ANGUS J, HODNETT E and O’BRIEN-PALLAS L. Nursing Inquiry 2003; 10: 218–228Implementing evidence-based nursing practice: a tale of two intrapartum nursing unitsDespite concerns that the rise of evidence-based practice threatens to transform nursing practice into a performative exercise disciplined by scientific knowledge, others have found that scientific knowledge is by no means the preeminent source of knowledge within the dynamic settings of health-care. We argue that the contexts within which evidence-based innovations are implemented are as influential in the (...) outcomes as the individual practitioners who attempt these changes. A focused ethnography was done in follow-up to an earlier trial that evaluated the effectiveness of a marketing strategy to encourage the adoption of evidence-based intrapartum nursing practice. Bourdieu's (1990, 1991) concepts of habitus, capital and social field were used in our refinement of the analysis of the ethnographic findings. Nursing leadership, interprofessional struggle with physicians, the characteristics of the community and the physical environment were prominent issues at all of the sites. Detailed descriptions of the sociohistorical context and of the experiences at two sites are presented to illustrate the complexities encountered when implementing innovations. (shrink)

Toward evidence‐based policy decisions: a case study of nursing health human resources in Ontario, CanadaThis paper reflects how health services research ‘evidence’ was used to influence decisions in the province of Ontario, Canada. The process involved interaction among a variety of stakeholders and decision‐makers with researchers to reduce uncertainty and to substantiate emerging service provision issues in the province. The issues presented here focus specifically on an analysis of the nursing situation completed in 1998 for the Minister of Health’s Nursing (...) Task Force, which examined key issues in service delivery. The issues were: restructured work environments; nurse supply and declining enrollments; labour trends and utilization of the nursing workforce; patient acuity and complexity of work environments and the influence on workload; and the paucity of reliable and valid data bases for analysis of nursing’s contribution to the health system. Ontarians can be confident that the Task Force recommendations were born from solid research‐based evidence and now the challenge becomes to monitor the implementation of these resolutions over time. (shrink)

Lucy O'Brien argues that a satisfactory account of first-person reference and self-knowledge needs to concentrate on our nature as agents. Clearly written, with rigorous discussion of rival views, this book will be of interest to anyone working in the philosophy of mind and action.

In this paper I want to propose that we see solipsism as arising from certain problems we have about identifying ourselves as subjects in an objective world. The discussion will centre on Wittgenstein’s treatment of solipsism in his Tractatus Logico- Philosophicus. In that work Wittgenstein can be seen to express an unusually profound understanding of the problems faced in trying to give an account of how we, who are subjects, identify ourselves as objects in the world. We have in his (...) compressed remarks, the kernels of a number of arguments which all come together to form what can be called the problem of self-identification. I want to argue that the solipsism of the Tractatus arises at least in part as a solution to, or – to put it less optimistically – as a symptom or articulation of this problem. In approaching Wittgenstein’s early discussion of solipsism in this way I will obviously be in disagreement with some other interpretations of the work. For example, there are those who think that there is no ‘solipsism of the Tractatus’.1 In fact, the Tractarian arguments presented below as motivating solipsism have been seen as fulfilling the quite opposite function of refuting it. I do not intend in this piece to engage with alternative interpretations. Let me say a little bit about why I have granted myself the licence not to do so. First, the focus of my concern with solipsism is on how it connects with what I have called the problem of self-identification. While it is a concern that emerged in an attempt to make sense of Wittgenstein’s remarks in. (shrink)

This book brings together a team of international scholars to attempt to understand David Hume’s conception of the self. The standard interpretation is that he holds a no-self view: we are just bundles of conscious experiences, thoughts and emotions. There is nothing deeper to us, no core, no essence, no soul. In the Appendix to A Treatise of Human Nature, though, Hume admits to being dissatisfied with such an account and Part One of this book explores why this might be (...) so. Part Two turns to Books 2 and 3 of the Treatise, where Hume moves away from the ‘fiction’ of a simple self, to the complex idea we have of our flesh and blood selves, those with emotional lives, practical goals, and social relations with others. In Part Three connections are traced between Hume and Madhyamaka Buddhism, Husserl and the phenomenological tradition, and contemporary cognitive science. (shrink)

How is it that we think and refer in the first-person way? For most philosophers in the analytic tradition, the problem is essentially this: how two apparently conflicting kinds of properties can be reconciled and united as properties of the same entity. What is special about the first person has to be reconciled with what is ordinary about it. The range of responses reduces to four basic options. The orthodox view is optimistic: there really is a way of reconciling these (...) apparently contradictory properties as contained within the same thing. The heretical views are pessimistic and content to be so: there is no such way, and that is because there is simply nothing to reconcile – because there is really nothing special about what is in question; or there is really nothing ordinary about it; or there is really nothing …. (shrink)

Directed panspermia is the deliberate seeding of lifeless planets with microbes, in the hopes that, over evolutionary timescales, they will give rise to a complex self-sustaining biosphere on the target planet. Due to the immense distances and timescales involved, human beings are unlikely ever to see the fruits of their labours. Such missions must therefore be justified by appeal to values independent of human wellbeing. In this paper I investigate the values that a directed panspermia mission might promote. Paying special (...) attention to the outcome in which sentient animals evolve, I argue that we have strong reasons to believe the value of a mission would be negative. Research on wild animal suffering has shown that there is a huge amount of suffering among wild animals on Earth. I argue that there are structural features of evolution by natural selection which explain the prevalence of suffering on Earth, and make it predictable that suffering would prevail on the target planet too. Finally, using insights from procreative ethics I argue on non-consequentialist grounds that creators have duties to their sentient creations which cannot be met in directed panspermia missions. (shrink)

The 2015 Paris Agreement set a global warming limit of 2°C above preindustrial levels. Corporations play an important role in achieving this objective, and methods have recently been developed to map global climate targets to specific industries, and individual corporations within those industries. In this article, we assess whether Sustainability ratings capture corporate performance in meeting the 2°C target. We analyze nine rating schemes used by investors and three commonly used in academic studies. Most rating schemes do consider corporate greenhouse (...) gas emissions in their analysis, whereas only a minority scale emissions by factors that have the potential to allow benchmarking against science-based targets. None take the final step of mapping climate indicators against the 2°C target. Furthermore, we find a lack of consistency in the climate change ratings of the databases used in academic studies. These results are concerning in the context of being able to meet global climate change goals. (shrink)

Heidegger's thinking in the decades following the publication of Being and Time is often deemed irreconcilable with that work. Critics contrast the notion of "resoluteness" in Being and Time with Heidegger's post-war account of "releasement" in an attempt to establish a discrepancy between the allegedly voluntarist humanism of his early work and the supposedly 'anti-humanist' thinking of his later work. By contrast, Mahon O'Brien argues for the structural and thematic coherence of Heidegger's movement from authenticity to the search for an (...) authentic free relation to the world - as captured by the term "releasement". By demonstrating the structural and thematic unity of Heidegger's thought in its entirety, O'Brien paves the way for a more measured and philosophically grounded understanding of the issues at stake in the Heidegger controversy. (shrink)

In chapter 3 of Wild Animal Ethics Johannsen argues for a collective obligation based on beneficence to intervene in nature in order to reduce the suffering of wild animals. In the same chapter he claims that the non-identity problem is merely a “theoretical puzzle” which doesn’t affect our reasons for intervention. In this paper I argue that the non-identity problem affects both the strength and the nature of our reasons to intervene. By intervening in nature on a large scale we (...) change which animals come into existence. In doing so, we enable harmful animals to inflict harms on other animals, and we put other animals in harm’s way. The harms that these animals will inflict and endure are foreseeable. Furthermore, since non-human animals aren’t moral agents, harmful animals cannot be morally responsible for their harmful actions. I argue therefore that by causing animals to exist, knowing that they will inflict and suffer harms, we become morally responsible for those harms. By engaging in identity-affecting actions then we take on secondary moral duties towards the animals we have thereby caused to exist, and these secondary moral duties may be extremely demanding, even more so than the initial costs of intervention. Finally, these duties are duties of justice rather than duties of beneficence, and as such are more stringent than purely beneficence-based moral reasons. Furthermore, this conclusion flows naturally from several plausible principles which Johannsen explicitly endorses. (shrink)

The twelve specially written essays in this volume investigate the neglected topic of mental action, and show its importance for the metaphysics, epistemology, and phenomenology of mind. The essays investigate what mental actions are, how we are aware of them, and what is the relationship between mental and physical action.

The dominant model for bioethical inquiry taught in medical schools is that of principlism. The heritage of this methodology can be traced to the Enlightenment project of generating a universalizable justification for normative morality arising from within the individual, rational agent. This project has been criticized by Alasdair MacIntyre who suggests that its failure has resulted in a fragmented and incoherent contemporary ethical framework characterized by fundamental intractability in moral debate. This incoherence implicates principlist conceptions of bioethics. Medical ethics as (...) practiced, though, is partially in keeping with teleological alternatives to principlism. Nonetheless, the hegemony of principlism threatens to harm the practice of good medicine whenever it is used to provide justification for the sanction or prohibition of practices, despite not being equipped to grant moral authority to such justifications. An example of this failure and its resulting harm is expressed in the growing obsolescence of living donor liver transplantation. (shrink)

I am working on a substantially revised second edition of this. It is due to be published by Palgrave in 2024.

It has been widely accepted that intentional actions are “the actions to which “a certain sense of the question ‘why?’ is given application” (Anscombe 1957/2000: 9). But there are robust reasons for thinking that this claim is false. First, there are intentional actions for which such questions are unsound. We have good reasons for thinking that the questions are not “given application” in these cases. Second, when these questions are “given application” this is best explained, it is argued, not in (...) terms of a necessary link between intentional action and this type of enquiry, but in terms of the fact that this is an enquiry that we pursue when we take an agent to have exercised certain of their rational capacities. (shrink)

In Just Fodder, Milburn argues for a relational account of our duties to animals. Following Clare Palmer, he argues that, though all animals have negative rights that we have a duty not to violate, we only gain positive obligations towards animals in the contexts of our relationships with them, which can be personal or political. He argues that human beings have collective positive duties towards domesticated animals, in virtue of the kind of relationship between us established by domestication. However, when (...) it comes to wild animals, he argues that we have no such morally relevant relationships, and so we have only negative duties towards them. I argue that throughout history and even prehistory human beings have morally entangled themselves with wild animals sufficiently that we may in fact have collective positive duties towards many, if not all, wild animals. (shrink)

ABSTRACT This paper argues that the retort ‘easy for you to say’ is a complaint about the target’s standing, but that it invokes a standing norm that is unjustified. Moreover, I argue that in many cases the person for whom it is ‘easy to say’ should speak.

Doctors have an ethical and legal duty to respect patient confidentiality. We consider the basis for this duty, looking particularly at the meaning and value of autonomy in health care. Enabling patients to decide how information about them is disclosed is an important element in autonomy and helps patients engage as active partners in their care.Good quality data is, however, essential for research, education, public health monitoring, and for many other activities essential to provision of health care. We discuss whether (...) it is necessary to choose between individual rights and the wider public interest and conclude that this should only rarely be necessary. The paper makes some recommendations on practical steps which could help ensure that good quality information is available for work which benefits society and the public health, while still enabling patients’ autonomy to be respected. (shrink)

This paper addresses the question “what connection is there between our answer to the question of what we are, and the question, what our actions are?” Suppose that actions are reflexive changes of agents. On that supposition, there would be a direct connection between the answers to those two questions. An action of mine will be a reflexive change of me, and what I am will fix the nature of those changes. I hold that supposition to be true and consider (...) reasons in favor of believing it. However, the paper is not primarily aimed at defense of that thesis. It rather concerned with exploring what consequences accepting it has for the competing notions of what we are, given what we ordinarily think actions are, and bringing to light a tension between thinking of actions as reflexive changes of agents in this way, and a kind of causal understanding of actions that is prevalent. What emerges is that we should shift where we start our theorizing: we cannot assume that action theory primarily involves the task of characterizing the relation between an agent and changes caused, rather than a characterization of a particular kind of relation between the agent and herself. (shrink)

While much has been written about the functional profile of intentions, and about their normative or rational status, comparatively little has been said about the subjective authority of intention. What is it about intending that explains the ‘hold’ that an intention has on an agent—a hold that is palpable from her first-person perspective? I argue that several prima facie appealing explanations are not promising. Instead, I maintain that the subjective authority of intention can be explained in terms of the inner (...) structure of intention. In adopting an intention the agent comes to see herself as criticizable depending on whether she executes the intention. This allows us to explain in first-personal terms why the agent becomes disposed to act and deliberate in ways that are characteristic of intention. As intention-formation involves profound changes to reflexive evaluative attitudes, this is the ‘Self-Evaluation’ view of the subjective authority of intention. (shrink)

My aim in this piece is to understand what kinds of acts sneering acts are. I aim to look at what sneering acts do and what social function they perform. In particular, I want to mark them out as acts of ‘making people feel’. I explore the grounds on which we might criticize sneering acts, and ask whether the thing that we do when we sneer is always vicious.

The Pātañjalayogaśāstra concludes with a description of the pinnacle of yoga practice: a state of samādhi called dharmamegha, cloud of dharma. Yet despite the structural importance of dharmamegha in the soteriology of Pātañjala yoga, the śāstra itself does not say much about this term. Where we do find dharmamegha discussed, however, is in Buddhist yogācāra, and more broadly in early Mahāyāna soteriology, where it represents the apex of attainment and the superlative statehood of a bodhisattva. Given the relative paucity of (...) Brahmanical mentions of dharmamegha in the early common era, Patañjali appears to adopt this key metaphor from a Mahāyāna context—and to revise its primary meaning from fullness to emptiness. This article traces the early elaborations of dharmamegha in Buddhist texts, and, drawing on conceptual metaphor theory, lays out four arguments that each, in part, accounts for the stark contrast in how classical yoga and yogācāra employ the superlative metaphor of dharmamegha. (shrink)

Reformers urge that representation no longer earns its explanatory keep in cognitive science, and that it is time to discard this troublesome concept. In contrast, we hold that without representation cognitive science is utterly bereft of tools for explaining natural intelligence. In order to defend the latter position, we focus on the explanatory role of representation in computation. We examine how the methods of digital and analog computation are used to model a relatively simple target system, and show that representation (...) plays an in-eliminable explanatory role in both cases. We conclude that, to the extent that biologic systems engage in computation, representation is destined to play an explanatory role in cognitive science. (shrink)

Although connectionism is advocated by its proponents as an alternative to the classical computational theory of mind, doubts persist about its _computational_ credentials. Our aim is to dispel these doubts by explaining how connectionist networks compute. We first develop a generic account of computation—no easy task, because computation, like almost every other foundational concept in cognitive science, has resisted canonical definition. We opt for a characterisation that does justice to the explanatory role of computation in cognitive science. Next we examine (...) what might be regarded as the “conventional” account of connectionist computation. We show why this account is inadequate and hence fosters the suspicion that connectionist networks aren’t genuinely computational. Lastly, we turn to the principal task of the paper: the development of a more robust portrait of connectionist computation. The basis of this portrait is an explanation of the representational capacities of connection weights, supported by an analysis of the weight configurations of a series of simulated neural networks. (shrink)

Heidegger, History and the Holocaust is an important contribution to the longstanding debate concerning Martin Heidegger's association with National Socialism. Although a difficult topic, this ambitious new work moves the entire debate on the Heidegger controversy forward. -/- Following Being and Time Heidegger expands on his notion of authenticity and related notions such as historicity and discusses the possibility of an authentic Dasein of a people along structurally consistent lines to his account of authenticity in Being and Time. O'Brien argues (...) that the same difficulties which appear to hamstring the early account of authenticity further affect the notion of an authentic Dasein of a people; Heidegger's political myopia in the thirties can thus be attributed to an underlying failure to come to terms with some of the difficulties discussed in this study. O'Brien concedes that Heidegger's philosophy is influenced by its historical period and context but argues that, however inflammatory, Heidegger's rhetoric cannot be simply reduced to crude Nazi jingoism. -/- This book is a genuinely philosophical approach to the Heidegger controversy and a much-needed re-examination of his ideas and influences. (shrink)

It is commonplace for both philosophers and cognitive scientists to express their allegiance to the "unity of consciousness". This is the claim that a subject’s phenomenal consciousness, at any one moment in time, is a single thing. This view has had a major influence on computational theories of consciousness. In particular, what we call single-track theories dominate the literature, theories which contend that our conscious experience is the result of a single consciousness-making process or mechanism in the brain. We argue (...) that the orthodox view is quite wrong: phenomenal experience is not a unity, in the sense of being a single thing at each instant. It is a multiplicity, an aggregate of phenomenal elements, each of which is the product of a distinct consciousness-making mechanism in the brain. Consequently, cognitive science is in need of a multi-track theory of consciousness; a computational model that acknowledges both the manifold nature of experience, and its distributed neural basis. (shrink)

In this paper I want to examine a claim made about the kind of immunity through misidentification relative to the first person (IEM) that attaches to action self-ascriptions. In particular, I want to consider whether we have reason to think a stronger kind of immunity attaches to action self-ascriptions, than attaches to self-ascriptions of bodily movement. I assume we have an awareness of our actions – agent’s awareness – and that agent’s awareness is not a form of perceptual bodily awareness. (...) The issue here is whether agents’ awareness grounds a kind of immunity to error that bodily awareness does not. However, perhaps more importantly, I want to argue that we only get a secure difference in immunity claims if have already decided whether a source of information is essentially first personal or not and made certain, not obviously warranted assumptions, about the transparency of content and about knowledge. If we hold that a subject’s knowledge of her actions is essentially first personal, in a way that a subject’s knowledge of her body through bodily awareness may not be, then we are better off arguing for that claim directly. Or so I will suggest. (shrink)

G. A. Cohen has argued that there is a surprising truth in conservatism—namely, that there is a reason for some valuable things to be preserved, even if they could be replaced with other, more valuable things. This conservative thesis is motivated, Cohen suggests, by our judgments about a range of hypothetical cases. After reconstructing Cohen's conservative thesis, I argue that the relevant judgments about these cases do not favor the conservative thesis over standard, nonconservative axiological views. But I then argue (...) that there is a Mirrored Histories case that is such that, if one shares Cohen's conservative attitude, judgments about this case favor Cohen's conservative thesis over a wide range of non-conservative axiological views. Reflection on this case also suggests a different explanation of apparently conservative judgments that merits consideration in its own right. (shrink)

The charge of hypocrisy is a peculiar kind of accusation: it is damning and ubiquitous; it is used to deny the hypocrite standing to speak; and it is levelled against a great variety of conduct. Much of the philosophical literature on hypocrisy is aimed at explaining why hypocrisy is wrongful and worthy of censure. We focus instead on the use of the accusation of hypocrisy and argue for a revisionary claim. People think that hypocrisy in politics is bad and that (...) calling it out is good. Our novel claim is that even if hypocrisy in politics is bad (and that is a big if), calling it out is worse. We give a feminist case as to why accusations of hypocrisy are problematic. We also go further and claim that hypocrisy is a ubiquitous and perhaps even a necessary and beneficial part of political debate in liberal democracies. We also consider and reject candour as a possible alternative solution to hypocrisy in public debate. We argue that requiring people to be candid is not necessarily a good solution because it will often require one to divulge what is private when there are good reasons not to do so. (shrink)

In this chapter I defend a novel view of the relationships among intention for the future, self-control, and co-operation. I argue that when an agent forms an intention for the future she comes to regard herself as criticizable if she does not act in accordance with her intention and as praiseworthy if she does. In forming intentions, then, agents acquire dispositions to have reflexive evaluative attitudes. In contexts where the agent has inclinations that run contrary to her unrescinded intention, these (...) evaluative attitudes help her to resist these inclinations. Intentions have, in other words, a built-in mechanism for self-control. I go on to argue that this mechanism can also function as a mechanism for co-operative behaviour. Sometimes a common species of co-operation just is the exercise of self-controlled behaviour in a social context. If this is on the right track, agents like us are not just equipped to formulate and abide by plans for the future, we are also thereby equipped for exercising self-control and participating in co-operative ventures. (shrink)

In order to promote social distancing during the recent COVID-19 pandemic, physicians and healthcare systems have made efforts to replace in-person with virtual clinic visits when feasible. While these efforts have been well received and seem compatible with sound clinical practice, they do not perfectly replicate the experience of a face-to-face exchange between doctor and patient. This essay attempts to describe features of the virtual visit that distinguish it from its face-to-face analog and considers the phenomenological work of Emmanuel Levinas (...) in arguing that these differences may limit the force of the ethical summons a provider would otherwise experience before the face of a patient. The diminishment of this signal therapeutic experience may engender vocational as well as clinical consequences, which should be weighed against the practical benefits of the virtual visit as we consider whether our enthusiasm for this mode of practice should continue. (shrink)

Heidegger’s accounts of Dasein’s dual nature as both individual and social in Being and Time have been a longstanding source of confusion and controversy in the literature. Many critics have been keen to identify contradictions between Heidegger’s positive account of the social nature of everyday Dasein and the putatively solipsistic account of authentic Dasein which comes later. This paper focuses on Heidegger’s brief attempts to sketch the outlines for the notion of something like authentic intersubjectivity. In doing so we will (...) see where the temptation arises to read Heidegger as having failed to remain consistent but also how Heidegger himself is responsible for some of the confusion here. (shrink)

In this innovative and cogent presentation of her concept of sustainable happiness, Catherine O’Brien outlines how the leading recommendations for transforming education can be integrated within a vision of _well-being for all_. Solution-focused, the book demonstrates how aspects of this vision are already being realized, and the potential for accelerating education transitions that enable people and ecosystems to flourish. Each chapter assists educators to understand how to apply the lessons learned, both personally and professionally. The aim is to support (...) educators to experience themselves as change-makers with growing confidence to implement new teaching strategies and inspire their students to become change-makers as well—engaged in deep learning that develops character, connections with life, and invigorating collaborations that revitalize the very purpose of education. (shrink)

Hitherto reconstructions of Empedocles' cosmic cycle have usually been offered as part of a larger work, a complete history of Presocratic thought, or a complete study of Empedocles. Consequently there has perhaps been a lack of thoroughness in collecting and sifting evidence that relates exclusively to the main features of the cosmic cycle.

Hume is usually taken to have an evidentialist account of testimonial belief: one is justified in believing what someone says if one has empincal evidence that they have been reliable in the past. This account is impartialist: such evidence is required no matter who the person is, or what refotions she may have to you. I, however, argue that Hume has another account of testimony, one grounded in sympathy. This account is partialist, in that empincal evidence is not required in (...) order for one to be justified in believing some of the assertions of one's friends. (shrink)