The phenomenon of systematic polysemy offers a fruitful domain for examining the theoretical differences between lexicological and lexicographic approaches to description. We consider here the process that provides for systematic conversion of count to mass nouns in English (a chicken Æ chicken, an oak Æ oak etc.). From the point of view of lexicology, we argue, standard syntactic and pragmatic tests suggest the phenomenon should be described by means of a single unindividuated transfer function that does not (...) distinguish between interpretations (rabbit = "meat" vs. "fur"). From the point of view of lexicography, however, these pragmatically determined"sense precisions" are made part of explicit description via the inclusion of semantic "licenses," a mechanism distinct from lexical rules. (shrink)

Polysemy is a phenomenon involving single lexical items with multiple related senses. Much theorizing about it has focused on developing linguistic accounts that are responsive to various compositional and representational challenges in semantics and psychology. We focus on an underexplored question: Why does systematic polysemy cluster in the ways it does? That is, why do we see certain regular patterns of sense multiplicity, but not others? Drawing on an independently motivated view of kind cognition – i.e. the (...) formal structures for different classes of kind representations – we argue for an answer centered on conceptual individuation. Specifically, we argue that classes of kind concepts vary in what they individuate (i.e. counting as one and specifying what makes it the same or different from others). By elucidating these differences, we can explain why a range of patterns of systematic polysemy are found cross-linguistically and why other patterns are not attested. Overall, our account provides an explanatory framework addressing an important question at the interface between language and mind and opens new avenues for future theoretical and empirical research. (shrink)

Proper names are usually considered devices of singular reference but, when considered as word-types, they also exhibit other kinds of uses. In this paper I intend to show that systematic kinds of uses of proper names considered as word-types can be accounted for by a generalized rule-based conception of systematic polysemy, one which not only postulates a multiplicity of stable senses for an expression, but also a multiplicity of content generating rules, each of which determines potentially different (...) contents in different contexts. In contrast to the currently extant polysemous conceptions of proper names (Leckie in Philos Stud 165:1139–1160, 2013), which only encompass individual and predicative uses, the presented proposal concerns all systematic uses of proper names considered in the literature, i.e., individual, predicative, deferred, descriptive, anaphoric, and bound uses of proper names. The resulting conception accommodates referential intuition about the default individual uses of proper names while also admitting other kinds of uses without generating homonymy. It transpires that proper names are semantically underdetermined and context-sensitive expressions. (shrink)

Viebahn (2018) has recently argued that several tests for ambiguity, such as the conjunction-reduction test, are not reliable as tests for polysemy, but only as tests for homonymy. I look at the more fine-grained distinction between regular and irregular polysemy and I argue for a more nuanced conclusion: the tests under discussion provide systematic evidence for homonymy and irregular polysemy but need to be used with more care to test for regular polysemy. I put this (...) conclusion at work in the context of the debate over the alleged referential-attributive ambiguity of the definite article. In reply to various criticisms, defenders of the ambiguity view argue that this is a case of polysemy. But opponents object that the dual use of the definite article fails tests for ambiguity. The debate seems to have come to stalemate, unless the relevance of the tests is determined for cases of alleged polysemy. I conclude that the balance of considerations incline towards rejecting the ambiguity thesis. (shrink)

Philosophical accounts of scientific explanation are broadly divided into ontic and epistemic views. This paper explores the idea that the lexical ambiguity of the verb to explain and its nominalisation supports an ontic conception of explanation (Salmon 1989; Craver 2007). I analyse one argument which challenges this strategy by criticising the claim that explanatory talk is lexically ambiguous (Wright, European Journal of Philosophy of Science 2(3), 375–394, 2012). I propose that the linguistic mechanism of transfer of meaning (Nunberg, Journal of (...) Semantics 12(2), 109–132, 1995) provides a better account of the lexical alternations that figure in the systematic polysemy of explanatory talk, and evaluate the implications of this proposal for the debate between ontic and epistemic conceptions of scientific explanation. (shrink)

Paul Horwich is aware of the fact that his theory as stated in his works is directly applicable only to a language in which a word, understood as a syntactic type, is connected with exactly one literal meaning. Yet he claims that the theory is expandable to include homonymy and indexicality and thus may be considered as applicable to natural language. My concern in this paper is with yet another kind of ambiguity—systematic polysemy—that assigns multiple meanings to one (...) linguistic type. I want to combine the characteristics of systematic polysemy with the Kaplanian insight that meanings of expressions may be defined by semantic rules which assign content in context and to ask the question if minimalism about truth and meaning is compatible with such rule-based systematic polysemy. I will first explain why the expressions that exhibit rule-based systematic polysemy are difficult to combine with a truth theory that is based on a use theory of meaning before proceeding to argue that indexicals and proper names are such expressions. (shrink)

Polysemy seems to be a relatively neglected phenomenon within philosophy of language as well as in many quarters in linguistic semantics. Not all variations in a word’s contribution to truth-conditional contents are to be thought as expressions of the phenomenon of polysemy, but it can be argued that many are. Polysemous terms are said to contribute senses or aspects to truth-conditional contents. In this paper, I will make use of the notion of aspect to argue that some apparently (...) wild variations in an utterance’s truth conditions are instead quite systematic. In particular, I will focus on Travis’ much debated green leaves case and explain it in terms of the polysemy of the noun; and in particular, in terms of the as-it-is and the as-it-looks aspects associated with kind words. (shrink)

Focusing on the systematic polysemy of institution-denoting terms, this paper defends the general view that such multiple-meaning phenomena take root in the complex ontological structure of the den...

Several recent theories of linguistic representation treat the lexicon as a highly structured object, incorporating fairly detailed semantic information, and allowing multiple aspects of meaning to be represented in a single entry (e.g. Pustejovsky, 1991; Copestake, 1992; Copestake and Briscoe, 1995). One consequence of these approaches is that word senses cannot be thought of as discrete units which are in one-to-one correspondence with lexical entries. This has many advantages in allowing an account of systematic polysemy, but leaves the (...) problem of accounting for effects such as zeugma and the absence of crossed readings, which have traditionally been explained in terms of multiple lexical entries, but which can also arise in examples where other criteria demand that a single entry be involved. Copestake and Briscoe (1995) claimed that these cases could be explained by discourse coherence, but did not describe how this might work. We remedy this here, by formalising a general pragmatic principle which encapsulates discourse effects on word meaning. We demonstrate how it contributes to the creation of zeugma and the non-availability of crossed readings. (shrink)

Many if not all evidential languages have a mirative evidential: an indirect evidential that can, in some contexts, mark mirativity (the expression of speaker surprise) instead of indirect evidence. We address several questions posed by this systematic polysemy: What is the affinity between indirect evidence and speaker surprise? What conditions the two interpretations? And how do mirative evidentials relate to other mirative markers? We propose a unified analysis of mirative evidentials where indirect evidentiality and mirativity involve a common (...) epistemic component. A mirative interpretation requires a close temporal proximity between the speech event and the event of the speaker's learning the at-issue content. (shrink)

Italian is a well-known exception to the cross-linguistic generalization according to which `belief' predicates are indicative selectors across languages. We newly propose that languages that select the subjunctive with epistemic predicates allow us to see a systematic polysemy between what we call an expressive-`belief' (featuring only a doxastic dimension) and an inquisitive-`belief' (featuring both a doxastic and an epistemic dimension conveying doxastic certainty (in the assertion) and epistemic uncertainty (in the presupposition)). We offer several previously unseen contrasts proving (...) this distinction and offer a new analysis for mood choice cross-linguistically. We argue that the distinction between expressive and inquisitive attitudes is not an idiosyncrasy of non-factive epistemics. We provide novel data, showing that fictional predicates (dream, imagine) license the subjunctive. We explain the indicative/subjunctive alternation by again appealing to epistemic uncertainty and disentangling expressive from inquisitive-fictional meanings. We thus pave the way for a new typology of attitudes relying on this systematic polysemy and propose new criteria to explain mood distribution cross-linguistically. (shrink)

This book offers a new approach to the analysis of the multiple meanings of English modals, conjunctions, conditionals, and perception verbs. Although such ambiguities cannot easily be accounted for by feature-analyses of word meaning, Eve Sweetser's argument shows that they can be analyzed both readily and systematically. Meaning relationships in general cannot be understood independently of human cognitive structure, including the metaphorical and cultural aspects of that structure. Sweetser shows that both lexical polysemy and pragmatic ambiguity are shaped by (...) our metaphorical folk understanding of epistemic processes and of speech interaction. Similar regularities can be shown to structure the contrast among root, epistemic and speech act uses of modal verbs, multiple uses of conjunctions and conditionals, and certain processes of historical change observed in Indo-European languages. Since polysemy is typically the intermediate step in semantic change, the same regularities observable in polysemy can be extended to an analysis of semantic change. (shrink)

Artistic images, of a universal nature and validated by global culture, are carriers of an emotional potential that can be used for therapeutic purposes in cultural centers as well as in clinical spaces. Esthetic studies reveal the mobilizing power in their contemplation and the capacity to bring out personal stories with healing potential. The general objective of this paper is to design and validate the PROJECTA instrument, consisting of the therapeutic use of artistic images to approach trauma or difficult conditions (...) in therapy, by means of the association between art images and emotions, feelings or states of mind related with a traumatic experience. A mixed approach of investigation with a concurrent triangulation design has been used for the integration of qualitative and quantitative results, where qualitative research outweighs quantitative, but both have been QUAL → quan sequentially developed. The study was carried out in two phases. The first was a systematic review of the literature. The second, divided into five steps, consisted of the validation of artworks and the associated emotions with the participation of students, experts in art therapy, psychologists and educators through focus groups, interviews and an online questionnaire. The analysis techniques were qualitative and quantitative. A set of 220 artistic images linked to emotional states were proposed by experts in education, psychology and art therapy, and validated through an online questionnaire. The respondents included 228 students and professionals and for 64.55% of these images a consensus of over 80% was obtained. These images and their associated emotions were again reviewed by a confirmatory focus group. Finally, 92 artistic works were linked to primary, secondary and tertiary emotions such as love, joy, victory, surprise, balance, sense of humor, anger, sadness, fear, and emptiness. In addition, there are mobilizing images that have not been related to any emotion because of the polysemy of their meanings. It concludes that PROJECTA is a visual art therapy tool that provides professionals with a resource that helps facilitate the identification, expression or demonstration of emotions or feelings related with trauma, and in challenging situations of vulnerability, psychological discomfort or post-traumatic stress. (shrink)

In this book I examine various forms of indeterminacy in the law and scrutinize (i.a. by way of game theoretical models) the conditions under which they can be strategically used. In particular, I analyze the advantages and disadvantages of indeterminacy in the wording of laws, contracts, and verdicts. Legal texts are particularly interesting insofar as they address a heterogeneous audience, are applied in a variety of unforeseeable circumstances and must, at the same time, lay down clear and unambiguous standards. I (...) argue for the claim that semantic vagueness is less relevant than commonly supposed in the debate, while other forms of indeterminacy (in particular, polysemy and standard-relativity) are underrated or altogether ignored. This misconception is, as I argue, due to a systematic confusion between semantic vagueness and these forms of indeterminacy. Once it is resolved, the value of indeterminacy can be clearly shown. (shrink)

Apart from references to perception, words such asseeandlistenhave shared, non-literal meanings across diverse languages. Such cross-linguistic meanings have not been systematically investigated as they appear in their natural home — informal spoken interaction. We present a qualitative examination of the semantic associations of perception verbs based on recorded everyday conversation in thirteen diverse languages. Across these diverse communities, spontaneous interaction provides evidence for two commonly-discussed extensions of perception verbs — perception~cognition, hearing~linguistic communication — as well as illustrating other meanings and (...) functions (e.g., the use of perception verbs as discourse markers) that have been less appreciated heretofore. The range of usage that is readily observable in informal conversation makes it clear that this type of data must take center stage for the empirically grounded study of semantics. Moreover, these data suggest that commonalities in polysemous meanings may rely not only on universal cognition, but also on the universal exigencies of social interaction. (shrink)

Polysemy has only recently entered the debate on semantic minimalism and contextualism. This is surprising considering that the key linguistic examples discussed in the debate, such as ‘John cut the grass’ or ‘The leaf is green’ appear to be prime examples of polysemy. Moreover, François Recanati recently argued that the mere existence of polysemy falsi!es semantic minimalism and supports radical contextualism. The aim of this paper is to discuss how the minimalism-contextualism debate relates to polysemy. This (...) connection turns out to be far from clear-cut. This is partly due to the fact that the term ‘polysemy’ is used in a number of different ways in the literature, which will be reviewed in this paper. Finally, I discuss and reject Recanati’s claim that the existence of polysemy supports radical contextualism against moderate versions and semantic minimalism. I show that minimalism has a number of plausible options to account for polysemy. (shrink)

Polysemy, understood as instances of a single linguistic expression having multiple related senses, is not a homogenous phenomenon. There are regular (apparently, rule‐based) cases and irregular (resemblance‐based) cases, which have different processing profiles. Although a primary source of polysemy is pragmatic inference, at least some cases become conventionalised and linguistically encoded. Three main issues are discussed: (a) the key differences between regular and irregular cases and the role, if any, of a “core meaning”; (b) the distinction between pragmatic (...) polysemy and semantic polysemy; and (c) the role of syntactic meaning in both generating and constraining polysemy. (shrink)

Polysemy is a term used in semantic and lexical analysis to describe a word with multiple meanings. Although such words present few difficulties in everyday communication, they do pose near-intractable problems for linguists and lexicographers. The contributors in this volume consider the implications of these problems for linguistic theory and how they may be addressed in computational linguistics.

ABSTRACT Copredication, as exhibited by sentences such as ‘That book is heavy but informative,’ is commonly seen as a phenomenon that is tied to sentences featuring polysemous expressions. David Liebesman and Ofra Magidor have recently attacked this view by arguing that ‘book’ has a single context-sensitive sense. The first aim of the present paper is to show that Liebesman and Magidor are wrong to claim that ‘book’ is univocal, but that they may nonetheless be right to question that copredication requires (...) polysemy. Its second aim is to consider implications of this result for the debates on copredication and on semantic variability. (shrink)

In this paper, we propose a framework for fostering argumentative skills in a systematic way in Philosophy and Ethics classes. We start with a review of curricula and teaching materials from the German-speaking world to show that there is an urgent need for standards for the teaching and learning of argumentation. Against this backdrop, we present a framework for such standards that is intended to tackle these difficulties. The spiral-curricular model of argumentative competences we sketch helps teachers introduce the (...) relevant concepts and skills to students early on in their school career. The focus is on secondary schools, but the proposal can also be of use for learning and teaching in universities, especially in introductory classes. (shrink)

Human values seem to vary across time and space. What implications does this have for the future of human value? Will our human and (perhaps) post-human offspring have very different values from our own? Can we study the future of human values in an insightful and systematic way? This article makes three contributions to the debate about the future of human values. First, it argues that the systematic study of future values is both necessary in and of itself (...) and an important complement to other future-oriented inquiries. Second, it sets out a methodology and a set of methods for undertaking this study. Third, it gives a practical illustration of what this ‘axiological futurism’ might look like by developing a model of the axiological possibility space that humans are likely to navigate over the coming decades. (shrink)

Clinical Ethics Committees (CECs), as distinct from Research Ethics Committees, were originally established with the aim of supporting healthcare professionals in managing controversial clinical ethical issues. However, it is still unclear whether they manage to accomplish this task and what is their impact on clinical practice. This systematic review aims to collect available assessments of CECs’ performance as reported in literature, in order to evaluate CECs’ effectiveness. We retrieved all literature published up to November 2019 in six databases (PubMed, (...) Ovid MEDLINE, Scopus, Philosopher’s Index, Embase and Web of Science), following PRISMA guidelines. We included only articles specifically addressing CECs and providing any form of CECs performance assessment. Twenty-nine articles were included. Ethics consultation was the most evaluated of CECs’ functions. We did not find standardized tools for measuring CECs’ efficacy, but 33% of studies considered “user satisfaction” as an indicator, with 94% of them reporting an average positive perception of CECs’ impact. Changes in patient treatment and a decrease of moral distress in health personnel were reported as additional outcomes of ethics consultation. The highly diverse ways by which CECs carry out their activities make CECs’ evaluation difficult. The adoption of shared criteria would be desirable to provide a reliable answer to the question about their effectiveness. Nonetheless, in general both users and providers consider CECs as helpful, relevant to their work, able to improve the quality of care. Their main function is ethics consultation, while less attention seems to be devoted to bioethics education and policy formation. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

Freedom of conscience is a core element of human rights respected by most European countries. It allows abortion through the inclusion of a conscience clause, which permits opting out of providing such services. However, the grounds for invoking conscientious objection lack clarity. Our aim in this paper is to take a step in this direction by carrying out a systematic review of reasons by midwives and nurses for declining, on conscience grounds, to participate in abortion. We conducted a (...) class='Hi'>systematic review of ethical arguments asking, “What reasons have been reported in the argument based literature for or against conscientious objection to abortion provision by nurses or midwives?” We particularly wanted to identify any discussion of the responsibilities of midwives and nurses in this area. Search terms were conscientious objection and abortion or termination and nurse or midwife or midwives or physicians or doctors or medics within the dates 2000–2016 on: HEIN legal, Medline, CINAHL, Psychinfo, Academic Search Complete, Web of Science including publications in English, German and Dutch. Final articles were subjected to a rigorous analysis, coding and classifying each line into reason mentions, narrow and broad reasons for or against conscientious objection. Of an initial 1085 articles, 10 were included. We identified 23 broad reasons, containing 116narrow reasons and 269 reason mentions. Eighty one narrow reasons argued in favour of and 35 against conscientious objection. Using predetermined categories of moral, practical, religious or legal reasons, “moral reasons” contained the largest number of narrow reasons. The reasons and their associated mentions in this category outnumber those in the sum of the other three categories. We identified no absolute argument either for or against conscientious objection by midwives or nurses. An invisibility of midwives and nurses exists in the whole debate concerning conscientious objection reflecting a gap between literature and practice, as it is they whom WHO recommend as providers of this service. While the arguments in the literature emphasize the need for provision of conscientious objection, a balanced debate is necessary in this field, which includes all relevant health professionals. (shrink)

Motivation und Ikonizität : Die Frage nach dem richtigen Wort -- Der Zusammenhang von Polysemie, Ikonizität und lexikalischer Motivation -- Empirische Ermittlung lexikalischer Motivation : Die Frage nach der richtigen Methode -- Der Einfluss konzeptueller Relationen auf intrinsische und extrinsische Motivierbarkeit -- Polysemie und Skalen diagrammatischer Transparenz : Ein formales und semantisches Transparenzmodell -- Zusammenfassung und Schlussbemerkungen.

Based on the existence of polysemy (e.g., lunch can refer to both food and events), it is argued that central tenets of externalist semantics and Fodorian concept atomism, an externalist theory on which words lack semantic structure, are unsound. We evaluate the premise that these arguments rely on—that polysemous words have separate, finer‐grained senses. We survey the evidence across psychology and linguistics and argue that it shows that polysemy does not exist, at least not in this “sense”. The (...) upshot is that if polysemy does not exist, it cannot pose a problem for atomism or externalism. (shrink)

Data science, and the related field of big data, is an emerging discipline involving the analysis of data to solve problems and develop insights. This rapidly growing domain promises many benefits to both consumers and businesses. However, the use of big data analytics can also introduce many ethical concerns, stemming from, for example, the possible loss of privacy or the harming of a sub-category of the population via a classification algorithm. To help address these potential ethical challenges, this paper maps (...) and describes the main ethical themes that were identified via systematic literature review. It then identifies a possible structure to integrate these themes within a data science project, thus helping to provide some structure in the on-going debate with respect to the possible ethical situations that can arise when using data science analytics. (shrink)

There is an ongoing debate about the meaning of lexical words, i.e., words that contribute with content to the meaning of sentences. This debate has coincided with a renewal in the study of polysemy, which has taken place in the psycholinguistics camp mainly. There is already a fruitful interbreeding between two lines of research: the theoretical study of lexical word meaning, on the one hand, and the models of polysemy psycholinguists present, on the other. In this paper I (...) aim at deepening on this ongoing interbreeding, examine what is said about polysemy, particularly in the psycholinguistics literature, and then show how what we seem to know about the representation and storage of polysemous senses affects the models that we have about lexical word meaning. (shrink)

BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...) promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

Background Moral distress is a common challenge among professional nurses when caring for their patients, especially when they need to make rapid decisions. Therefore, leaving moral distress unconsidered may jeopardize patient quality of care, safety, and satisfaction. Aim To estimate moral distress among nurses. Methods This systematic review and meta-analysis conducted systematic search in Scopus, PubMed, ProQuest, ISI Web of Knowledge, and PsycInfo up to end of February 2022. Methodological quality of included studies was assessed using the Newcastle (...) Ottawa checklist. Data from included studies were pooled by meta-analysis with random effect model in STATA software version 14. The selected key measure was mean score of moral distress total score with its’ 95% Confidence Interval was reported. Subgroup analyses and meta-regressions were conducted to identify possible sources of heterogeneity and potentially influencing variables on moral distress. Funnel plots and Begg’s Tests were used to assess publication bias. The Jackknife method was used for sensitivity analysis. Ethical consideration The protocol of this project was registered in the PROSPERO database under decree code of CRD42021267773. Results Eighty-six manuscripts with 19,537 participants from 21 countries were included. The pooled estimated mean score of moral distress was 2.55 on a 0–10 scale [95% Confidence Interval: 2.27–2.84, I2: 98.4%, Tau2:0.94]. Publication bias and small study effect was ruled out. Moral distress significantly decreased in the COVID-19 pandemic versus before. Nurses working in developing countries experienced higher level of moral distress compared to their counterparts in developed countries. Nurses' workplace (e.g., hospital ward) was not linked to severity of moral disturbance. Conclusion The results of the study showed a low level of pooled estimated score for moral distress. Although the score of moral distress was not high, nurses working in developing countries reported higher levels of moral distress than those working in developed countries. Therefore, it is necessary that future studies focus on creating a supportive environment in hospitals and medical centers for nurses to reduce moral distress and improve healthcare. (shrink)

This paper reviews the ethical literature on conflicts between health professionals and parents about medical decision-making for children. We present the results of a systematic review which addressed the question ‘when health professionals and parents disagree about the appropriate course of medical treatment for a child, under what circumstances is the health professional ethically justified in overriding the parents’ wishes?’ We identified nine different ethical frameworks that were put forward by their authors as applicable across various ages and clinical (...) scenarios. Each of these frameworks centred on a different key moral concept including harm, constrained parental autonomy, best interests, medically reasonable alternatives, responsible thinking and rationality. (shrink)

Recognition and Religion: A Historical and Systematic Study outlines the first intellectual history of religious recognition, stretching from the New Testament to present day. Risto Saarinen connects the history of religion with philosophical approaches, arguing that philosophers owe a considerable historical and conceptual debt to the religious processes of recognition. At the same time, religious recognition has a distinctive profile that differs from philosophy in some important respects. Saarinen undertakes a systematic elaboration of the insights provided by the (...) tradition of religious recognition. He proposes that theology and philosophy can make creative use of the long history of religious recognition. (shrink)

Most theories of concepts take concepts to be structured bodies of information used in categorization and inference. This paper argues for a version of atomism, on which concepts are unstructured symbols. However, traditional Fodorian atomism is falsified by polysemy and fails to provide an account of how concepts figure in cognition. This paper argues that concepts are generative pointers, that is, unstructured symbols that point to memory locations where cognitively useful bodies of information are stored and can be deployed (...) to resolve polysemy. The notion of generative pointers allows for unresolved ambiguity in thought and provides a basis for conceptual engineering. (shrink)

Orthodoxy assumes that the first-person thoughts of an individual are anchored to a stable object. I challenge this assumption by arguing that “I” is polysemous. The perspectival anchor of a first-person thought could be the bearer of the thought, the agent, the bearer of perception, or a body, to name just a few options. These different possible anchors do not form a unity. So, a unified or minimal self cannot, without argument, be posited as the stable anchor of on individual’s (...) first-person thoughts. I show how the polysemy of “I” can be analyzed in terms of polysemous mental files. (shrink)

The concept of moral distress comes from nursing ethics, and was initially defined as ‘…when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. There is a large body of literature associated with moral distress, yet multiple definitions now exist, significantly limiting its usefulness. We undertook a systematic review of the argument-based bioethics literature on this topic as the basis for a critical appraisal, identifying 55 papers for (...) analysis. We found that moral distress is most frequently framed around individual experiences of distress in relation to local practices and constraints, and understood in terms of power relations and workplace hierarchies. This understanding is directly derived from, and often still seen as specific to, nursing. Frequently the perspective of the morally distressed individual is privileged. Understandings of moral distress have evolved towards an ‘occupational health approach’, with the assumption that moral distress should be measured and prevented. Counter-perspectives were identified, highlighting conceptual problems. Based on our review, we propose a redefinition of moral distress: ‘Ethical unease or disquiet resulting from a situation where a clinician believes they have contributed to avoidable patient or community harm through their involvement in an action, inaction or decision that conflicts with their own values’. This definition is specific enough for research use, anchored in clinicians’ professional responsibilities and concerns about harms to patients, framed relationally rather than hierarchically, and amenable to multiple perspectives on any given morally distressing situation. (shrink)

A new edition of the first systematic reading of Hegel's political philosophy Elements of the Philosophy of Right is widely acknowledged to be one of the most important works in the history of political philosophy. This is the first book on the subject to take Hegel's system of speculative philosophy seriously as an important component of any robust understanding of this text. Key Features •Sets out the difference between 'systematic' and 'non-systematic' readings of Philosophy of Right •Outlines (...) the unique structure of Hegel's philosophical arguments •Explores key areas of Hegel's political philosophy: his theories of property, punishment, morality, law, monarchy, war, democracy and history This significantly expanded second edition includes: a more detailed explanation of Hegel's philosophical system, two new chapters on his theories of democracy and history and an appendix detailing the implications this work has for future interpretations of Hegel's philosophy. (shrink)

BackgroundWith the emergence of Brain Computer Interfaces, clinicians have been facing a new group of patients with severe acquired brain injury who are unable to show any behavioral sign of consciousness but respond to active neuroimaging or electrophysiological paradigms. However, even though well documented, there is still no consensus regarding the nomenclature for this clinical entity.ObjectivesThis systematic review aims to 1) identify the terms used to indicate the presence of this entity through the years, and 2) promote an informed (...) discussion regarding the rationale for these names and the best candidates to name this fascinating disorder.MethodsThe Disorders of Consciousness Special Interest Group of the International Brain Injury Association launched a search on Pubmed and Google scholar following PRISMA guidelines to collect peer-reviewed articles and reviews on human adults published in English between 2006 and 2021.ResultsThe search launched in January 2021 identified 4,089 potentially relevant titles. After screening, 1,126 abstracts were found relevant. Finally, 161 manuscripts were included in our analyses. Only 58% of the manuscripts used a specific name to discuss this clinical entity, among which 32% used several names interchangeably throughout the text. We found 25 different names given to this entity. The five following names were the ones the most frequently used: covert awareness, cognitive motor dissociation, functional locked-in, non-behavioral MCS and higher-order cortex motor dissociation.ConclusionSince 2006, there has been no agreement regarding the taxonomy to use for unresponsive patients who are able to respond to active neuroimaging or electrophysiological paradigms. Developing a standard taxonomy is an important goal for future research studies and clinical translation. We recommend a Delphi study in order to build such a consensus. (shrink)

ABSTRACTEffects of metaphorical framing of political issues on opinion have been studied widely by two approaches: a critical-discourse approach and a response-elicitation approach. The current article reports a systematic literature review that examines whether these approaches report converging or diverging effects. We compared CDA and REA on the metaphorical frames that were studied and their reported effects. Results show that the CDA frames are typically more negative, nonfictional, and extreme than REA frames. Reported effects in CDA and REA studies (...) differ in terms of presence, directionality, and strength, with CDA typically reporting strong effects in line with the frame, compared to REA. These differences in effects can be explained by the different frame characteristics. However, differences in the methods applied by CDA and REA could be responsible for these differences as well. In all, we conclude that the research field is fragmented on the impact of metaphors in politics. (shrink)

IntroductionClinical ethics committees (CECs) support and enhance communication and complex decision making, educate healthcare professionals and the public on ethical matters and maintain standards of care. However, a consistent approach to training members of CECs is lacking. A systematic scoping review was conducted to evaluate prevailing CEC training curricula to guide the design of an evidence-based approach.MethodsArksey and O’Malley’s methodological framework for conducting scoping reviews was used to evaluate prevailing accounts of CEC training published in six databases. Braun and (...) Clarke’s thematic analysis approach was adopted to thematically analyse data across different healthcare and educational settings.Results7370 abstracts were identified, 92 full-text articles were reviewed and 55 articles were thematically analysed to reveal four themes: the design, pedagogy, content and assessment of CEC curricula.ConclusionFew curricula employ consistent approaches to training. Many programmes fail to provide CEC trainees with sufficient knowledge, skills and experience to meet required competencies. Most programmes do not inculcate prevailing sociocultural, research, clinical and educational considerations into training processes nor provide longitudinal support for CEC trainees. Most CEC training programmes are not supported by host institutions threatening the sustainability of the programme and compromising effective assessment and longitudinal support of CEC trainees. While further reviews are required, this review underlines the need for host organisations to support and oversee a socioculturally appropriate ethically sensitive, clinically relevant longitudinal training, assessment and support process for CEC trainees if CECs are to meet their roles effectively. (shrink)

BackgroundMoral distress is one of the most important problems that nurses face in their care of patients. Various studies have reported the frequency and severity of moral distress in nurses. However, to date, a comprehensive study that shows the results of these research across the world was not found, therefore due to the importance of this issue, its role in the health of nurses and patients, and the lack of general statistics about it worldwide, the present study was conducted to (...) determine the frequency and severity of moral distress in nurses through a systematic review and meta-analysis.MethodsIn this review study, searching national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Embase, ScienceDirect, Scopus, CINHAL, PubMed, and Web of Science between 2005 and February 2020 were extracted. The random-effects model was used for analysis, and the heterogeneity of studies with the I2 index was investigated. Data were analyzed using Comprehensive Meta-Analysis.ResultsThe frequency of moral distress in 9 articles with a sample size of 1576 persons was 1.7 ± 0.5 from, in 13 articles with a sample size of 1870 persons, 3.07 ± 0.1 from, in 6 articles with a sample size of 1316 persons, 3.2 ± 0.29 from, in 18 articles with a sample size of 1959 persons, 4.6 ± 0.518 from and in 35 articles with a sample size of 3718 persons, 81.1 ± 4.6 from, and the severity of moral distress in 4 articles with a sample size of 1116 persons, 1.7 ± 0.37 from, in 5 articles with a sample size of 1282 persons, 2.6 ± 0.28 from, in 5 articles with a sample size of 944 persons, 3.9 ± 0.63 from and in 8 articles with a sample size of 901 persons was 82.3 ± 5.4.ConclusionThe results of this study showed that the frequency and severity of moral distress in nurses are high and are a serious problem in nurses. Therefore, policymakers in this field should consider its role in the health of nurses and patients. (shrink)

Although rationing of scarce health-care resources is inevitable in clinical practice, there is still limited and scattered information about how physicians perceive and execute this bedside rationing (BSR) and how it can be performed in an ethically fair way. This review gives a systematic overview on physicians’ perspectives on influences, strategies, and consequences of health-care rationing. Relevant references as identified by systematically screening major electronic databases and manuscript references were synthesized by thematic analysis. Retrieved studies focused on themes that (...) fell under three major headings: (i) conditions and influences of BSR, (ii) strategies of BSR, and (iii) consequences of BSR. The range of themes indicates that physicians’ rationing behavior is highly variable, strongly influenced by context-related factors, and consists mainly of implicit rationing strategies. Torn between patient advocacy and the obligation to contain costs, physicians experience various role conflicts. The development of explicit rationing strategies seems necessary to avoid arbitrary BSR and allow a fair allocation of health-care resources. (shrink)

Large-scale linkage of international clinical datasets could lead to unique insights into disease aetiology and facilitate treatment evaluation and drug development. Hereto, multi-stakeholder consortia are currently designing several disease-specific translational research platforms to enable international health data sharing. Despite the recent adoption of the EU General Data Protection Regulation, the procedures for how to govern responsible data sharing in such projects are not at all spelled out yet. In search of a first, basic outline of an ethical governance framework, we (...) set out to explore relevant ethical principles and norms. We performed a systematic review of literature and ethical guidelines for principles and norms pertaining to data sharing for international health research. We observed an abundance of principles and norms with considerable convergence at the aggregate level of four overarching themes: societal benefits and value; distribution of risks, benefits and burdens; respect for individuals and groups; and public trust and engagement. However, at the level of principles and norms we identified substantial variation in the phrasing and level of detail, the number and content of norms considered necessary to protect a principle, and the contextual approaches in which principles and norms are used. While providing some helpful leads for further work on a coherent governance framework for data sharing, the current collection of principles and norms prompts important questions about how to streamline terminology regarding de-identification and how to harmonise the identified principles and norms into a coherent governance framework that promotes data sharing while securing public trust. (shrink)

Background: This article aims to review research manuscripts in the past 5 years that focus on the effects of debt on depression, anxiety, stress, or suicide ideation in Asian countries.Methods: A search for literature based on the PRISMA guidelines was conducted on Medline, PubMed, Web of Science, Scopus, and ScienceDirect, resulting in nine manuscripts meeting inclusion criteria. The studies were conducted in Thailand, Korea, Singapore, Pakistan, India, Cambodia, and China.Results: The findings of the studies show that there is evidence to (...) support that being in debt is related to Asian participants experiencing depression, anxiety, stress, or suicide ideation. However, the studies are limited to quantitative studies only. The definition of debt is also unclear in most manuscripts. Few manuscripts also examined how other factors influence the relationship between debt and mental illness.Conclusion: There are limited studies on the psychological effects of debt on the Asian population. Future studies should focus on the relationship between debt and psychological well-being among this population. (shrink)

The paper investigates measures of explanatory power and how to define the inference schema “Inference to the Best Explanation”. It argues that these measures can also be used to quantify the systematic power of a hypothesis and the inference schema “Inference to the Best Systematization” is defined. It demonstrates that systematic power is a fruitful criterion for theory choice and IBS is truth-conducive. It also shows that even radical Bayesians must admit that systemic power is an integral component (...) of Bayesian reasoning. Finally, the paper puts the achieved results in perspective with van Fraassen’s famous criticism of IBE. (shrink)