BackgroundThe Mental Capacity Act was enacted in 2007 in England and Wales, but the assessment of mental capacity still remains an area of professional concern. Doctors’ compliance with legal and professional standards is inconsistent, but the reasons for poor compliance are not well understood. This preliminary study investigates doctors’ experiences of and attitudes toward mental capacity assessment.MethodsThis is a descriptive, cross-sectional study where a two-domain, study-specific structured questionnaire was developed, piloted and digitally disseminated to doctors at differing career stages employed (...) in a large, multi-site National Health Service Trust in London over 4 months in 2018. Descriptive statistics and frequency tables adjusted for missing data were generated and secondary analysis was conducted.ResultsParticipants were predominantly UK trained, female and between the ages of 30 and 44 years. Less than half of the participants reported receiving formal MCAx training. Only one-third of the participants self-rated themselves as very competent or extremely competent. Self-reported MCA confidence was significantly affected by career stage with Consultants with over 10 years of experience reporting lowest confidence.ConclusionsThis study describes significant variation in practice by doctors and low self-confidence in the practice of MCAx. These results raise concerns that MCAx continues to be inconsistently performed by doctors despite appropriate awareness of the law and professional guidance on best practice. (shrink)

The proto-code of ethics and conduct for European nurse directors was developed as a strategic and dynamic document for nurse managers in Europe. It invites critical dialogue, reflective thinking about different situations, and the development of specific codes of ethics and conduct by nursing associations in different countries. The term proto-code is used for this document so that specifically country-orientated or organization-based and practical codes can be developed from it to guide professionals in more particular or situation-explicit reflection and values. (...) The proto-code of ethics and conduct for European nurse directors was designed and developed by the European Nurse Directors Association’s (ENDA) advisory team. This article gives short explanations of the code’ s preamble and two main parts: Nurse directors' ethical basis, and Principles of professional practice, which is divided into six specific points: competence, care, safety, staff, life-long learning and multi-sectorial working. (shrink)

In this rich and detailed study of early modern women's thought, Jacqueline Broad explores the complexity of women's responses to Cartesian philosophy and its intellectual legacy in England and Europe. She examines the work of thinkers such as Mary Astell, Elisabeth of Bohemia, Margaret Cavendish, Anne Conway and Damaris Masham, who were active participants in the intellectual life of their time and were also the respected colleagues of philosophers such as Descartes, Leibniz and Locke. She also illuminates the continuities (...) between early modern women's thought and the anti-dualism of more recent feminist thinkers. The result is a more gender-balanced account of early modern thought than has hitherto been available. Broad's clear and accessible exploration of this still-unfamiliar area will have a strong appeal to both students and scholars in the history of philosophy, women's studies and the history of ideas. (shrink)

Jacqueline Taylor presents an original reconstruction of Hume's social theory, which examines the passions and imagination in relation to institutions such as government and the economy. She goes on to examine Hume's system of ethics, and argues that the principle of humanity is the central concept of Hume's Enlightenment philosophy.

With tumultuous changes occurring in the former Soviet Union, a unique opportunity exists to examine the implications of unethical behavior in what is,de facto, a totally unregulated market. Recent legalization of commodity trading in Moscow carried with it no legal structure to ensure swift compliance with contract terms. This paper demonstrates that in the absence of legal remedies, a free marketplace appropriately punishes unethical conduct.

Participation of end users in decision-making on science is increasingly practiced, as witnessed by the growing body of scientific literature on case evaluations. In the biomedical field, however, end-user participation in decision-making is rare. Some scholars argue that because patients are stakeholders and relevant experts, they could also provide important contributions to decision-making within the field of biomedical research. But what strategies could be used to effectively implement patient participation in decision-making on biomedical research? In this article, we analyze strategies (...) for patient participation and conclude that these can hardly be regarded effective because they do not ensure patients' structural influence on decision-making. We identify obstacles for effective patient participation, which seem to reflect a resilience of the current biomedical decision-making network. We subsequently elaborate on the concept of transition management in the search for clues on how to breach this resilience and change the network toward the inclusion of patients. (shrink)

The article deals with the financing of investment projects by the World Bank, especially the rehabilitation of hydropower plants. It is noted that cooperation with Ukraine World Bank launched since 1992. The World Bank develops and finances projects at the request of the Government of Ukraine. After evaluating the project and the terms of the loan are following the negotiations, the approval of the Board of Directors and the signing of the agreement. The funds of the World Bank in Ukraine (...) are on the system of financing and investment projects. The content system projects is to change the conditions and rules of certain sectors of the public administration or industries. The aim of the investment projects is the technical reconstruction of some existing businesses a particular industry or region, creating new companies or provide funds to replenish the working capital of enterprises. This clearly defined list of goods, services and works to be procured through the World Bank loan. The paper conclusions on the results of the project of rehabilitation of hydropower plants. SuccessinitiatedenergyreforminUkraineislargelydeterminedbytheefficiencyoftheinvestmentpolicy, including attracting loans from international financial organizations. On receipt of credit, including the World Bank, depend on the possibility of upgrading technologically obsolete and worn-out fixed assets of the energy sector and problems olving reduce country's energy dependence, improve energy efficiency and reduce the impact on the environment. In turn Hydropower Rehabilitation project funding by the World Bank Ukraine will ensure uninterrupted operation of hydropower plants and have a positive impact on the environmental and energy security. (shrink)

During the past decade, patient participation became an important issue in the medical field, and patient participation in biomedical research processes is increasingly called for. One of the arguments for this refers to the specific kind of knowledge, called experiential knowledge, patients could contribute. Until now, participation of patients in biomedical research has been rare, and integration of patients’ experiential knowledge with scientific knowledge—in the few cases it takes place—occurs implicitly and on an ad hoc basis. This is illustrated by (...) describing and analyzing the activities of the German patient group on retinitis pigmentosa. The authors argue that to be able to optimize the use of experiential knowledge of patients in biomedical research, a systematic approach is required. Transdisciplinary research provides such an approach, systematically, explicitly, and deliberately integrating knowledge from different scientific and nonscientific sources. In this article, the concept of transdisciplinarity is elaborated upon. The authors propose a possible procedure, identify necessary conditions and skills, and evaluate the feasibility of its implementation and institutionalization. Finally, the authors introduce a recent research project to further investigate and implement transdisciplinary research in the biomedical field. (shrink)

Jacqueline Rose argues for an expansion of the new boundaries of `English', and for the importance of psychoanalysis to the understanding of our literary and historical lives.

First published in 1999, this book brings together the extensive modern evidence for innate imitation in babies. Modern research has shown imitation to be a natural mechanism of learning and communication which deserves to be at centre stage in developmental psychology. Yet the very possibility of imitation in newborn humans has had a controversial history. Defining imitation has proved to be far from straightforward and scientific evidence for its existence in neonates is only now becoming accepted, despite more than a (...) century of enquiry. In this book, some of the world's foremost researchers on imitation and intellectual development review evidence for imitation in newborn babies. They discuss the development of imitation in infancy, in both normal and atypical populations and in comparison with other primate species, stressing the fundamental importance of imitation in human development, as a foundation of communication and a precursor to symbolic processes. (shrink)

Our exploratory research aims at suggesting design principles for educational software dedicated to people with high functioning autism. In order to explore the efficiency of educational games, we developed an experimental protocol to study the influence of the specific constraints of the learning areas as well as Human Computer Interface modalities. We designed computer games that were tested with 10 teenagers diagnosed with high functioning autism, during 13 sessions, at the rate of one session per week. Participants’ skills were assessed (...) before and after a training period. A group of 10 typical children matched on academic level also took part in the experiment. A software platform was developed to manage interface modalities and log users’ actions. Moreover, we annotated video recordings of two sessions. Results underline the influence of the task and interface modalities on executive functions. (shrink)

Introduction: Uncertainty is omnipresent in cancer care, including the ambiguity of diagnostic tests, efficacy and side effects of treatments, and/or patients' long-term prognosis. During second opinion consultations, uncertainty may be particularly tangible: doubts and uncertainty may drive patients to seek more information and request a second opinion, whereas the second opinion in turn may also affect patients' level of uncertainty. Providers are tasked to clearly discuss all of these uncertainties with patients who may feel overwhelmed by it. The aim of (...) this study was to explore how oncologists communicate about uncertainty during second opinion consultations in medical oncology.Methods: We performed a secondary qualitative analysis of audio-recorded consultations collected in a prospective study among cancer patients who sought a second opinion in medical oncology. We purposively selected 12 audio-recorded second opinion consultations. Any communication about uncertainty by the oncologist was double coded by two researchers and an inductive analytic approach was chosen to allow for novel insights to arise.Results: Seven approaches in which oncologists conveyed or addressed uncertainty were identified: specifying the degree of uncertainty, explaining reasons of uncertainty, providing personalized estimates of uncertainty to patients, downplaying or magnifying uncertainty, reducing or counterbalancing uncertainty, and providing support to facilitate patients in coping with uncertainty. Moreover, oncologists varied in their choice of words/language to convey uncertainty.Discussion: This study identified various approaches of how oncologists communicated uncertain issues during second opinion consultations. These different approaches could affect patients' perception of uncertainty, emotions provoked by it, and possibly even patients' behavior. For example, by minimizing uncertainty, oncologists may consciously steer patients toward specific medical decisions). Future research is needed to examine how these different ways of communicating about uncertainty affect patients. This could also facilitate a discussion about the desirability of certain communication strategies. Eventually, practical and evidence-based guidance needs to be developed for clinicians to optimally inform patients about uncertain issues and support patients in dealing with these. (shrink)

This work is a collection of the philosophical correspondences of English women thinkers of the late seventeenth century. It includes letters to and from some of the most famous philosophers of the age, including Locke and Leibniz. Their letters range over a wide variety of philosophical subjects, from religion and ethics to knowledge and metaphysics. The introductory essays and annotations to this work make these women's ideas accessible and comprehensible to modern readers. Taken as a whole, the collection significantly enhances (...) our appreciation of women's involvement in the shaping and development of philosophy from 1650 to 1700. (shrink)

Public engagement is increasingly advocated and applied in the development and implementation of technological innovations. However, initiatives so far are rarely considered effective. There is a need for more methodological rigor and insight into conducive conditions. The authors developed an evaluative framework and assessed accordingly the effectiveness of a project of the Dutch Ministry of Health, Welfare and Sport in which the application of interactive policy making was piloted in medical biotechnology, among others, to increase the legitimacy and quality of (...) the policy agenda. Relevant societal actors, including citizens, were actively involved in an open-exchange, action and reflection process, integrating relevant knowledge. Although the project was overall evaluated as effective, some difficulties were faced. These were mostly related to the novel roles public engagement requires of principal actors. The article concludes that more research is needed on the position of the executing team and on overcoming tensions existing between different governance modes. (shrink)

The present work considers the communicative dimensions of intellectual practices in an effort to discern how these practices can take full account of their own placement within and accountability to the human communities and cultures they cultivate. The discussion is framed with a focus on intellectual communities who have struggled against the dominance of Euromodern epistemological orientations that have constructed their own cultures and intellectual practices as irrelevant or, at best inferior. This struggle is a decolonial praxis. The development of (...) communicology during the post-World War II period in the United States is taken up as an approach to theory construction that allows for the fullest possible examination of the very human condition in which thought and action emerge. Chicana and Latina phenomenology constitute a further development of this decolonial praxis consonant with the sensibilities of communicology. Chicana and Latina phenomenology is shown to advance our understanding of philosophy as an intellectual (i.e., communicative) practice that takes place in a world of other human beings to whom we are accountable. Theory construction as it relates to boundary conditions is taken as an important point that spans the all too common gap between the existential and the cultural and aids in constituting a theory construction project that is also a decolonial praxis. (shrink)

In this article, I analyse the discursive construction of adolescent pregnancy and childbearing as a development ‘problem’ in Plan’s ‘Because I’m a Girl’ campaign. I draw on existing scholarship that configures teenage pregnancy prevention campaigns in the ‘developed’ world as a site of biopolitics that seeks to maximise the well-being of the population by governing adolescent girls’ reproductive and sexual behaviours. Identifying Plan’s campaign as part of a larger turn towards adolescent girls in development discourse and policy, I also draw (...) on a growing body of scholarship that examines how campaigns targeting adolescent girls reinforce neo-liberal understandings of ‘development’ as achievable through the empowerment of individuals rather than through structural change. I argue that by discursively constructing adolescent pregnancy and parenthood as risky, Plan’s campaign reinforces reproductive norms of delayed reproduction and sexual debut, according to which adolescent girls in the ‘developing’ world are expected to comply. The campaign’s goal of ‘empowerment’ thus acts as a means of constructing adolescent girls as responsible reproductive decision makers who will break the ‘cycle of poverty’ by making rational reproductive and sexual choices. Thus, although Plan’s ‘Because I’m a Girl’ campaign addressed important issues, including adolescent girls’ right to reproductive autonomy, their focus on empowerment operates as a form of biopower that pursues the project of development through the regulation of girls’ reproduction and sexuality. (shrink)

ABSTRACT This article addresses the growing literature in critical race studies, which holds that racism is permanent or incurable, and that by adopting this pessimistic view of racism, we can enact improved and healthier racialized lives. I argue that the focus on curing anti-Black racism, and the failure to do so in the civil rights era and its aftermath has left people of all races, to varying degrees, stuck in pessimistic states of racialized anger, resentment, guilt, and shame. These pessimistic (...) states have brought about an additional level of oppression for targets of racialized oppression. I call it “meta-oppression,” and it is the oppression of being oppressed. I argue that this oppression has exacerbated the effects of the social disease of racism, and it has literally affected the physiologies of many African Americans. This article provides a diagnosis of these existential and physiological states of meta-oppression and a clarification of its characteristics. This diagnosis is an initial step in a larger project of formulating and enacting effective treatments for it. I then argue that meta-oppression is a helpful diagnostic tool for clarifying the characteristics and ramifications on Blacks of US systemic racism during the post–civil rights movement period. I aim to establish meta-oppression as an existential and physiological condition that requires attention so as to expand the social imaginations of people of color and to allow us to engage in more systemic joyful affirmations of our racialized lives while still living within racist conditions. (shrink)

Mary Astell is best known today as one of the earliest English feminists. This book sheds new light on her writings by interpreting her first and foremost as a moral philosopher—as someone committed to providing guidance on how best to live. The central claim of this work is that all the different strands of Astell’s thought—her epistemology, her metaphysics, her philosophy of the passions, her feminist vision, and her conservative political views—are best understood in light of her ethical objectives. To (...) support that claim, this work examines Astell’s programme to bring about a moral transformation of character in her fellow women. This ethical programme draws on several key aspects of seventeenth-century philosophy, including Cartesian and Neoplatonist epistemologies, ontological and cosmological proofs for the existence of God, rationalist arguments for the soul’s immateriality, and theories about how to regulate the passions in accordance with reason. At the heart of Astell’s philosophical system lies a theory of virtue, including guidelines about how to cultivate generosity of character, a benevolent disposition towards others, and the virtue of moderation. This book explains the foundations of that moral theory, and then examines how it shapes and informs Astell’s response to male tyranny within marriage and to political tyranny in the state. It concludes with some reflections on the historiographical implications of writing Mary Astell back into the history of philosophy. (shrink)

This study involved using a mixed method research design to examine the moral philosophy difference between the ethical decision-making process of CEOs in U.S.-led and non-U.S.-led within the luxury goods industry. The study employed a MANOVA to compare the ethical profiles between the two leader types and a phenomenological qualitative process to locate themes that give indication as to the compatibility of the luxury strategy values and practices with the principles and concepts of responsible leadership and conscious capitalism. As the (...) luxury goods industry is facing the first slowdown since 2000, pressure to achieve sales targets in the U.S. to make up for losses in other markets will place these CEOs under extreme pressure from their headquarters. These leaders must possess the ethical decision-making capability to balance legal and moral dilemmas unique to multinational luxury goods organizations while delivering business results in a challenging environment. Results of the study show no evidence of difference in the ethical decision-making profiles between the two groups of leaders. The themes and emergent findings resulting from the qualitative analysis indicate a profound incompatibility between the values informing decision-makers using the luxury strategy and those employed by leaders operating within the principles and parameters of responsible leadership and conscious capitalism. Recommendations for future research include replicating the study with a larger sample, within a different geographic region or comparing leaders using the luxury strategy to those using conscious capitalism. (shrink)

Descriptive accounts of the nature of explanation in neuroscience and the global goals of such explanation have recently proliferated in the philosophy of neuroscience and with them new understandings of the experimental practices of neuroscientists have emerged. In this paper, I consider two models of such practices; one that takes them to be reductive; another that takes them to be integrative. I investigate those areas of the neuroscience of learning and memory from which the examples used to substantiate these models (...) are culled, and argue that the multiplicity of experimental protocols used in these research areas presents specific challenges for both models. In my view, these challenges have been overlooked largely because philosophers have hitherto failed to pay sufficient attention to fundamental features of experimental practice. I demonstrate that when we do pay attention to such features, evidence for reduction and integrative unity in neuroscience is simply not borne out. I end by suggesting some new directions for the philosophy of neuroscience that pertain to taking a closer look at the nature of neuroscientific experiments. (shrink)

Mary Astell The English writer Mary Astell is widely known today as an early feminist pioneer, but not so well known as a philosophical thinker. Her feminist reputation rests largely on her impassioned plea to establish an all-female college in England, an idea first put forward in her Serious Proposal to the Ladies. … Continue reading Astell, Mary →.

Summary Based on Clausius’ phrasing of a “transformational content” and the resulting 2nd law of thermodynamics, I demonstrated that Gilbert Simondon’s On the Mode of Existence of Technical Objects is historically situated at the threshold of understanding open systems thermodynamics and the related concepts of balance. Furthermore, I showed that Gestalt theory, as represented by Wolfgang Köhler, at least reproduced, if not partially anticipated or even prepared this development of 20th century thinking. Finally, I gave some short examples of how (...) Simondon applied the figure/ground distinction to human perception, memory, and a general theory of becoming and I introduced his proposal to analyse “the grounds” just as thoroughly as the laws of figuration. (shrink)

While accepting and welcoming our main thesis and project, Schäfer and Hühn’s Commentary on our paper focuses on two main criticisms, both of which seem to us mistaken. The first of these is that our paper falsely argues “that the existing definitions of leadership out there fall short in describing the role of ethics in leadership.” The second seems to be a belief that (i) we claim to be offering an entirely new definition of leadership and misrepresenting its nature because (...) (ii) in the view of Schäfer and Hühn this supposedly new definition “is essentially un-Aristotelian.”. (shrink)

The case of a dying baby with is one of the most difficult in pediatric ethics. I have been involved in several such cases and they are extremely challenging for all parties, especially the parents. With the luxury of being an I will comment on this case from the perspective of when it first began and at the end point described in the narrative.

Danièle-Djamila Minne-Amrane, née à Neuilly-sur-Seine le 13 août 1939, est décédée à Alger le 11 février dernier. Son père, Pierre Minne, professeur de philosophie, ancien résistant puis militant anticolonial au Sénégal, en est expulsé en 1947. Il s’installe alors en Algérie, dans la campagne de Tlemcen où sa femme, Jacqueline Netter, allait devenir institutrice. Après son divorce, cette dernière se remarie avec Abdelkader Guerroudj et tous deux militent au PCA (parti communiste algérien). Da...

This article investigates several consequences of a recent trend in philosophy of mind to shift the relata of realization from mental state–physical state to function‐mechanism. It is shown, by applying both frameworks to the neuroscientific case study of memory consolidation, that, although this shift can be used to avoid the immediate antireductionist consequences of the traditional argument from multiple realizability, what is gained is a far more modest form of reductionism than recent philosophical accounts have intimated and neuroscientists themselves have (...) claimed. (shrink)

The circumstances of later Stuart monarchy provide the context of John Locke's politics in its simplest sense. This chapter surveys the politics of memory, the politics of religion, partisanship and the public sphere, British and Irish contexts, and European events. Some of these remained constant throughout Locke's life, but specific works were stimulated by particular events as well. The politics of memory were dwarfed by the politics of religion. One of the major reasons why later Stuart England was so obsessed (...) with the memory of its earlier troubles was the continuing problem of imposing religious uniformity on a population divided by faith. The chapter explores the milieu in which Locke's political writings might have been, and then actually were, published. The context of Locke's political thought involves not just political events, but also the political culture of partisanship, print, and the "public sphere". (shrink)

What can contemporary machine learning (ML) models do? Given the proliferation of ML models in society, answering this question matters to a variety of stakeholders, both public and private. The evaluation of models' capabilities is rapidly emerging as a key subfield of modern ML, buoyed by regulatory attention and government grants. Despite this, the notion of an ML model possessing a capability has not been interrogated: what are we saying when we say that a model is able to do something? (...) And what sorts of evidence bear upon this question? -/- In this paper, we aim to answer these questions, using the capabilities of large language models (LLMs) as a running example. Drawing on the large philosophical literature on abilities, we develop an account of ML models' capabilities which can be usefully applied to the nascent science of model evaluation. Our core proposal is a conditional analysis of model abilities (CAMA): crudely, a machine learning model has a capability to X just when it would reliably succeed at doing X if it 'tried'. The main contribution of the paper is making this proposal precise in the context of ML, resulting in an operationalisation of CAMA applicable to LLMs. We then put CAMA to work, showing that it can help make sense of various features of ML model evaluation practice, as well as suggest procedures for performing fair inter-model comparisons. (shrink)

Emancipatory practice development (ePD) is a practitioner‐led research methodology which enables workplace transformation. Underpinned by the critical paradigm, ePD works through facilitation and workplace learning, with people in their local context on practice issues that are significant to them. Its purpose is to embed safe, person‐centred learning cultures which transform individuals and workplaces. In this article, we critically reflect on a year‐long ePD study in an acute care hospital ward. We explore the challenges of practice change within systems, building collective (...) strength with frontline collaborations and leadership to sustain new learning cultures. Our work advances practice development dialogue through working closely with the underpinning theories. Our critique analyses how ePD can enact and sustain change within a complex system. We argue that ePD works to strengthen safety cultures by challenging antidemocratic practices through communicative action. By opening communicative spaces, ePD enables staff to collectively deliberate and reach consensus. Their raised awareness supports staff to resist ways of working which conspire against safe patient care. Sustainability of practice change is fostered by the co‐operative democracies created within the frontline team and meso level enablement. We conclude that the democratising potential of ePDt generates staff agency at the frontline. (shrink)

Against those who dismiss Kant's project in the "Religion" because it provides a Pelagian understanding of salvation, this paper offers an analysis of the deep structure of Kant's views on divine justice and grace showing them not to conflict with an authentically Christian understanding of these concepts. The first part of the paper argues that Kant's analysis of these concepts helps us to understand the necessary conditions of the Christian understanding of grace: unfolding them uncovers intrinsic relations holding between God's (...) justice and grace. Parts two and three provide an analysis of two concepts of grace used by Kant. Getting clear on their differences is the key to understanding why Kant's account is not Pelagian. (shrink)