Background In May 2020, England moved to an opt-out organ donation system, meaning adults are presumed to be an organ donor unless within an excluded group or have opted-out. This change aims to improve organ donation rates following brain or circulatory death. Healthcare staff in the UK are supportive of organ donation, however, both healthcare staff and the public have raised concerns and ethical issues regarding the change. The #options survey was completed by NHS organisations with the aim of understanding (...) awareness and support of the change. This paper analyses the free-text responses from the survey. Methods The #options survey was registered as a National Institute of Health Research (NIHR) portfolio trial [IRAS 275992] 14 February 2020, and was completed between July and December 2020 across NHS organisations in the North-East and North Cumbria, and North Thames. The survey contained 16 questions of which three were free-text, covering reasons against, additional information required and family discussions. The responses to these questions were thematically analysed. Results The #options survey received 5789 responses from NHS staff with 1404 individuals leaving 1657 free-text responses for analysis. The family discussion question elicited the largest number of responses (66%), followed by those against the legislation (19%), and those requiring more information (15%). Analysis revealed six main themes with 22 sub-themes. Conclusions The overall #options survey indicated NHS staff are supportive of the legislative change. Analysis of the free-text responses indicates that the views of the NHS staff who are against the change reflect the reasons, misconceptions, and misunderstandings of the public. Additional concerns included the rationale for the change, informed decision making, easy access to information and information regarding organ donation processes. Educational materials and interventions need to be developed for NHS staff to address the concepts of autonomy and consent, organ donation processes, and promote family conversations. Wider public awareness campaigns should continue to promote the positives and refute the negatives thus reducing misconceptions and misunderstandings. Trial registration National Institute of Health Research (NIHR) [IRAS 275992]. (shrink)

Financial products and options are frequently complex and difficult for consumers to understand, which, alongside positively oriented sales pitches and predatory practices, may lead to uninformed and hazardous financial decisions. While several legal reforms have been implemented to improve consumers’ understanding of financial products, these modifications have only achieved mixed results. An ongoing challenge is the passive nature of such modifications, giving rise to confirmation bias—noticing the information which confirms one’s belief about a product, while ignoring or not paying enough (...) attention to the potential risks. The aim of this study was to test an implementable form of public policy to help older adults successfully navigate these financial decisions. We tested whether a self-evaluation worksheet, involving an active manipulation of financial content, would significantly impact older adult participants’ responses in an experimental reverse mortgage scenario. Forty community-dwelling, healthy older adults were randomized to one of two conditions: Control Condition and Manipulation Condition. In addition to completing a comprehensive neuropsychological examination, participants were administered the Reverse Mortgage Task. Results indicated that a simple yet active manipulation—imparting accurate and understandable information regarding a complex financial product that must be further manipulated—led to the following among participants in the Manipulation Condition: declines in mood; superior understanding of the financial product; and reduced intention of purchasing the financial product. In order for older adults to be well informed about reverse mortgages, policies must be put in place to ensure that adequate and accurate information has been not only provided but also actively processed by the individual. (shrink)

I consider reasons for questioning ‘the laws of logic’, and suggest that these laws do not accord with everyday reality. Either they are rhetorical tools rather than absolute truths, or else Plato and his successors were right to think that they identify a reality distinct from the ordinary world of experience, and also from the ultimate source of reality.

The Treatment Escalation Plan (TEP) was introduced into our trust in an attempt to improve patient involvement and experience of their treatment in hospital and to embrace and clarify a wider remit of treatment options than the Do Not Resuscitate (DNR) order currently offers. Our experience suggests that the patient and family are rarely engaged in DNR discussions. This is acutely relevant considering that the Mental Capacity Act (MCA) now obliges these discussions to take place. The TEP is a form (...) that the doctor completes, ideally with the competent patient or close relative, documenting what treatment options would be appropriate if that patient were to become acutely unwell. Ventilation of the lungs, cardiac resuscitation, renal replacement therapy, intravenous fluids and antibiotics are all discussed. The study evaluated patient and relative experiences with the TEP. 55 patients or their relatives were interviewed regarding their experience of the TEP and thoughts regarding the process. 96% of patients and relatives evaluated thought that the TEP was a good idea. Free text comments were all positive and only 34% of patients claimed to feel anxious when completing the form. Following this study, the TEP has been expanded hospital wide and into the community within our trust. Discussions are currently taking place in hospitals within our region to introduce the TEP form into other local trusts. (shrink)

1. Believing Enough to Think The Scottish system of university education requires most aspirants to an Ordinary Degree to study some philosophy. Philosophers in Scottish Universities must therefore contend with enormous first-year classes, stocked with youngsters who have little real desire to be philosophers, or even to philosophize. Some years ago, at Glasgow, a question in the final exam was as follows: ‘“Philosophy is of no use, and so should not be studied.” Discuss’. A couple of hundred students answered, more (...) or less fluently, that one should not assume that what was of no use should not be studied, since some things were worth studying in their own right, but that in any case the study of philosophy was useful since it helped one to question what authoritative figures said. No essayist, apparently, saw any paradox in this reply, which was, of course, taken word for word from the professor's lectures. (shrink)

Cette étude de l’histoire des femmes européennes qui ont eu une vie professionnelle du milieu du XIXe siècle à nos jours est une précieuse synthèse et une belle introduction à l’historiographie récente. Sylvie Schweitzer s’intéresse surtout aux femmes françaises, mais elle apporte de nombreux éléments qui permettent de les comparer à leurs collègues d’autres pays en Europe occidentale, voire de quelques pays de l’Europe de l’Est. Un thème central du livre est l’histoire de la résistance à l’é...

The accurate recognition of emotion is important for interpersonal interaction and when navigating our social world. However not all facial displays reflect the emotional experience currently being felt by the expresser. Indeed faces express both genuine and posed displays of emotion. In this article, we summarise the importance of motion for the recognition of face identity before critically outlining the role of dynamic information in determining facial expressions and distinguishing between genuine and posed expressions of emotion. We propose that both (...) dynamic information and face familiarity may modulate our ability to determine whether an expression is genuine or not. Finally, we consider the shared role for dynamic information across different face recognition tasks and the wider impact of face familiarity on determining genuine from posed expressions during real-world interactions. (shrink)

Previous studies have shown that children retreat from argument‐structure overgeneralization errors (e.g., *Don’t giggle me) by inferring that frequently encountered verbs are unlikely to be grammatical in unattested constructions, and by making use of syntax‐semantics correspondences (e.g., verbs denoting internally caused actions such as giggling cannot normally be used causatively). The present study tested a new account based on a unitary learning mechanism that combines both of these processes. Seventy‐two participants (ages 5–6, 9–10, and adults) rated overgeneralization errors with higher (...) (*The funny man’s joke giggled Bart) and lower (*The funny man giggled Bart) degrees of direct external causation. The errors with more‐direct causation were rated as less unacceptable than those with less‐direct causation. This finding is consistent with the new account, under which children acquire—in an incremental and probabilistic fashion—the meaning of particular constructions (e.g., transitive causative = direct external causation) and particular verbs, rejecting generalizations where the incompatibility between the two is too great. (shrink)

Two studies document that people are more willing to express emotions that reveal vulnerabilities to partners when they perceive those partners to be more communally responsive to them. In Study 1, participants rated the communal strength they thought various partners felt toward them and their own willingness to express happiness, sadness and anxiety to each partner. Individuals who generally perceive high communal strength from their partners were also generally most willing to express emotion to partners. Independently, participants were more willing (...) to express emotion to particular partners whom they perceived felt more communal strength toward them. In Study 2, members of romantic couples independently reported their own felt communal strength toward one another, perceptions of their partners’ felt communal strength toward them, and willingness to express emotions to each other. The communal strength partners reported feeling toward the participants predicted the participants’ willingness to express emotion to those partners. This link was mediated by participants’ perceptions of the partner’s communal strength toward them which, itself, was a joint function of accurate perceptions of the communal strength partners had reported feeling toward them and projections of their own felt communal strength for their partners onto those partners. (shrink)

Few diagnoses present as great a challenge to one's life as cancer. Many men each year are confronted with a diagnosis of early stage prostate cancer and find themselves making decisions about treatment in the face of side effects that present often devastating effects, including problems controlling one's urine and an inability to perform sexually. In this paper, we explore the narratives of men who, having chosen and undergone treatment for early stage prostate cancer, are living with the consequences. Faced (...) with what Charmaz calls an ‘identity dilemma’, how do these men linguistically construct their identities in the face of challenges to their bodily, personal, and social integrity? Drawing upon theories of social languages and Discourses, we examine how men linguistically resolve the identity dilemmas they encounter and in turn construct an identity in response to a question about the quality of their lives in the face of the adverse event of prostate cancer. We present an analysis of the interview narratives of two men and show how they ‘re-collage’ an identity in the face of fundamental changes in their functioning as men. We argue that these men draw upon alternative discourses to construct themselves as whole, competent, and ‘no less a man'. (shrink)

In The Art Instinct, Denis Dutton promoted a theoretical framework that “has more validity, more power, and more possibilities than the hermetic discourse that deadens so much of the humanities.”1 This framework is Charles Darwin’s theory of evolution by natural and sexual selection. Dutton proposed to seek “human universals that underlie the vast cacophony of cultural differences and across the globe” (AI, p. 39), based on a shared, evolved human nature.This contrasts with the relativistic presumptions of those falling under the (...) shadow of Margaret Mead and Clifford Geertz, or “the dogmas of Freud, the speculations of Jung, the sterile formulations of behaviorism, all variously empty or misleading” (p. 37). Also .. (shrink)

The notion that metaphorical statements are strictly false suggests that all statements, even those that seemed ‘literal’, are false, as none can ‘literally’ reflect reality. Statements about what we perceive or could perceive rely on evoking sensory images of such ‘visibles’, even though we have no direct access to what others, may perceive. In addition to what is visible, we must also deal with ‘invisibilia’ (both the fantasms that respectable moderns now reject and the realities that lie beyond or before (...) all sentient experience). Talking about such distant or long-ago realities must always be ‘metaphorical’, as they cannot have any of the merely ‘subjective’ properties of experience, nor do they explain those latter properties. Is there some way of confirming the brute conviction that there is a ‘real and intelligible world’, and that we can find it out or describe it ‘literally’? May ‘Reason’ be a route to understanding? But this too is an illusion: we seem never in practice to escape contradictions and had perhaps better turn again to consider the worlds of experience to which we are confined. What we experience is conditioned by our imagination: whether that metaphorical imagination points beyond experience remains uncertain. (shrink)

There are people where two or more personalities seem to have independent-and sometimes mutually forgetful-control of the same bodily individual. This chapter gives a brief account of the history of the diagnosis of "Multiple Personality Disorder" or "Dissociative Identity Disorder", and the conflicting judgment of therapists, lawyers, and philosophers as to whether this is a real syndrome. It is suggested that the diagnosis may be therapeutically helpful for some other disturbances, including anorexia, even if it does not carry the strong (...) metaphysical moral that some have supposed. The cases are of interest to philosophers as they purport to represent "real -life" difficulties for standard theories of "personal identity." The chapter argues that the diagnosis depend on prior assumptions about such identity, and so don't easily confirm or rebut any available theory, including more ancient theories about demonic possession. (shrink)

This second volume in the Limits and Renewals trilogy is an attempt to restate a traditional philosophy of mind, drawing on philosophical and poetical resources that are often neglected in modern and postmodern thought, and emphasizing the moral and political implications of differing philosophies of mind and value. Clark argues that without the traditional concept of the soul, we have little reason to believe that rational thought and individual autonomy are either possible or desirable. The particular topics covered include (...) the political context of identity claims, the possibility of knowledge and the dangers of curiosity, the fear of death, the philoprogenitive gene, and the mind-body problem. (shrink)

As the usual regulatory framework did not fit well during the last Ebola outbreak, innovative thinking still needed. In the absence of an outbreak, randomised controlled trials of clinical efficacy in humans cannot be done, while during an outbreak such trials will continue to face significant practical, philosophical, and ethical challenges. This article argues that researchers should also test the safety and effectiveness of novel vaccines in wild apes by employing a pluralistic approach to evidence. There are three reasons to (...) test vaccines in wild populations of apes: i) protect apes; ii) reduce Ebola transmission from wild animals to humans; and iii) accelerate vaccine development and licensing for humans. Data obtained from studies of vaccines among wild apes and chimpanzees may even be considered sufficient for licensing new vaccines for humans. This strategy will serve to benefit both wild apes and humans. (shrink)

It's surprising that contemporary moral philosophers have not thought more about food. The rapidly expanding industrialized landscape of modern western agribusiness raises moral concerns about large-scale livestock production, the increased usage of genetically modified crops, and the effects these now common practices may have on long-term environmental and human health. Here Pence argues that biotechnology is more helpful than harmful, on the ground that it will abate world hunger. Positioning himself as an "impartialbioethicist" he sets about the task of sorting (...) through the extremism he thinks drives all environ- mental movements' opposition to genetically modified (GM) crops. His argu- ment is simple: the claim that GM foods are unsafe is the product of alarmism, not sound reason. Discarding what environmentalists have called the Precau- tionary Principle, he argues that GM foods are safe because they have not been proven unsafe. And GM foods have been tested more than many food products now on the market. (shrink)

Many religious people are alarmed about features of the current age - violence in the media, a pervasive hedonism, a marginalization of religion, and widespread abortion. These concerns influence politics, but just as there should be a separation between church and state, so should there be a balance between religious commitments and secular arguments calling for social reforms. Robert Audi offers a principle of secular rationale, which does not exclude religious grounds for action but which rules out restricting freedom except (...) on grounds that any rational citizen would accept. The book describes the essential commitments of free democracy, explains how religious and secular moral considerations can be integrated to facilitate co-operation in a world of religious pluralism, and proposes ideals of civic virtue that express the mutual respect on which democracy depends. Audi offers a balanced and sophisticated treatment of the relations between religion and politics in a modern, secular society. (shrink)

Although Aristotle (Metaphysics, Book IV, Chapter 2) was perhaps the first person to consider the part-whole relationship to be a proper subject matter for philosophic inquiry, the Polish logician Stanislow Lesniewski [15] is generally given credit for the first formal treatment of the subject matter in his Mereology.1 Woodger [30] and Tarski [24] made use of a specific adaptation of Lesniewski's work as a basis for a formal theory of physical things and their parts. The term 'calculus of individuals' was (...) introduced by Leonard and Goodman [14] in their presentation of a system very similar to Tarski's adaptation of Lesniewski's Mereology. Contemporaneously with Lesniewski's development of his Mereology, Whitehead [27] and [28] was developing a theory of extensive abstraction based on the two-place predicate, 'x extends over y\ which is the converse of 'x is a part of y\ This system, according to Russell [22], was to have been the fourth volume of their Pήncipia Mathematica, the never-published volume on geometry. Both Lesniewski [15] and Tarski [25] have recognized the similarities between Whitehead's early work and Lesniewski's Mereology. Between the publication of Whitehead's early work and the publication of Process and Reality [29], Theodore de Laguna [7] published a suggestive alternative basis for Whitehead's theory. This led Whitehead, in Process and Reality, to publish a revised form of his theory based on the two-place predicate, 'x is extensionally connected with y\ It is the purpose of this paper to present a calculus of individuals based on this new Whiteheadian primitive predicate. (shrink)

le statut de l'intersubjectivité comme altérité à soi chez Husserl Natalie Depraz. REMERCIEMENTS À Jean-François Courtine tout d'abord, je tiens à exprimer ma très vive gratitude pour la confiance qu'il m'a témoignée en me donnant ...

Ethical Dilemmas in Community-Based Research: Working with Vulnerable Youth in Rural Communities Content Type Journal Article DOI 10.1007/s10805-010-9123-y Authors Natalie Clark, Thompson Rivers University, Kamloops, BC Canada V2C 5N3 Sarah Hunt, Simon Fraser University, Burnaby, Canada Georgia Jules, Thompson Rivers University, Kamloops, BC Canada V2C 5N3 Trevor Good, University of Victoria, Victoria, Canada Journal Journal of Academic Ethics Online ISSN 1572-8544 Print ISSN 1570-1727 Journal Volume Volume 8 Journal Issue Volume 8, Number 4.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 157-159 [Access article in PDF] Constructing Persons:The Psychopathology of Identity Stephen R. L. Clark Keywords identity, legal fictions, materialism, psychopathology. Steve Matthews argues that the criteria proposed by Stephen Behnke and Walter Sinnott-Armstrong for establishing personal identity in cases of Dissociative Identity Disorder (DID) are flawed. Neither brain identity nor memory convergence are adequate grounds for ascribing identity, even in the absence (...) of DID. Someone suffering from DID is no less responsible than a drunkard for the crimes she commits when not in her right—or at least her usual—mind, and perhaps no more responsible than someone suffering from some other mental disorder. We may decide to punish someone suffering from DID for her crimes only when she and her presumed alter both share a brain (as obviously they do) and might—at least after therapy—have memories in common, and only when the alternate personality that led to the crime is herself sane. But we should not pretend to ourselves that this judgment rests upon a clear and uncontentious notion of identity.It may be that Matthews still shares too much of his opponents' attitude: namely, that there is some matter of fact about identity, or at least some fact about the central principles by which we ascribe or recognize identity. This, at first sight, is the force of his counterexamples: that the Behnke/Sinnott-Armstrong criteria give counterintuitive results and so cannot exactly map the notion that we have in mind. Just so Socrates was able to prove that Justice did not consist in Paying One's Debts, because we would all at once acknowledge that it was not Just (or Right) to restore his sword to a homicidal maniac (or at least that there were real doubts about who it was that really owned the sword). But neither Socrates' nor Matthews' conclusion need be referred to any simple fact. It would not be sensible to say that the maniac had a right to have his sword, or that its keeper had a duty to return it, because we recognize implicitly that the very point of Justice is to do Good. Correspondingly, maybe the real effect of Matthews's counterexamples is to remind us what the point of Judgment is. Is there any matter of fact about identity, or is identity simply a way of saying who it is that should now be held responsible? Joe is not to be held responsible because he is the same person as the one who committed the crime: he is reckoned the same person because he is the one who is here now to be held responsible. That is what it is to be the same person: to be held responsible for what is personally done. [End Page 157]Someone who is not a person at all is not the same person as anyone (although they may be the same creature). And a person is a creature who holds herself responsible, or can do so: who has memories and anticipations to which she lays claim, appropriates as her own. This in turn is possible because (or so it seems) she has acquired the necessary words and customs: because she sees people being held responsible she can also hold herself responsible—or sometimes disclaim all responsibility. She will not always be allowed to escape all blame or credit, merely because her memories are of a self that no longer makes much sense to her, nor even because she has no memories at all of what was done. But this need not be because she is objectively the very same person as the sometime agent; rather, the person she is taken to be is constructed by the legal and moral attitudes of those who judge her. Those attitudes are not necessarily determinate: how exactly the ordinary rules apply in novel cases may be a matter of decision rather than discovery. The connections that ordinarily ground or specify identity are not robust enough to rely upon in DID patients (that, after all, is the trouble). We have to make... (shrink)

There are good reasons for being suspicious of the very concept of ‘a religion’, let alone a ‘world religion’. It may be useful for a hospital administrator to know a patient's ‘religion’ – as Protestant or Church of England or Catholic or Buddhist – but such labels clearly do little more than identify the most suitable chaplain, and connote groupings in the vast and confusing region of ‘religious thought and practice’ that are of very different ranks. By any rational, genealogical (...) taxonomy ‘Protestant’, ‘Anglican’, ‘Catholic’ connote species, genera or families within Christianity, which is in turn a taxon within the multivariant tradition traced back to Abraham. ‘Buddhism’ includes as many variants as would ‘Abrahamism’. Most Abrahamists, traditionally, have been theists, but it is difficult not to suspect that Marxist socialism is an atypical variant which has inherited a linear view of time, a contest between the chosen agents of justice and the doomed powers-that-be, and the prospect of a future in which ‘there shall be no more sea’. (shrink)