In lieu of an abstract, here is a brief excerpt of the content:I Had Never Heard Someone Use That Word BeforeAdrienne Feller NovickThe patient was dying. As the social worker, I had arranged the meeting and sat shoulder to shoulder with the family and the attending physician in the small nondescript room. The family was grief-stricken and asked intelligent questions as they made difficult decisions about end-of-life care for their loved one. The doctor spoke with gentle kindness, acknowledging their (...) difficult decision as he completed the neon pink Medical Orders for Life Sustaining Treatment (MOLST) form and left the room. I was tangled up with emotions; I felt relieved that the meeting had gone smoothly, sad for the patient and family, and in awe of the doctor for his ability to lead the difficult conversation. I stayed behind to ask the family if there was anything I could do to help them. [End Page E4]Before I could speak, the patient's wife turned to me and said, "I am so glad that k--- left the room." (Using a derogatory word for a person of the Jewish faith). My brain began processing the statement. I am a Jewish woman. Did I hear that right? Did she say what I think she said? Should I say something? I froze, and time seemed to stop. She was looking at me expectantly, waiting for a response. Her face reminded me of someone waiting for the other person to return a "high five." I was flooded with emotion. A succession of thoughts ran through my head, everything from being rude in response or getting physical. I did neither. I said nothing. I smiled and left the room feeling like I had been gut-punched.I was in denial. I made excuses for the wife; she was stressed. I kept thinking I must not have heard her correctly and that I was overreacting. I continued to work with the family as though nothing had happened until the patient died five days later. I felt ashamed and never told anyone about what happened. I regretted not saying anything. I replayed the conversation in my mind and felt depressed and angry. Inside I felt complicit for not speaking up, but I had no words. I assumed bias in healthcare was rare. I did nothing.Years later, after I completed a patient visit in the Intensive Care Unit (ICU), I observed a group of surgical residents doing rounds. The attending welcomed me to join this valuable clinical learning experience. As the group approached the next bed, the patient pointed to one resident and loudly said, "I don't want a doctor who looks like that to come near me." I gasped aloud and froze, waiting to see what would happen next. The attending looked directly at the patient and said calmly, "We are all here to help you. That is not an appropriate thing for you to say." Then, he turned to the resident and nodded, directing them to resume their bedside assessment. The patient mumbled something inaudibly and said nothing.To my astonishment, the doctor acknowledged the microaggression (a microaggression is a statement, action, or incident regarded as discrimination), addressed the issue, respectfully supported the resident, created a safe space for everyone on the healthcare team and resumed quality patient care without missing a beat. He modeled a strategy to address patient bias and taught a valuable skill. This was a learning moment for me. It helped me refocus my past experience and provided me with a useful strategy to address bias in the future.As a member of the medical ethics consultation service, I listen, provide support, and aid in challenging communications. I had the opportunity to model the communication strategy I acquired in the ICU. The medical ethics team was consulted for a patient refusing treatment. The patient was disrespectful to healthcare team members, cursing at nurses and residents, using ethnic slurs, and saying he "would rather die than let one of them touch him. I entered the patient's room with the healthcare team, introduced myself, and explained the reason for my visit. The patient defiantly agreed he had used slurs, saying he wanted to go home. I continued, everyone here... (shrink)

This article reports the results of an experiment involving 108 college students with varying backgrounds in biology. Subjects answered questions about the evolutionary history of sets of hominid and equine taxa. Each set of taxa was presented in one of three diagrammatic formats: a noncladogenic diagram found in a contemporary biology textbook or a cladogram in either the ladder or tree format. As predicted, the textbook diagrams, which contained linear components, were more likely than the cladogram formats to yield explanations (...) of speciation as an anagenic process, a common misconception among students. In contrast, the branching cladogram formats yielded more appropriate explanations concerning levels of ancestry than did the textbook diagrams. Although students with stronger backgrounds in biology did better than those with weaker biology backgrounds, they generally showed the same effects of diagrammatic format. Implications of these results for evolution education and for diagram design more generally are discussed. (shrink)

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

What exactly is hope and how does it influence our decisions? In How We Hope, Adrienne Martin presents a novel account of hope, the motivational resources it presupposes, and its function in our practical lives. She contends that hoping for an outcome means treating certain feelings, plans, and imaginings as justified, and that hope thereby involves sophisticated reflective and conceptual capacities. Martin develops this original perspective on hope--what she calls the "incorporation analysis"--in contrast to the two dominant philosophical conceptions (...) of hope: the orthodox definition, where hoping for an outcome is simply desiring it while thinking it possible, and agent-centered views, where hoping for an outcome is setting oneself to pursue it. In exploring how hope influences our decisions, she establishes that it is not always a positive motivational force and can render us complacent. She also examines the relationship between hope and faith, both religious and secular, and identifies a previously unnoted form of hope: normative or interpersonal hope. When we place normative hope in people, we relate to them as responsible agents and aspire for them to overcome challenges arising from situation or character. Demonstrating that hope merits rigorous philosophical investigation, both in its own right and in virtue of what it reveals about the nature of human emotion and motivation, How We Hope offers an original, sustained look at a largely neglected topic in philosophy. (shrink)

Current work in language models (LMs) helps us speed up or even skip thinking by accelerating and automating cognitive work. But can LMs help us with critical thinking -- thinking in deeper, more reflective ways which challenge assumptions, clarify ideas, and engineer new concepts? We treat philosophy as a case study in critical thinking, and interview 21 professional philosophers about how they engage in critical thinking and on their experiences with LMs. We find that philosophers do not find LMs to (...) be useful because they lack a sense of selfhood (memory, beliefs, consistency) and initiative (curiosity, proactivity). We propose the selfhood-initiative model for critical thinking tools to characterize this gap. Using the model, we formulate three roles LMs could play as critical thinking tools: the Interlocutor, the Monitor, and the Respondent. We hope that our work inspires LM researchers to further develop LMs as critical thinking tools and philosophers and other 'critical thinkers' to imagine intellectually substantive uses of LMs. (shrink)

ABSTRACTThe standard view in philosophy of mind is that the way to understand the difference between perception and misperception is in terms of accuracy. On this view, perception is accurate while...

This article defends a theory of diffuse attention and distinguishes it from focal attention. My view is motivated by evidence from psychology and neuroscience, which suggests that we can deploy visual selective attention in at least two ways: by focusing on a small number of items, or by diffusing attention over a group of items taken as a whole. I argue that diffuse attention is selective and can be object‐based. It enables a subject to select an object to guide behavior, (...) albeit in a different way than focusing does. (shrink)

People with disabilities use more medical care and see health professionals more often than do those of the same age, ethnic group, or economic class who do not have impairments. An indisputable medical goal is.

Fact-finding hearings may be held to determine disputed allegations of domestic violence in child contact cases in England and Wales, and can play a vital role for mothers seeking protection and autonomy from violent fathers. Drawing on the author’s empirical study, this article examines the implications for the holding of fact-finding hearings of judges’ and professionals’ understandings of domestic violence and the extent to which they perceive it to be relevant to contact. While more judges and professionals are developing their (...) understanding of domestic violence, the ambit of when and how it is considered relevant to contact has grown increasingly narrow, which suggests that many disputed allegations of domestic violence are disregarded and women and children continue to be put at risk from violent fathers. This bifurcated approach is likely to have significant implications for recent developments in this area of family law which are considered in this article. (shrink)

In cases of identity crowding, a subject consciously sees items in a figure, even though they are presented too closely together for her to shift attention to each item. Block uses such cases to challenge the view that attention is necessary for consciousness. I argue that in identity crowding cases, subjects really do attend to the items. Specifically, they attend to the figure as a global object that contains the individual items as parts. To support this view, I provide evidence (...) that attention can be directed to a global object or a local object. My response helps to defend the view that attention is necessary for conscious perception. (shrink)

Attention seems to raise a problem for pure representationalism, the view that phenomenal content supervenes on representational content. The problem is that shifts of attention sometimes seem to bring about a change in phenomenal content without a change in representational content. I argue that the representationalist can meet this challenge, but that doing so requires a new view of the representational content of perception. On this new view, the representational content of perception is always relative to a way of attending. (...) I call this the attention-indexed view of perceptual content. (shrink)

This article addresses an issue overlooked in most of the literature on judicial review: the legitimacy of judicial review of a constitution's federal and structural provisions. Debates about the legitimacy of judicial review—at least as conducted throughout the Commonwealth—are usually focussed on rights. These debates appear to assume that the power of courts like the Australian High Court and the Canadian Supreme Court to interpret and enforce federal and structural provisions is unproblematic. This article tests that assumption and concludes that (...) those who hold democracy-based objections to constitutional rights should seriously reconsider, and perhaps oppose, federal and structural judicial review as well. (shrink)

I argue for adopting a conception of obligation that is broader than the conception commonly adopted by moral philosophers. According to this broader conception, the crucial marks of an obligatory action are, first, that the reasons for the obliged party to perform the action include an exclusionary reason and, second, that the obliged party is the appropriate target of blaming reactive attitudes, if they inexcusably fail to perform the obligatory action. An obligation is directed if the exclusionary reason depends on (...) the relationship between the obliged person and the person to whom they owe the obligatory action, and the latter person is positioned to personally blame the obligated person for inexcusably failing to perform the obligatory action. Some direc- ted obligations are not owed as a matter of right, and the person to whom the obligatory action is owed is the only person positioned to blame nonperformance. Other directed obligations are owed as a matter of right, and people who are not part of the relationship grounding the obligation nevertheless are also positioned to (impersonally) blame non-performance. Only the rights-based form of directed obligation has received signifi- cant attention from moral philosophers, yet the former—which is at the heart of what I call “personal bonds”—is a pervasive and significant theme of our ordinary interpersonal lives. (shrink)

Kyle Stanford has recently given substance to the problem of unconceived alternatives, which challenges the reliability of inference to the best explanation (IBE) in remote domains of nature. Conjoined with the view that IBE is the central inferential tool at our disposal in investigating these domains, the problem of unconceived alternatives leads to scientific anti-realism. We argue that, at least within the biological community, scientists are now and have long been aware of the dangers of IBE. We re-analyse the nineteenth-century (...) study of inheritance and development (Stanford’s case study) and extend it into the twentieth century, focusing in particular on both classical Mendelian genetics and the studies by Avery et al. on the chemical nature of the hereditary substance. Our extended case studies show the preference of the biological community for a different methodological standard: the vera causa ideal, which requires that purported causes be shown on non-explanatory grounds to exist and be competent to produce their effects. On this basis, we defend a prospective realism about the biological sciences. 1 Introduction2 Stanford on Unconceived Alternatives3 Pangenesis: A Re-analysis4 The Vera Causa Ideal I: Negative Aspect5 Rendering Heredity Accessible6 The Vera Causa Ideal II: Positive Aspect7 Implications for Scientific Realism8 Conclusion. (shrink)

Purpose– This paper aims to consider selected results from the Arts and Humanities Research Council -funded “Managing Access to the internet in Public Libraries” project, from 2012-2014. MAIPLE has explored the ways in which public library services manage use of the internet connections that they provide for the public. This included the how public library services balance their legal obligations and the needs of their communities in a public space and the ethical dilemmas that arise.Design/methodology/approach– The researchers used a mixed-method (...) approach involving a review of the literature, legal analysis, a questionnaire survey and case studies in five public library authorities.Findings– UK public library services use a range of methods to regulate internet access. The research also confirms previous findings that filtering software is an ubiquitous tool for controlling access to and protecting library users from “inappropriate”, illegal and harmful internet content. There is a general, if sometimes reluctant, acceptance of filtering software as a practical tool by library staff, which seems to contrast with professional codes of ethics and attitudes in other countries. The research indicates that public library internet access will be a valued service for some time to come, but that some aspects of how public library services regulate internet access is currently managed can have socially undesirable consequences, including blocking legitimate sites and preventing users from accessing government services. Education could play a greater part in helping the general population to exercise judgement in selection of materials to view and use. This does not preclude implementing stricter controls to protect children, whilst allowing public libraries to continue providing a social good to those who are unable to otherwise participate in the digital age.Research limitations/implications– The response to the survey was 39 per cent meaning that findings may not apply across the whole of the UK. The findings of this study are compared with and supplemented by other quantitative sources, but a strength of this study is the depth of understanding afforded by the use of case studies.Originality/value– This paper provides both a quantitative and qualitative analysis of how internet access is managed in UK public libraries, including how library services fulfil their legal obligations and the ethical implications of how they balance their role in facilitating access to information with their perceived role as a safe and trusted environment for all members of their communities. The findings add to the international discussion on this issue and stimulate debate and policy making in the UK. (shrink)

Pacific Philosophical Quarterly, March 2006. Significant effort has been devoted to locating a good argument for Kant ’s Formula of Humanity. In this paper, I contrast two arguments, based on Kant ’s text, for the Formula of Humanity. The first, which I call the “Valued Ends” argument, is an influential and appealing argument developed most notably by Christine Korsgaard and Allen Wood. Notwithstanding the appeal and influence of this argument, it ultimately fails on several counts. I therefore present as an (...) alternative the “Autonomy” argument, which is largely inspired by the failings of the Valued Ends argument. (shrink)

Kyle Stanford has recently given substance to the problem of unconceived alternatives, which challenges the reliability of inference to the best explanation (IBE) in remote domains of nature. Conjoined with the view that IBE is the central inferential tool at our disposal in investigating these domains, the problem of unconceived alternatives leads to scientific anti-realism. We argue that, at least within the biological community, scientists are now and have long been aware of the dangers of IBE. We re-analyze the nineteenth-century (...) study of inheritance and development (Stanford’s case study) and extend it into the twentieth century, focusing in particular on both classical Mendelian genetics and the studies by Avery et al. on the chemical nature of the hereditary substance. Our extended case studies show the preference of the biological community for a different methodological standard: the vera causa ideal, which requires that purported causes be shown on non-explanatory grounds to exist and be competent to produce their effects. On this basis, we defend a prospective realism about the biological sciences. (shrink)

It is gratifying that thoughtful philosophers and bioethicists like Mahowald and Nelson are continuing to address the objections to prenatal testing that have been made by disability scholars and advocates. But it is frustrating to see those objections presented in ways that reflect the doubts of those who reject them more than the intentions of those who make them, in ways that make those objections appear censorious toward pregnant women and prospective parents or naïve about nonverbal expression. We recognize that (...) disability critics share the responsibility for these misunderstandings, that their objections to prenatal disability testing have not always been made as clearly or consistently as they might have been. We therefore welcome this opportunity for clarification and rebuttal. Briefly, we will argue against Mahowald that it is not apparent how prospective parents could have a duty to potential offspring requiring them to prevent the birth of any child expected to have a life worth living. And we will remind Nelson that our primary concern is with the perpetuation of stigma; that even if any reason for abortion can be framed in terms of a trait of the fetus to be aborted, only certain reasons for abortion are based on the rejection of future children because of stigmatized traits. (shrink)

This paper aims to show that the COVID-19 pandemic has amplified existing barriers to healthcare in England for ethnic minority and migrant women. These barriers include those embedded within the i...

Biological science uses multiple species concepts. Order can be brought to this diversity if we recognize two key features. First, any given species concept is likely to have a patchwork structure, generated by repeated application of the concept to new domains. We illustrate this by showing how two species concepts (biological and ecological) have been modified from their initial eukaryotic applications to apply to prokaryotes. Second, both within and between patches, distinct species concepts may interact and hybridize. We thus defend (...) a semantic picture of the species concept as a collection of interacting patchwork structures. Thus, although not all uses of the term pick out the same kind of unit in nature, the diversity of uses reflects something more than mere polysemy. We suggest that the emphasis on the use of species to pick out natural units is itself problematic, because that is not the term’s sole function. In particular, species concepts are used to manage inquiry into processes of speciation, even when these processes do not produce clearly delimited species. (shrink)

_Demons in the Consulting Room: Echoes of Genocide, Slavery and Extreme Trauma in Psychoanalytic Practice_ isthe second of two volumes addressing the overwhelming, often unmetabolizable feelings related to mourning, both on an individual and mass scale. Authors in this volume explore the potency of ghosts, ghostliness and the darker, often grotesque aspects of these phenomena. While ghosts can be spectral presences that we feel protective of, demons haunt in a particularly virulent way, distorting experience, our sense of reality and our (...) character. Bringing together a collection of clinical and theoretical papers, _emons in the Consulting Room_, reveals how the most extreme types of trauma can continue to have effects across generations, and how these effects manifest in the consulting room. Essays in this volume consider traumas that have affected multiple generations of people, such as the Holocaust, experiences in the gulags, and the experience of slavery. Authors here consider the clinical challenges of working with the demonic force in severe childhood abuse and the effects of serious and prolonged physical injury and illness. Inevitably, there is in such difficult clinical work, the combined effects of hauntings in the analysts and in patients and often in the surrounding culture. In this book, distinguished psychoanalysts explore the myriad forms of ghosts and the demonic, which interfere and disrupt the endlessly difficult psychic work of mourning. It will be of interest to psychotherapists and psychoanalysts, as well as social workers, family therapists, psychologists, and psychiatrists. _emons in the Consulting Room _ill appeal to those specializing in bereavement and trauma and, on a broader level, to sociologists and historians interested in understanding means of coping with loss and grief on both an individual and larger scale basis. (shrink)

George Lakoff discusses how emotion metaphors reflect the discrete bodily states associated with each emotion. The analysis raises questions about the context for and frequency of use of emotion metaphors and, indeed, emotion labels, per se. An assumption implicit to most theories of emotion is that emotion language is just another channel through which people express ongoing emotion states. Drawing from recent evidence that labeling ongoing emotions reduces their intensity, we propose that a primary function of emotion language is regulatory (...) rather than expressive. (shrink)

There is long-standing conflict between genealogical and developmental accounts of homology. This paper provides a general framework that shows that these accounts are compatible and clarifies precisely how they are related. According to this framework, understanding homology requires both an abstract genealogical account that unifies the application of the term to all types of characters used in phylogenetic systematics and locally enriched accounts that apply only to specific types of characters. The genealogical account serves this unifying role by relying on (...) abstract notions of ‘descent’ and ‘character’. As a result, it takes for granted the existence of such characters. This requires theoretical justification that is provided by enriched accounts, which incorporate the details by which characters are inherited. These enriched accounts apply to limited domains, providing the needed theoretical justification for recognizing characters within that domain. Though connected to the genealogical account of homology in this way, enriched accounts include phenomena that fall outside the scope of the genealogical account. They therefore overlap, but are not nested within, the genealogical account. Developmental accounts of homology are to be understood as enriched accounts of body part homology. Once they are seen in this light, the conflict with the genealogical account vanishes. It is only by understanding the fine conceptual structure undergirding the many uses of the term ‘homology’ that we can understand how these uses hang together. (shrink)

The objective of this study was to review the design and delivery of medical ethics education within medical programs across Australia and New Zealand, how current teaching has been informed by the proposed core curriculum published in 2001 by the ATEAM and how it could look moving forward. We conducted a mixed methods study using an online questionnaire consisting of 51 items. This included both binary and open-ended questions to categorise and explore similarities and differences in medical ethics curricula in (...) medical programs accredited by the Australian Medical Council across ANZ. Participants were asked about curriculum design format, duration, goals, assessments, content areas of their own ME curriculum. Convenors from 18 universities responded. The main commonality was that ME curricula were integrated both longitudinally and laterally with other content. There was also commonality in content areas addressed. The goals, format, educators, and assessments of the ME curricula were highly variable. Most respondents described a curriculum which prioritised knowledge and skill development related to ME. Although the core goals of including knowledge, skills, and attitudinal development in ME curricula are still present, there is no uniformity in terms of format, delivery, or assessment across medical programs in ANZ. This is an area for collaborative development. (shrink)

The discovery of conjunctive causes--factors that act in concert to produce or prevent an effect--has been explained by purely covariational theories. Such theories assume that concomitant variations in observable events directly license causal inferences, without postulating the existence of unobservable causal relations. This article discusses problems with these theories, proposes a causal-power theory that overcomes the problems, and reports empirical evidence favoring the new theory. Unlike earlier models, the new theory derives (a) the conditions under which covariation implies conjunctive causation (...) and (b) functions relating observable events to unobservable conjunctive causal strength. This psychological theory, which concerns simple cases involving 2 binary candidate causes and a binary effect, raises questions about normative statistics for testing causal hypotheses regarding categorical data resulting from discrete variables. (shrink)

Recently, there has been a surge of interest in the lexicon. The demand for a fuller and more adequate understanding of lexical meaning required by developments in computational linguistics, artificial intelligence, and cognitive science has stimulated a refocused interest in linguistics, psychology, and philosophy. Different disciplines have studied lexical structure from their own vantage points, and because scholars have only intermittently communicated across disciplines, there has been little recognition that there is a common subject matter. The conference on which this (...) volume is based brought together interested thinkers across the disciplines of linguistics, philosophy, psychology, and computer science to exchange ideas, discuss a range of questions and approaches to the topic, consider alternative research strategies and methodologies, and formulate interdisciplinary hypotheses concerning lexical organization. The essay subjects discussed include: * alternative and complementary conceptions of the structure of the lexicon, * the nature of semantic relations and of polysemy, * the relation between meanings, concepts, and lexical organization, * critiques of truth-semantics and referential theories of meaning, * computational accounts of lexical information and structure, and * the advantages of thinking of the lexicon as ordered. (shrink)

The history of biology is mottled with disputes between two distinct approaches to the organic world: structuralism and functionalism. Their persistence across radical theory change makes them difficult to characterize: the characterization must be abstract enough to capture biologists with diverse theoretical commitments, yet not so abstract as to be vacuous. This Element develops a novel account of structuralism and functionalism in terms of explanatory strategies (Section 2). This reveals the possibility of integrating the two strategies; the explanatory successes of (...) evolutionary-developmental biology essentially depend on such integration (Section 3). Neither explanatory strategy is universally subordinate to the other, though subordination with respect to particular explanatory tasks is possible (Section 4). Beyond structuralism and functionalism, philosophical analysis that centers explanatory strategies can illuminate conflicts within evolutionary theory more generally (Section 5). (shrink)