Since the 1980s, there has been an increasing acknowledgement of the importance of recognising the ethical dimension of clinical decision-making. Medical professional regulatory authorities in some countries now include ethical knowledge and practice in their required competencies for undergraduate and post graduate medical training. Educational interventions and clinical ethics support services have been developed to support and improve ethical decision making in clinical practice, but research evaluating the effectiveness of these interventions has been limited. We undertook a systematic review of (...) the published literature on measures or models of evaluation used to assess the impact of interventions to improve ethical decision making in clinical care. We identified a range of measures to evaluate educational interventions, and one tool used to evaluate a clinical ethics support intervention. Most measures did not evaluate the key impact of interest, that is the quality of ethical decision making in real-world clinical practice. We describe the results of our review and reflect on the challenges of assessing ethical decision making in clinical practice that face both developers of educational and support interventions and the regulatory organisations that set and assess competency standards. (shrink)

Many extant theories of placebo focus on their causal structure wherein placebo effects are those that originate from select features of the therapy (e.g., client expectations or “incidental” features like size and shape). Although such accounts can distinguish placebos from standard medical treatments, they cannot distinguish placebos from everyday occurrences, for example, when positive feedback improves our performance on a task. Providing a social-epistemological account of a treatment context can rule out such occurrences, and furthermore reveal a new way to (...) distinguish clinical placebos from standard medical treatments. (shrink)

According to Margaret Cavendish the entire natural world is essentially rational such that everything thinks in some way or another. In this paper, I examine why Cavendish would believe that the natural world is ubiquitously rational, arguing against the usual account, which holds that she does so in order to account for the orderly production of very complex phenomena (e.g. living beings) given the limits of the mechanical philosophy. Rather, I argue, she attributes ubiquitous rationality to the natural world in (...) order to ground a theory of the ubiquitous freedom of nature, which in turn accounts for both the world's orderly and disorderly behavior. (shrink)

A theoretical physicist and feminist theorist, Karen Barad elaborates her theory of agential realism, a schema that is at once a new epistemology, ontology, and ethics.

We frequently speak of certain things or phenomena being built out of or based in others. Making Things Up concerns these relations, which connect more fundamental things to less fundamental things: Karen Bennett calls these 'building relations'. She aims to illuminate what it means to say that one thing is more fundamental than another.

Between 1653 and 1655 Margaret Cavendish makes a radical transition in her theory of matter, rejecting her earlier atomism in favour of an infinitely-extended and infinitely-divisible material plenum, with matter being ubiquitously self-moving, sensing, and rational. It is unclear, however, if Cavendish can actually dispense of atomism. One of her arguments against atomism, for example, depends upon the created world being harmonious and orderly, a premise Cavendish herself repeatedly undermines by noting nature’s many disorders. I argue that her supposed difficulties (...) with atomism expose a deeper tension in her work between two fundamental metaphysical commitments each of which has substantial philosophical support: her monist theory of the material world (which maintains that there exists just one natural substance which is the single principal cause) and her occasional theory of causation (which requires multiple finite principal causes in nature -- causes that might be considered individual substances). Her monism undermines atomism while her theory of occasional cause seems to rest on a conception of nature that would be especially friendly to atomism. I argue further that we can solve this tension within a Cavendishian framework in such a way as to preserve her theory of causation and her monism, but that this solution depends upon our taking her monism in a particular (and weak) form. I finally note that we can best make sense of her unique and interesting form of monism by acknowledging her social-political motivations in addition to her motivations in natural philosophy. (shrink)

Huck Finn’s emotional responses constitute perfectly good moral reasons not to betray his friend, even though Huck is unable to recognise them as such.

In How We Get Along, J. David Velleman argues for two related theses: first, that ‘making sense’ of oneself to oneself and others is a constitutive aim of action; second, that this fact about action grounds normativity. Examining each thesis in turn, I argue against the first that an agent may deliberately act in ways which make sense in terms of neither her self-conception nor others' conceptions of her. Against the second thesis, I argue that some vices are such that (...) the agents concerned would make more sense to neither themselves nor others if they were to reform, and, furthermore, that an agent may make more sense to herself and others by becoming more, rather than less, vicious. I conclude that both theses should be rejected. (shrink)

The ideals and realities of field research have shaped the development of behavioural primatology over the latter half of the twentieth century. This paper draws on interviews with primatologists as well as a survey of the scientific literature to examine the idealized notion of the field site as a natural place and the physical environment of the field as a research space. It shows that what became standard field practice emerged in the course of wide ranging debate about the techniques, (...) personal qualities and site conditions best suited to the scientific study of the natural behaviour of apes and monkeys. Although the laboratory was a constant presence in this debate, the export of techniques from the laboratory to the field was limited, due to concerns that experimental manipulation would destroy the naturalness of the behaviour. The paper goes on to demonstrate the central significance given by primatologists to the unique social, historical and ecological circumstances of particular field sites, and to sketch some of the complexities that fieldworkers contend with in trying to realize their ideals. Primatologists seek field sites that answer their questions; but once their studies become long term, they also need to find questions that answer to ever changing conditions at those sites. (shrink)

In the ninth century BCE, the peoples of four distinct regions of the civilized world created the religious and philosophical traditions that have continued to nourish humanity to the present day: Confucianism and Daoism in China, Hinduism and Buddhism in India, monotheism in Israel, and philosophical rationalism in Greece. Later generations further developed these initial insights, but we have never grown beyond them. Rabbinic Judaism, Christianity, and Islam, for example, were all secondary flowerings of the original Israelite vision. Now, in (...) The Great Transformation , Karen Armstrong reveals how the sages of this pivotal “Axial Age” can speak clearly and helpfully to the violence and desperation that we experience in our own times. Armstrong traces the development of the Axial Age chronologically, examining the contributions of such figures as the Buddha, Socrates, Confucius, Jeremiah, Ezekiel, the mystics of the Upanishads, Mencius, and Euripides. All of the Axial Age faiths began in principled and visceral recoil from the unprecedented violence of their time. Despite some differences of emphasis, there was a remarkable consensus in their call for an abandonment of selfishness and a spirituality of compassion. With regard to dealing with fear, despair, hatred, rage, and violence, the Axial sages gave their people and give us, Armstrong says, two important pieces of advice: first there must be personal responsibility and self-criticism, and it must be followed by practical, effective action. In her introduction and concluding chapter, Armstrong urges us to consider how these spiritualities challenge the way we are religious today. In our various institutions, we sometimes seem to be attempting to create exactly the kind of religion that Axial sages and prophets had hoped to eliminate. We often equate faith with doctrinal conformity, but the traditions of the Axial Age were not about dogma. All insisted on the primacy of compassion even in the midst of suffering. In each Axial Age case, a disciplined revulsion from violence and hatred proved to be the major catalyst of spiritual change. (shrink)

Recently much has been made of the grounding relation, and of the idea that it is intimately tied to fundamentality. If A grounds B, then A is more fundamental than B (though not vice versa ), and A is ungrounded if and only if it is fundamental full stop—absolutely fundamental. But here is a puzzle: is grounding itself absolutely fundamental?

In this paper I describe and defend an account of virtuous motivation that differs from what we might call ordinary moral motivation. It is possible to be morally motivated without being virtuously motivated. In the first half of the essay, I explore different senses of moral motivation and the philosophical puzzles and problems it poses. In the second half, I give an account of virtuous motivation that, unlike ordinary moral motivation, requires the motivational structure characteristic of a fully virtuous person. (...) I draw on Aristotle's account of virtuous action to argue that a fully virtuous agent's judgment reflects a robust form of moral knowledge about what features of an action render it virtuous and hence, choiceworthy. Virtuously motivated actions are chosen in light of those features and are accompanied by the affective state appropriate to the overall moral landscape in which the judgment is made. (shrink)

Platonism, Ficino to Foucault explores some key chapters in the history Platonic philosophy from the revival of Plato in the fifteenth century to the new reading of Platonic dialogues promoted by the so-called ‘Critique of Modernity’.

A variety of relations widely invoked by philosophers—composition, constitution, realization, micro-basing, emergence, and many others—are species of what I call ‘building relations’. I argue that they are conceptually intertwined, articulate what it takes for a relation to count as a building relation, and argue that—contra appearances—it is an open possibility that these relations are all determinates of a common determinable, or even that there is really only one building relation.

Dummett's output has been prolific and highly influential, but not always as accessible as it deserves to be. This book sets out to rectify this situation.

This book discusses the notion that quantum gravity may represent the "breakdown" of spacetime at extremely high energy scales. If spacetime does not exist at the fundamental level, then it has to be considered "emergent", in other words an effective structure, valid at low energy scales. The author develops a conception of emergence appropriate to effective theories in physics, and shows how it applies (or could apply) in various approaches to quantum gravity, including condensed matter approaches, discrete approaches, and loop (...) quantum gravity. (shrink)

The basic form of the exclusion problem is by now very, very familiar. 2 Start with the claim that the physical realm is causally complete: every physical thing that happens has a sufficient physical cause. Add in the claim that the mental and the physical are distinct. Toss in some claims about overdetermination, give it a stir, and voilá—suddenly it looks as though the mental never causes anything, at least nothing physical. As it is often put, the physical does all (...) the work, and there is nothing left for the mental to do. (shrink)

A lot of people believe that distinct objects can occupy precisely the same place for the entire time during which they exist. Such people have to provide an answer to the 'grounding problem' – they have to explain how such things, alike in so many ways, nonetheless manage to fall under different sortals, or have different modal properties. I argue in detail that they cannot say that there is anything in virtue of which spatio-temporally coincident things have those properties. However, (...) I also argue that this may not be as bad as it looks, and that there is a way to make sense of the claim that such properties are primitive. (shrink)

The paper is an extended discussion of what I call the ‘dismissive attitude’ towards metaphysical questions. It has three parts. In the first part, I distinguish three quite different versions of dismissivism. I also argue that there is little reason to think that any of these positions is correct about the discipline of metaphysics as a whole; it is entirely possible that some metaphysical disputes should be dismissed and others should not be. Doing metametaphysics properly requires doing metaphysics first. I (...) then put two particular disputes on the table to be examined in the rest of the paper: the dispute over whether composite objects exist, and the dispute about whether distinct objects can be colocated. In the second part of the paper, I argue against the claim that these disputes are purely verbal disputes. In the third part of the paper, I present a new version of dismissivism, and argue that it is probably the correct view about the two disputes in question. They are not verbal disputes, and the discussion about them to date has not remotely been a waste of time. At this stage, however, our evidence has run out. I argue that neither side of either dispute is simpler than the other, and that the same objections in fact arise against both sides. (For example, the compositional nihilist does not in fact escape the problem of the many, and the one-thinger does not in fact escape the grounding problem.). (shrink)

In this paper, I consider Descartes’ Sixth Meditation dropsy passage on the difference between the human body considered in itself and the human composite of mind and body. I do so as a way of illuminating some features of Descartes’ broader thinking about teleology, including the role of teleological explanations in physiology. I use the writings on teleology of some ancient authors for the conceptual (but not historical) help they can provide in helping us to think about the Sixth Meditation (...) passage. From this, I draw several points, most notably that the Sixth Meditation passage is primarily concerned with the natures of body and composites, and that the issue of teleological explanation is derivative of this primary interest. So, we – and Descartes – must come to terms with what he takes the nature of the composite to be such that it has an intrinsic end-referred nature which grounds teleological explanations. I consider three possibilities: the human composite is a third type of substance – a hylomorphic substance; there is a sort of “satisfaction” relationship between mind and body (each of which retains its own distinct nature in the composite) such that the mind confers teleological value on the body; and there is a sort of “satisfaction” relationship between mind and body (each of which retains its own distinct nature in the composite) such that the mind recognizes teleological value in the body. None of these interpretations is without problems. So in the concluding section, I sketch a program for future research, specifically, trying to render Descartes’ teleological thinking consistent by distinguishing between the metaphysical natures of things (the concern of his Sixth Meditation passage) and the physical natures of things (his concern in his physiological writings). (shrink)

How much of philosophical, scientific, and political thought is caught up with the idea of continuity? What if it were otherwise? This paper experiments with the disruption of continuity. The reader is invited to participate in a performance of spacetime (re)configurings that are more akin to how electrons experience the world than any journey narrated though rhetorical forms that presume actors move along trajectories across a stage of spacetime (often called history). The electron is here invoked as our host, an (...) interesting body to inhabit (not in order to inspire contemplation of flat-footed analogies between ‘macro’ and ‘micro’ worlds, concepts that already presume a given spatial scale), but a way of thinking with and through dis/continuity – a dis/orienting experience of the dis/jointedness of time and space, entanglements of here and there, now and then, that is, a ghostly sense of dis/continuity, a quantum dis/continuity. There is no overarching sense of temporality, of continuity, in place. Each scene diffracts various temporalities within and across the field of spacetimemattering. Scenes never rest, but are reconfigured within, dispersed across, and threaded through one another. The hope is that what comes across in this dis/jointed movement is a felt sense of différance, of intra-activity, of agential separability – differentiatings that cut together/apart – that is the hauntological nature of quantum entanglements. (shrink)

In this chapter, I examine similarities and divergences between Du Châtelet and Descartes on their endorsement of the use of hypotheses in science, using the work of Condillac to locate them in his scheme of systematizers. I conclude that, while Du Châtelet is still clearly a natural philosopher, as opposed to modern scientist, her conception of hypotheses is considerably more modern than is Descartes’, a difference that finds its roots in their divergence on the nature of first principles.

I think that there is an awful lot wrong with the exclusion problem. So, it seems, does just about everybody else. But of course everyone disagrees about exactly _what_ is wrong with it, and I think there is more to be said about that. So I propose to say a few more words about why the exclusion problem is not really a problem after all—at least, not for the nonreductive physicalist. The genuine _dualist_ is still in trouble. Indeed, one of (...) my main points will be that the nonreductive physicalist is in a rather different position vis à vis the exclusion problem than the dualist is. Properly understanding nonreductive physicalism—and clearly recognizing that it is, after all, a form of _physicalism_—goes a long way toward solving the exclusion problem. (shrink)

This collection brings together fourteen contributions by authors from around the globe. Each of the contributions engages with questions about how local and global bioethical issues are made to be comparable, in the hope of redressing basic needs and demands for justice. These works demonstrate the significant conceptual contributions that can be made through feminists' attention to debates in a range of interrelated fields, especially as they formulate appropriate responses to developments in medical technology, global economics, population shifts, and poverty.

Relationships between current theories, and relationships between current theories and the sought theory of quantum gravity (QG), play an essential role in motivating the need for QG, aiding the search for QG, and defining what would count as QG. Correspondence is the broad class of inter-theory relationships intended to demonstrate the necessary compatibility of two theories whose domains of validity overlap, in the overlap regions. The variety of roles that correspondence plays in the search for QG are illustrated, using examples (...) from specific QG approaches. Reduction is argued to be a special case of correspondence, and to form part of the definition of QG. Finally, the appropriate account of emergence in the context of QG is presented, and compared to conceptions of emergence in the broader philosophy literature. It is argued that, while emergence is likely to hold between QG and general relativity, emergence is not part of the definition of QG, and nor can it serve usefully in the development and justification of the new theory. (shrink)

I argue that it is intuitive and useful to think about composition in the light of the familiar functionalist distinction between role and occupant. This involves factoring the standard notion of parthood into two related notions: being a parthood slot and occupying a parthood slot. One thing is part of another just in case it fills one of that thing's parthood slots. This move opens room to rethink mereology in various ways, and, in particular, to see the mereological structure of (...) a composite as potentially outreaching the individual entities that are its parts. I sketch one formal system that allows things to have individual entities as parts multiple times over. This is particularly useful to David Armstrong, given Lewis's charge that his structural universals must do exactly that. I close by reflecting upon the nature and point of formal mereology. (shrink)

Nursing staff of many specialities are taking on and developing their roles in new and advanced practice areas. Patients will be offered new services from highly skilled advanced nurse practitioners. Such nurses need guidance, direction and information to assist them in their new roles. This book will offer insight and guidance on a variety of issues that are likely to be encountered by the Nurse Practitioner in everyday practice.

Although for a long time, Dutch academic philosophy was characterized by a pluralism of – imported – philosophical frameworks and paradigms, in more recent decades, a type of ‘normal philosophy’, in the Kuhnian sense, has become dominant which aims to solve ethical and political problems and dilemmas through rational-normative argumentation. Contrary to what is often claimed, the new 'normal philosophy' amounts not to thinking ‘beyond the analytic-continental divide’ in a fruitful synthesis, but to the subsumption of continental philosophical themes and (...) concepts under the analytic tradition. The potentially critical tenor of continental philosophy threatens to be ‘solved’ by this subsumption. ‘Normal philosophy’, with its emphasis on rational-normative argumentation, risks leading to a state philosophy that fits in with existing policy questions, ignoring systemic and structural power inequalities. I argue that the journal Krisis, in keeping with its original principles, should hang on to critical philosophical reflection, which today is needed more than ever, specifically – pace current right-wing and left-wing populist attacks on identity politics – on systemic, multiple forms of deprivation and oppression. (shrink)

Concerns about ‘mental causation’ are concerns about how it is possible for mental states to cause anything to happen. How does what we believe, want, see, feel, hope, or dread manage to cause us to act? Certain positions on the mind-body problem—including some forms of physicalism—make such causation look highly problematic. This entry sketches several of the main reasons to worry, and raises some questions for further investigation.

Widely regarded as the most influential proponent of the truth of original sin in the twentieth century, Reinhold Niebuhr worked hard to excise any "literalistic" element from his interpretation of the doctrine. In his attempt to "correct" the Augustinian tradition on original sin by purging it of all "literalistic errors," however, Niebuhr assumed as his starting point the most characteristically modern objection to the doctrine: that birth is a thoroughly natural, animal, and morally meaningless event. As a result, Niebuhr unnecessarily (...) constrained his vision of the dimensions of human freedom, and hence his description of the dynamic of anxiety and freedom that energizes sin. Through a careful reading of Reinhold Niebuhr's writings on original sin, in light of the truth that the end of human life is inseparable from its origins, a reappraisal and recovery of the meaningfulness of the assertion of original sin as a literal inheritance is possible. The result of such a reappraisal and recovery is an amplified insight into the existential anxiety that Niebuhr otherwise described so convincingly. (shrink)