Aims:The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress.Background:Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon.Design:Systematic literature review and narrative synthesis (November (...) 2015–March 2016).Data sources:Ovid MEDLINE®In-Process & Other Non-Indexed Citations 1946–Present, PsycINFO®1967–Present, CINAHL®Plus 1937–Present, EMBASE 1974–24 February 2016, British Nursing Index 1994–Present, Social Care Online, Social Policy and Practice Database (1890–Present), ERIC (EBSCO) 1966–Present and Education Abstracts.Review methods:Literature relating to moral distress was systematically retrieved and subjected to relevance assessment. Narrative synthesis was the overarching framework that guided quality assessment, data analysis and synthesis.Results:In all, 152 papers underwent initial data extraction and 34 were chosen for inclusion in the narrative synthesis based on both quality and relevance. Analysis revealed different proposed conditions for the occurrence of moral distress: moral judgement, psychological and physical effects, moral dilemmas, moral uncertainty, external and internal constraints and threats to moral integrity.Conclusion:We suggest the combination of (1) the experience of a moral event, (2) the experience of ‘psychological distress’ and (3) a direct causal relation between (1) and (2) together are necessary and sufficient conditions for moral distress. (shrink)

The theory of visual perception that Irvin Rock develops and supports in this book with numerous original experiments, views perception as the outcome of a process of unconscious inference, problem solving, and the building of structural descriptions of the external world.

How would you feel about your husband, wife, or partner masturbating using pornography or erotica? For many, this would be a betrayal – a kind of cheating. I explore whether monogamous relationships should forbid solo masturbation using erotica and pornography, considering two possible objections: (1) the objection that such activity is a kind of infidelity; (2) the objection that such activity involves attitudes, usually attitudes towards women that are incompatible with an equal, loving relationship. I argue that the use of (...) erotic material in solo masturbation should not count as cheating. Solo use of pornography differs significantly from interpersonal sexual activity. Thus, unlike causal interpersonal sex, it does not undermine the role of sex within the relationship. Additionally, freedom to explore sexual fantasy through masturbation is an important element of sexual autonomy. Objection (2) holds against some but not all erotic material. Sexual enjoyment of pornography that depicts, or is produced by, suffering or degradation involves a way of seeing others that has implications for the user’s relationships with others, particularly sexual relationships. However, not all erotic material involves objectionable attitudes towards others. Thus partners should allow moderate use of some types of erotica in solo-masturbation. (shrink)

Which objects and properties are represented in perceptual experience, and how are we able to determine this? The papers in this collection address these questions together with other fundamental questions about the nature of perceptual content. The book draws together papers by leading international philosophers of mind, including Alex Byrne (MIT), Alva Noë (University of California, Berkeley), Tim Bayne (St Catherine’s College, Oxford), Michael Tye (University of Texas, Austin), Richard Price (All Souls College, Oxford) and Susanna Siegel (Harvard University) Essays (...) address the central questions surrounding the content of perceptual experience Investigates how are we able to determine the admissible contents of experience Published in association with the journal Philosophical Quarterly . (shrink)

This powerfully iconoclastic book reconsiders the influential nativist position toward the mind. Nativists assert that some concepts, beliefs, or capacities are innate or inborn: "native" to the mind rather than acquired. Fiona Cowie argues that this view is mistaken, demonstrating that nativism is an unstable amalgam of two quite different--and probably inconsistent--theses about the mind. Unlike empiricists, who postulate domain-neutral learning strategies, nativists insist that some learning tasks require special kinds of skills, and that these skills are hard-wired into (...) our brains at birth. This "faculties hypothesis" finds its modern expression in the views of Noam Chomsky. Cowie, marshaling recent empirical evidence from developmental psychology, psycholinguistics, computer science, and linguistics, provides a crisp and timely critique of Chomsky's nativism and defends in its place a moderately nativist approach to language acquisition. Also in contrast to empiricists, who view the mind as simply another natural phenomenon susceptible of scientific explanation, nativists suspect that the mental is inelectably mysterious. Cowie addresses this second strand in nativist thought, taking on the view articulated by Jerry Fodor and other nativists that learning, particularly concept acquisition, is a fundamentally inexplicable process. Cowie challenges this explanatory pessimism, and argues convincingly that concept acquisition is psychologically explicable. What's Within? is a clear and provocative achievement in the study of the human mind. (shrink)

Introduction -- The ethics of care and global politics -- Rethinking human security -- 'Women's work' : the global care and sex economies -- Humanitarian intervention and global security governance -- Peacebuilding and paternalism : reading care through postcolonialism -- Health and human security : gender, care and HIV/AIDS -- Gender, care, and the ethics of environmental security -- Conclusion. Security through care.

Scientific and philosophical perspectives on hallucination: essays that draw on empirical evidence from psychology, neuroscience, and cutting-edge philosophical theory.

Although the focus of "Globalizing Democracy and Human Rights" is practical, Gould does not shy away from hard theoretical questions, such as the relentless debate over cultural relativism, and the relationship between terrorism and democracy.

Artificial intelligence (AI) will drastically change the healthcare system. Radiology is one speciality that is most affected as AI algorithms are increasingly used in diagnostic imaging. AI‐enhanced health technologies will, inter alia, increase workflow efficiency, improve diagnostic accuracy, reduce healthcare‐related costs, and help alleviate medical personnel shortages in under‐resourced settings. However, the development of AI‐enhanced technologies in healthcare is fraught with legal, ethical, and human rights concerns. Currently, the use of AI in South African healthcare is not governed by sui (...) generis legislation or ethical guidance focused exclusively and specifically on AI, although various provisions and principles from law and ethics find application. This article outlines these normative principles and explains their relationship with the extant legal obligations and regulatory framework as applied to the use of AI in radiology services in South Africa. The article concludes with three key recommendations for radiology practitioners using AI in South Africa. These are the need for: vigilant monitoring of AI use in practice, reforms to the liability framework, and appropriate guidance from local regulators and the Health Professions Council of South Africa on the ethical use of AI. (shrink)

This book challenges readers to rethink rural health ethics. Traditional approaches to health ethics are often urban-centric, making implicit assumptions about how values and norms apply in health care practice, and as such may fail to take into account the complexity, depth, richness, and diversity of the rural context. There are ethically relevant differences between rural health practice and rural health services delivery and urban practice and delivery that go beyond the stereotypes associated with rural life and rural health services. (...) This book examines key values in the rural context that have not been fully explored or taken into account when we examine health ethics issues, including the values of community and place, and a need to “revalue” relationships. It also advocates for a greater attention to meso and macro level analysis in rural health ethics as being critical to ethical analysis of rural health care. This book is essential reading for those involved in health ethics, rural health policy and governance, and for rural health providers. (shrink)

Can the phenomenal character of perceptual experience be altered by the states of one's cognitive system, for example, one's thoughts or beliefs? If one thinks that this can happen then one thinks that there can be cognitive penetration of perceptual experience; otherwise, one thinks that perceptual experience is cognitively impenetrable. I claim that there is one alleged case of cognitive penetration that cannot be explained away by the standard strategies one can typically use to explain away alleged cases. The case (...) is one in which it seems subjects' beliefs about the typical colour of objects affects their colour experience. I propose a two-step mechanism of indirect cognitive penetration that explains how cognitive penetration may occur. I show that there is independent evidence that each step in this process can occur. I suspect that people who are opposed to the idea that perceptual experience is cognitively penetrable will be less opposed to the idea when they come to consider this indirect mechanism and that those who are generally sympathetic to the idea of cognitive penetrability will welcome the elucidation of this plausible mechanism. (shrink)

Block [Block, N. . Two neural correlates of consciousness. Trends in Cognitive Science, 9, 46–52] and Snodgrass claim that a signal detection theory analysis of qualitative difference paradigms, in particular the exclusion failure paradigm, reveals cases of phenomenal consciousness without access consciousness. This claim is unwarranted on several grounds. First, partial cognitive access rather than a total lack of cognitive access can account for exclusion failure results. Second, Snodgrass’s Objective Threshold/Strategic model of perception relies on a problematic ‘enable’ approach to (...) perception that denies the possibility of intentional control of unconscious perception and any effect of following different task instructions on the presence/absence of phenomenal consciousness. Many of Block’s purported examples of phenomenal consciousness without cognitive access also rely on this problematic approach. Third, qualitative difference paradigms may index only a subset of access consciousness. Thus, qualitative difference paradigms like exclusion failure cannot be used to isolate phenomenal consciousness, any attempt to do so still faces serious methodological problems. (shrink)

It is a philosophy of patient care, and is therefore open to critique and evaluation.Using the Oxford Textbook of Palliative Medicine Third Edition as their ...

In this paper we trace the historical exclusion of women from the legal profession in Canada. We examine women’s efforts to gain entry to law practice and their progress through the last century. The battle to gain entry to this exclusive profession took place on many fronts: in the courts, government legislature, public debate and media, and behind the closed doors of the law societies. After formal barriers to entry were dismantled, women continued to confront formidable barriers through overt and (...) subtler forms of discrimination and exclusion. Today’s legal profession in Canada is a contested one. Women have succeeded with large enrolments in law schools and growing representation in the profession. However, women remain on the margins of power and privilege in law practice. Our analysis of contemporary official data on the Canadian legal profession demonstrates that women are under-represented in private practice, have reduced chances for promotion, and are excluded from higher echelons of authority, remuneration, and status in the profession. Yet, the contemporary picture of the legal profession also reveals that women are having an important impact on the profession of law in Canada by introducing policy reforms aimed at creating a more humane legal profession. (shrink)

Research ethicists have recently declared a new ethical imperative: that researchers should communicate the results of research to participants. For some analysts, the obligation is restricted to the communication of the general findings or conclusions of the study. However, other analysts extend the obligation to the disclosure of individual research results, especially where these results are perceived to have clinical relevance. Several scholars have advanced cogent critiques of the putative obligation to disclose individual research results. They question whether ethical goals (...) are served by disclosure or violated by non-disclosure, and whether the communication of research results respects ethically salient differences between research practices and clinical care. Empirical data on these questions are limited. Available evidence suggests, on the one hand, growing support for disclosure, and on the other, the potential for significant harm. (shrink)

ABSTRACT This paper reveals David Hilbert’s position in the philosophy of mathematics, circa 1900, to be a form of non-eliminative structuralism, predating his formalism. I argue that Hilbert withstands the pressing objections put to him by Frege in the course of the Frege-Hilbert controversy in virtue of this early structuralist approach. To demonstrate that this historical position deserves contemporary attention I show that Hilbertian structuralism avoids a recent wave of objections against non-eliminative structuralists to the effect that they cannot distinguish (...) between structurally identical but importantly distinct mathematical objects, such as the complex roots of $-1$. (shrink)

In the late 1940s, a microanatomist from London Ontario, Murray Barr, discovered a mark of sex chromosome status in bodily tissues, what came to be known as the ‘Barr body’. This discovery offered an important diagnostic technology to the burgeoning clinical science community engaged with the medical interpretation and management of sexual anomalies. It seemed to offer a way to identify the true, underlying sex in those whose bodies or lives were sexually anomalous . The hypothesis that allowed the Barr (...) body to stand in for ‘chromosomal’ or ‘genetic’ sex was provisional, but it supported the expectation that genetic information established one’s primary identity, and the conviction that the animal world could be neatly divided into two, and only two, sexes. Ultimately, this provisional hypothesis, and its status as an unambiguous arbiter of true sex, was overturned. But during much of the 1950s, Barr’s thesis about the identity of the Barr body was consistent with a coherent set of theories and evidence explaining sexual development and sexual pathology. Though provisional, the scientific status of the sex chromatin within this system of knowledge was good enough to support a flourishing research enterprise in the clinical sciences. (shrink)

Fiona Woollard presents an original defence of the Doctrine of Doing and Allowing, according to which doing harm seems much harder to justify than merely allowing harm. She argues that the Doctrine is best understood as a principle that protects us from harmful imposition, and offers a moderate account of our obligations to offer aid to others.

This paper explores the potential for an international political theory of care as an alternative to liberalism in the context of contemporary global politics. It argues that relationality and interdependence, and the responsibilities for and practices of care that arise therewith, are fundamental aspects of moral life and sites of political contestation that have been systematically denied and obfuscated under liberalism. A political theory of care brings into view the responsibilities and practices of care that sustain not just ‘bare life’ (...) but all social life, from nuclear and extended families to local, national and transnational communities. It disrupts and challenges the individualism of liberalism, and the associated valorization of ‘freedom’, ‘autonomy’, and ‘toleration’. Instead, it emphasizes an ontology of relationality and interdependence that accepts the existence of vulnerability without reifying particular individuals, groups or states as ‘victims’ or ‘guardians’. Furthermore, by demonstrating the gendered and raced nature of caring in the contemporary world—from the household to the transnational level—an international political theory of care challenges our received assumptions about ‘dependence’ in world politics, and opens up space to interrogate politically not only gender but race and other aspects of inequality in the global political economy. (shrink)

Ethical perspectives on regional, rural, and remote healthcare often, understandably and importantly, focus on inequities in access to services. In this commentary, we take the opportunity to examine the implications of normalizing metrocentric views, values, knowledge, and orientations, evidenced by the recent (2022) New South Wales inquiry into health outcomes and access to hospital and health services in regional, rural and remote New South Wales, for contemporary rural governance and justice debates. To do this, we draw on the feminist inspired (...) approach to rural health ethics involving analysis of power relationships developed by Simpson and McDonald and related ideas from critical health sociology. In presenting this analysis, we extend contemporary thought about spatial health inequities and structural violence. (shrink)

This article develops an approach to ethical globalization based on a feminist, political ethic of care; this is achieved, in part, through a comparison with, and critique of, Thomas Pogge's World Poverty and Human Rights. In his book, Pogge makes the valid and important argument that the global economic order is currently organized such that developed countries have a huge advantage in terms of power and expertise, and that decisions are reached purely and exclusively through self-interest. Pogge uses an institutional (...) rights framework to argue that direct responsibility for global poverty and inequality lies with the citizens of developed countries, since suffering and death are caused by global economic arrangements designed and imposed by our governments. While this argument is certainly compelling, I have argued that it tells us little about the actual effects of globalization on the real people of the South - including women, children and the elderly. As a result, it can offer little in the way of real alternatives or policy prescriptions. As a moral orientation, a care ethic relies on a relational moral ontology, and leads us to consider different values in terms of human flourishing. Moreover, it pushes us to consider the normative implications of aspects of the global political economy which are usually not 'seen' at all, including the global distribution of care work and the corresponding patterns of gender and racial inequality, the underprovision of care and resources for caring work in both the developed and developing world, and the ways in which unpaid or low-paid caring work helps to sustain a cycle of exploitation and inequality on a global scale. (shrink)

Merleau-Ponty identifies an intertwined affective state of anxiety and courage, claiming that these are one and the same thing, as a fundamental characteristic of human existence. I argue that trust, understood as phenomenologically basic, is the unity, or the something beyond, the singularly conceived states of anxiety and courage, and that trust itself cannot be conceived apart from these states. Merleau-Ponty says little, directly, about trust in his work, yet his focus on the fundamental precariousness of existence demands such an (...) exploration. I explore how our ordinary day-to-day experience of existence is related to an intertwined affective state of anxiety and courage and how trust is operative in affective depth, in order to understand how it is we come to speak of trust not only in terms of proximity and distance, emotional depth and extension across time, but most markedly, in terms of how we see someone and what it is like to be in relation to them. (shrink)

Arien Mack and Irvin Rock make the radical claim that there is no conscious perception of the visual world without attention to it.

The biomedicalist conceptualization of disablement as a personal medical tragedy has been criticized by disability studies scholars for discounting the difference between disability and impairment and the ways disability is produced by socio-environmental factors. This paper discusses prospects for partnerships between disability studies teaching/research and medical education; addresses some of the themes around the necessity of critical disability studies training for medical students; and examines a selection of issues and themes that have arisen from disability education courses within medical schools (...) globally. The paper concludes that providing there is a commitment from senior management, universities are well positioned to apply both vertical and horizontal approaches to teaching disability studies to medical students. (shrink)

Many philosophers believe that God has been put to rest. Naturalism is the default position, and the naturalist can explain what needs to be explained without recourse to God. This book agrees that we should be naturalists, but it rejects the more prevalent scientific naturalism in favour of an 'expansive' naturalism inspired by David Wiggins and John McDowell. Fiona Ellis draws on a wide range of thinkers from theology and philosophy, and spans the gulf between analytic and continental philosophy. (...) She tackles various philosophical problems including the limits of nature and the status of value; some theological problems surrounding the natural/ supernatural relation, the Incarnation, and the concept of myth; and offers a model to comprehend the relation between philosophy and theology. (shrink)

There existed a tradition of mimetic experimentation in the late nineteenth century, whereby morphologists sought to scale down sublime natural phenomena to tabletop devices in the laboratory. Experimenters constructed analogs of the aurora, attempting to replicate the colors and forms of the phenomenon with discharge tube experiments and electrical displays, which became popular spectacles at London’s public galleries. This paper analyses a closely allied but different kind of imitation. Between 1872 and 1884, Professor Karl Selim Lemström (1838–1904) attempted to reproduce (...) the aurora borealis in all of its complexity atop four mountains in northern Finland. Crucially, his “artificial aurora” was to materialize at the same scale as the original phenomenon and in its natural habitat in the polar atmosphere. With his experiment Lemström hoped to uncover the workings of the aurora and the electrical currents that he believed were always present within the atmosphere; his epistemological framework was one of learning by making. This paper sheds light on the broader problem of what it meant to authentically replicate a phenomenon that remained largely enigmatic, and, most importantly, how this replication could be verified. This prompts a discussion as to whether model experiments needed only to appear visually similar to the objects they purported to imitate, were required to preserve their form, or needed to be materially identical in order to the original to be identified as legitimate “reproductions” in the late nineteenth century. (shrink)

Cet article propose une contribution théorique afin de penser la paix dans le champ de l’économie. Nous mettons en exergue que les conditions de pacification des relations socio-économiques demeurent en partie impensée par la discipline économique qui a pourtant consacré une part de ses analyses à la question de l’harmonie sociale. Codes JEL : A1, B13, B15, N01.

Analysis of a diverse cross‐sample of plant‐insect interactions suggests that the abundance of vitamin C (L‐ascorbic acid, ascorbate or AsA) in plants influences their susceptibility to insect feeding. These effects may be mediated by AsAs roles as an essential dietary nutrient, as an antioxidant in the insect midgut, or as a substrate for plant‐derived ascorbate oxidase, which can lead to generation of toxic reactive oxygen species. Ascorbate can also influence the efficacy of plant defenses such as myrosinases and tannins, and (...) alter insects' susceptibility to natural enemies. Conversely, herbivores appear to influence both de novo synthesis and redox cycling of AsA in their host plants, thereby potentially altering the nutritional value of crops and their susceptibility to pests. The recent development of genetically modified crops with enhanced AsA content provides both an impetus and a tool set for further studies on the role of AsA in plant‐insect interactions. (shrink)

This article defends an ethics of care approach to global justice, which begins with an empirically informed account of injustices resulting from the workings and effects of contemporary neo-liberalism and hegemonic masculinities. Dominant distributive approaches to global justice see the unequal distribution of resources or ?primary goods? as the basic source of injustice. Crucially, however, most of these liberal theories do not challenge the basic structural and ideational ?frames? that govern the global political economy. Instead, they seek to ?correct? unjust (...) patterns of distribution according to an ideal theory. Subjects in these theories are generally understood as abstract, autonomous and impartial; this is in contrast to an ethics of care, which starts with an ontology of the subject as embodied, vulnerable and relational. The first part of this article explores the role and nature of theory in relation to the task of considering injustice on a global scale and offers a critique of the narrow focus in traditional theories of justice on the distribution of ?primary goods?. The second part considers the effects of neo-liberal globalization and hegemonic masculinities on global working families in order to illustrate the relationship between care and global justice. The final section sketches out a care-ethics approach to global injustice, focusing on three features: first, care as a relational approach; second, the focus in care ethics on intersecting structures of injustice; and third, care as a multi-scalar approach to global injustice. (shrink)