La désinstitutionnalisation des services de santé mentale a créé un espace pour la création de solutions nouvelles et communautaires dans les pays occidentaux. Toutefois, le domaine semble encore manquer de dispositifs idéologiques et pratiques cohérentes. Cet article a pour objectif d’examiner les caractéristiques des services de logement conçus pour soutenir les individus atteints d’un handicap psychique en Suède, et s’appuie sur les expériences des prestataires de services locaux. L’accent est mis sur le cadre organisationnel des services, l’orientation principale et le (...) contenu conceptuel. L’article se fonde sur une étude de cas sur de multiples individus et portant sur dix municipalités suédoises. Les données consistent principalement en des entretiens avec des informateurs clés de l’organisation de services sociaux. Les conclusions soulignent l’émergence d’une nouvelle génération d’utilisateurs de services ayant des besoins complexes et qui remettent en question à la fois l’organisation et la nature des services offerts. Les foyers collectifs et l’aide au logement mobile ont été considérés comme les piliers de l’offre de services. Toutefois, un certain nombre de solutions locales pragmatiques ont également été identifiées, ainsi que des initiatives ayant pour objectif de réduire l’étendue des structures de type institutionnel. (shrink)

We respond in this paper to various counter arguments advanced against our stance on conscientious objection accommodation. Contra Maclure and Dumont, we show that it is impossible to develop reliable tests for conscientious objectors' claims with regard to the reasonableness of the ideological basis of their convictions, and, indeed, with regard to whether they actually hold they views they claim to hold. We demonstrate furthermore that, within the Canadian legal context, the refusal to accommodate conscientious objectors would not constitute (...) undue hardship for such objectors. We reject concerns that refusing to accommodate conscientious objectors would limit the equality of opportunity for budding professionals holding particular ideological positions. We also clarify various misrepresentations of our views by respondents Symons, Glick and Jotkowitz, and Lyus. (shrink)

According to one view of linguistic information, a speaker can convey contextually new information in one of two ways: by asserting the content as new information; or by presupposing the content as given information which would then have to be accommodated. This distinction predicts that it is conversationally more appropriate to assert implausible information rather than presuppose it. A second view rejects the assumption that presuppositions are accommodated; instead, presuppositions are assimilated into asserted content and both are correspondingly open to (...) challenge. Under this view, we should not expect to find a difference in conversational appropriateness between asserting implausible information and presupposing it. To distinguish between these two views of linguistic information, we performed two self-paced reading experiments with an on-line stops-making-sense judgment. The results of the two experiments—using the presupposition triggers the and too—show that accommodation is inappropriate relative to non-presuppositional controls when the presupposed information is implausible but not when it is plausible. These results provide support for the first view of linguistic information: the contrast in implausible contexts can only be explained if there is a presupposition-assertion distinction and accommodation is a mechanism dedicated to reasoning about presuppositions. (shrink)

This paper examines the famous doctrine that independent prediction garners more support than accommodation. The standard arguments for the doctrine are found to be invalid, and a more realistic position is put forward, that whether evidence supports or not a hypothesis depends on the prior probability of the hypothesis, and is independent of whether it was proposed before or after the evidence. This position is implicit in the subjective Bayesian theory of confirmation, and the paper ends with a brief (...) account of this theory, and answer to the principal objections to it. (shrink)

The emergence of the COVID-19 pandemic initiated major disruptions to higher education systems. Physical spaces that previously supported interpersonal interaction and community were abruptly inactivated, and faculty largely took on the responsibility of accommodating classroom structures in rapidly changing situations. This study employed interviews to examine how undergraduate Science, Technology, Engineering, and Mathematics (STEM) instructors adapted instruction to accommodate the mandated transition to virtual learning and how these accommodations supported or hindered community and belonging during the onset of (...) the pandemic. Interviews with 25 STEM faculty at an undergraduate Hispanic Serving Institution revealed a wide range of accommodations they made to their courses and how they managed communication with students. Faculty strived to support student belonging with responses ranging from caring to crisis management, though some faculty expressed feelings of powerlessness when unable to accommodate certain challenges. The case of a responsive and flexible instructor is presented to highlight a productive response to a crisis. These retrospective findings point to strategies to support faculty teaching in virtual learning environments in the future; increasing opportunities for student–student and student–faculty interaction, supporting faculty in learning technologies that support these interactions and addressing faculty’s feelings of powerlessness. (shrink)

Studies have supported the effectiveness of the From Timid to a Tiger and Supportive Parenting for Anxious Childhood Emotions program in reducing childhood anxiety. This study is the first to compare the effectiveness of the two programs in the treatment of childhood anxiety disorder and reducing family accommodations levels. Parents of children aged 6 to 9 were randomly allocated to either FTTT or SPACE groups, and each attended ten online sessions following the manuals of the interventions. Throughout the study, (...) 9 participants dropped out, resulting in a total of 49 participants, and we performed statistical analyses based on data from these 49 participants. The assessment took place pre- and post-treatment and at a ten-week follow-up on parent-rated child anxiety and family accommodation measures. Analyses of variance and gain scores were conducted to examine the data. The results indicated that both treatments approaches produced significant reductions in outcome measures, and the post-treatment gains of both treatments were maintained at a ten-week follow-up, though when considering the mean differences and effect sizes across the assessment scores and between groups, overall, the FTTT was significantly more effective in reducing child anxiety scores and family accommodation levels. Our results demonstrated that FTTT significantly outperformed the SPACE program in reducing childhood anxiety problems and family accommodation levels. (shrink)

This exploratory research aims to identify the accommodation and support measures, the challenges and the needs, for students with disabilities in teaching internship context. By answering an online questionnaire, 158 SH trainees in teaching in Belgium and Quebec, affirm, for the most part, that their situation of disability has repercussions on their internships. Their main challenges and needs are related to organization and written communication. However, few accommodation and support measures have been established during the internship.

One of the central claims of the neurodiversity movement is that society should accommodate the needs of autistics, rather than try to treat autism. People have variously tried to reject this accommodation thesis as applicable to all autistics. One instance is Pier Jaarsma and Stellan Welin, who argue that the thesis should apply to some but not all autistics. They do so via separating autistics into high- and low-functioning, on the basis of IQ and social effectiveness or functionings. I (...) reject their grounds for separating autistics. IQ is an irrelevant basis for separating autistics. Charitably rendering it as referring to more general capacities still leaves us mistaken about the roles they play in supporting the accommodation thesis. The appeal to social effectiveness or functionings relies on standards that are inapplicable to autistics, and which risks being deaf to the point of their claims. I then consider if their remaining argument concerning autistic culture may succeed independently of the line they draw. I argue that construing autistics' claims as beginning from culture mistakes their status, and may even detract from their aims. Via my discussion of Jaarsma and Welin, I hope to point to why the more general strategy of separating autistics, in response to the accommodation thesis, does not fully succeed. Finally, I sketch some directions for future discussions, arguing that we should instead shift our attention to consider another set of questions concerning the costs and extent of change required to accommodate all autistics. (shrink)

When should burdened social practices be granted special accommodation? One issue of concern—raised by Okin and others—is that some social practices involve domination, and so the accommodation of those practices might (inadvertently, perhaps) support social injustice. Suppose one wants to take this concern very seriously. Starting from the assumption that freedom from domination is an especially important value, this article examines whether cultural accommodation would ever be advisable. Approaching the problem of multicultural accommodation from this point (...) of view greatly clarifies the debate and yields some interesting results. In particular, the discussion concludes that there are circumstances under which the goal of minimizing domination itself would be furthered by policies of special accommodation. (shrink)

According to the thesis of Strong Predictionism, we typically have stronger evidence for a theory if it was used to predict certain data, than if it was deliberately constructed to accommodate those same data, even if we fully grasp the theory and all the evidence on which it was based. This thesis faces powerful objections and the existing arguments in support of it are seriously flawed. I offer a new defence of Strong Predictionism which overcomes the objections and provides a (...) deeper understanding of the epistemic importance of prediction. I conclude by applying this account to strategies for defending scientific realism. (shrink)

Chemical affinity is by itself inclusive of the action of a sign. Naturalization of the action of a sign is latent in the material organization holding its own identity by means of the exchange of material. A concrete experimental example is the citric acid cycle running in the absence of biological enzymes. The carbon atoms to be exchanged round the cycle serve as the signs for holding the cycle as a natural system. The action of a sign operates in the (...) present progressive tense and is also descriptively approachable in the same tense, as implying that a natural system holding its own identity assumes the first-person status acting for its own sake. The action of a sign is thus addressable in first person descriptions on the level of the supporting material system that can recognize the sign as such from within. Furthermore, if the action of a sign happens to precipitate the record registered in the present perfect tense, the record itself will be approachable in third person descriptions in the present tense. When one can relate the record of an earlier event to that of a later one, what is called information will come up. Information to be externalized and objectified is about the completed outcome from the action of a sign that is accessible in third person descriptions in the present tense. Conversely, if the action of a sign is carried by a natural system holding its own identity in a manner to be registered in the present perfect tense after the event, information will appear in a proper form of bookkeeping as relating the memory to anticipation on the part of the material agency. Although information in the present has the capacity of relating the past to future in the present tense as avoiding direct confrontation with the dynamic nature of the present or now head on, the action of a sign facing the present squarely is competent enough to address and decipher the generative capacity of information itself operating in the present progressive tense. (shrink)

1This work was supported in part by the projects TRINDI (Task Oriented Instructional Dialogue), EC Project LE4-8314, SDS (Swedish Dialogue Systems), NUTEK/HSFR Language Technology Project F1472/1997, INDI (Information Exchange in Dialogue), Riksbankens Jubileumsfond 1997-0134, and SIRIDUS (Specification, Interaction, Reconfiguration in Dialogue Understanding Systems), EC Project IST-1999-10516, and ILT (Interactive Language Technology), Vinnova Project 2001-6340. To appear in Presuppositions and Discourse ed. by Rainer Bäuerle, Uwe Reyle and Thomas Ede Zimmermann, Elsevier, Amsterdam.

A not unpopular thesis, when it comes to the confirmation of scientific theories, is that data which were used in the construction of a theory afford poorer support for that theory than data that played no role. Some compelling thought experiments have been offered in favour of this view, not as proof but rather to add some intuitive plausibility. In this paper I consider such thought experiments and argue that they do not support the thesis; the perceived importance of prediction (...) over accommodation, at least in these cases, is illusory. Introduction Background assumptions Strong thesis Weak thesis Conclusions. (shrink)

The unconscionability doctrine in contract law enables a court to decline to enforce a contract whose terms are seriously one-sided, exploitative, or otherwise manifestly unfair. It is often criticized for being paternalist. The essay argues that the characterization of unconscionability doctrine as paternalist reflects common but misleading thought about paternalism and obscures more important issues about autonomy and social connection. The defense responds to another criticism: that unconscionability doctrine is an inappropriate, because economically inefficient, egalitarian tool. The final part discusses (...) more interesting but neglected questions about the scope of accommodation necessary to support fully meaningful autonomous activity. (shrink)

The paper presents the results of two vignette studies that examine how company breastfeeding accommodation influences ratings of organizational attractiveness and work-related intentions. North American business students and employees engaged in long-term employment found organizations that accommodate breastfeeding to be more fair, attractive, and were more likely to apply to them, and accept jobs from them, than organizations that did not accommodate. Effects were stronger for female participants than for male participants. Female participants without children indicated lower support for (...) breastfeeding accommodation than female participants with children and male participants. (shrink)

All of us, including scientists, make judgments about what is true or false, probable or improbable. And in the process, we frequently appeal to concepts such as evidential support or explanation. Bayesian philosophers of science have given illuminating formal accounts of these concepts. This paper aims to follow in their footsteps, providing a novel formal account of various additional concepts: the likelihood-prior trade-off, successful accommodation of evidence, ad hocness, and, finally, consilience—sometimes also called “unification”. Using these accounts, I also (...) provide a new Bayesian analysis of how someone such as Charles Darwin hypothetically could have reasoned in favor of evolution over special creationism. Lastly, I explore how these accounts relate to other topics and accounts in philosophy, and I chart out some areas for further research. (shrink)

Evidential support is often equated with confirmation, where evidence supports hypothesis H if and only if it increases the probability of H. This article argues against this received view. As the author shows, support is a comparative notion in the sense that increase-in-probability is not. A piece of evidence can confirm H, but it can confirm alternatives to H to the same or greater degree; and in such cases, it is at best misleading to conclude that the evidence supports H. (...) The author puts forward an alternative view that defines support in terms of measures of degree of confirmation. The proposed view is both sufficiently comparative and able to accommodate the increase-in-probability aspect of support. The author concludes that the proposed measure-theoretic approach to support provides a superior alternative to the standard confirmatory approach. (shrink)

This research explores the experiences of UK NHS healthcare professionals working with asylum applicants housed in contingency accommodation during the COVID-19 pandemic. Using a critical understanding of the concept of moral resilience as a theoretical framework, we explore how the difficult circumstances in which they worked were navigated, and the extent to which moral suffering led to moral transformation. Ten staff from a general practice participated in semistructured interviews. Encountering the harms endured by people seeking asylum prior to arrival (...) in the UK and through the UK’s ‘Hostile Environment’ caused healthcare staff moral suffering. They responded to this in several ways, including: (1) feeling grateful for their own fortunes; (2) defining the limitations of their professional obligations; (3) focusing on the rewards of work and (4) going above and beyond usual care. Although moral resilience is reflected in much of the data, some participants described how the work caused ideological transformations and motivated challenges to systems of oppression. We show how current moral resilience theory fails to capture these transformative political and social responses, warning of how, instead, it might encourage healthcare staff to maintain the status quo. We caution against the widespread endorsement of current formulations of moral resilience in contemporary social and political climates, where the hostile and austere systems causing suffering are the result of ideological political decisions. Future work should instead focus on enabling working conditions to support, and developing theory to capture, collective resistance. (shrink)

Religion persists, even within enlightened secular society, because it has adaptive functions. In particular, Ralph Wendell Burhoe's theory holds that religion is the repository of cultural wisdom that most encourages mutual altruism among nonkin, long-term social survival, and human progress. This article suggests a variant of Burhoe's rationalized naturalistic view. Cognitive theism is a proposal that secularists sometimes take religion on its own terms by suspending disbelief about God. If we consider particular human capacities and limitations in memory, perception, personality, (...) and motivation, the regulated “mind expansion” of cognitive theism may help us to evaluate, coordinate, and invigorate things in a modern environment. In this environment, communicative and travel technologies have led to a high loading of consciousness with a historically unusual diverse range of experiences and responsibilities, a high rate of cultural change relative to biological evolution, and a tendency to factionalize. Burhoe's extension of the concept of symbiosis to the coevolution of culture and genes is modified here in recognition of individual differences and of individuals' potential for choosing strategies, recombining in groups, and learning. In human biocultural symbiont pools, cultural phenomena can evolve while changing partners in a dance with genetic substrates, a dance that broadly supports these substrates. In the context of diversity and incessant change in a large predominantly secular community, Judeo-Christian monotheism can have a valuable advisory unifying function. (shrink)

(OPEN ACCESS) In this article, I explore the implications of three moral grounds for the justification of supported voting – respect as opacity, respect as equal status, and respect as political care. For each ground, I ask whether it justifies surrogate voting for voters unable to either communicate or give effect to their electoral judgments, due to some cognitive or communicative disability. (Henceforth: incommunicability cases.) I argue that respect as opacity does not permit surrogate voting, and equal status does (...) not justify such support – although the latter account can make sense of the value loss involved in the persistent non-participation of individuals with cognitive and communicative disabilities. Finally, I argue that an account of supported voting based on the ethics of political care can accommodate a pro tanto moral permission to provide surrogate voting as a form of support in incommunicability cases, and it can account for the inclusive approach of the UN Convention on the Rights of Persons with Disabilities to supported decision-making. However, I show that in incommunicability cases, what the political community and individual caretakers ultimately owe to adult fellow citizens as equal members of the political community is some adequate form of political care – but not necessarily surrogate voting. (shrink)

This article explores how women seek power through both resisting and accommodating mainstream norms for female hair and delineates the strengths and limitations of these strategies. The data help to illuminate the complex role the body plays in sustaining and challenging women's subordinate position, how accommodation and resistance lie buried in everyday activities, the limits of resistance based on the body, and why accommodation and resistance are best viewed as coexisting variables rather than as polar opposites. Finally, these (...) data suggest the importance of defining resistance as actions that reject subordination by challenging the ideologies that support subordination. (shrink)

Background The legitimacy of conscientious objection to abortion continues to fuel heated debate in Italy. In two recent decisions, the European Committee for Social Rights underlined that conscientious objection places safe, legal, and accessible care and services out of reach for most Italian women and that the measures that Italy has adopted to guarantee free access to abortion services are inadequate. Nevertheless, the Ministry of Health states that current Italian legislation, if appropriately applied, accommodates both the right to conscientious objection (...) and the right to voluntary abortion. Main body One empirical argument used to demonstrate that conscientious objection does not create barriers to abortion is the “no correlation” argument, which the Italian Committee for Bioethics employed to demonstrate that no association exists between conscientious objection and waiting times for voluntary abortion in Italy and to support the weak form of conventional comprise adopted by the Italian legislation to balance the conflict between women’ autonomy and healthcare professionals’ moral integrity. Conversely, we showed how the “no correlation” argument fails to demonstrate the absence of a relationship between the number of conscientious objectors and waiting times for voluntary abortion, and that the limitations of the “no correlation” argument itself demonstrate how it is still difficult to describe the real effect of conscientious objection on the access to abortion services and to evaluate the suitability of conventional compromise to effectively balance conflicting moral principles. Conclusion Further studies are needed to better describe the relationship between conscientious objection and waiting times for voluntary abortion. If new evidence would show that the increasing proportion of objectors does undermine the efficacy of the Italian law and the right of a woman to freely obtain a voluntary abortion, new ways will need to be found to address the conflict between moral principles and restrict the protection accorded to the principle of moral integrity. This would inevitably imply the need to constrain and to redefine the terms and conditions for claiming conscientious objection. (shrink)

The number of students with disabilities has increased by more than 900% in Québec universities Such an increase generates undue pressures on both the academic services available to that clientele and the personnel responsible for internships placement and supervision. In the past decade, a number of studies have attempted to make up for the lack of scientific knowledge on in-class support (measures to support the trainees.), and only a small number of studies worldwide, have focused specifically on accommodation in (...) the context of internships. This situation prompted the current researchers to conduct an exploratory research in partnership with university supervisors, field supervisors and internship coordinators. The research concentrated on three professional programs in order to highlight the specific challenges and issues supervisors must confront while providing support to students with disabilities. The study will eventually focus on testing the identified measures so as to assess their impact and help in developing required modifications. (shrink)

This book focuses on the financing of religions, examining some European church-state models, using a philosophical methodology. The work defends autonomy-based liberalism and elaborates how this liberalism can meet the requirements of liberal neutrality. The chapters also explore religious education and the financing of institutionalized religion. This volume collates the work of top scholars in the field. Starting from the idea that autonomy-based liberalism is an adequate framework for the requirement of liberal neutrality, the author elaborates why a liberal state (...) can support religions and how she should do this, without violating the principle of neutrality. Taking into account the principle of religious freedom and the separation of church and state, this work explores which criteria the state should take into account when she actively supports religions, faith-based schools and religious education. A number of concrete church-state models, including hands-off, religious accommodation and the state church are evaluated, and the book gives some recommendations in order to optimize those church-state models, where needed. Practitioners and scholars of politics, law, philosophy and education, especially religious education, will find this work of particular interest as it has useful guidelines on policies and practices, as well as studies of church-state models. (shrink)

I set up two axiomatic theories of inductive support within the framework of Kolmogorovian probability theory. I call these theories ‘Popperian theories of inductive support’ because I think that their specific axioms express the core meaning of the word ‘inductive support’ as used by Popper (and, presumably, by many others, including some inductivists). As is to be expected from Popperian theories of inductive support, the main theorem of each of them is an anti-induction theorem, the stronger one of them saying, (...) in fact, that the relation of inductive support is identical with the empty relation. It seems to me that an axiomatic treatment of the idea(s) of inductive support within orthodox probability theory could be worthwhile for at least three reasons. Firstly, an axiomatic treatment demands from the builder of a theory of inductive support to state clearly in the form of specific axioms what he means by ‘inductive support’. Perhaps the discussion of the new anti-induction proofs of Karl Popper and David Miller would have been more fruitful if they had given an explicit definition of what inductive support is or should be. Secondly, an axiomatic treatment of the idea(s) of inductive support within Kolmogorovian probability theory might be accommodating to those philosophers who do not completely trust Popperian probability theory for having theorems which orthodox Kolmogorovian probability theory lacks; a transparent derivation of anti-induction theorems within a Kolmogorovian frame might bring additional persuasive power to the original anti-induction proofs of Popper and Miller, developed within the framework of Popperian probability theory. Thirdly, one of the main advantages of the axiomatic method is that it facilitates criticism of its products: the axiomatic theories. On the one hand, it is much easier than usual to check whether those statements which have been distinguished as theorems really are theorems of the theory under examination. On the other hand, after we have convinced ourselves that these statements are indeed theorems, we can take a critical look at the axioms—especially if we have a negative attitude towards one of the theorems. Since anti-induction theorems are not popular at all, the adequacy of some of the axioms they are derived from will certainly be doubted. If doubt should lead to a search for alternative axioms, sheer negative attitudes might develop into constructive criticism and even lead to new discoveries. -/- I proceed as follows. In section 1, I start with a small but sufficiently strong axiomatic theory of deductive dependence, closely following Popper and Miller (1987). In section 2, I extend that starting theory to an elementary Kolmogorovian theory of unconditional probability, which I extend, in section 3, to an elementary Kolmogorovian theory of conditional probability, which in its turn gets extended, in section 4, to a standard theory of probabilistic dependence, which also gets extended, in section 5, to a standard theory of probabilistic support, the main theorem of which will be a theorem about the incompatibility of probabilistic support and deductive independence. In section 6, I extend the theory of probabilistic support to a weak Popperian theory of inductive support, which I extend, in section 7, to a strong Popperian theory of inductive support. In section 8, I reconsider Popper's anti-inductivist theses in the light of the anti-induction theorems. I conclude the paper with a short discussion of possible objections to our anti-induction theorems, paying special attention to the topic of deductive relevance, which has so far been neglected in the discussion of the anti-induction proofs of Popper and Miller. (shrink)

There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and (...) somewhat instrumental views of patients. It tends to: restrict the pursuit of respectful and enabling ‘partnership working’; run the risk of undermining patients’ self-evaluative attitudes ; limit recognition of the supportive value of clinician-patient relationships; and obscure the practical and ethical tensions that clinicians face in the delivery of support for self-management. We suggest that a focus on enabling people to live well with their long-term conditions is a promising starting point for a more adequate conception of support for self-management. We then outline the theoretical advantages that a capabilities approach to thinking about living well can bring to the development of an account of support for self-management, explaining, for example, how it can accommodate the range of what matters to people for living well, help keep the importance of disease control in perspective, recognize social influences on people’s values, behaviours and wellbeing, and illuminate more of the rich potential and practical and ethical challenges of supporting self-management in practice. (shrink)

This article takes as its starting point the moral requirement to include persons with serious cognitive impairments in democratic decision‐making. That said, including such persons poses particular practical challenges to effective democratic participation. Nussbaum has set out the most extensive proposals for inclusion based on a model of guardianship, but we find they fall short due to not suitably respecting and facilitating the subjective decision‐making of impaired persons. Instead, we argue for a model of co‐constitution, whereby aides work within a (...) supported decision‐making paradigm to arrive at political choices in collaboration with impaired persons. To flesh out this model, we propose collaboration be based on three ideal types of interaction – expert, Socratic, and deliberative – designed to accommodate differing degrees and types of cognitive impairments. We further argue that the aide should have a relationship of detached professionalism with the impaired person and therefore should not be the person’s carer. Finally, we conclude that this separation be combined with transparent and regular invigilation of the aide’s decision‐making process to best safeguard the process from abuse or error. (shrink)

Transplantation programs commonly rely on clinicians’ judgments about patients’ social support (care from friends or family) when deciding whether to list them for organ transplantation. We examine whether using social support to make listing decisions for adults seeking transplantation is morally legitimate, drawing on recent data about the evidence-base, implementation, and potential impacts of the criterion on underserved and diverse populations. We demonstrate that the rationale for the social support criterion, based in the principle of utility, is undermined by its (...) reliance on tenuous evidence. Moreover, social support requirements may reinforce transplant inequities, interfere in patients’ personal relationships, and contribute to biased and inconsistent listing procedures. As such, accommodating the needs of patients with limited social support would better balance ethical commitments to equity, utility, and respect for persons in transplantation. We suggest steps for researchers, transplantation programs, and policymakers to improve fair use of social support in transplantation. (shrink)

We describe and analyze 13 cases handled by our ethics consultation service (ECS) in which families requested continuation of physiological support for loved ones after death by neurological criteria (DNC) had been declared. These ethics consultations took place between 2005 and 2013. Patients’ ages ranged from 14 to 85. Continued mechanical ventilation was the focal intervention sought by all families. The ECS’s advice and recommendations generally promoted “reasonable accommodation” of the requests, balancing compassion for grieving families with other ethical (...) and moral concerns such as stewardship of resources, professional integrity, and moral distress. In cases we characterized as finitegoal accommodation, a “reasonable accommodation” strategy proved effective in balancing stakeholders’ interests and goals, enabling steady progress toward resolution. When a family objected outright to a declaration of DNC and asked for an indefinite accommodation, the “reasonable accommodation” approach offered clinicians little practical direction, and resolution required definitive action by either the family or the clinical team. Based on our analysis and reflections on these 13 cases, we propose ethically justified and practical guidelines to assist healthcare professionals, administrators, and ECSs faced with similar cases. (shrink)

Purpose This research aims to study the coping experience of visually impaired bankers in India after they have received reasonable accommodation from their employers, that is, the work process or environment has been suitably modified to ensure a barrier-free environment for them. Design/methodology/approach Data were collected through semi-structured interviews with 12 VI bankers working with public sector banks in India. A phenomenological approach was adopted during data analysis. Findings Despite the provision of reasonable accommodations, VI employees often find it (...) difficult to fulfill their job responsibilities. This is on account of extensive paperwork required for completion of their jobs and the partially accessible information systems available to them. As a result, these VI employees are found resorting to workarounds to carry out their jobs, with the nature of workarounds adopted varying with the type and extent of visual impairment. Furthermore, it is observed that VI employees require social support not only from their superiors and peers but also from their subordinates and customers to carry out their tasks. Research limitations/implications Data collection was done through snowball sampling which could have resulted in sampling bias. Due to confidentiality issues, observation of workarounds in practice by VI employees could not be carried out as part of the study. Originality/value The study contributes to the literature on integration of persons with disabilities by examining their coping experience after provision of reasonable accommodations. It emphasizes the role of workarounds, an under-studied area in PwD integration, as well as support of other stakeholders in the experience. (shrink)

In pluralist societies, stakeholders in healthcare may have different experiences of and moral perspectives on health, well-being, and good care. Increasing cultural, religious, sexual, and gender diversity among both patients and healthcare professionals requires healthcare organizations to address these differences. Addressing diversity, however, comes with inherent moral challenges; for example, regarding how to deal with healthcare disparities between minoritized and majoritized patients or how to accommodate different healthcare needs and values. Diversity statements are an important strategy for healthcare organizations to (...) define their normative ideas with respect to diversity and to establish a point of departure for concrete diversity approaches. We argue that healthcare organizations ought to develop diversity statements in a participatory and inclusive way in order to promote social justice. Furthermore, we maintain that clinical ethicists can support healthcare organizations in developing diversity statements in a more participatory way by fostering reflective dialogues through clinical ethics support. We will use a case example from our own practice to explore what such a developmental process may look like. We will critically reflect on the procedural strengths and challenges as well as on the role of the clinical ethicist in this example. (shrink)

This article addresses whether cardiopulmonary resuscitation and sustained physiological support should ever be permitted in individuals who are diagnosed as brain dead and who had held previously expressed moral or religious objections to the currently accepted criteria for such a determination. It contrasts how requests for care would normally be treated in cases involving a brain-dead individual with previously expressed wishes to donate and a similarly diagnosed individual with previously expressed beliefs that did not conform to a brain-based conception of (...) death. The paper first focuses narrowly on requests for CPR and then expands its scope to address extended physiological support. It describes how refusing the brain-dead non-donor's requests for either CPR or extended support would represent enduring harm to the antemortem or previously autonomous individual by negating their beliefs and self-identity. The paper subsequently discusses potential implications of policy that would allow greater accommodations to those with conscientious objections to currently accepted brain-based death criteria, such as for cost, insurance, higher brain formulations and bedside communication. The conclusion is that granting wider latitude to personal conceptions around the definition of death, rather than forcing a contested definition on those with valid moral and religious objections, would benefit both individuals and society. (shrink)

Race, ethnicity and national identity are important discussions that are unfinished ecclesial business for churches in South Africa. Churches remain mono-cultural to a large extent; a significant challenge is the fact that churches still largely reflect the social divisions of a society. Although not common in South Africa, there are, at the same time, congregations that are successful at reaching across racial and cultural divides to attract new members and build social capital. This article discusses the reconciliation potential of multicultural (...) churches in that they are able to accommodate multiple racial groups, in a society where religious life remains overwhelmingly segregated. Racial integration is a sensitive issue that has divisive potential and churches and religions in general tend to avoid the issue. Religious communities played a critical role in the transition to democracy; what is needed now is for churches to deepen this reconciliation potential. (shrink)

The guiding premise of this chapter is that we, as teachers in higher education, must consider how the content and form of our teaching can foster inclusivity through a responsiveness to neurodiverse learning styles. A narrow pedagogical focus on lectures, textual engagement, and essay-writing threatens to exclude neurodivergent students whose ways of learning and making sense of the world may not be best supported through these traditional forms of pedagogy. As we discuss in this chapter, we, as engineering ethics (...) educators, designed and implemented a new engineering ethics exercise with which we aimed to promote inclusivity at the levels of form and content. At the content level, students were invited to critically engage with inclusivity-undermining ableist assumptions in technology development. This took shape, at the form level, through a hands-on ‘material tinkering’ workshop in which students collaboratively and creatively altered (or ‘hacked’) artifacts used in contexts of disability and healthcare, so as to operationalize values of inclusivity and accessibility. Our hunch was that this hands-on tinkering workshop would simultaneously encourage a meaningful way of engagement with these ethical issues and values, while also enacting a more inclusive learning environment by enriching the range of pedagogical activities and learning formats available to our students.As we aim to show in this chapter, we believe this hunch largely panned out – though there are clear areas for future improvement pertaining to the pilot exercise itself and the research we conducted on the exercise. We begin by offering a description of our tinkering exercise. We discuss the exercise’s source of inspiration (Sect. 16.2.1) and its implementation (Sect. 16.2.2), which is visually captured via photographic documentation. We then discuss (Sect. 16.3) how we utilized a triangulated research method to assess the pedagogical value of the exercise. After we discuss our findings, we conclude by identifying areas for future improvement (Sect. 16.4). (shrink)

Purpose This paper aims to outline how destructive communication exemplified by ransomware cyberattacks destroys the process of organization, causes a “state of exception,” and thus constitutes organization. The authors build on Agamben's state of exception and translate it into communicative constitution of organization theory. Design/methodology/approach A significant increase of cyberattacks have impacted organizations in recent times and laid organizations under siege. This conceptual research builds on illustrative cases chosen by positive deviance case selection of ransomware attacks. Findings CCO theory focuses (...) mainly on ordering characteristics of communication. The authors aim to complement this view with a perspective on destructive communication that destroys the process of organization. Based on illustrative cases, the authors conceptualize a process model of destructive CCO. Practical implications The authors expand thoughts about a digital “corporate immune system” to question current offensive cybersecurity strategies of deterrence and promote resilience approaches instead. Originality/value Informed by destructive communication of cyberattacks, this theory advancement supports arguments to include notions of disorder into CCO theory. Furthermore, the paper explains where disruptions like cyberattacks may trigger sensemaking and change to preserve stability. Finally, a novel definition of ‘destructive CCO’ is provided: Destructive Communication Constitutes Organization by disrupting and destroying its site and surface while triggering sensemaking and becoming part of sensemaking itself. (shrink)

A crucial question in relation to support designed to enable the legal capacity of people with mental disabilities concerns when support constitutes undue influence. This article addresses this question in order to facilitate the development of law and policy in England and Wales, by providing a normative analysis of the different approaches to undue influence across decisions about property, contracts, health, finances, and accommodation. These are all potential contexts for supporting legal capacity, and, in doing so, the article compares (...) approaches to undue influence that are rarely considered together. -/- Drawing on the UN Convention on the Rights of Persons with Disabilities, third sector and public body documents, and law in England and Wales, the analysis identifies six models that conceptualise undue influence in terms of: modes of influence; an overborne will; an inference from the situation; an overborne will understood as a mental incapacity; an overborne will in connection with vulnerability; and impaired discursive control. This final approach is a novel proposal for understanding undue influence. The analysis highlights key policy-relevant issues that distinguish the models, and generates a deliberative framework for navigating them, with the ‘overborne will’, ‘inference-based’, and ‘discursive control’ models identified as potentially fitting for the support context. (shrink)

Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was adopted recently by a team of informaticists designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, especially when (...) principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and non-maleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper we show how using ethical principles can help in the design of EHRs by first, explaining how ethical principles can and should be used generally, and then by, discuss how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting further ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest. (shrink)

In their strife for designing a moral system where everyone is given equal consideration, cosmopolitan theorists have merely tolerated partiality as a necessary evil (insofar it means that we give priority to our kin opposite the distant needy). As a result, the cosmopolitan ideal has long departed from our moral psychologies and our social realities. Here I put forward partial cosmopolitanism as an alternative to save that obstacle. Instead of demanding impartial universal action, it requires from us that we are (...) equally responsive in all the relationships we stand in. That goes from the local to the cosmopolitan sphere, since I defend that we are related with strangers as co-members of the global community. Thus, partiality not only is accommodated by cosmopolitanism, but actually supports it: only by having meaningful personal relationships we become able to care for distant strangers. (shrink)

This paper argues that in mathematical practice, conjectures are sometimes confirmed by “Inference to the Best Explanation” as applied to some mathematical evidence. IBE operates in mathematics in the same way as IBE in science. When applied to empirical evidence, IBE sometimes helps to justify the expansion of scientists’ ontological commitments. Analogously, when applied to mathematical evidence, IBE sometimes helps to justify mathematicians' in expanding the range of their ontological commitments. IBE supplements other forms of non-deductive reasoning in mathematics, avoiding (...) obstacles sometimes faced by enumerative induction or hypothetico-deductive reasoning. Both platonist and non-platonist interpretations of mathematics ought to accommodate explanation in mathematics and ought to recognize IBE in mathematics, though these interpretations disagree on the ontological commitments that mathematicians ought to have. This paper offers an inductive account of why mathematical IBE tends to lead to mathematical truths. (shrink)

Considerations of well-being or flourishing include Maslow’s and Rogers’ concepts of self-actualisation and actualising tendency. Recent empirical findings suggest that only a modest proportion of the population might be considered to be flourishing. Separate findings focused upon the nature and determinants of post-traumatic growth identify it as comparable to flourishing, and facilitated by supported accommodation to the trauma. This can be understood as reflecting self-actualisation. Empirical findings such as these provide ontological stability to a set of phenomena that (...) share much with ancient teachings extolling redemption through suffering. This framework challenges conventional healthcare policies and practices, but in ways that offer insights into how patient-centred approaches to chronic illness and disability might be better conceived and enabled. It also throws into doubt the rectitude of an economic model built around services and products designed to provide easy access to sources of immediate gratification. (shrink)

According to the Public Justification Principle, legitimate laws must be justifiable to all reasonable citizens. Proponents of this principle assume that its satisfaction requires speakers to offer justifications that are representable as arguments that feature premises which reasonable listeners would accept. I develop the concept of dark knowledge to show that this assumption is false. Laws are often justified on the basis of premises that many reasonable listeners know, even though they would reject these premises on the basis of the (...) further considerations that speakers implicitly rely on for their support. Accommodating the fact of dark knowledge requires us to consider the civic virtue of speakers to be more important for public justification than the acceptability of their arguments to reasonable citizens. I sketch an alternative conception of public justification that incorporates these results and argue that it provides a rationale for ignoring the otherwise sound contributions of some participants in political deliberation. (shrink)

Many liberal egalitarians support laws that prevent people from making exploitative and unconscionable contracts. These contracts may include low-wage labor agreements or payday loans, for example. I argue that liberal egalitarians should rethink their support for laws that limit the freedom to make these illiberal contracts, as long as the contracts are voluntary and do not violate people’s other enforceable rights. Paternalistic considerations cannot justify limits on illiberal contracts because they are not only likely to misfire; they also express condescending (...) and inegalitarian judgments of citizens. I then consider Seana Shiffrin’s argument that officials may avoid paternalism while still deterring illiberal contracts if they instead refuse to use public institutions to accommodate contracts that are contrary to the fundamental values on which those institutions are based. This argument encounters a dilemma. Officials may refuse to enforce illiberal contracts and ban private enforcement of illiberal contracts, but this strategy encounters the charges of paternalism it aimed to avoid. Or, officials may refuse to enforce illiberal contracts but tolerate private enforcement, but this approach would make the worst off members of society even more vulnerable and marginalized. Therefore, liberal egalitarians should support public enforcement of illiberal contracts because the alternatives are worse. (shrink)

In recent years, several scientific disciplines have been undergoing replication crises, and in response, preregistration has been offered as a solution to replicability problems. In this paper, I will draw connections between this new focus on preregistration and an older debate in the philosophy of science, namely predictivism—the thesis that predictions are epistemically superior to accommodations. Specifically, I shall argue that predictivism justifies preregistration. As it turns out, predictivists of all stripes have subtly different reasons to support preregistration. This unity (...) is significant because firstly, preregistration proponents often seem to be implicitly committed to stronger versions of predictivism, but strong predictivism has long been deemed untenable by philosophers of science. Furthermore, the efficacy of preregistration in dealing with Questionable Research Practices (QRPs) like p-hacking and HARKing is at best contentious, which blocks a straightforward empirical justification of preregistration. Although empirical validation of preregistration—which need not be based on preventing QRPs—will eventually be required, it would be nice to have a principled justification for preregistration while we await the empirical evidence. I will also argue that preregistration offers something in return to predictivism: the former bolsters the latter by serving as a counterargument to accommodationism—the antithesis of predictivism. (shrink)

We support Enlightenment Bayesianism's commitment to grounding Bayesian analysis in empirical details of psychological and neural mechanisms. Recent philosophical accounts of mechanistic science illuminate some of the challenges this approach faces. In particular, mechanistic decomposition of mechanisms into their component parts and operations gives rise to a notion of levels distinct from and more challenging to accommodate than Marr's.

Scientific theories are developed in response to a certain set of phenomena and subsequently evaluated, at least partially, in terms of the quality of fit between those same theories and appropriately distinctive phenomena. To differentiate between these two stages it is popular to describe the former as involving the accommodation of data and the latter as involving the prediction of data. Predictivism is the view that, ceteris paribus, correctly predicting data confers greater confirmation than successfully accommodating data. In this (...) paper, I take issue with a variety of predictivist theses, argue that their role for issues of confirmation is extremely limited, and attempt to account for the appeal that predictivism has enjoyed. Introduction Temporal Predictivism Heuristic Predictivism Weak Predictivism 4.1 Inference to better theories 4.2 Inference to better methods Arguments for Strong Heuristic Predictivism 5.1 Best explanations argument 5.2 Conditional support 5.3 Unique explanations Increased Explanatory Unification 6.1 Explaining what other theories can't 6.2 Contrived hypotheses 6.2 Strength and simplicity Conclusions CiteULike Connotea Del.icio.us What's this? (shrink)

We support the ambitious goal of unification within the behavioral sciences. We suggest that Darwinian evolution by means of natural selection can provide the integrative glue for this purpose, and we review our own work on selective investment theory (SIT), which is an example of how other-regarding preferences can be accommodated by a gene-centered account of evolution. (Published Online April 27 2007).

Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining about CPR, how (...) decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

Abstract Evidence that supports a theory may be available to the scientist who constructs the theory and used as a guide to that construction, or it may only be discovered in the course of testing the theory. The central claim of this essay is that information about whether the evidence was accommodated or predicted affects the rational degree of confidence one ought to have in the theory. Only when the evidence is accommodated is there some reason to believe that the (...) theoretical system was ?fudged? to fit the evidence in a way that weakens support. This weakening is an objective matter, but not one that can be conclusively determined by examining the contents of the theory and its logical relationship to the evidence. Consequently, there is less reason to believe a theory on the basis of that evidence when it is known that the evidence was accommodated than there would be if it was known instead that the same evidence had been predicted. (shrink)

The prospective study follows college students after the 9/11 attacks. Based on evidence and trauma-related theories, and guided by reports on positive and negative reactions and meaning-related actions among Americans after 9/11, we explored the seemingly contradictory, yet meaning-related pathways to posttraumatic growth and posttraumatic stress disorder symptoms , indicating the sense of deep interconnectedness and deep conflict. The final model showed that 9/11 emotional turmoil triggered processes of assimilation, as indicated in pathways between prayer coping and perceived spiritual and (...) social support, and of accommodation, as indicated in the pathway of spiritual struggle. Both pathways were directly associated with PTG in the follow-up. Perceived spiritual and social support contributed to lower levels of PTSD symptoms, whereas spiritual struggle had an opposite impact on symptoms; both effects were mediated through optimism but in opposite directions. The study suggests the interplay of complex crisis-related phenomena following meaning-laden collective trauma that presented existential challenges, involving coping, optimism, deep conflict, and deep interconnectedness. (shrink)