Having argued for an affirmative answer to my question, I consider arguments for a negative answer to it. With the important exception of those arguments in which the Basic Assumption is rejected, I think I can resist each of these. But in the case of arguments in which the Basic Assumption is rejected, I seem to reach an impasse. There is, however, some prospect of reconciliation. This comes in a species of transcendental idealism whereby all our representations are from a (...) ‘transcendent’ point of view and whereby the Basic Argument, though it has to be rejected at that ‘transcendent’ level, can be retained at a ‘non‐transcendent’ level. (shrink)

I further argue that we can make sense of. This requires a critique of nonsense, since, for reasons that I give, what replaces ‘x’ in the schema must be nonsense. I endorse an austere view of nonsense whereby there is nothing more to nonsense than sheer lack of sense, as in ‘phlump jing ux’. The point is this: because our ineffable knowledge is a mark of our finitude, and because we have a shared aspiration to transcend our finitude, we also (...) have a shared temptation to put our ineffable knowledge into words, which in turn gives us a shared sense of when a piece of nonsense is ‘apt’ to replace ‘x’ in the schema, where ‘aptness’ is a quasi‐aesthetic attribute. This is enough for instances of the schema to count as true or false—and, arguably, for ‘We are shown that transcendental idealism is true’ to count as true. (shrink)

I begin by raising the question whether there can be ‘absolute representations’ and explain what I mean by this. I define a ‘representation’ as anything, which has content and which, because of its content, is either true or false. I define an ‘absolute’ representation as a representation whose content can be combined with that of any other possible representation ‘by simple addition’. This contrasts with the case of a ‘non‐absolute’ or ‘perspectival’ representation, whose content may not be combinable with that (...) of another representation until the element of perspective has been eliminated. Thus if one person says, ‘I am English,’ and another says, ‘I am German,’ it is not possible for either of those people, nor indeed for anyone else, to combine the contents of their representations by saying, ‘I am English and I am German.’. (shrink)

I argue that both Kant and, in his later work, Wittgenstein indicate the possibility of just such a transcendental‐idealist response to the Basic Argument. I also argue, however, that transcendental idealism, for all its appeal, is incoherent. This is because its attempt to invoke the ‘transcendent’ is an attempt to invoke that which, by definition, cannot be invoked. So, it does not provide an alternative to unregenerate endorsement of the Basic Argument after all.

There remains the problem of accounting for the appeal of transcendental idealism. Transcendental idealists themselves may say that there is nothing wrong with the doctrine, but only with the attempt to express it, the point being that it is inexpressibly true: but I argue that this does not extricate them from the trap of self‐stultification. An importantly different proposal, which I derive from the earlier work of Wittgenstein, is this: while we cannot coherently state that transcendental idealism is true we (...) are shown that transcendental idealism is true, where ‘A is shown that x’ is defined as ‘ A has ineffable knowledge, and when an attempt is made to put that knowledge into words, the result is: x.’ I try to indicate how, provided we can make sense of and, this proposal has the threefold merit of: avoiding self‐stultification; being compatible with the incoherence of transcendental idealism; and providing an account of transcendental idealism's appeal. (shrink)

_Talking Politics_ is a philosophical examination of some of the basic concepts of political discourse. Its primary focus is on the _ordinary_; on what is said by politicians, in newspapers and by people in pubs, rather than on the works of political theorists. This is a work _of_, but not _on_ political theory. _Talking Politics_ is: * Invaluable as a source of reference for students, and contains a detailed index * Arranged thematically, around topics such as `Nation'. Each entry has (...) copious cross-references and suggestions for further reading A. W. Sparkes is uniquely qualified to write such a book, combining some thirty years' teaching as a philosopher with wide experience of, and a life-long fascination with, politics. His attitude is that of a critical, but uncynical, observer. (shrink)

Lifestyle diseases constitute an increasing proportion of health problems and this trend is likely to continue. A better understanding of the responsibility argument is important for the assessment of policies aimed at meeting this challenge. Holding individuals accountable for their choices in the context of health care is, however, controversial. There are powerful arguments both for and against such policies. In this article the main arguments for and the traditional arguments against the use of individual responsibility as a criterion for (...) the distribution of scarce health resources will be briefly outlined. It is argued that one of the most prominent contemporary normative traditions, liberal egalitarianism, presents a way of holding individuals accountable for their choices that avoids most of the problems pointed out by the critics. The aim of the article is to propose a plausible interpretation of liberal egalitarianism with respect to responsibility and health care and assess it against reasonable counter-arguments. (shrink)

Software piracy is a damaging and important moral issue, which is widely believed to be unchecked in particular areas of the globe. This cross-cultural study examines differences in morality and behavior toward software piracy in Singapore versus the United States, and reviews the cultural histories of Asia versus the United States to explore why these differences occur. The paper is based upon pilot data collected in the U.S. and Singapore, using a tradeoff analysis methodology and analysis. The data reveal some (...) fascinating interactions between the level of ethical transgression and the rewards or consequences which they produce. (shrink)

In this paper I argue that it is morally important for doctors to trust patients. Doctors' trust of patients lays the foundation for medical relationships which support the exercise of patient autonomy, and which lead to an enriched understanding of patients' interests. Despite the moral and practical desirability of trust, distrust may occur for reasons relating to the nature of medicine, and the social and cultural context within which medical care is provided. Whilst it may not be possible to trust (...) at will, the conscious adoption of a trusting stance is both possible and warranted as the burdens of misplaced trust fall more heavily upon patients than doctors. (shrink)

Talking Politics is a philosophical examination of some of the basic concepts of political discourse. Its primary focus is on the ordinary ; on what is said by politicians, in newspapers and by people in pubs, rather than on the works of political theorists. This is a work of , but not on political theory. Talking Politics is: * Invaluable as a source of reference for students, and contains a detailed index * Arranged thematically, around topics such as `Nation'. Each (...) entry has copious cross-references and suggestions for further reading A. W. Sparkes is uniquely qualified to write such a book, combining some thirty years' teaching as a philosopher with wide experience of, and a life-long fascination with, politics. His attitude is that of a critical, but uncynical, observer. (shrink)

This chapter contains section titled: Introduction1 Was the Early Wittgenstein a Transcendental Idealist? Was the Later Wittgenstein a Transcendental Idealist?

The philosophy of mathematics was of colossal importance to Wittgenstein. Its problems had a peculiarly strong hold on him; and he seems to have thought that it was in addressing these problems that he produced his greatest work. However robust the distinction between the calculus and the surrounding prose, the prose may infect the calculus; or the prose may infect how we couch the calculus. Yet Wittgenstein's writings in the philosophy of mathematics stand in a curious relation to this self‐assessment. (...) By 1938, he had written an early version of his master‐work Philosophical Investigations, the second half of which was on the philosophy of mathematics. This material did not survive into the version of Philosophical Investigations that was eventually published after his death. Instead it appeared, modified in various ways, along with notes that he wrote during World War II, as Remarks on the Foundations of Mathematics, another posthumous publication, assembled by his literary executors. (shrink)

Until about thirty years ago, the extent of disclosure about and consent-seeking for medical interventions was influenced by a beneficence model of professional behaviour. Informed consent shifted attention to a duty to respect the autonomy of patients. The new requirement arrived on the American scene in two separate contexts: for daily practice in 1957, and for clinical study in 1966. A confusing double standard has been established. 'Daily consent' is reviewed, if at all, only in retrospect. Doctors are merely exhorted (...) to obtain informed consent; they often minimise uncertainties about 'best' treatment and they feel duty-bound to provide patients with an unequivocal recommendation for action. 'Study consent' in a clinical trial is reviewed prospectively, and doctors are compelled by regulation to point out that there is insufficient evidence to make a rational choice between two compared treatments. It has been impossible to devise informed consent practices that satisfy, in full, the competing moral imperatives of respect for autonomy, concern for beneficence with emphasis on the value of health, and a vigil for justice. A way must be found to experiment with various discretionary approaches that would strike a realistic balance among competing interests. (shrink)

This book brings together essays on themes of human rights and legal history, reflecting the long and distinguished career of Brian Simpson as an academic writer and a human rights activist. The collection opens with a biography of Simpson's academic life, noting his major contribution to legal thought, and closes with an account of his career in the United States.

This is an updated version of an essay originally written for a special issue of Philosophical Topics on the links between Kant and analytic philosophy. It explores these links by focusing on: Wittgenstein’s Tractatus; the logical positivism endorsed by Ayer; and the (very different) variation on that theme endorsed by Quine. The claim defended is that in all three cases we see analytic philosophers trying to attain and express a general philosophical understanding of why the bounds of sense should be (...) drawn where they should—but thereby confronting the aporia, which Kant too confronted, that it is impossible to do this without transgressing those very bounds. The paper closes by suggesting that the problem is in trying to attain and express such an understanding; in other words, that such an understanding is attainable, but not expressible. (shrink)

Several decades of behavioral research have established that variations in socioeconomic status are related to differences in cognitive performance. Neuroimaging and psychophysiological techniques have recently emerged as a method of choice to better understand the neurobiological processes underlying this phenomenon. Here we present a systematic review of a particular sub-domain of this field. Specifically, we used the PICOS approach to review studies investigating potential relationships between SES and scalp event-related brain potentials. This review found evidence that SES is related to (...) amplitude variations in a diverse range of ERPs: P1, N1, N2, Error-Related Negativities, N400, auditory evoked potentials, negative difference waves, P3 and slow waves. These ERPs include early, mid-latency and late potentials that reflect a broad range of cognitive processes. In this review, all SES effects on ERPs appeared to reflect an impairment or a less efficient form of task-related neural activity for low-SES compared to high-SES individuals. Overall, these results confirm that a wide variety of distinct neural processes with different functional meanings are sensitive to SES differences. The findings of this review also suggest that the relationship between SES and some ERP components may depend on the developmental stage of study participants. Results are further discussed in terms of the current limitations of this field and future avenues of research. (shrink)

The additional data, perspectives, questions, and criticisms contributed by the commentaries strengthen our view that local cortical processors coordinate their activity with the context in which it occurs using contextual fields and synchronized population codes. We therefore predict that whereas the specialization of function has been the keynote of this century the coordination of function will be the keynote of the next.

Patient safety has only recently been subjected to wide-spread systematic study. Healthcare differs from other high risk industries in being more diverse and multi-contextual, and less certain and regulated. Also many patient safety problems are low-frequency events associated with many, varied contributing factors. The subject of this paper is the epistemology of patient safety (the science of the method of finding out about patient safety). Patient safety research is considered here on the background of a risk management framework which requires (...) researchers to: • Understand the context - as a subset of healthcare quality, services and systems research, with technical and human behavioural (cultural) components and a range of external and internal organisational influences, a wide range of research disciplines is necessary • Identify the risks - identify the things that go wrong and the frequency and nature of different types of incidents from sources such as medical record review, observational studies, audit, incident and medico-legal reports • Analyse the risks - deconstruct the things that go wrong, identifying contributing factors and trying to detect trends and patterns in contributing factors, detection, mitigation factors, ameliorating factors and actions taken to reduce risk • Evaluate the risks - decide on priorities, identifying preventive and corrective strategies and judging the risk- and cost-benefit of potential corrective strategies such as standardisation or simplification of a process or device • Manage the risk - evaluate and scope preventive and/or corrective strategies and then implement these, or place the problem on a risk register pending solution, or accept that what is needed is unaffordable • Communicate and consult - use interactive sessions, audit, on-going feedback, reminders and patient mediated prompts • Monitor and review the state of the problem - get baseline trends and patterns so that changes can be tracked and properly attributed to an intervention A hierarchy of levels of evidence has been proposed for clinical research and we argue that insufficient weighting has been given to lower ranked levels of research and to qualitative research, although critical interpretive synthesis is now gaining acceptance in mainstream thinking (e.g. by the Cochrane Collaboration). Fundamental challenges remain including how to grasp the elusive concept of patient safety, how to quantify, characterise and cost the problems, how to judge the extent to which harm can be attributed to errors, violations or system failures, how to identify contributing factors and the extent to which they can be implicated, how to judge whether incidents or their precursors are preventable, how to generate strong evidence to make healthcare safer and how to translate research into practice. Future directions include addressing the mundane as well as rare, dramatic events, and developing further research in non-hospital settings and in developing countries. In summary, a mixture of qualitative and quantitative methods, using information from all available data sources and combining retrospective, real time and prospective study designs, is necessary to address some of the more difficult patient safety problems. (shrink)

An interpretation of Kant's first antinomy is defended whereby both its thesis and its antithesis depend on a common basic principle that Kant endorses, namely that there cannot be an ‘infinite contingency’, by which is meant a contingent fact about how an infinite region of space or time is occupied. The greatest problem with this interpretation is that Kant explicitly declines to apply counterparts of the temporal arguments in the antinomy to the world’s future, even though, if the interpretation is (...) correct, such arguments are clearly there to be applied. This problem, it is argued, is surmountable. (shrink)

This article examines the implicit promises of fairness in evidence based medicine , namely to avoid discrimination through objective processes, and to distribute effective treatments fairly. The relationship between EBM and vulnerable groups is examined. Several aspects of EBM are explored: the way evidence is created , and the way evidence is applied in clinical care and health policy. This analysis suggests that EBM turns our attention away from social and cultural factors that influence health and focuses on a narrow (...) biomedical and individualistic model of health. Those with the greatest burden of ill health are left disenfranchised, as there is little research that is relevant to them, there is poor access to treatments, and attention is diverted away from activities that might have a much greater impact on their health. (shrink)