Kafka and the Work of Domination Is it reasonable to look for an apprehension of the practices of domination in the œuvre of a writer ? To be more specific, in the writings of Kafka whose short stories and novels are characterised by their formal innovations and their break with the codes of realist narration ? The social and historical analysis of his work clearly demonstrates that Kafka constantly strove to elucidate the mechanisms of the domination which he personally had (...) suffered from , and which he had been able to observe in various professional contexts : the family clothes-shop, the bureaucratic world of an insurance company dealing with accidents at work, the companies he visited as an assessor of the professional risks to which workers were liable through their contact with machines, or the family asbestos factory. Through his representation of a range of situations which are oppressive, alienating, and frequently humiliating, to which the dominated parties participate, involuntarily and frequently unconsciously, Kafka was proceeding with his vast enterprise aimed at self-knowledge and the knowledge of inter-human relations. (shrink)

The paper argues that in order to understand the nature of technological knowledge (i.e., knowledge of technical artefacts as distinct from knowledge of natural objects) it is necessary to develop an epistemology of technical functions. This epistemology has to address the problem of the meaning of the notion of function. In the dominant interpretations, functions are considered to be dispositions, comparable to physical dispositions such as fragility and solubility. It is argued that this conception of functions is principally (...) flawed. With the help of Carnap’s analysis of dispositional terms it is shown that there is a fundamental difference between physical dispositional terms and functional dispositional terms. This difference concerns the issue of the normativity; with regard to functional dispositions, it makes sense to construct normative statements of a particular kind, with regard to physical dispositions it does not. (shrink)

Jennifer Radden argues that delusions play an important role in modernist epistemology, which is preoccupied with the justification and evaluation of beliefs. Another theme running through the book is the importance of culture for attribution of delusion. Beliefs that look delusional will not be treated as pathological if they are expressions of religious views or other culturally acceptable forms of life. It is hard to see why cultural acceptability should play a role in the modernist project of justification. I suggest (...) that we think less about a philosophical project of justification and turn our attention instead to commonsense judgements of the circumstances in which we see a belief as evidence of underlying pathology. I discuss cases in which unjustified beliefs are nonetheless treated as phenomena that are consistent with our views of how healthy human beings act, and suggest that alongside folk psychology we should acknowledge a folk epistemology that embraces such instances. I suggest that delusions are beliefs that folk epistemology treats as inexplicable, and that this approach solves some of the puzzles that Radden identifies as growing out of the modernist epistemic project. (shrink)

In response to the looming environmental crisis, many have recommended lists of environmental virtues. As a result, environmental ethics has been enriched by new virtue terms, such as ecological sensitivity or kinship with nature, and with new applications of older terms, such as benevolence or care. But how do we know which of these are genuine virtues? Although this question is important, it is difficult to answer for two reasons. First, we might think of 'nature' in a variety of ways, (...) each of which presupposes ethical beliefs about the relationship between humans and the nonhuman world. Second, environmental virtue terms seem far less clear than our more familiar virtues, which calls into question both their intelligibility and usefulness as normative concepts. I respond to both problems by considering the environmental virtue of care for nature, and one plausible examplar of this quality, US nature writer and conservationist Rachel Carson. I claim that Carson's example illuminates this virtue, and that care for nature is one environmental virtue we have reason to recognise. While this account might seem vulnerable to a kind of relativism stemming from particular conceptions of nature, I claim that the threat of cultural variation need not shake our reflective confidence in recognising some ways of thinking about nature as excellent. (shrink)

Imagine that we are considering whether our healthcare system (or insurer) should fund treatment or procedure X. One factor that may be cited is that of so-called ‘medical necessity’. The claim would be that treatment X should be eligible for funding if it is medically necessary, but ineligible if this does not apply. Similarly, (and relevant to the debates in this special issue), if considering whether a particular treatment should be ethically and/or legally permitted, we may wish to distinguish between (...) cases where the treatment is medically necessary, and those were it is not. But what do we mean by this concept? Here I will propose and briefly defend one plausible and practical definition. (shrink)

Who should decide how a machine will decide what to do when it is driving a car, performing a medical procedure, or, more generally, when it is facing any kind of morally laden decision? More and more, machines are making complex decisions with a considerable level of autonomy. We should be much more preoccupied by this problem than we currently are. After a series of preliminary remarks, this paper will go over four possible answers to the question raised above. First, (...) we may claim that it is the maker of a machine that gets to decide how it will behave in morally laden scenarios. Second, we may claim that the users of a machine should decide. Third, that decision may have to be made collectively or, fourth, by other machines built for this special purpose. The paper argues that each of these approaches suffers from its own shortcomings, and it concludes by showing, among other things, which approaches should be emphasized for different types of machines, situations, and/or morally laden decisions. (shrink)

Jerry Fodor has argued that a modular mind must include central systems responsible for updating beliefs, and has defended this position by appealing to shared properties of belief fixation and scientific confirmation. Peter Carruthers and Stephen Pinker have attacked this analogy between science and ordinary inference. I examine their arguments and show that they fail. This does not show that Fodor's more general position is correct.

It is widely assumed that science is the enemy of religious faith. The idea is so pervasive that entire industries of religious apologetics converge around the challenge of Darwin, evolution, and the "secular worldview." This book challenges such assumptions by proposing a different cause of unbelief in the West: the Christian conscience. Tracing a history of doubt and unbelief from the Reformation to the age of Darwin and Karl Marx, Dominic Erdozain argues that the most powerful solvents of religious orthodoxy (...) have been concepts of moral equity and personal freedom generated by Christianity itself. Revealing links between the radical Reformation and early modern philosophers such as Baruch Spinoza and Pierre Bayle, Erdozain demonstrates that the dynamism of the Enlightenment, including the very concept of "natural reason" espoused by philosophers such as Voltaire, was rooted in Christian ethics and spirituality. The final chapters explore similar themes in the era of Darwin and Marx, showing how moral revolt preceded and transcended the challenges of evolution and "scientific materialism" in the unseating of religious belief. The picture that emerges is not of a secular challenge to religious faith, but a series of theological insurrections against divisive accounts of Christian orthodoxy. (shrink)

BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)

Civilization is often equated with the story of human advancement and progress. Yet it is also the story of human oppression, exploitation, war, and empire. In our own time, modern global civilization has brought us to the brink of planetary destruction. By offering an understanding of our past, this book aims to provide a stimulus to considering a different future. Our Shadowed World considers how we have been brought to this point. It describes how the fragmented and conflicted state of (...) humanity has "progressed" from the earliest city-states to the devastation of world war and holocaust--how civilization has brought its own form of savagery. What beliefs have underlain and motivated human action? How have humans tried to understand their world? Driven by the relentless quest for power, by greed, and by extreme beliefs, the human enterprise today has placed the very idea of civilization under threat, the subject of radical questioning. Despite a new ecological awareness dedicated to saving the planet from civilization's carelessness, and a preoccupation with the nature of apocalyptic thinking, a question mark looms over the very survival of humanity in its present state--a question mark that now overshadows the world. (shrink)

Jerry Fodor has argued that a modular mind must include central systems responsible for updating beliefs, and has defended this position by appealing to shared properties of belief fixation and scientific confirmation. Peter Carruthers and Stephen Pinker have attacked this analogy between science and ordinary inference. I examine their arguments and show that they fail. This does not show that Fodor’s more general position is correct.

The belief in innate knowledge has a history almost as long as that of philosophy itself. In our own century it has been propounded in a linguistic context by Chomsky, who sees himself as the heir to a tradition including such philosophers as Descartes, the Cambridge Platonists and Leibniz. But the ancestor of all these is, of course, Plato's theory of recollection or anamnesis. This stands out as unique among all other innatist theses not simply because it was the first, (...) but also because it is in some respects the strangest: Plato proposed not just a theory of innate knowledge, but of forgotten knowledge, and this, of course, goes hand in hand with his interest in the pre-existence of the soul. But my concern here is with another difference that makes Plato's theory unique, though it is not as clear as the previous one: in fact it has been for the most part over-looked by commentators and scholars. I wish to argue that while other theories of innate knowledge or ideas hold that much of what is innate in us is realized automatically and with ease, be it knowledge of moral principles, the idea of cause and effect or linguistic competence, anamnesis is concerned only with the attainment of hard philosophical knowledge, which most of us never reach. (shrink)

What exactly is the human element separating humans from animals and machines? The common answers that immediately come to mind—like art, empathy, or technology—fall apart under close inspection. Dominic Pettman argues that it is a mistake to define such rigid distinctions in the first place, and the most decisive “human error” may be the ingrained impulse to understand ourselves primarily in contrast to our other worldly companions. In _Human Error_, Pettman describes the three sides of the cybernetic triangle—human, animal, and (...) machine—as a rubric for understanding key figures, texts, and sites where our species-being is either reinforced or challenged by our relationship to our own narcissistic technologies. Consequently, species-being has become a matter of _specious_-being, in which the idea of humanity is not only a case of mistaken identity but indeed the mistake of identity. _Human Error_ boldly insists on the necessity of relinquishing our anthropomorphism but also on the extreme difficulty of doing so, given how deeply this attitude is bound with all our other most cherished beliefs about forms of life. (shrink)

There is a popular conception among many Zeitgeist watchers, especially in places like the US, Western Europe and Australia, of the urbanized East as existing somehow further into the future. As William Gibson once stated: `The future is here; it just isn't equally distributed yet.' This kind of cultural fetishism extends to not only technolust, but the practices that new gadgets and electronics encourage. The specific phenomenon explored in this article is that of virtual girlfriends and boyfriends: whether in the (...) form of avatars or automated SMS text messages. This particularly Japanese `craze', if we can call it that, fascinates and appals people who still hold P2P romance IRL in high-esteem. It seems like an insult to the intrinsically human and humanist discourse of courtship; and indeed it is. How does this perspective change, however, if we consider `love' as a technology? That is, as both a code with its own algorithmic parameters, and a discourse that also challenges the hyper-rational assumptions of the `merely machinic'. Extending the argument articulated in my book, Love and Other Technologies, this article asks how the emergence of virtual dating and other techno-inflected treatments of romance are working to undo our jealously held notions of intimacy and identity. It concludes that all sex can be considered cybersex, given the communication flows that occur both before, during and after the act. For, as we continue to enframe the discourse of intimacy via new and mobile media, we find it increasingly difficult to deny that intensified inter-subjectivity is always already a matter of technics. Indeed, what Heidegger says of modern technology can effectively be applied to modern love: that it embodies an `unreasonable demand' of nature (and thus has the capacity to reveal something essential about the posthuman condition). (shrink)

Lisa Bortolotti argues convincingly that opponents of the doxastic view of delusion are committed to unnecessarily stringent standards for belief attribution. Folk psychology recognises many non-rational ways in which beliefs can be caused, and our attributions of delusions may be guided by a sense that delusions are beliefs that we cannot explain in any folk psychological terms.

Aesthetic appreciation involves background belief. While some appreciations are adequate when these beliefs are false, there is an important class of beliefs -- beliefs about the nature art work kinds -- whose truth is required for adequate appreciation. Photography is an interesting case, since many of our beliefs about it are false.

This thesis investigates Hume’s philosophy of external existence in relation to, and within the context of, his philosophy of scepticism. In his two main works on metaphysics – A Treatise of Human Nature (1739–40) and the first Enquiry (first ed. 1748) – Hume encounters a predicament pertaining to the unreflective, ‘vulgar’ attribution of external existence to mental perceptions and the ‘philosophical’ distinction between perceptions and objects. I argue that we should understand this predicament as follows: the vulgar opinion is our (...) natural and default belief for Hume, but causal reasoning reveals it to be false, and the philosophical alternative is a confabulation that we cannot permanently believe and is devoid of justification. Hume uses the fact that we cannot have a satisfactory account of belief in external existence as a sceptical consideration to motivate his wider philosophical scepticism. Hume’s response to his predicament about external existence is found in the context of his confrontation with other sceptical worries (Treatise 1.4.7 and Enquiry 12), in which Hume also reflects generally on the nature and implications of scepticism. I argue that we should characterise Hume’s position as residually sceptical. This means that, while Hume accepts the unanswerability of some sceptical problems, he denies that it is possible to eradicate all belief as a result (and denies that it is practically useful to even try) and instead uses sceptical problems as a motivation to adopt a moderately sceptical position. While we inevitably return to entertaining the vulgar belief, there is no solution to the sceptical predicament; Hume does not endorse the vulgar belief, or the philosophical system, or indeed any alternative system of the external world that might extinguish the predicament. Sceptical doubt, for Hume, does not derail intellectual pursuits, but rather modifies our attitudes in those very pursuits. (shrink)

I take up the challenge of whyfalsebeliefs are better than “cautious actionpolicies” (target article, sect. 9) in navigating adaptive problems with asymmetric errors. I then suggest that there areinteractionsbetween supernatural beliefs, self-deception, and positive illusions, rendering elements of all such misbeliefs adaptive. Finally, I argue that supernatural beliefs cannot be rejected as adaptive simply because recent experiments are inconclusive. The great costs of religion betray its even greater adaptive benefits – we just have not yet nailed down exactly what they (...) are. (shrink)

Feminists have argued that oppressive socialization undermines the liberal model of autonomy. We contend that this argument can also be employed effectively as a challenge to the standard bioethical model of informed consent. We claim that the standard model is inadequate because it relies on presumptions of procedural autonomy and rational choice that overlook the problem of how agents are often socialized so that they adopt and internalize oppressive norms as part of their motivational structure. The argument that oppressive socialization (...) undermines liberalism’s view of autonomy is most relevant to what Beauchamp and Childress call the threshold elements of informed consent—competence and voluntariness. We show how these elements fail to account for morally relevant factors such as oppressive socialization. (shrink)

Feminists have argued that oppressive socialization undermines the liberal model of autonomy. We contend that this argument can also be employed effectively as a challenge to the standard bioethical model of informed consent. We claim that the standard model is inadequate because it relies on presumptions of procedural autonomy and rational choice that overlook the problem of how agents are often socialized so that they adopt and internalize oppressive norms as part of their motivational structure. The argument that oppressive socialization (...) undermines liberalism’s view of autonomy is most relevant to what Beauchamp and Childress call the threshold elements of informed consent—competence and voluntariness. We show how these elements fail to account for morally relevant factors such as oppressive socialization. (shrink)

The theory that photographs are images made by belief‐independent feature‐tracking is not a philosopher's invention. It gives concise, precise, and unifying expression to an assemblage of ideas about photography with a long and influential history. Traditional theory ironically flubs the line between photography and drawing precisely because it attempts to put them in opposition to each other. Photographs made by drawing can have a special significance because they originate in richly embodied action with a distinctive expressive character. Making marks by (...) printing has different expressive resources. Photography avails itself of the expressive power of printing and drawing too. The new theory of photography prevails over the traditional theory if it helps to make sense of how the authors use photographs in art and communication. The traditional theory was developed partly in order to explain photographs’ special epistemic power. (shrink)

The critic Dominic Eichler recently described some abstract photographs by Wolfgang Tillmans as exposing a forgotten reservoir of unseen pictures, a kind of mysterious, enormous underbelly of photography past and present. Modernist period abstract photography shared the ambition of the classic tradition to open up a window into a hitherto unseen reality. Photography's having made realistic depiction a trivial achievement, painters tacked toward an exploration of light and form. The effects of this new direction first made their mark on figurative (...) painting. A tonic dose of methodological skepticism remedies the sidelining of abstract photography. Abstract photographs are images that depict by belief‐independent feature tracking, reveal little of interest about the visual world, and communicate no special thoughts. The grip of the representational theory of art has been most tenacious when it comes to photography, because it has seemed entangled with the traditional theory of photography. (shrink)

Photography is probably the first art to have developed alongside and in tandem with systematic thinking about its nature. Photography theory has always been implicated in photographic creativity and appreciation. Methodological skepticism treats the skeptic's argument as a tool by taking it seriously in a rather special way. In this chapter, philosophy has been used to bring out some hidden structures in the thinking that obscure photography's range of powers. A second art of photography, exemplified by some important art made (...) since the 1980s, stands up to the assumption that thoughts cannot be expressed where there is depiction by belief‐independent feature‐tracking. Lyric photography is our third art, which questions whether photography is depiction by belief‐independent feature‐tracking, and which conceives photography as means of fashioning marked surfaces from recording events. Finally, since art need not be representational, a fourth art of photography foregrounds form over content. (shrink)

This chapter uses the patterns of inference that the authors find in the history to understand how photography can be practiced as an art. The history contains the makings of some sophisticated reasoning for the skeptical claim that photography is not an art. The argument for skepticism about photographic art brings on questions about the nature of photography and when it is an art. Purity is a tool designed to sharpen the question of whether photographs can be works of art (...) by nature. The nature of photography is depiction by belief‐independent feature‐tracking. Belief‐independent feature‐tracking is incompatible with depictively expressed thought. Photography is a signaling system wherein individual photographs are cues to the appearance of depicted scenes. Drawing is another signaling system of the same type, since drawings also cue the appearance of depicted scenes. Unlike drawings, though, photographs are reliably honest signals. (shrink)

Having been invented by scientists, who first saw it as a new tool of inquiry and only later began to suspect the possibility of photographic art, photography's special epistemic character has dominated thinking about its nature. Photographs are introduced as evidence in scientific reports, journalism, and courts of law. They can also be used to make discoveries. According to the new theory of photography, a photograph is a product of a photographic process where an artifactual image is rendered from a (...) photographic event that records information in a light image of a pro‐photographic scene. One class of photographic practices is epistemic, centering on norms that restrict the photographic process in order to ensure belief‐independent feature‐tracking. For historical reasons, this restricted conception of photography dominated both the design of the technology and its use. It would be perfectly accurate to call the epistemically centered practice as standard photography. (shrink)

Huang and colleagues provide some intriguing insights into the attitudes about end of life care of practising Taiwanese neonatal doctors and nurses.1 There are some similarities with surveys from other parts of the world. Most Taiwanese neonatologists and nurses agreed that it was potentially appropriate to withhold or limit treatment for infants who were dying. A very high proportion was opposed to active euthanasia of such infants. But there were also some striking differences. Only 21% of Taiwanese doctors ‘agreed’ with (...) withdrawal of mechanical ventilation for dying newborn infants. This proportion is lower than reported in any European country.2 More than 90% of neonatologists surveyed in the UK, the USA, The Netherlands and Sweden found withdrawal of mechanical ventilation acceptable.2 ,3 Taiwanese doctors also seemed reluctant to give analgesia or sedatives to such infants, with almost 60% disagreeing with their use in dying infants where there was a risk of hastening death.1 In contrast, two-thirds or more of European neonatologists thought this was acceptable .2The results of the survey of Huang et al highlight three beliefs about end-of-life care that are widespread, but all of which are seriously mistaken1. None are new, but …. (shrink)

Proponents of deliberative democracy believe deliberation provides the best chance of finding effective and legitimate climate policies. However, in many societies there is substantial evidence of biased cognition and polarisation about climate change. Further, many appear unable to distinguish reliable scientific information from false claims or misinformation. While deliberation significantly reduces polarisation about climate change, and can even increase the provision of reliable beliefs, these benefits are difficult to scale up, and are slow to affect whole societies. In response, I (...) propose a combined strategy of ‘thinking and nudging’. While deliberative theorists tend to view nudging askance, combining deliberation with nudges promises to be a timelier and more effective response to climate change than deliberation alone. I outline several proposals to improve societal deliberative capacity while reducing climate risks, including media reform, strategic communication and framing of debates, incentivising pro-climate behaviour change, and better education about science. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Collective Violence and Birthday PartiesA Girardian Analysis of the PiñataDominic Pigneri (bio)The piñata is a tradition most commonly associated with Latin America, but this party game has a mysterious origin. Some suppose that the origin of the practice was brought to the Americas by the Spanish, who received the custom from the Italians.1 Some say that the Italians, through Marco Polo, appropriated the ritual from the Chinese.2 Others see (...) the Mexican piñata as originating locally in an Aztec religious ritual.3 But looking at this festival activity through a Girardian lens we can see that wherever a custom came into being, it seems that its origins lie in the lethal practice of collective violence. The following description may serve as an exemplar of the tradition:In Mexico, a plain, round clay cooking pot called an olla is decorated and finally almost entirely concealed by ruffles and streamer coverings shaped into animals, stars, etc. It is filled with nuts, sugar cane, fruits and small toys and is hung overhead from a rope. One participant in the game is blindfolded and given a long stick with which he or she tries to hit the pot. Several people (usually children) take turns at being blindfolded and swinging the stick, and finally when someone hits the pot [End Page 209] hard enough to break it, the other players scramble on the ground for the scattered prizes. It is a kind of noisy and happy version of a grab-bag, and the game goes on for quite a few minutes, since a controlling cord is used to swing the pot out of reach of the batters. There are several sing-song chants which the children say as the game goes on with each new target.4While the clay pot is the most traditional, piñatas are also made from other materials, including papier-mâché and cane plants.5 Furthermore, the piñata has a place in many different festivals; it is especially associated with Christmas, Easter, and birthday parties all over the Americas where there is a Latin influence.While the ritual of the piñata contains no explicit violence, the ritual itself contains many of the elements of the scapegoat mechanism René Girard describes in Violence and the Sacred. What Girard describes here is the banding together of society as they focus their internal animosity onto an arbitrary third-party victim. The peace that arrives after this violence is so profound that it is instinctually associated with the divine. This peace inspires a reenactment of this violence as a religious ritual. Therefore, religion functions as the force that keeps internal violence from turning all members of a society against one another. This controlled violence is the safety valve that releases the violence that would otherwise rend the social fabric of a community.6 Religion also veils the violence, which grants peace. It is important that the violence be expressed, but also hidden. Girard says, "Men cannot confront the naked truth of their own violence without the risk of abandoning themselves to it entirely. They have never had a very clear idea of this violence, and it is possible that the survival of all human societies of the past was dependent on this fundamental lack of understanding."7 This is the significance of the ritualism of cultic sacrifice.This relates to our current question of the piñata in the sense that the practice is reminiscent of a sacrificial ritual, especially when the piñata takes the shape of a being like an animal or human person. First, destruction is the initial aim of the activity. The piñata, like the oblation, must be destroyed in some way. This is what grants the ritual its efficacy. Second, there is a need for rubrics, a carefully followed procedure for the desired effect to come about. In cultic sacrifice, this can take place in a variety of ways, from ritualistic washing of the priest and the victim to the exact procedure and order for dissecting the victim. Similarly, as we saw in the description of the piñata above, there is a procedure. The piñata is... (shrink)

Who were the true forerunners of the seventeenth-century theorists of innate ideas? Credit should go, not to Plato, despite the common label Platonist, but to the Stoics—or so this challenging new study claims. Plato’s celebrated doctrine of knowledge as recollection differed from these others’ theories not merely in its extravagant postulate of a prenatal knowing state but in many hitherto unrecognized ways, Scott argues. Among those who shared the belief that all men are endowed at birth with considerable epistemological resources, (...) Plato alone is a pessimist both about how few of us make any use of these—only those who make philosophical progress—and about the difficulty of unearthing these resources. Contrary to a prevalent view, Scott holds that Plato invokes recollection to explain not “ordinary learning,” the acquisition or application of everyday concepts such as equality or beauty, but “higher learning”—the province of the philosopher. (shrink)

This essay explores the unique perspective of medical students regarding the ethical challenges of providing full disclosure to patients and their families when medical mistakes are made, especially when such mistakes lead to tragic outcomes. This narrative underscores core precepts of the healing profession, challenging the health care team to be open and truthful, even when doing so is uncomfortable. This account also reminds us that nonabandonment is an obligation that assumes accountability for one’s actions in the healing relationship and (...) that apologizing for mistakes can serve to heal. It argues that even medical students have an obligation to speak up when actions violate their moral beliefs, even if this means confronting a superior. Ethical principles cannot be abandoned in fear of adverse evaluation or failure to conform. Healthcare workers have an obligation to address mistakes made around the time of a patient’s death with the patient’s family. This responsibility trumps any selfish desire to avoid unpleasant feelings of guilt or regret. Such events often bring closure to already anguished relatives and spouses, and may help to facilitate the grieving process. This includes pressing forward the need to apologize to patients and/or their families when mistakes are made and when decisions are made that lead to poor outcomes for the patient, even when benevolently intended. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Autonomy, Experience, and TherapyDominic Murphy (bio)The contemporary philosophical idea of autonomy has a psychological implication, to wit, that there exists a comprehensive set of ideal competences, realized in our mind/brain, that enable a person to be self-governing. Autonomy is normally accorded individuals who enjoy a certain kind of psychological functioning and, perhaps, a certain sort of psychological history (Christman 1991). We think that autonomous individuals critically evaluate their life (...) and actions, endorse them as self-determined rather than imposed from without, and guide their own lives in accordance with the plans and values they have worked out for themselves. Such self-government has to depend on some psychological structures, but philosophers have tended to theorize about what these structures might be at a considerable distance from what the behavioral sciences can tell us. Anderson and Lux's paper is a welcome contribution to the growing literature that tries to connect issues in ethics with empirical considerations. This sort of methodological, as opposed to merely metaphysical, naturalism, is only just coming into vogue in ethics, even in moral psychology.1 Anderson and Lux are, as far as I am aware, the first people to reflect seriously on what we can learn about autonomy from clinical experience. Theirs is a very suggestive and fruitful paper that looks at real-life cases of loss of autonomy and tries to reach conclusions about what the deficits in performance tell us about the psychological preconditions of autonomy. Their paper also opens the way for an investigation into the precise neurologic and computational underpinnings of these capacities, which is essential if we are to get a serious moral psychology underway.I find little to quarrel with in the story that Anderson and Lux tell, but I will try to modify it slightly to bring out what I think is the important psychological point they make and explore some ramifications. I begin by claiming that they have scored a decisive point in favor of an external conception of autonomy. Second, I suggest that what Anderson and Lux have really put their finger on is less a requirement of accurate self-assessment than a requirement of sensitivity to feedback from the environment. I conclude by raising some of these issues about the relations between autonomy and assessments of psychological function when the deficit responsible is less amenable to clear cut neurologic identification.The External Perspective on AutonomyOne way of taking the paper (although this goes beyond anything that Anderson and Lux suggest) is that there is a smooth naturalistic picture of the cognitive basis of autonomy. When people have a normally functioning neurocomputational setup in their heads, we should assume that they are autonomous, and vice versa. However, autonomy cannot simply be identifiable with a mind that is working as some scientific theory says it should, because a mind that is [End Page 303] in that sense working correctly could, nonetheless, be directed by forces other than the agent. Servile or deluded individuals might endorse their lives even if those lives are the product of indoctrination, self-deception, or internalized oppression (Mackinnon 1997; Mele 1995). Normal mechanisms of belief fixation, for example, may not foster one's autonomy if the only context in which they are exercised is one in which many possible ways of life are simply unavailable for consideration, having been excluded from consideration by the dominant forces around one. We might, then, think of full autonomy as depending on relational rather than intrinsic properties. Perhaps autonomy requires a subject to have both normal psychological capacities and the right sort of environment in which to exercise them. I do not follow-up on this suggestion, but I mention it because it introduces two dimensions, within the subject and around the subject, where the externalist perspective on autonomy can get a grip. I discuss the former, but I do not mean to suggest that the latter is not important. A full account must deal with both. But even the psychological structures that foster autonomy cannot be identified with a mind working according to some scientific theory, as we shall see.Many writers on autonomy argue that we must recognize appropriate, objective constraints... (shrink)

Vast research has sought to better understand the origins and development of rape myth beliefs given the problematic influence of such misconceptions throughout global societies and criminal justice pathways. The current research aims to build on this body of literature by examining the contribution that psychopathic personality traits (affective responsiveness, cognitive responsiveness, interpersonal manipulation, egocentricity) and emotional intelligence may have upon rape myth beliefs. Furthermore, this study will investigate the extent to which sociodemographic characteristics (age, gender, ethnicity, education), and prior (...) experience of sexual victimisation, contribute to variance in rape myth acceptance scores. In total 251 participants (M Age = 31.66) completed an online, self-report questionnaire which included contemporary measures of psychopathy and rape myth acceptance, never previously tested in combination. Results of a hierarchical multiple regression analysis indicate that egocentricity, age, and gender were significantly associated with rape myth beliefs. Emotional intelligence, as well as affective and interpersonal traits of psychopathy, were not directly related with rape mythology. Findings are interpreted alongside previous research, where we suggest there is an urgent need for larger, nationally representative samples, systematically recruited from the general population to help clarify uncertainty in existing literature emerging from small-scale opportunistic datasets. (shrink)

Knowledge of the structure of the cosmos, Plato suggests, is important in organizing a human community which aims at happiness. This book investigates this theme in Plato's later works, the Timaeus, Statesman, and Laws. Dominic J. O'Meara proposes fresh readings of these texts, starting from the religious festivals and technical and artistic skills in the context of which Plato elaborates his cosmological and political theories, for example the Greek architect's use of models as applied by Plato in describing the (...) making of the world. O'Meara gives an account of the model of which Plato's world is an image; of the mathematics used in producing the world; and of the relation between the cosmic model and the political science and legislation involved in designing a model state in the Laws. Non-specialist scholars and students will be able to access and profit from the book. (shrink)

Background: Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students’ experiences during the first (...) semester of an undergraduate problem-based learning medical program at an African medical school. Method: We employed a qualitative case study approach using in-depth interviews with 23 first-year medical students. Participants ranged in age from 18 to 25 years. All students were bi/multilingual (some spoke three to five languages), with English as the learning language. We conducted an inductive thematic analysis to systematically identify and analyze patterns in the data using the Braun and Clarke framework. Results: Before medical school, students worked hard to compete for admission to medical school, were primarily taught using a teacher-centered approach, and preferred working alone. At the beginning of medical school, students found it challenging to understand the problem-based learning process, the role of the case, speaking and working effectively in a group, managing a heavy workload, and taking increased responsibility for their learning. By the end of the first semester, most students were handling the workload better, were more comfortable with their peers and facilitators, and appreciated the value of the problem-based learning approach. Conclusions: Our study highlights the importance of interrogating contextual sociocultural factors that could cause tension when implementing problem-based learning in non-western medical schools. Adjustment to problem-based learning requires a conceptual and pedagogic shift towards learner-centered practice, particularly concerning self direction, the role of the case, and collaborative learning. As such, there is a need to develop and implement research informed learning development programs that enable students to reflect on their sociocultural beliefs and practices, and enhance their regulatory learning competence to optimize meaningful and early engagement with the problem based learning process. (shrink)

Catholic integralism is a tradition of thought which insists upon the ideal nature of political arrangements on which the Church can mandate the State to advance the supernatural good of the baptized. Thomas Pink, one of the foremost defenders, has proposed controversially that these arrangements are ideal because the Church possesses rights to civil coercive authority. But I argue this fact would not entail – by itself – the ideal nature of those arrangements. To the contrary, I argue that integralism (...) is unjust, even assuming Pink’s claims are true. The integralist ideal necessarily involves violating moral duties toward unbaptized citizens. Integralism does so in imposing differential civic burdens upon baptized/unbaptized citizens and in implying that non-Catholics might be rightly excluded from power merely on account of religious beliefs, both without just cause. I conclude by showing that readings of the relevant Catholic teaching can be given which are non-integralist. (shrink)

Perception of a property (e.g. a colour, a shape, a size) can enable thought about the property, while at the same time misleading the subject as to what the property is like. This long-overlooked claim parallels a more familiar observation concerning perception-based thought about objects, namely that perception can enable a subject to think about an object while at the same time misleading her as to what the object is like. I defend the overlooked claim, and then use it to (...) generate a challenge for a standard way of thinking about the relationship between visual experience and rational belief formation. Put informally, that view holds that just as we can mislead others by saying something false, illusory experience misleads by misrepresenting how things stand in the world. I argue that we ought to abandon this view in favour of some radical alternative account of the relationship between visual experience and rational belief formation. (shrink)

Pautz has argued that the most prominent naive realist account of hallucination—negative epistemic disjunctivism—cannot explain how hallucinations enable us to form beliefs about perceptually presented properties. He takes this as grounds to reject both negative epistemic disjunctivism and naive realism. Our aims are two: First, to show that this objection is dialectically ineffective against naive realism, and second, to draw morals from the failure of this objection for the dispute over the nature of perceptual experience at large.

One way in which the practice of inclusion can be actualised in classrooms is through the use of consistent, appropriate differentiated instruction. What remains elusive, however, is insight into what teachers in different contexts think and believe about differentiation, how consistently they differentiate instruction and what challenges they experience in doing so. In the study reported on here high school classrooms in a private and a government school in Lesotho were compared in order to determine teachers’ thoughts and beliefs about (...) differentiation, the frequency of differentiated instruction, and the challenges faced by teachers who implement this inclusive practice. Sampled teachers offered their views on what they understood differentiated instruction to be, the frequency of differentiated instruction, and identified challenges via an administered questionnaire. Data analysis was based on frequency counts and bar charts for comparative purposes. Findings indicate that private school teachers have a higher frequency of differentiated teaching practice, with time constraints indicated as the main challenge. Government school teachers had a lower frequency of differentiation, and identified a lack of resources, and the learner-teacher ratio as challenges, among others. In the study we highlighted the critical role that private schools can play in the national call for the implementation of inclusive teaching in Lesotho, in terms of active collaboration with surrounding government schools. Private schools, with their resources and access to professional development opportunities, can become catalysts in the implementation of inclusive teaching practices. (shrink)

Will the ecological crises of our time be resolved using the same form of thought that has brought them about? Are technological prowess and political power the proper tools to address them? Is there not a deeper connection between our ecological crises and our human, social, political, economic, and ethical crises? This book argues that the popular approaches to ecological, bioethical, and other human crises are not working because they fail to examine the problem in its full depth. This depth (...) escapes us because we have abandoned true metaphysical reflection on the whole and substituted it unknowingly for a series of inadequate alternatives. Both the technocratic paradigm that views all of nature mechanistically and its antagonists--the eco-philosophies that argue for the realities of intrinsic value, relationality, and beauty--carry partial truths but are insufficient. This book presents a more radical alternative, rooted in the classical tradition yet fresh and vibrant. The metaphysics of gift, based in the giftedness of existence shared by all, offers a deeper and more satisfying vision of all things that can transform our relationship with nature and touches every aspect of human life: social, political, economic, technical, and ethical"-- Back cover. (shrink)

Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of (...) ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients’ access to the relevant procedural information and therefore enhance informed decision-making.In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices. (shrink)

Our awareness of the boundedness of the spatial sensory field—a paradigmatic structural feature of visual experience—possesses a distinctive epistemic role. Properly understood, this result undermines a widely assumed picture of how visual experience permits us to learn about the world. This paper defends an alternative picture in which visual experience provides at least two kinds of non-inferential justification for beliefs about the external world. Accommodating this justification in turn requires recognising a new way for visual experience to encode information about (...) the world. Reflection upon the epistemic contribution of sensory experience's structural features thus forces us to revise our understanding of how perception, cognition, and the world fit together. (shrink)

This article investigates some of the constraining factors experienced by 16 school-going mothers in the Okalongo circuit, Namibia. This was a qualitative phenomenological study, conducted through in-depth individual interviews, focus group discussions, and reflective journals with 16 school-going mothers between the ages of 17 and 20, purposively selected from three different public rural schools. This qualitative, phenomenological study analyses, through feminist and intersectionality theory, the lived experiences of these young mothers as they encounter the traditional, patriarchal attitudes and practices of (...) the Ovambadja community because these girls fell pregnant before their formal, cultural initiation. The article documents, through the voices of the young women themselves, the numerous constraints they experienced and overcame in their determination to complete their schooling. The findings show that, aside from the deeply held destructive patriarchal beliefs that significantly constrain and harm the mother-learners, the Namibian Learners Pregnancy Policy, which is intended to protect and ensure pregnant learners and motherlearners complete their schooling, is not being properly or effectively implemented. The study recommends an increase in efforts at the national level in Namibia to raise awareness among members of parliament, school administrators and principals, and all policymakers to develop better monitoring systems that will improve policy implementation in schools. (shrink)

In late February and early March 2020, Italy became the European epicenter of the COVID-19 pandemic. Despite increasingly stringent containment measures enforced by the government, the health system faced an enormous pressure, and extraordinary efforts were made in order to increase overall hospital beds’ availability and especially ICU capacity. Nevertheless, the hardest-hit hospitals in Northern Italy experienced a shortage of ICU beds and resources that led to hard allocating choices. At the beginning of March 2020, the Italian Society of Anesthesia, (...) Analgesia, Resuscitation, and Intensive Care issued recommendations aimed at supporting physicians in prioritizing patients when the number of critically ill patients overwhelm the capacity of ICUs. One motivating concern for the SIAARTI guidance was that, if no balanced and consistent allocation procedures were applied to prioritize patients, there would be a concrete risk for unfair choices, and that the prevalent “first come, first served” principle would lead to many avoidable deaths. Among the drivers of decision for admission to ICUs, age, comorbidities, and preexisting functional status were included. The recommendations were criticized as ageist and potentially discriminatory against elderly patients. Looking forward to the next steps, the Italian experience can be relevant to other parts of the world that are yet to see a significant surge of COVID-19: the need for transparent triage criteria and commonly shared values give the Italian recommendations even greater legitimacy. (shrink)

This book proposes a reexamination of ancient skepticism with the purpose of both throwing new light on ancient skepticism and contributing to modern epistemological debate. The author hopes to achieve these goals by approaching the ancient texts with a more developed philosophical viewpoint than is found in much historical scholarship, and by showing how the account of ancient skepticism thus achieved is philosophically superior in various ways to modern versions of skepticism. He interprets ancient skepticism as being essentially directed against (...) "realist truth," that is, against the theory that "a claim is true if it corresponds to an objective world that exists independently of the mind". Ancient skepticism is therefore antirealist: it is a mitigated form of skepticism which admits an antirealist conception of truth, "arguing that our beliefs are necessarily relative to human nature and perception, the culture we live in, philosophical commitments, and so on". Ancient skeptics are thus much nearer to modern antirealists than would be the case if their skepticism were unmitigated, as is frequently claimed in modern work on ancient skepticism. Interpreted as antirealism, ancient skepticism turns out to present certain philosophical advantages as compared to modern forms of antirealism. (shrink)

BackgroundObtaining informed consent for participation in genomic research in low-income settings presents specific ethical issues requiring attention. These include the challenges that arise when providing information about unfamiliar and technical research methods, the implications of complicated infrastructure and data sharing requirements, and the potential consequences of future research with samples and data. This study investigated researchers’ and participants’ parents’ experiences of a consent process and understandings of a genome-wide association study of malaria involving children aged five and under in (...) Mali. It aimed to inform best practices in recruiting participants into genomic research.MethodsA qualitative rapid ethical assessment was undertaken. Fifty-five semi-structured interviews were conducted with the parents of research participants. An additional nine semi-structured interviews were conducted with senior research scientists, research assistants and with a member of an ethics committee. A focus group with five parents of research participants and direct observations of four consent processes were also conducted. French and translated English transcripts were descriptively and thematically coded using OpenCode software.ResultsParticipants’ parents in the MalariaGEN study had differing understandings of the causes of malaria, the rationale for collecting blood samples, the purposes of the study and the kinds of information the study would generate. Genomic aspects of the research, including the gene/environment interaction underlying susceptibility or resistance to severe malaria, proved particularly challenging to explain and understand.ConclusionsThis study identifies a number of areas to be addressed in the design of consent processes for genomic research, some of which require careful ethical analysis. These include determining how much information should be provided about differing aspects of the research and how best to promote understandings of genomic research. We conclude that it is important to build capacity in the design and conduct of effective and appropriate consent processes for genomic research in low and middle-income settings. Additionally, consideration should be given to the role of review committees and community consultation activities in protecting the interests of participants in genomic research. (shrink)

For most of the history of prejudice research, negativity has been treated as its emotional and cognitive signature, a conception that continues to dominate work on the topic. By this definition, prejudice occurs when we dislike or derogate members of other groups. Recent research, however, has highlighted the need for a more nuanced and “inclusive” (Eagly 2004) perspective on the role of intergroup emotions and beliefs in sustaining discrimination. On the one hand, several independent lines of research have shown that (...) unequal intergroup relations are often marked by attitudinal complexity, with positive responses such as affection and admiration mingling with negative responses such as contempt and resentment. Simple antipathy is the exception rather than the rule. On the other hand, there is mounting evidence that nurturing bonds of affection between the advantaged and the disadvantaged sometimes entrenches rather than disrupts wider patterns of discrimination. Notably, prejudice reduction interventions may have ironic effects on the political attitudes of the historically disadvantaged, decreasing their perceptions of injustice and willingness to engage in collective action to transform social inequalities.These developments raise a number of important questions. Has the time come to challenge the assumption that negative evaluations are inevitably the cognitive and affective hallmarks of discrimination? Is the orthodox concept of prejudice in danger of side-tracking, if not obstructing, progress towards social justice in a fuller sense? What are the prospects for reconciling a prejudice reduction model of change, designed to get people to like one another more, with a collective action model of change, designed to ignite struggles to achieve intergroup equality? (shrink)