Issues of resource allocationResource allocation, triageTriage, and rationingRationing decisions are common in the context of disasters and public healthPublic health emergencies, such as pandemics. However, to date, the majorityMajority of the literature focuses on an adult population with very little attention given to a pediatric population or to a population that may be mixed: adults and children. Furthermore, decisions of rationingRationing scarce resources do not only occur during disasters and other wide-scale emergencies. Such decisions are commonplace in pediatric organ transplantation (...) and can creep into areas of experimental medicine, such as xenotransplantation. This chapter explicates differences between pediatric and adult triageTriage decisions by first looking at the trifold issues of resource allocationResource allocation, triageTriage, and rationingRationing decisions mainly in the context of a disaster situation or public healthPublic health emergency. However, the issues of pediatric organ transplantation, health disparitiesHealth disparities, and experimental medicine will also be covered. (shrink)

This volume gathers papers, which were read at the congress held at the University of Castilla-La Mancha in Toledo (Spain), in September 2007, under the general subject of phenomenology. The book is devoted to Wittgenstein’s thoughts on phenomenology. One of its aims is to consider and examine the lasting importance of phenomenology for philosophic discussion. For E. Husserl phenomenology was a discipline that endeavoured to describe how the world is constituted and experienced through a series of conscious acts. His fundamental (...) concept was that of intentional consciousness. What did drag Wittgenstein into working on phenomenology? In his 'middle period' work, Wittgenstein used the headline 'Phenomenology is Grammar'. These cornerstones can be signalled by notions like language, grammar, rule, visual space versus Euclidean space, minima visibilia and colours. L. Wittgenstein’s main interest takes the form of a research on language. (shrink)

La antropología filosófica de L. Wittgenstein está siendo discutida intensamente desde diferentes puntos de vista. El libro reflexiona alrededor de la propuesta de P. M. S. Hacker de su trabajo ‘El enfoque antropológico y etnológico de Wittgenstein’. El autor se interroga si cuando adoptamos una visión antropológica ubicamos nuestra posición externamente, para ver las cosas objetivamente. Para ello, se analiza el problema vinculado a la gramática y su constitución conceptual. Plantea hasta que punto compartimos los conceptos que usamos en nuestro (...) enfoque antropológico. V. Sanfélix entiende que L. Wittgenstein ha ido desarrollando un historicismo sin historia y una etnología sin etnografía e indica que la utilidad de esta “etnología fantástica” ayuda a ganar una visión sinóptica de la gramática de nuestros conceptos. A. Tomasini Bassols reflexiona alrededor la plataforma sobre la que elabora la antropología filosófica y si se puede sostenerse que la obra de Wittgenstein contiene una antropología filosófica. L. Hertzberg examina el modo como Hacker analiza los conceptos. Repasa la distinción “analítico/sintético” y el “historicismo sin historia”. M. Holguín razona acerca de la “historia natural”. Desde su punto de vista, Hacker justifica los calificativos de aproximación “antropológica” o “etnológica” con el fin de describir una nueva perspectiva que le permite abordar los problemas conceptuales. W. Jacorzynski reconsidera el enfoque etnológico de Wittgenstein y se para a considerar el análisis conductual, la regularidad/uniformidad, la historicidad (“sin historia”), la autonomía y la arbitrariedad de la gramática. J. Sádaba profundiza acerca del esquema general desde donde se interpreta nuestra actividad existencial sin que por ello se proponga describir historiográficamente los recorridos de la humanidad. J. Padilla Gálvez ubica el programa antropológico en una fenomenología epistemológica que se caracteriza por el estudio del análisis del lenguaje usado y conjetura que el proyecto fenomenológico quedaría corto si analiza exclusivamente la gramática ya que esta carece de perspicuidad. Por esta razón, el programa requiere de un análisis amplio cuyo proyecto se complemente con la “representación perspicua”. (shrink)

This volume gathers papers, which were read at the congress held at the University of Castilla-La Mancha in Toledo (Spain), in September 2007, under the general subject of phenomenology. The book is devoted to Wittgenstein s thoughts on phenomenology. One of its aims is to consider and examine the lasting importance of phenomenology for philosophic discussion. For E. Husserl phenomenology was a discipline that endeavoured to describe how the world is constituted and experienced through a series of conscious acts. His (...) fundamental concept was that of intentional consciousness. What did drag Wittgenstein into working on phenomenology? In his 'middle period' work, Wittgenstein used the headline 'Phenomenology is Grammar'. These cornerstones can be signalled by notions like language, grammar, rule, visual space versus Euclidean space, minima visibilia and colours. L. Wittgenstein s main interest takes the form of a research on language.". (shrink)

Afin de répondre à cette question, nous devons clarifier ce à quoi elle fait référence. Nous devons déterminer si la « globalisation » peut être sémantiquement mise en rapport avec l’idéologie. L’idéologie signifie l’ensemble de nos attitudes personnelles, idées et points de vue fondés sur la connaissance, l’expérience et les sensations à travers lesquels nous percevons et interprétons le monde, la position que nous y occupons et la société toute entière. Dans la perspective des Lumières, l’idéologie est considérée comme une (...) sorte de préjugé qui domine la raison. Pourquoi cela est-il important dans le contexte de la globalisation ? De manière générale, la globalisation est considérée comme un processus d’interconnexion internationale permanente et de progrès dans presque tous les champs de la vie, tels que l’économie, la politique, la culture ou la communication. Ce point de vue implique l’expérience d’un changement qui touche non seulement notre environnement, notre société et ses institutions, mais aussi les États-nations et leurs citoyens. L’environnement et ses ressources sont un pré-requis à la globalisation. Le processus continu de libéralisation du marché entraîne la modification et, en définitive, la destruction des ressources. Dans cet article, nous examinerons si les mesures politiques ont la capacité d’exercer le contrôle de ce mécanisme dialectique. (shrink)

Es probable que todos nos hayamos encontrado alguna vez en la situación de no saber si la persona que tenemos delante habla en serio o bromea. Nuestra expresión de sorpresa acaba por dar lástima a nuestro interlocutor, y al final, resuelto el equívoco, los dos terminamos riéndonos. La ironía y el sarcasmo forman parte del lenguaje y de nuestra existencia desde etapas muy primitivas. Con la ironía hacemos frente a las tristezas, a las situaciones que no nos gustan, o simplemente, (...) nos divertimos un rato. Porque la ironía - no lo olvidemos - es un juego, lo practiquemos nosotros o lo practique el destino. Este libro intenta ofrecer respuestas a algunas de las preguntas que plantea su análisis. Su alumbramiento ha sido promovido por el grupo GRIALE (Grupo de la Ironía. Alicante, Lengua Española), pero en el camino nos han acompañado otros colegas y amigos, preocupados también por el mismo tema. Desde una perspectiva pragmática, se ha estructurado en tres grandes bloques: I. Las teorías, II. Indicadores y marcas de la ironía y III. Más allá de la ironía. Cada bloque se compone a su vez de diversos capítulos, y todos ellos se han concebido como un conjunto integrado que favorece la consulta y garantiza la coherencia. (shrink)

The term fuzzy logic is used in this paper to describe an imprecise logical system, FL, in which the truth-values are fuzzy subsets of the unit interval with linguistic labels such as true, false, not true, very true, quite true, not very true and not very false, etc. The truth-value set, , of FL is assumed to be generated by a context-free grammar, with a semantic rule providing a means of computing the meaning of each linguistic truth-value in as a (...) fuzzy subset of [0, 1].Since is not closed under the operations of negation, conjunction, disjunction and implication, the result of an operation on truth-values in requires, in general, a linguistic approximation by a truth-value in . As a consequence, the truth tables and the rules of inference in fuzzy logic are (i) inexact and (ii) dependent on the meaning associated with the primary truth-value true as well as the modifiers very, quite, more or less, etc. (shrink)

Causation is at once familiar and mysterious. Neither common sense nor extensive philosophical debate has led us to anything like agreement on the correct analysis of the concept of causation, or an account of the metaphysical nature of the causal relation. Causation: A User's Guide cuts a clear path through this confusing but vital landscape. L. A. Paul and Ned Hall guide the reader through the most important philosophical treatments of causation, negotiating the terrain by taking a set of examples (...) as landmarks. They clarify the central themes of the debate about causation, and cover questions about causation involving omissions or absences, preemption and other species of redundant causation, and the possibility that causation is not transitive. Along the way, Paul and Hall examine several contemporary proposals for analyzing the nature of causation and assess their merits and overall methodological cogency.The book is designed to be of value both to trained specialists and those coming to the problem of causation for the first time. It provides the reader with a broad and sophisticated view of the metaphysics of the causal relation. (shrink)

I explore some of the ways that assumptions about the nature of substance shape metaphysical debates about the structure of Reality. Assumptions about the priority of substance play a role in an argument for monism, are embedded in certain pluralist metaphysical treatments of laws of nature, and are central to discussions of substantivalism and relationalism. I will then argue that we should reject such assumptions and collapse the categorical distinction between substance and property.

It seems natural to choose whether to have a child by reflecting on what it would be like to actually have a child. I argue that this natural approach fails. If you choose to become a parent, and your choice is based on projections about what you think it would be like for you to have a child, your choice is not rational. If you choose to remain childless, and your choice is based upon projections about what you think it (...) would be like for you to have a child, your choice is not rational. This suggests we should reject our ordinary conception of how to make this life-changing decision, and raises general questions about how to rationally approach important life choices. (shrink)

I defend a one category ontology: an ontology that denies that we need more than one fundamental category to support the ontological structure of the world. Categorical fundamentality is understood in terms of the metaphysically prior, as that in which everything else in the world consists. One category ontologies are deeply appealing, because their ontological simplicity gives them an unmatched elegance and spareness. I’m a fan of a one category ontology that collapses the distinction between particular and property, replacing it (...) with a single fundamental category of intrinsic characters or qualities. We may describe the qualities as qualitative charactersor as modes, perhaps on the model of Aristotelian qualitative (nonsubstantial) kinds, and I will use the term “properties” interchangeably with “qualities”. The qualities are repeatable and reasonably sparse, although, as I discuss in section 2.6, there are empirical reasons that may suggest, depending on one’s preferred fundamental physical theory, that they include irreducibly intensive qualities. There are no uninstantiated qualities. I also assume that the fundamental qualitative natures are intrinsic, although physics may ultimately suggest that some of them are extrinsic. On my view, matter, concrete objects, abstract objects, and perhaps even spacetime are constructed from mereological fusions of qualities, so the world is simply a vast mixture of qualities, including polyadic properties (i.e., relations). This means that everything there is, including concrete objects like persons or stars, is a quality, a qualitative fusion, or a portion of the extended qualitative fusion that is the worldwhole. I call my view mereological bundle theory. (shrink)

The question I want to explore is whether experience supports an antireductionist ontology of time, that is, whether we should take it to support an ontology that includes a primitive, monadic property of nowness responsible for the special feel of events in the present, and a relation of passage that events instantiate in virtue of literally passing from the future, to the present, and then into the past.

Critics of contemporary metaphysics argue that it attempts to do the hard work of science from the ease of the armchair. Physics, not metaphysics, tells us about the fundamental facts of the world, and empirical psychology is best placed to reveal the content of our concepts about the world. Exploring and understanding the world through metaphysical reflection is obsolete. In this paper, I will show why this critique of metaphysics fails, arguing that metaphysical methods used to make claims about the (...) world are similar to scientific methods used to make claims about the world, but that the subjects of metaphysics are not the subjects of science. Those who argue that metaphysics uses a problematic methodology to make claims about subjects better covered by natural science get the situation exactly the wrong way around: metaphysics has a distinctive subject matter, not a distinctive methodology. The questions metaphysicians address are different from those of scientists, but the methods employed to develop and select theories are similar. In the first section of the paper, I will describe the sort of subject matter that metaphysics tends to engage with. In the second section of the paper, I will show how metaphysical theories are classes of models and discuss the roles of experience, common sense and thought experiments in the construction and evaluation of such models. Finally, in the last section I will discuss the way these methodological points help us to understand the metaphysical project. Getting the right account of the metaphysical method allows us to better understand the relationship between science and metaphysics, to explain why doing metaphysics successfully involves having a range of different theories, to understand the role of thought experiments involving fictional worlds, and to situate metaphysical realism in a scientifically realist context. (shrink)

In this paper, I argue that the spatiotemporalist approach way of modeling the fundamental constituents, structure, and composition of the world has taken a wrong turn. Spatiotemporalist approaches to fundamental structure take the fundamental nature of the world to be spatiotemporal: they take the category of spatiotemporal to be fundamental. I argue that the debates over the nature of the fundamental space in the physics show us that (i) the fact that it is conceivable that the manifest world could be (...) exactly as it appears to us, even though spatiotemporal entities are not fundamental, means that a central premise of spatiotemporalism, that we may assume, given ordinary experience, that the world is fundamentally spatiotemporal, is false. (ii) Spatiotemporalism must be seen as a contingent, a posteriori physical truth. Finally, (iii) I argue that a metaphysically deeper conclusion follows from the debate over the nature of the fundamental space. The debate in physics over which sort of space is the fundamental space suggests that physicists have discovered that, even if a spacetime is an actual constituent of the world-space category, there is a world-space category that is more fundamental than the category of spacetime. (shrink)

A theory of the causal relate as aspects or property instances is developed. A supposed problem for transitivity is assessed and then resolved with aspects as the causal relata.

Summary of Transformative Experience by L.A. Paul and replies to symposiasts. Discussion of undefined values, preference change, authenticity, experiential value, collective minds, mind control.

I discuss puzzles involving coinciding material objects (such as statues and their constitutive lumps of clay) and propose solutions.

In “What you can’t expect when you’re expecting,” I argue that, if you don’t know what it’s like to be a parent, you cannot make this decision rationally—at least, not if your decision is based on what you think it would be like for you to become a parent. My argument hinges on the idea that becoming a parent is a transformative experience. This unique type of experience often transforms people in a deep and personal sense, and in the process, (...) changes their preferences. In section 1, I will explain transformative experience in terms of radical first-personal epistemic and self change. In section 2, I’ll explain the notion of subjective value that I use to develop the decision problem. In section 3, I will discuss the way we ordinarily combine our introspective assessments with testimony and evidence. In section 4, I will discuss the problems for rational decision-making. In section 5, I will explore the problem of first-personally transformed future selves. In section 6, I will engage with the main themes and arguments and ideas of the authors of the papers contributed to this volume. (shrink)

I argue that we can understand the de se by employing the subjective mode of presentation or, if one’s ontology permits it, by defending an abundant ontology of perspectival personal properties or facts. I do this in the context of a discussion of Cappelen and Dever’s recent criticisms of the de se. Then, I discuss the distinctive role of the first personal perspective in discussions about empathy, rational deference, and self-understanding, and develop a way to frame the problem of lacking (...) prospective access to your future self as a problem with your capacity to imaginatively empathize with your future selves. (shrink)

A commitment to truth requires that you are open to receiving new evidence, even if that evidence contradicts your current beliefs. You should be open to changing your mind. However, this truism gives rise to the paradox of empathy. The paradox arises with the possibility of mental corruption through transformative change, and has consequences for how we should understand tolerance, disagreement, and the ability to have an open mind. I close with a discussion of how understanding this paradox provides a (...) new explanation for a certain kind of standoff between the believer and the skeptic with regard to religious belief. (shrink)

As you face a life-defining change, you might ask yourself: Who will I become? This can be understood as a question about the nature and character of your future life, asked from your first person, or subjective, perspective. The nature and character of your conscious, first person, lived experience is a defining constituent of what it is like to be you. Framed this way, knowing the nature of your future lived experience is a way of knowing your future self. In (...) this paper, I explore this way of understanding one’s self and its implications for understanding life-defining changes in high-stakes contexts. My exploration of this way of understanding one’s self highlights the role of experience in grasping perceptual truths, and the importance of imagination, empathy, and testimony in self-understanding and prediction. (shrink)

The self can be understood in objective metaphysical terms as a bundle of properties, as a substance, or as some other kind of entity on our metaphysical list of what there is. Such an approach explores the metaphysical nature of the self when regarded from a suitably impersonal, ontological perspective. It explores the nature and structure of the self in objective reality, that is, the nature and structure of the self from without. This is the objective self. I am taking (...) a different approach. In addition to objective reality, which is usually understood and explored from an impersonal, quasi-observational and metaphysically realist perspective, we can also explore the nature and structure of subjective reality. The nature and structure of subjective reality is defined by the nature and structure of first-personal, conscious experience. Subjective reality is as real as objective reality, and a metaphysical realist such as myself can endorse the existence of both kinds of ontology. The mental states that, as experienced from the first-personal or subjective perspective, capture the nature and structure of subjective reality, are included in objective reality. The questions to explore in a subjective ontology of the self concern the nature and structure of the self from the first-personal or subjective perspective, that is, the nature and structure of the self from within. This is the subjective self. (shrink)

Recent work in philosophy could benefit from paying greater attention to empirical results from cognitive science involving judgments about the nature of our ordinary experience. This paper describes the way that experimental and theoretical results about the nature of ordinary judgments could—and should—inform certain sorts of enquiries in contemporary philosophy, using metaphysics as an exemplar, and hence defines a new way for experimental philosophy and cognitive science to contribute to traditional philosophical debates.

Monists about material constitution typically argue that when Statue is materially constituted by Clay, Statue is just Clay. Pluralists about material constitution deny that constitution is identity: Statue is not just Clay. When Clay materially constitutes Statue, Clay is not identical to Statue. I discuss three familiar puzzles involving grounding, overdetermination and conceptual issues, and develop three new puzzles stemming from the connection between mereological composition and material constitution: a mereological puzzle, an asymmetry puzzle, and a structural puzzle.

I summarize the main argument of Transformative Experience (OUP 2014). The book develops familiar examples from classical philosophical debates, as well as original examples, to argue that an agent’s decision to undergo a transformative experience—an experience constituted by radical personal and epistemic change for the agent—must either be authentic or irrational, but not both. The Precis of Transformative Experience walks the reader through the main ideas involved in epistemically and personally transformative experiences, the problems they pose for rational decision-making, and (...) discusses a number of key original examples of transformative experiences. (shrink)

Bundle theory takes objects to be bundles of properties. Some bundle theorists take objects to be bundles of instantiated universals, and some take objects to be bundles of tropes. Tropes are instances of properties: some take instantiated universals to be tropes, while others deny the existence of universals and take tropes to be ontologically fundamental. Historically, the bundling relation has been taken to be a primitive relation, not analyzable in terms of or ontologically reducible to some other relation, and has (...) been variously characterized as, e.g., “compresence,” “concurrence,” or “consubstantiation.” Bertrand Russell (1940) defends compresence of universals, and Hector-Neri Castañeda (1974) defends consubstantiation of universals. John Bacon (1995) defends concurrent tropes and Keith Campbell (1990) defends compresent tropes. Jonathan Schaffer (2001) bucks this trend, endorsing compresence understood as co-location in spacetime, but this brings with it undesireable consequences such as the impossibility of distinguishing between objects (such as electrons or other microentities) with the same location. Mereological bundle theory improves upon traditional bundle theory by taking the primitive relation of bundling to be the more familiar relation of fusing or composing, such that objects are fusions of properties or fusions of property instances. Hence, mereological bundle theorists endorse a property mereology: a mereology where properties or property instances can be parts of objects. An advantage of the approach derives from the fact that standard mereologies take composition to be primitive or define it using a different primitive mereological notion (such as primitive parthood). Thus, taking the basic primitive of bundle theory to be composition can reduce the need for.. (shrink)

I address two related questions: first, what is the best theory of how objects have de re modal properties? Second, what is the best defence of essentialism given the variability of our modal intuitions? I critically discuss several theories of how objects have their de re modal properties and address the most threatening antiessentialist objection to essentialism: the variability of our modal intuitions. Drawing on linguistic treatments of vagueness and ambiguity, I show how essentialists can accommodate the variability of modal (...) intuitions while holding that objects have their modal properties independently of contexts. (shrink)

This chapter offers an overview of the phenomenological approach to delusions, emphasizing what Karl Jaspers called the "true delusions" of schizophrenia. Phenomenological psychopathology focuses on the experience of delusions and the delusional world. Several features of this approach are surveyed, including emphasis on formal qualities of subjective life and questioning of standard assumptions about delusions as erroneous belief. The altered modalities of world-oriented and self-oriented experience that precede and ground delusions in schizophrenia, especially the experiences of revelation that Klaus Conrad (...) termed the outer and inner apophany, are then discussed. The chapter first considers the famous "delusional mood", then the role of ipseity-disturbance. In both cases it is explained how delusions can develop out of these distinctive alterations of perception and feeling. The classic question of the understandability or comprehensibility of schizophrenic delusion, together with the related issues of wish-fulfillment and rationalizing motives are then considered. The chapter addresses the crucial but neglected issue of the felt reality-status of delusions or the delusional world, discussing derealization, "double bookkeeping", and "double exposure". The chapter concludes by discussing delusions typically found in paranoid and affective psychoses, and monothematic delusions found in certain organic conditions. (shrink)

Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. These limitations warrant (...) research into complementary ways of providing CES to healthcare professionals. Our research objective was therefore to develop a low threshold CES tool based on a series of MCDs on autonomy in long-term care. We used a qualitative research design in which we analyzed the process and content of a series of MCDs, combined with reflections on the theoretical background of MCD. In total 28 MCDs were analyzed by means of a thematic content analysis. In various rounds of development, the results of the analysis were combined with theoretical reflections on CES. Consequently, the tool was evaluated in three focus groups and adjusted. The CES tool, called ‘moral compass’, guides the users through a series of six subsequent questions in order to methodically reflect on their concrete moral dilemma, in the form of a booklet of 23 pages. It combines a methodical element that encourages and structures a reflection process with a substantive element, including norms, values, options, strategies, and insights regarding dealing with client autonomy. By using data from a series of MCDs, combined with theoretical reflections on MCD, ethics support and moral learning, we developed a thematic, low-threshold CES tool that supports healthcare professionals in daily practice in dealing with moral questions regarding client autonomy. It integrates examples and insights from earlier MCDs on the same topic. The moral compass is not a replacement of, but can be used complementary to MCD. The feasibility and impact of the moral compass need to be investigated in an evaluative follow-up study. The methodology presented in this paper may be used to develop moral compasses on different topics in various healthcare organizations. (shrink)

It is often claimed that the intentions of physicians are multiple, ambiguous, and uncertain—at least with respect to end-of-life care. This claim provides support for the conclusion that the principle of double effect is of little or no value as a guide to end-of-life pain management. This paper critically discusses this claim. It argues that proponents of the claim fail to distinguish two different senses of “intention,” and that, as a result, they are led to exaggerate the extent to which (...) clinical intentions in end-of-life contexts are ambiguous and uncertain. It argues further that physicians, like others who make life and death decisions, have a duty to get clear on what their intentions are. Finally, it argues that even if the principle of double effect should be rejected, clinical intentions remain ethically significant because they condition the meaning of extraordinary clinical interventions, such as that of palliative sedation. (shrink)

Researchers and ethicists have long been concerned about the expectations for direct medical benefit expressed by participants in early phase clinical trials. Early work on the issue considered the possibility that participants misunderstand the purpose of clinical research or that they are misinformed about the prospects for medical benefit from these trials. Recently, however, attention has turned to the possibility that research participants are simply expressing optimism or hope about their participation in these trials. The ethical significance of this therapeutic (...) optimism remains unclear. This paper argues that there are two distinct phenomena that can be associated with the term ‘therapeutic optimism’—one is ethically benign and the other is potentially worrisome. Distinguishing these two phenomena is crucial for understanding the nature and ethical significance of therapeutic optimism. The failure to draw a distinction between these phenomena also helps to explain why different writers on the topic often speak past one another. (shrink)