Adults who are incapacitated and alone, having no surrogates, may be known as “unbefriended.” Decision-making for these particularly vulnerable patients is a common and vexing concern for healthcare providers and hospital ethics committees. When all other avenues for resolving the need for surrogate decision-making fail, patients who are incapacitated and alone may be referred for “public guardianship” or guardianship of last resort. While an appropriate mechanism in theory, these programs are often under-staffed and under-funded, laying the consequences of inadequacies on (...) the healthcare system and the patient him or herself. We describe a qualitative study of professionals spanning clinical, court, and agency settings about the mechanisms for resolving surrogate consent for these patients and problems therein within the state of Massachusetts. Interviews found that all participants encountered adults who are incapacitated and without surrogates. Four approaches for addressing surrogate needs were: work to restore capacity; find previously unknown surrogates; work with agencies to obtain surrogates; and access the guardianship system. The use of guardianship was associated with procedural challenges and ethical concerns including delays in care, short term gains for long term costs, inabilities to meet a patient’s values and preferences, conflicts of interest, and ethical discomfort among interviewees. Findings are discussed in the context of resources to restore capacity, identify previously unknown surrogates, and establish improved surrogate mechanisms for this vulnerable population. (shrink)

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n (...) = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (shrink)

An interview with Ed Casey where we discuss the intersections of his philosophical work with current political issues, including the Israel-Palestine conflict.

This paper motivates a constraint on how to explain the “sense of agency” for conscious thinking. It argues that a prominent model fails to satisfy the constraint before sketching an alternative that does. On the alternative, punctate acts of conscious thinking, such as episodes of inner speech, are recognizable as our deeds because they are recognizable as parts of complex cognitive activities, which we know non-observationally in virtue of holding intentions to perform them.

This is an interview with Edward S. Casey, conducted by Donald A. Landes.

Perin argues that theSceptic is engaged in the search for truth and that since this is so, the Sceptic aims to satisfy certain basic rational requirements.

What happens when we glance around a room? How do we trust what we see in fleeting moments? In The World at a Glance, Edward S. Casey describes how glancing counts for more of human perception than previously imagined. An entire universe is perceived in a glance, but our quick and uncommitted attention prevents examination of these rapid acts and processes. While breaking down this paradox, Casey surveys the glance as an essential way by which we acquaint ourselves (...) with the world. This experiential tour-de-force reveals what happens in a blink of an eye. It will become a landmark study in phenomenology, philosophy, environmental philosophy, and the philosophy of mind. (shrink)

I argue that the debates over which norm constitutes assertion can be abandoned by challenging the three main motivations for a constitutive norm. The first motivation is the alleged analogy between language and games. The second motivation is the intuition that some assertions are worthy of criticism. The third is the discursive responsibilities incurred by asserting. I demonstrate that none of these offer good reasons to believe in a constitutive norm of assertion, as such a norm is understood in the (...) literature. Others who have made similar arguments conclude that assertion does not exist at all—that there is no such thing as assertion. I disagree: we do not have to relinquish the category of assertion just because it is not normatively constituted. There are alternative ways to understand and individuate assertion that do not rely on a constitutive norm. (shrink)

The American Recovery and Reinvestment Act of 2009 (ARRA) required healthcare providers in the United States to adopt and demonstrate meaningful use of electronic health records (EHRs) by January 1, 2014. In many ways, EHRs mark a notable improvement over paper medical records as they are more easily accessible and allow for electronic searching and sharing of medical history. However, as EHRs have become mandated by ARRA, many nurses now rely upon computers far more heavily during nurse–patient interactions, thereby decreasing (...) the level of direct interpersonal communication between the two. There is evidence that eye contact between nurses and patients positively affects patient satisfaction. Above and beyond the issue of patient satisfaction is the more basic ethical issue of respecting the patient as a person. The author argues that the templates used in electronic health systems have the possibility of eroding the respect for humanity that is the hallmark of nurse–patient relationships, as signalled by the American Nurses Association’s first principle in their Code of Ethics. Using concepts from philosophers Martin Heidegger and Emmanuel Levinas, the author provides guidance as to what an ethical interaction between nurse and patient should look like in an age of EHRs. (shrink)

This book provides an in-depth analysis of Thomas Hobbes's philosophy and political writings. The author argues that Hobbes was not only a philosopher, but also a publicist who played an important role in shaping political discourse in his time. This is an essential resource for anyone interested in political philosophy and the history of ideas. This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work (...) is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Suppose I make an utterance, intending it to be a command. You don’t take it to be one. Must one of us be wrong? In other words, must each utterance have, at most, one illocutionary force? Current debates over the constitutive norm of assertion and over illocutionary silencing, tend to assume that the answer is yes—that each utterance must be either an assertion, or a command, or a question, but not more than one of these. While I think that this (...) assumption is intuitive, I will argue in this paper that it is not sustainable. I’ll argue that this assumption makes it hard to explain what determines illocutionary force in a consistent and non-ad hoc way. I will demonstrate this is not fatal for the notion of illocutionary force writ large by offering some alternatives. (shrink)

Since the development of assisted reproductive technologies, infertile individuals have crossed borders to obtain treatments unavailable or unaffordable in their own country. Recent media coverage has focused on the outsourcing of surrogacy to developing countries, where the cost for surrogacy is significantly less than the equivalent cost in a more developed country. This paper discusses the ethical arguments against international surrogacy. The major opposition viewpoints can be broadly divided into arguments about welfare, commodification and exploitation. It is argued that the (...) only valid objection to international surrogacy is that surrogate mothers may be exploited by being given too little compensation. However, the possibility of exploitation is a weak argument for prohibition, as employment alternatives for potential surrogate mothers may be more exploitative or more harmful than surrogacy. It is concluded that international surrogacy must be regulated, and the proposed regulatory mechanism is termed Fair Trade Surrogacy. The guidelines of Fair Trade Surrogacy focus on minimizing potential harms to all parties and ensuring fair compensation for surrogate mothers. (shrink)

Yli-Vakkuri offers a deductive argument for Content Externalism that primarily appeals to two main principles he says should be adopted by all parties to the debate. Sawyer criticizes this argument on the grounds that there are internalist theories that are not consistent with the two principles he offers, although she takes no issue with the derivation itself. While Sawyer’s critique is insightful and largely correct, there is a more fundamental problem with the original argument. The formal proof given in the (...) original paper begs the question. The informal argument is enthymematic, and all the possible valid reconstructions require assumptions that can be legitimately rejected by content internalists. This is significant to point out as someone might think that the internalist views that Sawyer says are not consistent with the two principles that drive Yli-Vakkuri’s argument can be successfully challenged and thereby the original argument defended. (shrink)

It is uncontroversial that we sometimes have moral obligations to voice our disagreements, when, for example, the stakes are high and a wrong course of action will be pursued. But might we sometimes also have epistemic obligations to voice disagreements? In this paper, I will argue that we sometimes do. In other words, sometimes, to be behaving as we ought, qua epistemic agents, we must not only disagree with an interlocutor who has voiced some disagreed-with content but must also testify (...) to this disagreement. This is surprising given that norms on testimony are generally taken to be permissive, and epistemic obligations are usually taken to be negative. In this paper I will discuss some occasions in which epistemic obligations to testify may arise, and I will attempt to investigate the nature of these obligations. I'll briefly discuss the relationship between epistemic and moral norms. I'll offer an account of what it takes to discharge epistemic obligations to testify. Finally, I'll look at some accounts of epistemic obligation that might explain these obligations. (shrink)

At the center of much contemporary work on self-knowledge of our attitudes is a debate between Agentialists and Empiricists. Empiricists hold that first-person knowledge of one’s own attitudes possesses a broadly empirical basis, such as observation or inference. Agentialists insist that an account of self-knowledge must make sense of the intimate connection between knowing one’s attitudes and actively forming them in response to reasons. But it is plausible to suppose that a psychologically realistic account of self-knowledge will emphasize both active (...) and passive elements. Focusing on the idea that we form self-ascriptions of belief on the basis of active deliberation, this paper outlines such a middle ground position. (shrink)

Brought to you by: Crop X editors: Jonathan Alexander Perez, Harmony Smith, Corinne Tendorf, David Turturo, and Derek Rahn Williams. Faculty Advisor: David Turturo; Crop X team included: Chaimae Alehyane, Zachary S. Casey, Suzanna Brinez, Jacob Brown, Elizabeth George, Francisco Javier Muniz Ituarte, Brodey Myers. -/- Credits: Huckabee College of Architecture; Graphic Designers: Studio BLDG (Blossom Liu + Danny Gray); English Editor: Luke Studebaker; Spanish Translator: Jessie Forbes; Printer: Die Keure. Cover Photo: Derek Williams. -/- Generously supported by the (...) Graham Foundation for Advanced Studies in the Fine Arts and the Huckabee College of Architecture, Texas Tech University. (shrink)

I can, given the right conditions, transmit my knowledge to you by telling you some information. If I know the time, and if all goes well, I can bring it about that you know it too. If conditions are right, all I have to do is assert to you what time it is. Paradigmatically, speakers use assertions to transmit what they know to their hearers. Clearly, assertion and testimony are tightly connected. The nature of this connection, however, is not so (...) clear. According to many accounts, assertion has an epistemic constitutive norm. This norm appears to be able to account for some important features of testimony: first, testimonial knowledge transmission, second, the reliability of testimony, and third, the epistemic rights exchanged in cases of testimony. In this paper, however, I argue against this apparent ability. The constitutive norm of assertion, I argue, plays no role in accounts of testimonial knowledge transmission, or of the epistemic rights that testimony confers. This is especially clear whe.. (shrink)

During the debates about the legalization of Voluntary Assisted Dying in Victoria, Australia, the presence of anti-VAD health professionals in the medical community and reported high rates of conscientious objection to VAD suggested access may be limited. Most empirical research on CO has been conducted in the sexual and reproductive health context. However, given the fundamental differences in the nature of such procedures and the legislation governing it, these findings may not be directly transferable to VAD. Accordingly, we sought to (...) understand how CO operates in the context of VAD. Prior to the implementation of the VAD legislation in June 2019, we conducted semi-structured interviews with seventeen health professionals with a self-declared CO to VAD, to explore what motivated their CO. Participants identified multiple motivations, which can be broadly categorized as: concerns for oneself; concerns for patients; concerns about the current Victorian legislation; and concerns for the medical profession. Participants’ moral commitments included personal, professional, and political commitments. In some cases, one’s CO was specific to Victoria’s current legislation rather than VAD more broadly. Our findings suggest CO motivations extend beyond those traditionally cited and suggest a need to better understand and manage CO in the healthcare context. (shrink)

Shows how contemporary artists re-envision the earth in innovative painterly, sculptural, and architectural ways.

Edward S. Casey provides a thorough description of the varieties of human memory, including recognizing and reminding, reminiscing and commemorating, body memory and place memory. The preface to the new edition extends the scope of the original text to include issues of collective memory, forgetting, and traumatic memory, and aligns this book with Casey's newest work on place and space. This ambitious study demonstrates that nothing in our lives is unaffected by remembering.

I am going to begin, as all philosophers do, by going back to the ancient Greeks, and then taking a quick tour of the present day, before returning to the ancient Greeks again. Let us begin with the so-called quarrel between philosophy and poetry–what was the reason for this? Well, philosophy was invented at a particular point in time, and in relation to poetry, it was a newcomer. When philosophy was invented it found another intellectual enterprise already in possession of (...) the field, and that enterprise was poetry, primarily Homer and Hesiod. Plato, in trying to make intellectual space for philosophy, made so much space that he risked pushing poetry out of the field altogether as an intellectual enterprise. Plato assumes that poetry and philosophy are competitors in the same business; he can then be seen as attempting to make a hostile take-over bid. (shrink)

In this article the author argues against the dominant trend in Kierkegaardian scholarship by claiming that the primary reason for the break-up of Soren Kierkegaard's engagement to Regine Olsen was his conviction that God was calling him to celibacy. He explores the nature of this call, the struggles associated with it, and asks what exemplary value it possesses.

We can try to imagine a people who in circumstances of hardship and danger—in hunting and warfare, for instance—show endurance, persistence, indifference to pain, and an unflinching readiness to accept death. Yet it may be that these qualities do not have any important place in their picture of themselves. Their courage is simply something they take for granted and it does not go with any practice of praise and blame. They are not proud of themselves when they act bravely, nor (...) ashamed of themselves if they fail to do so. This would be a courage that would be independent of the social practices of praise and blame, admiration and contempt, pride and shame. It would be a courage that did not fit into a scheme of values. This raises the question whether it could properly be regarded as an ethical quality, as a virtue. (shrink)

Synesthesia is a neurological phenomenon in which a single stimulus typically associated with one sensory modality automatically and involuntarily produces sensations not typically associated with that modality. I argue that synesthesia elucidates how two naturalistic theories of representation and phenomenal experience conflict. Strong representationalism holds that what an experience is like is determined by the experience’s representational content. Informational semantics holds that representational content is determined by causal co-variation between a representation and an external object or property. I argue that (...) according to informational semantics, synesthetes and normal perceivers represent the same content in different ways. However, according to strong representationalism, two experiences with the same content must be represented in the same way. Therefore, if strong representationalists want to account for synesthesia, they cannot hold onto informational semantics as a theory of mental content. (shrink)

Abstract:Qu Yuan (c. 340–278 BC) is often called “the first Chinese poet,” because the primary work attributed to him, Li sao (“Sublimating Sorrow”), is the first in the tradition to evoke a distinctive persona engaged in self-reflection and personal narrative. To explain why this story of frustrated political ambition became arguably the first instance of Chinese autobiography or life writing, this paper uses the notion of “biological handicap,” proposed by Amotz Zahavi. As a peacock’s cumbersome tail feathers reduce its individual (...) chances of survival but communicate valuable information to potential mates, the Li Sao’s poetic persona uses images its audience understood as external marks of invisible, spiritual potency, like long eyebrows and fragrant adornments, to evoke unfulfilled political potential, resulting in an early model of literary interiority. (shrink)

Yet such a contrast fails to provide an adequate account of the full scope of either philosophy or psychoanalysis. On the one hand, philosophical inquiry is not wholly pre-empted by the question of reality; it may also extend into the realm of phantasy, as can be seen in Plato's effort to determine the epistemological value of eikasia or in Husserl's consideration of Phantasie as a basis of insight into essences. On the other hand, psychoanalysts are as concerned about reality as (...) they are about phantasy. Indeed, one of the key phrases of psychoanalytic therapy is "adaptation to reality." The reason for this concern with reality is clear: if phantasies are modifications or distortions of the real, it is imperative to discern what the character of reality is, especially since it is held out as the standard of a sound state of mental health. (shrink)

Dewey's "Art as Experience" defends the view that art and life are a y. But his version of this view exhibits an ambiguity, arising from his ency to move back and forth in the text between two usages of "art". These usages allow for two different interpretations of the theme of the unity and life: an "aesthetic" interpretation emphasizing the uniqueness of the arts as instrumentally valuable sources of aesthetic and ummatoryexperience, and an "aestheticist" interpretation emphasizing the ence of such (...) experience not only in the fine arts but throughout the trum of intelligent practice. Are these interpretations necessarily in ion, or can we read them as part of a single consistent argument about the re of art in Dewey's text? I arguethat we can, but to do so we need to dialectically, and with a glance toward a figure whose influence on Dewey nderappreciated in the recent literature: Hegel. (shrink)