Energy has an ambivalent status in social theory, variously figuring as a driver or an outcome of social and institutional change, or as something that is woven into the fabric of society itself. In this article the authors consider the underlying models on which different approaches depend. One common strategy is to view energy as a resource base, the management and organization of which depends on various intersecting systems: political, economic and technological. This is not the only route to take. (...) The authors develop an alternative approach, viewing energy supply and energy demand as part of the ongoing reproduction of bundles and complexes of social practice. In articulating and comparing these two positions they show how social-theoretical commitments influence the ways in which problems like those of reducing carbon emissions are framed and addressed. Whereas theories of practice highlight basic questions about what energy is for, these issues are routinely and perhaps necessarily obscured by those who see energy as an abstract resource that structures or that is structured by a range of interlocking social systems. (shrink)

Total knee arthroplasty (TKA) is a commonly implemented elective surgical treatment for end-stage osteoarthritis of the knee, demonstrating high success rates when assessed by objective medical outcomes. However, a considerable proportion of TKA patients report significant dissatisfaction postoperatively, related to enduring pain, functional limitations, and diminished quality of life. In this conceptual analysis, we highlight the importance of assessing patient-centred outcomes routinely in clinical practice, as these measures provide important information regarding whether surgery and postoperative rehabilitation interventions have effectively remediated (...) patients’ real-world “quality of life” experiences. We propose a novel precision medicine approach to improving patient-centred TKA outcomes through the development of a multivariate machine-learning model. The primary aim of this model is to predict individual postoperative recovery trajectories. Uniquely, this model will be developed using an interdisciplinary methodology involving non-linear analysis of the unique contributions of a range of preoperative risk and resilience factors to patient-centred TKA outcomes. Of particular importance to the model’s predictive power is the inclusion of a comprehensive assessment of modifiable psychological risk and resilience factors that have demonstrated relationships with TKA and other conditions in some studies. Despite the potential for patient psychological factors to limit recovery, they are typically not routinely assessed preoperatively in this patient group, and thus can be overlooked in rehabilitative referral and intervention decision-making. This represents a research-to-practice gap that may contribute to adverse patient-centred outcomes. Incorporating psychological risk and resilience factors into a multivariate prediction model could improve the detection of patients at risk of sub-optimal outcomes following TKA. This could provide surgeons and rehabilitation providers with a simplified tool to inform postoperative referral and intervention decision-making related to a range of interdisciplinary domains outside their usual purview. The proposed approach could facilitate the development and provision of more targeted rehabilitative interventions on the basis of identified individual needs. The roles of several modifiable psychological risk and resilience factors in recovery are summarised, and intervention options are briefly presented. While focusing on rehabilitation following TKA, we advocate for the broader utilisation of multivariate prediction models to inform individually-tailored interventions targeting a range of health conditions. (shrink)

During the past two decades, several reports have documented substantial support from clinicians, policy-makers, and the general public for the use of advance directives, yet studies continue to find that only a minority of individuals have completed these legal documents. Advance directives are written instructions, such as living wills or durable powers of attorney for health care, which describe an individual's medical treatment wishes in the event that individual becomes incapacitated in the future. The completion and use of advance directives (...) is one of several components of the broader activity of advance care planning, that is, the overall planning and communication of personal wishes concerning future medical care.In December 1991, the federal Patient Self-Determination Act became effective. Promoted as a federal initiative to enhance an individual's control over medical treatment decision making and, therefore, patient autonomy and self-determination, PSDA placed several new requirements on health care organizations receiving Medicare or Medicaid payments. (shrink)

During the past two decades, several reports have documented substantial support from clinicians, policy-makers, and the general public for the use of advance directives, yet studies continue to find that only a minority of individuals have completed these legal documents. Advance directives are written instructions, such as living wills or durable powers of attorney for health care, which describe an individual's medical treatment wishes in the event that individual becomes incapacitated in the future. The completion and use of advance directives (...) is one of several components of the broader activity of advance care planning, that is, the overall planning and communication of personal wishes concerning future medical care.In December 1991, the federal Patient Self-Determination Act became effective. Promoted as a federal initiative to enhance an individual's control over medical treatment decision making and, therefore, patient autonomy and self-determination, PSDA placed several new requirements on health care organizations receiving Medicare or Medicaid payments. (shrink)

Adopting the perspective of another person is an important aspect of social cognition and has been shown to depend on multisensory signals from one’s own body. Recent work suggests that interoceptive signals not only contribute to own-body perception and self-consciousness, but also to empathy. Here we investigated if social cognition – in particular adopting the perspective of another person – can be altered by a systematic manipulation of interoceptive cues and further, if this effect depends on empathic ability. The own-body (...) transformation task – wherein participants are instructed to imagine taking the perspective and position of a virtual body presented on a computer screen – offers an effective way to measure reaction time differences linked to the mental effort of taking an other’s perspective. Here, we adapted the OBT with the flashing of a silhouette surrounding the virtual body, either synchronously or asynchronously with the timing of participants’ heartbeats. We evaluated the impact of this cardio-visual synchrony on reaction times and accuracy rates in the OBT. Empathy was assessed with the empathy quotient questionnaire. Based on previous work using the cardio-visual paradigm, we predicted that synchronous cardio-visual stimulation would increase self-identification with the virtual body and facilitate participants’ ability to adopt the virtual body’s perspective, thereby enhancing performance on the task, particularly in participants with higher empathy scores. We report that participants with high empathy showed significantly better performance during the OBT task during synchronous versus asynchronous cardio-visual stimulation. Moreover, we found a significant positive correlation between empathic ability and the synchrony effect. We conclude that synchronous cardio-visual stimulation between the participant’s body and a virtual body during an OBT task makes it easier to adopt the virtual body’s perspective, presumably based on multisensory integration processes. However, this effect depended on empathic ability, suggesting that empathy, interoception and social perspective taking are inherently linked. (shrink)

Orations of the Fatimid Caliphs: Festival Sermons of the Ismaili Imams. Ed. and tr. Paul E. Walker. Ismaili Texts and Translations Series, vol. 10. London: I. B. Tauris, with the Institute of Ismaili Studies, 2009. Pp. xvii + 162 + 58. £29.50, $51.29.

Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values (...) and responsibilities in situations of moral distress. We also discuss the importance of nurses creating “counterstories” of their work as knowledgeable and trustworthy professionals to repair their damaged moral identities, and, finally, we recommend that efforts toward shifting the goal of health care away from the prolongation of life at all costs to the relief of suffering to diminish the moral distress that is a common response to aggressive care at end-of-life. (shrink)

Walker Percy was both a medical doctor and a serious Catholic—a scientist and a religious believer. He thought, however, that science had become hegemonic in the twentieth century and that it was incapable of answering the most fundamental needs of human beings. He thus leveled a critique of the scientific method and its shortcomings in failing to address the individual person over against the group. In response to these shortcomings Percy postulates a religious understanding of human life, one in (...) which man's life is understood as a pilgrimage or a search. The person who searches may not find the “object” of his search during his earthly life, but it is likely that he will come to a better understanding of himself by means of it. (shrink)

It may be the case that the most challenging moral problem of the twenty‐first century will be the relationship between the individual moral agent and the practices and institutions in which the moral agent is embedded. In this paper, we continue the efforts that one of us, Joan Liaschenko, first called for in 1993, that of using feminist ethics as a lens for viewing the relationship between individual nurses as moral agents and the highly complex institutions in which they do (...) the work of nursing. Feminist ethics, with its emphasis on the inextricable relationship between ethics and politics, provides a useful lens to understand the work of nurses in context. Using Margaret Urban Walker's and Hilde Lindemann's concepts of identity, relationships, values, and moral agency, we argue that health care institutions can be moral communities and profoundly affect the work and identity and, therefore, the moral agency of all who work within those structures, including nurses. Nurses are not only shaped by these organizations but also have the power to shape them. Because moral agency is intimately connected to one's identity, moral identity work is essential for nurses to exercise their moral agency and to foster moral community in health care organizations. We first provide a brief history of nursing's morally problematic relationship with institutions and examine the impact institutional master narratives and corporatism exert today on nurses’ moral identities and agency. We close by emphasizing the significance of ongoing dialogue in creating and sustaining moral communities, repairing moral identities, and strengthening moral agency. (shrink)

Background:While there have been studies exploring moral habitability and its impact on the work environments of nurses in Western countries, little is known about the moral habitability of the work environments of nurses and midwives in resource-constrained settings.Research objective:The purpose of this research was to examine the moral habitability of the work environment of nurses and midwives in Ghana and its influence on their moral agency using the philosophical works of Margaret Urban Walker.Research design and participants:A critical moral ethnography (...) was conducted through the analysis of interviews with 30 nurses and midwives, along with observation, and documentary materials.Ethical considerations:After receiving ethics approval, signed informed consent was obtained from participants before data collection.Results:Five themes were identified: (1) holding onto the values, identities, and responsibilities of being a midwife/nurse; (2) scarcity of resources as limiting capacity to meet caring responsibilities; (3) gender and socio-economic inequities shaping the moral-social context of practice; (4) working with incoherent moral understandings and damaged identities in the context of inter- and intra-professional relationships; and (5) surviving through adversity with renewed commitment and courage.Discussion:The nurses and midwives were found to work in an environment that was morally uninhabitable and dominated by the scarcity of resources, overwhelming and incoherent moral responsibilities, oppressive conditions, and workplace violence. These situations constrained their moral agency and provoked suffering and distress. The nurses and midwives negotiated their practice and navigated through morally uninhabitable work environment by holding onto their moral values and commitments to childbearing women.Conclusion:Creating morally habitable workplaces through the provision of adequate resources and instituting interprofessional practice guidelines and workplace violence prevention policies may promote safe and ethical nursing and midwifery practice. (shrink)

Medical futility is often defined as providing inappropriate treatments that will not improve disease prognosis, alleviate physiological symptoms, or prolong survival. This understanding of medical futility is problematic because it rests on the final outcomes of procedures that are narrow and medically defined. In this article, Walker's `expressivecollaborative' model of morality is used to examine how certain critical care interventions that are considered futile actually have broader social functions surrounding death and dying. By examining cardiopulmonary resuscitation and life-sustaining intensive (...) care measures as moral practices, we show how so-called futile interventions offer ritualistic benefit to patients, families, and health care providers, helping to facilitate the process of dying. This work offers a new perspective on the ethical debate concerning medical futility and provides a means to explore how the social value of treatments may be as important in determining futility as medical scientific criteria. (shrink)

This essay explores small “ordinary” experiences of moral harm as problems of social injustice. Starting with two stories, we first argue against a dominant framework of personal responsibility that assigns responsibility to particular blameworthy agents. Instead we sketch an account of why structural responsibility for social harm must be considered, drawing on the work of Iris Marion Young and Pierre Bourdieu. Finally, drawing on Margaret Walker’s notion of moral repair and Christopher Marshall’s interpretation of the parable of the Good (...) Samaritan, we sketch an account of Christian moral responsibility grounded in restorative justice that seeks to address daily experiences of moral harm through the moral repair work of neighbor-love. (shrink)

For deliberations on the ethical and meta-ethical implications of Alfred North Whitehead's process philosophy, here are abstracts and papers from the Ethics Section of the 6th International Whitehead Conference held at the University of Salzburg in Salzburg, Austria in July 2006. In accordance with the conference schedule, there are three subsections. The subsection on "Metaphysics of Morals and Moral Theory" includes contributions from Franklin I. Gamwell (Does Morality Presuppose God?), John W. Lango (abstract only), Duane Voskuil ("Ethics' Dipolar Necessities and (...) Theistic Implications), and Theodore Walker Jr. ("Neoclassical Cosmology and Matthew 22:36-40). The subsection on "Evaluating Moral Practices" includes contributions from Frederick Ferrè (abstract only), Seung Gap Lee (Hope for the Earth: A Process Eschatological Eco-ethics for South Korea), Mary Elizabeth Mullino Moore (Compassion, Creativity, and Form: The Ethics of Institutions), and George W. Shields (Ruse, Altruism, and Process Philosophy). The subsection on "Ethics and Aesthetic Values" includes contributions from Stephen T. Franklin (abstract only), Brian G. Henning (Is There an Ethics of Creativity?), Mihàly Tòth (Art of Life and the Ethics of Life Forming), and Guorong Yang (Problems and Perspectives in the Emerging of Global Society). (shrink)

In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...

In this paper, we explore how the prospect of artificial placenta technology (nearing clinical trials in human subjects) should encourage further consideration of the loss experienced by individuals when their pregnancy ends unexpectedly. Discussions of pregnancy loss are intertwined with procreative loss, whereby the gestated entity has died when the pregnancy ends. However, we demonstrate how pregnancy loss can and does exist separate to procreative loss in circumstances where the gestated entity survives the premature ending of the pregnancy. In outlining (...) the value that can be attached to pregnancy beyond fetal-centric narratives, we illustrate how pregnancy loss, separate to procreative loss, can be experienced. This loss has already been recognised among parents who have experienced an unexpected early ending of their pregnancy, resulting in their child being cared for in neonatal intensive care unit. Artificial placentas, however, may exacerbate these feelings and make pregnancy loss (without procreative loss) more visible. We argue that pregnancy is an embodied state in which gestation is facilitated by the body but gestation itself should be recognised as a process—and one that could be separable from pregnancy. In demarcating the two, we explore the different ways in which pregnancy loss can be understood. Our objective in this paper goes beyond contributing to our philosophical understanding of pregnancy towards practical-orientated conclusions regarding the care pathways surrounding the artificial placenta. We make recommendations including the need for counselling and careful consideration of the language used when an artificial placenta is used. (shrink)

If the world itself is metaphysically indeterminate in a specified respect, what follows? In this paper, we develop a theory of metaphysical indeterminacy answering this question.

What do we mean when we call a work of art "beautiful"? How have artists responded to changing notions of the beautiful? Which works of art have been called beautiful, and why? Fundamental and intriguing questions to artists and art lovers, but ones that are all too often ignored in discussions of art today. Elizabeth Prettejohn argues that we simply cannot afford to ignore these questions. Charting over two hundred years of western art, she illuminates the vital relationship between (...) our changing notions of beauty and specific works of art, from the works of Kauffman to Whistler, Ingres to Rosetti, Cezanne to Pollack. Beautifully illustrated with 100 photographs--60 in full color--Beauty and Art concludes with a challenging question for the future: Why should we care about beauty in the twenty-first century? (shrink)

This new and important study of semantic change examines how new meanings arise through language use, especially the various ways in which speakers and writers experiment with uses of words and constructions in the flow of strategic interaction with addressees. In the last few decades there has been growing interest in exploring systemicities in semantic change from a number of perspectives including theories of metaphor, pragmatic inferencing, and grammaticalization. Like earlier studies, these have for the most part been based on (...) data taken out of context. This book is the first detailed examination of semantic change from the perspective of historical pragmatics and discourse analysis. Drawing on extensive corpus data from over a thousand years of English and Japanese textual history, Traugott and Dasher show that most changes in meaning originate in and are motivated by the associative flow of speech and conceptual metonymy. (shrink)

In this chapter I address the concern that UNESCO World Heritage designation leads to unregulated tourism. I argue that heritage tourism not only has a negative impact on the site but may adversely impact local populations and descendant communities. I detail two related worries, UNESCO-cide and the Disneyfication of cultural heritage. The term ‘UNESCO-cide’ was coined by Marco d’Eramo to describe the role overtourism has played in the death of cities listed on UNESCO’s World Heritage list. Disneyfication is the process (...) of sanitizing potentially controversial or seemingly negative narratives from the tourist site to make the experience more palatable. I focus my analysis on two UNESCO World Heritage sites: Angkor Archaeological Complex in Cambodia and George Town in Malaysia. After a discussion about the negative impacts World Heritage designation has had on these sites, I suggest some mitigating strategies for tourism. (shrink)

In a recent paper, Barry Loewer attempts to defend Humeanism about laws of nature from a charge that Humean laws are not adequately explanatory. Central to his defense is a distinction between metaphysical and scientific explanations: even if Humeans cannot offer further metaphysical explanations of particular features of their “mosaic,” that does not preclude them from offering scientific explanations of these features. According to Marc Lange, however, Loewer’s distinction is of no avail. Defending a transitivity principle linking scientific explanantia to (...) their metaphysical grounds, Lange argues that a charge of explanatory inadequacy resurfaces once this intuitive principle is in place. This paper surveys, on behalf of the Humean, three strategies for responding to Lange’s criticism. The ready availability of these strategies suggests that Lange’s argument may not bolster anti-Humean convictions, since the argument rests on premises that those not antecedently sharing these convictions may well reject. The three strategies also correspond to three interesting ways of thinking about relations of grounding linking Humean laws and their instances, all of which are consistent with theses of Humean supervenience, and some of which have been heretofore overlooked. (shrink)

This book sets out to generate new ways of reflecting ethically about the purposes and values of contemporary higher education in relation to agency, learning, public values and democratic life, and the pedagogies which support these.

One of the alleged advantages of a constructivist theory in metaethics is that the theory avoids the epistemological problems with moral realism while reaping many of realism's benefits. According to evolutionary debunking arguments, the epistemological problem with moral realism is that the evolutionary history of our moral beliefs makes it hard to see how our moral beliefs count as knowledge of moral facts, realistically construed. Certain forms of constructivism are supposed to be immune to this argument, giving the view a (...) key advantage. This paper considers the challenge that evolutionary debunking arguments pose for the possibility of moral knowledge and concludes that such arguments do not reveal any advantages for constructivism. Furthermore, once we consider how defenders of moral knowledge should best respond to this epistemological objection, constructivists may face more difficulties, not less, explaining how our moral beliefs represent moral knowledge. (shrink)

Despite All Critique (2014) -- World Politics and Western Reason (1980) -- The Doubled Outsides of the Modern International (2005) -- The Subject of Security (1995) -- The Protection of Nature and the Nature of Protection (2005) -- Social Movements/World Politics (1994) -- Europe is Not Where It is Supposed to Be (2000) -- They Seek it Here, They Seek it There : Looking for Politics in Clayoquot Sound (2003) -- Violence, Modernity, Silence : From Weber to International Relations (1993) (...) -- Hobbes, Origins, Limits (2011) -- War, Terror, Judgement (2002) -- International, Imperial, Exceptional (2005) -- Which Democracy for Which Demos? (2013) -- The Political Theory of Boundaries and the Boundaries of Political Theory : Interview With Raia Prokhovnik (2012). (shrink)

Should monkeys be used in painful and often deadly infectious disease research that may save many human lives? This is the challenging question that Anne Barnhill, Steven Joffe, and Franklin G. Miller take on in their carefully argued and compelling article “The Ethics of Infection Challenges in Primates.” The authors offer a nuanced and even-handed position that takes philosophical worries about nonhuman primate moral status seriously and still appreciates the very real value of such research for human welfare. Overall, they (...) argue for an extension and revision of the recommendations regarding chimpanzee research offered by the Institute of Medicine in 2011; the practical upshot of their argument would allow for infection challenge research for promising interventions for Ebola and Marburg virus diseases but not for smallpox or the common cold. The IOM recommendations regarding chimpanzee research put in motion an exceptionalist policy for this great ape population. Barnhill and colleagues’ proposal would enlarge the scope of that exceptionalism to embrace NHPs other than great apes. But is such exceptionalism warranted? It is not obvious to me either that the more sophisticated capacities of a species as a whole give it greater ethical protections or that less intellectually or socially sophisticated animals ought to therefore receive less protection when it comes to painful experimental interventions. (shrink)

Gregory Bateson’s career from anthropologist, through his development of cybernetics and systems theory, to developing ideas around ‘the sacred’, has parallels with Roy Bhaskar’s intellectual journey. This paper proposes that as well as Bateson’s theory of cybernetics and systemic thought making a contribution to basic and dialectic critical realism, his final and posthumously published Angels Fear: Towards and Epistemology of the Sacred adds to our understanding of Bhaskar’s metaReality. Similarities between the development of Bateson’s work from 1936 to 1987 and (...) Bhaskar’s work from 1975 to 2016 enable the development of theory that adds to both of their respective appreciations of metaReality and the sacred. Thus, by starting a conversation between Bateson and Bhaskar, we can develop a higher order understanding of the world than proposed by Bhaskar’s metaReality alone. (shrink)

This comprehensive and up-to-date textbook gives a clear account of the different philosophical and theoretical approaches to psychology and discusses major philosophical questions such as free will and the relation between mind and body.

Our language system is ambiguous in that the same utterance can be interpreted in different ways depending on the intention of the speaker. For example, the phrase, “Nice job!” can be interpreted a...

In Nicomachean Ethics X.7–8, Aristotle defends a striking view about the good for human beings. According to Aristotle, the single happiest way of life is organized around philosophical contemplation. According to the narrowness worry, however, Aristotle's contemplative ideal is unduly Procrustean, restrictive, inflexible, and oblivious of human diversity. In this paper, I argue that Aristotle has resources for responding to the narrowness worry, and that his contemplative ideal can take due account of human diversity.

Part of the Blackwell Readings in the History of Philosophy series, this survey of late modern philosophy focuses on the key texts and philosophers of the period whose beliefs changed the course of western thought.