For many children with complex medical conditions, decisions regarding their goals of care lie in the zone of parental discretion. That is, clinicians appropriately recognize that in many cases whether to prioritize quantity of life or quality of life is a deeply personal, values-laden decision best made by those who are most deeply invested in the outcome. Once a family has committed to a goal, however, there may be new or ongoing conflict between parents and clinicians regarding the specific interventions (...) provided or not provided in support of that goal. To what extent is it ethically permissible for a seriously ill child’s surrogate decision makers to reject individual interventions that support their desired goal of care? This question might be best described thus: is pediatric healthcare “prix fixe,” in which clinicians help parents decide the best of one or more set combinations (“menus”) of interventions, or is it “à la carte,” in which parents are free to accept or reject each individual intervention? We argue that the concept of a “prix fixe” approach should be discussed with families early in the development of the clinical relationship, as an essential facet of shared decision making. (shrink)

Money is a symbol. Beginning with this simple notion, we have completed a qualitative study of how money exists in people’s everyday lives and how it is used symbolically. A review of the financial, economic, psychological, and semiotic literature shows that even though money is written and talked about exhaustively, little symbol theory appears in economic writing, and we rarely found money mentioned in semiotic texts. We used a qualitative, phenomenological approach to identify critical thematic elements and underlying structures of (...) participants’ experience. We also incorporated an accepted symbol-structure template in our analysis of the functions, emotions, actions, and reactions in the transactions our participants described. Participants refer to money both as wealth in the abstract and as concrete amounts about to be used. Our analysis of money in the abstract describes a structure of experience involving belonging, privacy and secrecy, unequal distribution, quantitative uncertainty, reflections of life history, and values. Our analysis of money in the concrete reveals a symbolic intention and a variety of “Others” engaged in the symbolic action. (shrink)

Background: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. Research question: This article reports on one component and dataset from a larger study – ‘the positives, perils and pitfalls of Facebook for nurses’. It explores the specific (...) issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. Participants: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and ‘snowballed’ through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 (66.9%) completed surveys and 54 partially (33.1%) completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. Ethical considerations: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. Findings/results: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme ‘blurred boundaries’ was generated, which comprised three sub-themes: ‘follow the science, ‘abuse of power and erosion of trust’ and ‘the moral and ethical responsibility to safeguard public health’. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to promulgate anti-vaccination messages and/or give medical advice online. Conclusion: There are many positives and negatives for nurses and midwives associated with using Facebook for personal and professional communication, which is in keeping with the results of the larger study from which this article is taken. Professional behaviour is a key theme in the larger research as is the ethical construct of ‘every act has a consequence’; however, in this article, the theme ‘blurred boundaries’ offers an overall understanding of how nurses and midwives interpret the behaviour of their colleagues who espouse anti-vaccination sentiment and/or give medical advice online that is outside their scope of practice and education. (shrink)

Background Families whose child has unexplained intellectual or developmental differences often hope that a genetic diagnosis will lower barriers to community-based therapeutic and support services. However, there is little known about efforts to mobilize genetic information outside the clinic or how socioeconomic disadvantage shapes and constrains outcomes.Methods We conducted an ethnographic study with predominantly socioeconomically disadvantaged families enrolled in a multi-year genomics research study, including clinic observations and in-depth interviews in English and Spanish at multiple time points. Coding and thematic (...) development were used to collaboratively interpret fieldnotes and transcripts.Results Thirty-two families participated. Themes included familial expectations that a genetic diagnosis could be translated into information, understanding, and assistance to improve the quality of a child’s day-to-day life. After sequencing, however, genetic information was not readily converted into improved access to services beyond the clinic, with families often struggling to use a genetic diagnosis to advocate for their child.Conclusion Families’ ability to use a genetic diagnosis as an effective advocacy tool beyond the clinic was limited by the knowledge and resources available to them, and by the eligibility criteria used by therapeutic service providers’ – which focused on clinical diagnosis and functional criteria more than etiologic information. All families undertaking genomic testing, particularly those who are disadvantaged, need additional support to understand the limits and potential benefits of genetic information beyond the clinic. (shrink)

An individual's health, genetic, or environmental-exposure data, placed in an online repository, creates a valuable shared resource that can accelerate biomedical research and even open opportunities for crowd-sourcing discoveries by members of the public. But these data become “immortalized” in ways that may create lasting risk as well as benefit. Once shared on the Internet, the data are difficult or impossible to redact, and identities may be revealed by a process called data linkage, in which online data sets are matched (...) to each other. Reidentification, the process of associating an individual's name with data that were considered deidentified, poses risks such as insurance or employment discrimination, social stigma, and breach of the promises often made in informed-consent documents. At the same time, re-ID poses risks to researchers and indeed to the future of science, should re-ID end up undermining the trust and participation of potential research participants. The ethical challenges of online data sharing are heightened as so-called big data becomes an increasingly important research tool and driver of new research structures. Big data is shifting research to include large numbers of researchers and institutions as well as large numbers of participants providing diverse types of data, so the participants’ consent relationship is no longer with a person or even a research institution. In addition, consent is further transformed because big data analysis often begins with descriptive inquiry and generation of a hypothesis, and the research questions cannot be clearly defined at the outset and may be unforeseeable over the long term. In this article, we consider how expanded data sharing poses new challenges, illustrated by genomics and the transition to new models of consent. We draw on the experiences of participants in an open data platform—the Personal Genome Project—to allow study participants to contribute their voices to inform ethical consent practices and protocol reviews for big-data research. (shrink)

One barrier to optimal pain management in the neonatal intensive care unit (NICU) is how the healthcare community perceives, and therefore manages, neonatal pain. In this paper, we emphasise that healthcare professionals not only have a professional obligation to care for neonates in the NICU, but that these patients are intrinsically worthy of care. We discuss the conditions that make neonates worthy recipients of pain management by highlighting how neonates are (1) vulnerable to pain and harm, and (2) completely dependent (...) on others for pain management. We argue for a relational account of ethical decision-making in the NICU by demonstrating how an increase in vulnerability and dependence may be experienced by the healthcare community and the neonate’s family. Finally, an ethical framework for decisions around neonatal pain management is proposed, focussing on surrogate decision-making and the importance of compassionate action through both a reflective and an affective empathy. As empathy can be highly motivating against pain, we propose that, in addition to educational programs that raise awareness and knowledge of neonatal pain and pain management, healthcare professionals must cultivate empathy in a collective manner, where all members of the NICU team, including parents, are compassionate decision-makers. (shrink)

The two target articles in this issue bring into focus the struggle for governance over biomedical interventions that may offer some families more agency—the capacity to act—in the context of many...

_Black Intellectual Thought in Education_ celebrates the exceptional academic contributions of African-American education scholars Anna Julia Cooper, Carter G. Woodson, and Alain Leroy Locke to the causes of social science, education, and democracy in America. By focusing on the lives and projects of these three figures specifically, it offers a powerful counter-narrative to the dominant, established discourse in education and critical social theory--helping to better serve the population that critical theory seeks to advocate. Rather than attempting to "rescue" a (...) few African American scholars from obscurity or marginalization, this powerful volume instead highlights ideas that must be probed and critically examined in order to deal with prevailing contemporary educational issues. Cooper, Woodson, and Locke’s history of engagement with race, democracy, education, gender and life is a dynamic, demanding, and authentic narrative for those engaged with these important issues. (shrink)

Black Americans are underrepresented members of the US accounting academy (Brown-Liburd and Joe 2020). By interviewing Black accounting faculty about their experiences during their doctoral education and institutional hiring and promotion processes, we discover stories of degradation, stereotyping, and exclusion (i.e., microaggressions) that participants report negatively impact their views of the academic accounting profession and increase their turnover intentions. Microaggressions committed against Black accounting faculty may contribute to underrepresentation that can be addressed through enlightenment, education, and interaction. Our findings (...) are important as they fill gaps in related extant literature concerning the existence and impacts of microaggressions, and they may help improve diversity and equity in the accounting academy. (shrink)

Over the past decade, Canadian media coverage of street sex work has steadily increased. The majority of this interest pertains to graphic violence against street sex workers, most notably from Vancouver, British Columbia. In this article, the authors analyze newspaper coverage that appeared in western Canadian publications between 2006 and 2009. In theorizing the violence both depicted and perpetrated by newspapers, the authors propose an analytic framework capable of attending to the process of othering in all of its complexity. To (...) this end, the authors supplement a Foucauldian analysis of abjection by considering the work of Judith Butler along with Julia Kristeva's conceptualization of abjection. Using excerpts from western Canadian newspapers, the authors illustrate how the media's discursive practices function as triggers for the process of cultural abjection by inscribing street sex workers with images of defilement. The authors argue that newspaper coverage of street sex workers reinforces the inviolability of normalized life by constantly reiterating the horror reserved for abjected bodies. (shrink)

According to an increasingly popular epistemological view, people need outright beliefs in addition to credences to simplify their reasoning. Outright beliefs simplify reasoning by allowing thinkers to ignore small error probabilities. What is outright believed can change between contexts. It has been claimed that thinkers manage shifts in their outright beliefs and credences across contexts by an updating procedure resembling conditionalization, which I call pseudo-conditionalization (PC). But conditionalization is notoriously complicated. The claim that thinkers manage their beliefs via PC is (...) thus in tension with the view that the function of beliefs is to simplify our reasoning. I propose to resolve this puzzle by rejecting the view that thinkers employ PC. Based on this solution, I furthermore argue for a descriptive and a normative claim. The descriptive claim is that the available strategies for managing beliefs and credences across contexts that are compatible with the simplifying function of outright beliefs can generate synchronic and diachronic incoherence in a thinker’s attitudes. Moreover, I argue that the view of outright belief as a simplifying heuristic is incompatible with the view that there are ideal norms of coherence or consistency governing outright beliefs that are too complicated for human thinkers to comply with. (shrink)

There are many cases in which people collectively cause some morally significant outcome (such as a harmful or beneficial outcome) but no individual act seems to make a difference. The problem in such cases is that it seems each person can argue, ‘it makes no difference whether or not I do X, so I have no reason to do it.’ The challenge is to say where this argument goes wrong. My approach begins from the observation that underlying the problem and (...) motivating the typical responses to it is a standard, intuitive assumption. The assumption is that if an act will not make a difference with respect to an outcome, then it cannot play a sig- nificant, non-superfluous role in bringing that outcome about. In other words, helping to bring about an outcome requires making a difference. I argue that the key to solving the problem is to reject this assumption. I develop an account of what it is to help to bring about an outcome, where this does not require making a difference, and I use this explain our reasons for action in the problem cases. This account also yields an error theory that explains why the standard assumption is so tempting, even though it is mistaken. (shrink)

This paper proposes a novel answer to the question of what attitude agents should adopt when they receive misleading higher-order evidence that avoids the drawbacks of existing views. The answer builds on the independently motivated observation that there is a difference between attitudes that agents form as conclusions of their reasoning, called terminal attitudes, and attitudes that are formed in a transitional manner in the process of reasoning, called transitional attitudes. Terminal and transitional attitudes differ both in their descriptive and (...) in their normative properties. When an agent receives higher-order evidence that they might have reasoned incorrectly to a belief or credence towards p, then their attitude towards p is no longer justified as a terminal attitude towards p, but it can still be justified as a transitional attitude. This view, which I call the unmooring view, allows us to capture the rational impact of misleading higher-order evidence in a way that integrates smoothly with a natural picture of epistemic justification and the dynamics of deliberation. (shrink)

In this opinionated review, I draw attention to some of the contributions reinforcement learning can make to questions in the philosophy of mind. In particular, I highlight reinforcement learning's foundational emphasis on the role of reward in agent learning, and canvass two ways in which the framework may advance our understanding of perception and motivation.

Abstract The article argues that a consideration of the idea, common in ancient ethical theory, that virtue is a skill or craft, reveals that some common construals of it are mistaken. The analogy between virtue and skill is not meant to suggest that virtue is an unreflective habit of practised action. Rather what interests ancient ethical theorists is the intellectual structure of a skill, one demanding grasp of the principles defining the field and an ability to reflect on the justification (...) of particular actions. This is brought out with reference particularly to the discussion of virtue as analogous with skill in Plato's early Socratic dialogues. The demands made of the virtuous agent by philosophers who regard virtue as analogous to skill are akin to the demands made by more recent theories of morality which demand that the moral agent be able to reflect on her practices, extract the principles that these depend on, and produce justification when needed. This point about ancient ethical theories enables us to appreciate their distance from modern versions of ?virtue ethics? ? which stress the importance of the traditions and contexts within which the content of the virtues is learned, and place less importance on the need for intellectual justification. The type of virtue ethics defended by Alasdair Maclntyre provides an instructive example of this contrasting kind of theory. (shrink)

What is it like to be a good person? I examine and reject suggestions that this will involve having thoughts which have virtue or being a good person as part of their content, as well as suggestions that it might be the presence of feelings distinct from the virtuous person’s thoughts. Is there, then, anything after all to the phenomenology of virtue? I suggest that an answer is to be found in looking to Aristotle’s suggestion that virtuous activity is pleasant (...) to the virtuous person. I try to do this, using the work of the contemporary social psychologist Mihalyi Csikszentmihalyi and his work on the ‘flow experience’. Crucial here is the point that I consider accounts of virtue which take it to have the structure of a practical expertise or skill. It is when we are most engaged in skilful complex activity that the activity is experienced as ‘unimpeded’, in Aristotle’s terms, or as ‘flow’. This experience does not, as might at first appear, preclude thoughtful involvement and reflection. Although we can say what in general the phenomenology of virtue is like, each of us only has some more or less dim idea of it from the extent to which we are virtuous—that is, for most of us, not very much. (shrink)

Sentences containing predicates of personal taste exhibit two striking features: whether they are true seems to lie in the eye of the beholder and whether they are true can be—and often is—subject to disagreement. In the last decade, there has been a lively debate about how to account for these two features. In this paper, I shall argue for two claims: first, I shall show that even the most promising approaches so far offered by proponents of so-called indexical contextualism fail (...) to account for the disagreement feature. They might be able to account for some disagreement data, but they have trouble accounting for two kinds of disagreement data that caused the estrangement from indexical contextualism and the migration to relativism in the first place: the denial and the retraction data. Second, I shall show that we still do not have to abandon indexical contextualism, because what I shall call the superiority approach—a new pragmatically extended version of indexical contextualism—can very well account for the data. (shrink)

This paper investigates the norm of presupposition, as one pervasive type of indirect speech act. It argues against the view that sees presuppositions as an indirect counterpart of the direct speech act of assertion and proposes instead that they are much more similar to the direct speech act of assumption. More concretely, it suggests that the norm that governs presuppositions is not an epistemic or doxastic attitude such as knowledge, justified belief, or mere belief; it's a practical attitude, most plausibly (...) the attitude of rational acceptance. This view has important ramifications well beyond debates in philosophy of language and linguistics. It affects not only our view of which speech act sequences are fine and which are off; it bears on whether presuppositions can function as testimony, whether they can be lies, and whether they are ontologically committal, thus addressing central topics in epistemology, ethics, and metaphysics. (shrink)

Tanney challenges not only the cognitivist approach that has dominated philosophy and the special sciences for fifty years, but metaphysical-empirical approaches to the mind in general. Rules, Reason, and Self-Knowledge advocates a return to the world-involving, circumstance-dependent, normative practices where the rational mind has its home.

In Accuracy and the Laws of Credence Richard Pettigrew assumes a particular view of belief, which states that people don't have any other doxastic states besides credences. This is in tension with the popular position that people have both credences and outright beliefs. Pettigrew claims that such a dual view of belief is incompatible with the accuracy-first approach. I argue in this paper that it is not. This is good news for Pettigrew, since it broadens the appeal of his framework.

This essay explores the question of how to be good. My starting point is a thesis about moral worth that I’ve defended in the past: roughly, that an action is morally worthy if and only it is performed for the reasons why it is right. While I think that account gets at one important sense of moral goodness, I argue here that it fails to capture several ways of being worthy of admiration on moral grounds. Moral goodness is more multi-faceted. (...) My title is intended to capture that multi-facetedness: the essay examines saintliness, heroism, and sagacity. The variety of our common-sense moral ideals underscores the inadequacy of any one account of moral admirableness, and I hope to illuminate the distinct roles these ideals play in our everyday understanding of goodness. Along the way, I give an account of what makes actions heroic, of whether such actions are supererogatory, and of what, if anything, is wrong with moral deference. At the close of the essay, I begin to explore the flipside of these ideals: villainy. (shrink)

There are many sorts of day-to-day choices that are such that, if enough people were to choose one way rather than another, serious harm could be avoided or reduced, and yet it does not seem that any one such choice will itself make a difference. Consider, for example, how our collective consumer choices have various serious environmental and social consequences, and yet for many products, it is doubtful that one purchase more or less will itself make a difference to these (...) outcomes. How are we to understand what each of us ought to do in these sorts of contexts? This paper further advances and illuminates a thesis that I have argued for elsewhere: that a purely ‘non-instrumental’ approach to this question is not satisfactory. A necessary and central part of understanding how to think about an individual choice in these contexts is showing that it does matter for instrumental reasons - for reasons having to do with its ability to have an influence on the outcome. Once a core instrumental solution is found, other moral considerations can build on top. I argue for this by way of an examination of a new non-instrumental approach advanced by Wieland and van Oeveren: a participation-based approach. I also identify what I think is the main source of resistance to my thesis: a mistaken conflation of two different problems. (shrink)

The emerging field of synthetic biology aims to engineer novel biological entities. The envisioned future bio-based economy builds largely on “cell factories”: organisms that have been metabolically engineered to sustainably produce substances for human ends. In this paper, we argue that synthetic biology’s goal of creating efficient production vessels for industrial applications implies a set of ontological assumptions according to which living organisms are machines. Traditionally, a machine is understood as a technological, isolated and controllable production unit consisting of parts. (...) But modified organisms, or hybrids, require us to think beyond the machine paradigm and its associated dichotomies between artificial and natural, organisms and artefacts. We ask: How may we conceptualise hybrids beyond limiting ontological categories? Our main claim is that the hybrids created by synthetic biology should be considered not as machines but as metabolic systems. We shall show how the philosophical account of metabolism can inform an ontology of hybrids that moves beyond what we call the “machine ontology”, considering that metabolism enables thinking beyond the dominant dichotomies and allows us to understand and design lifeforms in a bio-based economy. Thus, the aim of this paper is twofold: first, to develop the philosophical ontology of hybrids, and second, to move synthetic biology beyond the problematically limiting view of hybrids. (shrink)

Epistemologists routinely distinguish between two kinds of justification or rationality – the propositional and the doxastic kind – in order to characterize importantly different ways in which an attitude can be justified or rational for a person. I argue that these notions, as they are commonly understood, are well suited to capture rationality judgments about the attitudes that agents reach as conclusions of their reasoning. Yet, these notions are ill-suited to capture rationality judgments about attitudes that agents form while their (...) reasoning is still in progress. In fact, we currently lack any suitable theory of rationality that lets us capture the ways in which we evaluate the rationality of such transitional attitudes, even though they are ubiquitous. I propose to capture these rationality judgments by introducing a new notion of rationality that is orthogonal to the propositional/doxastic distinction, which I call pro tem rationality. This new notion can be integrated with both traditional and formal ways of characterizing rationality or justification. It can be used to enlighten debates about logical and empirical learning, higher-order evidence, and the epistemology of philosophy, among others. (shrink)

People disagree frequently, about both objective and subjective matters. But while at least one party must be wrong in a disagreement about objective matters, it seems that both parties can be right when it comes to subjective ones: it seems that there can be faultless disagreements. But how is this possible? How can people disagree with one another if they are both right? And why should they? In recent years, a number of philosophers and linguists have argued that we must (...) become relativists about truth to understand faultless disagreements. This book shows that we can dispense with relativism. It combines a more standard semantics with a novel pragmatic theory to develop a superior approach. The book discusses both classic and recent literature in philosophy and linguistics. It provides a general introduction to the debate about the semantics and pragmatics of perspectival expressions, as well as an original contribution to the contemporary discussion. (shrink)

This chapter concerns the nature of our obligations as individuals when it comes to our emissions-producing activities and climate change. The first half of the chapter argues that the popular ‘expected utility’ approach to this question faces a problematic dilemma: either it gives skeptical verdicts, saying that there are no such obligations, or it yields implausibly strong verdicts. The second half of the chapter diagnoses the problem. It is argued that the dilemma arises from a very general feature of the (...) view, and thus is shared by other views as well. The chapter then discusses what an account of our individual obligations needs to look like if it is to avoid the dilemma. Finally, the discussion is extended beyond climate change to other collective impact contexts. (shrink)

An agent exercises instrumental rationality to the degree that she adopts appropriate means to achieving her ends. Adopting appropriate means to achieving one’s ends can, in turn, involve overcoming one’s strongest desires, that is, it can involve exercising synchronic self-control. However, contra prominent approaches, I deny that synchronic self-control is possible. Specifically, I draw on computational models and empirical evidence from cognitive neuroscience to describe a naturalistic, multi-system model of the mind. On this model, synchronic self-control is impossible. Must we, (...) then, give up on a meaningful conception of instrumental rationality? No. A multi-system view still permits something like synchronic self-control: an agent can control her very strong desires. Adopting a multi-system model of the mind thus places limitations on our conceptions of instrumental rationality, without requiring that we abandon the notion altogether. (shrink)

What attitudes can we rationally take towards our philosophical views? In this paper, I offer a novel answer to this question that draws on the distinction between transitional and terminal attitudes (Staffel 2019). Terminal attitudes are the kinds of attitudes, such as beliefs and credences, that we form as conclusions of reasoning processes. Transitional attitudes, by contrast, are attitudes we form during ongoing deliberations, before we settle on an opinion about how our information bears on the question of interest. I (...) argue that we can rationally hold terminal attitudes towards local philosophical claims, but not global ones. Only transitional attitudes can be rationally held towards global philosophical claims, at least in most cases. (shrink)

Hohwy et al.’s (2008) model of binocular rivalry (BR) is taken as a classic illustration of predictive coding’s explanatory power. I revisit the account and show that it cannot explain the role of reward in BR. I then consider a more recent version of Bayesian model averaging, which recasts the role of reward in (BR) in terms of optimism bias. If we accept this account, however, then we must reconsider our conception of perception. On this latter view, I argue, organisms (...) engage in what amounts to policy-driven, motivated perception. (shrink)

In the area of moral epistemology, there is an interesting problem facing the person in my area, ancient philosophy, who hopes to write a historical paper which will engage with our current philosophical concerns. Not only are ancient ethical theories very different in structure and concerns from modern ones, but the concerns and emphases of ancient epistemology are very different from those of modern theories of knowledge. Some may think that they are so different that they are useful to our (...) own discussions only by way of contrast. I am more sanguine, but I am quite aware that this essay's contribution to modern debates does not fall within the established modern traditions of discussing moral epistemology. (shrink)

Epistemic utility theory seeks to establish epistemic norms by combining principles from decision theory and social choice theory with ways of determining the epistemic utility of agents’ attitudes. Recently, Moss, 1053–69, 2011) has applied this strategy to the problem of finding epistemic compromises between disagreeing agents. She shows that the norm “form compromises by maximizing average expected epistemic utility”, when applied to agents who share the same proper epistemic utility function, yields the result that agents must form compromises by splitting (...) the difference between their credence functions. However, this “split the difference” norm is in conflict with conditionalization, since applications of the two norms don’t commute. A common response in the literature seems to be to abandon the procedure of splitting the difference in favor of compromise strategies that avoid non-commutativity. This would also entail abandoning Moss’ norm. I explore whether a different response is feasible. If agents can use epistemic utility-based considerations to agree on an order in which they will apply the two norms, they might be able to avoid diachronic incoherence. I show that this response can’t save Moss’ norm, because the agreements concerning the order of compromising and updating it generates are not stable over time, and hence cannot avoid diachronic incoherence. I also show that a variant of Moss’ norm, which requires that the weights given to each agent’s epistemic utility change in a way that ensures commutativity, cannot be justified on epistemological grounds. (shrink)

Some expressions, such as ‘generous’ and ‘stingy’, are used not only to describe the world around us. They are also used to evaluate the things to which they are applied. In this paper, I suggest a novel account of how this evaluation is conveyed—the conventional triggering view. It partly agrees and partly disagrees with both the standard semantic view and its popular pragmatic contender. Like the former and unlike the latter, my view has it that the evaluation is conveyed due (...) to the conventional meaning of the sentences in question. Unlike the former and much like the latter, my view suggests that the evaluation is a secondary rather than a primary content. (shrink)

Background: COVID-19 pandemic has led to heightened moral distress among healthcare providers. Despite evidence of gendered differences in experiences, there is limited feminist analysis of moral distress. Objectives: To identify types of moral distress among women healthcare providers during the COVID-19 pandemic; to explore how feminist political economy might be integrated into the study of moral distress. Research Design: This research draws on interviews and focus groups, the transcripts of which were analyzed using framework analysis. Research Participants and Context: 88 (...) healthcare providers, based in British Columbia Canada, participated virtually. Ethical Considerations: The study received ethical approval from Simon Fraser University. Findings: Healthcare providers experienced moral dilemmas related to ability to provide quality and compassionate care while maintaining COVID-19 protocols. Moral constraints were exacerbated by staffing shortages and lack of access to PPE. Moral conflicts emerged when women tried to engage decision-makers to improve care, and moral uncertainty resulted from lack of clear and consistent information. At home, women experienced moral constraints related to inability to support children’s education and wellbeing. Moral conflicts related to lack of flexible work environments and moral dilemmas developed between unpaid care responsibilities and COVID-19 risks. Women healthcare providers resisted moral residue and structural constraints by organizing for better working conditions, childcare, and access to PPE, engaging mental health support and drawing on professional pride. Discussion: COVID-19 has led to new and heightened experiences of moral distress among HCP in response to both paid and unpaid care work. While many of the experiences of moral distress at work were not explicitly gendered, implicit gender norms structured moral events. Women HCP had to take it upon themselves to organize, seek out resources, and resist moral residue. Conclusion: A feminist political economy lens illuminates how women healthcare providers faced and resisted a double layering of moral distress during the pandemic. (shrink)

I propose that the successes and contributions of reinforcement learning urge us to see the mind in a new light, namely, to recognise that the mind is fundamentally evaluative in nature.