BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...) hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior.ConclusionLevels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. (shrink)

Written by one of today's most creative and innovative philosophers, Ruth Garrett Millikan, this book examines basic empirical concepts; how they are acquired, how they function, and how they have been misrepresented in the traditional philosophical literature. Millikan places cognitive psychology in an evolutionary context where human cognition is assumed to be an outgrowth of primitive forms of mentality, and assumed to have 'functions' in the biological sense. Of particular interest are her discussions of the nature of abilities as (...) different from dispositions, her detailed analysis of the psychological act of reidentifying substances, and her critique of the language of thought for mental representation. In a radical departure from current philosophical and psychological theories of concepts, this book provides the first in-depth discussion on the psychological act of reidentification. (shrink)

The fourth edition of this bestselling title is designed to help you think critically and thoughtfully about ethical decisions you'll face in practice-in any health care discipline. Utilizing a unique 6-step decision making process designed by the author, this multi-disciplinary text provides an expert framework for making effective choices that lead to a professional and caring response to patients and clients.

The early Augustan Age witnessed an increase in building activities and overall interest in mainland Greece which has primarily been understood from the perspective of Roman appropriation of Greek culture, or from that of local Greek independence and “re-Hellenization.” Taking late Republican Athens as an extensive case study, this article shows that, when moving beyond either a top-down or bottom-up vision, developments in the late Republican and early Augustan Age can be properly contextualized as being part of a continuous strategy (...) of Roman leaders and the Athenian elite to negotiate power and influence within a shared field of references. (shrink)

Sor Juana Inés de la Cruz -- Gabriel Álvarez de Toledo -- Pedro de Peralta Barnuevo -- Francisco Botello de Moraes.

Hannah Arendt claims the concept of brotherhood presents false notions of political community that elide historic hatreds of others and threaten modern political life. This paper explores Arendt’s critical assessment of the concept of brotherhood in order to reflect on one specific example: the politics of the Muslim Brotherhood in Egypt in the wake of the Arab Spring of 2011. While some observers reject Arendt’s assessment of brotherhood as too narrow, her criticisms raise useful questions about democracy and plurality, which (...) confront any community that exhorts its members to act as ‘brethren’ rather than as ‘citizens.’ The Muslim concept of brotherhood suggests many different possibilities for belonging: a classic universalism of the Abrahamic natural law tradition; a progressive counter-public sphere; and as well the authoritarian private community of believers as represented in the early writings of the Muslim Brotherhood leadership. Therefore, the politically controversial Muslim Brotherhood has no monopoly over the understanding of the Muslim concept of brotherhood. However, it is the most powerful, most well-organized brotherhood movement. The paper opens and ends with reflections on the Arab Spring of 2011, its one-year anniversary in January 2012, and considers other possibilities for the concept of brotherhood against the backdrop of Arendt’s analysis. (shrink)

This article considers two arguments that purport to show that inductive reasoning is unjustified: the argument adduced by Sextus Empiricus and the (better known and more formidable) argument given by Hume in the Treatise. While Sextus’ argument can quite easily be rebutted, a close examination of the premises of Hume’s argument shows that they are seemingly cogent. Because the sceptical claim is very unintuitive, the sceptical argument constitutes a paradox. And since attributions of justification are theoretical, and the claim that (...) they are never (or seldom) true isn’t preposterous, the correct response to the paradox may well be to admit that the sceptic has exposed our error in making them. (shrink)

Based on her earlier ground-breaking axiomatization of quantified modal logic, the papers collected here by the distinguished philosopher Ruth Barcan Marcus cover much ground in the development of her thought, spanning from 1961 to 1990. The first essay here introduces themes initially viewed as iconoclastic, such as the necessity of identity, the directly referential role of proper names as "tags", the Barcan Formula about the interplay of possibility and existence, and alternative interpretations of quantification. Marcus also addresses the putative (...) puzzles about substitutivity and about essentialism. The collection also includes influential essays on moral conflict, on belief and rationality, and on some historical figures. Many of her views have been incorporated into current theories, while others remain part of a continuing debate. (shrink)

In liberal political theory, meaningful work is conceptualised as a preference in the market. Although this strategy avoids transgressing liberal neutrality, the subsequent constraint upon state intervention aimed at promoting the social and economic conditions for widespread meaningful work is normatively unsatisfactory. Instead, meaningful work can be understood to be a fundamental human need, which all persons require in order to satisfy their inescapable interests in freedom, autonomy, and dignity. To overcome the inadequate treatment of meaningful work by liberal political (...) theory, I situate the good of meaningful work within a liberal perfectionist framework, from which standpoint I develop a normative justification for making meaningful work the object of political action. To understand the content of meaningful work, I make use of Susan Wolf’s distinct value of meaningfulness, in which she brings together the dimensions of objectivity and subjectivity into the ‘bipartite value’ of meaningfulness (BVM) (Wolf, Meaning in life and why it matters, 2010). However, in order to be able to incorporate the BVM into our lives, we must become valuers, that is, co-creators of values and meanings. This demands that we acquire the relevant capabilities and status as co-authorities in the realm of value. I conclude that meaningful work is of first importance because it is a fundamental human need, and that society ought to be arranged to allow as many people as possible to experience their work as meaningful through the development of the relevant capabilities. (shrink)

Research on visual attention has uncovered significant anomalies, and some traditional methods may have inadvertently probed peripheral vision rather than attention. Vision science needs to rethink visual attention from the ground up. To facilitate this, for a year I banned the word “attention” in my lab. This constraint promoted a more precise discussion of attention-related phenomena, capacity limits, and mechanisms. The insights gained lead me to challenge attributing to “attention” those phenomena that can be better explained by perceptual processes, are (...) predictable by an ideal observer model, or that otherwise may not require an additional mechanism. I enumerate a set of critical phenomena in need of explanation. Finally, I propose a unifying theory in which all perception results from performing a task, and tasks face a limit on complexity. (shrink)

On rivers, mountains and secrets : an introduction to the study and its subjects -- Talking to God-- and God talking back -- Mind embodied : spiritual practice and consciousness -- Place and the making of religious practice -- The spirit of the work : challenging oppression, nurturing diversity -- Conscious sex, sacred celibacy : sexuality and the spiritual path.

Christians, health care, and basic moral reasoning -- When life ends -- Chronic illness, suffering, and Christian responses -- Organ donation and heroic medicine -- Scarce resources and Christian compassion -- Abortion -- Assisted reproduction and embryo selection -- Embryo research and cloning -- What happened to the neighbors? global health care -- The global challenge of HIV/AIDS -- Concluding thoughts.

Based on Robert Baker's metaphorical view of damaging language, I argue that morally responsible individuals are obligated to refrain from using the word as a negative adjective directed towards that which the speaker dislikes. According to the metaphorical view, while a speaker may understand her use of the word as devoid of homosexual connotations, the hearer is likely to conclude that his puts him in the same hated category as all of those other objects, events, and persons who are negatively (...) called. (shrink)

To the Editor: I was glad to see the Times taking an interest in the growing field of philosophical counseling, as evidenced by its March 21 article “The Socratic Shrink”. However, while providing...

Phenomenal reports were obtained immediately after participants retrieved information from long-term memory. Data were gathered for six basic forms of memory and for three forms of memory that asked for declarative information about procedural tasks . The data show consistent reports of mental imagery during retrieval of information from the generic perceptual, recollective, motor—declarative, rote—declarative, and cognitive—declarative categories; much less imagery was reported for the semantic, motor, rote, and cognitive categories. Overall, the data provide support for the theoretical framework outlined (...) in Brewer and Pani. (shrink)

" Biosemantics " was the title of a paper on mental representation originally printed in The Journal of Philosophy in 1989. It contained a much abbreviated version of the work on mental representation in Language Thought and Other Biological Categories. There I had presented a naturalist theory of intentional signs generally, including linguistic representations, graphs, charts and diagrams, road sign symbols, animal communications, the "chemical signals" that regulate the function of glands, and so forth. But the term " biosemantics " (...) has usually been applied only to the theory of mental representation. Let me first characterize a more general class of theories called "teleological theories of mental content" of which biosemantics is an example. Then I will discuss the details that distinguish biosemantics from other naturalistic teleological theories. (shrink)

We report the results of a study that examines the association between gender and individuals’ intentions to report fraudulent financial reporting using non-anonymous and anonymous reporting channels. In our experimental study, we examine whether reporting intentions in response to discovering a fraudulent financial reporting act are associated with the participants’ gender, the perpetrator’s gender, and/or the interaction between the participants’ and perpetrator’s gender. We find that female participants’ reporting intentions for an anonymous channel are higher than for male participants; the (...) fraud perpetrator’s gender and the interaction with participants’ gender were not significantly associated with anonymous channel reporting intentions. Neither of the two factors nor the interaction between the two factors was associated with reporting intentions to a non- anonymous reporting channel. Results from an additional analysis indicate that male and female participants differ in the extent to which they judge the reduction in personal costs of an anonymous reporting channel compared to a non-anonymous reporting channel and that the reduction in personal costs mediates the relationship between participant gender and anonymous reporting intentions. (shrink)

Ruth Garrett Millikan presents a strikingly original account of how we get to grips with the world in thought. Her question is Kant's 'How is knowledge possible?', answered from a contemporary naturalist standpoint. We begin with an understanding of what the world is like prior to cognition, then develop a theory of cognition within that world.

Sexual abuse by clergymen, poisoned water, police brutality—these cases each involve two wrongs: the abuse itself and the attempt to avoid responsibility for it. Our focus is this second wrong—the cover up. Cover ups are accountability failures, and they share common strategies for thwarting accountability whatever the abuse and whatever the institution. We find that cover ups often succeed even when accountability mechanisms are in place. Hence, improved institutions will not be sufficient to prevent accountability failures. Accountability mechanisms are tools (...) that people must be willing to use in good faith. They fail when people are complicit. What explains complicity? We identify certain human proclivities and features of modern organizations that lead people to become complicit in the wrongdoing of others. If we focus exclusively on the design of institutions, we will fail to constrain the perpetrators of wrongdoing. Understanding complicity is key to understanding accountability failures. (shrink)

El ánimo de esta investigación es la de valorar a través de la revisión documental, uno de los aspectos fundamentales para el aprendizaje y el desarrollo de destrezas musicales como es la velocidad de procesamiento (VP). Además, se aborda la estimulación cognitiva (EC) y la atención, como elementos propios del ser humano, que proporcionan aprendizajes significativos. Por otro lado, y para la consecución de contenidos musicales, se establece una relación de procedimientos para la secuenciación docente y a modo de herramientas (...) innovadoras, Music Mind Games, sistema de enseñanza de lenguaje musical, inspirado por la metodología Suzuki. (shrink)

Die vorliegende Untersuchung setzt sich mit jenen Werken auseinander, die im frühen 18. Jahrhundert hermeneutische Problemgehalte ansprechen. Gleichsam als Vorbotin einer Kritik der Verstandeserkenntnis wird in der rationalistischen Aufklärung eine Bewegung spürbar, die geschichtshermeneutische, erkenntnis- und moralkritische Ansätze hervorbringt und in Opposition zu allgegenwärtigen nomologischen Vorstellungen die Frage nach dem ganzen Menschen neu formuliert. Diese ästhetisch-hermeneutische Kritik bezieht sich nicht nur auf die Gesetzeswissenschaften, sondern auch auf geschichtliche Problemstellungen, so daß die hier thematisierten Diskussionen über Gemeinsinn, empfindsame Moralkritik und ästhetische (...) Erkenntniskritik gleichsam Momente eines umfassenden Zusammenhangs verkörpern. (shrink)

We were shocked and deeply saddened to learn the news today. We had not heard from Martin for some time and were planning to write soon. Like so many others I considered Martin a loyal friend as well as a distinguished scholar. He set the highest standards for integrity and dedication to scholarship. No one was more generous in sharing his knowledlge with younger scholars.

Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)

A leading scholar in the psychology of thinking and reasoning argues that the counterfactual imagination—the creation of "if only" alternatives to ...

Ruth Millikan is well known for having developed a strikingly original way for philosophers to seek understanding of mind and language, which she sees as biological phenomena. She now draws together a series of groundbreaking essays which set out her approach to language. Guiding the work of most linguists and philosophers of language today is the assumption that language is governed by prescriptive normative rules. Millikan offers a fundamentally different way of viewing the partial regularities that language displays, comparing (...) them to biological norms that emerge from natural selection. This yields novel and quite radical consequences for our understanding of the nature of public linguistic meaning, the process of language understanding, how children learn language, and the semantics/pragmatics distinction. (shrink)