Voluntades anticipadas: desafíos éticos en el cuidado del paciente Diretivas antecipadas de vontade: desafios éticos no cuidado do paciente Advance healthcare directives are intended for the individual to personally express their will and preferences about healthcare and treatment ahead of time. This literature review aims to describe the concept and structure of advance directives and the ethical aspects involved in patient care. Using the keywords “Advance Healthcare Directive” AND “Ethical Implication” and its Spanish equivalents, five databases were accessed: ProQuest, Philosophy, (...) PubMed, Web of Science and Scielo. Publications were narrowed down to the 2010-2018 period. Thirty-one articles were obtained and read critically. Results of this review were grouped into the following categories: concept, structure, clinical situations in which advance directives apply, strengths and limitations, as well as the ethical aspects involved. End of life-related experiences in which a person loses their ability to make decisions and cannot express their wishes, so it is impossible to know their will, are more common nowadays. Most health workers are not appropriately trained in the preparation and application of advance directives, which becomes an opportunity to research and delve deeper into the subject. Advance directives are a tool that gives health workers reliable information on a patient’s values and wishes, so it is vital to train them to provide respectful quality care. Para citar este artículo / To reference this article / Para citar este artigo Forero J, Vargas I, Bernales M. Voluntades anticipadas: desafíos éticos en el cuidado del paciente. Pers Bioet. 2019;23:224-244. DOI: https://doi.org/10.5294/pebi.2019.23.2.5 Recibido: 26/01/2019 Aceptado: 22/08/2019. (shrink)

The purpose of this paper is to analyse the gap between the strategic and operational levels of corporate responsibility. The strategic level of corporateresponsibility refers to the strategic plans concerning corporate responsibility which are examined by looking at the corporate responsibility documents. The operational level stands for the everyday actions of retailers which are analysed through interviews of nine retailers. The gap between the strategic plans and operational actions is described and analysed to understand why and how the gap exists (...) and what could be done to overcome the gap in the future. (shrink)

Workplace‐collected blood spots deposited on filter paper were analysed with multiplexed affinity‐based protein assays and found to be suitable for proteomics analysis. The protein extension assay (PEA) was used to characterize 92 proteins using 1.2 mm punches in repeated samples collected from 20 workers. Overall, 97.8% of the samples and 91.3% of the analysed proteins passed quality control. Both within and between spot correlations using six replicates from the same individual were above 0.99, suggesting that comparable levels are obtained from (...) multiple punches from the same spot and from consecutive spots. Protein levels from dried blood and wet serum from the same individuals were compared and the majority of the analysed proteins were found to be significantly correlated. These results open up for simplified sample collection of blood in field conditions for proteomic analysis, but also highlight that not all proteins can be robustly measured from dried whole blood. (shrink)

This is a descriptive and detailed revision of qualitative investigations of coping styles and strategies; academic performance of adolescent students. It considered both, independent and correlational studies among the two variables. Different data bases were revised like Dialnet, Redalyc, Scielo y Science Direct. 479 articles were obtained from these, 46 of these responded to the selection criteria that entailed (research article, indexed journal, adolescents). Alongside this search there was a prevalence of the studies related to different variables and their relationship (...) with coping styles and strategies. The studies present common results in terms of positive correlations between active coping styles and well being. (shrink)

Freedom and the subject were guiding themes for Michel Foucault throughout his philosophical career. In this clear and comprehensive analysis of his thought, Johanna Oksala identifies the different interpretations of freedom in his philosophy and examines three major divisions of it: the archaeological, the genealogical, and the ethical. She shows convincingly that in order to appreciate Foucault's project fully we must understand his complex relationship to phenomenology, and she discusses Foucault's treatment of the body in relation to recent feminist (...) work on this topic. Her sophisticated but lucid book illuminates the possibilities that Foucault's philosophy opens up for us in thinking about freedom. (shrink)

A growing number of decision theorists have, in recent years, defended the view that rationality is permissive under risk: Different rational agents may be more or less risk-averse or risk-inclined. This can result in them making different choices under risk even if they value outcomes in exactly the same way. One pressing question that arises once we grant such permissiveness is what attitude to risk we should implement when choosing on behalf of other people. Are we permitted to implement any (...) of the rationally permissible risk attitudes, is there some specific risk attitude that is required when choosing for others, or are we required to defer to the risk attitudes of the people on whose behalf we are choosing? This article elaborates on this question, explains its wider practical and theoretical significance, provides an overview of existing answers, and explores how to go about providing a more systematic account of how to choose on behalf of others in risky contexts. (shrink)

This article argues that Lara Buchak’s risk-weighted expected utility (REU) theory fails to offer a true alternative to expected utility theory. Under commonly held assumptions about dynamic choice and the framing of decision problems, rational agents are guided by their attitudes to temporally extended courses of action. If so, REU theory makes approximately the same recommendations as expected utility theory. Being more permissive about dynamic choice or framing, however, undermines the theory’s claim to capturing a steady choice disposition in the (...) face of risk. I argue that this poses a challenge to alternatives to expected utility theory more generally. (shrink)

Some scientists are happy to follow in the footsteps of others; some like to explore novel approaches. It is tempting to think that herein lies an epistemic division of labor conducive to overall scientific progress: the latter point the way to fruitful areas of research, and the former more fully explore those areas. Weisberg and Muldoon’s model, however, suggests that it would be best if all scientists explored novel approaches. I argue that this is due to implausible modeling choices, and (...) I present an alternative ‘epistemic landscape’ model that demonstrates the alleged benefits from division of labor, with one restriction. (shrink)

The paper aims to contribute to the ongoing conversation on critical phenomenology with reflections on its method. The key argument is that critical phenomenology should be understood as a form of historico-transcendental inquiry and therefore it cannot forgo the phenomenological reduction. Rather, this methodological step should be centered in critical phenomenology, and appropriated in problematized and rethought forms. The methodological assessment of critical phenomenology has implications also for how we read its canon. The paper shows that while Simone de Beauvoir (...) did not adopt the phenomenological reduction in its full Husserlian meaning, her analyses of experience did not remain on the level of personal or experiential description either. The contention is that if we want to read her as a critical phenomenologist, we should focus on her seminal modification of the historico-transcendental method of phenomenology. (shrink)

This paper defends revealed preference theory against a pervasive line of criticism, according to which revealed preference methodology relies on appealing to some mental states, in particular an agent’s beliefs, rendering the project incoherent or unmotivated. I argue that all that is established by these arguments is that revealed preference theorists must accept a limited mentalism in their account of the options an agent should be modelled as choosing between. This is consistent both with an essentially behavioural interpretation of preference (...) and with standard revealed preference methodology. And it does not undermine the core motivations of revealed preference theory. (shrink)

How is feminist metaphysics possible? -- In defense of experience -- Foucault and experience -- The problem of language -- A phenomenology of birth -- A phenomenology of gender -- The neoliberal subject of feminism -- Feminism and neoliberal governmentality -- Feminist politics of inheritance.

Ontic structural realists hold that structure is all there is, or at least all there is fundamentally. This thesis has proved to be puzzling: What exactly does it say about the relationship between objects and structures? In this article, I look at different ways of articulating ontic structural realism in terms of the relation between structures and objects. I show that objects cannot be reduced to structure, and argue that ontological dependence cannot be used to establish strong forms of structural (...) realism. At the end, I show how a weaker, but controversial, form of structural realism can be articulated on the basis of ontological dependence. (shrink)

General Process Theory (GPT) is a new (non-Whiteheadian) process ontology. According to GPT the domains of scientific inquiry and everyday practice consist of configurations of ‘goings-on’ or ‘dynamics’ that can be technically defined as concrete, dynamic, non-particular individuals called general processes. The paper offers a brief introduction to GPT in order to provide ontological foundations for research programs such as interactivism that centrally rely on the notions of ‘process,’ ‘interaction,’ and ‘emergence.’ I begin with an analysis of our common sense (...) concept of activities, which plays a crucial heuristic role in the development of the notion of a general process. General processes are not individuated in terms of their location but in terms of ‘what they do,’ i.e., in terms of their dynamic relationships in the basic sense of one process being part of another. The formal framework of GPT is thus an extensional mereology, albeit a non-classical theory with a non-transitive part-relation. After a brief sketch of basic notions and strategies of the GPT-framework I show how the latter may be applied to distinguish between causal, mechanistic, functional, self-maintaining, and recursively self-maintaining interactions, all of which involve ‘emergent phenomena’ in various senses of the term. (shrink)

Ariane Fischer, David Woodruff, and Johanna Bockman have translated Karl Polanyi’s “Sozialistische Rechnungslegung” [“Socialist Accounting”] from 1922. In this article, Polanyi laid out his model of a future socialism, a world in which the economy is subordinated to society. Polanyi described the nature of this society and a kind of socialism that he would remain committed to his entire life. Accompanying the translation is the preface titled “Socialism and the embedded economy.” In the preface, Bockman explains the historical context (...) of the article and its significance to the socialist calculation debate, the social sciences, and socialism more broadly. Based on her reading of the accounting and society that Polanyi offers here, Bockman argues that scholars have too narrowly used Polanyi’s work to support the Keynesian welfare state to the exclusion of other institutions, have too broadly used his work to study social institutions indiscriminately, and have not recognized that his work shares fundamental commonalities with and often unacknowledged distinctions from neoclassical economics. (shrink)

Behavioural economics has taught us that human agents don't always display consistent, context-independent and stable preferences in their choice behaviour. Can we nevertheless do welfare economics...

Philosophy &Public Affairs, Volume 52, Issue 1, Page 5-41, Winter 2024.

In this paper I aim to answer two questions: Can spin be treated as a determinable? Can a treatment of spin as a determinable be used to understand quantum indeterminacy? In response to the first question I show that the relations among spin number, spin components and spin values cannot be captured by a single determination relation; instead we need to look at spin number and spin value separately. In response to the second question I discuss three ways in which (...) the determinables model might be modified to account for indeterminacy, and argue that none of them is fully successful in helping us to understand quantum indeterminacy. (shrink)

This chapter engages with Roger Cotterrell's characterisation of the trust as 'ideological.' However, rather than agreeing with Cotterrell that the trust disguises the true ownership of the beneficiary, it shows that the family trust subverts this idea of a one-sided ownership relation altogether by effecting a reversal in the hierarchical distinction between persons and things. Under the appearance of wealth, beneficial owners are serving the very things they own by ensuring their protection and continuous reproduction.

In her Choosing Well, Chrisoula Andreou puts forth an account of instrumental rationality that is revisionary in two respects. First, it changes the goalpost or standard of instrumental rationality to include “categorial” appraisal responses, alongside preferences, which are relational. Second, her account is explicitly diachronic, applying to series of choices as well as isolated ones. Andreou takes both revisions to be necessary for dealing with problematic choice scenarios agents with disorderly preferences might find themselves in. Focusing on problem cases involving (...) cyclical preferences, I will first argue that her first revision is undermotivated once we accept the second. If we are willing to grant that there are diachronic rationality constraints, the preference-based picture can get us further than Andreou acknowledges. I will then turn to present additional grounds for rejecting the preference-based picture. However, these grounds also seem to undermine Andreou’s own appeal to categorial appraisal responses. (shrink)

This important new collection considers Jurgen Habermas's discourse theory from a variety of feminist vantage points. Feminist scholars have been drawn to Habermas's work because it reflects a tradition of emancipatory political thinking rooted in the Enlightenment and engages with the normative aims of emancipatory social movements. The essays in Feminists Read Habermas analyze various aspects of Habermas's work, ranging from his moral theory to political issues of identity and participation. The contributors share a conviction about the potential significance of (...) Habermas's work for feminist reflections on power, norms and subjectivity. (shrink)

Background Moral courage means courage to act according to individual’s own ethical values and principles despite the risk of negative consequences for them. Research about the moral courage of whistle-blowers in health care is scarce, although whistleblowing involves a significant risk for the whistle-blower. Objective To analyse the moral courage of potential whistle-blowers and its association with their background variables in health care. Research design Was a descriptive-correlational study using a questionnaire, containing Nurses Moral Courage Scale©, a video vignette of (...) the wrongdoing situation with an open question about the vignette, and several background variables. Data were analysed statistically and inductive content analysis was used for the narratives. Participants and research context Nurses as healthcare professionals (including registered nurses, public health nurses, midwives, and nurse paramedics) were recruited from the membership register of the Nurses’ Association via email in 2019. A total of 454 nurses responded. The research context was simulated using a vignette. Ethical considerations Good scientific inquiry guidelines were followed. Permission to use the Nurses’ Moral Courage Scale© was obtained from the copyright holder. The ethical approval and permission to conduct the study were obtained from the participating university and the Nurses’ Association. Findings The mean value of potential whistle-blowers’ moral courage on a Visual Analogue Scale (0–10) was 8.55 and the mean score was 4.34 on a 5-point Likert scale. Potential whistle-blowers’ moral courage was associated with their socio-demographics, education, work, personality and social responsibility related background variables. Discussion and conclusion In health care, potential whistle-blowers seem to be quite morally courageous actors. The results offer opportunities for developing interventions, practices and education to support and encourage healthcare professionals in their whistleblowing. Research is needed for developing a theoretical construction to eventually increase whistleblowing and decrease and prevent wrongdoing. (shrink)

This thesis promotes a therapeutic revision of fundamental assumptions in contemporary ontological thought. I show that none of the extant standard theories of objects provides a viable account of the numerical, qualitative, and trans-temporal identity of objects, and that this is due to certain substance-ontological premises. I argue that in order to state the identity conditions of objects we must abandon these premises, together with the idea that objects enjoy ontological primacy. ;I follow a methodological program of formally criticizing an (...) ontological framework by demonstrating that each of the theories developed within this framework is incoherent, i.e., either inconsistent or subject to vicious regress. I proceed in three steps. First, I show that the substance-ontological paradigm cannot be characterized in terms of its basic entities, since there is no extensional, intensional, or functional definition of the notion of substance common to all extant substance ontologies; consequently, I propose to describe the substance-ontological paradigm in terms of its basic assumptions. ;Second, I analyze the contemporary discussion of the problem of individuality, the problem of universals, and the problem of persistence, and uncover 22 characteristic implicit assumptions of substance ontology. I show on the basis of representative examples that, due to their commitment to substance-ontological presuppositions, all extant types of solutions to the three mentioned problems are incoherent. In particular, I take issue with the bare particular view, the qualified particular view, and the bundle view of individuality; different varieties of platonist and nominalist theories of universals and of relational and functional theories of predication; and the endurance and perdurance approaches to persistence. ;Third, while historical process-ontological schemes have dropped some of the revealed substance-ontological presuppositions, I finally explore the result of rejecting all of them and sketch a scheme based on dynamic masses which promises to yield coherent explanations of the ontological features of those complex processes which we commonly consider to be objects. (shrink)

The paper presents some essential heuristic and constructional elements of Free Process Theory (FPT), a non-Whiteheadian, monocategoreal framework. I begin with an analysis of our common sense concept of activities, which plays a crucial heuristic role in the development of the notion of a free process. I argue that an activity is not a type but a mode of occurrence, defined in terms of a network of inferences. The inferential space characterizing our concept of an activity entails that anything which (...) is conceived of as occurring in the activity mode is a concrete,dynamic, non-particular individual. Such individuals, which I call free processes, may be used for the interpretation of much more than just common sense activities. I introduce the formal theory FPT, a mereology with anon-transitive part-relation, which contains a typology of processes based on the following five parameters relating to: (a) patterns of possible spatial and temporal recurrence (automerity); (b) kinds of components (participant structure); (c) kinds of dynamic composition; (d) kinds of dynamic flow (dynamic shape); and (e) dynamic context. I show how these five evaluative dimensions for free processes can be used to define ontological correlates for various common sense categories,and to draw distinctions between various forms of agency(distributed, collective, reciprocal, entangled) and emergence (weak, strong,as autonomous system (Bickhard/Christensen)). (shrink)

Risk-weighted expected utility theory is motivated by small-world problems like the Allais paradox, but it is a grand-world theory by nature. And, at the grand-world level, its ability to handle the Allais paradox is dubious. The REU model described in Risk and Rationality turns out to be risk-seeking rather than risk-averse on one natural way of formulating the Allais gambles in the grand-world context. This result illustrates a general problem with the case for REU theory, we argue. There is a (...) tension between the small-world thinking marshaled against standard expected utility theory, and the grand-world thinking inherent to the risk-weighted alternative. (shrink)

This article analyzes the legal-philosophical situation of Artificial Intelligence and the intelligent robot on being a subject of Law to be considered a creative person or author. The contradiction involved in allowing an object to present the legal duality of being protected as an object that it is and at the same time being considered a subject by the resulting work is analyzed, an impairment or vulgarization for the subject of Law as a moral subject when proposing the fictio legis (...) de a moral object, which is not conceivable. Instead, an alternative to such an aporia is proposed, more fictitious than real. (shrink)

We explore aversion to the use of algorithms in moral decision-making. So far, this aversion has been explained mainly by the fear of opaque decisions that are potentially biased. Using incentivized experiments, we study which role the desire for human discretion in moral decision-making plays. This seems justified in light of evidence suggesting that people might not doubt the quality of algorithmic decisions, but still reject them. In our first study, we found that people prefer humans with decision-making discretion to (...) algorithms that rigidly apply exogenously given human-created fairness principles to specific cases. In the second study, we found that people do not prefer humans to algorithms because they appreciate flesh-and-blood decision-makers per se, but because they appreciate humans’ freedom to transcend fairness principles at will. Our results contribute to a deeper understanding of algorithm aversion. They indicate that emphasizing the transparency of algorithms that clearly follow fairness principles might not be the only element for fostering societal algorithm acceptance and suggest reconsidering certain features of the decision-making process. (shrink)

The ever increasing ability of medical technology to reshape the human body in fundamental ways—from organ and tissue transplants to reconstructive surgery and prosthetics—is something now largely taken for granted. But for a philosopher, such interventions raise fundamental and fascinating questions about our sense of individual identity and its relationship to the physical body. Drawing on and engaging with philosophers from across the centuries, Jenny Slatman here develops a novel argument: that our own body always entails a strange dimension, (...) a strangeness that enables us to incorporate radical physical changes. (shrink)

"As a doctor, I make every effort to strengthen the belief in immortality, especially with older patients when such questions come threateningly close. For, seen in correct psychological perspective, death is not an end but a goal, and life's inclination towards death begins as soon as the meridian is past."--C.G. Jung, commentary on The Secret of the Golden FlowerHere collected for the first time are Jung's views on death and immortality, his writings often coinciding with the death of the most (...) significant people in his life. The book shows many of the major themes running throughout the writings, including the relativity of space and time surrounding death, the link between transference and death, and the archetypes shared among the world's religions at the depths of the Self. The book includes selections from "On Resurrection," "The Soul and Death," "Concerning Rebirth," "Psychological Commentary on The Tibetan Book of the Dead" from the Collected Works, "Letter to Pastor Pfafflin" from Letters, and "On Life after Death.". (shrink)

Judgementalism is an interpretation of normative decision theory according to which preferences are all-things-considered judgements of relative desirability, and the only attitudes that rationally constrain choice. The defence of judgementalism we find in Richard Bradley’s Decision Theory with a Human Face relies on a kind of internalism about the requirements of rationality, according to which they supervene on an agent’s mental states, and in particular those she can reason from. I argue that even if we grant such internalism, attitudes other (...) than preferences in the judgementalist sense rationally constrain choice. This ultimately supports a different interpretation of preference. (shrink)

The article asks how phenomenology, understood as a philosophical method of investigation, can account for gender. Despite the fact that it has provided useful tools for feminist inquiry, the question remains how gender can be studied within the paradigm of a philosophy of a subject. The article explicates four different understandings of phenomenology and assesses their respective potential in terms of theorizing gender: a classical reading, a corporeal reading, an intersubjective reading and a post-phenomenological reading. It concludes by arguing that (...) phenomenology can extend its analysis to the question of gender only if its method is radically revised. (shrink)

Many current problems surrounding science revolve around the complex epistemological framework that shapes a new vision of knowledge about reality. The traditional epistemological positions are characterized by the explanation of nature by means of concatenated facts; that is, as bricks attached to each other giving shape to the edifice of science. A conception of this nature showed that the idea of certainty was nothing more than a mere illusion, opening the way, on the contrary, to the idea of the uncertainty (...) of knowledge based on the descriptions of quantum physics, also a product of the non-reductionist conception of reality, thus criticizing the specular representation. This article addresses the main problems surrounding the critical conceptions that the emerging epistemology reveals about knowledge, pointing towards a much more complex vision of reality. (shrink)

Ethics is a foundational competency in healthcare inherent in everyday nursing practice. Therefore, the promotion of qualified nurses’ and nursing students’ moral competence is essential to ensure ethically high-quality and sustainable healthcare. The aim of this integrative literature review is to identify the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence. The review has been registered in PROSPERO (CRD42023386947) and reported according to the PRISMA guideline. Focusing on qualified nurses’ and nursing students’ moral competence, a (...) literature search was undertaken in January 2023 in six scientific databases: CINAHL, Cochrane Library, PsycINFO, PubMed Medline, Scopus and Web of Science. Empirical studies written in English without time limitation were eligible for inclusion. A total of 29 full texts were retrieved and included out of 5233 citations. Quality appraisal was employed using Joanna Briggs Institute checklists and the Mixed Method Appraisal Tool. Data were analysed using inductive content analysis. Research about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence is limited and mainly explored using descriptive research designs. The contributing factors were identified as comprising two main categories: (1) human factors, consisting of four categories: individual, social, managerial and professional factors, and ten sub-categories; and (2) structural factors, consisting of four categories: educational, environmental, organisational and societal factors, and eight sub-categories. This review provides knowledge about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence for the use of researchers, nurse educators, managers, organisations and policymakers. More research about the contributing factors is needed using complex intervention, implementation and multiple methods designs to ensure ethically sustainable healthcare. (shrink)

This article defends the theoretical centrality of Michel Foucault’s account of subjectivation for critical responses to neoliberalism against those Marxist critics who claim that his focus on the subject pushed the Left into the fraught terrain of identity politics. A key contention is that a theoretically sophisticated account of subjectivation is a requisite for any philosophically coherent and politically effective theorization of resistance against neoliberalism. Critical accounts of neoliberal subjectivation must be recognized as indispensable for understanding the conditions of possibility (...) for class struggle and not as an alternative theoretical frame to it. The article also relates Foucault’s and Karl Marx’s thought on the question of power and its relationship to the subject. It presents a reading of Foucault as a post-Marxist who modified, rejuvenated, and extended Marx’s views on power and subjectivation. While Foucault developed his understanding of subjectivation as a critical response to the problems he identified in the French Marxist accounts of his time—particularly in the work of Louis Althusser—his appropriation of Marx should be recognized as decisive for the development of his account of productive power and the concomitant understanding of the subject. (shrink)

Realists about science tend to hold that our scientific theories aim for the truth, that our successful theories are at least partly true, and that the entities referred to by the theoretical terms of these theories exist. Antirealists about science deny one or more of these claims. A sizable minority of philosophers of science prefers not to take sides: they believe the realism debate to be fundamentally mistaken and seek to abstain from it altogether. In analogy with other realism debates (...) I will call these philosophers quietists. In the philosophy of science quietism often takes a somewhat peculiar form, which I will call naturalistic quietism. In this paper I will characterize Maddy’s Second Philosophy as a form of naturalistic quietism, and show what the costs for making it feasible are. (shrink)

In her book, Oksala shows that the arguments for the ineliminability of violence from the political are often based on excessively broad, ontological conceptions of violence distinct from its concrete and physical meaning and, on the other hand, on a restrictively narrow and empirical understanding of politics as the realm of conventional political institutions.