The development and deployment of medical devices, along with most areas of healthcare, has been significantly impacted by the COVID-19 pandemic. This has had variable ethical implications, two of which we will focus on here. First, medical device regulations have been rapidly amended to expedite approvals of devices ranging from face masks to ventilators. Although some regulators have issued cessation dates, there is inadequate discussion of triggers for exiting these crisis standards, and evidence that this may not be feasible. Given (...) the relatively low evidence standards currently required for regulatory approval of devices, this further indefinite reduction in standards raises serious ethical issues. Second, the pandemic has disrupted the usual operations of device representatives in hospitals, providing an opportunity to examine and refine this potentially ethically problematic practice. In this paper we explain and critically analyse the ethical implications of these two pandemic-related impacts on medical devices and propose suggestions for their management. These include an endpoint for pandemic-related adjustments to device regulation or a mechanism for continued refinement over time, together with a review of device research conducted under crisis conditions, support for the removal and replacement of emergency approved devices, and a review of device representative credentialling. (shrink)

Protective measurements illustrate how Yakir Aharonov's fundamental insights into quantum theory yield new experimental paradigms that allow us to test quantum mechanics in ways that were not possible before. As for quantum theory itself, protective measurements demonstrate that a quantum state describes a single system, not only an ensemble of systems, and reveal a rich ontology in the quantum state of a single system. We discuss in what sense protective measurements anticipate the theorem of Pusey, Barrett, and Rudolph (PBR), stating (...) that, if quantum predictions are correct, then two distinct quantum states cannot represent the same physical reality. (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)

BackgroundExisting clinical ethics support (CES) instruments are considered useful. However, users report obstacles in using them in daily practice. Including end users and other stakeholders in developing CES instruments might help to overcome these limitations. This study describes the development process of a new ethics support instrument called CURA, a low-threshold four-step instrument focused on nurses and nurse assistants working in palliative care. MethodWe used a participatory development design. We worked together with stakeholders in a Community of Practice throughout the (...) study. Potential end users (nurses and nurse assistants in palliative care) used CURA in several pilots and provided us with feedback which we used to improve CURA.ResultsWe distinguished three phases in the development process. Phase one, Identifying Needs, focused on identifying stakeholder and end user needs and preferences, learning from existing CES instruments, their development and evaluation, and identify gaps. Phase two, Development, focused on designing, developing, refining and tailoring the instrument on the basis of iterative co-creation. Phase three, Dissemination, focused on implementation and dissemination. The instrument, CURA, is a four-step low-threshold instrument that fosters ethical reflection.ConclusionsParticipatory development is a valuable approach for developing clinical ethics support instruments. Collaborating with end users and other stakeholders in our development study has helped to meet the needs and preferences of end users, to come up with strategies to refine the instrument in order to enhance its feasibility, and to overcome reported limitations of existing clinical ethics instruments. (shrink)

Is linguistic understanding a form of knowledge? I clarify the question and then consider two natural forms a positive answer might take. I argue that, although some recent arguments fail to decide the issue, neither positive answer should be accepted. The aim is not yet to foreclose on the view that linguistic understanding is a form of knowledge, but to develop desiderata on a satisfactory successor to the two natural views rejected here.

Philosophers have long theorized about which things make people’s lives go well, and why, and the extent to which morality and self-interest can be reconciled. Yet little time has been spent on meta-prudential questions, questions about prudential discourse. This is surprising given that prudence is, prima facie, a normative form of discourse and, as such, cries out for further investigation. Chapter 4 takes up two major meta-prudential questions. It first examines whether there is a set of prudential reasons, generated by (...) evaluative prudential properties, and defends the view that evaluative well-being facts generate agent-relative reasons for the relevant agent. It also investigates whether prudential discourse is normative. It is proposed that prudential discourse is normative by arguing that prudential judgements are normative judgements. The case for this is presented by analogy with moral discourse by showing that the features of moral judgements that metaethicists appeal to when articulating, explaining, and justifying the claim that moral judgements are normative are also possessed by prudential judgements. Various objections to the analogy are also considered. (shrink)

THE STRUCTURE OF THIS PAPER IS AS FOLLOWS. I begin §1 by dealing with preliminary issues such as the different relations expressed by the “good for” locution. I then (§2) outline the Locative Analysis of good for and explain its main elements before moving on to (§3) outlining and discussing the positive features of the view. In the subsequent sections I show how the Locative Analysis can respond to objections from, or inspired by, Sumner (§4-5), Regan (§6), and Schroeder and (...) Feldman (§7). I then (§8) reply to an imagined objector who claims that the Locative Analysis generates implausible results with respect to punishment, virtue and agent-centered duties. (shrink)

This book takes a new approach to ethics by focusing on the kinds of dilemmas that confront people almost daily on the job.

Many believe that severe intellectual impairment, blindness or dying young amount to serious harm and disadvantage. It is also increasingly denied that it matters, from a moral point of view, whether something is biologically normal to humans. We show that these two claims are in serious tension. It is hard explain how, if we do not ascribe some deep moral significance to human nature or biological normality, we could distinguish severe intellectual impairment or blindness from the vast list of seemingly (...) innocent ways in which we fail to have as much wellbeing as we could, such not having super‐intelligence, or not living to 130. We consider a range of attempts to draw this intuitive normative distinction without appealing to normality. These, we argue, all fail. But this doesn't mean that we cannot draw this distinction or that we must, implausibly, conclude that biological normality does possess an inherent moral importance. We argue that, despite appearances, it is not biological normality but rather statistical normality that, although lacking any intrinsic moral significance, nevertheless makes an important moral difference in ways that explain and largely justify the intuitive distinction. (shrink)

The return of Hephaistos to Olympos, as a myth, concerns the establishment of a balance of power among the Olympian gods. Many visual representations of the myth in Archaic and Classical Greek art give visible form to the same theme, but they do so in a manner entirely distinct from the manner in which it is expressed in literary narratives of the tale. In this paper, I argue that vase-painters incorporated elements of Dionysiac processional ritual into representations of the return (...) of Hephaistos in order to articulate visually the principal theme of the myth. The vase-painters structured the myth along the lines of epiphanic processions in which Dionysos was escorted into the city of Athens. Like Dionysiac epiphanic processions, the procession of Hephaistos, Dionysos and the wine-god's followers is distinguished visually by drunkenness, ostentatious display of the phallus and obscene or insulting behaviour. To judge from the aetiological myths associated with them, the epiphanic processions symbolized the triumph of Dionysos over, and his belated acceptance by, those who denied his status as a god. By structuring the visual representations of the return of Hephaistos along the lines of such Dionysiac processions, artists conveyed visually the idea that the myth al so concerned the triumph of a god over those who rejected him, and his acceptance among the Olympians. It is not necessary to assume that the vase-painters relied on a detailed poetic account of the myth to create their representations of it, because they employed elements of religious spectacle, an inherently visual phenomenon, to convey the essence of the story. (shrink)

A common starting point for ‘going hybrid’ is the thought that moral discourse somehow combines belief and desire-like aspects, or is both descriptive and expressive. Hybrid meta-ethical theories aim to give an account of moral discourse that is sufficiently sensitive to both its cognitive and its affective, or descriptive and expressive, dimensions. They hold at least one of the following: moral thought: moral judgements have belief and desire-like aspects or elements; moral language: moral utterances both ascribe properties and express desire-like (...) attitudes. This entry concerns hybrid theories of moral language. The main division within such theories is between those treating the expression of desire-like attitudes as semantic and those treating it as pragmatic. This entry exclusively focuses on pragmatic forms of and examines the prospects for treating moral attitude expression as working via certain standard pragmatic mechanisms. I explain these mechanisms, outline the properties that standardly define them, and test to see whether moral attitude expression matches them. At the end, I briefly explain a more minimal pragmatic alternative. The main conclusions are that we should disregard presupposition and conventional implicature views and that the most plausible options for a pragmatic hybrid view are a generalised conversational implicature view and a more minimal pragmatic view. (shrink)

John Cook Wilson is an important predecessor of contemporary knowledge first epistemologists: among other parallels, he claimed that knowledge is indefinable. We reconstruct four arguments for this claim discernible in his work, three of which find no clear analogues in contemporary discussions of knowledge first epistemology. We pay special attention to Cook Wilson’s view of the relation between knowledge and forms of thinking (like belief). Claims of Cook Wilson’s that support the indefinability of knowledge include: that knowledge, unlike belief, straddles (...) an active/passive divide; that, rather than entailing belief, knowledge excludes belief; and that understanding forms of thinking other than knowledge (such as belief) depends on understanding knowledge. Reflecting on Cook Wilson’s framework highlights underappreciated concerns relevant to any attempt to define knowledge. (shrink)

Discrete choice experiments—selecting the best and/or worst from a set of options—are increasingly used to provide more efficient and valid measurement of attitudes or preferences than conventional methods such as Likert scales. Discrete choice data have traditionally been analyzed with random utility models that have good measurement properties but provide limited insight into cognitive processes. We extend a well-established cognitive model, which has successfully explained both choices and response times for simple decision tasks, to complex, multi-attribute discrete choice data. The (...) fits, and parameters, of the extended model for two sets of choice data (involving patient preferences for dermatology appointments, and consumer attitudes toward mobile phones) agree with those of standard choice models. The extended model also accounts for choice and response time data in a perceptual judgment task designed in a manner analogous to best–worst discrete choice experiments. We conclude that several research fields might benefit from discrete choice experiments, and that the particular accumulator-based models of decision making used in response time research can also provide process-level instantiations for random utility models. (shrink)

The solitary language user is again stalking the critical fields of Europe . This pre-social individual, abstracted from all social and historical context, has been seemingly revived after what many of us saw as a death-blow dealt by Wittgenstein in his analysis of the notion of following a rule , and his related discussions bringing out the impossibilities of a ‘private’ language—what has come to be known as Wittgenstein's ‘private language argument’. Just what a ‘private language’ is has become the (...) issue. Did Wittgenstein show that language-use and rule-following essentially and necessarily involved others, and were therefore necessarily social in character ? Or did his arguments bear only against the notion of a language which was essentially and necessarily private, one which could not in principle be taught to another? (shrink)

The traditional organizational boundaries between healthcare, social work, police and other non-profit organizations are fading and being replaced by new relational patterns among a variety of disciplines. Professionals work from their own history, role, values and relationships. It is often unclear who is responsible for what because this new network structure requires rules and procedures to be re-interpreted and re-negotiated. A new moral climate needs to be developed, particularly in the early stages of integrated services. Who should do what, with (...) whom and why? Departing from a relational and hermeneutic perspective, this article shows that professionals in integrated service networks embark upon a moral learning process when starting to work together for the client’s benefit. In this context, instrumental ways of thinking about responsibilities are actually counterproductive. Instead, professionals need to find out who they are in relation to other professionals, what core values they share and what responsibilities derive from these aspects. This article demonstrates moral learning by examining the case of an integrated social service network. The network’s development and implementation were supported by responsive evaluation, enriched by insights of care ethics and hermeneutic ethics. (shrink)

This is the only general selection available of the writings of the renowned English idealist philosopher F. H. Bradley; it is the ideal introduction to his thought. Bradley's original texts are given an editorial framework in the introductions to each section, allowing students to investigate his philosophy first-hand and yet to be guided through the difficulties presented by his work.

All the passages are from the writings and translations of Thomas Taylor.

In Book 9 of his Confessions, Augustine recounts that his mother Monica told him how ‘a weakness for wine gradually got grip upon her’ as a little girl. After some time, so the story goes, God healed her from her bad habit. In this context, Augustine observes: ‘When father and mother and nurses are not there, you are present. You have created us, you call us, you use human authorities set over us to do something for the health of our (...) souls.’ Even though at first sight this passage does not seem to pose any problems, one wonders about the exact meaning of the last part: etiam per praepositos homines boni aliquid agis ad animarum salutem. First, it is to be noted that Henry Chadwick's translation cited here leaves etiam untranslated. Moreover, it is not certain at all that Augustine really wants to say that God heals human souls ‘even by those human beings who are set over us’. As the subsequent lines of this paragraph make clear, God freed Monica from her sin through her servant, who scoffingly called her young mistress ‘a little boozer’. This renders the phrase etiam per praepositos homines problematic, on the one hand, because the meaning of etiam is unclear and, on the other, because it is difficult to regard Monica's servant as one of the ‘human authorities’. Nothing in the text compels us to identify this servant with the old famula of Monica's parents who, according to the preceding paragraph, was ‘vehement with a holy severity in administering correction and soberly prudent in her teaching’. At any rate, the ancilla mentioned here is depicted not as an authoritative person but rather as someone who quarrels with her young domina, not in order to heal or educate her but merely to irritate her. (shrink)

Machine-generated contents note: Preface -- 1 - Introduction -- Section One: Race Relations and Racial (In)justice in Colonial New Zealand -- 2 - Missionary and Maori, 1840-1865 -- 3 - Voiceless at Parihaka, 1881 -- 4 - Anti-Asian Racism in 'White' New Zealand -- Section Two: Legislating for Godliness -- 5 - Keeping Quiet About the Sabbath, 1860-1930 -- 6 - Sunday or Fun-day, 1931-1990 -- 7 - The Battle of the Booze -- 8 - Uncorking the Bottle: The Alcohol (...) Issue, 1920-2000 -- Section Three: In Search of Utopia -- 9 - Women Count in the 1890s -- 10 - Social Gospel and Socialism -- 11 - The 'Great Depression', 1929-1935 -- Section Four: Issues of War and Peace -- 12 - Fighting for Peace, 1899-1918 -- 13 - Versailles to Vietnam (and Beyond): Issues of War and Peace, 1919-1989 -- Section Five: Combating Racism at Home and Abroad -- 14 - Racism and Religion in Pukekohe, 1959 -- 15 - No Horis in the Scrum: Rugby and Race, 1959-1980 -- 16 - Tackling Apartheid: The 1981 Rugby Tour Controversy -- 17 - Race in the Eighties: 'Not One Acre More' at Bastion Point -- Section Six: The Place of Sex in Society -- 18 - Sex and Celluloid: The Film Censorship Debate, 1965- 1976 -- 19 - Abortion in the Back Streets: 1930 to 1960s -- 20 - Life versus Life: The 1970s Abortion Debate -- Section Seven: Issues of Gender and Sexuality -- 21 - Liberation at Last: Second-wave Feminism from 1970 -- 22 - Good as You? Gay or Sad? Debate over Homosexuality, 1960-1986 -- Section Eight: Toward the Future -- 23 - Hikoi and Hope: Social Justice in the 1990s -- 24 - Afterword -- Notes -- Abbreviations -- Bibliography -- Index. (shrink)

The ability to develop and use models to explain phenomena is a key component of the Next Generation Science Standards, and without examples of what modeling instruction looks like in the reality of classrooms, it will be difficult for us as a field to understand how to move forward in designing curricula that foreground the practice in ways that align with the epistemic commitments of modeling. In this article, we illustrate examples drawn from a model-based curriculum development project to problematize (...) and bring to the fore issues and tensions we observed through the course of modeling instruction. In doing so, we argue that instruction that is model-based may not be actualizing modeling as an epistemic practice to support student sensemaking. We suggest that this kind of enactment may be a result of the tensions between viewing models as content to be learned and modeling as a scientific practice in which the end products are not known ahead of time. We discuss the implications of our analysis for teacher learning and curriculum development. (shrink)

Peter Abelard’s (1079-1142) conception of moral sin contains a fundamental element from Stoicism, which is the notion of “consent” (consensus). After the presentation of the essentials of that Abelardian theory, we return to the source of that same idea in ancient and imperial Stoicism. According to their main representatives, “consent” or “assent” (sugkata/qesij) has a determining function not only in ethics, but also in the process of knowledge as well. We emphasize in passing the resemblance between some important components of (...) Stoic epistemology and the theory expounded by Aristotle in the Posterior Analytics on the origin of knowledge. Augustine represents without any doubt one of the main intermediaries through whom this notion of consent is transmitted up to the time of Abelard in the 12th century. Even if he was influenced by the Bishop of Hippo on moral questions in general, Abelard seems to distance himself from Augustine by considering that consent is more a rational matter than a volitional one. (shrink)

The Stoic School takes up the tripartite division of philosophy of the post-Platonic Academy, in which physics occupies, alongside dialectics and ethics, a prominent place. In this tripartition, there is no metaphysics, nor in the two subdivisions of Stoic physics. For the thinkers of the Stoa, there is nothing beyond physics. In spite of this statement, we try to discover, in this article, the presence of a study devoted to first philosophy among the various topics investigated by the Stoics in (...) their physics. It is with this aim that we first examine what precisely Aristotle deals with in the Metaphysics. This preliminary investigation will serve as a point of reference for determining what can be considered as metaphysics, at least in ancient Greece. Afterwards, we are interested in the Stoic view of nature itself since nothing superior exists. This examination leads us to scrutinize the Stoic conception of the Good, a notion closely linked to the subject of physics. We then take a good look at each one of the topics found in the two Stoic divisions of physics, highlighting the matters approaching Aristotelian metaphysics. On that occasion, a specific analysis is devoted to the two Stoic principles, due notably to the relevance of the subject in relation to first philosophy. From the diversity of the elements found in the course of our study, we come to the final part, in which we establish the position of the Stoic School on metaphysics. (shrink)