The search for “usable” expert systems is leading somemedical researchers to question the appropriate role of these programs. Most current systems assume a limited role for the human user, delegating situated “decision-control” to the machine. As expert systems are only able to replace a narrow range of human intellectual functions, this leaves the programs unable to cope with the “constructivist” nature of human knowledge-use. In returning practical control to the human doctor, some researchers are abandoning focusedproblem-solving in favour of supportiveproblem-analysis. (...) Using ONCOCIN and QMR as examples, this article contrasts these approaches and suggests that the latter avoids many of the difficulties currently facing medical expert systems. (shrink)

In a well?known passage, Wittgenstein suggests that claims about what I would have said if asked, offered as an elucidation of what I meant, are hypotheses. Some have argued that Wittgenstein commits himself here to the view that claims about what I meant are hypotheses. I argue that this is to misinterpret the relevant passages and is at odds with central themes in Wittgenstein's philosophy, particularly what he has to say about the first?person relation to meaning. This is not of (...) the external kind that the hypothesis model would suggest. Claims about what I would in fact have said are indeed hypotheses; but claims about what I would have said that are used to explicate what I meant have a quite different status. In a final section, I consider Wittgenstein's belief that the regularity of our meaning?governed behaviour need continue ?no further in the direction of the centre? and may emerge out of ?chaos?. I offer an account of these claims which gives no support to the hypothesis theory. (shrink)

This research illustrates dangers inherent in the gap created when organizations decouple ethics program adoption from implementation. Using a sample of 182 professionals in the pharmaceutical and financial services industries, we examine the relationship between structural decoupling of formal ethics programs and individual-level perceptions and behavior. Findings strongly support the hypothesized relationships between decoupling and organizational members’ legitimacy perceptions of the ethics program, psychological contract breach, organizational cynicism, and unethical behavior.

Plotinus was much exercised by Plato's doctrines of the soul. In this treatise, at chapter 1 line 27, he talks of "the divine Plato, who has said in many places in his works many noble things about the soul and its arrival here, so that we can hope for some clarity from him. So what does the philosopher say? It is clear that he does not always speak with sufficient consistency for us to make out his intentions with any ease." (...) The issue in this treatise is one that has puzzled students of Plato from ancient to modern times—and is indeed a popular topic for undergraduate essays even today: Why should the philosopher, who has ascended through a long and painful process of dialectic to "assimilation to the divine," ever descend back into the body? Plotinus himself is said by Porphyry to have attained such a state of other-worldly transcendence on at least four occasions during his lifetime, so this was a very real and personal issue for him. In this treatise we see him grappling with it. (shrink)

Sexual depictions were analyzed in 139 episodes of seven drama serials on British mainstream television over a four-week period in November–December 2006. Scenes that depicted sexual behavior and talk about sexual matters were counted separately. Further distinctions were made on the basis of the levels of intimacy and the graphic nature of portrayals. A total of 506 sexual scenes were found that occurred at the rate of 6.5 per hour across the seven soaps, but this figure was inflated by one (...) late-night serial that averaged 16.0 scenes per hourly episode. Nearly two-thirds of these scenes were restricted to talk about sexual matters, while the others contained overt depictions of sexual behavior. Sexual intercourse was relatively rare and restricted in terms of overt depictions to the late-night serial. Passionate kissing was far more prevalent throughout these programs regardless of the time of day the program was transmitted. When sexual intercourse was featured, this was generally in the context of loss of virginity or of infidelity. (shrink)

This paper considers the problems that arise when death, which is a philosophically difficult concept, is incorporated into healthcare metrics, such as the quality-adjusted life year (QALY). These problems relate closely to the debate over euthanasia and assisted suicide because negative QALY scores can be taken to mean that patients would be ‘better off dead’. There is confusion in the literature about the meaning of 0 QALY, which is supposed to act as an ‘anchor’ for the surveyed preferences on which (...) QALYs are based. In the context of the debate over euthanasia, the QALY assumes an ability to make meaningful comparisons between life-states and death. Not only is this assumption questionable, but the ethical debate is much more broad than the question of whether death is preferable to a state of living. QALYs are derived from preferences about health states, so do not necessarily reflect preferences about events (eg, dying) or actions (eg, killing). This paper presents a new kind of problem for the QALY. As it stands, the QALY provides confused and unreliable information when it reports zero or negative values, and faces further problems when it appears to recommend death. This should preclude its use in the debate over euthanasia and assisted suicide. These problems only apply where the QALY involves or seems to involve a comparison between life-states and death, and are not relevant to the more general discussion of the use of QALYs as a tool for comparing the benefits derived from treatment options. (shrink)

When I engage in some routine activity, it will usually be the case that I mean or intend the present move to be followed by others. What does meaning the later moves consist in? How do I know, when I come to perform them, that they were what I meant? Problems familiar from Wittgenstein's and Kripke's discussions of linguistic meaning arise here. Normally, I will not think of the later moves. But, even if I do, there are reasons to deny (...) that thinking of them can constitute what it is to mean to perform them. I argue that the problem can be solved, in the case of routine action, by the notion that our behavioural routines are guided by what I callmodest agent memory. It will help explain both how wecan have future moves in mind and how we can be in a position to avow the fact. (shrink)

I am concerned to understand that relation to a situation which we call fearing it. Some say this cannot be done: it is a brute fact about us that we fear certain things and we understand another's fear when we see that he confronts a situation of this sort (a basic fear object) or one which he understandably associates with this sort. In Section I, I argue that being associated with a basic fear object will not usefully explain a current (...) fear. In Section II, I argue that the obvious candidates for being basic fears will not do the required work. The notion should be rejected. I then argue that to fear an object is to take it as exhibiting one's lack of control and I proceed to describe the nature and content of this notion. (shrink)

There is a common view that as well as being conscious of the world in virtue of having thoughts about it, forming representations of its various states and processes, we are also conscious of it in virtue of feeling it. What I have in mind is not the fact that we have feelings about the world—indignation at this, pleasure at that—but that we sensorily feel its colours, sounds, textures and so on. And this feeling form of consciousness, it's often thought, (...) constitutes a peculiarly intimate and intense focus upon things. The feel of the first drops of rain on one's face and the sounds of the gull's cry will quickly be recognized for what they are; and the fact that events of this sort are occurring will thereafter hold one's attention just insofar as they are relevant to some current business. But what can also happen is that such experiences cut through any current concerns and cause a state in which, for a time, one does nothing except feel the soft coolness of the rain and the particular quality of the bird's cry. We can become absorbed, it seems, in the mere presence of these phenomena and this is an experience to which we attach great value. (shrink)

Plotinus can be regarded as the greatest Greek philosopher of late Antiquity, and as the father of Neoplatonism. His Enneads are now recognised as seminal works in the development of Western thought. This book is the only detailed scholarly commentary available on this part of Plotinus' work, and should be invaluable to all scholars interested in ancient philosophy and early Christian theology. All Greek in the commentary is translated.

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Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one’s moral knowledge about what one (...) ought to do. We begin by unpacking the philosophical components of Andrew Jameton’s original formulation from his landmark 1984 work and identify two key respects in which that formulation remains unclear: the origins of moral knowledge and impediments to acting on that moral knowledge. We then selectively review subsequent literature that shows that there is more than one concept of moral distress and that explores the origin of the values implicated in moral distress and impediments to acting on those values. This review sets the stage for identifying the elements of a philosophical taxonomy of ethically significant moral distress. The taxonomy uses these elements to create six categories of ethically significant moral distress: challenges to, threats to, and violations of professional integrity; and challenges to, threats to, and violations of individual integrity. We close with suggestions about how the proposed philosophical taxonomy of ethically significant moral distress sheds light on the concepts of moral residue and crescendo effect of moral distress and how the proposed taxonomy might usefully guide prevention of and future qualitative and quantitative empirical research on ethically significant moral distress. (shrink)

In this article I will address the critical question of the constitution of global systems and the part played in such processes by what is often summarized as culture. I examine the important distinction between culture and globalization and culture as constitutive of global social relations. The need to cleave to a systemic treatment of globality is put, while noting the dangers that lie in one-dimensional accounts of global system constitution. To offset any such tendency I explore the constitution of (...) global systemness from a structurationist perspective. I outline the nature and significance of culture in the study of global systems, drawing attention to different literatures. Finally I underscore the importance of the cultural turn in the study of global systems and what has to be done to take full advantage of it.In what follows I will address the critical question of the constitution of global systems and the part played in such processes by what is conveniently – if sometimes unhelpfully – summarized as “culture”. By global systems I mean networks of interaction and meaning that transcend both societal and national frames of reference. I want to shift the emphasis away from an under-theorized focus on cultural globalization to a consideration of global systems as enacted in part through cultural processes. In other words, I do not want to conflate the conjunctional features of contemporary (cultural) globalization with culture as the realm of lived experience integral to the enactment of all social-systemic relations. In some respects this approach may be seen as part of a shift – perhaps a paradigm shift – in how we understand the space of the social, and in how, or whether, we construe the global as the constitutive of all social relations (Beck 2003; Shaw 2003). I will begin with a mild polemic against a well-known systemic account of world-making forces that highlights some of these issues. (shrink)

This exploratory study contributes to the literature on disclosing concealable stigmatized identities (CSI) by positing authenticity and identity centrality as antecedents to disclosing body art within a workplace context. We analyze identity centrality and its effect on amplifying or suppressing disclosure and/or fear of disclosure of white‐collar professionals' body art. The research question focuses on whether white‐collar employees believe they can be authentic and disclose body art in the workplace and whether there are adverse career outcomes associated with disclosing body (...) art. Findings suggest authenticity was only related to the degree of disclosure through fear of disclosure, highlighting the role that fear played in the disclosure decision. Identity centrality moderated the relationship between authenticity and fear of disclosure. Both fear of and degree of disclosure were indirectly related to turnover intentions through affective organizational commitment. Given the limited research on body art as a stigma and its disclosure by white‐collar professionals, we believe this study adds to the CSI literature by offering insights into the impact that changing social mores associated with body art may have on the willingness of white‐collar professionals to disclose it. (shrink)