philosophers cannot rely on (...) the case strategy to support the Normative Competence theory of moral responsibility over the Deep Self theory. However, we also outline ways in which further empirical and philosophical work would shift the debate, by showing that there is a significant departure between ordinary concepts and corresponding philosophical concepts, or by focusing on a different type of coherence with ordinary judgments. (shrink)