What do we mean when we call something or someone evil? The word "evil" tends to conjure up images of demons, devils, and horrifying crimes, things that you and I couldn't possibly get involved with! But is that true? Is evil really something that only wicked people who are "quite unlike ourselves" get up to? Could it be that you and I are not only capable of doing evil things, but are already involved with such things? This book explores the (...) hidden nature of evil and draws out the ways in which all of us, knowingly or otherwise, are caught up in webs of evil that bring about disastrous consequences, often to the weakest and most vulnerable amongst us. We need to find ways of learning to see evil and resisting it by all means possible. If we can't see evil, we can't resist it. If we can't resist it, we get sucked into it. (shrink)

Following an initial study of the needs of healthcare providers (HCP) regarding the introduction of Medical Assistance in Dying (MAiD), and the subsequent development of an assisted dying program, this study sought to determine the efficacy and impact of MAiD services following the first two years of implementation. The first of three aims of this research was to understand if the needs, concerns and hopes of stakeholders related to patient requests for MAiD were addressed appropriately. Assessing how HCPs and families (...) perceived the quality of MAiD services, and determining if the program successfully accommodated the diverse needs and perspectives of HCPs, rounded out this quality evaluation. This research implemented a mixed-methods design incorporative of an online survey with Likert scale and open-ended questions, as well as focus groups and interviews with staff and physicians, and interviews with MAiD-involved family members. There were 356 online surveys, as well as 39 participants in six focus groups with HCP, as well as fourteen interviews with MAiD-involved family members. Participants indicated that high-quality MAiD care could only be provided with enabling resources such as policies and guidelines to ensure safe, evidence-based, standardized care, as well as a specialized, trained MAiD team. Both focus group and survey data from HCPs suggest the infrastructure developed by the hospital was effective in delivering high-quality MAiD care that supports the diverse needs of various stakeholders. This study may serve as a model for evaluating the impact and quality of services when novel and ethically-contentious clinical practices are introduced to healthcare organizations. (shrink)

Background Biobank participants often do not understand much of the information they are provided as part of the informed consent process, despite numerous attempts at simplifying consent forms and improving their readability. We report the first assessment of biobank enrollees’ comprehension under an "integrated consent” process, where patients were asked to enroll in a research biobank as part of their normal healthcare experience. A number of healthcare systems have implemented similar integrated consent processes for biobanking, but it is unknown how (...) much patients understand after enrolling under these conditions. Methods: We recruited patients who enrolled in a biobank while in a healthcare setting when receiving ordinary care. We assessed knowledge of consent materials using 11 true/false questions drawn from a well-known biobank knowledge test. After reviewing the results from 114 participants, we revised the consent form and repeated the knowledge assessment with 144 different participants. Results: Participants scored poorly on the knowledge test in both rounds, with no significant differences in overall scores or individual items between the rounds. In Phase 1, participants answered 53% of the questions correctly, 25% incorrectly, and 22% “I don’t know.” In Phase 2, participants answered 53% of questions correctly, 24% incorrectly, and 23% “I don’t know.” Participants scored particularly poorly on questions about data sharing and accessing medical records. Conclusions: Enrollees under an integrated consent model had significant misunderstandings that persisted despite an attempt to improve information specifically about those topics in a consent form. These results raise challenges for current approaches that attribute misunderstanding to overly complex consent forms. They also suggest that the pressures of the clinic may compound other problems with patient understanding of biobank consent. As health systems increasingly blend research and care, they may need to rethink their approach to educating patients about participation in a biobank. (shrink)

Laland and colleagues have sought to challenge the proximate–ultimate distinction claiming that it imposes a unidirectional model of causation, is limited in its capacity to account for complex biological phenomena, and hinders progress in biology. In this article the core of their argument is critically analyzed. It is claimed that contrary to their claims Laland et al. rely upon the proximate–ultimate distinction to make their points and that their alternative conception of reciprocal causation refers to phenomena that were already accounted (...) for by standard theory. (shrink)

Realists about universals face a question about grounding. Are things how they are because they instantiate the universals they do? Or do they instantiate those universals because they are how they are? Take Ebenezer Scrooge. You can say that Scrooge is greedy because he instantiates greediness, or you can say that Scrooge instantiates greediness because he is greedy. I argue that there is reason to prefer the latter to the former. I develop two arguments for the view. I also respond (...) to some concerns one might have about the view defended. I close by showing that analogous views regarding the truth of propositions and the existence of facts are supported by analogs of one of these arguments. (shrink)

Recent work on extended mind theory has considered whether the material realizers of phenomenally conscious states might be distributed across both body and world. A popular framework for understanding perceptual consciousness in world-involving terms is sensorimotor enactivism, which holds that subjects make direct sensory contact with objects by means of their active, exploratory skills. In this paper, I consider the case of emotional experience, and argue that although the enactivist view does not transfer neatly to this domain, there are elements (...) of emotional consciousness whose physical underpinnings include parts of the extra-bodily environment. (shrink)

‘Scientific dishonesty’ implies the fabrication, falsification or plagiarism in proposing, performing or reviewing research or in reporting research results. A questionnaire was given to postgraduate students at the medical faculties in Sweden who attended a course in research ethics during the academic year 2008/2009 and 58% answered (range 29%–100%). Less than one-third of the respondents wrote that they had heard about scientific dishonesty in the previous 12 months. Pressure, concerning in what order the author should be mentioned, was reported by (...) about 1 in 10 students. We suggest that all departments conducting research should have a written policy about acceptable research behaviour and that all doctoral students should be informed of the content of this policy. Participants in the research groups concerned should also be required to analyse published articles about scientific dishonesty and critically discuss what could be done about unethical conduct. (shrink)

Gametes, tissue, and organs can be taken from the dying or dead for reproduction, transplantation, and research. Whole bodies as well as parts can be used for teaching anatomy. While these uses are diverse, they have an ethical consideration in common: the claims of the people whose bodies are used. Is some use permissible only when people have consented to the use, actually wanted the use, would have wanted the use, not opposed the use, or what? The aim of this (...) article is to make progress in answering these questions. Initially I assume knowledge of people’s desires in order to test whether consent is directly required by their rights without worrying about mistaken uses against their wishes. I claim consent is not directly required by people’s rights. If we know people wanted or would want a use, their rights permit the use, but if we know they wanted or would want not to be used, their rights do not permit the use. The knowledge assumption is then dropped and the question becomes how to decide what to do when the wishes of rightholders are not known. I suggest working out what to do when wishes are known and then adjusting, on the basis of whatever evidence there is, for probability and strength of desire. There are other considerations too, for instance about default rules. The key general comment here is that, in setting rules, the costs to rightholders in not getting what they want needs to be taken into account. The final section tries to show that, in setting these rules, mistaken uses are not to be taken as worse than mistaken failure to use. (shrink)

A medical centre is an institution established for a specific purpose: to facilitate the health and health-related welfare of the medical centre's patients. Within this institution, there are a variety of professionals who act and interact to serve this purpose. Of particular interest is the interaction between physician and nurse. Generally, the nurse is thought to be under a certain obligation to implement a physician's orders unless there is good reason not to do so. This qualifier places a conflicting obligation (...) upon the nurse not to implement some physician orders. How should a judgement about which orders there is 'good reason' not to implement be made? I propose to approach this question through an analysis of the obligation the nurse has to implement the order of a physician, and the conditions under which the order does not pose such obligations. This analysis will consist of an examination of the obligation in terms of the purposive authority of the physician. For example, in the context of the medical centre, the physician's medical training qualifies her as best able to make determinations of what treatment would promote the patient's health. However, this purpose not only serves as the basis of the physician's authority, but also serves as a limitation upon the physician's authority (for example, an order which would harm the patient would not reflect the purpose for which the physician has been given authority). Thus, a philosophical investigation into the nature of the obligation to implement a physician's orders can help to clarify those occasions when a nurse should not implement an order. (shrink)

This paper disputes the widely held view that one cannot establish the reliability of a belief-forming process with the use of belief's that are obtained by that very process since such self-dependent justification is circular. Harold Brown ([1993]) argued in this journal that some cases of self-dependent justification are legitimate despite their circularity. I argue instead that under appropriate construal many cases of self-dependent justification are not truly circular but are instances of ordinary Bayesian confirmation, and hence they can raise (...) the probability of the hypothesis as legitimately as any such confirmation does. I shall argue in particular that despite its dependence on perception we can use naturalized epistemology to confirm the reliability of a perceptual process without circularity. (shrink)

This paper introduces a logical analysis of convex combinations within the framework of Łukasiewicz real-valued logic. This provides a natural link between the fields of many-valued logics and decision theory under uncertainty, where the notion of convexity plays a central role. We set out to explore such a link by defining convex operators on MV-algebras, which are the equivalent algebraic semantics of Łukasiewicz logic. This gives us a formal language to reason about the expected value of bounded random variables. As (...) an illustration of the applicability of our framework we present a logical version of the Anscombe–Aumann representation result. (shrink)

In this paper I want to suggest that, while the argued philosophical distinction between logic, epistemolgoy and ontology is one of the many achievements of Aristotle, his predecessor Parmenides was in fact already operating with a theory of knowledge and an elementary propositional logic that are of abiding philosophical interest. As part of the thesis I shall be obliged to reject a number of interpretations of particular passages in his poem, including one or two currently fashionable ones. Since so much (...) turns on points of translation, I note for purposes of comparison what seem to be significant alternatives to my own in any particular instance. The line numbers are those of the DK text. (shrink)

« Mais pourquoi diable les humains, sur leur petite planète bleue, s’intéressent-ils à ce point à moi, qui ne suis qu’un extraterrestre? » : telle est la question que pose un E. T. parmi tant d’autres, depuis l’espace intersidéral, à une autrice de science-fiction qui a transformé ce genre littéraire qu’est le space opéra et à un astrophysicien qui est aussi le président du plus grand festival de sciences et de science-fiction en France : les Utopiales à Nantes.

An important contribution to the foundations of probability theory, statistics and statistical physics has been made by E. T. Jaynes. The recent publication of his collected works provides an appropriate opportunity to attempt an assessment of this contribution.

I argue here that in the end Bourdieu's theory of practice fails to overcome the problem on which it expressly centers, namely, subject-object dualism. The failure is registered in his avowed materialism, which, though significantly "generalized," remains what it says: a materialism. In order to substantiate my criticism, I examine for their ontological presuppositions three areas of his theoretical framework pertaining to the questions of (1) human agency (as seen through the conceptual glass of the habitus), (2) otherness, and (3) (...) the gift. By scrutinizing Bourdieu's powerful and progressive social theory, with an eye to finding fault, I hope to show the need to take a certain theoretical action, one that is patently out of keeping with the usual self-presentation and self-understanding of social science. The action I have in mind is this: because the problem of subject-object dualism is in the first place a matter of ontology, in order successfully to address it there must take place a direct shift of ontological starting point, from the received starting point in Western thought to one that projects reality in terms of ambiguity that is basic. With this shift the dualism of subject and object dissolves by definition, leaving a social reality that, for reasons of its basic ambiguity, is best approached as a question of ethics before power. (shrink)

In his investigation of the concept of "Being", Aristotle relates the question of "existence" to the question "essence" and considers essence as "whatness" and quiddity. Although in his logical discussions he treats the concepts of "existence" and "whatness" separately and makes a distinction between them, but does not extend this distinction to the area of philosophical topics. But in the prepatetic Islamic system of Philosophy, explanation and distinction between "Being" and "quidity" is without doubt one of the most fundamental philosophical (...) doctrines and beliefs. In the history of Islamic philosophy, the theory of metaphysical distinction between being and essence has been attributed to Ibn Sina, but it is Farabi who for the first time has propounded clearly and decisively a two – part division between "being" and "quiddity" and has prepared the way for Avecinian philosophy. In addition to his logical distinction between "existence" and "whatness" of things he has stressed on a metaphysical distinction between them and has made this distinction the foundation of his metaphysical system. From Farabi's view, being is an inherent accident of quiddity. In this article we try to explain the concepts of "existence" and "whatness" of things and their relation as one of the most fundamental topics in prepatetic philosophy in the philosophical thought of these two great prepatetic philosophers, ie Aristotle and Farabi, with specific stress on comparing their views. (shrink)

Byzantine Empire; economic and social conditions; history.

Externalism holds that the content of our utterances and thoughts are determined partly by the environment. Here, I offer an argument which suggests that externalism is incompatible with a natural view about ontological commitment--namely, the Quinean view that such commitments are fixed by the range of the variables in your theory. The idea in brief is that if Oscar mistakenly believes that water = XYZ, the externalist ontologically commits Oscar to two waterish kinds, whereas the Quinean commits him to one (...) such kind (albeit a metaphysically impossible kind). The penultimate section addresses a variety of objections to the argument. (shrink)

al-juzʼ 1. Kitāb al-maqūlāt wa-kitāb al-ʻibārah.

Codes of medical ethics issued by professional organizations typically contain statements affirming the importance of confidentiality between patients and health-care practitioners. Seldom, however, is the confidentiality obligation depicted as absolute. Instead, exceptions are noted, the most common of which is that health-care professionals are justified in breaching the confidence of a patient if required by law to do so. Reasons that might be given to support this exception are critically discussed in this paper. The conclusion argued for is that this (...) is not a legitimate exception to the confidentiality rule. (shrink)