The statement that we are currently failing to address some of humanity’s greatest challenges seems uncontroversial—we are not doing enough to limit global warming to a maximum of 2 °C and we are exposing vulnerable people to preventable diseases when failing to produce herd immunity. But what singles out such failings from all the things we did not do when all are unintended? Unlike their individualist counterparts, collective inaction and omission have not yet received much attention in the (...) literature. collective inaction, I argue, can be attributed to a group of agents where a collective action x that the agents did not perform was collectively feasible at time t where each agent in that group had sufficient reason to contribute to performing x or others had a reasonable expectation that they would perform x. I show that, perhaps surprisingly, we can speak of collective inaction even where only one member of the group fails to act. However, where large and dispersed groups of agents are concerned, there is often no meaningful way of attributing collective failings. Still, I contend that the failure to close the global emissions gap and—in some cases—to generate herd immunity are indeed on us. (shrink)

In this chapter I offer a critique of the received way of thinking about responsibility for collective inaction and propose an alternative approach that takes as its point of departure the epistemic agency exhibited by people navigating impossible situations together. One such situation is becoming increasingly common in the context of climate change: so-called “natural” disasters wreaking havoc on communities—flooding homes, collapsing infrastructures, and straining the capacities of existing organizations to safeguard lives and livelihoods. What happens when philosophical (...) reflection begins here—in places where the institutions and practices that have emerged over the last century seem incapable of addressing the problems communities face now, and where people find themselves turning to one another for the sake of their own survival? (shrink)

When confronted with especially complex ecological and social problems such as climate change, how are we to think about responsibility for collective inaction? Social and political philosophers have begun to consider the complexities of acting collectively with a view to creating more just and sustainable societies. Some have recently turned their attention to the question of whether more or less formally organized groups can ever be held morally responsible for not acting collectively, or else for not organizing themselves (...) into groups capable of so doing. In this paper I argue that several questionable assumptions have shaped the character and scope of inquiry to this point, precluding us from grappling with a range of important questions concerning the epistemic dimensions of collective inaction. I offer an overview of recent conversation concerning collective inaction, advance a critique of the picture of responsibility that has emerged from this conversation, and propose an alternative approach to th... (shrink)

Sometimes it seems intuitively plausible to hold loosely structured sets of individuals morally responsible for failing to act collectively. Virginia Held, Larry May, and Torbj rn T nnsj have all drawn this conclusion from thought experiments concerning small groups, although they apply the conclusion to large-scale omissions as well. On the other hand it is commonly assumed that (collective) agency is a necessary condition for (collective) responsibility. If that is true, then how can we hold sets of people (...) responsible for not having acted collectively? This paper argues that that loosely structured inactive groups sometimes meet this requirement if we employ a weak (but nonetheless non-reductionist) notion of collective agency. This notion can be defended on independent grounds. The resulting position on distribution of responsibility is more restrictive than Held's, May's or T nnsj 's, and this consequence seems intuitively attractive. (shrink)

The effects of anthropogenic climate change may be devastating. Nevertheless, most people do not seem to be seriously concerned. We consume as much as we always did, drive as much as we always did, eat as much meat as we always did. What can we do to overcome this collective apathy? In order to be able to develop effective measures, we must first get clear about the causes of climate change inaction. In this paper I ask whether moral (...) nihilism is a significant cause of climate change inaction. The answer to this question depends mainly on the extent to which being a moral nihilist reduces one's likelihood of taking action against climate change. At first sight, the extent seems to be considerable. I argue, however, that this assumption is false. Only slightly more non-nihilists than nihilists are led to climate-friendly actions by moral considerations. And in absolute terms, morality plays such a minor role in leading people to act that the difference is barely noticeable. (shrink)

This Article explores several meanings of a regulatory preference for government inaction. It explains the rise to dominance of this inaction preference in the United States and its distorting influence on the perception and understanding of regulation. Specifically, the Article demonstrates how basic terms in regulation, such as “government failure,” “regulatory capture,” and “deregulation,” acquired misleading connotations suggesting that government inaction is always superior to government action. The Article further explains how, through government inaction, the U.S. (...) legal system accommodates rent extraction - the profitable exploitation of market imperfections and favorable laws. Several developments in recent decades have considerably improved the capacity of very small groups in society to collect rents, namely, use talent and positional advantages to gain increasing levels of earnings. The Article argues that the parallel rise of the inaction preference has contributed to this trend, primarily because the availability of rent extraction opportunities draws talent that utilizes them with growing effectiveness. The purpose of the Article is to clarify several aspects of the relationships between regulation and rent extraction or, more precisely, to emphasize that government inaction may entail undesirable income effects. (shrink)

The common notion of artifacts characterizes them as the products of successful activities of their makers, guided by intentions that such objects would instantiate certain features, such as their specific functions. Many counterexamples, however, reveal the unsuitability of the common notion. In the face of this acknowledgment, the paper explores the possibility that features of artifacts, and more specifically, the possession of their functions, may arise, at least partially, from collective assignments. In order to achieve the mentioned goal, the (...) paper critically examines some notions and theses put forward by John Searle and others. Its main result, however, consists in offering and elucidating an original thesis, namely, that the functions of many artifacts would be maintained, partially, by forms of continuous collective intentionality, which can involve conscious or unconscious, active or inactive collective intentional states. Keywords: Artifacts, assignment of function, collective intentionality, maintenance of function. (shrink)

Humans are prone to producing morally suboptimal and even disastrous outcomes out of ignorance. Ignorance is generally thought to excuse agents from wrongdoing, but little attention has been paid to group-based ignorance as the reason for some of our collective failings. I distinguish between different types of first-order and higher order group-based ignorance and examine how these can variously lead to problematic inaction. I will make two suggestions regarding our epistemic obligations vis-a-vis collective (in)action problems: (1) that (...) our epistemic obligations concern not just our own knowledge and beliefs but those of others, too and (2) that our epistemic obligations can be held collectively where the epistemic tasks cannot be performed by individuals acting in isolation, for example, when we are required to produce joint epistemic goods. (shrink)

First published in 1998. Routledge is an imprint of Taylor & Francis, an informa company.

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

Tackling climate change is one of the most demanding challenges of humanity in the 21st century. Still, the efforts to mitigate the current environmental crisis do not seem enough to deal with the increased existential risks for the human and other species. Persson and Savulescu have proposed that our evolutionarily forged moral psychology is one of the impediments to facing as enormous a problem as global warming. They suggested that if we want to address properly some of the most pressing (...) problems that cause catastrophic harm to our existence, we should enhance our moral behavior by biomedical means. The objective of this paper is, precisely, to reflect on whether a Moral Bio-Enhancement (henceforth MBE) program would be a viable option to confront the climate emergency. To meet this goal, I will propose the Ultimate Mostropic (hereafter UM) thought experiment, a hypothetical situation where we have already discovered the UM, an available, safe (without any deleterious secondary effects), extremely cheap and effective pill to enhance our cognitive, affective and motivational abilities related to morality. After briefly presenting the main argument of Persson and Savulescu regarding MBE and climate change, I will point out some of the difficulties that make MBE a daunting but exciting philosophical and scientific debate. In order to overcome these complications, I will describe the UM thought experiment, which involves two scenarios of the MBE program: (a) the state-driven, compulsory and universal enterprise, and (b) the initiative of voluntary individuals. I will show that the shortcomings of MBE programs through the UM in both scenarios make Persson and Savulescu’s proposal a not appealing pathway to mitigate climate change. In the final section, I will suggest that an inaccurate attribution of responsibilities underlies their proposal and that the collective inaction problem should be redirected primarily through a reinforcement of the political nature of the solutions. (shrink)

In recent debates about inequality, many have pointed to the predominant position of the finance. This article highlights that structural power, not lobbying resources, are key to explaining variations across countries. It examines finance-government negotiations over national bank rescue schemes during the recent financial crisis. Given the structural power of finance, the variation in bank bailouts across countries cannot be explained by lobbying differences. Instead of observing organized interest intermediation, we can see that disorganization was crucial for the financial industry (...) to get off the hook and let the government carry the burden of stabilizing the economy. Put differently, structural power is strongest when finance remains collectively inactive. In contrast to traditional accounts of the lobbying influence of finance, the comparison highlights that the lack of organization can have crucial redistributive consequences. (shrink)

Through empirical investigation of the Eurozone and Greek debt crisis 2010–12, this article demonstrates how a peak organization of financial firms—the Institute of International Finance —was able to mobilize its members transnationally to secure several key political and economic objectives. At the height of the crisis, large European banking firms were threatened by the prospect of a disorderly Greek default, coercive intervention by governments, and, potentially, a regional banking collapse. In this context, representatives from the IIF entered the policymaking process (...) to facilitate concerted private sector action, assisting EU officials with the negotiation of a substantial and orderly creditor writedown, and cooperating with legal action by the Greek government to sideline a minority of financial firms hostile to the deal. The article shows that the IIF’s disproportionate influence over policymaking was a result of their technical expertise, their ability to recruit individuals with long-standing experience of sovereign debt restructuring from the public and private sector, and the operation of elite revolving-door processes. In contrast to recent studies showing that financial actors are able to exercise more power at the national level by remaining collectively inactive, these findings suggest that, at the transnational level, financial actors can be most effective at securing their preferences when they are well organized and when they coordinate politically on the basis of collective interests. (shrink)

The problems caused by anthropogenic climate change threaten the lives and well-being of millions, yet it seems that we, as individuals, are powerless to prevent or worsen these problems. In this essay we consider the difficulty of assigning moral responsibility in cases of collective action problems like the problem of anthropogentic climate change. We consider two promising solutions, the expected utility and rights based solution, and argue that both are incapable of explaining why individuals have moral obligations to address (...) collective action problems. We believe, however, that this result does not justify inaction, instead it reveals a failure of moral philosophy to adequately address collective action problems. More work must be done to address the moral responsibilities that arise in cases of collective action problems and we close by pointing in the direction of some promising work in this area. (shrink)

To what extent do moral judgments depend on conscious reasoning from explicitly understood principles? We address this question by investigating one particular moral principle, the principle of the double effect. Using web-based technology, we collected a large data set on individuals' responses to a series of moral dilemmas, asking when harm to innocent others is permissible. Each moral dilemma presented a choice between action and inaction, both resulting in lives saved and lives lost. Results showed that: (1) patterns of (...) moral judgments were consistent with the principle of double effect and showed little variation across differences in gender, age, educational level, ethnicity, religion or national affiliation (within the limited range of our sample population) and (2) a majority of subjects failed to provide justifications that could account for their judgments. These results indicate that the principle of the double effect may be operative in our moral judgments but not open to conscious introspection. We discuss these results in light of current psychological theories of moral cognition, emphasizing the need to consider the unconscious appraisal system that mentally represents the causal and intentional properties of human action. (shrink)

: To what extent do moral judgments depend on conscious reasoning from explicitly understood principles? We address this question by investigating one particular moral principle, the principle of the double effect. Using web-based technology, we collected a large data set on individuals’ responses to a series of moral dilemmas, asking when harm to innocent others is permissible. Each moral dilemma presented a choice between action and inaction, both resulting in lives saved and lives lost. Results showed that: patterns of (...) moral judgments were consistent with the principle of double effect and showed little variation across differences in gender, age, educational level, ethnicity, religion or national affiliation and a majority of subjects failed to provide justifications that could account for their judgments. These results indicate that the principle of the double effect may be operative in our moral judgments but not open to conscious introspection. We discuss these results in light of current psychological theories of moral cognition, emphasizing the need to consider the unconscious appraisal system that mentally represents the causal and intentional properties of human action. (shrink)

In recent years, the family of algorithms collected under the term ``deep learning'' has revolutionized artificial intelligence, enabling machines to reach human-like performances in many complex cognitive tasks. Although deep learning models are grounded in the connectionist paradigm, their recent advances were basically developed with engineering goals in mind. Despite of their applied focus, deep learning models eventually seem fruitful for cognitive purposes. This can be thought as a kind of biological exaptation, where a physiological structure becomes applicable for a (...) function different from that for which it was selected. In this paper, it will be argued that it is time for cognitive science to seriously come to terms with deep learning, and we try to spell out the reasons why this is the case. First, the path of the evolution of deep learning from the connectionist project is traced, demonstrating the remarkable continuity, and the differences as well. Then, it will be considered how deep learning models can be useful for many cognitive topics, especially those where it has achieved performance comparable to humans, from perception to language. It will be maintained that deep learning poses questions that cognitive sciences should try to answer. One of such questions is the reasons why deep convolutional models that are disembodied, inactive, unaware of context, and static, are by far the closest to the patterns of activation in the brain visual system. (shrink)

Peace education is now well recognized within international legal instruments and within critical educational literature as an important aspect of education. Despite this, little attention has been given in the critical literature to the philosophical foundations for peace education and the rationale for peace education thus remains substantially an assumed one. This investigation explores some possible ethico-philosophical foundations for peace education, through an examination of five specific ethical traditions: 1) virtue ethics, whereby peace may be interpreted as a virtue, and/or (...) virtue is interpreted as peacefulness, and peace education as education in that virtue; 2) consequentialist ethics, whereby peace education may be interpreted as education regarding the consequences of our action and inaction, both as individuals and collectivities; 3) conservative political ethics, whereby peace education may be interpreted as emphasizing the importance of the evolution of social institutions and the importance of ordered and lawful social change; 4) aesthetic ethics, whereby peace may be interpreted as something beautiful and valuable in itself, and peace education as emphasizing the importance of that beauty and value; and 5) the ethics of care, whereby care may be interpreted as a core element in peace, and peace education as encouraging trust and engagement with the other. The study addresses major contributions to each of these ethical traditions, the strengths and weaknesses of the tradition, and the ways in which the tradition provides support for peace education. It is argued in this book that each tradition provides only a partial basis for peace education, and that ultimately a holistic and integrative understanding is required, one that encourages a culture of peace. (shrink)

In this paper I provide a preliminary account of weakness of political will (political akrasia). My aim is to use theories from the weakness of will literature as a guide to develop a model of the same phenomenon as it occurs in collective agents. Though the account will parallel the traditional view of weakness of will in individuals, weakness of political will is a distinctly political concept that will apply to group agents such as governments, institutional actors, and other (...) political collectives. I further argue that blaming inaction by collective political agents on a “lack of political will” should be understood as blaming a kind of akratic break within the deliberative process, leading to an inability of the collective agent to capitalize on existing group attitudes in order to translate them into policy or legislation. My primary example throughout will be U.S. political inaction with respect to the climate crisis. (shrink)

Given emerging evidence that learning to play a musical instrument may lead to a number of cognitive benefits for older adults, it is important to clarify how these training programs can be delivered optimally and meaningfully. The effective acquisition of musical and domain-general skills by later-life learners may be influenced by social, cultural and individual factors within the learning environment. The current study examines the effects of a 10-week piano training program on healthy older adult novices’ cognitive and motor skills, (...) in comparison to an inactive waitlisted control group. Fifteen participants completed piano training led by a music facilitator in small groups (max n = 4 per lesson class; two experimental, two waitlisted control groups). Data was collected using an explanatory sequential design: quantitative data from a battery of cognitive and motor tests was collected pre/post-test on all participants, with further post-test data from the waitlisted control group (n = 7). Qualitative data included weekly facilitator observations, participant practice diaries, and an individual, semi-structured, post-experiment interview. Bayesian modelling demonstrated moderate evidence of a strong positive impact of training on part A of the Trail Making test (TMT), indicating improved visuo-motor skills. Moderate evidence for negative impacts of training on part B of the Trail Making Test (and difference score delta) was also found, suggesting no benefit of cognitive... (shrink)

Marking the tercentenary of Berkeley's birth, this collection of previously unpublished essays covers such Berkeleian topics as: imagination, experience, and possibility; the argument against material substance; the physical world; idealism; science; the self; action and inaction; beauty; and the general good. Among the contributors are: Christopher Peacocke, Ernest Sosa, Margaret Wilson, C.C.W. Taylor, and J.O. Urmson.

This article examines the question of life's meaning in the Anthropocene, an era where the biosphere is significantly threatened by human activities. To introduce the existential dilemma posed by the Anthropocene, Leboeuf considers Samuel Scheffler's Death and the Afterlife. According to Scheffler, the existence of others after one's death shapes how one finds life meaningful. Thus, anyone who sees a connection between the meaning of life and the future of humanity should ask, why live in the Anthropocene? Leboeuf answers this (...) question via William James's lecture “Is Life Worth Living?” James, Leboeuf argues, would enjoin us not to waste time deliberating about life's worthwhileness. Instead, we must meet the challenges placed on us. Today we are summoned by our climate crisis to fight for our survival. Even if our collective future will have been shortened by our inaction, life is worth living in the Anthropocene. (shrink)

The effects of anthropogenic climate change will be devastating. Nevertheless, most people do not seem to be seriously concerned. We consume as much as we always did, drive as much as we always did, eat as much meat as we always did. What can we do to overcome this collective apathy? In order to be able to develop effective measures, we must first get clear about the causes of climate change inaction. In this paper I ask whether moral (...) nihilism (the denial of moral truths) is a significant cause of climate change inaction. The answer to this question depends mainly on the extent to which being a moral nihilist reduces one’s likelihood of taking action against climate change. At first sight, the extent seems to be considerable. I will argue, however, that this assumption is false. Only slightly more non-nihilists than nihilists are led to climate-friendly actions by moral considerations. And in absolute terms, morality plays such a minor role in leading people to act that the difference is barely noticeable. (shrink)

Interest in NFIB v. Sebelius has been extraordinarily high, from as soon as the legislation was passed, through lower court rulings, the Supreme Court’s grant of certiorari, and the decision itself, both for its substantive holdings and the purported behind-the-scene dynamics. Legal blogs exploded with analysis, bioethicists opined on our collective responsibilities, and philosophers tackled concepts like ‘coercion’ and the activity/inactivity distinction. This volume aims to bring together scholars from disparate fields to analyze various features of the decision. It (...) comprises over twenty essays from a range of academic disciplines, namely law, philosophy, and political science. Essays are divided into five units: context and history, analyzing the opinions, individual liberty, Medicaid, and future implications. (shrink)

I will first discuss how social interactions organize, coordinate, and specialize as “artifacts,” tools; how these tools are not only for coordination but for achieving something, for some outcome (goal/function), for a collective work. In particular, I will argue that these artifacts specify (predict and prescribe) the mental contents of the participants, both in terms of beliefs and acceptances and in terms of motives and plans. We have to revise the behavioristic view of “scripts” and “roles”; when we play (...) a role we wear a “mind.” No collective action would be possible without shared and/or ascribed mental contents. This is also very crucial for a central form of automatic mind-reading (mind ascription). Second, I will argue that often what really matters is the ascribed/prescribed, worn, mind not the real, private one. We have to play (like in the symbolic play) “as if” we had those mental contents. This social convention and mutual assumption makes the interaction work. The ascribed beliefs and goals are not necessarily explicitly there; they might be just implicit as inactive (we act just by routine and automatically) or implicit as potential. The coordination and social action works thanks to these “as if” (ascribed and pretended) minds, thanks to those conventional constructs. Our social minds for social interactions are coordination artifacts and social institutions. (shrink)

This paper offers a sketch of the complicated conflicts which arise—and metastasize seemingly daily—in the era of Big Data. Given the public’s ubiquitous-yet-ostensibly-voluntary data surrender, and industry’s ubiquitous-yet-ostensibly-anodyne collection of the same, inaction is not an option for any near-just society. By revisiting the philosophical basis for Panoptic apparatus, sketching the tumultuous history of US contract law trying to protect the public from itself, and comparing existing industry codes for similarly-situated—read: terrifyingly invasive—fields, the paper will provide a preliminary framework (...) for identifying and confronting the galaxy of problems associated with data analytics. (shrink)

While suicide occurs in numbers across countries, it has rarely been used as a form of collective action. In South Korea, however, a total of 107 protesters died from the act of committing suicide, most notably by means of self-immolation, in protest against injustice in the country. While they are regarded as political "martyrs," it remains unclear why they committed suicide and what they wanted to achieve with this highly unusual and costly form of protest. The paper addresses this (...) largely neglected issue by examining the suicide notes left by 48 Korean suicide protesters. The findings reveal that at least in Korea suicide protest was used not only as a from of protest and resistance, but also as an unusual form of micromobilization of mobilizing "consensus" and "action" among halfhearted activists and apathetic bystanders, by accusing the political and economic system as unjust and illegitimate, by identifying the apathy and inaction of the people as the main culprit for persistent injustice, and by urging and shaming the target audience to join a movement. The model presented here of suicide protest as a form of micromobilization provides a useful conceptual framework with which to compare seemingly diverse incidents of suicide protest across countries. (shrink)

The research study aimed at assessing the various difficulties that speech teachers had in delivering lessons during the distance learning era. The various phenomena and themes that emerged from the survey were determined using a descriptive research design. The survey was conducted to collect information about the various characteristics and behavior of speech teachers. It also explored the factors that influenced their decisions and actions when it came to addressing the pandemic. The repeated themes that emerged, include low motivation, altered (...) activities, unstable internet connection, comprehension, questionable output integrity, delayed submissions, in-person monitoring, and the system of communicating with inactive students in online mode. (shrink)

In ways accentuated by the global coronavirus pandemic, corporations constitute vital instruments of the acts of beneficence needed by the people of the world to make progress in public health and increase collective and individual well-being. This article contributes to understanding the variety of moral forces that may lead corporations to commit acts of beneficence, including Friedman’s business case for corporate beneficence, the duty of beneficence as developed by business ethicists, and Dunfee’s social contract account of corporate obligation. Whereas (...) Mejia recently contributed to scholarship on corporate beneficence by expressly adopting shareholder primacy’s conception of corporate governance, this article embraces a stakeholder-oriented, managerialist picture of corporate governance. I extend the literature on beneficence by incorporating what I argue is the intuition underlying Dunfee’s contractualist formula of minimal contribution, namely that management’s duty to do good is awakened and unshackled to the extent management judges the corporation can afford to commit acts of beneficence, all stakeholders considered. The all-stakeholders-considered case for corporate beneficence compels management to act, I argue, when inaction would undermine the moral integrity of managers personally committed to promoting the well-being of humanity. (shrink)

Recent pluralist accounts of the People and popular sovereignty, defining it as either a performance or a process, are divorced from the realities of mass disempowerment. By shifting emphasis from who to what, these notions of the People, though seemingly unconcerned with the problem of positing this entity as a collective agent, have actually posited the politically active as the concrete subject of the People. Consequently, I argue that these recent theories exclude the reality of mass disempowerment within contemporary (...) democracies by marginalizing agency, presupposing empowerment, and assuming the resonance of the various representations of the People. Simply put, they suffer from an activist-centric bias that renders the politically alienated, disempowered, and inactive as irrelevant entities, a nameless shadow lurking behind analyses of popular power. Hence, my task is to clear the ground for a more comprehensive theory of the People and Popular Sovereignty by exposing the roots, limits, and costs of this activist-centric bias. (shrink)

Despite efforts to make virtue-acquisition more accessible, neo-Aristotelian accounts of virtue currently exclude those who occasionally experience depressive episodes from potentially possessing moral virtue. This problem of accessibility is especially relevant given the increased prevalence of depression due to, e.g., the COVID19 pandemic. Through an interdisciplinary analysis, I argue that one’s ability to adequately recognise and respond to virtuous possibilities for action is impoverished during a depressive episode. This is illustrated through the depressed agent’s field of affordances: the collection of (...) possible actions an agent perceives. As moral virtues are conceptualised as stable dispositions, even a temporary yet significant decrease in moral competence excludes the agent from possessing the relevant virtue. To solve this problem of accessibility, I argue that, similar to Aristotle’s discussion of sleep, depressive episodes can be conceptualised as temporary states that cause one’s virtues to be inactive, rather than absent. (shrink)

BackgroundChronic airway diseases are prevalent and costly conditions. Interdisciplinary rehabilitation programs that include Acceptance and Commitment-based components could be important to tackle the vicious circle linking progression of the disease, inactivity, and psychopathological symptoms.MethodsA retrospective evaluation of routinely collected data of an interdisciplinary rehabilitation program was performed. The program included group sessions including patient education, breathing exercise, occupational therapy and an ACT-based psychological treatment, and individual sessions of physical therapy. Demographic data, clinical characteristics of the patients and the values of (...) outcome variables before treatment, at discharge, at 3 months, and at 6 months were extracted from medical records. Multiple imputation was employed to address missing data. Linear mixed models were employed to assess changes over time. Multivariable logistic regression was performed to assess predictors of a minimum clinically important change of health status from baseline to the 6-months follow-up.ResultsData from 31 patients with chronic obstructive pulmonary disease and 12 patients with bronchiectasis were extracted. Health status improved from baseline to discharge to the 3 months follow-up, but not to the 6 months follow-up. Anxiety and depression improved across all the time points. Quality of life did not improve over time. Having a worse health status at baseline and fewer depressive symptoms were significantly associated with achieving a minimum clinically important change of health status at 6 months. The effects of the interdisciplinary program were not different for patients with COPD or with bronchiectasis.DiscussionInterdisciplinary programs including ACT-based components are promising treatments for the rehabilitation of patients with chronic airway diseases. (shrink)

Both philosophical and practical analyses of global justice issues have been vitiated by two errors: a too-high emphasis on the supposed duties of collectives to act, and a too-low emphasis on the analysis of causes and risks. Concentrating instead on the duties of individual actors and analysing what they can really achieve reconfigures the field. It diverts attention from individual problems such as poverty or refugees or questions on what states should do. Instead it shows that there are different duties (...) for political leaders, intelligence operatives, opinion leaders and citizens in devising, urging and implementing such plans as transfers of aid with accountability, military interventions in rogue states and limited intakes of refugees. With collectivist excuses for inaction such as sovereignty out of the way, it is possible to take a cautiously optimistic view of the possibility of forceful and morally responsible interventions in the range of major global problems. (shrink)