OBJECTIVE: To describe the issues faced, and how they were addressed, by the University of Toronto Critical Care Medicine Program/Joint Centre for Bioethics Task Force on Appropriate Use of Life-Sustaining Treatment. The clinical problem addressed by the Task Force was dealing with requests by patients or substitute decision makers for life-sustaining treatment that their healthcare providers believe is inappropriate. DESIGN: Case study. SETTING: The University of Toronto Joint Centre for Bioethics/Critical Care Medicine Program Task Force on Appropriate Use of Life-Sustaining (...) Treatment. PARTICIPANTS: The 24-member Task Force included physician and nursing leaders from five critical care units, bioethicists, a legal scholar, a health administration expert, a social worker, and a hospital public relations professional. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Our specific lessons learned include a) a policy focus on process; b) use of a negotiation and mediation model, rather than a hospital ethics committee model, for this process; and c) the policy development process is itself a negotiation, so we recommend equal involvement of interested groups including patients, families, and the public. CONCLUSIONS: This article describes the key issues faced by the Task Force while developing its policy. It will provide a useful starting point for other groups developing policy on appropriate use of life-sustaining treatment. (shrink)

Modern bioethics, which is based on Western moral philosophy and Western biomedical perspectives, has evolved within a complex, highly individualistic culture that draws a sharp distinction between church and state and tolerates a multitude of values. This discipline defines its principles in secular and objective terms that often are bewildering to people of non-Western origin. Despite much discourse, principlism remains the fundamental framework of bioethics. Principlism is held in such high regard that many bioethicists equate autonomy with personhood, as if (...) autonomy exists independently of specific beliefs and commitments.In addition, we continue to minimize the substantial differences in the way people of different cultures perceive, experience, and explain illness, although our views of the potential cultural limitations of Western medicine have grown and expanded in recent years. At the heart of it we continue to be tied to a biomedical focus that largely neglects the context of the situation. (shrink)

Modern bioethics, which is based on Western moral philosophy and Western biomedical perspectives, has evolved within a complex, highly individualistic culture that draws a sharp distinction between church and state and tolerates a multitude of values. This discipline defines its principles in secular and objective terms that often are bewildering to people of non-Western origin. Despite much discourse, principlism remains the fundamental framework of bioethics. Principlism is held in such high regard that many bioethicists equate autonomy with personhood, as if (...) autonomy exists independently of specific beliefs and commitments.In addition, we continue to minimize the substantial differences in the way people of different cultures perceive, experience, and explain illness, although our views of the potential cultural limitations of Western medicine have grown and expanded in recent years. At the heart of it we continue to be tied to a biomedical focus that largely neglects the context of the situation. (shrink)

Causation is important when considering how an organism maintains health, why disease arises in a healthy person, and how one may intervene to change the course of a disease. This paper explores the form of causative relationships in health, disease and intervention, with particular regard to the pathological and biopsychosocial models. Consistent with the philosophical view of dispositionalism, we believe that objects are the fundamental relata of causation. By accepting the broad scope of the biopsychosocial model, we argue that psychological (...) and social constructs be considered objects. We think that this 'biopsychosocial dispositionalism' offers the flexibility required to describe causation throughout health, disease and intervention pathways. When constructing mechanistic chains to describe causative pathways, we argue that an object will causally connect with others through actions; transfers of energy from one object to another, initiated by the manifestation of one or more dispositional property. Finally, our analysis of causative interactions utilises the concept that a common form of interaction exists between disease and intervention pathways. This common form will always be an object, but the mode of interaction will vary with each disease. We describe how intervention may act through objects being shared between converging mechanistic chains, or through the removal and/or insertion of objects in such chains. We believe that this analysis provides novel insight to the forms of causative transactions that can occur. In addition, we hope that the findings of this analysis represent the first step towards developing a framework for appraising the composition of mechanistic theories. (shrink)

Early in his career, Karl Marx complained that “Philosophers have hitherto only interpreted the world in various ways; the point is to change it.” Philosophers Robert Frodeman and Adam Briggle have recently issued this same complaint against their contemporaries, arguing that philosophy has become an isolated, “purified” discipline, detached from its historical commitments to virtue and to public engagement. In this paper I argue that they are wrong about contemporary philosophy and about its history. Philosophy hitherto has always been characterized (...) both by a concern with practical engagement and by serious misgivings about such engagement. I show that reluctance to engage with practical affairs was a feature of philosophy long before the advent of the modern university and that a wide range of contemporary philosophers are concerned with virtue and public engagement. Finally, I argue that Frodeman and Briggle’s own account of contemporary philosophy makes it unsuitable both as the subject of their title (“When Philosophy Lost Its Way”) and as the object of their call to action. (shrink)

Sir Austin Bradford Hill’s ‘aspects of causation’ represent some of the most influential thoughts on the subject of proximate causation in health and disease. Hill compiled a list of features that, when present and known, indicate an increasing likelihood that exposure to a factor causes—or contributes to the causation of—a disease. The items of Hill’s list were not labelled ‘criteria’, as this would have inferred every item being necessary for causation. Hence, criteria that are necessary for causation in health, disease (...) and intervention processes, whether known, knowable, or not, remain undetermined and deserve exploration. To move beyond this position, this paper aims to explore factors that are necessary in the constitution of causative relationships between health, disease processes, and intervention. To this end, disease is viewed as a causative pathway through the often overlapping stages of aetiology, pathology and patho-physiology. Intervention is viewed as a second, independent causative pathway, capable of causing changes in health for benefit or harm. For the natural course of a disease pathway to change, we argue that intervention must not only occupy the same time and space, but must also share a common form; the point at which the two pathways converge and interact. This improved conceptualisation may be used to facilitate the interpretation of clinical observations and inform future research, particularly enabling predictions of the mechanistic relationship between health, disease and intervention. (shrink)

Causation is important when considering: how an organism maintains health; why disease arises in a healthy person; and, how one may intervene to change the course of a disease. This paper explores the form of causative relationships in health, disease and intervention, with particular regard to the pathological and biopsychosocial models. Consistent with the philosophical view of dispositionalism, we believe that objects are the fundamental relata of causation. By accepting the broad scope of the biopsychosocial model, we argue that psychological (...) and social constructs be considered objects. We think that this ‘biopsychosocial dispositionalism’ offers the flexibility required to describe causation throughout health, disease and intervention pathways. When constructing mechanistic chains to describe causative pathways, we argue that an object will causally connect with others through actions; transfers of energy from one object to another, initiated by the manifestation of one or more dispositional property. Finally, our analysis of causative interactions utilises the concept that a common form of interaction exists between disease and intervention pathways. This common form will always be an object, but the mode of interaction will vary with each disease. We describe how intervention may act through objects being shared between converging mechanistic chains, or through the removal and/or insertion of objects in such chains. We believe that this analysis provides novel insight to the forms of causative transactions that can occur. In addition, we hope that the findings of this analysis represent the first step towards developing a framework for appraising the composition of mechanistic theories. (shrink)

This work contributes to recent transdisciplinary efforts to view the Haitian slave revolt (1791–1804) as the historical inspiration for Hegel’s master-slave dialectic. Reconstructions offered by contemporary postcolonial scholars argue that the Haitian revolt was chronicled in Minerva as Hegel raced to finish his Phenomenology. Benhabib recently recognized the Hegel-Haiti thesis as entailing the sort of inclusive dialogical learning process necessary to validate subaltern experiences. The thesis has also drawn its share of sceptical scrutiny as Badiou claims that it risks forcing (...) an unnecessary moral dissymmetry, neglects objectionable features of enslavement and imposes a mismatch between apolitical subject and revolutionary. In reply, we appeal to the pioneering work of Tavares to show that the asymmetrical construction of classification schemes for persons of mixed-racial statuses accords with decades of documented literary exchanges between Hegel and Gregoire. We then turn to the work of James on the role of mixed-race merchants in the testimonial accounts of late 18th century French historians to show that European literate publics were well aware of the extremely coercive forms of commodified labour found in Saint-Domingue. We then invoke the archival work of Du Bois on French, British and American parliamentary proceedings that show the provisional colonial identities ascribed to Caribbean subjects did not hinder their self-conscious exercise of political agency. Viewing Hegel in terms of the historiographic records of the racial ontologies of early modern transatlantic literary exchanges helps explain how he adapted these tropes concerning mixed-race subjects in a manner that better explains many of the anomalous features of the dialectic. However, conferring the Haitian revolution its proper world-historical warrant as inspiration for his infamous master-slave dialectic need not lead us to overlook Hegel’s complicity with many of the epistemic and ontological flaws of colonial tropes held in early modern transatlantic print. (shrink)

Allies of those experiencing injustice or oppression face a dilemma: to be neutral in the face of calls to solidarity risks siding with oppressors, yet to speak or act on behalf of others risks compounding the injustice. We identify what we call ‘a normative demand for deference’ (NDD) to those with lived experience as a response to this dilemma. Yet, while the NDD is prevalent, albeit sometimes implicitly so, in contemporary solidarity theory and activist practice, it remains under-theorised. In this (...) article, we analyse the potential benefits of adhering to the NDD, highlighting both a commonly accepted epistemic benefit, and a neglected but important good in bearing witness. Yet adhering to the NDD also raises real challenges. While the literature focuses on a gold standard model of direct engagement, we defend a valuable role for a second-order form of engagement through reading, films, and similar media, which, we argue, is particularly salient for global and transnational solidarity, an important element of contemporary global politics. (shrink)

Certainly I am in no way opposed to philosophy, or metaphysics in the sense that Wm. James defined it as a particularly intense effort to think clearly. Indeed, Klein would like to say that what I am talking about is nothing but metaphysics. But the kind of philosophy/metaphysics that is needed here is of a particular kind: a kind that does not separate philosophy/metaphysics and physics into two disjoint realms. It is of the kind that seeks to construct useful testable (...) physical theories that are adequately connected to what we can know. (shrink)

I argue that Arendt’s understanding of “society” deepens Green critiques of productivism. By avoiding subjectivist or objectivist modes of thought, Arendt uncovers hidden links between life-sustaining labor and a world-destroying drive to consume. Checking environmentally destructive desires to produce and consume requires structuring communities around an optimal configuration of public deliberation, work and labor. I conclude that an Arendt-inspired ecological politics stresses the interdependence of human values and an all-encompassing natural order.

A suite of questions concerning fundamentality lies at the heart of contemporary metaphysics. The relation of grounding, thought to connect the more to the less fundamental, sits at the heart of those debates in turn. Since most contemporary metaphysicians embrace the doctrine of physicalism and thus hold that reality is fundamentally physical, a natural question is how physics can inform the current debates over fundamentality and grounding. This Element introduces the reader to the concept of grounding and some of the (...) key issues that animate contemporary debates around it, such as the question of whether grounding is 'unified' or 'plural' and whether there exists a fundamental level of reality. It moves on to show how resources from physics can help point the way towards their answers - thus furthering the case for a naturalistic approach to even the most fundamental of questions in metaphysics. (shrink)

Managers seeking to respect local norms when operating in cross-cultural settings may encounter ethical dilemmas when faced with values that potentially conflict with their own. The question of whose ethics or values should be applied or whether a set of universal ethical norms should be developed often confronts managers in their international business dealings. This article explores the findings from a qualitative research study that examines critical ethical dilemmas confronting Australian managers in their international business operations and their responses to (...) those dilemmas. For Australians managers in this study, bribery emerged as the major ethical dilemma confronting them in their international operations. (shrink)

In this article, I address concerns that the ontological priority claims definitive of ontic structural realism are as they stand unclear, and I do so by placing these claims on a more rigorous formal footing than they typically have been hitherto. I first of all argue that Kit Fine’s analysis of ontological dependence furnishes us with an ontological priority relation that is particularly apt for structuralism. With that in place, and with reference to two case studies prominent within the structuralist (...) literature, I consider whether any of structuralism’s distinctive priority claims may be regarded as warranted. The discussion as a whole has largely negative implications for the radical structuralism of French and Ladyman (including their ‘eliminativist’ interpretation of it), largely positive implications for the moderate structuralism primarily advocated by Esfeld and Lam, and some broad lessons for contemporary fundamentalist metaphysics as a whole. 1 Introduction2 The Right Priority Relation for Structuralism: Supervenience or Dependence?3 Introducing Ontological Dependence4 Fine’s System5 The Priority of Structure 1: Entangled Quantum Particles6 The Priority of Structure 2: The Group-Theoretic Conception of Elementary Particles7 Concluding Remarks. (shrink)

Ontic structural realism is a thesis of fundamentality metaphysics: the thesis that structure, not objects, has fundamental status. Claimed as the metaphysic most befitting of modern physics, OSR first emerged as an entreaty to eliminate objects from the metaphysics of fundamental physics. Such elimination was urged by Steven French and James Ladyman on the grounds that only it could resolve the ‘underdetermination of metaphysics by physics’ that they claimed reduced any putative objectual commitment to a merely ‘ersatz’ form of realism. (...) Few, however, have joined French and Ladyman either in acknowledging that such underdetermination exists or in attributing to it such drastic consequences. However, an alternative view that physics does sanction objects, albeit merely as ontologically secondary entities, represents a different and seemingly less extreme route to the same conclusion regarding the fundamentality of structure. But since what it means to be ‘ontologically prior’ is itself a vexed philosophical question, a stance must be taken as to how we are to understand priority before its prospects may be evaluated. In an earlier paper, I outlined how Fine’s notion of ontological dependence might be utilized to defend the priority-based approach to structuralism. Since then, however, I have become convinced that that ontological dependence is not a relation of priority after all. As a result, the arguments outlined in that paper stand in need of reassessment. In this work, I consider the prospects for priority-based structuralism when expressed in the idiom of determination. My conclusion will be that it has yet to be vindicated by our best physical theories, owing to the failure of symmetry structures to determine the world’s inventory of fundamental kinds. Nevertheless, the same symmetry considerations point towards there being renewed prospects for eliminativism—an eliminativism, moreover, of more naturalistic appeal than that hitherto associated with OSR. 1Introduction 2Structuralist Strategies 3Defining Ontological Priority: Dependence or Determination? 4Structuralism in the Idiom of Determination 4.1Determining plurality 4.2Determining kind properties 5A Reinvigorated Eliminativism. (shrink)

The pull to coordinate with other individuals is fundamental, serving as the basis for our social connectedness to others. Discussed is a dynamical and ecological perspective to joint action, an approach that embeds the individual’s mind in a body and the body in a niche, a physical and social environment. Research on uninstructed coordination of simple incidental rhythmic movement, along with research on goal‐directed, embodied cooperation, is reviewed. Finally, recent research is discussed that extends the coordination and cooperation studies, examining (...) how synchronizing with another, and how emergent social units of perceiving and acting are reflected in people’s feelings of connection to others. (shrink)

A priori metaphysics has come under repeated attack by naturalistic metaphysicians, who take their closer connection to the sciences to confer greater epistemic credentials on their theories. But it is hard to see how this can be so unless the problem of theory change that has for so long vexed philosophers of science can be addressed in the context of scientific metaphysics. This paper argues that canonical metaphysical claims, unlike their scientific counterparts, cannot meaningfully be regarded as ‘approximately true,’ and (...) that this means that the epistemic progress that science arguably enjoys through episodes of theory change cannot be expected to transfer to its metaphysics. What the value of engaging in metaphysics of science before the emergence of a final theory becomes correspondingly unclear. (shrink)

Ontic structural realism is at its core the view that “structure is ontologically fundamental.” Informed from its inception by the scientific revolutions that punctuated the 20th century, its advocates often present the position as the perspective on ontology best befitting of modern physics. But the idea that structure is fundamental has proved difficult to articulate adequately, and what OSR's claimed naturalistic credentials consist in is hard to precisify as well. Nor is it clear that the position is actually supported by (...) our most fundamental physical theories. What is clear, however, is that structuralists have revealed a seam of material at the core of modern physics that is replete with implications for metaphysics. This article will survey some positions subsumed under the rubric of OSR, considering both their warrant and the interconnections that exist between them. It will be argued that the fundamental kind properties pose a challenge to ontic structuralism, because it seems that these properties do not supervene upon the relevant structures. But it will also be argued that the development of structuralist metaphysics will require both an engagement with the details of modern physical theories and the deployment of tools more typically developed in a priori metaphysics. As such, it seems armchair metaphysicians have not just a stake in whether OSR's claims may ultimately be shown to stand up, but a crucial role to play in getting them to the point where they can be subjected to scrutiny in the first place. (shrink)

This book provides students with a concise introduction to the philosophy of methodology. The book stands apart from existing methodology texts by clarifying in a student-friendly and engaging way distinctions between philosophical positions, paradigms of inquiry, methodology and methods. Building an understanding of the relationships and distinctions between philosophical positions and paradigms is an essential part of the research process and integral to deploying the methodology and methods best suited for a research project, thesis or dissertation.

Is there life after death? Can we prove the big bang theory? In his engrossing and accessible style, Dr Kerry Spackman uses everyday examples to answer these questions and other diverse issues. the Ant and the Ferrari is a magical tour-de-force that takes on the big questions in life and answers them in Dr Kerry Spackman's easily accessible writing style. this is one of those rare books that will change your beliefs - and in doing so will change (...) your life. tHE ANt AND tHE FERRARI offers readers a clear, navigable path through the big questions that confront us all today. What is the meaning of life? Can we be ethical beings in today's world? Can we know if there is life after death? Is there such a thing as Absolute truth? What caused the Big Bang and why should you care? (shrink)

This paper aims to open up discussion on the relationship between fundamentality and naturalism, and in particular on the question of whether fundamentality may be denied on naturalistic grounds. A historico-inductive argument for an anti-fundamentalist conclusion, prominent within contemporary metaphysical literature, is examined; finding it wanting, an alternative ‘internal’ strategy is proposed. By means of an example from the history of modern physics - namely S-matrix theory - it is demonstrated that this strategy can generate similar anti-fundamentalist conclusions on more (...) defensible naturalistic grounds, and that fundamentality questions can be empirical questions. Some implications and limitations of the proposed approach are discussed. (shrink)

In metaphysics, the fundamental is standardly equated with that which has no explana- tion – with that which is, in other words, ‘brute’. But this doctrine of brutalism is in tension with physicists’ ambitions to not only describe but also explain why the fundamental is as it is. The tension would ease were science taken to be incapable of furnishing the sort of explanations that brutalism is concerned with, given that these are understood to be dis- tinctively ‘metaphysical’ in character. (...) But to assume this is to assume a sharp demarcation between physics and metaphysics that surely cannot be taken for granted. This paper sets out to examine the standing of brutalism from the perspective of contem- porary fundamental physics, together with theories of explanation drawn from philosophy of science and metaphysics. Focusing on what fundamental kinds the world instantiates and how physicists go about determining them, I argue that a partial explanation, in Hempel’s sense, may be given of this fundamental feature. Moreover, since this partial explanation issues, at least in part, from stipulations as to the essential nature of the kinds involved, I claim that it has as much right to be regarded as a metaphysical explanation as do grounding explanations. As such, my conclusion will be that the doctrine of brutalism can no longer be regarded as tenable: at least modulo certain plausible essentialist assumptions, it is no longer the case that no explanation can be given of the fundamental. (shrink)

This paper explores the value of the eros motif for critical pedagogy and citizenship education. The conceptual affinities between eros and democracy are identified and integrated into a theory of democratic political education. Long recognized as vital to the process of self knowledge, the ancient Greek concept of eros has nevertheless been largely erased from contemporary educational debate. By retrieving eros from the fringe of academic discourse and integrating it with critical pedagogy, the aims of radical democracy can be more (...) fully achieved. The essay emphasizes the civil society or cultural dimensions of democracy as against its legal or procedural aspects. Renewed emphasis on the associational qualities of democracy underscore the importance of eros as an educational principle. The ancient pedagogical motif of educating the desires is posited as an alternative to the liberal/modernist paradigm of education which de-values affective domains of knowledge. (shrink)