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)

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)

The meaning of life and man's alienation from himself and his natural environment is examined in brief selections, illustrated with photographs, from the works of Albert Schweitzer.

Pionnière dans la pénalisation du viol en 1980, la France a été en eurocrime qu’aurait entraîné l’unanimité dans l’acceptation de la nouvelle définition proposée par la Commission européenne. L’absence de consentement devient finalement pour tous le critère principal, et de nombreux pays ont aligné récemment leur législation avec la directive européenne. Sur le droit à l’avortement, la convergence est moins sensible, plusieurs pays mettent d’importantes restrictions. La constitutionnalisation de la liberté d’avorter et de sa garantie en France va peut-être conduire (...) à son inscription dans les droits humains. (shrink)

Was passiert, wenn die Bevölkerung die Möglichkeit erhält, sich ungeschminkt und ungefiltert zu bioethischen Problemstellungen zu äußern?

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)

This long-awaited two-volume set constitutes the definitive presentation of the system of classifying moral judgment built up by Lawrence Kohlberg and his associates over a period of twenty years. Researchers in child development and education around the world, many of whom have worked with interim versions of the system, indeed, all those seriously interested in understanding the problem of moral judgment, will find it an indispensable resource. Volume I reviews Kohlberg's stage theory, and the by-now large body of research on (...) the significance and utility of his moral stages. Issues of reliability and validity are addressed. The volume ends with detailed instructions for using the forms in Volume 2. Volume 2, in a specially-designed, user-friendly format, includes three alternative functionally-equivalent forms of the scoring system. (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.

In 1621 Francis Bacon, luminary of the English Renaissance and Lord Chancellor, was tried in Parliament for corruption. There were many things which made his case unusual – such as the revival of the impeachment process after 150 years of disuse and the degree of political factionalism that lay behind the accusations – but perhaps the most striking was Bacon’s apparent readiness to admit his guilt. On 30 April 1621 he made his confession to the House of Lords: ‘I do (...) plainly and ingenuously confess that I am guilty of corruption; and do renounce all defence’. He confessed to each of the 28 articles against him and concluded by again admitting that there had been ‘a great deal of corruption and neglect’ in his conduct for which he was ‘heartily and penitently sorry’. Bacon acknowledged receiving £11-12,000 worth of bribes from suitors who appeared in court before him. (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)

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)

We propose a multi-agent logic of knowledge, public announcements and arbitrary announcements, interpreted on topological spaces in the style of subset space semantics. The arbitrary announcement modality functions similarly to the effort modality in subset space logics, however, it comes with intuitive and semantic differences. We provide axiomatizations for three logics based on this setting, with S5 knowledge modality, and demonstrate their completeness. We moreover consider the weaker axiomatizations of three logics with S4 type of knowledge and prove soundness and (...) completeness results for these systems. (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)

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)

WINNER BEST SOCIAL PHILOSOPHY BOOK IN 2021 / NASSP BOOK AWARD 2022 -/- Together we can often achieve things that are impossible to do on our own. We can prevent something bad from happening or we can produce something good, even if none of us could do it by herself. But when are we morally required to do something of moral importance together with others? This book develops an original theory of collective moral obligations. These are obligations that individual moral (...) agents hold jointly, but not as unified collective agents. To think of some of our obligations as joint or collective is the best way of making sense of our intuitions regarding collective moral action problems. Where we have reason to believe that our efforts are most efficient as part of a collective endeavor we may incur collective obligations together with others who are similarly placed as long as we are able to establish compossible individual contributory strategies towards that goal. The book concludes with a discussion of “massively shared obligations” to large-scale moral problems such as global poverty. (shrink)