Based on a study undertaken by the Institute of Medical Ethics and the Royal College of Nursing, this book examines what nurses, midwives and health visitors are taught about ethics in the UK. It defines ethics and related terms and discusses their relevance to the practice of nursing.

Abstract: The notion of a self-pattern, as developed in the pattern theory of self, which holds that the self is best explained in terms of the kind of reality that pertains to a dynamical pattern, acknowledges the importance of neural dynamics, but also expands the account of self to extra-neural (embodied and enactive) dynamics. The pattern theory of self, however, has been criticized for failing to explicate the dynamical relations among elements of the self-pattern; as such, it seems to be (...) nothing more than a mere list of elements. We’ll argue that the dynamics of a self-pattern are reflected in three significant and interrelated ways that allow for investigation. First, a self-pattern is reflectively reiterated in its narrative component. Second, studies of psychiatric or neurological disorders can help us understand the precise nature of the dynamical relations in a self-pattern, and how they can fail. Third, referencing predictive processing accounts, neuroscience can also help to explicate the dynamical relations that constitute the self-pattern. (shrink)

ArgumentA number of theorists have proposed simulation theories of empathy. A review of these theories shows that, despite the fact that one version of the simulation theory can avoid a number of problems associated with such approaches, there are further reasons to doubt whether simulation actually explains empathy. A high-level simulation account of empathy, distinguished from the simulation theory of mindreading, can avoid problems associated with low-level (neural) simulationist accounts; but it fails to adequately address two other problems: the diversity (...) problem and the starting problem. It is argued that a narrative approach to empathy obviates all these problems and offers a more parsimonious account. (shrink)

What does it mean for an actor to empathize with the character she is playing? We review different theories of empathy and of acting. We then consider the notion of “twofoldness”, which has been used to characterize the observer or audience perspective on the relation between actor and character. This same kind of twofoldness or double attunement applies from the perspective of the actor herself who must, at certain points of preparation, distinguish between the character portrayed and her own portrayal (...) effected in her craft. We argue that this concept helps us to understand how the actor can empathize with her character. For the actor who must study and rehearse her character, empathy may begin with higher-order processes that provide a contextualized understanding of the character. This understanding eventually integrates with more basic empathic processes in her actual performance. (shrink)

An important part of what it means for agents to be situated in the everyday world of human affairs includes their engagement with economic practices. In this paper we employ the concept of cognitive institutions in order to provide an enactive and interactive interpretation of market and economic reasoning. We challenge traditional views that understand markets in terms of market structures or as processors of distributed information. The alternative conception builds upon the notion of the market as a ‘scaffolding institution’. (...) Introducing the concept of market as a ‘socially extended’ cognitive institution we go beyond the notion of scaffolding to provide an enactive view of economic reasoning that understands the market participant in terms of social interactive processes and relational autonomy. Markets are more than inert devices for information processing; they can be viewed as ‘highly scaffolded’, where strong constraints and incentives predictably direct agents’ behavior. Building on this idea we argue that markets emerge from (a) the economic interaction of both supply and demand sides, in continual and mutual interplay, and (b) more basic social interactions. Consumer behavior in the marketplace is complex, not only determining the market price, but also extending the consumer’s cognitive processes to reliably attain a correct evaluation of the good. Moreover, this economic reasoning is socially situated and not something done in isolation from other consumers From a socially situated, interactive point of view buying or not buying a good is something that enacts the market. This shifts the status of markets from external institutions that merely causally affect participants’ cognitive processes to social institutions that constitutively extend these cognitive processes. On this view the constraints imposed by social interactions, as well as the possibilities enabled by such interactions, are such that economic reasoning is never just an individual process carried out by an autonomous individual, classically understood. In this regard, understanding the concept of relational autonomy allows us to see how economic reasoning is always embodied, embedded in, and scaffolded by intersubjective interactions, and how such interactions make the market what it is. (shrink)

Questions about the nature of self and self-consciousness are closely aligned with questions about the nature of autonomy. These concepts have deep roots in traditional philosophical discussions that concern metaphysics, epistemology and ethics. They also have direct relevance to practical considerations about informed consent in medical contexts. In this paper, with reference to understanding specific side effects of deep brain stimulation treatment in cases of, for example, Parkinson’s Disease, Obsessive Compulsive Disorder, and Major Depressive Disorder, I’ll argue that it is (...) best to frame discussions of informed consent in terms of relational autonomy and a pattern theory of self. (shrink)

Narrative is rarely mentioned in philosophical discussions of collective intentionality and group identity despite the fact that narratives are often thought important for the formation of action intentions and self-identity in individuals. We argue that the concept of the ‘we-narrative’ can solve several problems in regard to defining the status of the we. It provides the typical format for the attribution of joint agency; it contributes to the formation of group identity; and it generates group stability.

Gesellschaftskritik, or social philosophy that aims to provide firm criticism of pathological social practices, requires normatively grounded evaluative principles. In this article, we assess different possibilities for such principles with focus on a model that takes specific patterns of intersubjective interaction as its point of reference. We argue that in order to understand the full significance of this ‘intersubjective turn’ for social philosophy, and to strengthen the normative foundation of social philosophy, we need to distinguish several levels of intersubjectivity and, (...) in particular, focus on the somewhat neglected level of primary intersubjectivity. The article will discuss the account of primary intersubjectivity in Honneth’s work. We show that Honneth’s account runs into difficulties, and drawing on recent findings in developmental psychology, we suggest a rethinking of elementary recognition in terms of ‘affective proximity’. This both renders the account less susceptible to criticism and provides a normative perspective that can effortlessly enter into interdisciplinary collaboration. (shrink)

We review the distinction between sense of agency and sense of ownership, and then explore these concepts, and their reflective attributions, in schizophrenic symptoms and agoraphobia. We show how the underlying dynamics of these experiences are different across these disorders. We argue that these concepts are complex and cannot be reduced to neural mechanisms, but involve embodied and situated processes that include the physical and social environments. We conclude by arguing that the subjective and intersubjective dimensions of agency and ownership (...) cannot be considered in isolation from one another, but instead form an interdependent pairing. (shrink)

Context: Challenges by embodied, enactive, extended and ecological approaches to cognition have provided good reasons to shift away from neurocentric theories. Problem: Classic cognitivist accounts tend towards internalism, representationalism and methodological individualism. Such accounts not only picture the brain as the central and almost exclusive mechanism of cognition, they also conceive of brain function in terms that ignore the dynamical relations among brain, body and environment. Method: I review four areas of research where enactivist accounts have shown alternative ways of (...) thinking about the brain. Results: Taken together, such analyses form a comprehensive alternative to the classic conceptions of cognitivist, computational neuroscience. Implications: Such considerations motivate the need to re-think our understanding of how the brain itself works. They suggest that the best explanation of brain function may be found in the mixed vocabularies of embodied and situated cognition, developmental psychology, ecological psychology, dynamic systems theory, applied linguistics, the theory of affordances and material engagement, rather than the narrow vocabulary of computational neuroscience. Constructivist content: This account is consistent with an enactivist-constructivist approach to cognition. (shrink)

This is a precis of my book Enactivist Interventions (Oxford 2017), published with commentaries by Louise Barrett, Amanda Corris and Anthony Chemero, and Daniel Hutto, plus my replies.

I trace back the relation between phenomenology and pragmatism from contemporary discussions about a pragmatic turn in embodied-enactive cognitive science to the earliest associations between the phenomenologies of Husserl and Peirce. I argue against the claim that there has been a pragmatic turn per se in either phenomenology or cognitive science. Pragmatism, and a form of phenomenological pragmatism had already been informing debates in cognitive science from the very beginning. On the one hand, the recent phenomenological and pragmatic emphases in (...) embodied-enactive cognitive science represent more of a phenomenological turn in cognitive science than a pragmatic turn. On the other hand, since various versions of phenomenology were already operating in cognitive science, even if they were operating in opposition to the establishment view, embodied-enactive views do not involve a phenomenological turn. It may be better to say that such views continue and build upon the phenomenology and pragmatism that had been informing ongoing debates in the study of the mind. Not only can we trace a close connection between phenomenology and pragmatism all the way back to the beginnings of these philosophical approaches, they continue to operate in a dialectical fashion throughout their history. (shrink)

In 1937, John Dewey delivered a lecture to the College of Physicians in Saint Louis. His clear message was that in the practice of medicine it does not suffice for physicians to treat just the body, or to look to just the body for the mechanism of disease. Emphasizing the relational nature of organism-environment, he argued that the physician must treat the whole patient and must therefore consider the environment of the patient. It makes no sense, he suggested, to provide (...) medicine to address a problem with the patient's lungs and then to send him back into the coal mine. As he put it: "We must observe and understand internal processes and their interactions from the standpoint of their interactions with what is... (shrink)

In this analysis of the ethical dimensions of doctors’ participation in macroallocation we set out to understand the skills they use, how they are acquired, and how they influence performance of the role. Using the principles of grounded moral analysis, we conducted a semi-structured interview study with Australian doctors engaged in macroallocation. We found that they performed expertise as argument, bringing together phronetic and rhetorical skills founded on communication, strategic thinking, finance, and health data. They had made significant, purposeful efforts (...) to gain skills for the role. Our findings challenge common assumptions about doctors’ preferences in argumentation, and reveal an unexpected commitment to practical reason. Using the ethics of Paul Ricoeur in our analysis enabled us to identify the moral meaning of doctors’ skills and learning. We concluded that Ricoeur’s ethics offers an empirically grounded matrix for ethical analysis of the doctor’s role in macroallocation that may help to establish norms for procedure. (shrink)

This book presents a positive account of Aristotle's theory of political economy, arguing that it contains elements that may help us better understand and resolve contemporary social and economic problems. The book considers how Aristotle's work has been utilized by scholars including Marx, Polanyi, Rawls, Nussbaum and Sen to develop solutions to the problem of injustice. It then goes on to present a new Social Welfare Function as an application of Aristotle's theory. In exploring how Aristotle's theories can be applied (...) to contemporary social welfare analysis, the book offers a study that will be of relevance to scholars of the history of economic thought, political theory and the philosophy of economics. (shrink)

After a brief review of different definitions and types of loneliness I offer an analysis of the concept of existential loneliness and its philosophical background. In contrast to the interpersonal aspects of other types of loneliness, existential loneliness has been characterized as an intrapersonal default state of incommunicability or profound aloneness, part of or based on a fundamental ontological or transcendental structure in human existence. There are both conceptual and practical issues with the notion of existential loneliness, with implications for (...) psychotherapy. I offer a critical approach, and argue that there is no good philosophical basis for this conception of existential loneliness, and that although loneliness can be existential in some respect, it typically manifests itself in interpersonal contexts, and should not be considered a fundamental ontological structure of human existence. (shrink)

In a New York Times article last month, entitled Cells that read minds, the neuroscience reporter, Sandra Blakeslee (January 10, 2006) provided a list of all the things that mirror neurons can explain. As we know, mirror neurons, discovered by Rizzolattis group in Parma, are neurons that are activated when we engage in action, and when we perceive intentional movement in another person. According to Blakeslee and the scientists she interviewed, mirror neurons explain not only how we are capable of (...) understanding another persons actions, but also language, empathy, how children learn, why people respond to certain types of sports, dance, music and art, why watching media violence may be harmful and why many men like pornography. Let me set aside the controversial questions about whether mirror neurons can explain all of these things, and accept that mirror neurons are clearly smart little cells. But let me ask whether Blakeslee and her scientists are expressing things in the right way. (shrink)

Conversation is, first of all, an event, something that happens. But the concept of conversation has also been appropriated by various thinkers as a model or metaphor of hermeneutical experience, of communication, political discourse, the acquisition of knowledge, and so forth. As an event it has been analyzed within the hermeneutical tradition, from Schleiermacher to Gadamer, and in this analysis it has been tied to Romantic conceptions such as the universality of language, "linguistic heritage" (Angeborenheit der Sprache ), and what (...) von Humboldt called "the common denominator of human nature," the universal and spiritual humanity that we all share.1 So conceived conversation has been made a model of hermeneutical experience. Gadamer, as is well known, characterizes reading as a conversation or dialogue with a text. This is more than metaphor, he tells us. Interpretation means bringing the text "into the living present of conversation" (TM 368), restoring it to an original condition. (shrink)

In response to Stueber’s “Varieties of Empathy, Neuroscience, and the Narrativist Challenge to the Contemporary Theory of Mind Debate,” I identify three areas for further discussion: the frame problem, diversity, and an altogether different variety of empathy.

This article proposes a new social welfare measure based on Aristotle’s theory of reciprocity. Unlike existing metrics of social welfare, the proposed Aristotelian social welfare function measures reciprocity in a society, that is, the degree to which members of a society cooperate to benefit each other. We provide numerical estimates of the welfare function using data from income distribution quintiles in the recent past for the U. S., Germany, Russia, Ukraine, and Iran. The numerical results show that, starting from different (...) initial values, the U. S. and Germany have experienced declining social welfare, while Iran and Ukraine have experienced increasing social welfare. GDP per capita appears to be inversely correlated with social welfare in the U. S. and Germany. Europeans seem to enjoy higher social welfare than Americans. The article introduces its topic by advancing criticism that contemporary approaches to social welfare, such as the capabilities approaches, estimate a presumed welfare of individuals, rather than social welfare. (shrink)

Volume 27, Issue 5, September 2019, Page 1041-1046.

The social psychologist George Herbert Mead and the cognitive linguist Noam Chomsky both investigated the nature of language and mind during the 20th century. They approached the issues broadly, pursuing both philosophical and scientific lines of reasoning and evidence. This comparative analysis of Mead and Chomsky identifies fourteen questions that summarize their collective effort, and which animated much of the debate concerning language and mind in the 20th century. These questions continue to be relevant to 21st century inquiries. This paper (...) identifies which questions have been resolved and which have not, and discusses each in the context of relevant literature. The net result is a set of questions that inform interdisciplinary-minded inquiries today into the nature of language and mind. (shrink)

In this article, the author introduces readers to the Catalan Marxist Andreu Nin and his writings on Italian fascism. While this is an introduction to Nin it also makes the argument that his writing is of particular importance, since it clarifies the class nature of fascism, sorting out in detail the way the fascists recruited and used the middle class (petite bourgeoisie) to build a mass movement and rise to power, and then proceeded to build a corporatist state that served (...) the interest of the Italian bourgeoisie. (shrink)

Doctors are increasingly enjoined by their professional organisations to involve themselves in supraclinical advocacy, which embraces activities focused on changing practice and the system in order to address the social determinants of health. The moral basis for doctors’ decisions on whether or not to do so has been the subject of little empirical research. This opportunistic qualitative study of the values of medical graduates associated with the Sydney Medical School explores the processes that contribute to doctors’ decisions about taking up (...) the advocate role. Our findings show that personal ideals were more important than professional commitments in shaping doctors’ decisions on engagement in advocacy. Experiences in early life and during training, including exposure to power and powerlessness, significantly influenced their role choices. Doctors included supraclinical advocacy in their mature practices if it satisfied their desire to achieve excellence. These findings suggest that common approaches to promoting and facilitating advocacy as an individual professional obligation are not fully congruent with the experiences and values of doctors that are significant in creating the advocate. It would seem important to understand better the moral commitments inherent in advocacy to inform future developments in codes of medical ethics and medical education programs. (shrink)

In response to Robert Young's critical comments concerning Hermeneutics and Education I clarify two issues. First, I suggest that a more detailed account of interpretation and learning could be developed in a hermeneutically informed cognitive psychology. This would be an account that escapes the textual model of silent reading construed as private mental experience, and that acknowledges the social and communicative dimensions of understanding. Second, in contrast to Young's view, I contend that phronesis is not reducible to a set of (...) inner thought processes and that it has a role to play even in a critical social theory of education. (shrink)

Phenomenology involves a first‐person approach to consciousness. Husserl initiated phenomenology as a transcendental investigation in opposition to naturalism. It includes a methodologically guided analysis of intentionality as the primary characteristic of consciousness. Phenomenology also addresses the issue of the phenomenal character of consciousness tied to the notion of pre‐reflective self‐awareness, to embodiment, and to variations in intentional structures. It also offers a detailed analysis of the temporal nature of consciousness which helps to explain not only how one can have a (...) coherent experience of an object, but also how the subject of experience – a pre‐reflective self – can maintain identity over time. Husserl and later phenomenologists, like Merleau‐Ponty, emphasized the embodied nature of consciousness in a way that foreshadowed recent enactivist accounts. (shrink)

When I raise my arm, what makes it the case that my arm's going up is an instance of my raising my arm? In this paper, I discuss Aristotle's answer to this question. His view, I argue, is that my arm's going up counts as my raising my arm just in case it is an exercise of a certain kind of causal power of mine. I show that this view differs in an interesting way both from the Davidsonian ‘standard causal (...) account’ of action and from accounts put forward by recent critics of Davidson, such as Hornsby, Alvarez and Hyman. (shrink)

This book aims to present Thomas Aquinas’s theory of natural law as a cogent theory of ethics for those trained in Anglo-American analytic philosophy. To this end, Lisska explains the Thomistic theory in language intelligible to those untrained in scholastic philosophy and also takes up modern criticisms leveled against Aquinas with respect to his naturalism, his reliance on an outmoded metaphysics of essences, his failure to acknowledge the is/ought distinction, the absence of categorical imperatives, and so forth. In addition, Lisska (...) locates his own interpretation of Aquinas’s theory among other contemporary interpretations, particularly those of John Finnis and Henry Veatch. (shrink)