COVID-19 is a highly contagious infection with no proven treatment. Approximately 2.5% of patients need mechanical ventilation while their body fights the infection.1 Once COVID-19 patients reach the point of critical illness where ventilation is necessary, they tend to deteriorate quickly. During the pandemic, patients with other conditions may also present at the hospital needing emergency ventilation. But ventilation of a COVID-19 patient can last for 2–3 weeks. Accordingly, if all ventilators are in use, there will not be time for (...) patients to ‘queue up’ to wait for those who arrived earlier to recover. Those who need a ventilator will die if they do not receive access to one quickly. Many nations now face the prospect that they failed to prepare appropriately for this foreseen risk of pandemic (another issue worthy of legal analysis) and that their populations will need far more ventilators than the health service can supply. For many weeks, the UK has been anticipating a surge of COVID-19 infections that could leave patients queuing in hospitals for ICU care. Luckily, social distancing has ‘flattened the curve’ and this problem might not arise. There is still a degree of risk, however, and other countries will not be so lucky. At some point, during this pandemic or the next, all countries will need to answer hard questions about whether and when scarce ICU resources (such as ventilators, beds and staff) should be either withheld or withdrawn from certain groups of patients solely for the purpose of providing them to others. Attempts to answer these questions can be found in a wide range of ICU triage protocols and ethical guidance documents, many of which embrace the foundational principle of ‘save the most lives’. Unfortunately, this worthwhile goal has generated many suggestions that could violate the law. This article identifies …. (shrink)

Different opinions are expressed in the literature regarding when children and adolescents can start to make decisions to participate in research and give informed consent. Nurses are frequently involved in research, either as investigators or caregivers, and must therefore have a thorough understanding of consent and related issues. In this article the issues are explored from a Canadian perspective. The argument is put forward that adolescents may be capable of a greater involvement in the research consent process than is the (...) norm. Increasing adolescents’ involvement in research has the potential to enhance their growing autonomy and capabilities. Adolescents appreciate being treated with respect and dignity by adults. This can be achieved in an environment in which protection from harm does not also mean prevention from decision making. The use of empowering processes by nurses to enhance adolescent involvement will provide benefit to adolescents in their transition to adult levels of responsibility. (shrink)

Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

The concept of a relational self has been prominent in feminism, communitarianism, narrative self theories, and social network theories, and has been important to theorizing about practical dimensions of selfhood. However, it has been largely ignored in traditional philosophical theories of personal identity, which have been dominated by psychological and animal theories of the self. This book offers a systematic treatment of the notion of the self as constituted by social, cultural, political, and biological relations. The author's account incorporates practical (...) concerns and addresses how a relational self has agency, autonomy, responsibility, and continuity through time in the face of change and impairments. This cumulative network model of the self incorporates concepts from work in the American pragmatist and naturalist tradition. The ultimate aim of the book is to bridge traditions that are often disconnected from one another--feminism, personal identity theory, and pragmatism--to develop a unified theory of the self. (shrink)

Feminist critiques of science provide fertile ground for any investigation of the ways in which social influences may shape the content of science. Many authors working in this field are from the natural and social sciences; others are philosophers. For philosophers of science, recent work on sexist and androcentric bias in science raises hard questions about the extent to which reigning accounts of scientific rationality can deal successfully with mounting evidence that gender ideology has had deep and extensive effects on (...) the development of many scientific disciplines.Feminist critiques of biology have been especially important in the political struggle for gender equality because biologically determinist arguments are so often cited to ‘explain’ women’s oppression. They explain why it is ‘natural’ for women to function in a socially subordinate role, why men are smarter and more aggressive than women, why women are destined to be homebodies, and why men rape. (shrink)

This book offers an intervention into the process of decolonization through the re-subjectification of the settler subject. The authors draw on what Deleuze and Guattari call minor threads of philosophy, pedagogy, spirituality, and healing practices rooted in neglected lineages of European thought and ceremony. The book proposes a methodology for unontologizing the settler subject, which they term 'desettlering.' Rather than fetishizing indigenous theory and practice as a mode for resubjectifying settlers to facilitate land-based decolonization, it offers a fresh approach by (...) looking towards alternative sets of traditions and identity. These alternatives are used to interrogate minoritarian European philosophies, practices, and beliefs, which the authors propose could be deployed to unontologize the settler within current historical conditions. Asserting that such a process is not volitional but a historical necessity, the book offers a novel and timely investigation into who settlers become if they intend to engage seriously in decolonization. It will appeal to an interdisciplinary audience of scholars and researchers in psychological science, social psychology, counseling, philosophy, indigenous studies, and sociology. (shrink)

The French and German political economies have been significantly reconfigured over the past two decades. Although the changes have often been more piecemeal than revolutionary, their cumulative effects are profound. The authors characterize the changes that have taken place as involving the institutionalization of new forms of dualism and argue that what gives contemporary developments a different character from the past is that dualism is now explicitly underwritten by state policy. They see this outcome as the culmination of a sequence (...) of developments, beginning in the field of industrial relations, moving into labor market dynamics, and finally finding institutional expression in welfare state reforms. Contrary to theoretical accounts that suggest that institutional complementarities support stability and institutional reproduction, the authors argue that the linkages across these realms have helped to translate employer strategies that originated in the realm of industrial relations into a stable, new, and less egalitarian model with state support. (shrink)

This entry considers the question “What is objectification?” After preliminary remarks about different methodological approaches, several possible answers, or groups of answers, are introduced, separated out in terms of broad themes. Each is situated in relation to historical and more contemporary authors. These themes are: objectification as instrumentalization; objectification as reduction to the body; objectification as negation of subjectivity or agency; objectification as naturalization. Objectification is considered in relation to both sexual and racial contexts. Finally, these themes are discussed in (...) relation to the wider category of “mind suppression,” and its relation to objectification in the familiar context of imagery. (shrink)

This paper explores the relationship between common-sense psychology (CSP) and scientific psychology (SP) — which we could call the mind-mind problem. CSP has come under much attack recently, most of which is thought to be unjust or misguided. This paper's first section examines the many differences between the aims, interests, explananda, explanantia, methodology, conceptual frameworks, and relationships to the neurosciences, that divide CSP and SP. Each of the two is valid within its own territory, and there is no competition between (...) them — primarily because CSP is not, and has no interest in being, a scientific theory. In the second section some implications are drawn. First, neither CSP nor SP has the mind-body problem in its familiar form. Second, CSP, for excellent reasons, is not equipped to handle irrational or non-rational behaviour; there are some grounds for believing that this can and should be the task of SP. Third, philosophical psychology, or armchair theories of action, perception, etc., are doomed to failure. And, fourth, the realm of the psychological is so heterogeneous that no single model for either CSP or SP is likely to succeed. (shrink)

The political theorist William E. Connolly reads Augustine 's Confessions as an exhortation to deny the paradox of identity/difference. The paradox for Connolly is this: if one confesses a true identity, one must be false to difference, but if one is true to difference, one must sacrifice the promise of true identity. I revisit Augustine 's Confessions here in order to offer a reading of their paradoxical character that contrasts with Connolly's. I will argue that Augustine 's confession does not (...) deny the paradox of identity/difference but exemplifies what it means to struggle within it. I turn to James Wetzel's work on Augustine 's idea of free will and Catherine Keller's work on the doctrine of creatio ex nihilo to suggest that treating Augustine 's confession as confession reveals this struggle. (shrink)

Throughout the text, fundamental questions concerning the nature of visual perception are addressed.

In this paper l examine the extent to which Locke’s reIigious and poIiticaI ideoIogy might be considered to exempIify values which have Ied to environmentaI deterioration. In the Two Treatises of Governlnent, Locke appears to hold a view of dominion which compromises humanitarian principles for economic gain. He often asserts that man has a right to accumulate property and to use land and animals for comfort and convenience. This right issues from God’s decree that men subdue the Earth and have (...) dominion over every living thing. Although abuse of the environment appears to be justified in Locke’s political works, I argue that there are many passages in this work that cast doubt on such an interpretation. Further, the view of dominion adopted in Locke's educational work is one of responsible stewardship. On the whole, his view stresses man’s duties and obligation towards all creation. (shrink)

The burden of this article is that although the idea of `the self'which Galen Strawson decribes in his target article is initially very attractive, it eventually doesn't work. There is a lot of competition for a `pole position'notion -- `human', `person', psuche, `soul', even `sake'-- and the idea of `self'does not seem to deserve the prize. What Strawson wants to do with the notion of a `self'can be done equally well, and more economically, by the first-person pronoun. A question raised (...) repeatedly is: `What is a self worth wanting?'Perhaps the greatest area of disagreement with Strawson's article is with his idea that `the self'needs to have little or nothing to do with time-related plans and emotions: guilt and remorse; pride; hope and expectation; career choices... even such apparently mundane things as pension-plans -- in fact, any long-term forward- or backward-looking psychological phenomena. The question of realism is pressed. (shrink)

Feminist critiques of science provide fertile ground for any investigation of the ways in which social influences may shape the content of science. Many authors working in this field are from the natural and social sciences; others are philosophers. For philosophers of science, recent work on sexist and androcentric bias in science raises hard questions about the extent to which reigning accounts of scientific rationality can deal successfully with mounting evidence that gender ideology has had deep and extensive effects on (...) the development of many scientific disciplines.Feminist critiques of biology have been especially important in the political struggle for gender equality because biologically determinist arguments are so often cited to ‘explain’ women’s oppression. They explain why it is ‘natural’ for women to function in a socially subordinate role, why men are smarter and more aggressive than women, why women are destined to be homebodies, and why men rape. (shrink)

No presente artigo pretende-se abordar o conceito de liberdade nas principais obras de Thomas Hobbes, objetivando discutir a centralidade do manuscrito Liberdade e Necessidadepara a compreensão das variações que caracterizam o pensamento hobbesiano na abordagem do referido conceito. A pouca clareza que se verifica na noção de liberdade decorre, em parte, de mudanças de convicção do filósofo quanto à possibilidade de usar de modo diferente a liberdade do indivíduo como entidade física e a liberdade do indivíduo no seio do corpo (...) político. Todavia, será sustentado, como hipótese teórica para a presente pesquisa, que ao longo do debate com Bramhall teria sido possível a Hobbes esclarecer muitas dessas imprecisões terminológicas e variações conceituais, sobretudo no que toca a relação entre liberdade e necessidade na sua teoria das causas antecedentes. (shrink)

The paper discusses Dr. Floris Tomasini's paper “What Is Bioethics: Notes toward a New Approach?”. Based on Tomasini's account of methodological and ethical pluralism, the paper explores the demarcation problem of bioethics and suggests a full methodological laissez-faire.

Twenty years ago, Australian biomedical researchers took the first steps along a pathway toward common ground with opponents of the use of animals in science. Leaders of Australian medical research at that time saw the necessity of established science facing the ethical and political challenges that a revived antivivisectionist movement was mounting in the late 1970s and the 1980s.

Many problems of inequality in developing countries resist treatment by formal egalitarian policies. To deal with these problems, we must shift from a distributive to a relational conception of equality, founded on opposition to social hierarchy. Yet the production of many goods requires the coordination of wills by means of commands. In these cases, egalitarians must seek to tame rather than abolish hierarchy. I argue that bureaucracy offers important constraints on command hierarchies that help promote the equality of workers in (...) bureaucratic organizations. Bureaucracy thus constitutes a vital if limited egalitarian tool applicable to developing and developed countries alike. (shrink)

This article finds little to disagree with in Neurophilosophy The sole area of disagreement is with Professor Churchland's attitude to common?sense psychology. Unfortunately, though, the author has already attempted to describe what should be the proper view of common?sense psychology in an earlier article in this very journal. Therefore the present article tries to build on the earlier one, advocating an instrumentalist constraal of many ordinary?language mental terms ? a construal with which Professor Churchland is unlikely to agree, but which, (...) if she did agree, would give her further ammunition with which to beat her opponents. The other main strand of this article suggests that Aristotle has anticipated Professor Churchland (and also most other theoreticians of psychology and physiology), and so, willy?nilly, we are ? correctly ? returning to an Aristotelian picture of human capacity and activity. (shrink)

Much feminist philosophy of science has been developed as a reaction against logical empiricism and the associated view that social factors play no role in good science. Recent accounts of the Vienna Circle that highlighted the ways in which some of its members attempted to combine their empiricism with emancipatory politics are used here as a basis on which to reassess the relationship between logical empiricism and feminism. The focus is chiefly on Otto Neurath.

Commissurotomy surgery has lately attracted considerable philosophical attention. It has seemed to some that the surgical scalpel that bisects the brain bisects consciousness and the mind as well; and that the ordinary concept of a person is thereby most seriously threatened. I shall assess the extent of the threat, arguing that it is overestimated. The argument begins with section III; section II, which describes the operation and its effects, should be omitted by those already familiar with these facts.

In this article, we respond in general and specific terms to the commentaries written on our target article . In so doing, we revisit the motivation for our initial article and attempt to clarify certain aspects of our argument. Given that we were taken by some to be trying to undermine the Representational Theory of Mind , we discuss RTM in some detail. We also discuss Wittgenstein's methods and their relevance to the issues raised in our article and in the (...) commentaries. 2012 APA, all rights reserved). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:John Locke and the Eighteenth-Century Divine by Alan P.F. SellKathy SquadritoAlan P.F. Sell. John Locke and the Eighteenth-Century Divine. Cardiff: University of Wales Press, 1997. Pp. xi + 444. Cloth, $75.00.Professor Sell’s goal is to discern the impact of Locke’s thought upon the later divines; Sell’s scope is the seventeenth century through the nineteenth century. Most of the text is a detailed descriptive account of various scholars’ reactions (...) to Locke’s epistemology, metaphysics, and views concerning religion. Sell focuses on the question of the relative authority of scripture, reason and revelation. He contends that Locke’s epistemological and political positions are intimately bound up with his Christian faith, that as a conservative empiricist, Locke is “much more the rationalist than he has sometimes been painted” (48). The important question bequeathed by Locke to Christian apologetics is: “can the epistemological starting point be redeemed for Christian apologetic use or is it not viable at all?” (12). Sell addresses this question throughout the following chapters: “Ideas, Knowledge and Truth”; “Reason, Revelation, Faith and Scripture”; “Morality and Liberty”; “Toleration and Government”; and “Christian Doctrine”.Sell notes Locke’s roots in Calvinism, his appreciation of Arminian doctrine and his friendship with a number of prominent Latitudinarians. He argues that most criticisms of Locke’s Reasonableness of Christianity are misguided. During the seventeenth and eighteenth centuries Locke was charged with scepticism, deism, Socinianism and materialism. Sell presents the objections of numerous scholars, notably Bishop Stillingfleet, William Carroll, John Norris, Richard Bentley, Henry Lee, Richard Price, Bishop Berkeley, and Samuel Johnson. He also covers the views of Locke’s defenders, including Anthony Collins, Catharine Cockburn and Samuel Bold.The reader might be disappointed with Sell’s short presentation of an inordinate number of Lockean critics; there is little analysis or discussion of the merits of the particular objections cited. He does offer an analysis of the general charges against Locke, but rarely quotes Locke sufficiently to justify his conclusion that Locke was not a deist, sceptic, or materialist. Sell simply takes Locke’s word for it. This book is best taken as an excellent reference guide.Sell contends that in spite of Locke’s friendship with deists such as Collins, Locke’s Reasonableness of the Christian Religion was written to dissolve the deist prejudice against Christianity. He dismisses the charge of deism because: (1) Locke argues for revelation and against natural religion, (2) Locke’s God possesses the traditional attributes assigned to him (power, omniscience, providence), (3) Locke grounds morality not exclusively in natural law, as did deists, but in the gospel, (4) the anti-materialist thrust of Book IV, Chapter X of the Essay, and (5) Locke’s argument that there can be truths of revelation which are above reason. Sell concludes that the “main problem posed to Locke by the deists was that of guilt by association” (209), in other words Locke’s work was misused for political reasons.Sell considers the charge of Socinianism more serious than that of deism. Socinianism is defined by its denial of the Trinity, and by the claims that there cannot be an innate idea of God, that there is no original corruption deriving from Adam, that the wicked will not suffer eternal torments, and that some bodies are not raised at general resurrection. Despite Locke’s agreement with most Socinian claims, Sell claims that [End Page 631] Locke cannot be pinned down on the issue of the Trinity. There is no question, he says, that “the Locke of 1662 affirmed both the doctrine of the Trinity and the human divine nature of Christ, whilst recognizing that the human mind could not explain how these things could be so; there is no question that especially from the 1690’s onwards he was actively reviewing the matter; there is no hard evidence that he ever repudiated the doctrine.” (214)According to Stillingfleet, Locke’s sensationalism and his proposal that matter might be capable of thought undermine Christian faith. Sell does not find this charge convincing. He defends Locke’s distinction between “the man” and “the person,” stressing that Locke claims a high degree of probability that the... (shrink)

This chapter contains sections titled: Metaphysics Metaphysics of Natural Complexes Metaphysics of Human Process.

This paper responds to four commentators (Diana Tietjens Meyers, Lawrence Cahoone, Vincent Colapietro, and Scott L. Pratt) on my book The Network Self: Relation, Process, and Personal Identity (2019). Aspects of the book focused on and about which I respond include reflexive communication (Meyers); identity and integrity (Cahoone); embodiment, self‐deception, and autonomy (Colapietro); and social location and power (Pratt). I also clarify my strategy in the book, namely, to shift the ontological framework away from the dualistic mind/body or psychological/animalist distinction (...) and embrace the idea that as relational processes selves are particular kinds of natural complexes (to use a term from Justus Buchler). In doing so, I aim to avoid metaphysically narrow views of human selves or persons, and to provide a framework for conceptualizing selves in both abstract and practical terms. (shrink)

SUMMARYThis paper discusses the scientific instruments made and used by the microscopist Antony van Leeuwenhoek. The immediate cause of our study was the discovery of an overlooked document from the Delft archive: an inventory of the possessions that were left in 1745 after the death of Leeuwenhoek's daughter Maria. This list sums up which tools and scientific instruments Leeuwenhoek possessed at the end of his life, including his famous microscopes. This information, combined with the results of earlier historical research, gives (...) us new insights about the way Leeuwenhoek began his lens grinding and how eventually he made his best lenses. It also teaches us more about Leeuwenhoek's work as a surveyor and a wine gauger.A further investigation of the 1747 sale of Leeuwenhoek's 531 single lens microscopes has not only led us to the identification of nearly all buyers, but also has provided us with some explanation about why only a dozen of this large number of microscopes has survived. (shrink)

This qualitative study was designed to explore ethical issues in public health nursing in the Canadian context, and to begin to identify strategies to support ethical practice. Twenty-two public health nurses, 11 in rural and 11 in urban settings, were asked to describe ethical problems they had experienced in the course of their work. These participants most often described situations that required a relational response rather than an active choice between options. Their goal was to optimize the good, while at (...) the same time maintaining a supportive relationship. Analysis revealed five interrelated themes, each with several subthemes: relationships with health care professionals; systems issues; character of relationships; respect for persons; and putting self at risk. It was clear that all aspects of public health nursing have ethical components. (shrink)