Rationale Treatment guidelines recommend a more conservative surgical approach than mastectomy for early stage breast cancer and a stronger emphasis on adjuvant therapy. Registry data at South Australian teaching hospitals have been used to monitor survivals and treatment in relation to these guidelines.Aims and objectives To use registry data to: (1) investigate trends in survival and treatment; and (2) compare treatment with guidelines.Methods Registry data from three teaching hospitals were used to analyse trends in primary courses of treatment of breast (...) cancers during 1977–2003 (n = 4671), using univariate analyses and multiple logistic regression. Disease-specific survivals were analysed using Kaplan–Meier product limit estimates and multivariable Cox proportional hazards regression.Results The 5-year survival was 79.9%, but with a secular increase, reaching 83.6% in 1997–2003. The relative risk of death (95% confidence limits) was 0.74 (0.62, 0.88) for 1997–2003, compared with previous diagnoses, after adjusting for tumour node metastasis stage, grade, age and place of residence. Treatment changes included an increase in conservative surgery (as opposed to mastectomy) from 51.7% in 1977–1990 to 76.8% in 1997–2003 for stage I (P < 0.001) and from 31.1% to 52.2% across these periods for stage II (P < 0.001). Adjuvant radiotherapy also became more common (P < 0.001), with 20.6% of patients receiving this treatment in 1977–1990 compared with 60.7% in 1997–2003. Radiotherapy generally was more prevalent when conservative surgery was provided, although also relatively common in mastectomy patients when tumour diameters exceeded 50 mm or when there were four or more involved nodes. The proportion of patients receiving chemotherapy increased (P < 0.001), from 19.6% in 1977–1990 to 36.9% in 1997–2003, and the proportion having hormone therapy also increased (P < 0.001), from 34.3% to 59.4% between these periods.Conclusions Survivals appear to be increasing and treatment trends are broadly consistent with guideline directions, and the earlier research on which these recommendations were based. (shrink)

A Brief History of Time: From the Big Bang to Black Holes is a popular-science book on cosmology (the study of the origin and evolution of the universe) by British physicist Stephen Hawking. It was first published in 1988. Hawking wrote the book for readers who have no prior knowledge of the universe and people who are interested in learning.

A comprehensive reassessment of the concept of mimesis in the history of ancient Greek aesthetics and philosophy of art, with particular attention to Plato, Aristotle, Hellenistic philosophy, and neoplatonism. There is also a wide-ranging review of arguments pro and contra the idea of artistic mimesis from the Renaissance to modern literar theory. The book challenges standard accounts in numerous respects and builds a new dialectical model with which to make sense of the entire history of mimeticist thinking in aesthetics.

Aboutness has been studied from any number of angles. Brentano made it the defining feature of the mental. Phenomenologists try to pin down the aboutness-features of particular mental states. Materialists sometimes claim to have grounded aboutness in natural regularities. Attempts have even been made, in library science and information theory, to operationalize the notion. But it has played no real role in philosophical semantics. This is surprising; sentences have aboutness-properties if anything does. Aboutness is the first book to examine through (...) a philosophical lens the role of subject matter in meaning. A long-standing tradition sees meaning as truth-conditions, to be specified by listing the scenarios in which a sentence is true. Nothing is said about the principle of selection--about what in a scenario gets it onto the list. Subject matter is the missing link here. A sentence is true because of how matters stand where its subject matter is concerned. Stephen Yablo maintains that this is not just a feature of subject matter, but its essence. One indicates what a sentence is about by mapping out logical space according to its changing ways of being true or false. The notion of content that results--directed content--is brought to bear on a range of philosophical topics, including ontology, verisimilitude, knowledge, loose talk, assertive content, and philosophical methodology. Written by one of today's leading philosophers, Aboutness represents a major advance in semantics and the philosophy of language. (shrink)

In Return to Reason, Stephen Toulmin argues that the potential for reason to improve our lives has been hampered by a serious imbalance in our pursuit of ...

The Anthropocene prompts renewed critical reflection on some of the central tenets of modern thought including narratives of ‘progress’, the privileging of the nation state, and the universalist rendering of the human. In this context it is striking that ‘rights’, a quintessentially modern mode of articulating normativity, are often presumed to have an enduring relevance in the contemporary moment, exemplified in renewed recourse to rights in their attribution to parts of the nonhuman world. Our intervention contemplates ways in which the (...) apparent disorientations of the Anthropocene might allow for a generative reorientation of some of these presuppositions. We critically consider the institutional and discursive limitations of rights and the ambivalence of rights language, and argue that the monism that rights so often implies limits the capacity to foster generative encounters between Indigenous and non-Indigenous legal traditions. We develop a critical discourse of obligation, understood here to both precede and exceed the rights-duty correlate so central to modern law. An attentiveness to the priority of obligation, we argue, might allow us to foreground an ethics of encounter between traditions, to examine the limits of modernity’s legal and political imaginary, and to pursue a ‘radical re-storying’ of laws for the Anthropocene. (shrink)

Stephen Hetherington's prominent career within epistemology has been a series of distinctive, bold, varied and provocative arguments and ideas. Bringing together Hetherington's unique body of writing for the first time, this collection features previously published as well as new material that link his approaches to key issues including knowledge, justification, fallibility, scepticism and the Gettier Problem. Advancing our understanding of the systemic nature of Hetherington's thinking, Stephen Hetherington on Epistemology presents his distinctive perspective on some of philosophy's central (...) questions about knowledge - an inviting blend of forensic detail and 'big picture' proposals. (shrink)

Corporate sustainability introduces multiple tensions or paradoxes into organisations which defy traditional approaches such as trading-off contrasting options. We examine an alternative approach: to manage corporate sustainability with a paradoxical lens where contradictory elements are managed concurrently. Drawing on paradox theory, we focus on two specific pathways: to the organisation-wide acceptance of paradox and to paradoxical resolution. Introducing the concept of strategic agility, we argue that strategically agile organisations are better placed to navigate these paradox pathways. Strategic agility comprises three (...) organisational meta-capabilities: strategic sensitivity, collective commitment, and resource fluidity. We propose that strategically agile organisations draw on strategic sensitivity and collective commitment to achieve organisation-wide acceptance of paradox, and collective commitment and resource fluidity to achieve paradoxical resolution. For each of these meta-capabilities, we identify three organisational practices and processes specifically related to corporate sustainability that organisations can leverage in pursuit of strategic agility. We offer a conceptual framework depicting the strategic agility meta-capabilities, and associated practices and processes, which organisations draw on to successfully manage corporate sustainability with a paradoxical lens. (shrink)

Defenders of pragmatic encroachment in epistemology (or what I call practicalism) need to address two main problems. First, the view seems to imply, absurdly, that knowledge can come and go quite easily—in particular, that it might come and go along with our variable practical interests. We can call this the stability problem. Second, there seems to be no fully satisfying way of explaining whose practical interests matter. We can call this the “whose stakes?” problem. I argue that both problems can (...) be addressed in roughly the same terms. More exactly, I argue that by first clarifying the whose stakes? problem an answer to the stability problem naturally falls out. (shrink)

Elizabeth Anscombe famously argued that "modern moral philosophy" centrally involved unsupported notions of obligation and culpability. Modern Moral Philosophy: From Grotius to Kant exhibits, for the first time, resources that modern moral philosophers had to respond to Anscombe's challenge, also enhancing our own philosophical grasp of morality and its foundations.

In this paper I elucidate various ways in which understanding can be seen as an excellence of the mind or intellectual virtue. Along the way, I take up the neglected issue of what it might mean to be an “understanding person”—by which I mean not a person who understands a number of things about the natural world, but a person who steers clear of things like judgmentalism in her evaluation of other people, and thus is better able to take up (...) different perspectives and view them with a sympathetic eye. Being an understanding person in this sense seems to be a character-level virtue that interestingly combines moral and epistemic elements; it also seems to be a virtue particularly needed in our age of deep political division, where it is commonly said that failures of mutual understanding are partly to blame for this problem. (shrink)

Keith Augustine’s critical evaluation of the essay contest sponsored by the Bigelow Institute of Consciousness Studies (BICS) is an interesting but problematic review. It mixes reasonable and detailed criticisms of the contest and many of the winning essays with a disappointing reliance on some of the most trite and superficial criticisms of parapsychological research. Ironically, Augustine criticizes the winning essays for using straw-man arguments and cherry-picked evidence even though many of his own arguments commit these same errors.

Can hybridism about moral claims be made to work? I argue it can if we accept the conventional implicature approach developed in Barker (Analysis 2000). However, this kind of hybrid expressivism is only acceptable if we can make sense of conventional implicature, the kind of meaning carried by operators like ‘even’, ‘but’, etc. Conventional implictures are a form of pragmatic presupposition, which involves an unsaid mode of delivery of content. I argue that we can make sense of conventional implicatures, but (...) doing so requires we embrace a form of pure, non-hybrid expressivism. This is a cognitivist expressivism I have developed elsewhere. We need cognitivist expressivism to make sense of how we evaluate—judge as correct or incorrect—implicature-bearing sentences. Once we embraced the possibility of this pure expressivism, we might as well be pure expressivists about normative discourse too. I show how we can do that. The motivations for a specifically hybrid theory are dialectically undercut. (shrink)

What does it mean to be ethical in psychotherapy? Does adherence to ethical codes and rules make a psychotherapist ethical? This article examines standard ways of thinking about ethics in the field and argues that these ways are inadequate, creating a false dichotomy between the ethical and the clinical, and that they are designed only for formal and contractual relationships, in which psychotherapy is more often personal and affecting. The ethic of care and the approach to ethics of Emmanuel Levinas (...) are presented as additional approaches, along with their challenges to rationality and autonomy. An ethic of listening is then presented, and it is argued that ethics should be not an afterthought, but the primary consideration of clinical utility. (shrink)

What does it mean to be ethical in psychotherapy? Does adherence to ethical codes and rules make a psychotherapist ethical? This article examines standard ways of thinking about ethics in the field and argues that these ways are inadequate, creating a false dichotomy between the ethical and the clinical, and that they are designed only for formal and contractual relationships, in which psychotherapy is more often personal and affecting. The ethic of care and the approach to ethics of Emmanuel Levinas (...) are presented as additional approaches, along with their challenges to rationality and autonomy. An ethic of listening is then presented, and it is argued that ethics should be not an afterthought, but the primary consideration of clinical utility. (shrink)

In a tribute to the intellectual legacy of Peter Fitzpatrick, this article explores the poiesis of modern law, as a constitutive ambivalence distilled in the affinity between law and literature. Reading with Fitzpatrick, the resolution of the contradictions of this law in myth depends, paradoxically, upon its fundamental irresolution. Reflecting upon the profound significance of his revelation of the mythology of modern law and its scholarly reverberations, I consider the constitutive tensions of this law as exemplified in the relation between (...) praxis and poiesis, the operative function of the former dependent upon the creative unfolding of the latter. The alchemy of autopoiesis, by which law boldly proclaims itself law, is made explicit in the eschatology of its archive and the formation of its sovereign subject in negation. Revealing the literary dimensions of this law, the conceit of autonomy is nonetheless subject to the subversive substitutions of the supplement. Pressing yet further, the autopoiesis of law is found to be enfolded within a generative sympoiesis, constituted by the movement between its apposite dimensions. Ultimately, extending Fitzpatrick’s rendering of the irresolution of modern law as decolonial, I explore the possibilities afforded by a reading of the fundamental mutuality of myths, and the decolonial conviviality of poiesis. (shrink)

No progress has been made over the past decade in improving equity of access to higher education for young people from low socio-economic backgrounds. New evidence indicates that both family income and cultural factors explain this situation. The cultural factor is particularly strong for boys from blue collar backgrounds. Current Government equity policy ignores these findings.

Many experimental philosophers are philosophers by training and professional affiliation, but some best work in experimental philosophy has been done by people who do not have advanced degrees in philosophy and do not teach in philosophy departments. This chapter explains that the experimental philosophy is the empirical investigation of philosophical intuitions, the factors that affect them, and the psychological and neurological mechanisms that underlie them. It explores what are philosophical intuitions, and why do experimental philosophers want to study them using (...) the methods of empirical science. The positive program in experimental philosophy shares the goal of the substantial part of traditional philosophy that is concerned with the analysis of important philosophical concepts. The negative program has implications for philosophical projects whose goal is conceptual analysis. There have been a number of responses to the challenge posed by experimental philosophy's negative program. The chapter also focuses on the expertise defense. (shrink)

In November 2022, OpenAI released ChatGPT, an incredibly sophisticated chatbot. Its capability is astonishing: as well as conversing with human interlocutors, it can answer questions about history, explain almost anything you might think to ask it, and write poetry. This level of achievement has provoked interest in questions about whether a chatbot might have something similar to human intelligence or even consciousness. Given that the function of a chatbot is to process linguistic input and produce linguistic output, we consider the (...) question whether a sophisticated chatbot might have inner speech. That is: Might it talk to itself, internally? We explored this via a conversation with ‘Playground’, a chatbot which is very similar to ChatGPT but more flexible in certain respects. We asked it questions which, plausibly, can only be answered if one first produces some inner speech. Here, we present our findings and discuss their philosophical significance. (shrink)

Why is there anything, rather than nothing at all? This question often serves as a debating tactic used by theists to attack naturalism. Many people apparently regard the question—couched in such stark, general terms—as too profound for natural science to answer. It is unanswerable by science, I argue, not because it’s profound or because science is superficial but because the question, as it stands, is ill-posed and hence has no answer in the first place. In any form in which it (...) is well-posed, it has an answer that naturalism can in principle provide. The question therefore gives the foes of naturalism none of the ammunition that many on both sides of the debate think it does. (shrink)

Tracing the history of American sociology since the Civil War, the authors of this important volume explain the field′s diversity, its lack of unifying paradigms, its broad, eclectic research agenda and its general weakness as an institutional force in either academia or the policy arena. They highlight the equivocal and often contradictory missions that sociologists prescribe for themselves and the variable nature of human, financial and intellectual resources available to the profession.

Punishment and Reparations are sometimes held to express retaliatory emotions whose object is to strike back against a victimizer. I begin by examining a version of this idea in Mill's writings about natural resentment and the sense of justice in Chapter V of Utilitarianism. Mill's view is that the ?natural? sentiment of resentment or ?vengeance? that is at the heart of the concept of justice is essentially retaliatory, therefore has ?nothing moral in it,? and so must be disciplined or moralized (...) from without by the desire to promote the general welfare. I argue to the contrary that if ?reactive attitudes? like resentment and moral blame are understood as Strawson analyzed them, as essentially ?interpersonal? or ?second personal?, they have a different content and function. They implicitly demand respect in a way that also expresses respect for the victimizer as a member of mutually accountable community of moral equals. Some implications of this idea are discussed for the ?expressive theory of punishment? and ?civil recourse? theories of torts. (shrink)

From 1876, this influential work in the history of ideas focuses on the eighteenth-century deist controversy and its effects.

A controversial life -- School life -- Family life -- Public life/private life -- Love life -- Writing life -- Pirate life -- An armed and neutral life -- A life concluded -- A life continued -- Afterword -- Overviews of the works of Søren Kierkegaard.

"Stretta è la porta e angusta è la via." I fondamentalisti di ogni sorta ispirano la propria vita a questo venerabile motto e quindi devono brandire senza sosta le proprie spade in una continua battaglia mentale contro le opinioni antitetiche degli apostati e dei rivali.

The long human odyssey of self-discovery has reached a crucial stage: everything we do affects everyone and everything else - and we know it. The next hundred years will bring more change than we can easily imagine: more opportunities for more people to achieve the fulfilment of a good life, and more risks that could result in catastrophic harm to the entire planet.Viewed geopolitically, the main question is whether the world-views of the world's most important and influential powers - China (...) and America (the one fundamentally Confucian, the other essentially individualist) - can be made to work together constructively.At the same time, on a deeper level, the even greater question is how the irreversible fact of urbanisation may nurture healthy and mature human individuality, such that the accumulated wisdom of the world's great cultures becomes mutually transforming and enriching.This bold and wide-ranging book explores those questions, with all the risks and opportunities they hold for generations still to com"--Publisher information. (shrink)

The field of modern day bioethics is relatively young and continues to constantly evolve in parallel with the ever increasingly complex nature of contemporary medical practice. These advances present clinicians with an array of therapeutic options that would have not seemed possible only a generation ago. Given these medical advances and the expansion of the academic and medicolegal field of bioethics, one would have thought that clinical decision making would have become easier. However paradoxically this has not proved to be (...) the case. Each advance may provide an answer to a particular clinical question which is almost immediately replaced by a whole new set of ethical problems that require consideration. (shrink)

Traces the rise and fall of successive international systems from medieval times to the present, showing how international order is created, how it is maintained, and why it breaks down.

A reply to Fine’s critique of Aboutness. Fine contrasts two notions of truthmaker, and more generally two notions of “state.” One is algebraic; states are sui generis entities grasped primarily through the conditions they satisfy. The other uses set theory; states are sets of worlds, or, perhaps, collections of such sets. I try to defend the second notion and question some seeming advantages of the first.

I introduce and discuss an underappreciated form of motivated cognition: motivational pessimism, which involves the biasing of beliefs for the sake of self-motivation. I illustrate how motivational pessimism avoids explanatory issues that plague other (putative) forms of motivated cognition and discuss distinctions within the category, related to awareness, aetiology, and proximal goals.

This book examines the psychological responses of people to the excitements and terrors that characterise the modern world. Beginning with a description of modernist and post-modernist accounts of contemporary life, it then moves into detailed discussions of narcissism and psychosis - two states of mind that seem to characterise the 'crises of self' to which the modern world gives rise. With an interweaving of social theory and psychodynamic explanations, this is a sophisticated and compelling text. Identity Crisis will be of (...) interest to students in a wide range of disciplines including psychology, sociology, psychoanalysis, politics and cultural studies. (shrink)

Kant and Mysticism interprets Kant’s early criticism of Swedenborg’s mysticism as the fountainhead of the Critical philosophy. Kantian Critique revolutionizes not only traditional metaphysics, but also our understanding of mysticism: Critical mysticism is a unitive experience that impels us to lay bare all human pretensions to reason’s light.

The slavery contract is not a rights violation since the right not to be enslaved and the right not to give out a benefit are waivable and the conjunction of their voluntary waiver is not itself a rights violation. The case for the contract being pejoratively exploitative is not clear. Hence given the general presumption in favor of liberty of contract, such a transaction ought to be permitted. The contract is also not invalid on the grounds that the wrongdoer’s consent (...) to it necessarily reflects involuntariness or irrationality or on the grounds that it is logically impossible for the wrongdoer to satisfy the contract. Allowing such contracts may not have desirable consequences, but for the liberal this by itself is not a sufficient reason against allowing them. One case where the slavery contract might be relevant is where a victim’s agent or the state agrees to waive its claim to harsh punishment in return for the offender agreeing to be enslaved. (shrink)

This chapter contains sections titled: Reply to Devitt and Jackson Reply to Egan Reply to Cowie Reply to Goldman Reply to Sterelny Reply to Prinz Reply to Godfrey‐Smith Reply to Sosa Reply to Bishop References.

Abstract This paper examines a number of ways in which Wittgenstein's later philosophical method has been appropriated for moral philosophy. The work of Paul Johnston, Sabina Lovibond and Cora Diamond is discussed in relation to the following questions. Is there a sustainable distinction between ethics and meta-ethics (in the form, say, of distinctively ethical language games and grammatical reminders about them)? What role does the imagination, and hence the domain of literature, play in ethical understanding? How far does ethical discourse (...) presuppose, and hence find itself constrained by, the shared natural reactions of a specific culture or form of life? (shrink)

Dr. Stephen Hawking was the most renowned scientist since Einstein, known both for his groundbreaking work in physics and cosmology and for his mischievous sense of humor. He educated millions of readers about the origins of the universe and the nature of black holes, and inspired millions more by defying a terrifying early prognosis of ALS, which originally gave him only two years to live. In later life he could communicate only by using a few facial muscles, but he (...) continued to advance his field and serve as a revered voice on social and humanitarian issues. Hawking not only unraveled some of the universe's greatest mysteries but also believed science plays a critical role in fixing problems here on Earth. Now he turns his attention to the most urgent issues facing us. Will humanity survive? Should we colonize space? Does God exist? These are just a few of the questions Hawking addresses in this wide-ranging, passionately argued final book from one of the greatest minds in history. Featuring a foreword by Eddie Redmayne, who won an Oscar playing Stephen Hawking, an introduction by Nobel Laureate Kip Thorne, and an afterword from Hawking's daughter, Lucy. (shrink)

The slavery contract is not a rights violation since the right not to be enslaved and the right not to give out a benefit are waivable and the conjunction of their voluntary waiver is not itself a rights violation. The case for the contract being pejoratively exploitative is not clear. Hence given the general presumption in favor of liberty of contract, such a transaction ought to be permitted. The contract is also not invalid on the grounds that the wrongdoer’s consent (...) to it necessarily reflects involuntariness or irrationality or on the grounds that it is logically impossible for the wrongdoer to satisfy the contract. Allowing such contracts may not have desirable consequences, but for the liberal this by itself is not a sufficient reason against allowing them. One case where the slavery contract might be relevant is where a victim’s agent or the state agrees to waive its claim to harsh punishment in return for the offender agreeing to be enslaved. (shrink)