The Perceptions of Conscience Questionnaire (PCQ) and the Stress of Conscience Questionnaire (SCQ) have previously been developed and validated within the ‘Stress of Conscience Study’. The aim was to revalidate these two questionnaires, including two additional, theoretically and empirically significant items, on a sample of healthcare personnel working in direct contact with patients. The sample consisted of 503 healthcare personnel. To test variation and distribution among the answers, descriptive statistics, item analysis and principal component analysis (PCA) were used to examine (...) the underlying factor structure of the questionnaires. Support for adding the new item to the PCQ was found. No support was found for adding the new item to the SCQ. Both questionnaires can be regarded as valid for Swedish settings but can be improved by rephrasing some of the PCQ items and by adding items about private life to the SCQ. (shrink)

Orthodoxy says that the thesis that composition is identity (CAI) entails universalism: the claim that any collection of entities has a sum. If this is true it counts in favour of CAI, since a thesis about the nature of composition that settles the otherwise intractable special composition question (SCQ) is desirable. But I argue that it is false: CAI is compatible with the many forms of restricted composition, and SCQ is no easier to answer given CAI than otherwise. Furthermore, in (...) seeing why this is the case we reveal an objection to CAI: that it allows for the facts concerning what there is to be settled whilst leaving open the question about what is identical to what. (shrink)

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

This paper provides the first thorough assessment of a physics-based answer, the Bound State Answer, to the Special Composition Question. According to the BSA some objects compose something if they are in a common bound state. The reasons to endorse such an answer, in particular, motivations coming from empirical adequacy and conservativeness, precision, simplicity, and parsimony, are critically addressed. I then go on to compare the BSA to other moderate answers to the SCQ and consider whether objections raised against such (...) answers can be raised against the BSA as well. I finally relate the discussion with mereological pluralism. (shrink)

Introduction: Neurobiological systems engineering models are useful for treating patients. We show a model of “high opioid tone” autism and present a hypothesis about how autism is caused by administration of opioids during childbirth.Main Symptoms: Clinical diagnosis of autism in a 25 year old man was confirmed by a Social Responsiveness Scale self-rating of 79, severe, and a Social Communications Questionnaire by the patient's father scoring 27. Cold pressor time was 190 seconds—unusually long, consonant with the high pain tolerance of (...) autism.Therapeutic Intervention and Outcomes: At naltrexone 50 mg/day SRS fell to 54 and SCQ-−2–9; both non-significant. CPT fell to 28, repeat 39 s. Improved relatedness was experienced ambivalently, understood as feelings never before experienced—causing pain. Non-compliance with naltrexone was followed by cutting open his palm and drinking alcoholically. Transference focused psychotherapy has helped him remain naltrexone—compliant while he works on issues of identity and relatedness.Conclusion: The model suggests studies that could be conducted to both prevent and treat this form of autism. (shrink)

In his Material Beings, Peter van Inwagen distinguishes two questions about parthood. What are the conditions necessary and sufficient for some things jointly to compose a whole? What are the conditions necessary and sufficient for a thing to have proper parts? The first of these, the Special Composition Question (SCQ), has been widely discussed, and David Lewis has argued that an important constraint on any answer to the SCQ is that it should not permit borderline cases of composition. This is (...) a far-reaching claim, since many plausible-seeming accounts of composition do permit borderline cases. Ned Markosian has recently directed our attention to the second, the neglected Inverse Special Composition Question (ISCQ). I will argue that those who accept Lewis’s constraint on answers to the SCQ should accept an analogous constraint on answers to the ISCQ, and I will discuss the effects of such a constraint. (shrink)

I develop and defend a novel answer to Peter van Inwagen’s ‘Special Composition Question,’ (SCQ) namely, under what conditions do some things compose and object? My answer is that things will compose an object when and only when they exist simultaneously relative to a reference frame (I call this ‘Temporally Restricted Composition’ or TREC). I then show how this view wards off objections given to ‘Unrestricted Mereology’ (UM). TREC, unlike other theories of Restricted Composition, does not fall prey to worries (...) about vagueness, anthropocentrism, or arbitrariness. TREC also has advantages over all the other answers to the SCQ. TREC is an account an A-theorist anti-Eternalist who wants an unrestricted mereology should accept. I also engage in some conceptual hygiene by showing how UM, as it should be used, should not, in itself, entail or contain a commitment to either Eternalism or Four-Dimensionalism. (shrink)

Caring for older persons is both rewarding and consuming. Work with older people in Finland has been shown to be more burdensome than in the other Nordic countries. The aim of this study was to try out a Finnish version of the Stress of Conscience Questionnaire (SCQ) and explore stress of conscience in staff caring for older persons in Finland. The data were collected from the nursing staff (n = 350) working with older people in health centre wards, municipal and (...) private nursing homes, and municipal and private dementia care units in Finland. It emerged clearly from the results that Finnish nursing staff mostly felt that they did not have enough time to provide good care to patients, and this gave them a troubled conscience. They also felt that the demanding work taxed their energy, a consequence being that they could not give their own families and loved ones the attention they would have liked. (shrink)

The special composition question, which asks under which conditions objects compose a further object, establishes a central debate in modern metaphysics. Recent successes of inductive metaphysics, which studies the implications of the natural sciences for metaphysical problems, suggest that insights into the SCQ can be gained by investigating the physics of composite systems. In this work, I show that the minus first law of thermodynamics, which is concerned with the approach to equilibrium, leads to a new approach to the SCQ, (...) the thermodynamic composition principle : Multiple systems in thermal contact compose a single system. This principle, which is justified based on a systematic classification of possible mereological models for thermodynamic systems, might form the basis of an inductive argument for universalism. A formal analysis of the TCP is provided on the basis of mereotopology, which is a combination of mereology and topology. Here, “thermal contact” can be analyzed using the mereotopological predicate “self-connectedness”. Self-connectedness has to be defined in terms of mereological sums to ensure that scattered objects cannot be self-connected. (shrink)

Philosophical problems about the part-whole relation have been discussed throughout the history of philosophy, at least since Plato and Aristotle. In contemporary philosophy, the understanding of these issues has benefited from the formal tools of Classical Extensional Mereology. This paper aims is to defend mereological restrictivism against some constraints imposed by the vagueness argument. To achieve this, the paper is divided into three parts. In the first, I introduce the special composition question (hereafter SCQ) as formulated by [Van Inwagen, 1990] (...) and briefly present the three sets of theories that proffer answers to it. In the second part, I focus on the vagueness argument, that was presented by [Lewis, 1986, ] and [Sider, 2007, ] to defend mereological universalism. In the third section, I introduce the theory of natural properties by David Lewis. From this theory, I propose a new mereological operation labeled as natural fusion. The purpose of this operation is to falsify one of the premises of the vagueness argument. Then, I discuss some examples and counter-examples to natural fusion. (shrink)

manuscript delves into the philosophical debate surrounding the Special Composition Question (SCQ), focusing on the causal relationships between objects and their constituent parts. By distinguishing between Weak and Strong Causal Composition, the article explores how causal mechanisms underpin the composition of objects. Theories from notable philosophers, including van Inwagen and Leibniz, are evaluated. This study seeks to bridge the gap between common sense perspectives and principled ontological theories by introducing the concepts of Weak and Strong Causal Composition. The analysis reveals (...) how a causal approach can offer insightful resolutions to longstanding debates in mereology and ontology, emphasizing the role of causality in understanding the essence of material composition. The proposed causal perspective encourages further philosophical inquiry into the foundational principles governing the composition of objects. (shrink)

Mereological nihilism (henceforth just "nihilism") is the thesis that composition never occurs. Nihilism has often been defended on the basis of its theoretical simplicity, including its ontological simplicity and its ideological simplicity (roughly, nihilism's ability to do without primitive mereological predicates). In this paper I defend nihilism on the basis of the theoretical unification conferred by nihilism, which is, roughly, nihilism's capacity to allow us to take fewer phenomena as brute and inexplicable. This represents a respect in which nihilism enjoys (...) greater theoretical simplicity than its rivals which has not yet been explored, and which is immune to many of the objections which have been leveled against previous arguments for nihilism from nihilism's theoretical simplicity. Composition as identity might be thought to confer a similar degree of theoretical unification as nihilism. I end the paper by arguing that this is not the case. (shrink)

Background In long-term care, registered nurses and other care providers often experience tensions between ideals and realities in the delivery of services, which can result in stress of conscience. Burnout, low quality of care and a tendency to leave the profession are perceived as consequences. Objectives This study aimed to identify the socio-demographic and work-related factors associated with a high level of stress of conscience, particularly between nursing occupations. Research design A cross-sectional survey was conducted among care providers who worked (...) in Norwegian nursing homes and home care services in the spring of 2021. The sample consisted of 950 registered nurses and 1143 other care providers. Data were collected online using the Stress of Conscience Questionnaire (SCQ). Ethical considerations Participation was voluntary and based on consent. The study was approved by the Norwegian Center for Research Data. Results Registered nurses were nearly twice as likely to report high levels of stress of conscience compared to other care providers in long-term care. In addition, being a female, living alone, caring for their own children, working in an institution (versus home based), working >75% time, working shifts, not having scheduled meetings for ethical reflection and working in municipalities with a higher population density were factors associated with a high level of SCQ score. Discussion Knowledge of factors that increase the risk of high SCQ scores in registered nurses provides opportunities for prevention. Managers in long-term care should pay more attention to how work is distributed between the occupational groups and should facilitate real opportunities for ethical reflection. Conclusions The results of this study show that registered nurses have particular exposure to high levels of stress of conscience compared to other care providers in long-term care. Particular attention should be paid to registered nurses working in nursing homes. (shrink)

Most writers working on simultaneous use and mention assume a distinction between mixed quotation and scare quoting. The consensus is that MQ affects truth-conditions. Hence, many writers regard MQ as a semantic phenomenon. There is no such consensus about ScQ. On the face of it, there is a clear difference between: Alice said that life “is difficult to understand”. Several ‘groupies' followed the band on their tour. The words quoted in are attributed to Alice, and would seem false if Alice (...) had not uttered them. No such intuition is available for. This induces Cappelen & Lepore, leading writers in the field, to regard as a blend of Direct and Indirect Discourse and to propose the following semantic analysis : there is an utterance u such that Alice said u and u samesays “Life is difficult to understand” and u sametokens “is difficult to understand”. As for, they regard the impact of the quotation in it as being entirely pragmatic. I show, however, that there is no principled distinction between MQ and ScQ. The main points are: speech attribution to Alice in is defeasible; there are cases of simultaneous use and mention without “say” which are semantically relevant ; there is apparent MQ with reporting verbs that pose a problem because they cannot govern Direct Speech reports. Hence, it is illegitimate to appeal to the sametokening predicate in logical form. These examples that ‘refuse' to fall neatly under MQ or ScQ seal the fate of Cappelen & Lepore's account. To conclude, I discuss Benbaji's fully semantic theory. Benbaji adopts Cappelen & Lepore's views on MQ. But he also proposes a semantic account of ScQ. One option for him is to give up the Cappelen & Lepore story and extend his views on ScQ to all instances of simultaneous use and mention. I show, however, that this too fails. Therefore, in the end, only a pragmatic account of simultaneous use and mention remains as a viable option. (shrink)

Mereological nihilism is the thesis that composite objects—objects with proper parts—do not exist. Nihilists generally paraphrase talk of composite objects F into talk of there being “xs arranged F-wise” . Recently several philosophers have argued that nihilism is defective insofar as nihilists are either unable to say what they mean by such phrases as “there are xs arranged F-wise,” or that nihilists are unable to employ such phrases without incurring significant costs, perhaps even undermining one of the chief motivations for (...) nihilism. In this paper I defend nihilism against these objections. A key theme of the paper is this: if nihilists need to employ such phrases as “there are xs arranged F-wise,” non-nihilists will need to do so as well. Accordingly, any costs incurred by the nihilist when she employs such phrases will be shared by everyone else. What’s more, such phrases are intelligible when employed by the nihilist, as well as when they are employed by the non-nihilist, insofar as analyses of such phrases will not essentially involve mereological concepts incompatible with nihilism. (shrink)

I argue that mereological nihilism fails because it cannot answer the special arrangement question: when is it true that the xs are arranged F-wise? I suggest that the answers given in the literature fail and that the obvious responses that could be made look to undermine the motivations for adopting nihilism in the first place.

Unwilling to adopt the radical ontologies that leading answers to van Inwagen's special composition question imply, Ned Markosian proposes that there is no true, non-trivial, and finitely long answer to the SCQ. On my usage, this makes Markosian a particularist about composition. I argue that an improved version of Markosian's particularism fails because it cannot explain how sense perception justifies many of the ordinary-object beliefs we base on it. I further argue that psychologists' research on object perception suggests that general (...) principles govern how we perceptually discriminate unified wholes from mere pluralities, and this narrows the range of answers to the SCQ available to commonsense ontologists. (shrink)

This manuscript delves into the philosophical debate surrounding the Special Composition Question (SCQ), focusing on the causal relationships between objects and their constituent parts. By distinguishing between Weak and Strong Causal Composition, the article explores how causal mechanisms underpin the composition of objects. Theories from notable philosophers, including van Inwagen and Leibniz, are evaluated. This study seeks to bridge the gap between common sense perspectives and principled ontological theories by introducing the concepts of Weak and Strong Causal Composition. The analysis (...) reveals how a causal approach can offer insightful resolutions to longstanding debates in mereology and ontology, emphasizing the role of causality in understanding the essence of material composition. The proposed causal perspective encourages further philosophical inquiry into the foundational principles governing the composition of objects. (shrink)

This manuscript delves into the philosophical debate surrounding the Special Composition Question (SCQ), focusing on the causal relationships between objects and their constituent parts. By distinguishing between Weak and Strong Causal Composition, the article explores how causal mechanisms underpin the composition of objects. Theories from notable philosophers, including van Inwagen and Leibniz, are evaluated. This study seeks to bridge the gap between common sense perspectives and principled ontological theories by introducing the concepts of Weak and Strong Causal Composition. The analysis (...) reveals how a causal approach can offer insightful resolutions to longstanding debates in mereology and ontology, emphasizing the role of causality in understanding the essence of material composition. The proposed causal perspective encourages further philosophical inquiry into the foundational principles governing the composition of objects. (shrink)