I review the recent case of Edna Folz, a 73 year-old woman who was suffering through the end stages of very advanced Alzheimer's dementia when her case was adjudicated by the Wisconsin Supreme Court. I consider this case as an example of how courts are increasingly misinterpreting the ethical and legal decision-making standards known as substituted judgment and best interests and thereby threatening individuals' treatment decision-making rights as developed by other courts over the past two decades and creating serious roadblocks (...) to health-care providers' ability to render appropriate patient care. The Wisconsin Supreme Court held that Edna's legal guardian could not authorize withdrawal of Edna's treatment, ruling that as a matter of law, if an incompetent person is not in a persistent vegetative state, it is not in his or her best interests for life-sustaining treatment to be withdrawn unless (s)he has executed an advance directive or other statement clearly indicating his or her desires. (shrink)

Recent studies have exposed the startling inadequacy of health care providers knowledge about and practice of effective pain management. For example, in one study, it was reported that 79 percent of a random sample of 454 medical-surgical inpatients experienced pain during hospitalization, and that 58 percent of patients with pain considered the pain horrible or excruciating. In another study, 67 percent of 2,415 randomly selected hospitalized patients had pain during the twenty-four hours prior to being interviewed, and 50 percent reported (...) pain at the time of the interview. In a study of seriously ill hospitalized patients reported in 1996, half of the patients complained of pain, and one-sixth reported that they experienced extremely severe pain at least half the time. According to one literature review, 75 percent of cancer patients have reported suffering pain, and one study estimates that 25 percent of cancer patients die with severe unrelieved pain. Chronic nonmalignant pain has been described as an extremely prevalent problem, and over two-thirds of nursing home residents experience serious pain. (shrink)

Recent studies have exposed the startling inadequacy of health care providers knowledge about and practice of effective pain management. For example, in one study, it was reported that 79 percent of a random sample of 454 medical-surgical inpatients experienced pain during hospitalization, and that 58 percent of patients with pain considered the pain horrible or excruciating. In another study, 67 percent of 2,415 randomly selected hospitalized patients had pain during the twenty-four hours prior to being interviewed, and 50 percent reported (...) pain at the time of the interview. In a study of seriously ill hospitalized patients reported in 1996, half of the patients complained of pain, and one-sixth reported that they experienced extremely severe pain at least half the time. According to one literature review, 75 percent of cancer patients have reported suffering pain, and one study estimates that 25 percent of cancer patients die with severe unrelieved pain. Chronic nonmalignant pain has been described as an extremely prevalent problem, and over two-thirds of nursing home residents experience serious pain. (shrink)

Over the past two decades ethics committees have proliferated in healthcare institutions across the country. Catalysts for this growth include the endorsement of ethics committees by the New Jersey Supreme Court in the Quinlan case, by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical Research in its report entitled Deciding to Forgo Life Sustaining Medical Treatment, by the U.S. Department of Health and Human Services in its 1985 “Baby Doe” regulations, by numerous other courts in (...) treatment decisionmaking opinions issued after Quinlan, and more recently by the Joint Commission on Accreditation of Healthcare Organizations. (shrink)

Recently, the U.S. House of Representatives voted, for the second time in two years, to ban all human-cloning research, whether the research involves reproduction or creating cells that might be used to understand and treat disease. As I explain in this article, the proposed legislation has important implications not only for human cloning research but also for research in general.

For over a decade, managed care has profoundly altered how healthcare is delivered in the United States. There have been concerns that the patient-physician relationship may be undermined by various aspects of managed care, such as restrictions on physician choice, productivity requirements that limit the time physicians may spend with patients, and the use of compensation formulas that reward physicians for healthcare dollars not spent. We have previously published data on the effects of managed care on the physician-patient relationship from (...) the physician's perspective. In 1999, we collected data on the impact of managed care arrangements on the physician-patient relationship from the patient's perspective. This article discusses our collective findings. (shrink)

Over the past several years, healthcare has been profoundly altered by the growth of managed care. Because managed care integrates the financing and delivery of healthcare services, it dramatically alters the roles and relationships among providers, payers, and patients. While analysis of this change has focused on whether and how managed care can control costs, an increasingly important concern among healthcare providers and recipients is the impact of managed care on the physicianpatient relationship, but little data have been collected and (...) analyzed. We designed a survey for distribution to Wisconsin physicians to analyze the prevalence and types of managed care arrangements in the state, and the impact of these arrangements on physicians and their relationships with patients. (shrink)

Harmful algal blooms in Lake Erie’s western basin are caused in large part by nutrient loss from agricultural production. While use of nutrient management practices is encouraged to reduce agricultural nutrient loss and its consequent environmental impacts, such practices are not universally adopted. This study aims to better understand the factors that influence western Lake Erie basin farmers’ risk perceptions associated with agricultural nutrient loss, and thus further our knowledge of how adoption of nutrient management practices may be increased. We (...) propose a conceptual model to explain the relationships that we hypothesize to influence farmers’ risk perceptions associated with agricultural nutrient loss. Specifically, we consider the roles that farmer conservation identity, farmers’ perceived sufficiency of their nutrient management practices, and land vulnerability to nutrient loss play in influencing risk perceptions. We find that many of the hypothesized relationships are not statistically significant, and that risk perception associated with nutrient loss is primarily driven by farmers’ conservation identities. While farmers’ perceived sufficiency of their nutrient management practices plays some role in governing risk perceptions, we do not observe the hypothesized relationship between land vulnerability to nutrient loss and perceived sufficiency of nutrient management practices. (shrink)

What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that require an institutional policy on limitation or (...) withdrawal of treatment to include a specified mechanism for resolving conflict. Unfortunately, despite these developments, prospective case consultation remains one of the most controversial and poorly understood aspects of IEC functions. Questions and concerns persist about the relation the IEC has and should have to actual decisions in specific cases.We briefly examine the clinical, organizational, and regulatory complexity of the NICU environment and suggest five potential sources of uncertainty, disagreement, and conflict among parent and NICU staff. (shrink)

What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that require an institutional policy on limitation or (...) withdrawal of treatment to include a specified mechanism for resolving conflict. Unfortunately, despite these developments, prospective case consultation remains one of the most controversial and poorly understood aspects of IEC functions. Questions and concerns persist about the relation the IEC has and should have to actual decisions in specific cases.We briefly examine the clinical, organizational, and regulatory complexity of the NICU environment and suggest five potential sources of uncertainty, disagreement, and conflict among parent and NICU staff. (shrink)

Experts identified water quality, manure, good handling practices (including personal hygiene and equipment sanitation), and traceability as critical farm problem areas that, if addressed, are likely to decrease risk associated with microbial contamination of fresh produce from all scales of agriculture. However, the diverse nature of production strategies used by produce farmers presents multiple options for addressing foodborne illness issues while simultaneously creating potential complications. We use a mental models methodology to enhance our understanding of the underlying factors and assumptions (...) of small, medium, and large produce growers that influence their decision-making processes for contamination prevention and control. This empirical evidence demonstrates how challenges and opportunities to food safety are related to the scale of production and marketing strategies. We believe that refining the development of standards and existing extension and outreach food safety programs are important to both consumer protection and supporting agricultural communities. Additionally, this approach will help develop and refine food safety programs that will result in empirically grounded recommendations based on identified grower information needs. (shrink)

This book explores the central questions and themes lying at the heart of a vibrant area of philosophical inquiry. Aligning core issues in psychiatry with traditional philosophical areas, it presents a focused overview of the historical and contemporary problems dominating the philosophy of psychiatry. -/- Beginning with an introduction to research issues, it addresses what psychiatry is and distinguishes it from other areas of medical practice, other health care professions and psychology. With each section of the companion corresponding to a (...) philosophical subject, contributors systematically relate themes in philosophy of psychiatry to topics in philosophy of mind, phenomenology, philosophy of science, ethics, social and political philosophy, metaphysics, epistemology, and philosophy of medicine. Looking ahead to new research directions, chapters address recent issues including the metaphysics of mental disorders, gender and race in psychiatry and psychiatric ethics. -/- Featuring discussion questions, suggestions for further reading and an annotated bibliography, The Bloomsbury Companion to Philosophy of Psychiatry is an accessible survey of the debates and developments in the field suitable for undergraduates in philosophy and professional philosophers new to philosophy of psychiatry. (shrink)

Including the perspectives of scientists about the nature and process of science is important for an authentic and nuanced portrayal of science in science education. The small number of studies that have explored scientists’ worldviews about science has thus far generated contradictory findings, with recent studies claiming that scientists simultaneously hold contradictory sophisticated and naïve views. This article reports on an exploratory study that uses the framework of Bhaskar’s critical realism to elicit and separately analyse academic scientists’ ontological and epistemological (...) views about science in semi-structured interviews. When the views of scientists are analysed through the lens of critical realism, it is clear that it is possible to hold a realist ontological commitment about what knowledge is of, simultaneously with a fallibilist epistemological commitment about knowledge itself. The apparent incongruence of scientists’ so-called naïve and sophisticated views about science is resolved when analysed using a critical realist framework. Critical realism offers a simple and coherent framework for science educators that avoids many of the problems of positivism and social constructivism by finding a middle ground between them. The three pillars of critical realism: ontological realism, epistemological fallibilism and judgmental rationality help to make sense of how socially constructed scientific knowledge can be anchored in an independent reality. (shrink)

Proper linear models are those in which predictor variables are given weights such that the resulting linear composite optimally predicts some criterion of interest; examples of proper linear models are standard regression analysis, discriminant function analysis, and ridge regression analysis. Research summarized in P. Meehl's book on clinical vs statistical prediction and research stimulated in part by that book indicate that when a numerical criterion variable is to be predicted from numerical predictor variables, proper linear models outperform clinical intuition. Improper (...) linear models are those in which the weights of the predictor variables are obtained by some nonoptimal method. The present article presents evidence that even such improper linear models are superior to clinical intuition when predicting a numerical criterion from numerical predictors. In fact, unit weighting is quite robust for making such predictions. The application of unit weights to decide what bullet the Denver Police Department should use is described; some technical, psychological, and ethical resistances to using linear models in making social decisions are considered; and arguments that could weaken these resistances are presented. (shrink)

Drawing on 38 in-depth, qualitative interviews, this article explores how people working in the equality sector in England and Wales view and use the current law around sex and gender, and how they imagine law’s future, particularly potential decertification, where the state would withdraw from certifying and regulating a person’s sex/gender. Whilst situated in the bureaucratic strand of the literature, the paper also contributes to wider legal consciousness studies. This literature has generally focused on people’s relationships to law in terms (...) of domination, alienation and game-playing. Drawing on idioms and the language of touch, the paper unpacks the way in which equality actors talked about law not as remote or alienating, but as close and familiar; not as oppressive, but as “precious” and hard-won. Some also regarded law as a place of safety in unsafe times. These proposed ‘attached to law’ and ‘protective of law’ strands of consciousness enrich and extend Ewick and Silbey’s classic ‘before the law’ narrative. The findings are also useful for critical legal and feminist scholarship. Combined with the equality sector’s pragmatic and tactical use of law to problem-solve, this close and protective orientation towards law reproduces its hegemony. The paper concludes by exploring a recurrent refrain that, in relation to decertification, “we’re not there yet” and that gender equality would need to be achieved before decertification would “fly”. (shrink)

This article responds to Marzia Milazzo's article ‘On white ignorance, white shame, and other pitfalls in critical philosophy of race’, in which Milazzo argues that the concepts white shame, white guilt, white privilege, white habits, white invisibility and white ignorance are pitfalls in the process of decolonisation. Milazzo contends that the way these concepts are theorised in much critical philosophy of race minimises white people's active interest in reproducing the racial status quo. While I agree with Milazzo's critique of white (...) shame and white guilt, I argue that these affective responses are fundamentally different to the remaining concepts. Drawing on critical whiteness studies and agnotology, I argue that white privilege, white invisibility and white ignorance are valuable conceptual tools for revealing white people's active investment in maintaining racial inequality. Whereas Milazzo sees a contradiction between white people's active interest in maintaining racial inequality and concepts like white invisibility and white ignorance, I argue that, correctly theorised, these concepts resolve this apparent contradiction. I contest Milazzo's call to reject white privilege, white invisibility and white ignorance, arguing that these concepts are useful tools in the project of decolonisation. (shrink)

Teaching students to ask and answer questions is critically important if they are to engage in reasoned argumentation, problem-solving, and learning. This study involved 35 groups of grade 6 children from 18 classrooms in three conditions (cognitive questioning condition, community of inquiry condition, and the comparison condition) who were videotaped as they worked on specific inquiry-based science tasks. The study also involved the teachers in these classrooms who were audio-taped as they interacted with the children during these tasks. The results (...) show that while there were no significant differences in the children's explanatory behaviour across the two time periods, there were significant differences in the total verbal interactions between the children in the cognitive questioning condition and their peers in the community of inquiry and comparison conditions. Furthermore, the children in the cognitive questioning condition obtained higher reasoning and problem-solving scores than peers in the other conditions. Interestingly, while there were no significant differences between the teachers’ basic and extended mediating behaviours in the three conditions at Times 1 and 2, there was a significant difference in extended mediation behaviours with the teachers demonstrating nearly three times more extended mediation to promote students’ learning at Time 2 than they did at Time 1. Teacher intervention in providing guidance in how to interact during cooperative, inquiry-based science appears to be critical to helping students engage in higher-level thinking and learning. (shrink)

In Free Will and Luck, Mele presents a case of an agent Ernie, whose zygote was intentionally designed so that Ernie A-s in 30 years, bringing about a certain event E. Mele uses this case of original design to outline the zygote argument against compatibilism. In this paper I criticize the zygote argument. Unlike other compatibilists who have responded to the zygote argument, I contend that it is open to the compatibilist to accept premise one, that Ernie does not act (...) freely and is not morally responsible for anything he does. I argue that compatibilists should deny premise two. Diana’s effective intention to create Ernie’s zygote such that Ernie A-s in 30 years and her intervention to bring about his A-ing mark a significant difference between Ernie and normal agents in a deterministic universe with regard to how their zygotes were created that affects whether those agents act freely and are morally responsible for so acting. (shrink)

Gilbert et al. argue that discussions of self-related changes in patients undergoing DBS are overblown. They show that there is little evidence that these changes occur frequently and make recommendations for further research. We point out that their framing of the issue, their methodology, and their recommendations do not attend to other important questions about these changes.

This article draws from the reading protocols developed by José Esteban Muñoz to advance a political reading of Georges Bataille. It argues for a consistent and coherent anti-fascism across Bataille’s work, from the early “political” writings to the mature turn toward mysticism. Focusing in particular on his writings from the 1930s, this article clarifies some of the key concepts in Bataille’s critical theory of fascism: expenditure, heterology, base materialism, and democratic anguish.

It is commonly assumed that only women, and in particular women who have recently given birth, are able to breastfeed. However, through induced lactation, adoptive mothers, fathers and trans people have begun breastfeeding with greater frequency. Although breastfeeding is often regarded as a paradigmatic example of sexual difference, it actually exposes the instability of binary categories of sex. Luce Irigaray insists that sexual difference demands a new poetics, a language that is dynamic and fluid, capable of expressing difference while always (...) keeping open the possibility of transformation and change. This article extends Irigaray’s work in order to theorise breastfeeding from a perspective that is both feminist and queer. (shrink)

Jean-Luc Marion is one of the leading Catholic thinkers of our time: a formidable authority on Descartes and a major scholar in the philosophy of religion. This book presents a concise, accessible, and engaging introduction to the theology of Jean-Luc Marion. Described as one of the leading thinkers of his generation, Marion's take on the postmodern is richly enhanced by his expertise in patristic and mystical theology, phenomenology, and modern philosophy. In this first introduction to Marion's thought, Robyn Horner (...) provides the essential background to Marion's work, as well as analysing the most significant themes for contemporary theology. This book serves as an ideal starting point for students of theology and philosophy, as well as for those seeking to further their knowledge of cutting-edge thinking in contemporary theology. (shrink)

This article examines the reparative turn in current queer feminist scholarship by tracking its twin interest in the study of affect and time. By foregrounding Eve Kosofsky Sedgwick’s influential critique of what she called paranoid reading, I am interested in the ways that various critics – Ann Cvetkovich, Heather Love, and Elizabeth Freeman in particular – take up the call for reparative reading by using the temporal frameworks of the everyday, backward feeling, and queer time to reparative ends. In the (...) process, I consider the reparative work being done to reclaim Sedgwick as a major thinker for queer feminist concerns, and speculate on the attraction, in a time of declining economic and cultural support for the interpretative humanities, of a critical practice that seeks to love and nurture its objects of study. (shrink)

ABSTRACTThis paper examines discursive change in Australia from 1950 to 2010 through the lens of critical whiteness studies. Using textbooks as records of dominant narratives, I evaluate discourses of whiteness and Aboriginality in Australian history textbooks over this period of substantial social change. I show that overt discourses of white exceptionalism and Aboriginal deficiency are only present in the earliest decades of my sample. However, these discourses persist in later decades in ‘polite’ forms, maintaining the racial status quo while enabling (...) whites to be positioned favourably. I argue that discursive change only becomes embedded in textbooks if it bolsters the status of whites, evidencing Bell’s thesis of interest-convergence. (shrink)

In the current socio‐political climate pedagogies consistent with rationalism are in the ascendancy. One way to challenge the purchase of rationalism within educational discourse and practice is through the body, or by re‐thinking the nature of mind‐body relations. While the orientation of this paper is ultimately phenomenological, it takes as its point of departure recent feminist scholarship, which is demonstrating that attending to physiology can provide insight into the complexity of mind‐body relations. Elizabeth Wilson's account of the role of the (...) gut in psychological processes suggests a far less hierarchical relation between brain and body than rationalism allows. Such insights are also supported by recent phenomenological inquiries into cognition and the body. My question is, what implications do these insights have for how the nature of embodiment is understood, and, by extension, learning? This paper explores how informal, non‐cognitive modes of knowing, or of engaging with the world, inform learning in higher education contexts. More specifically, it raises the question of what role non‐cognitive modes of engagement, such as sensibility, have in augmenting, enabling or delimiting the learning process. (shrink)

Hegel's "highway of despair," introduced in his _Phenomenology of Spirit_, represents the tortured path traveled by "natural consciousness" on its way to freedom. Despair, the passionate residue of Hegelian critique, also indicates fugitive opportunities for freedom and preserves the principle of hope against all hope. Analyzing the works of an eclectic cast of thinkers, Robyn Marasco considers the dynamism of despair as a critical passion, reckoning with the forms of historical life forged along Hegel's highway. _The Highway of Despair_ (...) follows Theodor Adorno, Georges Bataille, and Frantz Fanon as they each read, resist, and reconfigure a strand of thought in Hegel's _Phenomenology of Spirit_. Confronting the twentieth-century collapse of a certain revolutionary dialectic, these thinkers struggle to revalue critical philosophy and recast Left Hegelianism within the contexts of genocidal racism, world war, and colonial domination. Each thinker also re-centers the role of passion in critique. Arguing against more recent trends in critical theory that promise an escape from despair, Marasco shows how passion frustrates the resolutions of reason and faith. Embracing the extremism of what Marx, in the spirit of Hegel, called the "ruthless critique of everything existing," she affirms the contemporary purchase of radical critical theory, resulting in a passionate approach to political thought. (shrink)

Fregoli delusion is the mistaken belief that some person currently present in the deluded person's environment is a familiar person in disguise. The stranger is believed to be psychologically identical to this known person even though the deluded person perceives the physical appearance of the stranger as being different from the known person's typical appearance. To gain a deeper understanding of this contradictory error in the normal system for tracking and identifying known persons, we conducted a detailed survey of all (...) the Fregoli cases reported in the literature since the seminal Courbon and Fail paper. Our preliminary reading of these cases revealed a notable lack of definitional clarity. So, we first formulated a classification scheme of different person misidentification delusions so as to identify those cases that qualified as instances of Fregoli according to the above characterization: the mistaken belief that a known person is present in the environment in a different guise to his or her typical appearance. We identified 38 clear cases of this type and set out to answer a series of questions motivated by current hypotheses about the origin of the Fregoli delusion. We asked whether the patients misidentified particular strangers, made reference to the misidentified known persons using wigs or plastic surgery , misidentified many different strangers or only one, showed other symptoms , and made inferences about the motives of the known persons in disguise. We conclude by discussing the implications of our findings for current hypotheses concerning the origin of the Fregoli delusion. (shrink)

This volume brings together philosophical perspectives on emotions, imagination and moral reasoning with contributions from neuroscience, cognitive science, social psychology, personality theory, developmental psychology, and abnormal psychology. The book explores what we can learn about the role of emotions and imagination in moral reasoning from psychopathic adults in the general community, from young children, and adolescents with callous unemotional traits, and from normal child development. It discusses the implications for philosophical moral psychology of recent experimental work on moral reasoning in (...) the cognitive sciences and neurosciences. Conversely, it shows what cognitive scientists and neuroscientists have still to learn from philosophical perspectives on moral reasoning, moral reflection, and moral responsibility. Finally, it looks at whether experimental methods used for researching moral reasoning are consistent with the work in social psychology and with philosophical thought on adult moral reasoning in everyday life. The volume's wide-ranging perspectives reflect the varied audiences for the volume, from students of philosophy to psychologists working in cognition, social and personality psychology, developmental psychology, abnormal psychology, and cognitive neuroscience. (shrink)

In this article, we explore smart deterrents and their historical precedents marketed to women and girls for the purpose of preventing harassment, sexual abuse and violence. Rape deterrents, as we define them, encompass customs, architectures, fashions, surveillant infrastructures, apps and devices conceived to manage and protect the body. Online searches reveal an array of technologies, and we engage with their prevention narratives and cultural construction discourses of the gendered body. Our critical analysis places recent rape deterrents in conversation with earlier (...) technologies to untangle the persistent logics. These are articulated with reference to the ways that proto-digital technologies have been imported into the realm of ubiquitous computing and networks. Our conceptual framework offers novel pathways for discussing feminine bodies and their messy navigation of everyday life that include both threats to corporeal safety and collective imaginings of empowerment. (shrink)

Originating as a proponent of U.S. exceptionalism during the Cold War, American Studies has now reinvented itself, vigorously critiquing various kinds of critical hegemony and launching innovative interdisciplinary endeavors. _The Futures of American Studies_ considers the field today and provides important deliberations on what it might yet become. Essays by both prominent and emerging scholars provide theoretically engaging analyses of the postnational impulse of current scholarship, the field's historical relationship to social movements, the status of theory, the state of higher (...) education in the United States, and the impact of ethnic and gender studies on area studies. They also investigate the influence of poststructuralism, postcolonial studies, sexuality studies, and cultural studies on U.S. nationalist—and antinationalist—discourses. No single overriding paradigm dominates the anthology. Instead, the articles enter into a lively and challenging dialogue with one another. A major assessment of the state of the field, _The Futures of American Studies_ is necessary reading for American Studies scholars. _Contributors._ Lindon Barrett, Nancy Bentley, Gillian Brown, Russ Castronovo, Eric Cheyfitz, Michael Denning, Winfried Fluck, Carl Gutierrez-Jones, Dana Heller, Amy Kaplan, Paul Lauter, Günter H. Lenz, George Lipsitz, Lisa Lowe, Walter Benn Michaels, José Estaban Muñoz, Dana D. Nelson, Ricardo L. Ortiz, Janice Radway, John Carlos Rowe, William V. Spanos. (shrink)

This article contrasts the cognitive neuropsychiatric approach with the traditional psychiatric approaches to delusions to develop testable cognitive theories of delusions so as to render the generation of delusions psychologically understandable. It illustrates how cognitive neuropsychiatrists use the Bruce and Young model of face processing to explain the generation of misidentification delusions. The study of facial expression highlights that future cognitive neuropsychiatric study of self and non-self face processing using different representational media in patients with mirrored-self misidentification delusions will likely (...) be informative with regard to advancing scientific understanding of the putative differences between self and non-self recognition. It reviews cognitive neuropsychiatric research into the Capgras delusion and shows the distinction between overt face recognition and person identity authentication, and suggests the need for further modification of Bruce and Young's model to remove direct pathways between the person's identity module and the affective response system and to incorporate a separate integrative device. (shrink)

Most people working on linguistic meaning or communication assume that semantics and pragmatics are distinct domains, yet there is still little consensus on how the distinction is to be drawn. The position defended in this paper is that the semantics/pragmatics distinction holds between encoded linguistic meaning and speaker meaning. Two other ‘minimalist’ positions on semantics are explored and found wanting: Kent Bach’s view that there is a narrow semantic notion of context which is responsible for providing semantic values for a (...) small number of indexicals, and Herman Cappelen and Ernie Lepore’s view that semantics includes the provision of values for all indexicals, even though these depend on the speaker’s communicative intentions. Finally, some implications are considered for the favoured semantics/pragmatics distinction of the fact that there are linguistic elements which do not contribute to truth-conditional content but rather provide guidance on pragmatic inference. (shrink)

The idea is that, in a wide range of contexts, utterances of the sentences in (a) in each case will communicate the assumption in (b) in each case (or something closely akin to it, there being a certain amount of contextually governed variation in the speaker's propositional attitude and so the scope of the negation). These scalar inferences are taken to be one kind of (generalized) conversational implicature. As is the case with pragmatic inference quite generally, these inferences are defeasible (...) (cancellable), which distinguishes them from entailments, and they are nondetachable, which distinguishes them from conventional implicatures. The core idea is that the choice of a weaker element from a scale of elements ordered in terms of semantic strength (that is, numbers of entailments) tends to implicate that, as far as the speaker knows, none of the stronger elements in the scale holds in this instance. The pattern is quite clear in (1) and (2), where the weak/strong alternatives are some/all and five/six respectively. In the case of (3), the stronger expression must be intelligent and good-hearted which entails intelligent; what Y's utterance implicates is that Mary does not have the two properties: intelligence and good-heartedness, so that, given the proposition expressed (Mary is intelligent) it follows, deductively, that she is not good-hearted, in Y's opinion. The example in (4) involves a scale inversion due to the negation, so that the weak/strong alternatives are not necessarily/not possibly; the negation which the scalar inference generates creates a double negation, which is eliminated giving possibly. (shrink)

I provide an exposition and critique of the ecological ethics of Murray Bookchin. First, I show how Bookchin draws on ecology and evolutionary biology to produce a mutually constraining cluster of ethical guidelines to underpin and justify his vision of a nonhierarchical, ecological society. I then critically examine Bookchin’s method of justification and the normative consequences that flow from his position. I argue that Bookchin’s enticing promise that his ecological ethics offers the widest realm of freedom to all life forms (...) is undermined by the way in which he distinguishes and privileges second nature over first nature. I conclude that Bookchin’s promise can only be delivered by a biocentric philosophy rather than by his own ecological ethics. (shrink)

Deep brain stimulation (DBS) uses electrodes implanted in the brain to modulate dysregulated brain activity related to a variety of neurological and psychiatric conditions. A number of people who use DBS have reported changes that affect their sense of self. In the neuroethics literature, there has been significant debate over the exact nature of these changes. More recently, there have been suggestions that this debate is overblown and detracts from clinically-relevant ways of understanding these effects of DBS. In this paper, (...) we offer an alternative approach to understanding the effects of DBS on the self, drawing on John Sadler’s work on self-illness ambiguity. We argue that self-illness ambiguity is a complex concept, with at least three different aspects, and that each of the three aspects we identify also characterizes one kind of DBS-related change. Our analysis also suggests ways of helping patients to adjust to life as a DBS user. (shrink)

Deep brain stimulation (DBS) uses electrodes implanted in the brain to modulate dysregulated brain activity related to a variety of neurological and psychiatric conditions. A number of people who use DBS have reported changes that affect their sense of self. In the neuroethics literature, there has been significant debate over the exact nature of these changes. More recently, there have been suggestions that this debate is overblown and detracts from clinically-relevant ways of understanding these effects of DBS. In this paper, (...) we offer an alternative approach to understanding the effects of DBS on the self, drawing on John Sadler’s work on self-illness ambiguity. We argue that self-illness ambiguity is a complex concept, with at least three different aspects, and that each of the three aspects we identify also characterizes one kind of DBS-related change. Our analysis also suggests ways of helping patients to adjust to life as a DBS user. (shrink)

This paper looks at the implications of contemporary work in philosophy of science for nursing science. Early work on the nature of theories in nursing was strongly influenced by logical empiricism, and this influence remains even long after nurse scholars have come to reject logical empiricism as an adequate philosophy of science. Combined with the need to establish nursing as an autonomous profession, nursing theory's use of logical empiricism has led to serious conceptual problems. Philosophers of science have also rejected (...) many of the central tenets of logical empiricism, including its focus on the logical justification of theories and the idea that science is, or should be, unified. Instead, there has been an increasing focus on the practice of science, which in turn has led to a pluralist understanding of science that emphasizes the construction of scientific models that are appropriate for certain purposes or in certain contexts. I suggest that this approach to philosophy of science may provide better resources for nursing science. (shrink)

Amoral actions are actions outside of the moral domain. To establish a way of understanding amoral actions, I will draw upon Dale Dorsey’s agency view which, in sum, maintains that an agent must have a reason to perform an action and be able to perform the action in question based upon that reason. Dorsey focuses upon both cognitive and circumstantial limitations to establish the fact that moral agents can (and do) perform amoral actions. In this paper, however, I will focus (...) upon a kind of deficiency of knowledge that is imparted socially. Some actions of persons suffering from autism seem to fall into the category of amoral actions that I have in mind but, so too, would some actions of persons who suffer from a moral injury. In sum, I aim to expand upon the category of amoral actions among moral agents. (shrink)

Biochemists investigating the problem of the vitamins in the early years of the twentieth century were working without an object, as such. Although they had developed a fairly elaborate idea of the character of the ‘vitamine’ and its role in metabolism, vitamins were not yet biochemical objects, but rather ‘functional ascriptions’ and ‘explanatory devices’. I suggest that an early instance of the changing status of the object of the ‘vitamins’ can be found in their stabilization, through the course of World (...) War I, as bio-political objects for the British and Allied war effort. Vitamins emerged as players, active agents, in Britain’s wartime bio-political problems of food distribution and population health and because of this they became increasingly real as bio-political objects, even prior to their isolation as bio-chemical molecules. I suggest that the materiality of our biology has agency in the development of political regimes and schemes. (shrink)