BackgroundJunior medical doctors have a key role in discussions and decisions about treatment and end-of-life care for people with dementia in hospital. Little is known about junior doctors’ decision-making processes when treating people with dementia who have advance care directives, or the factors that influence their decisions. To describe among junior doctors in relation to two hypothetical vignettes involving patients with dementia: their legal compliance and decision-making process related to treatment decisions; the factors influencing their clinical decision-making; and the factors (...) associated with accurate responses to one hypothetical vignette. MethodA cross-sectional survey of junior doctors, including trainees, interns, registrars and residents, on clinical rotation in five public hospitals located in one Australian state. The anonymous, investigator-developed survey was conducted between August 2018 and June 2019. Two hypothetical vignettes describing patients with dementia presenting to hospital with an ACD and either: bacterial pneumonia; or suspected stroke were presented in the survey. Participants were asked to indicate whether they would commence treatment, given the ACD instructions described in each vignette.ResultsOverall, 116 junior doctors responded. In Vignette 1, 58% of respondents selected the legally compliant option. Participants who chose the legally compliant option perceived ‘following patient wishes’ and ‘legal requirements to follow ACDs’ as equally important reasons for complying with the ACD. The most common reason for not selecting the legally compliant option in Vignette 1 was the ‘ACD is relevant in my decision-making process, but other factors are more relevant’. In Vignette 2, 72% of respondents indicated they would commence treatment and 18% selected they would not commence treatment.. Similar reasons influenced participant decision-making in Vignette 2, a less legally certain scenario.ConclusionsThere are critical gaps in junior doctors’ compliance with the law as it relates to the implementation of ACDs. Despite there being differences in relation to the legal answer and its certainty, clinical and ethical factors guided decision-making over and above the law in both vignettes. More education and training to guide junior doctors’ clinical decision-making and ensure compliance with the law is required. (shrink)

Marine ecosystems are under increasing pressure from human activity, yet successful management relies on knowledge. The evidence-based policy (EBP) approach has been promoted on the grounds that it provides greater transparency and consistency by relying on ‘high quality’ information. However, EBP also creates epistemic responsibilities. Decision-making where limited or no empirical evidence exists, such as is often the case in marine systems, creates epistemic obligations for new information acquisition. We argue that philosophical approaches can inform the science-policy interface. Using marine (...) biosecurity examples, we specifically examine the epistemic challenges in the acquisition and acceptance of evidence to inform policy, discussing epistemic due care and biases in consideration of evidence. (shrink)

Public health nursing is grounded in public health ideologies and fundamental nursing values. Researchers have argued that ethical responsibility from the perspective of the nurse is an understudied phenomenon. This meta-ethnography provides in-depth knowledge of how public health nurses (PHNs) experience ethical responsibility when working to prevent injury and disease, and promote health and well-being in children, young people and their families. There are reciprocal findings across the 10 included studies. The findings reveal that these nurses often feel alone, have (...) worries and uncertainties and are afraid of doing wrong. They describe unclear boundaries in their work, creating a heightened sense of responsibility. PHNs fight lonely battles. Yet they show courage and commitment and are ready to stand up and fight for children and families who do not receive adequate care. A line of argument is developed and the metaphorical phrase Chivalrous knights in moral armour is used to express the authors’ overall interpretations of the findings. Reflection on the findings shows how the different dimensions of ethical responsibility are interconnected. The nurses’ ethical sensitivity enables them to feel compassion for others and they show indignation when vulnerable others are not treated with dignity and respect. Indignation and compassion are interrelated, and when human life and dignity are threatened, the ethical demand to respond emerges. Indignation is a precursor to moral courage, and the nurses’ moral sensitivity and respect for their clients emboldens them to stand up for vulnerable others. The findings also illustrate the paradoxical nature of freedom. Freedom of choice due to unclear boundaries heightens the nurses' sense of responsibility. This research is an important step in theory development and has implications for further research, education and practice. (shrink)

Dans la genese de sa constitution, la philosophie n'a pu faire l'economie d'une confrontation avec la musique qui fournissait aux anciens Grecs les schemes fondamentaux de la culture. De cette confrontation Platon est le temoin. Scindant la musique, il privilegie l'Harmonique, qui en est la partie theorique, sans toutefois lui reconnaitre la titre de science supreme. Correlativement, il condamne comme dysharmonie, tumulte fracassant et perturbateur de l'ordre cosmique, l'harmonie chromaticiste dont il s'emploie, non sans paradoxe, a decrire le detail. Par (...) cette lecture en filigrane des Dialogues de Platon, l'auteur se propose de reconstruire la pensee qui procede de l'harmonie chromaticiste et de montrer son importance dans l'elaboration de la philosophie fondatrice. Au carrefour des disciplines du savoir antique, ce livre s'adresse non seulement aux philosophes, mais aussi a tous ceux qui, musiciens ou stylisticiens, s'interessent a la forme musicale. (shrink)

Widely adopted as a textbook, Issues and Alternatives in Educational Philosophy has been a classic in its field for more than a quarter of a century. As a survey of philosophic issues relevent to the educational profession, it highlights the relationship between philosophic starting points and educational outcomes - between theory and practice. -- from back cover.

In this paper, I take a critical look at Sartorio’s book Causation and Free Will (2016). Sartorio offers a rich defence of an actual-sequence view of freedom, which pays close attention to issues in the philosophy of causation and how they relate to freedom. I argue that although this focus on causation is illuminating, Sartorio’s project nevertheless runs into some serious difficulties. Perhaps most worrying amongst them is whether the agent-based reason-sensitivity account, offered by Sartorio, is consistent with Frankfurt-style cases (...) – the very cases which are provided as the sole reason to endorse an actual-sequence view of freedom. I suggest that given that powers and causation are so intimately bound together, the debate is skewed somewhat by thinking of these as rivals. (shrink)

_A portion of the revenue from this book’s sales will be donated to Doctors Without Borders to assist the humanitarian work of nurses, doctors, and other health care providers in the fight against COVID-19 and beyond._ _Concepts and Cases in Nursing Ethics_ is an introduction to contemporary ethical issues in health care, designed especially for Canadian audiences. The book is organized around six key concepts: beneficence, autonomy, truth-telling, confidentiality, justice, and integrity. Each of these concepts is explained and discussed with (...) reference to professional and legal norms. The discussion is then supplemented by case studies that exemplify the relevant concepts and show how each applies in health care and nursing practice. This new fourth edition includes an added chapter on end-of-life issues, and it is revised throughout to reflect the latest developments on topics such as global health ethics, cultural competence, social media, and palliative sedation, as well as ethical issues relating to COVID-19. (shrink)

Nietzsche's opinions on philosophy and aesthetics developed under strong and lasting impulses from classical antiquity. These were not always the same, for at various periods in his life Nietzsche placed Heraclitus, Empedocles, Aeschylus, and even Socrates and Plato on the highest summit of wisdom. In his so-called first stage of development the pre-Socratics were generally his favourite thinkers, and in the third and last stage these same figures tend to come into prominence again. On the other hand, in the works (...) of Nietzsche's second, rationalistic period, when he was particularly influenced by Comte, Voltaire, and Darwin, Socrates and Plato—usually so hated and despised—are mentioned with affection, with gratitude or even with warm enthusiasm; and so, over and over again, is Epicurus. (shrink)

Species are ordinarily conceived of as being native or non-native to either a geographical location or an ecological community. I submit that species may also be native or non-native to human communities. I argue, by way of an analogy with varieties of domesticated and cultivated species, that this sense of nativity is grounded by the cultural relationships human communities have with species. A further analogy is drawn with the motivations of varietal nativists – who seek to protect native varieties of (...) domesticated and cultivated species for the sake of their cultural value – to argue for the consideration of the cultural value of native species in environmental policy decisions regarding invasive non-native species. (shrink)

Concepts and Cases in Nursing Ethics maps the ethical landscape of contemporary nursing. The book is the product of a collaboration between philosopher-ethicist Michael Yeo, nurse-ethicist Anne Moorhouse, and six representatives of various areas of professional nursing. It thus combines philosophical and ethical analysis with nursing knowledge and experience in a manner that is both understandable and relevant. The book is organized around six main concepts in nursing ethics: beneficence, autonomy, confidentiality, truth-telling, justice, and integrity. A chapter is devoted (...) to the elucidation of each of these concepts. In each chapter, historical background and conceptual analysis are supplemented by case studies that exemplify issues and show how the concept applies in nursing practice. In this new edition, the materials in each chapter have been updated to reflect recent developments in nursing and more generally in health care. In addition, a totally new chapter on ethical theory has been added. Complete with bibliographies and study questions for further analysis of cases, this book is ideally suited for textbook use. It will help both practitioners and students to deal better with the clinical problems and issues that are encountered in the field. However, it's simple prose and clear exposition of complex issues will make Concepts and Cases in Nursing Ethics attractive to anyone concerned about health care. (shrink)

Enhancing the usability of the brain, as a more intriguing alloy for interaction design, by employing the Brain Current Interface model (BCIm). Instead of studying interaction design through the angle of cognitive semiotics, where signs and signifiers produce meaning, I propose, in this case, to approach the paradigm of interaction design from a metaphorical angle, as a product of perceptual and intentional consciousness. Through this disposition, I argue, it is possible to approach the hypothesis of bringing together the use of (...) non-invasive brain computer interfaces (BCI) and the field of contemporary neuroscience, especially the role of the chemical modulation on a cellular level of the brain while learning, in order to propose a model for interaction via deliberate attention, that influences cognitive performance and advances well-being of individuals of any age.That which was previously mentally projected, which was lived as a metaphor in the terrestrial habitat is from now on projected entirely without metaphor …. (shrink)

Some theories of goodness are descriptively rich: they have much to say about what makes things good. Neo-Aristotelian accounts, for instance, detail the various features that make a human being, a dog, a bee good relative to facts about those forms of life. Famously, such theories of relative goodness tend to be comparatively poor: they have little or nothing to say about what makes one kind of being better than another kind. Other theories of goodness—those that take there to be (...) absolute goodness—are comparatively rich: they offer grounds for judging some types of things better than others because they have more absolute goodness. Moorean accounts, for example, can tell us that humans and human experiences are superior to bees and blades of grass. But such theories tend to be descriptively poor: they struggle to tell us in virtue of what this is so. In this essay we motivate and flesh out a view that splits the difference between accounts of goodness as relative and accounts of goodness as absolute. Such a view holds promise only if the mechanics of this kind of metaphysics of goodness can be worked out. Here we present a view on which the paradigm for absolute goodness is God and the paradigm for each kind of relative goodness is a divine idea. (shrink)

This book is an intercultural exploration of the full scope of evil. The problems of evil have beset humanity throughout the ages and continue to trouble us. The studies here examine evil in Asian thought, in Western theory, in the cosmic order, in human psychology, and in social practice. Insights are added to the philosophical discussions from religion, culture, history, law, technology, and literature.

La 4ème de couverture indique : "Cet ouvrage, qui réunit juristes, sociologues, anthropologue et psychanalyste, se propose de saisir la place du genre en bioéthique à l'heure de questions sociétales liées tant aux progrès de la médecine reproductive qu'aux rôles assignés aux femmes et aux hommes à l'intérieur de la famille ou en dehors de celle-ci. Il s'agit, au travers de regards croisés, d'éclairer le débat du genre au sein de la sphère bioéthique en identifiant, au sein et au-delà des (...) thèmes de la procréation, de la parentalité et du patrimoine, les questions juridiques qui peuvent naître de la rencontre de la bioéthique et du genre. Les sujets sont nombreux, regroupés autour d'interrogations telles que : le genre est-il reçu dans le droit du vivant? Que font les lois bioéthique au genre? Y a-t-il un âge pour procréer? Existe-t-il une égalité entre les femmes et les hommes en termes d'accès aux soins? Assiste-t-on à une désexualisation du couple? Peut-on parler de patrimoine sexuel?... Éventail d'interrogations, diversité des opinions : les meilleurs spécialistes de chaque question abordée y analysent les réponses fournies par le droit en livrant des pistes de réflexion sur le traitement des inégalités ou des différences existant entre hommes et femmes dans l'exercice, parfois l'existence, des droits et libertés qui sont les leurs en ce domaine.". (shrink)

Many scholars assume a connection between the evolution of language and that of distinctively human group-level morality. Unfortunately, such thinkers frequently downplay a central implication of modern Darwinian theory, which precludes the possibility of innate psychological mechanisms evolving to benefit the group at the expense of the individual. Group level moral regulation is indeed central to public life in all known human communities. The production of speech acts would be impossible without this. The challenge, therefore, is to explain on a (...) Darwinian basis how life could have become subject to the rule of law. Only then will we have an appropriate social framework in which to contextualize our models of how language may have evolved. (shrink)

This article argues that, suitably modified, the method of reflective equilibrium is a plausible way of selecting moral principles. The appropriate conception of the method is wide and radical, admitting consideration of a full range of moral principles and arguments, and requiring the enquiring individual to consider others' views and undergo experiences that may offset any formative biases. The individual is not bound by his initial considered judgments, and may revise his view in any way whatsoever. It is appropriate to (...) describe the method as a balance between coherentism and fallibilist foundationalism. With these points in mind, various criticisms, including the claims that considered judgments are not initially credible and are shaped by prejudice, and that the method itself fails to determine principle selection, are challenged. (shrink)

We offer a topological treatment of scattered theories intended to help to explain the parallelism between, on the one hand, the theorems provable using Descriptive Set Theory by analysis of the space of countable models and, on the other, those provable by studying a tree of theories in a hierarchy of fragments of infinintary logic. We state some theorems which are, we hope, a step on the road to fully understanding counterexamples to Vaught's Conjecture. This framework is in the early (...) stages of development, and one area for future exploration is the possibility of extending it to a setting in which the spaces of types of a theory are uncountable. (shrink)

In [3], two different effective versions of Borel embedding are defined. The first, called computable embedding, is based on uniform enumeration reducibility, while the second, called Turing computable embedding, is based on uniform Turing reducibility. While [3] focused mainly on computable embeddings, the present paper considers Turing computable embeddings. Although the two notions are not equivalent, we can show that they behave alike on the mathematically interesting classes chosen for investigation in [3]. We give a “Pull-back Theorem”, saying that if (...) Φ is a Turing computable embedding of K into K’, then for any computable infinitary sentence φ in the language of K’, we can find a computable infinitary sentence φ* in the language of K such that for all. (shrink)

Non-suicidal self-harm is common in youth. The behavior may have negative and sometimes dangerous consequences, such as feelings of guilt, scars, nerve damage and accidental death. Is this behavior a mental disorder? This question is attracting serious consideration. I want to say that non-suicidal self-harm in youth is never a mental disorder in its own right. Yet, I do not want to commit to saying what is a mental disorder. So I identify the characteristic features and functions of non-suicidal self-harm (...) in youth and show that these features and functions are also seen in non-disordered behaviors in youth. This, I say, shows that non-suicidal self-harm in youth is non-disordered too. I say that non-suicidal self-harm in youth is a characteristic youth behavior that when seen in youth has an understandable practical function. I offer to the general discussion about mental disorder the strategy I use. (shrink)

COVID-19 vaccine refusal seems like a paradigm case of irrationality. Vaccines are supposed to be the best way to get us out of the COVID-19 pandemic. And yet many people believe that they should not be vaccinated even though they are dissatisfied with the current situation. In this paper, we analyze COVID-19 vaccine refusal with the tools of contemporary philosophical theories of responsibility and rationality. The main outcome of this analysis is that many vaccine-refusers are responsible for the belief that (...) they should not be vaccinated and epistemically rational in holding it. This is an important result because it provides insights into the legitimacy of certain public health policies. In particular, this result shows that a public health policy that would abandon the project of convincing certain vaccine-refusers with reasons – e.g., by simply making vaccination compulsory – is prima facie illegitimate. (shrink)

Kenneth C. Schaffner's paper is an important contribution to the literature on behavioral genetics and on genetics in general. Schaffner has a long record of injecting real molecular biology into philosophical discussions of genetics. His treatments of the reduction of Mendelian to molecular genetics first drew philosophical attention to the problems of detail that have fuelled both anti-reductionism and more sophisticated models of theory reduction. An injection of molecular detail into discussions of genetics is particularly necessary at the present time, (...) when so many philosophers seem happy to discuss the philosophical and ethical implications of molecular biology using gene concepts derived from evolutionary biology ). Schaffner has long advocated the view that the philosophy of biology should be more than the philosophy of evolution. This paper shows how radically a picture of gene action derived from molecular biology undercuts the popular picture associated with a more evolutionary view of genes as units of heredity or as ‘difference-makers’ mediated by the ‘black box’ of development. (shrink)

Several attempts have been made to apply the choice-sensitive theory of distributive justice, luck egalitarianism, in the context of health and healthcare. This article presents a framework for this discussion by highlighting different normative decisions to be made in such an application, some of the objections to which luck egalitarians must provide answers and some of the practical implications associated with applying such an approach in the real world. It is argued that luck egalitarians should address distributions of health rather (...) than healthcare, endorse an integrationist theory that combines health concerns with general distributive concerns and be pluralist in their approach. It further suggests that choice-sensitive policies need not be the result of applying luck egalitarianism in this context. (shrink)