Ethics training is an important integrative theme in the American Psychological Association guidelines for the psychology undergraduate major. Similarly, preparation for ethical research and clinical practice are central to training health service psychologists. With the move toward competence-based education, skill-based assessment and training are needed to extend the usual didactic instruction in ethics. In this study, we examined the use of deliberate practice as a form of competence-based education in comparison to control groups for the training of (...) 63 novice undergraduates to handle basic ethical situations in therapy. We found that students’ ability to respond to simulated therapy clients improved in the deliberate practice group, but not in the case discussion or motivational interviewing control groups. Findings suggest that basic and focused applied ethics’ skill training can be effectively used early in a student’s training. (shrink)

The question of what explains individual differences in expertise within complex domains such as music, games, sports, science, and medicine is currently a major topic of interest in a diverse range of fields, including psychology, education, and sports science, to name just a few. Ericsson and colleagues’ deliberate practice view is highly influential perspective in the literature on expertise and expert performance—but is it viable as a testable scientific theory? Here, reviewing more than 25 years of Ericsson and (...) colleagues’ writings, we document critical inconsistencies in the definition of deliberate practice, along with apparent shifts in the standard for evidence concerning deliberate practice. We also consider the impact of these issues on progress in the field of expertise, focusing on the empirical testability and falsifiability of the deliberate practice view. We then discuss a multifactorial perspective on expertise, and how open science practices can accelerate progress in research guided by this perspective. (shrink)

Howe et al. proposed that the “talent account” is not suited to explain exceptional performance in specific domains. Their conclusion that early experiences and deliberate practice are highly important for high levels of skill is supported by numerous studies on the acquisition of expertise. However, the two popular views they contrast (experts are born versus experts are made) do not seem representative of current theorizing. Models that integrate the effects of basic abilities and deliberate practice are (...) more appropriate in light of the available evidence. (shrink)

Moral deliberation has been receiving more attention in nursing ethics. Several ethical conversation models have been developed. This article explores the feasibility of the so-called CARE (Considerations, Actions, Reasons, Experiences) model as a framework for moral deliberation in psychiatric nursing practice. This model was used in combination with narrative and dialogical approaches to foster discourse between various stakeholders about coercion in a closed admission clinic in a mental hospital in the Netherlands. The findings demonstrate that the CARE model provides (...) a substantial framework for structuring moral deliberations. Narratives and dialogue are useful tools for broadening issues in conversations, to engage various stakeholders (including patients), and to gain shared understandings. (shrink)

It is common for philosophers to suggest that practical deliberation is normative; deliberation about what to do essentially involves employing normative concepts. This thesis – ‘the Normativity Thesis’ – is significant because, among other things, it supports the conclusion that normative thought is inescapable for us. In this paper, I defend the Normativity Thesis against objections.

David Wiggins; II*—Deliberation and Practical Reason, Proceedings of the Aristotelian Society, Volume 76, Issue 1, 1 June 1976, Pages 29–52, https://doi.org/10.

It is widely assumed that severe mental disabilities prevent relevant deliberative capacities from developing or persisting. Accordingly, excluding many people with mental disabilities from discourse practices seems justified. Against this common assumption I wish to show that the general exclusion is not justified and amounts to a form of epistemic injustice, as theorised by Miranda Fricker. The received norm of capable deliberators is connected to a specific model of deliberation. I introduce an alternative model of deliberation, which I dub the (...) joint effort model. According to this model, people with minority minds (as I call them) add valuable cognitive diversity to the process of deliberation, which is a relevant element of epistemic improvement. In this part of the argument I rely on empirically informed theoretical work by Hélène Landemore. I scrutinise the minimal requirements of capable deliberators from the perspective of a joint effort model of deliberation, and I highlight specific beneficial contributions people with minority minds can make to discourse practices. I will argue that people with minority minds can be presumptively deemed capable deliberators and that therefore their general exclusion is unjustified. (shrink)

To make genuine progress toward explicating the relation between innate talent and high levels of ability, we need to consider the differences in structure between most everyday abilities and expert performance. Only in expert performance is it possible to show consistently that individuals can acquire skills to circumvent and modify basic characteristics (talent).

It is a popular view thatpractical deliberation excludes foreknowledge of one's choice. Wolfgang Spohn and Isaac Levi have argued that not even a purely probabilistic self-predictionis available to thedeliberator, if one takes subjective probabilities to be conceptually linked to betting rates. It makes no sense to have a betting rate for an option, for one's willingness to bet on the option depends on the net gain from the bet, in combination with the option's antecedent utility, rather than on the offered (...) odds. And even apart from this consideration, assigning probabilities to the options among which one is choosing is futile since such probabilities could be of no possible use in choice. The paper subjects these arguments to critical examination and suggests that, appearances notwithstanding, practical deliberation need not crowd outself-prediction. (shrink)

Can new technology enhance purpose-driven, democratic dialogue in groups, governments, and societies? Online Deliberation: Design, Research, and Practice is the first book that attempts to sample the full range of work on online deliberation, forging new connections between academic research, technology designers, and practitioners. Since some of the most exciting innovations have occurred outside of traditional institutions, and those involved have often worked in relative isolation from each other, work in this growing field has often failed to reflect the (...) full set of perspectives on online deliberation. This volume is aimed at those working at the crossroads of information/communication technology and social science, and documents early findings in, and perspectives on, this new field by many of its pioneers. -/- CONTENTS: -/- Introduction: The Blossoming Field of Online Deliberation (Todd Davies, pp. 1-19) -/- Part I - Prospects for Online Civic Engagement -/- Chapter 1: Virtual Public Consultation: Prospects for Internet Deliberative Democracy (James S. Fishkin, pp. 23-35) -/- Chapter 2: Citizens Deliberating Online: Theory and Some Evidence (Vincent Price, pp. 37-58) -/- Chapter 3: Can Online Deliberation Improve Politics? Scientific Foundations for Success (Arthur Lupia, pp. 59-69) -/- Chapter 4: Deliberative Democracy, Online Discussion, and Project PICOLA (Public Informed Citizen Online Assembly) (Robert Cavalier with Miso Kim and Zachary Sam Zaiss, pp. 71-79) -/- Part II - Online Dialogue in the Wild -/- Chapter 5: Friends, Foes, and Fringe: Norms and Structure in Political Discussion Networks (John Kelly, Danyel Fisher, and Marc Smith, pp. 83-93) -/- Chapter 6: Searching the Net for Differences of Opinion (Warren Sack, John Kelly, and Michael Dale, pp. 95-104) -/- Chapter 7: Happy Accidents: Deliberation and Online Exposure to Opposing Views (Azi Lev-On and Bernard Manin, pp. 105-122) -/- Chapter 8: Rethinking Local Conversations on the Web (Sameer Ahuja, Manuel Pérez-Quiñones, and Andrea Kavanaugh, pp. 123-129) -/- Part III - Online Public Consultation -/- Chapter 9: Deliberation in E-Rulemaking? The Problem of Mass Participation (David Schlosberg, Steve Zavestoski, and Stuart Shulman, pp. 133-148) -/- Chapter 10: Turning GOLD into EPG: Lessons from Low-Tech Democratic Experimentalism for Electronic Rulemaking and Other Ventures in Cyberdemocracy (Peter M. Shane, pp. 149-162) -/- Chapter 11: Baudrillard and the Virtual Cow: Simulation Games and Citizen Participation (Hélène Michel and Dominique Kreziak, pp. 163-166) -/- Chapter 12: Using Web-Based Group Support Systems to Enhance Procedural Fairness in Administrative Decision Making in South Africa (Hossana Twinomurinzi and Jackie Phahlamohlaka, pp. 167-169) -/- Chapter 13: Citizen Participation Is Critical: An Example from Sweden (Tomas Ohlin, pp. 171-173) -/- Part IV - Online Deliberation in Organizations -/- Chapter 14: Online Deliberation in the Government of Canada: Organizing the Back Office (Elisabeth Richard, pp. 177-191) -/- Chapter 15: Political Action and Organization Building: An Internet-Based Engagement Model (Mark Cooper, pp. 193-202) -/- Chapter 16: Wiki Collaboration Within Political Parties: Benefits and Challenges (Kate Raynes-Goldie and David Fono, pp. 203-205) -/- Chapter 17: Debian’s Democracy (Gunnar Ristroph, pp. 207-211) -/- Chapter 18: Software Support for Face-to-Face Parliamentary Procedure (Dana Dahlstrom and Bayle Shanks, pp. 213-220) -/- Part V - Online Facilitation -/- Chapter 19: Deliberation on the Net: Lessons from a Field Experiment (June Woong Rhee and Eun-mee Kim, pp. 223-232) -/- Chapter 20: The Role of the Moderator: Problems and Possibilities for Government-Run Online Discussion Forums (Scott Wright, pp. 233-242) -/- Chapter 21: Silencing the Clatter: Removing Anonymity from a Corporate Online Community (Gilly Leshed, pp. 243-251) -/- Chapter 22: Facilitation and Inclusive Deliberation (Matthias Trénel, pp. 253-257) -/- Chapter 23: Rethinking the ‘Informed’ Participant: Precautions and Recommendations for the Design of Online Deliberation (Kevin S. Ramsey and Matthew W. Wilson, pp. 259-267) -/- Chapter 24: PerlNomic: Rule Making and Enforcement in Digital Shared Spaces (Mark E. Phair and Adam Bliss, pp. 269-271) -/- Part VI - Design of Deliberation Tools -/- Chapter 25: An Online Environment for Democratic Deliberation: Motivations, Principles, and Design (Todd Davies, Brendan O’Connor, Alex Cochran, Jonathan J. Effrat, Andrew Parker, Benjamin Newman, and Aaron Tam, pp. 275-292) -/- Chapter 26: Online Civic Deliberation with E-Liberate (Douglas Schuler, pp. 293-302) -/- Chapter 27: Parliament: A Module for Parliamentary Procedure Software (Bayle Shanks and Dana Dahlstrom, pp. 303-307) -/- Chapter 28: Decision Structure: A New Approach to Three Problems in Deliberation (Raymond J. Pingree, pp. 309-316) -/- Chapter 29: Design Requirements of Argument Mapping Software for Teaching Deliberation (Matthew W. Easterday, Jordan S. Kanarek, and Maralee Harrell, pp. 317-323) -/- Chapter 30: Email-Embedded Voting with eVote/Clerk (Marilyn Davis, pp. 325-327) -/- Epilogue: Understanding Diversity in the Field of Online Deliberation (Seeta Peña Gangadharan, pp. 329-358). -/- For individual chapter downloads, go to odbook.stanford.edu. (shrink)

Joint practical deliberation is the activity of deciding together what to do. In this dissertation, I argue that several speech acts that we can use to alter our moral obligations – promises, offers, requests, demands, commands, and agreements – are moves within joint practical deliberation. -/- The dissertation begins by investigating joint practical deliberation. The resulting account implies that joint deliberation is more flexible than we usually recognize, in two ways. First, we can make joint decisions not only about what (...) we will do together, but also about what you or I will do alone. Second, we can deliberate by means of two distinct methods: propose-and-ratify, in which a proposed joint decision must be explicitly accepted to come into effect, and propose-and-challenge, in which a proposed joint decision comes into force unless it is explicitly challenged. -/- Varying these parameters generates a botany of different kinds of proposals we can make within joint deliberation. When we look at these proposals more closely, we make a surprising discovery: for each kind of proposal we can make in joint practical deliberation, there is an everyday speech act with the very same properties. A certain kind of proposal to make a joint decision regarding one’s own actions has the same normative effects, under the same conditions, as a promise. One kind of proposal to make a joint decision regarding one’s addressee’s actions has all the essential features of a command; another kind of deliberative proposal – with the same content but a different method of evaluation – looks exactly like a request. And so on. -/- These similarities are too systematic to be coincidental. The only explanation, I argue, is that these ordinary speech acts are identical to their doppelgängers within joint practical deliberation. Promises and offers are proposals to make joint decisions about what I will do. Commands, demands, and requests are proposals to make joint decisions about what you will do. And agreements are joint decisions about what we will do. Call this the deliberative theory of these speech acts. -/- Considering each speech act in turn, I defend the deliberative theory by arguing that it provides a uniquely powerful explanation of its targets’ social and moral significance. Once we see how naturally these speech acts fall out of our practice of joint deliberation, theories that treat them as sui generis – as many moral philosophers now do – will come to seem redundant and nonexplanatory. Conversely, thinking of promises, offers, commands, demands, requests, and agreements as moves within joint practical deliberation allows us to give an elegant and generative theory of these phenomena that have confounded moral philosophers for so long. (shrink)

Bobier argued that hope is necessary for practical deliberation. I will demonstrate that Bobier’s argument for this thesis fails. The problem is that one of its main premisses rests on a sufficient condition for hoping that is subject to counterexamples. I consider two ways to save the argument, but show that they are unsuccessful in doing so.

Although both codes of practice and virtue ethics are integral to the ethos and history of “medical professionalism”, the two trends appear mutually incompatible. Hence, in the first part of the paper we explore and explicate this apparent conflict and seek a direction for medical education. The theoretical and empirical literature indicates that moral deliberation may transcend the incompatibilities between the formal and the virtuous, may enhance moral and other aspects of personal sensitivity, may help design and improve other (...) parts of the curricula, and may foster self-awareness and clarification of the professional role. Not only are these goals essential for good and conscientious doctoring, but they may also reduce physicians’ “burn-out”. We argue that medical education should focus on the ubiquitous practice of deliberation in contemporary medicine, and especially the practice of moral deliberation. (shrink)

The “participatory turn” cutting across technical approaches for appraising environment, risk, science, and technology has been accompanied by intense debates over the desired nature, extent, and quality of public engagement in science. Burgeoning work evaluating the effectiveness of such processes and the social study of science in society more generally is notable, however, for lacking systematic understanding of the very actors shaping these new forms science-society interaction. This paper addresses this lacuna by drawing on United Kingdom based in-depth empirical research (...) that made space for participatory appraisal experts to reflect on effective practice and novel questions of competence, expertise, and citizen-specialist relations within analytic-deliberative processes. Emerging practitioner principles warn that existing participatory models have not sufficiently considered constructivist perspectives on knowledge, analysis, and deliberation. Effective participatory appraisal under uncertainty needs to guard against the “technocracy of participation” by opening up to diversity, difference, antagonism, and uncertainties/indeterminacies. (shrink)

J.G. Fichte’s 1798 System of Ethics is seldom read, despite the fact that it remains, after more than two centuries, one of the most original and insightful efforts at a systematic normative ethical theory on Kantian foundations. Part of the reason for its obscurity lies in the perceived implausibility of Fichte’s account of practical deliberation and of the authority of individual conscience. The view typically attributed to Fichte is a conjunction of four claims: that moral deliberation consists entirely in consultation (...) of one’s conscience; that conscience is a faculty that gives immediate epistemic access to substantive moral truths; that conformity with the verdict of conscience is the sole criterion of the moral worth of actions; and that an individual’s conscientious decision is therefore morally incorrigible. This set of views is indeed implausible; but Fichte in fact held none of them. Hegel was the first to attribute them to him and, incredibly, Hegel’s has remained for 200 years the dominant interpretation, even among scholars of Fichte. In this paper I explain how Fichte actually thought about practical deliberation and the role of conscience, and diagnose the sources of appeal of the Hegelian interpretation. (shrink)

In the present paper, I want to contribute to a correct understanding of Aristotle's action theory by explaining just how two of the key concepts which it involves are connected and by showing that, contrary to what a number of commentators have said, there are causal concepts. The concepts in question are those of deliberation and the so-called "practical syllogism.".

Many important thinkers in the philosophical tradition, like Aristotle or Hume, have used an explicit theory of action as the basis of their respective normative theories of practical rationality and morality. The idea behind this architecture of theories is that action theory can inform us about the origin, bonds, reach and limits of practical reason. The aim of this book is to revive this direct connection between action theory and practical philosophy, in particular to provide systematic action-theoretical underpinnings for the (...) discussion about the normative structure of practical reason. This book brings together a collection of specially commissioned essays from internationally prestigious scholars in the field and represents the state of the art in contemporary philosophy of action. The book is divided into three parts: i. conceptual work about what actions, intentions and intentional actions are; ii. empirical theory of practical deliberation; and iii.theories about the action theoretic features of autonomy. The volume significantly advances these three lines of research and offers important new contributions to each of them. (shrink)

Harry G. Frankfurt has put the problem of volitional conflict at the center of philosophical attention. If you care fundamentally about your career and your family, but these cares conflict, this conflict undermines the coherency of your decision standard and thereby your ability to choose and act autonomously. The standard response to this problem is to argue that you can overcome volitional conflict by unifying your foundational motivational states. As Frankfurt puts it, the ‘totality of things that an agent cares (...) about’ plus his ‘ordering of how important to him they are effectively specifies his answer to the question of how to live’ (The Reasons of Love(Princeton: Princeton University Press, 2004), p. 23). In this paper, I critically assess the three main reasons given for such a coherency requirement: 1) we can do only one action at a time; 2) our motivational states come with normative pressure towards coherency; and 3) conflicting motivational states provide us with an incoherent decision-making framework. I conclude that these reasons do not ground a coherency requirement for practical deliberation and argue that we can autonomously express ourselves as volitionally conflicted by acting on our conflicting motivational states over the course of multiple actions. (shrink)

On a Humean account, a person's reasons for action are determined by her desires---in the broadest sense of 'desires', that is, noncognitive pro-attitudes. In four essays, I defend this account against several prominent objections. The first essay addresses the concern that the Humean cannot account for rationalizing reasons . The next three essays concern justifying reasons : reasons for action that are more fully normative than those that merely make action intelligible. Instrumental reasons, prudential reasons, and intrinsic reasons are three (...) different sorts of reasons to which an agent can appeal in justifying her action. ;Each essay focuses on a specific attack against the Humean account. In the second essay I argue that the normatively of instrumental reasons is brute ; and that, contrary to the received view, this is compatible with Humeanism. In the third essay I consider prudential reasons and defend the Humean claim that all and only present concerns provide normative reasons for action. In the final essay I address the fundamental question considerations of deliberative relevance: what makes certain desires and considerations relevant to a specific decision-making context, that is, what puts them among a person's present active reasons. ;In addition to defending a broadly Humean account of practical reasons, I am concerned to expand the components of a plausible form of Humeanism. Specifically, I argue that desires alone are not always sufficient to ground an agent's reasons, and that affective states are sometimes also necessary. I call this view "thick Humeanism". In essays one and four especially, I urge that a central place be given to affective states in determining practical reasons. I also invoke recent studies in cognitive psychology to support my claims about the role of the emotions in practical deliberation. (shrink)

Accounts of practical deliberation tend to overlook any possible role for hope. I offer an argument showing that hope sets the ends of our practical deliberations and is thereby necessary for practical deliberation. It is because I hope to summit the mountain by midday that I deliberate about how to do so. Absent this particular hope, I could not deliberate about how to summit the mountain by midday.

Readers of Hobbes usually take his account of practical deliberation to be a passive process that does not respond to agents’ judgements about what normative reasons they have. This is ostensibly because deliberation is purely conative and/or excludes reasoning, or because Hobbesian reasoning is itself a process in which reasoners merely experience a succession of mental states (e.g. according to purely associative mental structures). I argue to the contrary that for Hobbes deliberation (and hence the basis for voluntary action) is (...) not purely conative and amongst humans it involves reasoning. Furthermore, while non-linguistic reasoning is passive, specifically linguistic reasoning is for Hobbes an active process in which reasoners affirm propositions from which they reason. The historical significance of Hobbes’s new account of agency lies in his attempt, in deploying the tool of language, to weld a materialist determinism to a cognitive account of practical deliberation that can involve reasoning and be reason-responsive. (shrink)

We have it on the authority of Aristotle that “reason (nous) is the best thing in us” (EN X.7, 1177a20). This idealization of reason permeates his account of eudaimonia, a term commonly translated as ‘happiness’, which Aristotle identifies with living and doing well (EN I.4, 1095a18-20). In harmony with a certain intellectualism peculiar to the mainstream of ancient philosophical accounts of eudaimonia, Aristotle holds that living well requires the unique practical application of rationality of which only humans are capable (EN (...) I.7, 1098a13-15/EE I.7, 1217a25-27). This dissertation investigates Aristotle’s substantive view on the practical application of reason by examining how, according to him, human agents use reason to decide what to do, what kind of person to be, and indeed how to live well. A distinctively human way of making decisions is deliberation (bouleusis), an exercise of practical reason par excellence. The first chapter reconstructs Aristotle’s account of deliberation from a wide range of texts in the corpus. It argues that deliberation is a complex decision-making process that, for the most part, unfolds into four stages: (1) positing a provisional goal; (2) constructing a set of alternatives; (3) identifying the best alternative; (4) forming an intention to do the most proximate action as identified in the penultimate stage. This reading offers a comprehensive representation of Aristotle’s theory while rendering his theory more sophisticated—and indeed more modern—than the alternatives in recent years. Deciding what to do often requires that we confront the question, “Which is preferable (hairetōteron) or better (beltion) between two or more options?” In Topics III, a text widely acknowledged as the inaugural treatment of the logic of preference, Aristotle articulates a set of principles to guide our preference-ranking. While scholars pay historical homage to Aristotle, there is little engagement with his treatment of preference logic. The second chapter addresses the need for a current study and reassessment of Aristotle’s preference-ranking principles. It argues that, despite differences in scope and methodology between the Aristotelian and modern systems, the description inaugural treatment of preference logic comfortably, and accurately, applies to Topics III. When one looks at the role that Aristotle allows reason to play in the production and motivation of action, it is tempting to conclude that Aristotle endorses the Humean division of labor. For Aristotle claims that deliberation is about “the things towards the goal” (EN III.3, 1112b11-16) and that virtue (aretē) makes our goals right (EN VI.12, 1144a7-9). Chapter three seeks to show, against a recent influential quasi-Humean interpretation, that the primary function of practical reason is mapping the landscape of value corresponding to the agent’s reasoned conception of what eudaimonia consists in, as a rational being that she is. Aristotle notoriously defends the political subordination of individuals he believes to have a defective deliberative capacity. In Politics I.13, he claims that the deliberative faculty is undeveloped in children and “ineffectual” (akuron) in women (1260a12). The concluding chapter considers a puzzle about the development of the female’s deliberative faculty: How do women become ineffective in their deliberation, but freemen do not, given that all children have deliberative faculties that are unperfected? Drawing from the theories defended in previous chapters, I argue that the female’s deliberative defect is primarily due to her lack of moral education rather than inalterable sexual, biological differences—a thesis widely endorsed by scholars lately. (shrink)

Discursive theories of justice have been questioned for putting forward high-level principles that should nevertheless play a role in practical discourses in which the justice of a claim is at stake. Here, I will critically examine and systematize the main tenets in Rawls’s and Habermas’s discursive theories, and will suggest that the principles of justice (Rawls) and universalization (Habermas) can and play the role of mandates of optimalization in real deliberations on justice.

Bernard Williams questioned whether impartial morality “can allow for the importance of individual character and personal relations in moral experience.” Underlying his position is a distinction between factual and practical deliberation. While factual deliberation is about the world and brings in a standpoint that is impartial, practical deliberation is, he claims, radically first‐personal; it “involves an I that [is] intimately the I of my desires.” While it may be thought that Williams's claim implies an unpalatable Humean subjectivism, the present article (...) argues that this does not follow: That first‐person practical deliberation is directed both by the “I of my desires” and by the world. Drawing on Peter Winch's argument against the universalizability of moral judgments and D. H. Lawrence's Lady Chatterley's Lover, the article argues that practical deliberations involve discovering value in the world, but that what is revealed about the world depends constitutively on the first‐person deliberations and decisions of particular agents. (shrink)

Next SectionIncreasingly a focus of research as well as media reports and online forums, the use of placebos in clinical medicine extends beyond sugar pills and saline injections. Physician surveys conducted in various countries invariably report that placebos are routinely used clinically, impure placebos more frequently than the pure ones, and that physicians consider them to be of legitimate therapeutic value. Inconsistent study methodologies and physician conceptualisations of placebos may complicate the interpretation of survey data, but hardly negate the valuable (...) insights these research findings provide. Because impure placebos are often not recognised as such by practitioners, they remain at the fringe of many placebo-related debates, hence quietly absent from discussions concerning policy and regulation. The apparent popularity of impure placebos used in clinical practice thus presents unresolved ethical concerns and should direct future discussion and research. (shrink)

The question of how to reason well is an important normative question,one which ultimately motivates some of our interest in the more abstracttopic of the principles of practical reason. It is this normative questionthat I propose to address by arguing that given the goal of an importantkind of deliberation, we will deliberate better if we develop certainvirtues. I give an account of the virtue of stability and I argue thatstability makes reasoners reason better. Further,I suggest at the end of (...) the paper that an account of virtues thatconduce to good reasoning might go a long way toward answering someof the traditional questions about the principles ofpractical reason. (shrink)

This paper argues that promises are proposals in joint practical deliberation, the activity of deciding together what to do. More precisely: to promise to ϕ is to propose (in a particular way) to decide together with your addressee(s) that you will ϕ. I defend this deliberative theory by showing that the activity of joint practical deliberation naturally gives rise to a speech act with exactly the same properties as promises. A certain kind of proposal to make a joint decision regarding (...) one's own actions turns out to have the very same normative effects, under the very same conditions, as a promise. I submit that this cannot be a coincidence: we should conclude that promises and the relevant kind of proposals in joint practical deliberation are one and the same. (shrink)

Introduction Although there have been reports of misbehavior and disrespectful maternal care by healthcare providers worldwide, there are few intervention studies aimed at promoting respectful care, particularly among midwives. Research objectives The aim of this study was to examine the effect of Moral Case Deliberation (MCD) on the of midwives’ knowledge and practice in the field of respectful maternity care. Research design and methods This semi-experimental study involved 46 midwives working in the maternity departments of two hospitals affiliated with (...) Bushehr University of Medical Sciences in 2023. The two hospitals were randomly divided into control and intervention groups. All midwives from both hospitals were included in the study. The Dilemma Method of MCD was implemented for midwives of intervention hospital. The Midwives’ Knowledge and Practice of Respectful Maternity Care scale was used for data collection. It was administered both before and two weeks after the intervention. Data were analyzed using SPSS (version 20). Ethical considerations The study was approved by ethics committee of Bushehr University of Medical Sciences in Bushehr, Iran (ethics code: IR.BPUMS.REC.1402.017). All participants provided written informed consent. Findings The intervention group showed a significantly greater increase in knowledge scores from pre-test to post-test compared to the control group ( p <.001). The intervention group had a significantly higher mean change score in practice self-assessment and practice peer evaluation, from pre-test to post-test, than in the control group ( p <.001). Discussion MCD based on the dilemma method can improve practice in the field of respect-oriented midwifery care by increasing knowledge and potentially changing attitudes. Conclusion The Dilemma Method of MCD improved midwives’ knowledge and practice regarding respectful maternity care. This method can be included in the midwifery care quality improvement program to promote respectful maternity care. It is necessary to develop methods for wider dissemination of MCD in the cultural context of Iran. (shrink)

Theoretical and practical deliberation are voluntary activities, and like all voluntary activities, they are performed for reasons. To hold that all voluntary activities are performed for reasons in virtue of their relations to past, present, or even merely possible acts of deliberation thus leads to infinite regresses and related problems. As a consequence, there must be processes that are nondeliberative and nonvoluntary but that nonetheless allow us to think and act for reasons, and these processes must be the ones that (...) generate the voluntary activities making up ordinary deliberation. These nondeliberative, nonvoluntary processes by means of which we are able to deliberate for reasons are the fundamental processes by means of which we can think or do anything for a reason: once it has been seen that they must exist, it can be recognized that they are ubiquitous. As a result, the usefulness of deliberation to rational belief and action is intermittent, contingent, and modest. Deliberation is a tremendously valuable tool for increasing human capacities to think and act for good reasons in challenging contexts, but in the end it is merely a tool, wielded by people through the same nondeliberative, nonvoluntary capacities to think and act for reasons that they are enhancing the effectiveness of by deliberating. (shrink)

In this pilot study, deliberate practice and competence-based assessment were incorporated into a first-year graduate course on professional issues and ethics. Students responded to challenging simulations of basic ethical situations in therapy before and after the course. Aspects of deliberate practice were incorporated into the course. Student self-report ratings and independent performance ratings blind to timing found improvements in students’ ability to manage basic ethical situations in practice. Pilot evidence suggests competence-based assessment and training have (...) potential use for training students preparing to engage in their first therapy practicum experiences. Additional controlled studies are needed to examine the benefits of competence-based assessment and training. (shrink)

In clinical moral decision making, emotions often play an important role. However, many clinical ethicists are ignorant, suspicious or even critical of the role of emotions in making moral decisions and in reflecting on them. This raises practical and theoretical questions about the understanding and use of emotions in clinical ethics support services. This paper presents an Aristotelian view on emotions and describes its application in the practice of moral case deliberation.According to Aristotle, emotions are an original and integral (...) part of (virtue) ethics. Emotions are an inherent part of our moral reasoning and being, and therefore they should be an inherent part of any moral deliberation. Based on Aristotle's view, we examine five specific aspects of emotions: the description of emotions, the attitude towards emotions, the thoughts present in emotions, the reliability of emotions, and the reasonable principle that guides an emotion. We then discuss three ways of dealing with emotions in the process of moral case deliberation. Finally, we present an Aristotelian conversation method, and present practical experiences using this method. (shrink)

Normative reasons for action are considerations that count in favor of actions. They are the considerations that determine what an agent should do in a given situation. If the agent acts on these considerations, they justify her action. This paper concerns accounts of normative reasons that separate the explanation of why a particular reason counts in favor of an agent’s performing some action from the content of that reason. Elements of this explanation of why the reason is a reason are (...) “background conditions” on that reason, rather than part of the reason itself. (shrink)

BackgroundMoral Case Deliberation is a specific form of bioethics education fostering professionals’ moral competence in order to deal with their moral questions. So far, few studies focus in detail on Moral Case Deliberation methodologies and their didactic principles. The dilemma method is a structured and frequently used method in Moral Case Deliberation that stimulates methodological reflection and reasoning through a systematic dialogue on an ethical issue experienced in practice.MethodsIn this paper we present a case-study of a Moral Case Deliberation (...) with the dilemma method in a health care institution for people with an intellectual disability, describing the theoretical background and the practical application of the dilemma method. The dilemma method focuses on moral experiences of participants concerning a concrete dilemma in practice. By an in-depth description of each of the steps of the deliberation process, we elucidate the educational value and didactics of this specific method.ResultsThe didactics and methodical steps of the dilemma method both supported and structured the dialogical reflection process of the participants. The process shows that the participants learned to recognize the moral dimension of the issue at stake and were able to distinguish various perspectives and reasons in a systematic manner. The facilitator played an important role in the learning process of the participants, by assisting them in focusing on and exploring moral aspects of the case.DiscussionThe reflection and learning process, experienced by the participants, shows competency-based characteristics. The role of the facilitator is that of a Socratic teacher with specific knowledge and skills, fostering reflection, inquiry and dialogue.ConclusionThe specific didactics of the dilemma method is well suited for teaching bioethics in clinical settings. The dilemma method follows an inductive learning approach through a dialogical moral inquiry in which participants develop not only knowledge but also skills, attitude and character. The role of a trained facilitator and a specific view on teaching and practicing ethics are essential when using the dilemma method in teaching health care professionals how to reflect on their own moral issues in practice. (shrink)

Religion refers to two excuses for the deliberately abandoning of prayers: sleep and forgetting. However, according to some scholars, some other reasons may also allow the deliberately abandoning of prayers. The most important support of these scholars is that the Messenger of Allah performed some prayers outside their own time during the al-Khandaq. However, there is a serious obstacle in front of this approach: The fear prayer. The aim of the article is to reveal the relationship between this application of (...) the Prophet and the fear prayer and investigates whether it is a general rule to leave a prayer due to the fear of war or the enemy. The importance of this issue stems from the fact that the practice in this battle is comparable. If this is accepted as a general rule, the framework of the issues that may cause a prayer to be left can be expanded. Excuses that can be considered force majeure and legitimate in terms of daily life can be added to the unconscious states of harmony and forgetting. Therefore, the article mentions a much smaller dimension of this broad framework, rather than the general aspects of the issue, such as the deliberately abandoning of prayers, whether it is possible or not, and its proofs. In this context, it can be said that it is of great importance to determine the historical sequence between this battle and the prayer of fear. The article comes to a conclusion through the determination of this relationship, which has clues in various hadith, history, and commentary books. (shrink)