'Quality' is a widely invoked concept in healthcare, and 'quality improvement' is now a central part of healthcare service delivery. However, these concepts and their associated practices represent relatively uncharted territory for applied philosophy and bioethics. In this paper, we explore some of the conceptual complexity of quality in healthcare and argue that quality is best understood to be conceptually plural. Quality is widely agreed to be multidimensional and as such constitutively plural. However, we argue that quality is plural in (...) two further senses. First, quality is competitively plural : that is, different high-level conceptions of quality can be appropriately invoked in different contexts and serve... (shrink)

The distinguished philosopher of language, Francois Recanati, has proposed a wide-ranging truth-conditional model of pragmatics. In this collection, various aspects of his theories are addressed by distinguished contributors, and are then commented on or answered by Recanati himself. This allows the reader to be drawn into the central debate within philosophy of language and cognitive science as to what kind of pragmatics system is needed.

Patient safety is a central aspect of healthcare quality, focusing on preventable, iatrogenic harm. Harm, in this context, is typically assumed to mean physical injury to patients, often caused by technical error. However, some contributions to the patient safety literature have argued that disrespectful behavior towards patients can cause harm, even when it does not lead to physical injury. This paper investigates the nature of such dignitary harms and explores whether they should be included within the scope of patient safety (...) as a field of practice. We argue that dignitary harms in health care are—at least sometimes—preventable, iatrogenic harms. While we caution against including dignitary harms within the scope of patient safety just because they are relevantly similar to other iatrogenic harms, we suggest that thinking about dignitary harms can help to elucidate the value of patient safety, and to illuminate the evolving relationship between safety and quality. (shrink)

Constructivist research in Science and Technology Studies is committed to revealing the heterogeneity of technological change and the fluid boundaries between the elements involved. Its major theories, the Social Construction of Technology and Actor Network Theory, have however both been criticized for limiting themselves to the micro-level of cases, impeding a structural analysis of technological systems. This article seeks to bridge any such divides. We research the recent changes in the viticulture of Mendoza, Argentina, which underwent radical changes over the (...) past decades: once governed by low-cost yield maximization, grape production now revolves around “quality.” To show how the particular quality definition developed, we depart from a social-constructivist framework, following the sociotechnical shaping of problem-solution relationships across the wine production system. To include relevant social groups from different settings around the world, we gradually incorporate the ANT concepts of obligatory passage points, enrollment, convergence, delegation, and codes into the analysis. Combined into the concept of “sociotechnical alliance,” our analysis follows the dual process of creating agreement while establishing heterogeneous practices across settings at different levels. It shows that functioning involves alliance building and highlights the hybridity and continuous dynamics of systems at large. (shrink)

It is a commonly expressed sentiment that the science and philosophy of well-being would do well to learn from each other. Typically such calls identify mistakes and bad practices on both sides that would be remedied if scientists picked the right bit of philosophy and philosophers picked the right bit of science. We argue that the differences between philosophers and scientists thinking about well-being are more difficult to reconcile than such calls suggest, and that pluralism is central to this task. (...) Pluralism is a stance that explicitly drives towards accommodating and nurturing the richness and diversity of well-being, both as a concept and as an object of inquiry. We show that well-being science manifests a contingent pluralism at the level of methodology, whereas philosophy of well-being has largely rejected pluralism at the conceptual level. Recently, things have begun to change. Within philosophy, conceptual monism is under attack. But so is methodological pluralism within science. We welcome the first development, and bemoan the second. We argue that a joined-up philosophy and science of well-being should recognise the virtues of both conceptual and methodological pluralism. Philosophers should embrace the methodological justification of pluralism that can be found in the well-being sciences, and scientists should embrace the conceptual reasons to be pluralist that can be found in philosophical debate. (shrink)

The concept of cooperative communities that enforce norm conformity through reward, as well as shaming, ridicule, and ostracism, has been central to anthropology since the work of Durkheim. Prevailing approaches from evolutionary theory explain the willingness to exert sanctions to enforce norms as self-interested behavior, while recent experimental studies suggest that altruistic rewarding and punishing—“strong reciprocity”—play an important role in promoting cooperation. This paper will use data from 308 conversations among the Ju/’hoansi (!Kung) Bushmen (a) to examine the dynamics of (...) norm enforcement, (b) to evaluate the costs of punishment in a forager society and understand how they are reduced, and (c) to determine whether hypotheses that center on individual self-interest provide sufficient explanations for bearing the costs of norm enforcement, or whether there is evidence for strong reciprocity. (shrink)

Evaluation, as the expression of a writer’s attitudes, opinions and values, has become a key term in discourse studies in recent years and has proved to be a particularly fruitful way of analysing academic texts. But while studies have shown the importance of evaluation in research genres, its role in seemingly more promotional academic genres has been largely neglected. This article examines the journal description, a brief but ubiquitous feature of all journals, whether online or in print. Situated at the (...) academic—commercial interface, the JD provides information for prospective readers and authors while endorsing a particular view of the field and positioning the journal in the academic community. Drawing on a corpus of 200 JDs in four contrasting disciplines, we show how evaluation is a key feature of this genre, influencing both lexical choices and rhetorical structure. The analysis contributes both to our understanding of a neglected academic genre and the evaluative resources of language. (shrink)

This book provides a major new cross-disciplinary framework for thinking about poverty and human rights. Drawing on the fields of ethics, economics, and international law, Vizard demonstrates how the work of Nobel Laureate Amartya Sen has expanded and deepened human rights discourse across traditional disciplinary divides.

People who have not experienced diseases and health conditions tend to judge them to be worse than they are reported to be by people who have experienced them. This phenomenon, known as the disability paradox, presents a challenge for health policy, and in particular, healthcare resource distribution. This divergence between patient and public preferences is most plausibly explained as a result of hedonic adaptation, a widespread phenomenon in which people tend to adapt fairly quickly to the state they are in, (...) good or bad, and adjust their baseline utility accordingly.If patient utilities can be shown to be inappropriate for use in public policy decision making, the disability paradox fades away. This paper offers a critique of one such attempt: the idea that adaptation leads to adaptive preferences. I argue that none of the main accounts of adaptive preferences in fact characterise adapted patient preferences as irrational. Adapted preferences should not, therefore, be treated as synonymous with adaptive preferences. I suggest that much patient adaptation should be understood as a form of the ubiquitous human ability to respond to environmental change. Consequently, we ought not to discount patient preferences. (shrink)

There is growing evidence that dopamine replacement therapy (DRT) used to treat Parkinson’s Disease can cause compulsive behaviours and impulse control disorders (ICDs), such as pathological gambling, compulsive buying and hypersexuality. Like more familiar drug-based forms of addiction, these iatrogenic disorders can cause significant harm and distress for sufferers and their families. In some cases, people treated with DRT have lost their homes and businesses, or have been prosecuted for criminal sexual behaviours. In this article we first examine the evidence (...) that these disorders are caused by DRT. If it is accepted that DRT cause compulsive or addictive behaviours in a significant minority of individuals, then the following ethical and clinical questions arise: Under what circumstances is it ethical to prescribe a medication that may induce harmful compulsive behaviours? Are individuals treated with DRT morally responsible and hence culpable for harmful or criminal behaviour related to their medication? We conclude with some observations of the relevance of DRT-induced ICDs for our understanding of addiction and identify some promising directions for future research and ethical analysis. (shrink)

Este artigo tem como finalidade analisar aspectos teóricos comuns entre o historiador inglês Edward Palmer Thompson e o educador brasileiro Paulo Freire, como a crítica ao idealismo marxista desvinculado da experiência cultural dos sujeitos e a consequente negação de seu papel na história. Não há a pretensão de incluir os dois autores em um mesmo campo teórico, um marxismo, mas destacar que a cultura - enquanto modos de vida e experiência em Thompson – e como leitura de mundo em Freire, (...) se constitui como fundamento da historiografia social e da educação popular humanizadora. Desta forma, o marxismo e a educação são vistos de baixo. (shrink)

In this reproduction of his original publication of 1649, Rene Descartes discusses how seekers of knowledge can best attain true insight of the world around them. Often referred to as simply the Discourse on the Method, this work is frequently cited as one of the most important to appear during the Enlightenment era. It discusses the ideal means through which those in search of knowledge can approach the world, and the practice of science, as a means of attaining true and (...) definitive insight. The Discourse on Method is influential chiefly for its role in establishing the scientific method; a technique which scientists have used to make valid discoveries over the centuries. Descartes instructs the reader to doubt everything, and to use this universal doubt as a starting point from which to approach a problem. In addition to matters of science, Descartes reflects upon his own personal, religious beliefs. In addition to his Method, Descartes also explains certain social and personal notions such as obeying the laws and statutes of his country and prioritizing self-advancement over the achievement of material wealth or fortune. Famous for including the much-quoted phrase "Je pense, donc je suis" - "I think, therefore I am" - the Discourse on Method today stands as a crucial cornerstone of countless educational courses on philosophy. (shrink)

The cultural evolutionary approach to the dynamics of cumulative culture is insufficient for understanding how culture affects heritability estimates; it ignores the agency of individuals and internal complexity of social groups that drive cultural evolution. Both environmental and social selection need consideration. The WEIRD (western, educated, industrialized, rich, and democratic) problem has never plagued anthropology: A wealth of ethnography is available for the problem at hand.

In his 1987 paper “Truth or Consequences,” Dan Brock describes a deep conflict between the goals and virtues of philosophical scholarship and public policymaking: whereas the former is concerned with the search for truth, the latter must primarily be concerned with promoting good consequences. When philosophers are engaged in policymaking, he argues, they must shift their primary goal from truth to consequences—but this has both moral and methodological costs. Brock’s argument exemplifies a pessimistic, but not uncommon, view of the possible (...) shape and nature of applied philosophy. The present paper paints a richer and more optimistic picture. It argues that the difference between theoretical philosophy and applied philosophy is not best understood as a choice between truth and consequences. On the contrary, applied philosophers engage in forms of truth‐seeking that are properly concerned with consequences—including the consequences of philosophical practice itself. (shrink)

P. J. Rhodes: Preface Polly Low and Graham Oliver: Comparing Cultures of Commemoration in Ancient and Modern Societies Polly Low: The Monuments ot the War Dead in Classical Athens: Forms, Contexts, Meanings Alison Cooley: Commemorating the War Dead of the Roman World Angelos Chaniotis: The Ritualised Commemoration of War in the Hellenistic City: Memory, Identity, Emotion Avner Ben-Amos: Two Neo-Classical Monuments in Modern France: The Pantheon and Arc de Triomphe Graham Oliver: Naming the Dead, Writing the Individual: Classical (...) Traditions and Commemorative Practices in the Nineteenth and Twentieth Centuries Stefan Goebel: Cultural Memory and the Great War: Medievalism and Classicism in British and German War Memorials Lawrence A. Tritle: Monument to Defeat: the Vietnam Veterans Memorial in American Culture and Society. (shrink)

This ground-breaking book is designed to raise awareness of human rights implications in psychology, and provide knowledge and tools enabling psychologists to put a human rights perspective into practice. Psychologists have always been deeply engaged in alleviating the harmful consequences human rights violations have on individuals. However, despite the fundamental role that human rights play for professional psychology and psychologists, human rights education is underdeveloped in psychologists' academic and vocational training. This book, the first of its kind, looks to change (...) this, by: raising awareness among professional psychologists, university teachers and psychology students about their role as human rights promoters and protectors providing knowledge and tools enabling them to put a human rights perspective into practice providing texts and methods for teaching human rights. Featuring chapters from leading scholars in the field, spanning18 countries and six continents, the book identifies how psychologists can ensure they are practising in a responsible way, as well as contributing to wider society with a clear knowledge of human rights issues in relation to culture, gender, organisations and more. Including hands-on recommendations, case studies and discussion points, this is essential reading for professional psychologists as part of continuing professional development and those in training and taking psychology courses. (shrink)

Person-centred care is a cornerstone of contemporary health policy, research and practice. However, many researchers and practitioners worry that it lacks a 'clear definition and method of measurement,' and that this creates problems for the implementation of person-centred care and limits understanding of its benefits. In this paper we urge caution about this concern and resist calls for a clear, settled definition and measurement approach. We develop a philosophical and conceptual analysis which is grounded in the body of literature concerning (...) the theory and practice of person-centred care. We consider a range of influential definitional frameworks of person-centred care, highlighting their differences and showing that they do not correspond to a clearly circumscribed and consistent underlying concept. We argue that a degree of indeterminacy and vagueness should not be seen as a problem with the concept of person-centred care; these are features of a rich and contested concept which exists prior to and outside of practical and technical operational definitions and applications. We defend the value of operating with multiple accounts of person-centred care, arguing that what counts as being person-centred can vary across different care contexts, in relation to different patient groups, and as a reflection of different, defensible ethical perspectives. Although the idea of a single, agreed definition is attractive and may seem to be a practical or even necessary step towards meaningful and coordinated action, we argue that this is only the case in a qualified sense. Comprehensive attempts to narrow down the concept in this way should be resisted, as they risk undermining what it is that makes person-centredness a valuable concept in healthcare. (shrink)

Morse has produced a work that emphasizes the extreme significance and vital discipline of legal philosophy in representing the integration of legal principles and moral precepts. The Thinkers discusses, delineates, and analyzes the integral legal philosophies of Hobbes, Wilson, Aquinas, Augustine, Descartes, Hegel, Leibnitz, Kant, Carlyle,Thoreau, and Hohfeld.

Thelen et al. criticize “spatial coding” approaches to the A-not-B error. However, newer thinking about spatial coding provides more precise analytic categories and recognizes that different spatial coding systems normally coexist. Theorizing about spatial coding is largely compatible with dynamic-systems theory, augmenting it with an analysis of what one means when discussing “location at A” (or B).

This issue assesses how human spatial navigation differs: within individuals across short‐term variations in mood or stress, and between individuals across variations in age, gender, education, culture, and physical environment.

This article investigates the theoretical assumptions and implications of de Ste. Croix’s approach to interstate politics in The Origins of the Peloponnesian War. It suggests that two approaches can be identified in the work: one which sees a fundamental connection between political systems within a state and that state’s conduct of interstate politics, and another, closer to conventional ‘Realist’ theories, which sees a clear dividing line between domestic and interstate politics, and in which interstate relations need to be understood according (...) to a distinct analytical framework. Although this tension was probably not a particular concern to de Ste. Croix himself, it does have a bearing on ongoing debates in International Theory; the final part of the article briefly explores the possibility that the concept of ‘compulsion’, important to both Thucydides’ and de Ste. Croix’s understanding of the causes of the Peloponnesian War, might provide a way of reconciling these two approaches. (shrink)

Traditional scientific views of the conscious self and world we live in are challenged by an unprecedented outburst of emerging new paradigms, theories of consciousness, perceptions of reality, new sciences, new philosophies, epistemologies, and a host of other transformative approaches. This still expanding outburst can be traced, on both logical and chronologic grounds, not to chaos theory, ecology, the new physics, or dozens of other currently ascribed sources, but rather to the cognitive (consciousness) revolution that immediately preceded. These new approaches (...) all share one key feature in common, namely, they all depend, directly or indirectly, upon a refutation and successful overthrow of the long dominant materialist paradigm. This is what was required to shift consciousness from an acausal or "eliminable" status to a functionally indispensable role. Traditional "bottom‐up" micro‐determinism had to be supplemented by a reciprocal, "top‐down" control exerted by mental emergents over lower‐level components. This does not dispose of behaviorism or reductionism, as methodology, but simply incorporates these within a more comprehensive explanatory framework. With the long reign of materialist constraints finally broken, other antireductive views have proliferated but with little regard for what the new paradigm allows. (shrink)

Neste trabalho apresentamos alguns resultados da pesquisa de doutorado desenvolvida junto à faculdade de Educação da Universidade de São Paulo entre 2002 e 2006, com o título: Ética do discurso e Ética Universal do Ser Humano: convergências entre Paulo Freire e Jurgen Habermas. Trata-se de uma breve descrição dos resultados obtidos, no intuito de aproximar o pensamento de dois autores complexos e de grande importância no pensamento filosófico mundial. Por um lado temos Paulo Freire e sua preocupação em relacionar educação (...) e crítica social libertadora. Por outro, o esforço gigantesco de Jürgen Habermas em produzir uma grande interpretação sobre o mundo, defendendo o projeto inicial da modernidade. Ambos se aproximam no final da década de 1990, chegando quase a um encontro pessoal, no âmbito da Teoria Crítica da Sociedade, quando seguidores de lado a lado identificam conceitos e intenções próximos, como a ideia do diálogo qualificado, de uma ética universalista possível, de uma emancipação humana no horizonte. (shrink)

This study investigates whether the host personality and the primary alterpersonality of a woman with multiple personality disorder are controlled by the left and right hemispheres, respectively. Results support the hypothesis. Behavioral and preference measures indicate that Pe is strongly right handed and Pa is left handed. Verbal and musical dichotic tests show significantly greater accuracy for stimuli presented to the left ear for Pa and to the right ear for Pe. It is concluded that shifts in hemisphericity involve redistribution (...) of attentional resources and callosal suppression. “Conditional handedness” is proposed as a handedness subtype, characterizing persons who alternate personalities and consistently display alternate hand preferences linked to specific personality characteristics. (shrink)

I do not by any means with to take on the philosophy or aesthetics of music as a whole. In his review of Edward Lippman’s Humanistic Philosophy of Music, Monroe Beardsley lists six areas in which an ideal philosophy of music ought to provide guidance: an ontology of music, an answer to the question What is a musical work of art? a taxonomy of music, a categorical scheme for the basic and universal aspects of music; a hermeneutics or semiotics of (...) music, an answer to the question What, if anything, can music refer to? an epistemology of music; a theory of music criticism, an answer to the question What makes one musical work better than another? the foundations of a social philosophy of music.4 My subject here is the third item. I want most particularly to separate it from the fifth item, for to arrive at an interpretation of a particular piece is not to arrive at an evaluation of it. I shall also try, particularly in my discussion of Nelson Goodman’s seminal Languages of Art, to avoid the first item.5 And I shall try throughout to avoid embroilment in the question of how the aesthetic experience can be separated from the nonaesthetic.My subject is in fact only a part of the third item above, namely, current theories of musical expression. “Expression” is not equivalent to “meaning”; I understand and shall use the word “expression” to indicate a kind of meaning that entails some kind of reference outside the internal syntax of the artwork itself. As Goodman remarks, “rather obviously, to express is to refer in some way to what is expressed.”6 How this reference is made by the artwork is interaction with the listener, and what sort of purpose it serves—these concerns will be the focus of this essay. To choose this focus is not to deny something of which I have no doubt, both from Peter Faltin’s careful arguments and from my own experience: there is a kind of musical meaning that is purely syntactic, that operates without reference outside the internal operations or procedures of musical systems themselves.7 But through this may be ontologically the most fundamental kind of musical meaning, it is not the only kind. To listen for this alone is not the only way to approach music. Indeed, I should guess it is not the most fundamental way for many listeners. 4. I paraphrase and abbreviate from Monroe C. Beardsley, review of A Humanistic Philosophy of Music by Edward A. Lippman, Musical Quarterly 66 : 305.5. See Nelson Goodman, Languages of Art: An Approach to a Theory of Symbols ; all further references to this work, abbreviated LA, will be included in the text.6. Goodman, “Reply to Beardsley,” Erkenntnis 12, pt. 1 : 171; and see Edward T. Cone: “Expressive values in any art … cannot arise from analytical values alone. How could they? Unless one wishes to explain what it could possibly mean for a work of art to ‘express itself,’ then one must agree that expression, by its very definition, implies a relationship between the work of art and something else; while analytical values are derivable purely from internal structure” . Anthony Newcomb, professor of music at the University of California, Berkeley, is the author of The Madrigal at Ferrara. He is currently at work on a book on musica ficta, Understood Accidentals in Renaissance Vocal Polyphony, 1450-1600, and a study of the relationship between structure and expression in nineteenth-century music. (shrink)

Memory for spatial location is typically biased, with errors trending toward the center of a surrounding region. According to the category adjustment model, this bias reflects the optimal, Bayesian combination of fine-grained and categorical representations of a location. However, there is disagreement about whether categories are malleable. For instance, can categories be redefined based on expert-level conceptual knowledge? Furthermore, if expert knowledge is used, does it dominate other information sources, or is it used adaptively so as to minimize overall error, (...) as predicted by a Bayesian framework? We address these questions using images of geological interest. The participants were experts in structural geology, organic chemistry, or English literature. Our data indicate that expertise-based categories influence estimates of location memory—particularly when these categories better constrain errors than alternative categories. Results are discussed with respect to the CAM. (shrink)

While not a coherent body of thought, the socialist ideology of the Panhellenic Socialist Movement (PASOK) and its leader, Andreas Papandreou, diverges from the socialist principles of post-World War II social democratic parties of Western Europe. The latter spoke for the working class in advanced industrialized societies. These social democrats accepted the legitimacy of capitalism and, assuming continued economic growth, advocated reformist policies. Such programs were meant to strengthen the welfare state and bring about a more equitable distribution of income. (...) As social democracy began to falter, its Keynesian theoretical presuppositions became transparently inadequate. Social democracy's ideological moorings were adrift, while its policies became barely distinguishable from those of its conservative political opponents. (shrink)