Context Conflicts over treatment decisions have been linked to physicians' emotional states. Objective To measure the prevalence of emotional exhaustion and conflicts over treatment decisions among US obstetrician/gynaecologists (ob/gyns), and to examine the relationship between the two and the physician characteristics that predict each. Methods Mailed survey of a stratified random sample of 1800 US ob/gyn physicians. Criterion variables were levels of emotional exhaustion and frequency of conflict with colleagues and patients. Predictors included physicians' religious characteristics and self-perceived empathy. Results (...) Response rate among eligible physicians was 66% (1154/1760). 36% of ob/gyns reported high levels of emotional exhaustion, and majorities reported conflict with colleagues (59%) and patients (61%). Those reporting conflict were much more likely to report emotional exhaustion (58% vs 29% who never conflict, OR, 95% CI 2.8, 1.6 to 4.8 for conflict with colleagues; 55% versus 26%, OR, 95% CI 2.2, 1.4 to 3.5 for conflict with patients). Physicians with lower self-perceived empathy were more likely to report physician-patient conflicts (65% vs 58% with higher empathy, OR, 95% CI 1.4, 1.0 to 1.9), as were female ob/gyns (66% vs 57% of males, OR, 95% CI 1.5, 1.1 to 2.0). Foreign-born physicians were less likely to report such conflicts (47% vs 64% of US born, OR, 95% CI 0.5, 0.4 to 0.8). Physicians' religious characteristics were not significantly associated with reporting conflict. Conclusions Conflicts over treatment decisions are associated with physicians' empathy, gender, immigration history and level of emotional exhaustion. With respect to the latter, conflict in the clinical encounter may represent an overlooked source or sign of burnout among ob/gyns. (shrink)

This paper examines and rejects some purported refutations of eliminative materialism in the philosophy of mind: a quasi-transcendental argument due to Jackson and Pettit (1990) to the effect that folk psychology is “peculiarly unlikely” to be radically revised or eliminated in light of the developments of cognitive science and neuroscience; and (b) certain straight-out transcendental arguments to the effect that eliminativism is somehow incoherent (Baker, 1987; Boghossian, 1990). It begins by clarifying the exact topology of the dialectical space in which (...) debates between eliminativist and anti-eliminativist ought to be framed. I claim that both proponents and opponents of eliminativism have been insufficiently attentive to the range of dialectical possibilities. Consequently, the debate has not, in fact, been framed within the correct dialectical setting. I then go onto to show how inattentiveness to the range of dialectical possibilities undermines both transcendental and quasi-transcendental arguments against eliminativism. In particular, I argue that the quasi-transcendentalist overestimates the degree to which folk psychology can be insulated from the advance of neuroscience and cognitive science just in virtue of being a functional theory. I argue further that transcendental arguments are fallacious and do not succeed against even the strongest possible form of eliminativism. Finally, I argue that that transcendental arguments are irrelevant. Even if such arguments do succeed against a certain'very strong form of eliminativism, they remain complete non-starters against certain weaker forms of eliminativism. And I argue that if any of these weaker forms is true, folk psychology is in trouble enough to vindicate Paul Ckurchland's claim that our common sense psychological framework is “a radically false and misleading conception of the causes of human behavior and the nature of cognitive activity”. (shrink)

This essay some first steps toward the naturalization of what I call rational intentionality or alternatively type II intentionality. By rational or type II intentionality, I mean that full combination of rational powers and content-bearing states that is paradigmatically enjoyed by mature intact human beings. The problem I set myself is to determine the extent to which the only currently extant approach to the naturalization of the intentional that has the singular virtue of not being a non-starter can be aggregated (...) up into an account of rational intentionality. I have in mind a broadly defined family of accounts whose main members are the indicator/information-theoretic approach of Dretske (1988), the asymmetric dependence theory of Jerry Fodor (1987, 1990, 1994) and the teleo-semantics of Ruth Millikan (1984, 1993). Somewhat inaccurately, I will call this family of approaches the information-theoretic family. To be sure, there is only a rough family resemblance among the members of the information-theoretic family. Indeed, several intense quarrels divide the members of that family one from another, but the precise outcome of those internecine struggles is not directly relevant to the aims of this essay. ² Taken collectively, the information-theoretic family yields a compelling picture of the place of at least a crude form of intentionality -- what I call frog-like or type I intentionality -- in the natural order. Though frog-like or type I intentionality is, I think, a genuine species of intentionality, it may subsist in the absence of rational powers. It is that species of intentionality enjoyed by irritable creatures who, following Brandom (1994). (shrink)

This paper examines two questions. The first is what it would mean for schools to be communities. This question is pursued by examining four metaphors for community: families, congregations, guilds, and democratic polities. Three models of school communities are then sketched. The second question is whether schools that are communities are inherently illiberal. The paper distinguishes between a liberal interpretation of schools as communities, where schools are viewed as limited-purpose free associations, and a communitarian interpretation where community and polity are (...) not adequately distinguished. I argue that, within a framework of liberal pluralism, schools can be communities without being illiberal. (shrink)

In this essay, I consider three different conceptions of ‘the people’ and what it means to ‘respect’ their collective will and wisdom: (a) the democratic conception of the people as a sprawling demos, (b) the populist conception of the people as an authentic folk (c) and, finally, the vanguardist conception of the people as the semi-mute masses who stand in need of revolutionary transformation. Although my ultimate aim is to defend the democratic conception of the people over both the populist (...) conception and the vanguardist conception, much of this essay is taken up simply spelling out each of these conceptions of the people and outlining their consequences for the conduct of politics. I begin by contrasting the democratic conception with the populist conception. I then turn briefly to the vanguardist conception. I close with a brief, and admittedly incomplete defence of a particular form of democracy – what I call transformative or ameliorative democracy – which conceives of the people as a self-transformative totality. (shrink)

In the article Privacy and Health Practices in the Digital Age, the authors describe current privacy challenges for digital health data and review the theoretical framework on privacy in the contex...

Schools in liberal societies are responsible for producing liberal citizens. However, if they have too robust a view of citizenship, they may find themselves undermining the view of good lives held by many pacific and law abiding groups. Here I argue against treating citizenship as an educational good that simply trumps private values when they conflict and in favor of a view that seeks a context sensitive balance between such conflicting goods. The paper explores Rawls's distinction between two moral powers (...) as a way of understanding the character of some of the private interests in schooling. (shrink)

Definitions of health and disease are of more than theoretical interest. Understanding what it means to be healthy has implications for choices in medical treatment, for ethically sound informed consent, and for accurate assessment of policies or programs. This deeper understanding can help us create more effective public policy for health and medicine. It is notable that such contentious legal initiatives as the Americans with Disability Act and the Patients' Bill of Rights fail to define adequately the medical terms on (...) which their effectiveness depends. In Ethics and the Metaphysics of Medicine, Kenneth Richman develops an "embedded instrumentalist" theory of health and applies it to practical problems in health care and medicine, addressing topics that range from the philosophy of science to knee surgery."Embedded instrumentalist" theories hold that health is a match between one's goals and one's ability to reach those goals, and that the relevant goals may vary from individual to individual. This captures the normative implications of the term health while avoiding problematic relativism. Richman's embedded instrumentalism differs from other theories of health in drawing a distinction between the health of individuals as biological organisms and the health of individuals as moral agents. This distinction illuminates many difficulties in patient-provider communication and helps us understand conflicts between promoting health and promoting ethically permissible behavior. After exploring, expanding, and defending this theory in the first part of the book, Richman examines its ethical implications, discussing such concerns as the connection between medical beneficence and respect for autonomy, patient-provider communication, living wills, and clinical education. (shrink)

This essay examines the syntax of names. It argues that names are a syntactically and not just semantically distinctive class of expressions. Its central claim is that names are a distinguished type of anaphoric device—devices of explicit co-reference. Finally it argues that appreciating the true syntactic distinctiveness of names is the key to resolving certain long-standing philosophical puzzles that have long been thought to be of a semantic nature.

This paper discusses the role of religious speech in the public square and the common school. It argues for more openness to political theology than many liberals are willing to grant and for an educational strategy of engagement over one of avoidance. The paper argues that the exclusion of religious debate from the public square has dysfunctional consequences. It discusses Rawls’s more recent views on public reason and claims that, while they are not altogether adequate, they are consistent with engagement. (...) The outcome of these arguments is applied to three ‘hot button’ issues in US education: creationism, an issue of gay rights, and teaching the Bible in schools. (shrink)

In the summer of 1998, the Wisconsin State legislature amended its child protection laws. Under new child abuse provisions, Wisconsin judges can confine pregnant women who abuse alcohol or drugs for the duration of their pregnancies. South Dakota enacted similar legislation almost simultaneously. The South Dakota statute requires mandatory drug and alcohol treatment for pregnant women who abuse those substances and classifies such activity as child abuse. In addition, the South Dakota legislation gives relatives the power to commit pregnant women (...) involuntarily for two days; a court order can place the pregnant women in custody for up to nine months. These recent legislative “successes” follow scores of failed attempts by legislators in other states to establish fetal protection laws aimed at women who use and abuse drugs and alcohol during pregnancy. (shrink)

Strike explores the differences between Marxists and liberals over the nature of the good life, about how human beings are formed, and about episemology, and uses these discussions to explore views of schooling.

This chapter contains sections titled: Orientation Teacher Ethics and the Law The NEA Code of Ethics Teaching with Integrity Citizenship, Civic Norms, and Moral Education Conclusion.

This paper discusses the role of religious speech in the public square and the common school. It argues for more openness to political theology than many liberals are willing to grant and for an educational strategy of engagement over one of avoidance. The paper argues that the exclusion of religious debate from the public square has dysfunctional consequences. It discusses Rawls’s more recent views on public reason and claims that, while they are not altogether adequate, they are consistent with engagement. (...) The outcome of these arguments is applied to three ‘hot button’ issues in US education: creationism, an issue of gay rights, and teaching the Bible in schools. (shrink)

A meta-analytic review of studies that experimentally elicited awe and compared the emotion to other conditions (84; 487 effects; 17,801 participants) examined the degree to which experimentally elicited awe (1) affects outcomes relative to other positive emotions (2) affects experience, judgment, behaviour, and physiology, and (3) differs in its effects if the awe state was elicited through positive or threatening contexts. The efficacy of methods that have been used to experimentally elicit awe and the possibility of assessing changes in the (...) state of the self with experimental awe elicitations were also examined. Meta-analyses with robust variance estimation revealed that awe affected outcomes compared to other positive emotions and control conditions; affected experience, judgment, and behaviour; and had similar effects if elicited through positive or threatening contexts. The ability to compare awe to negative emotion states and its effects on physiology was limited by a small number of available effects. Images, videos, autobiographical recall, and naturalistic exposure were effective in eliciting awe. Exploratory analyses suggested that some processes involved in changes in the self can be related to experimental awe elicitations. These findings suggest awe is a discrete emotion and identifies areas for future investigation. (shrink)

Translations and commentaries on Greek philosophy.

Agricultural research raises fundamental ethical and value questions going beyond those in other fields both because of its public funding and because its results have significant impacts on habitats and other species. Questions about the sustainability of modern agriculture, which are shared with other sectors, require us to examine alternative visions and structures. These can be seen to range from status quo preserving ideologies to change-oriented utopias. It is argued that at the national level current ideologies—which include positivistic approaches and (...) belief in the neutrality of technology—mask real structural and policy choices as well as their ethical and value implications. At the international level, the export of fossil-fuel based modes of agriculture to the developing countries raises additional structural, policy, value, and ethical issues. (shrink)

We glide easily from thought and talk about worldly objects to thought and talk about the contents of our beliefs about such worldly objects all the time. Smith ask Jones about the whereabouts of their pet cat and on the basis of Jones’s assertion that the cat is on the mat, Smith comes to believe that the cat is on the mat. Black in turn may ascribe to Smith the belief that the cat is on the mat. Such transitions from (...) thought and talk about worldly objects to thought and talk about states of mind are so familiar to us as to seem second nature. But there is a long-standing philosophical tradition, originating with Frege, but endorsed by philosophers with otherwise varying philosophical outlooks, which makes the very possibility of such transitions puzzling. That tradition assumes that in making at least certain attitude ascriptions – so-called de dicto or “notionally sensitive” ascriptions -- speakers refer to, describe, quantify over, or somehow pragmatically implicate the notions, representations, or modes of presentations that plausibly figure as constituents of our mental contents -- either to the exclusion of the worldly objects themselves or in addition to those objects. Such attitude ascriptions are widely taken to be the primary or unmarked case of an attitude ascription. But it is seldom acknowledged that twin facts that on this approach worldly objects will relate to the representational items that supposedly serve as ingredients of thought content in a one-many fashion and there is no automatic way “back-up” from worldly objects to modes of presentation thereof together generate a mystery about how possibly we are able execute transitions from thought and talk about worldly objects to thought and talk about representational states of mind. It is argued in this essay that the way around this mystery is to see that de re, rather than de dicto ascriptions are the unmarked form of attitude ascription and that our representations of mental contents are parasitic on our representations of worldly objects. That is, we talk about the contents of our states of mind not by adverting, in the first instance, to talk about peculiarly mental or representational entities like notions or modes of presentations, but primarily by talking about worldly entities themselves. That is, to attribute to another the belief that the cat is on the mat, one need not refer to modes of presentations, or their ilk, of said cat or said mat, but only to the relevant cat and the relevant mat. (shrink)

This chapter contains sections titled: Abstract What is Conceptual Relativism? The Kantian Roots of Conceptual Relativism Epistemology or Metaphysics? Conceptual Relativism and Truth The Scheme and Content Relativized? Davidson Against the Very Idea of a Conceptual Scheme Empirical Sources: Conceptual Relativism in Linguistics and Psychology References.

Whether to treat autism as exculpatory in any given circumstance appears to be influenced both by models of autism and by theories of moral responsibility. This article looks at one particular combination of theories: autism as theory of mind challenges and moral responsibility as requiring appropriate experience of the reactive attitudes. In pursuing this particular combination of ideas, we do not intend to endorse them. Our goal is, instead, to explore the implications of this combination of especially prominent ideas about (...) autism and about moral responsibility. These implications can be quite serious and practical for autists and those who interact directly with autists, as well as for broader communities as they attend to the fair, compassionate, and respectful treatment of increasing numbers of autistic adults. We find that these theories point to a limited range of situations in which autists should not be blamed for transgressive actions for which neurotypical individuals should be blamed. We build on what others have written on these issues by bringing in a recent cognitive model of the role theory of mind plays in empathy, by discussing the social implications of the theoretical findings, and by raising questions about the compatibility of reactive attitude theories of moral responsibility with the neurodiversity approach to autism. (shrink)

In the summer of 1998, the Wisconsin State legislature amended its child protection laws. Under new child abuse provisions, Wisconsin judges can confine pregnant women who abuse alcohol or drugs for the duration of their pregnancies. South Dakota enacted similar legislation almost simultaneously. The South Dakota statute requires mandatory drug and alcohol treatment for pregnant women who abuse those substances and classifies such activity as child abuse. In addition, the South Dakota legislation gives relatives the power to commit pregnant women (...) involuntarily for two days; a court order can place the pregnant women in custody for up to nine months. These recent legislative “successes” follow scores of failed attempts by legislators in other states to establish fetal protection laws aimed at women who use and abuse drugs and alcohol during pregnancy. (shrink)

The argument in this paper is that the exclusion of empirical research has led to a deficiency in the Positivist model; the neglect of conflict in the form of the trouble-case. In the attempt to define law in a relatively narrow way Positivists have avoided important knowledge about social behavior. In addition the analytical method of Positivism has been connected with a value-position which tends to exaggerate the extent to which law functions within social structures as an orderly system. One (...) consequence of this perspective is that the role of conflict in the law process is hardly appreciated. Studies of law in some primitive societies suggest that although social behavior generally is not regulated in rule-terms, conflict often is institutionalized in a manner capable of providing norms appropriate to new situations. It is suggested that the focus upon the trouble-case is more likely to develop our understanding of conflict as a dynamic element in the law process. (shrink)

If reason is a real causal force,operative in some, but not all ofour cognition and conation, then itought to be possible to tell anaturalistic story that distinguishes themind which is moved byreason from the mind which is movedby forces other than reason.This essay proposes some steps towardthat end. I proceed by showingthat it is possible to reconcile certainemerging psychological ideasabout the causal powers of themind/brain with a venerablephilosophical vision of reason as the facultyof norms. My accountof reason is psychologistic, social, (...) and consistent with anevolutionary approach to mind. The account preserves thenormativity by deflating it. But I argue that onlysuch deflated normativity has any chance of beingmade naturalistically respectable. (shrink)

By appealing to Paul Ricoeur’s view of interpretation as the dialectical process of understanding through explanation, Kenneth A. Reynhout contributes to the growing field of religion and science by developing an alternative understanding of interdisciplinary theology that is fundamentally hermeneutical.

Kenneth Strike’s essay on pluralism, personal identity, and freedom of conscience, takes up the concept of identity, and contrasts cultural and religious pluralism. He argues that the issues of affiliational obligation and recognition are often different in these two types of pluralism, and that religious groups are often asking for something very different from cultural groups. Strike makes a case for a more fluid conception of the idea of identity and against its essentialist form; he holds, e.g. that some (...) of his affiliations are stronger than others and more tied to his sense of a larger self, but it is questionable, he argues, whether any of these affiliations could not be re-evaluated without loss of the larger idea of the self. Strike does allow that members of groups more oppressed than his might certainly rally around the attributes that they hold in common, and he is sympathetic to this strategic function of identity. Nevertheless, he wants to hold onto the individualized and phenomenological conception of identity: identity is whatever the agent feels it to be. (shrink)