This book discusses feature films that enrich our understanding of doctor-patient dilemmas. The book comprises general clinical ethics themes and principles and is written in accessible language. Each theme is discussed and illuminated in chapters devoted to a particular film. Chapters start with a discussion of the film itself, which shares details behind the making of the film; critical reception; casting and other facts about production. The chapter situates the film in a history of medicine and medical sociology context, analyzes (...) ethical issues raised in the film from a clinical ethics lens, and explains to readers how to use each film as a teaching aid for clinical ethics. Readers will understand how each film in this collection served to bring particular clinical ethics issues to the public’s attention, or reflected medico-legal issues that were part of the public discourse. The book is a perfect instructor's guide for anyone teaching bioethics, healthcare ethics, medical sociology, medical history, healthcare systems narrative medicine, or nursing ethics. (shrink)

IntroductionThis case study describes the process faculty at a large research university undertook to build a stand-alone online academic integrity course for first-year and transfer students. Because academic integrity is decentralized at the institution, building a more systematic program had to come from the bottom-up (faculty developed) rather than from the top down (institutionally mandated).Case descriptionUsing the learning management system, faculty and e-learning designers collaborated to build the course. Incorporating nuanced scenarios for six different types of misconduct (consistent with the (...) University’s Code of Student Rights, Responsibilities & Conduct), a pre- and post-test, and assessments for each scenario, the course provides experience in recognizing and avoiding academic misconduct.Discussion and evaluationAs a stand-alone course, the faculty who created it maintain control over content and are able to analyze student performance across the institution. In the ten months since its launch, the course has been eagerly adopted by faculty (n = 1853 students have completed the course) and post-test scores indicate students are learning from the course.ConclusionsAfter the successful launch of the student course, the next step, already underway, is the launch of learning modules for faculty and teaching assistants. (shrink)

Consciousness and Mind presents David Rosenthal's influential work on the nature of consciousness. Central to that work is Rosenthal's higher-order-thought theory of consciousness, according to which a sensation, thought, or other mental state is conscious if one has a higher-order thought that one is in that state. The first four essays develop various aspects of that theory. The next three essays present Rosenthal's homomorphism theory of mental qualities and qualitative consciousness, and show how that theory fits with (...) and helps sustain the HOT theory. A crucial feature of homomorphism theory is that it individuates and taxonomizes mental qualities independently of the way we're conscious of them, and indeed independently of our being conscious of them at all. So the theory accommodates the qualitative character not only of conscious sensations and perceptions, but also of those which fall outside our stream of consciousness. Rosenthal argues that, because this account of mental qualities makes no appeal to consciousness, it enables us to dispel such traditional quandaries as the alleged conceivability of undetectable quality inversion, and to disarm various apparent obstacles to explaining qualitative consciousness and understanding its nature. Six further essays build on the HOT theory to explain various important features of consciousness, among them the complex connections that hold in humans between consciousness and speech, the self-interpretative aspect of consciousness, and the compelling sense we have that consciousness is unified. Two of the essays, one an extended treatment of homomorphism theory, appear here for the first time. There is also a substantive introduction, which draws out the connections between the essays and highlights their implications. (shrink)

No mental phenomenon is more central than consciousness to an adequate understanding of the mind. Nor does any mental phenomenon seem more stubbornly to resist theoretical treatment. Consciousness is so basic to the way we think about the mind that it can be tempting to suppose that no mental states exist that are not conscious states. Indeed, it may even seem mysterious what sort of thing a mental state might be if it is not a conscious state. On this way (...) of looking at things, if any mental states do lack consciousness, they are exceptional cases that call for special explanation or qualification. Perhaps dispositional or cognitive states exist that are not conscious, but nonetheless count as mental states. (shrink)

Ned BlockÕs influential distinction between phenomenal and access consciousness has become a staple of current discussions of consciousness. It is not often noted, however, that his distinction tacitly embodies unargued theoretical assumptions that favor some theoretical treatments at the expense of others. This is equally so for his less widely discussed distinction between phenomenal consciousness and what he calls reflexive consciousness. I argue that the distinction between phenomenal and access consciousness, as Block draws it, is untenable. Though mental states that (...) have qualitative character plainly differ from those with no mental qualities, a mental stateÕs being conscious is the same property for both kinds of mental state. For one thing, as Block describes access consciousness, that notion does not pick out any property that we intuitively count as a mental stateÕs being conscious. But the deeper problem is that BlockÕs notion of phenomenal consciousness, or phenomenality, is ambiguous as between two very different mental properties. The failure to distinguish these results in the begging of important theoretical questions. Once the two kinds of phenomenality have been distinguished, the way is clear to explain qualitative consciousness by appeal to a model such as the higher-order-thought hypothesis. Ó 2002 Elsevier Science . All rights reserved. (shrink)

In response to your kind offer to read through portions of the typescript of my thesis pertaining to your views on intentionality, I am sending you a copy of an introductory section to such a chapter.{1} The enclosed typescript represents a first draft, for which I apologize, but I thought it might be useful to get any comments you might have in at the ground floor, so to speak.

At the level of our platitudinous background knowledge about things, speech is the expression of thought. And understanding what such expressing involves is central to understanding the relation between thinking and speaking. Part of what it is for a speech act to express a mental state is that the speech act accurately captures the mental state and can convey to others what mental state it is. And for this to occur, the speech act at least must have propositional content that (...) somehow reflects that of the mental state, and perhaps must have other such properties as well. (shrink)

One phenomenon pertains roughly to being awake. A person or other creature is conscious when it's awake and mentally responsive to sensory input; otherwise it's unconscious. This kind of consciousness figures most often in everyday discourse.

Advancements in novel neurotechnologies, such as brain computer interfaces and neuromodulatory devices such as deep brain stimulators, will have profound implications for society and human rights. While these technologies are improving the diagnosis and treatment of mental and neurological diseases, they can also alter individual agency and estrange those using neurotechnologies from their sense of self, challenging basic notions of what it means to be human. As an international coalition of interdisciplinary scholars and practitioners, we examine these challenges and make (...) recommendations to mitigate negative consequences that could arise from the unregulated development or application of novel neurotechnologies. We explore potential ethical challenges in four key areas: identity and agency, privacy, bias, and enhancement. To address them, we propose democratic and inclusive summits to establish globally-coordinated ethical and societal guidelines for neurotechnology development and application, new measures, including “Neurorights,” for data privacy, security, and consent to empower neurotechnology users’ control over their data, new methods of identifying and preventing bias, and the adoption of public guidelines for safe and equitable distribution of neurotechnological devices. (shrink)

All mental states, including thoughts, feelings, perceptions, and sensations, often occur consciously. But they all occur also without being conscious. So the first thing a theory of consciousness must do is explain the difference between thoughts, feelings, perceptions, and sensations that are conscious and those which are not.

be realized. Whatever gets access to phenomenal awareness is represented within this absent together.

This experiment uses quantitative and qualitative measures to address the effect of two syllabus statements on academic misconduct: one based on prohibitions and one on academic integrity. Students expressed favorable attitudes toward the statements, showed an increase in guilt compared to a control group, but showed no decrease in intentions to cheat. Including only a standard academic misconduct statement in one's syllabus is not sufficient to alter behavior, which should be acknowledged by faculty.

Everyone — or almost everyone — was agreed that what is [mental] … has a common quality in which its essence is expressed: namely the quality of being conscious — unique, indescribable, but needing no description. All that is conscious … is [mental], and conversely all that is [mental] is conscious; that is self-evident and to contradict it is nonsense.

(No abstract is available for this citation).

Contemporary discussions typically give somewhat sort shrift to the theory of judgment Descartes advances in the Fourth Meditation.' One reason for this relative neglect is presumably the prima facie implausibility of the theory. It sounds odd to say that, in believing something, one's mental affirmation is an act of free will, on a par with freely deciding what to do. In addition, Descartes advances the theory as a way to explain the possibility of human error, which doubtless strikes many as (...) a rather esoteric undertaking. The need to explain error, moreover, arises because of the divine guarantee, and epistemic theodicy is a project unlikely to interest most contemporary readers. And because the theory of judgment postulates two mental.. (shrink)

What is it that we are conscious of when we are conscious of ourselves? Hume famously despaired of finding self, as against simply finding various impressions and ideas, when, as he put it, “I enter most intimately into what I call myself.” “When I turn my reflexion on myself, I never can perceive this self without some one or more perceptions; nor can I ever perceive any thing but the perceptions.”.

Remarks such as ‘I am in pain’ and ‘I think that it’s raining’ are puzzling, since they seem to literally describe oneself as being in pain or having a particular thought, but their conditions of use tend to coincide with unequivocal expressions of pain or of that thought. This led Wittgenstein, among others, to treat such remarks as expressing, rather than as reporting, one’s mental states. Though such expressivism is widely recognized as untenable, Bar-On has recently advanced a neo-expressivist view, (...) on which such remarks exhibit characteristics of both expressions of mental states and reports of those states. I argue against any attempt to see such remarks as both reporting and expressing the same mental states, and that a correct account rests on distinguishing the truth conditions of such remarks from their conditions of use. (shrink)

An expanded and updated edition of this classic collection.

The purpose of this article is to describe the development of a model of moral distress in military nursing. The model evolved through an analysis of the moral distress and military nursing literature, and the analysis of interview data obtained from US Army Nurse Corps officers (n = 13). Stories of moral distress (n = 10) given by the interview participants identified the process of the moral distress experience among military nurses and the dimensions of the military nursing moral distress (...) phenomenon. Models of both the process of military nursing moral distress and the phenomenon itself are proposed. Recommendations are made for the use of the military nursing moral distress models in future research studies and in interventions to ameliorate the experience of moral distress in crisis military deployments. (shrink)

This anthology brings together readings mainly from contemporary philosophers, but also from writers of the past two centuries, on the philosophy of mind. Some of the main questions addressed are: is a human being really a mind in relation to a body; if so, what exactly is this mind and how it is related to the body; and are there any grounds for supposing that the mind survives the disintegration of the body?

Because there is a fair amount of overlap in the points by Balog and Rey, I will organize this response topically, referring specifically to each commentator as rele- vant. And, because much of the discussion focuses on my higher-order-thought hypothesis independent of questions about metacognition, I will begin by addressing a cluster of issues that have to do with the status, motivation, and exact formulation of that hypothesis.

Theories of what it is for a mental state to be conscious must answer two questions. We must say how we're conscious of our conscious mental states. And we must explain why we seem to be conscious of them in a way that's immediate. Thomas Natsoulas distinguishes three strategies for explaining what it is for mental states to be conscious. I show that the differences among those strategies are due to the divergent answers they give to the foregoing questions. Natsoulas (...) finds most promising the strategy that amounts to the higher-order-thought hypothesis that I've defended elsewhere. But he raises a difficulty for it, which he thinks probably can be met only by modifying that strategy. I argue that this is unnecessary. The difficulty is a special case of a general question, the answer to which is independent of any issues about consciousness. So it's no part of a theory of consciousness to address the problem, much less solve it. Moreover, the difficulty seems to have intuitive force only given the picture that underlies the other two explanatory strategies, which both Natsoulas and I reject. (shrink)

As G. E. Moore famously observed, sentences such as 'It's raining but I don't think it is', though they aren't contradictory, cannot be used to make coherent assertions.' The trouble with such sentences is not a matter of their truth conditions; such sentences can readily be true. Indeed, it happens often enough with each of us that we think, for example, that it isn't raining even though it is. This shows that such sentences are not literally contradictory. But even though (...) such sentences have unproblematic truth conditions, we cannot say the same about their conditions of assertibility. There are no circumstances in which one can use such sentences to perform coherent assertoric speech acts. Situations exist in which these sentences would be true, but none in which anybody could use them to say so. (shrink)

Because metacognition consists in our having mental access to our cognitive states and mental states are conscious only when we are conscious of them in some suitable way, metacognition and consciousness shed important theoretical light on one another. Thus, our having metacognitive access to information carried by states that are not conscious helps con?rm the hypothesis that a mental state.

The so-called unity of consciousness consists in the compelling sense we have that all our conscious mental states belong to a single conscious subject. Elsewhere I have argued that a mental state's being conscious is a matter of our being conscious of that state by having a higher-order thought (HOT) about it. Contrary to what is sometimes argued, this HOT model affords a natural explanation of our sense that our conscious states all belong to a single conscious subject. HOTs often (...) group states together, so that each HOT is about a cluster of target states; single HOTs represent qualitative states as spatially unified and intentional states as unified inferentially. More important, each HOT makes one conscious of oneself in a seemingly immediate way, encouraging a sense of unity across HOTs. And the same considerations that make us assume that our first-person thoughts all refer to the same self apply also to HOTs; becoming conscious of our HOTs in introspection thus leads to a sense that our conscious states are unified in a single self. I argue that neither essential-indexical reference to oneself nor the alleged immunity to error through misidentification conflicts with this account. I close by discussing the apparent connection of unity with free agency. (shrink)

Striking experimental results by Benjamin Libet and colleagues have had an impor- tant impact on much recent discussion of consciousness. Some investigators have sought to replicate or extend Libet’s results (Haggard, 1999; Haggard & Eimer, 1999; Haggard, Newman, & Magno, 1999; Trevena & Miller, 2002), while others have focused on how to interpret those findings (e.g., Gomes, 1998, 1999, 2002; Pockett, 2002), which many have seen as conflicting with our commonsense picture of mental functioning.

Contemporary bioethics education has been developed predominately within Euro-American contexts, and now, other global regions are increasingly joining the field, leading to a richer global understanding. Nevertheless, many standard bioethics curriculum materials retain a narrow geographic focus. The purpose of this article is to use local cases from the Asia-Pacific region as examples for exploring questions such as ‘what makes a case or example truly local, and why?’, ‘what topics have we found to be best explained through local cases or (...) examples?’, and ‘how does one identify a relevant local case?’ Furthermore, we consider the global application of local cases to help extend the possible scope of the discussion, opening new avenues for the development of practical bioethics educational materials. We begin with a background description and discussion of why local cases enhance bioethics education, move to an overview of what is currently available and what is not for the region, and then outline a discussion of what it means to be local using example cases drawn from Hong Kong, Australia, Pakistan, and Malaysia. We are not creating a casebook but rather constructing by example a toolbox for designing active and dynamic learning cases using regional diversity as contextualised cases with generalised principles. (shrink)