Collaboration among nurses and other healthcare professionals is needed for effective hospital discharge planning. However, interprofessional interactions and practices related to discharge vary within and across hospitals. These interactions are influenced by the ways in which healthcare professionals’ roles are being shaped by hospital discharge priorities. This study explored the experience of bedside nurses’ interprofessional collaboration in relation to discharge in a general medicine unit. An ethnographic approach was employed to obtain an in‐depth insight into the perceptions and practices of (...) nurses and other healthcare professionals regarding collaborative practices around discharge. Sixty‐five hours of observations was undertaken, and 23 interviews were conducted with nurses and other healthcare professionals. According to our results, bedside nurses had limited engagement in interprofessional collaboration and discharge planning. This was apparent by bedside nurses’ absence from morning rounds, one‐way flow of information from rounds to the bedside nurses following rounds, and limited opportunities for interaction with other healthcare professionals and decision‐making during the day. The disconnection, disempowerment and devaluing of bedside nurses in patient discharge planning has implications for quality of care and nursing work. Study findings are positioned within previous work on nurse–physician interactions and the current context of nursing care. (shrink)

RESUMEN D. Pritchard ha sostenido que el conocimiento requiere la satisfacción de una condición de habilidad y una anti-suerte que no guardan relación de implicación entre sí. Se sostiene que la satisfacción de una condición anti-suerte implica cumplir con la condición de habilidad, primero, porque, las características centrales del caso de D. Pritchard en contra de esta implicación son compartidas con casos en los que hay habilidad; y segundo, el caso de A. Goldman del dios benevolente es más efectivo (...) que TEMP, pero involucra un tipo de seguridad diferente a la requerida para el conocimiento. Por último, se muestra que la respuesta de D. Pritchard al problema de la generalidad bloquea la implicación de seguridad a habilidad. Se propone un contraejemplo, adaptando un caso tomado de la epistemología del testimonio. ABSTRACT D. Pritchard holds that knowledge requires the satisfaction of an ability condition and an anti-luck condition that bear no relation of implication to each other. The article argues that the satisfaction of the anti-luck condition implies satisfying the ability condition for two reasons: first, that the main characteristics of Pritchard's case against this implication are shared by cases in which there is ability; and, second, that although A. Goldman's benevolent demon case is more effective than TEMP, it involves a different type of certainty than that required for knowledge. Finally, the article shows that Pritchard's response to the generality problem blocks the implication between certainty and ability, and proposes a counterexample that draws on the epistemology of testimony. (shrink)

In recent decades, epistemology has witnessed the development and growth of externalist theories of knowledge and justification. Critics of externalism have focused a bright spotlight on this approach and judged it unsuitable for realizing the true and original goals of epistemology. Their own favored approach, internalism, is defended as a preferable approach to the traditional concept of epistemic justification. I shall turn the spotlight toward internalism and its most prominent rationale, revealing fundamental problems at the core of internalism and challenging (...) the viability of its most popular rationale. Although particular internalist theories such as (internalist) foundationalism and coherentism will occasionally be discussed, those specific theories are not my primary concern. The principal concern is rather the general architecture of internalism, and the attempt to justify this architecture by appeal to a certain conception of what justification consists in. (shrink)

In his doctoral dissertation, O. Chateaubriand favored Dedekind’s analysis of the notion of number; whereas in Logical Forms, he favors a fregean approach to the topic. My aim in this paper is to examine the kind of logicism he defends. Three aspects will be considered: the concept of analysis; the universality of arithmetical properties and their definability; the irreducibility of arithmetical objects.

This paper supports the basic integrity of the folk psychological conception of consciousness and its importance in cognitive theorizing. Section 1 critically examines some proposed definitions of consciousness, and argues that the folk- psychological notion of phenomenal consciousness is not captured by various functional-relational definitions. Section 2 rebuts the arguments of several writers who challenge the very existence of phenomenal consciousness, or the coherence or tenability of the folk-psychological notion of awareness. Section 3 defends a significant role for phenomenal consciousness (...) in the execution of a certain cognitive task, viz., classification of one's own mental states. Execution of this task, which is part of folk psychologizing, is taken as a datum in scientific psychology. It is then argued that the most promising sort of scientific model of the self-ascription of mental states is one that posits the kinds of phenomenal properties invoked by folk psychology. Cognitive science and neuroscience can of course refine and improve upon the folk understanding of consciousness, awareness, and mental states generally. But the folk-psychological constructs should not be jettisoned; they have a role to play in cognitive theorizing. (shrink)

This is the editorial introduction to the four papers on consciousness comprising the July 2014 issue of Essays in Philosophy (vol. 15, issue 2). The four authors are Keith E. Turausky, John K. Grandy, Adam Green, and Ben Gubran.

Dedekind’s methodology, in his classic booklet on the foundations of arithmetic, has been the topic of some debate. While some authors make it closely analogue to Hilbert’s early axiomatics, others emphasize its idiosyncratic features, most importantly the fact that no axioms are stated and its careful deductive structure apparently rests on definitions alone. In particular, the so-called Dedekind “axioms” of arithmetic are presented by him as “characteristic conditions” in the _definition_ of the complex concept of a _simply infinite_ system. Making (...) sense of Dedekind’s method may be dependent on an analysis of the classical model of deductive science, as presented by authors from the eighteenth and early nineteenth centuries. Studying the modern reconstructions of Euclidean geometry, we show that they did not presuppose deductive independence of the axioms from the definitions. Authors like Wolff elaborated a mathematics _based on definitions_, and the Wolffian model of deductive science shows significant coincidences with Dedekind’s method, despite the great differences in content and approach. Wolff had a conception of definitions as _genetic_, which bears some similarities with Kant’s idea of synthetic definitions: they are understood as positing the content of mathematical concepts and introducing thought objects (_Gedankendinge_) that are the objects of mathematics. The emphasis on the spontaneity of the understanding, which can be found in this philosophical tradition, can also be fruitfully related with Dedekind’s idea of the “free creation” of mathematical objects. (shrink)

A conception of social epistemology is articulated with links to studies of science and opinion in such disciplines as history, sociology, and political science. The conception is evaluative, though, rather than purely descriptive. Three types of evaluative approaches are examined but rejected: relativism, consensualism, and expertism. A fourth, truth-linked, approach to intellectual evaluation is then advocated: social procedures should be appraised by their propensity to foster true belief. Standards of evaluation in social epistemics would be much the same as those (...) in individual epistemics, only the objects of evaluation would be interpersonal patterns of judgment and communication, and institutional practices that bear on opinion formation. (shrink)

Epistemology has had a strongly individualist orientation, at least since Descartes. Knowledge, for Descartes, starts with the fact of one’s own thinking and with oneself as subject of that thinking. Whatever else can be known, it must be known by inference from one’s own mental contents. Achieving such knowledge is an individual, rather than a collective, enterprise. Descartes’s successors largely followed this lead, so the history of epistemology, down to our own time, has been a predominantly individualist affair.

This paper addresses the emergence of the ‘death drive’ in Sigmund Freud’s later work, and thesignificance of this development for his psychoanalytic theory as a whole. In particular, the paper arguesthat the ‘death drive’ is a pivotal concept, articulating a connection between what are commonlyunderstood as the ‘lower’ and ‘higher’ functions of the psyche. Moreover, the death drive is pivotal in asecond sense, in that it articulates a turn away from the strictly empirical realm of science, to a dark andobscure (...) field indicated , but not comprehended, by observable phenomena. Finally, thepaper suggests that as Freud’s departure from his scientific methodology into the wilderness of speculation,the death drive represents his most valuable contribution to psychoanalysis. With the death drive, Freud isable to engender a new perspective of human being: one that is not already encompassed by themechanistic neurological viewpoint from which his researches first issued. (shrink)

‘Medically unexplained symptoms’, through the lens of the biopsychosocial model, are understood in mainstream psy disciplines and related literature as a primarily psychosocial phenomenon perpetuated by ‘dysfunctional’ psychology on the part of people labelled with such. Biopsychosocial discourse and practice in this field, underpinned by little empirical foundation and lacking theoretical coherency, are associated with harms sustained by people labelled with MUS. Yet, little attention is paid to the psychology of social actors and institutions whose practice and policy derives from (...) biopsychosocial theorising, or whose vested interests produce such theorising. This article contends that lack of reflexivity among psy practitioners and other social actors on individual, institutional and structural levels furthers biopsychosocial hegemony and contributes to harms. Non-reflexive behaviour on the part of practitioners within clinical and ‘therapeutic’ encounters and on the part of social actors within institutions and broader power structures is examined, and possible psychological underpinnings of non-reflexivity are explored. Notably, the concept of gain, drawn from dominant discourse around MUS, is applied broadly to explore what might be gained from eschewing reflexivity and from adhering to biopsychosocial narratives. Implications for practice, supervision, training and research are discussed, notably highlighting a need for critical reflexivity in all domains. (shrink)

This article aims to say what democracy is or what the predicate ‘democratic’ means, as opposed to saying what is good, right, or desirable about it. The basic idea—by no means a novel one—is that a democratic system is one that features substantial equality of political power. More distinctively it is argued that ‘democratic’ is a relative gradable adjective, the use of which permits different, contextually determined thresholds of democraticness. Thus, a system can be correctly called ‘democratic’ even if it (...) does not feature perfect equality of power. The article's central undertaking is to give greater precision to the operative notion of power. No complete or fully unified measure of power is offered, but several conceptual tools are introduced that help give suitable content to power measurement. These tools include distinctions between conditional versus unconditional power and direct versus indirect power. Using such tools, a variety of prima facie problems for the power equality approach are addressed and defused. Finally, the theory is compared to epistemic and deliberative approaches to democracy; and reasons are offered for the attractiveness of democracy that flows from the power equality theme. (shrink)

The frontispiece of Hobbes's Leviathan is justly renowned as a powerful visual advertisement for his political philosophy. Consequently, its rich imagery has been the subject of extensive scholarly commentary. Surprisingly, then, its gendered dimensions have received relatively limited attention. This essay explores this neglected facet of the frontispiece. I argue that the image initially appears to present a hypermasculine sovereign. However, upon closer inspection, and considered alongside Hobbes's economic theory, it yields to a reading of the sovereign as an ambiguously (...) gendered figure. Reading the frontispiece through the prism of gender and the economy reveals not a static image of unwavering male power but rather one of an equivocally-sexed creature teeming with life, contradictions, and complexities worthy of continued examination. (shrink)

Inhaltsverzeichnis/Table of Contents Abhandlungen/Articles Massimiliano Vignolo: Why Non-Factualists Should Love Conceptual Role Semantics Jeffrey Goodman: Fictionalia as Modal Artifacts Alberto Voltolini: Against Against Fictional Realism Roderick Batchelor: Grounds and Consequences Timm Lampert and Michael Baumgartner: The Problem of Validity Proofs Ish Haji: On the Direct Argument for the Incompatibility of Determinism and Moral Responsibility Matthias Neuber: Philosophie der modernen Physik ¿ Philipp Frank und Abel Rey Nicola Mössner: Testimoniale Akte neu definiert ¿ ein zentrales Problem des Zeugnisses Anderer Simon (...) Dierig: Goldmans Scheunen-Beispiel und das Problem der Vereinbarkeit von Externalismus und Selbstkenntnis Diskussionen/Discussions Essay-Wettbewerb/Essay Competition Besprechungen/Review Essays Buchnotizen/Critical Notes Eingelangte Bücher/Books Received. (shrink)

As the Roman philosopher Lucretius asked, why do we fear and regret death, but do not regret not having been born earlier, when death and prenatal nonexistence are mirror images? Both deprive us of goods we might have had, and this deprivation most plausibly explains the badness of death. This paper first considers and rejects explanations other than the deprivation of goods. It then suggests an explanation in terms of a state of which death deprives us, and which is itself (...) asymmetrical in regard to the future and the past. This sharp asymmetry in this one very important good helps to justify the difference in our attitudes, especially among those for whom death approaches. The paper departs from the usual rigid format in which a philosopher says what she is going to say, then says it, and then repeats it. In matching form to mystery content, the missing clue to the solution will not be revealed until later in the paper. (shrink)

This paper criticizes the account of desire defended by Nomy Arpaly and Timothy Schroeder in their recent book, In Praise of Desire. It contrasts their account with one that I favor, a cluster analysis listing various criteria that are together sufficient for having paradigm desires, but none of which is necessary or sufficient for desiring. I argue that their account fails to state necessary or sufficient conditions, that it is explanatorily weaker than the cluster account, that it fails to provide (...) a neat reduction of desires to neurophysical terms, and that in any case such a reduction is not required for the preservation of the concept of desire in mature psychology. Implications are drawn for the broader debate between reductionists, eliminativists, and defenders of folk psychological concepts. (shrink)