While strike action has been common since the industrial revolution, it often invokes a passionate and polarising response, from the strikers themselves, from employers, governments and the general public. Support or lack thereof from health workers and the general public is an important consideration in the justification of strike action. This systematic review sought to examine the impact of strike action on patient and clinician attitudes, specifically to explore (1) patient and health worker support for strike action and (2) the (...) predictors for supporting strike action and the reasons given for engaging in strike action. A systematic scoping review was employed to identify all relevant literature, followed by a textual narrative synthesis. A total of 34 studies met inclusion criteria. Support for strike action was largely context‐dependent. A range of factors impact support for strike action; broader cultural and structural factors, such as unionisation and general acceptance of strike action; systemic factors, such as the nature of the healthcare system, including infrastructure and work conditions; the strike itself and a range of individual factors, the most notable of which was being a student or in an early career stage. There were also some surprising results, for example, during doctors strike, nurses were provided with the opportunity to expand their role, which led to greater professional autonomy and job satisfaction. (shrink)

For this second edition, the editors have returned to Austin's original lecture notes, amending the printed text where it seemed necessary.

The word utiliarianism was coined by Jeremy Bentham in 1781 in a letter to friend in which he said: "A new religion would be an odd sort of thing without a name." While the doctrine never quite became a religion, its thesis, as expressed by Mill in the first essay in this volume-that the good and right are to be defined as that which promotes happiness-became the dominant naturalistic theory of the nineteenth century and provided the moral basis for classical (...) liberalism. (shrink)

First published in 1962, contains the William James Lectures delivered at Harvard University in 1955. It sets out Austin's conclusions in the field to which he directed his main efforts for at least the last ten years of his life. Starting from an exhaustive examination of his already well- known distinction of performative utterances from statements, Austin here finally abandons that distinction, replacing it by a more general theory of 'illocutionary forces' of utterances which has important bearings on (...) a wide variety of philosophical problems. (shrink)

This book is the one to put into the hands of those who have been over-impressed by Austin 's critics....[Warnock's] brilliant editing puts everybody who is concerned with philosophical problems in his debt.

It is considered the right of children to have their pain managed effectively. Yet, despite extensive research findings, policy guidelines and practice standard recommendations for the optimal management of paediatric pain, clinical practices remain inadequate. Empirical evidence definitively shows that unrelieved pain in children has only harmful consequences, with no benefits. Contributing factors identified in this undermanaged pain include the significant role of nurses. Nursing attitudes and beliefs about children’s pain experiences, the relationships nurses share with children who are suffering, (...) and knowledge deficits in pain management practices are all shown to impact unresolved pain in children. In this article, a relational ethics perspective is used to explore the need for nurses to engage in authentic relationships with children who are experiencing pain, and to use evidence-based practices to manage that pain in order for this indefensible suffering of children to end. (shrink)

The majority of healthcare professionals regularly witness fragility, suffering, pain and death in their professional lives. Such experiences may increase the risk of burnout and compassion fatigue, especially if they are without self-awareness and a healthy work environment. Acquiring a deeper understanding of vulnerability inherent to their professional work will be of crucial importance to face these risks. From a relational ethics perspective, the role of the team is critical in the development of professional values which can help to cope (...) with the inherent vulnerability of healthcare professionals. The focus of this paper is the role of Communities of Practice as a source of resilience, since they can create a reflective space for recognising and sharing their experiences of vulnerability that arises as part of their work. This shared knowledge can be a source of strength while simultaneously increasing the confidence and resilience of the healthcare team. (shrink)

Although the advising literature has emphasized the importance of good academic advising, there has been little emphasis on ethical issues. NACADA: The Global Community for Academic Advising provides Core Values to guide ethical behavior. This study used an experimental design to examine perspectives of ethical behavior among faculty, staff, and students. All groups could differentiate between ethical and unethical extremes, but students had difficulty differentiating between ethical and neutral behavior. All groups hesitated to rate advisors as highly ethical or unethical. (...) Even when behavior was seen as less ethical, students and faculty/staff perceived limited opportunity for students to do something about that behavior, such as change advisors. Suggestions are offered to increase the likelihood of more ethical behavior within advisement. (shrink)

Climate change is expected to increase the frequency and intensity of drought in many parts of the world, including Montana. In the face of worsening drought conditions, agricultural producers need to adapt their operations to mitigate risk. This study examined the role of local knowledge and climate information in drought-related decisions through five focus groups with Montana farmers and ranchers. We found that trust and risk perceptions mediated how producers utilized both local knowledge and climate information. More specifically, producers relied (...) on local knowledge in drought-related decisions, regarding their own observation and past experience as trustworthy and not particularly risky. In contrast, climate information and seasonal climate forecasts in particular were regarded as risky and untrustworthy, largely due to a perceived lack of accuracy. Since producers tended to be risk averse, especially given market and climate uncertainties, they rarely relied on “risky” climate information. At the same time, producers actively managed risk and tested out new technologies and practices through processes of trial and error, what they called “experimenting,” which enabled them to build firsthand knowledge of potential adaptations. In the context of uncertainty and risk aversion, programs that reduce the financial risk of experimenting with new technologies and adaptive practices are needed to enable producers to develop direct experience with innovations designed to mitigate drought risk. Further, scientists developing climate information need to work directly with farmers and ranchers to better integrate local knowledge into climate information. (shrink)

The making of mistakes by organisms and living systems generally is an underexplored way of conceptualising biology and organising experimental research. We set out an informal account of biological mistakes and why they should be taken seriously in biological investigation. We then give an indirect defence of their importance by applying the concept of mistake making to three kinds of activity: timing, calculation, and communication. We give a range of examples to show that mistakes in these kinds of behaviour can (...) be found across a diversity of scales and systems. We also suggest ideas for empirical research that naturally arise from these cases. The reality and potential for mistake making across such a wide range of biological entities shows that it is not a purely human phenomenon. Getting it wrong seems to be central to biology as a whole, and to be a potentially productive organising principle for generating novel research questions and experimental hypotheses. (shrink)

The world is currently facing a wave of data centre construction. Fuelled by an explosion of data production and the emergence of edge computing, our cities are witnessing the materialisation of new architectural typologies that increasingly convolute notions of digital and bodily distinction. Whilst the last 2 decades have seen the proliferation of separate human and post-human urban environments, here we consider the agency and performativity of human communities within increasingly tangled contexts. As edge computing continues to bring the material (...) reality of data processing closer to our physical bodies, perhaps its time to reassess who, or what, our cities now serve. In an age of unprecedented digital transformation, when our identities seem to be ever more intangible, how we might perform within environments that are increasingly catering to our digital rather than bodily needs? Today, the Anthropocene expels nature to the periphery. Tomorrow, humans become marginalised—“weeds”, thriving in an epoch of data. (shrink)

Deep convolutional networks exceed humans in sensitivity to local image properties, but unlike biological vision systems, do not discover and encode abstract relations that capture important properties of objects and events in the world. Coupling network architectures with additional machinery for encoding abstract relations will make deep networks better models of human abilities and more versatile and capable artificial devices.

John Austin's classic work that has had a profound influence on the study of English and American law presents Austin's distinction between "positive law" (i.e.

Background Pragmatic randomized controlled trials are designed to evaluate the effectiveness of interventions in real-world clinical conditions. However, these studies raise ethical issues for researchers and regulators. Our objective is to identify a list of key ethical issues in pragmatic RCTs and highlight gaps in the ethics literature. Methods We conducted a scoping review of articles addressing ethical aspects of pragmatic RCTs. After applying the search strategy and eligibility criteria, 36 articles were included and reviewed using content analysis. Results Our (...) review identified four major themes: 1) the research-practice distinction; 2) the need for consent; 3) elements that must be disclosed in the consent process; and 4) appropriate oversight by research ethics committees. 1) Most authors reject the need for a research-practice distinction in pragmatic RCTs. They argue that the distinction rests on the presumptions that research participation offers patients less benefit and greater risk than clinical practice, but neither is true in the case of pragmatic RCTs. 2) Most authors further conclude that pragmatic RCTs may proceed without informed consent or with simplified consent procedures when risks are low and consent is infeasible. 3) Authors who endorse the need for consent assert that information need only be disclosed when research participation poses incremental risks compared to clinical practice. Authors disagree as to whether randomization must be disclosed. 4) Finally, all authors view regulatory oversight as burdensome and a practical impediment to the conduct of pragmatic RCTs, and argue that oversight procedures ought to be streamlined when risks to participants are low. Conclusion The current ethical discussion is framed by the assumption that the function of research oversight is to protect participants from risk. As pragmatic RCTs commonly involve usual care interventions, the risks may be minimal. This leads many to reject the research-practice distinction and question the need for informed consent. But the function of oversight should be understood broadly as protecting the liberty and welfare interest of participants and promoting public trust in research. This understanding, we suggest, will focus discussion on questions about appropriate ethical review for pragmatic RCTs. (shrink)

The subject of this paper, Excuses, is one not to be treated, but only to be introduced, within such limits. It is, or might be, the name of a whole branch, even a ramiculated branch, of philosophy, or at least of one fashion of philosophy. I shall try, therefore, first to state what the subject is, why it is worth studying, and how it may be studied, all this at a regrettably lofty level: and then I shall illustrate, in more (...) congenial but desultory detail, some of the methods to be used, together with their limitations, and some of the unexpected results to be expected and lessons to be learned. Much, of course, of the amusement, and of the instruction, comes in drawing the coverts of the microglot, in hounding down the minutiae, and to this I can do no more here than incite you. But I owe it to the subject to say, that it has long afforded me what philosophy is so often thought, and made, barren of -- the fun of discovery, the pleasures of co-operation, and the satisfaction of reaching agreement. (shrink)

‘Unfair to Facts’ is a follow-up on Ch. 5, addressing objections Peter Strawson raised against Austin’s view of truth as a description of the conditions that must be satisfied if we are to say of a statement that it is true. Austin addresses the objection that his description of these conditions is due to a misunderstanding about the use of ‘fact’, arguing, against Strawson, that facts are not pseudo-entities and that the notion of ‘fitting the facts’ is not (...) a useless notion. (shrink)

Austin takes on the problem of other minds, of how to respond to the question ‘how do you know?’, if this question is raised with regard to the thoughts, feelings, sensations, minds of other creatures. This problem has traditionally been understood as the problem of justifying our belief in the existence of other minds. Austin argues that believing in other persons, in authority and testimony, is an essential part of the act of communicating, and as such is an (...) irreducible part of our experience. While we can state certain advantages of communicative performances, there is no justification for our doing them as such. (shrink)

The book uses Zen Buddhism as the opening wedge for an extraordinarily wide-ranging exploration of consciousness.

This sequel to the widely read Zen and the Brain continues James Austin's explorations into the key interrelationships between Zen Buddhism and brain research. In Zen-Brain Reflections, Austin, a clinical neurologist, researcher, and Zen practitioner, examines the evolving psychological processes and brain changes associated with the path of long-range meditative training. Austin draws not only on the latest neuroscience research and new neuroimaging studies but also on Zen literature and his personal experience with alternate states of consciousness.Zen-Brain (...) Reflections takes up where the earlier book left off. It addresses such questions as: how do placebos and acupuncture change the brain? Can neuroimaging studies localize the sites where our notions of self arise? How can the latest brain imaging methods monitor meditators more effectively? How do long years of meditative training plus brief enlightened states produce pivotal transformations in the physiology of the brain? In many chapters testable hypotheses suggest ways to correlate normal brain functions and meditative training with the phenomena of extraordinary states of consciousness.After briefly introducing the topic of Zen and describing recent research into meditation, Austin reviews the latest studies on the amygdala, frontotemporal interactions, and paralimbic extensions of the limbic system. He then explores different states of consciousness, both the early superficial absorptions and the later, major "peak experiences." This discussion begins with the states called kensho and satori and includes a fresh analysis of their several different expressions of "oneness." He points beyond the still more advanced states toward that rare ongoing stage of enlightenment that is manifest as "sage wisdom."Finally, with reference to a delayed "moonlight" phase of kensho, Austin envisions novel links between migraines and metaphors, moonlight and mysticism. The Zen perspective on the self and consciousness is an ancient one. Readers will discover how relevant Zen is to the neurosciences, and how each field can illuminate the other. (shrink)

This book offers a novel defence of a highly contested philosophical position: biological natural kind essentialism. This theory is routinely and explicitly rejected for its purported inability to be explicated in the context of contemporary biological science, and its supposed incompatibility with the process and progress of evolution by natural selection. Christopher J. Austin challenges these objections, and in conjunction with contemporary scientific advancements within the field of evolutionary-developmental biology, the book utilises a contemporary neo-Aristotelian metaphysics of "dispositional properties", (...) or causal powers, to provide a theory of essentialism centred on the developmental architecture of organisms and its role in the evolutionary process. By defending a novel theory of Aristotelian biological natural kind essentialism, Essence in the Age of Evolution represents the fresh and exciting union of cutting-edge philosophical insight and scientific knowledge. (shrink)

Side effects are ubiquitous in medicine and they often play a role in treatment decisions for patients and clinicians alike. Philosophers and health researchers often use side effects to illustrate issues with contemporary medical research and practice. However, technical definitions of ‘side effect’ differ among health authorities. Thus, determining the side effects of an intervention can differ depending on whose definition we assume. Here I review some of the common definitions of side effect and highlight their issues. In response, I (...) offer an account of side effects as jointly (i) unintended and (ii) effects due to the causal capacities or invariances of an intervention. I discuss (i) by examining the intentions or reasons behind therapeutic interventions, and I discuss (ii) by appealing to a manipulationist model of causation. The analysis here highlights that side effects are conceptually distinct from related outcomes like adverse events, adverse drug reactions, and placebo effects. The analysis also allows for reflection on the utility of ‘side effect’ as a technical term in medical research and practice. (shrink)

A recent development in biology has been the growing acceptance that holobionts, entities comprised of symbiotic microbes and their host organisms, are widespread in nature. There is agreement that holobionts are evolved outcomes, but disagreement on how to characterize the operation of natural selection on them. The aim of this paper is to articulate the contours of the disagreement. I explain how two distinct foundational accounts of the process of natural selection give rise to competing views about evolutionary individuality.

As there is currently a neo-Aristotelian revival currently taking place within contemporary metaphysics and dispositions, or causal powers are now being routinely utilised in theories of causality and modality, more attention is beginning to be paid to a central Aristotelian concern: the metaphysics of substantial unity, and the doctrine of hylomorphism. In this paper, I distinguish two strands of hylomorphism present in the contemporary literature and argue that not only does each engender unique conceptual difficulties, but neither adequately captures the (...) metaphysics of Aristotelian hylomorphism. Thus both strands of contemporary hylomorphism, I argue, fundamentally misunderstand what substantial unity amounts to in the hylomorphic framework – namely, the metaphysical inseparability of matter and form. (shrink)

Though the realm of biology has long been under the philosophical rule of the mechanistic magisterium, recent years have seen a surprisingly steady rise in the usurping prowess of process ontology. According to its proponents, theoretical advances in the contemporary science of evo-devo have afforded that ontology a particularly powerful claim to the throne: in that increasingly empirically confirmed discipline, emergently autonomous, higher-order entities are the reigning explanantia. If we are to accept the election of evo-devo as our best conceptualisation (...) of the biological realm with metaphysical rigour, must we depose our mechanistic ontology for failing to properly “carve at the joints” of organisms? In this paper, I challenge the legitimacy of that claim: not only can the theoretical benefits offered by a process ontology be had without it, they cannot be sufficiently grounded without the metaphysical underpinning of the very mechanisms which processes purport to replace. The biological realm, I argue, remains one best understood as under the governance of mechanistic principles. (shrink)

Once a term used primarily by moral philosophers, “moral distress” is increasingly used by health professionals to name experiences of frustration and failure in fulfilling moral obligations inherent to their fiduciary relationship with the public. Although such challenges have always been present, as has discord regarding the right thing to do in particular situations, there is a radical change in the degree and intensity of moral distress being expressed. Has the plight of professionals in healthcare practice changed? “Plight” encompasses not (...) only the act of pledging, but that of predicament and peril. The author claims that health professionals are increasingly put in peril by healthcare reform that undermines their efficacy and jeopardizes ethical engagement with those in their care. The re-engineering of healthcare to give precedence to corporate and commercial values and strategies of commodification, service rationing, streamlining, and measuring of “efficiency,” is literally demoralizing health professionals. Healthcare practice needs to be grounded in a capacity for compassion and empathy, as is evident in standards of practice and codes of ethics, and in the understanding of what it means to be a professional. Such grounding allows for humane response to the availability of unprecedented advances in biotechnological treatments, for genuine dialogue and the raising of difficult, necessary ethical questions, and for the mutual support of health professionals themselves. If healthcare environments are not understood as moral communities but rather as simulated marketplaces, then health professionals’ moral agency is diminished and their vulnerability to moral distress is exacerbated. Research in moral distress and relational ethics is used to support this claim. (shrink)

Joona Räsänen argues that vegans ought to be anti-natalists and therefore abstain from having children. More precisely, Räsänen claims that vegans who accept a utilitarian or rights-based argument for veganism, ought to, by parity of reasoning, accept an analogous argument for anti-natalism. In this paper, I argue that the reasons vegans have for refraining from purchasing animal products do not commit them to abstaining from having children. I provide novel arguments to the following conclusion: while there is good reason to (...) believe that factory farming results in a net disutility and involves treating non-human animals as mere means, there is not good reason to believe that having children results in a net disutility or involves treating the children as mere means. Subsequently, I respond to what I take to be Räsänen’s underlying reasoning—that vegans are committed to abstaining from other practices which cause unnecessary suffering. I respond by arguing that this is plausibly false as various practices which cause unnecessary suffering are likely permissible, whereas factory farming is not. (shrink)

_The Foundations of Arithmetic_ is undoubtedly the best introduction to Frege's thought; it is here that Frege expounds the central notions of his philosophy, subjecting the views of his predecessors and contemporaries to devastating analysis. The book represents the first philosophically sound discussion of the concept of number in Western civilization. It profoundly influenced developments in the philosophy of mathematics and in general ontology.

The advent of contemporary evolutionary theory ushered in the eventual decline of Aristotelian Essentialism (Æ) – for it is widely assumed that essence does not, and cannot have any proper place in the age of evolution. This paper argues that this assumption is a mistake: if Æ can be suitably evolved, it need not face extinction. In it, I claim that if that theory’s fundamental ontology consists of dispositional properties, and if its characteristic metaphysical machinery is interpreted within the framework (...) of contemporary evolutionary developmental biology, an evolved essentialism is available. The reformulated theory of Æ offered in this paper not only fails to fall prey to the typical collection of criticisms, but is also independently both theoretically and empirically plausible. The paper contends that, properly understood, essence belongs in the age of evolution. (shrink)

Unable to answer the call of our patients: mental health nurses’ experience of moral distress When health practitioners’ moral choices and actions are thwarted by constraints, they may respond with feelings of moral distress. In a Canadian hermeneutic phenomenological study, physicians, nurses, psychologists and non‐professional aides were asked to identify care situations that they found morally distressing, and to elaborate on how moral concerns regarding the care of patients were raised and resolved. In this paper, we describe the experience of (...) moral distress related by nurses working in mental healthcare settings who believed that lack of resources (such as time and staff) leads to dispiritedness, lack of respect, and absence of recognition (for both patients and staff) which severely diminished their ability to provide quality care. The metaphors of flashlight and hammer are used to elaborate nurses’ possible responses to intolerable situations. (shrink)

This sequel to the widely read Zen and the Brain continues James Austin's explorations into the key interrelationships between Zen Buddhism and brain research. In Zen-Brain Reflections, Austin, a clinical neurologist, researcher, and Zen practitioner, examines the evolving psychological processes and brain changes associated with the path of long-range meditative training. Austin draws not only on the latest neuroscience research and new neuroimaging studies but also on Zen literature and his personal experience with alternate states of consciousness.Zen-Brain (...) Reflections takes up where the earlier book left off. It addresses such questions as: how do placebos and acupuncture change the brain? Can neuroimaging studies localize the sites where our notions of self arise? How can the latest brain imaging methods monitor meditators more effectively? How do long years of meditative training plus brief enlightened states produce pivotal transformations in the physiology of the brain? In many chapters testable hypotheses suggest ways to correlate normal brain functions and meditative training with the phenomena of extraordinary states of consciousness.After briefly introducing the topic of Zen and describing recent research into meditation, Austin reviews the latest studies on the amygdala, frontotemporal interactions, and paralimbic extensions of the limbic system. He then explores different states of consciousness, both the early superficial absorptions and the later, major "peak experiences." This discussion begins with the states called kensho and satori and includes a fresh analysis of their several different expressions of "oneness." He points beyond the still more advanced states toward that rare ongoing stage of enlightenment that is manifest as "sage wisdom."Finally, with reference to a delayed "moonlight" phase of kensho, Austin envisions novel links between migraines and metaphors, moonlight and mysticism. The Zen perspective on the self and consciousness is an ancient one. Readers will discover how relevant Zen is to the neurosciences, and how each field can illuminate the other. (shrink)

Although they are continually compositionally reconstituted and reconfigured, organisms nonetheless persist as ontologically unified beings over time – but in virtue of what? A common answer is: in virtue of their continued possession of the capacity for morphological invariance which persists through, and in spite of, their mereological alteration. While we acknowledge that organisms‟ capacity for the “stability of form” – homeostasis - is an important aspect of their diachronic unity, we argue that this capacity is derived from, and grounded (...) in a more primitive one – namely, the homeodynamic capacity for the “specified variation of form”. In introducing a novel type of causal power – a „structural power‟ – we claim that it is the persistence of their dynamic potential to produce a specified series of structurally adaptive morphologies which grounds organisms‟ privileged status as metaphysically “one over many” over time. (shrink)

A personal story of the ways in which persistence, chance, and creativity interact in biomedical research. This first book by the author of Zen and the Brain examines the role of chance in the creative process. James Austin tells a personal story of the ways in which persistence, chance, and creativity interact in biomedical research; the conclusions he reaches shed light on the creative process in any field. Austin shows how, in his own investigations, unpredictable events shaped the (...) outcome of his research and brought about novel results. He then goes beyond this story of serendipity to propose a new classification of the varieties of chance, drawing on his own research and examples from the history of science—including the famous accidents that led Fleming to the discovery of penicillin. Finally, he explores the nature of the creative process, considering not only the environmental and neurophysiological correlates of creativity but also the role of intuition in both scientific discoveries and spiritual quests. This updated MIT Press paperback edition includes a new introduction and recent material on medical research, creativity, and spirituality. (shrink)

Provides a philosophical analysis of the numerous and distinct conceptions of parenthood. This work considers such issues as the nature and justification of parental rights, the sources of parental obligations, the value of autonomy, and the moral obligations and tensions present within interpersonal relationships.

According to contemporary ‘process ontology’, organisms are best conceptualised as spatio-temporally extended entities whose mereological composition is fundamentally contingent and whose essence consists in changeability. In contrast to the Aristotelian precepts of classical ‘substance ontology’, from the four-dimensional perspective of this framework, the identity of an organism is grounded not in certain collections of privileged properties, or features which it could not fail to possess, but in the succession of diachronic relations by which it persists, or ‘perdures’ as one entity (...) over time. In this paper, I offer a novel defence of substance ontology by arguing that the coherency and plausibility of the radical reconceptualisation of organisms proffered by process ontology ultimately depends upon its making use of the ‘substantial’ principles it purports to replace. (shrink)