BackgroundDecision-making in out-of-hospital cardiac arrest should ideally include clinical and ethical factors. Little is known about the extent of ethical considerations and their influence on prehospital resuscitation. We aimed to determine the transparency in medical records regarding decision-making in prehospital resuscitation with a specific focus on ethically relevant information and consideration in resuscitation providers’ documentation.MethodsThis was a Danish nationwide retrospective observational study of out-of-hospital cardiac arrests from 2016 through 2018. After an initial screening using broadly defined inclusion criteria, two experienced (...) philosophers performed a qualitative content analysis of the included medical records according to a preliminary codebook. We identified ethically relevant content in free-text fields and categorised the information according to Beauchamp and Childress’ four basic bioethical principles: autonomy, non-maleficence, beneficence, and justice. ResultsOf 16,495 medical records, we identified 759 (4.6%) with potentially relevant information; 710 records (4.3%) contained ethically relevant information, whereas 49 did not. In general, the documentation was vague and unclear. We identified four kinds of ethically relevant information: patients’ wishes and perspectives on life; relatives’ wishes and perspectives on patients’ life; healthcare professionals’ opinions and perspectives on resuscitation; and do-not-resuscitate orders. We identified some “best practice” examples that included all perspectives of decision-making. ConclusionsThere is sparse and unclear evidence on ethically relevant information in the medical records documenting resuscitation after out-of-hospital cardiac arrests. However, the “best practice” examples show that providing sufficient documentation of decision-making is, in fact, feasible. To ensure transparency surrounding prehospital decisions in cardiac arrests, we believe that it is necessary to ensure more systematic documentation of decision-making in prehospital resuscitation. (shrink)

Person‐specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self‐determination method with people with various long‐term health conditions. It explains the mechanisms of mobilizing relational capacity by including person‐specific evidence in shared decision‐making. Person‐specific self‐insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self‐management challenges. This step paved the way for sharing these insights and (...) challenges in a relationship with a supportive health professional, who could then rely on person‐specific evidence instead of assumptions or a narrow disease perspective for shared decision‐making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person‐specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self‐insights in daily life with other people, decreasing loneliness they experienced in self‐management. Relational capacity, the core of the theory, is mobilized in both people with long‐term health conditions and healthcare professionals. Further research on person‐specific evidence and relational capacity in healthcare is recommended. (shrink)

Conciliationism holds that disagreement of apparent epistemic peers often substantially undermines rational confidence in our opinions. Uniqueness principles say that there is at most one maximally rational doxastic response to any given batch of total evidence. The two views are often thought to be tightly connected. This paper distinguishes two ways of motivating conciliationism, and two ways that conciliationism may be undermined by permissive accounts of rationality. It shows how conciliationism can flourish under certain strongly permissive accounts of rationality. This (...) occurs when the motivation for conciliationism does not come from taking disagreement as evidence of one's own rational failings. However, divorcing the motive for conciliating from worries about rationality does not remove a feature of conciliationism that some find troubling: that conciliationism can lead to cases of “rational toxicity,” in which the most rational response to one's evidence involves violating some rational ideal. (shrink)

For the purpose of contributing to a clarification of the term “process”, different kinds of musical processes are investigated: A rule-determined phase shifting process in Steve Reich's Piano Phase (1966), a model for an indeterminate composition process in John Cage's Variations II (1961), a number of evolution processes in György Ligeti's In zart fliessender Bewegung (1976), and a generative process of fractal nature in Per Nørgård's Second Symphony (1970). In conclusion I propose that six process categories should be included in (...) a typology of processes: Rule-determined, goal-directed and indeterminate transformation processes, and rule-determined, goal-directed and indeterminate generative processes. (shrink)

Oregon is the only state in the United States where a physician may legally prescribe a lethal dose of barbiturate for a patient intending suicide. The Oregon Death with Dignity Act was passed by voters in 1994 and came into effect after much legal wrangling in October of 1997. At the same time, a cabinetmaker named Pat Matheny was struggling with progressive weakness from amyotrophic lateral sclerosis, or ALS. I met with Pat and his family for a lengthy interview in (...) October 1998 in Coos Bay, Oregon, for a television news report on his decision to get a lethal prescription. Below is an extract from that interview. On the day this introduction was written, 10 March 1999, Pat took the prescribed lethal overdose of barbiturates and died at home. His illness was taking his voice, he could not move his hands or legs, and breathing was becoming very difficult. His mother told me he knew that was for him. (shrink)

Understanding when it is acceptable to interrupt a joint activity is an important part of understanding what cooperation entails. Philosophical analyses have suggested that we should release our partner from a joint activity anytime the activity conflicts with fulfilling a moral obligation. To probe young children’s understanding of this aspect, we investigated whether 3-year-old children (N = 60) are sensitive to the legitimacy of motives (selfish condition vs. moral condition) leading agents to intentionally interrupt their joint activity. We measured whether (...) children protested or released their partner by scoring their reactions. Our results indicate that children did not manifest different reactions when the motive behind their partner leaving was moral than when the motive was selfish. However, our data showed a stable pattern: regardless of the partner’s motives, some 3-year-olds take initiatives to release their partners from joint activity, suggesting that measuring release is a valuable tool for investigating joint action. -/- . (shrink)

How do concert pianists commit to memory the structure of a piece of music like Bach’s Italian Concerto, learning it well enough to remember it in the highly charged setting of a crowded performance venue, yet remaining open to the freshness of expression of the moment? Playing to this audience, in this state, now, requires openness to specificity, to interpretation, a working dynamicism that mere rote learning will not provide. Chaffin, Imreh and Crawford’s innovative and detailed research suggests that the (...) key to this skill is a declarative mental roadmap aiding musical performance. This hypothesis is neatly and unintentionally summarized by professional pianist Imreh, who states when learning a new piece of music “My fingers were playing the notes just fine. The practice I needed was in my head. I had to learn to keep track of where I was. It was a matter of learning exactly what I needed to be thinking of as I played, and at exactly what point. . .” (Chaffin & Imreh 1997, p.326). (shrink)

In recent decades, the Organisation for Economic Co-operation and Development has become a powerful forum for trade liberalization and regulatory harmonization. OECD members have worked to reconcile divergent national regulatory approaches, applying a single framework across sovereign states, in effect determining whose knowledge-making practices would guide regulatory action throughout the industrialized world. Focusing on US regulators, industry associations, and environmental groups, this article explores the participatory politics of OECD chemical regulation harmonization in the late 1970s to early 1980s. These efforts (...) were conditioned by differential institutional access and resources among stakeholders who sought to shape regulatory knowledge rules. Facing competing European and US approaches to chemical data—a minimum “base set” of test data versus case-by-case determinations—OECD members chose the European approach in 1980. However, US regulatory politics shifted with the election of President Reagan, prompting industry associations to lobby the US government to block the agreement. Examining the micropolitics of these standards in the making, I demonstrate that while long-term structures advantaged industrial actors, ideological alignment with the US government precipitated their decisive influence. The case illustrates the importance of attending to the distinctive politics of international harmonization and the effects on transnational knowledge-making and regulatory intervention. (shrink)

In this highly original study, Jerome Christensen reconstructs the career of a representative Enlightenment man of letters, David Hume. In doing so, Christensen develops a prototype for a post-structuralist biography. Christensen motivates the interplay between Hume’s texts as arguments and as symbolic acts by conceiving of Hume’s literary career as an adaptive discursive practice, the projected and performed narrative of his social life. Students and scholars of eighteenth-century English and French literature, feminist studies, political theory and history, (...) philosophy, and intellectual history will welcome this unprecedented and challenging view of David Hume and his times. (shrink)

In the following study we shall investigate the ancient Greek ‘(all-)day runners’ (ήμεροδρόμοι) 2 from a historical as well as from a modern physiological perspective. Hemerodromoi were of some importance in Greek interstate communication, in particular in military long-distance communication, and are, accordingly, a subject of some interest for the study of interaction in the ancient Greek city-state culture. The investigation begins by considering the ancient evidence on these ‘(all-)day runners’ and moves on to a physiological consideration of this evidence, (...) with particular reference to the feat of the Athenian hemerodromos Pheidippides 3 who ran from Athens to Sparta in 490 BC, shortly before the famous battle of Marathon. (shrink)

Heightened concern with global issues has led to shifts in corporate social responsibility (CSR) programs. To capture the distinct nature of this global focus, researchers have developed a three-generation CSR typology. In this paper, we first evaluate the usefulness of this typology for understanding corporate approaches to CSR by examining how several companies position themselves thematically in CEO introductions to sustainability reports. On the basis of this, we then evaluate the practical value of this typology for assisting those who work (...) with CSR strategy. The analysis revealed expressions of all three CSR generations, with third-generation thinking being apparent, but not dominant. It also verified that the three-generation CSR typology can be an instructive means of both evaluating as well as framing a company's approach to sustainability, though with modifications. On the basis of the identified strengths and weaknesses of the typology, we develop a practitioner-focused, three-tiered model that can strategically guide the development of CSR programs. (shrink)

‘There is no place in the phenomenology of fully absorbed coping’, writes Hubert Dreyfus, ‘for mindfulness. In flow, as Sartre sees, there are only attractive and repulsive forces drawing appropriate activity out of an active body’1. Among the many ways in which history animates dynamical systems at a range of distinctive timescales, the phenomena of embodied human habit, skilful movement, and absorbed coping are among the most pervasive and mundane, and the most philosophically puzzling. In this essay we examine both (...) habitual and skilled movement, sketching the outlines of a multidimensional framework within which the many differences across distinctive cases and domains might be fruitfully understood. Both the range of movement phenomena which can plausibly be seen as instances of habit or skill, and the space of possible theories of such phenomena are richer and more disparate than philosophy easily encompasses. We seek to bring phenomenology into contact with relevant movements in psychological theories of skilful action, in the belief that phenomenological philosophy and cognitive science can be allies rather than antagonists. (shrink)

As the structure of healthcare delivery undergoes a breathtaking transformation, many ethics committees are wondering how and if they will be affected. Although the impact has not yet been widely felt, hospital-based ethics committees cannot avoid the pressures and upheaval caused by the reorganization of healthcare. This article will briefly review some of the factors contributing to the transformation of medicine, and suggest a number of ways in which ethics committees can respond proactively.

According to the Stoics, ordinary unified bodies—animals, plants, and inanimate natural bodies—each have a single cause of unity and being: pneuma. Pneuma itself has no distinct cause of unity; on the contrary, it acts as a cause of unity and being for itself. In this paper, I show how pneuma is supposed to be able to unify itself and other bodies in virtue of its characteristic tensile motion (τονικὴ κίνησις). Thus, we will see how the Stoics could have hoped to (...) account for corporeal unity by positing another body (pneuma) apparently itself in need of unification. (shrink)

A letter protesting the publication of a homophobic rant in the Proceedings of the APA.

According to Socrates, as he is described in Plato?s Phaedo, the definition of a true philosopher is a wise man who is continuously practicing dying and being dead. Already in this life, the philosopher tries to free his soul from the body in order to acquire true knowledge as the soul is progressively becoming detached from the body. Centuries after it was written, Plato?s Phaedo continued to play a role for some early Christian authors, and this article focuses on three (...) instances where Christian women mirror Socrates and/or his definition of philosophy. We find these instances in hagiographical literature from the fourth and fifth centuries at different locations in the Roman Empire - in the Lives of Macrina, Marcella and Syncletica. These texts are all to varying degrees impacted by Platonic philosophy and by the ideal of the male philosopher Socrates. As women mastering philosophy, they widened common cultural expectations for women, revealing how Christian authors in certain contexts ascribed authority to female figures. (shrink)

The sense of agency is typically defined as the experience of controlling one’s own actions, and through them, changes in the external environment. It is often assumed that this experience is a single, unified construct that can be experimentally manipulated and measured in a variety of ways. In this article, we challenge this assumption. We argue that we should acknowledge four possible agency-related psychological constructs. Having a clear grasp of the possible constructs is important since experimental procedures are only able (...) to target some but not all the possible constructs. The unacknowledged misalignment of the possible constructs of a sense of agency and the experimental procedures is a major theoretical and methodological obstacle to studying the sense of agency. Only if we recognize the nature of this obstacle will we be able to design the experimental paradigms that would enable us to study the responsible computational mechanisms. (shrink)

How should one react when one has a belief, but knows that other people—who have roughly the same evidence as one has, and seem roughly as likely to react to it correctly—disagree? This paper argues that the disagreement of other competent inquirers often requires one to be much less confident in one’s opinions than one would otherwise be.

In his essay, ‘Heidegger's Categories in Sein und Zeit’, Robert Brandom argues that Heidegger, particularly in the notion of Zuhandenheit, anticipates his own normatively pragmatist conception of intentionality. He attempts to demonstrate this by marshalling short passages from right across the relevant sections of Sein und Zeit in such a way that they do seem to say what Brandom claims. But does one reach the same conclusion when one examines, more or less in sentence‐by‐sentence fashion, the large slab of text (...) in which Heidegger introduces the notion of Zuhandenheit? I believe not. First, however, let us look at how Brandom reads Heidegger, in particular, how he interprets the notion of Zuhandenheit, which, in contrast both to Macquarrie and Robinson and to Brandom, I shall translate as ready‐to‐handedness.1. (shrink)

Sometimes we get evidence of our own epistemic malfunction. This can come from finding out we’re fatigued, or have been drugged, or that other competent and well-informed thinkers disagree with our beliefs. This sort of evidence seems to seems to behave differently from ordinary evidence about the world. In particular, getting such evidence can put agents in a position where the most rational response involves violating some epistemic ideal.

What role, if any, does formal logic play in characterizing epistemically rational belief? Traditionally, belief is seen in a binary way - either one believes a proposition, or one doesn't. Given this picture, it is attractive to impose certain deductive constraints on rational belief: that one's beliefs be logically consistent, and that one believe the logical consequences of one's beliefs. A less popular picture sees belief as a graded phenomenon.

By drawing on testimonies gathered in rural Vietnam, this article focuses on the violence to which local inhabitants were subjected when Vietnam was under French rule. On a self-imposed ‘civilizing mission’, the control of local bodies was critical for the colonial powers and they became the subject of brutal abuse. Violence was exercised with impunity in the occupied areas and rendered ‘logic’ in accordance with western imaginations about racial superiority. While such ideas informed colonial terror in general, the differentiated registers (...) of terror implemented in regard to women and men disclose how sovereign attempts of reducing local inhabitants to bare life were designed, in addition to race, along the lines of gender and sexuality. Vietnamese testimonies from the French colonial period reveal experiences of a reality of horror which in the article is considered through the prism of four different body typologies; typologies which elucidate the symbolic, physical, and imaginary metamorphoses through which women and men in differentiated ways were being increasingly dehumanized in the encounter with the colonial power. (shrink)

In his essay, ‘Heidegger's Categories in Sein und Zeit’, Robert Brandom argues that Heidegger, particularly in the notion of Zuhandenheit, anticipates his own normatively pragmatist conception of intentionality. He attempts to demonstrate this by marshalling short passages from right across the relevant sections of Sein und Zeit in such a way that they do seem to say what Brandom claims. But does one reach the same conclusion when one examines, more or less in sentence‐by‐sentence fashion, the large slab of text (...) in which Heidegger introduces the notion of Zuhandenheit? I believe not. First, however, let us look at how Brandom reads Heidegger, in particular, how he interprets the notion of Zuhandenheit, which, in contrast both to Macquarrie and Robinson and to Brandom, I shall translate as ready‐to‐handedness.1. (shrink)

In this paper we outline a theory of normative functionality aimed at understanding the nature of adaptive systems as globally structured, integrated systems. More specifically, the account is concerned with understanding the process relations constitutive of such systems. The explanatory agenda of this approach includes the following questions.

Sensation of Movement explores the role of sensation in motor control, bodily self-recognition and sense of agency. The sensation of movement is dependent on a range of information received by the brain, from signalling in the peripheral sensory organs to the establishment of higher order goals. Through the integration of neuroscientific knowledge with psychological and philosophical perspectives, this book questions whether one type of information is more relevant for the ability to sense and control movement. Addressing conscious sensations of movement, (...) experimental designs and measures, and the possible functions of proprioceptive and kinaesthetic information in motor control and bodily cognition, the book advocates the integration of neuroscientific knowledge and philosophical perspectives. With an awareness of the diverse ideas and theories from these distinct fields, the book brings together leading researchers to bridge these divides and lay the groundwork for future research. -/- Contributors: Thor Grünbaum and Mark Schram Christensen Andreas Kalckert Myrto Mylopoulos Mads Jensen, Mia Dong, Mikkel C. Vinding, and Morten Overgaard Anne Kavounoudias Matthew R. Longo Hong Yu Wong. (shrink)