Background A combination of theoretical and practical approaches is required to learn and acquire ethical competencies in caring. Occasionally, reflection on practical action differs from theoretical learning. In the context of reflective learning, issues such as ethical values can be discussed since they evoke conflict among nursing students. Aim To identify ethical conflicts encountered by nursing students during clinical placements and to determine their cooperation strategies. Research design Qualitative study with a content analysis according to Elo and Kinglas framework. Participants (...) and research context Students enrolled in a nursing program at a Spanish university aged between 22 and 35, mainly women. Methodology The study includes 134 ethical reflections from nursing students in the last year of the nursing program, written during their clinical practices in a variety of learning environments. The research team analyzed the reflections using an inductive content analysis method. Ethical considerations Ethical permission was obtained by the management center according to Law 3/2028, and all the participants accepted to participate through the informed consent form. Findings Three main categories emerged from the analysis of the ethical reflections: (1) evaluation of professional performance and patient care; (2) the student as the protagonist of the dilemma; (3) student coping. Student dilemmas and concerns are related to ignorance, student-patient communication, mistakes made and self-confidence. Some situations conflict with the autonomy of patients and their rights, and can contribute to stressful situations for patients. Stress factors include hospital routines, which the patient cannot modify, and asymmetric relationships with staff, which encourage passivity. Conclusion All ethical problems detected by the students begin with the professional-patient relationship, including issues related to bad news, errors or malpractice. Reflection on the ethical values of nursing, both in the classroom and in clinical practices, allows students to develop a greater ethical awareness of care, enhancing their decision-making skills in ethical dilemmas. (shrink)

Julián Sanz del Río, founder of the philosophical movement of Spanish krausism, evolved politically from the moderate to the progressive liberalism between 1844 and 1854. His moderate friends ignored this occurrence, and supported him, until his reviews of two french books published in the Gaceta de Madrid, denounced for heterodoxy by the traditionalist press and then by the Bishops from Barcelona and Zamora, revealed to them his true true political positions and his anticlericalism.

Julián Sanz del Río, fundador del movimiento filosófico del krausismo español, evolucionó políticamente desde el liberalismo moderado al progresista entre 1844 y 1854. Sus amigos moderados desconocían esta circunstancia, y se prestaron a ayudarlo, hasta que una recensión de dos libros franceses publicada en la Gaceta de Madrid, denunciada primero por la prensa tradicionalista por heterodoxia, y luego por los Obispos de Barcelona y Zamora, permitió conocer su verdaderos planteamientos políticos y su anticlericalismo.

The concept of vital force – the immanent energy that promotes the processes of life in the body and in nature – has proved a source of endless fascination and controversy. Indeed, the question of what vitalizes the body has haunted humanity since antiquity, and became even more pressing during the Scientific Revolution and beyond. Examining the complexities and theories about vital force in Spanish modernity, Nicolás Fernández-Medina's Life Embodied offers a novel and provocative assessment of the question of bodily (...) life in Spain. Starting with Juan de Cabriada's landmark Carta filosófica, médico-chymica of 1687 and ending with Ramón Gómez de la Serna's avant-gardism of the 1910s, Fernández-Medina incorporates discussions of anatomy, philosophy, science, critical theory, history of medicine, and literary studies to argue that concepts of vital force served as powerful vehicles to interrogate the possibilities and limits of corporeality. Paying close attention to how the body's capabilities were conceived and strategically woven into critiques of modernity, Fernández-Medina engages the work of Miguel Boix y Moliner, Martín Martínez, Diego de Torres Villarroel, Sebastián Guerrero Herreros, Ignacio María Ruiz de Luzuriaga, Gaspar Melchor de Jovellanos, Pedro Mata y Fontanet, Ángela Grassi, Julián Sanz del Río, Miguel de Unamuno, and Pío Baroja, among others. Drawing on extensive research and analysis, Life Embodied breaks new ground as the first book to address the question of vital force in Spanish modernity. (shrink)

There are more philosophy teachers alive today than existed from Socrates until 1900, and this year alone there will be more "contact hours" in philosophical wisdom than in the two millenia before Descartes. One might legitimately wonder what is done with all that time and why the world is not immensely better for it. The first, if not the second, of these questions is addressed and answered in this serious, thorough and much-needed collection of essays. Eduard Fey, founder and long (...) the president of the International Society for Teachers of Philosophy, and a dozen coworkers have surveyed the historical background and present-day structure of philosophical instruction in every country of Western Europe—in sixteen essays, some as long as fifty pages, some as brief as five pages. The volume is thorough. One can learn, for example, exactly what a gymnasium senior in Luxembourg studies during his weekly three hours of philosophy. One can learn how Hans Richert tried to reform high school instruction in Germany in 1925, only to be opposed by the Catholic hierarchy’s insistence that metaphysical questions be treated only in religious instruction, or how the German Idealist Krause influenced Spanish pedagogy through his student Julian Sanz del Rio, and so on. Given the range and detail of the material, the lack of an index to the volume is keenly felt. (shrink)

Este artículo examina una doble y contrapuesta línea de recepción del pensamiento de Max Weber en el mundo hispanoparlante, que hemos denominado línea “conservadora” y línea “liberal”. Este esquema interpretativo permite agrupar y reseñar a algunos de los más destacados intelectuales españoles, cuyas obras estuvieron marcadas por la influencia del pensamiento de Max Weber. Revisamos el contexto, el sentido de la recepción, la labor de traducción y el modo peculiar en que asimilaron el trabajo del autor alemán. Nos centramos, en (...) suma, en la obra de algunos renombrados filósofos, juristas y sociólogos de habla hispana, si bien limitamos nuestro análisis a la “primera generación receptora”, que fechamos en las décadas de los años 20 a los 40 del siglo XX. (shrink)

There are no egalitarians in a pandemic. The scale of the challenge for health systems and public policy means that there is an ineluctable need to prioritize the needs of the many. It is impossible to treat all citizens equally, and a failure to carefully consider the consequences of actions could lead to massive preventable loss of life. In a pandemic there is a strong ethical need to consider how to do most good overall. Utilitarianism is an influential moral theory (...) that states that the right action is the action that is expected to produce the greatest good. It offers clear operationalizable principles. In this paper we provide a summary of how utilitarianism could inform two challenging questions that have been important in the early phase of the pandemic: (a) Triage: which patients should receive access to a ventilator if there is overwhelming demand outstripping supply? (b) Lockdown: how should countries decide when to implement stringent social restrictions, balancing preventing deaths from COVID‐19 with causing deaths and reductions in well‐being from other causes? Our aim is not to argue that utilitarianism is the only relevant ethical theory, or in favour of a purely utilitarian approach. However, clearly considering which options will do the most good overall will help societies identify and consider the necessary cost of other values. Societies may choose either to embrace or not to embrace the utilitarian course, but with a clear understanding of the values involved and the price they are willing to pay. (shrink)

In order to prevent the rapid spread of COVID-19, governments have placed significant restrictions on liberty, including preventing all non-essential travel. These restrictions were justified on the basis the health system may be overwhelmed by COVID-19 cases and in order to prevent deaths. Governments are now considering how they may de-escalate these restrictions. This article argues that an appropriate approach may be to lift the general lockdown but implement selective isolation of the elderly. While this discriminates against the elderly, there (...) is a morally relevant difference—the elderly are far more likely to require hospitalisation and die than the rest of the population. If the aim is to ensure the health system is not overwhelmed and to reduce the death rate, preventing the elderly from contracting the virus may be an effective means of achieving this. The alternative is to continue to keep everyone in lockdown. It is argued that this is levelling down equality and is unethical. It suggests that in order for the elderly to avoid contracting the virus, the whole population should have their liberty deprived, even though the same result could be achieved by only restricting the liberty of the elderly. Similar arguments may also be applied to all groups at increased risk of COVID-19, such as men and those with comorbidities, the obese and people from ethnic minorities or socially deprived groups. This utilitarian concern must be balanced against other considerations, such as equality and justice, and the benefits gained from discriminating in these ways must be proportionately greater than the negative consequences of doing so. Such selective discrimination will be most justified when the liberty restriction to a group promotes the well-being of that group (apart from its wider social benefits). (shrink)

In this paper, we investigate how data about public preferences may be used to inform policy around the use of controversial novel technologies, using public preferences about autonomous vehicles (AVs) as a case study. We first summarize the recent ‘Moral Machine’ study, which generated preference data from millions of people regarding how they think AVs should respond to emergency situations. We argue that while such preferences cannot be used to directly inform policy, they should not be disregarded. We defend an (...) approach that we call ‘Collective Reflective Equilibrium in Practice’ (CREP). In CREP, data on public attitudes function as an input into a deliberative process that looks for coherence between attitudes, behaviours and competing ethical principles. We argue that in cases of reasonable moral disagreement, data on public attitudes should play a much greater role in shaping policies than in areas of ethical consensus. We apply CREP to some of the global preferences about AVs uncovered by the Moral Machines study. We intend this discussion both as a substantive contribution to the debate about the programming of ethical AVs, and as an illustration of how CREP works. We argue that CREP provides a principled way of using some public preferences as an input for policy, while justifiably disregarding others. (shrink)

Francesco Guala once wrote that ‘The problem of extrapolation is a minor scandal in the philosophy of science’. This paper agrees with the statement, but for reasons different from Guala’s. The scandal is not, or not any longer, that the problem has been ignored in the philosophy of science. The scandal is that framing the problem as one of external validity encourages poor evidential reasoning. The aim of this paper is to propose an alternative—an alternative which constitutes much better evidential (...) reasoning about target systems of interest, and which makes do without consideration of external validity. (shrink)

The publication of the first study to use gene editing techniques in human embryos (Liang et al., 2015) has drawn outrage from many in the scientific community. The prestigious scientific journals Nature and Science have published commentaries which call for this research to be strongly discouraged or halted all together (Lanphier et al., 2015; Baltimore et al., 2015). We believe this should be questioned. There is a moral imperative to continue this research.

I contend that mathematical domains are freestanding institutional entities that, at least typically, are introduced to serve representational functions. In this paper, I outline an account of institutional reality and a supporting metaontological perspective that clarify the content of this thesis. I also argue that a philosophy of mathematics that has this thesis as its central tenet can account for the objectivity, necessity, and atemporality of mathematics.

Chapter 1 Idealism § 1 Introduction Schopenhauer says that his philosophy grows out of Kant's, as from its "parent stem" (WR I p.501). ...

Anti-realism is plagued by Fitch’s paradox: the remarkable result that if one accepts that all truths are knowable, minimal assumptions about the nature of knowledge entail that every truth is known. Dorothy Edgington suggests to address this problem by understanding p is knowable to be a counterfactual claim, but her proposal must contend with a forceful objection by Timothy Williamson. I revisit Edgington’s basic idea and find that Williamson’s objection is obviated by a refined understanding of counterfactual knowability that is (...) grounded in possible courses of inquiry. I arrive at a precise definition of knowability that is not just a technical avoidance of paradox, but is metaphysically sound and does justice to the anti-realist idea. (shrink)

Economic environmental valuation remains a much debated and contested issue. Concerns have been voiced that it is unable to capture the manifold immaterial values of ecosystems due to conceptual and methodological issues. Thus, additional value categories (social values) as well as novel valuation approaches like deliberative (monetary) valuation are areas of growing interest, yet the theoretical foundations are rather weak. Against this background, this article aims to develop a consistent conceptual framework for making sense of social values in economic environmental (...) valuation. Based on a holistic view of society and individuals, the role of institutions, the social environment, culture and transcendental values is emphasised. To synthesise diverging concepts of value into an economic concept and to account for the multidimensionality of social values, the framework consists of three spheres: social, natural and contextual. The novel framework demonstrates that social values may be integrated into a preference-based utility framework when denoting a holistic understanding of social preferences and human embeddedness in nature and society. (shrink)

This paper argues that, within the Western ‘classical’ tradition of performing works of music, there exists a performance value of authenticity that is distinct from that of complying with the instructions encoded in the work's score. This kind of authenticity—interpretive authenticity—is a matter of a performance's displaying an understanding of the performed work. In the course of explaining the nature of this norm, two further claims are defended: that the respective values of interpretive authenticity and score compliance can come into (...) conflict; and that when this happens, compromising ideal score compliance for the sake of making the performance more interpretively authentic can make for a better performance. (shrink)

A popular claim in recent philosophy of mind and action is that events only exist once they are over. This has been taken to have the consequence that many temporal phenomena cannot be understood ‘from the inside’, as they are unfolding, purely in terms of events. However, as I argue here, the claim that events exist only when over is incoherent. I consider two ways of understanding the claim and the notion of existence it involves: one that ties existence to (...) the logic of quantification, and another that assimilates the existence of an event to that of a continuant. The first of these, I argue, cannot be the right way to understand the target claim, as there are serious logical obstacles to regarding this notion of existence as temporally variable. The second, on the other hand, leaves it ultimately mysterious what the existence of an event could amount to. I close with the suggestion that the undeniable temporal asymmetries which parties to the debate are interested in are properly understood in perspectival, not ontological, terms. (shrink)

The genus problem of populism presents one of the most vexing conceptual questions across the social sciences: Some theorists believe that populism is nothing more than an assembly of discursive patterns, while others maintain that populism is a strategy to gain political power. Then there are those that argue that populism is a thin ideology that lacks a coherent set of guiding principles. The paper intervenes in this debate in two ways: First, it offers a methodological apparatus for evaluating and (...) developing contested concepts such as populism. Second, it puts forward and defends the claim that populism can be fruitfully understood as a coherent ideology that rests on four foundational principles. These principles, I will argue, are necessary for explaining the paradigmatic beliefs and dispositions exhibited by exponents of populism. One of the key characteristics of populism, on the account developed in this paper, is its peculiar epistemic stance. (shrink)

This paper presents a novel account of focal stress and pitch contour in English dialogue. We argue that one should analyse and treat focus and pitch contour jointly, since (i) some pragmatic interpretations vary with contour (e.g., whether an utterance accepts or rejects; or whether it implicates a positive or negative answer); and (ii) there are utterances with identical prosodic focus that in the same context are infelicitous with one contour, but felicitous with another. We offer an account of two (...) distinct pitch contours that predicts the correct felicity judgements and implicatures, outclassing other models in empirical coverage or formality. Prosodic focus triggers a presupposition, where what is presupposed and how the presupposition is resolved depends on prosodic contour. If resolving the presupposition entails the proffered content, then the proffered content is uninteresting and hence the utterance is in-felicitous. Otherwise, resolving the presupposition may lead to an implicature. We regiment this account in SDRT. (shrink)

Can we employ the property of rationality in establishing what rationality requires? According to a central and formal thesis of John Broome’s work on rational requirements, the answer is ‘no’ – at least if we expect a precise answer. In particular, Broome argues that (i) the property of full rationality (i.e. whether or not you are fully rational) is independent of whether we formulate conditional requirements of rationality as having a wide or a narrow logical scope. That is, (ii) by (...) replacing a wide-scope requirement with a corresponding narrow-scope requirement (or vice versa), we do not alter the situations in which a person is fully rational. As a consequence, (iii) the property of full rationality is unable to guide us in determining whether a rational requirement has a wide or a narrow logical scope. We cannot resolve the wide/narrow scope debate by appealing to a theory of fully rational attitudes. This paper argues that (i), (ii) and (iii) are incorrect. Replacing a wide- with a corresponding narrow-scope requirement (or vice versa) can alter the set of circumstances in which a person is fully rational. The property of full rationality is therefore not independent of whether we formulate conditional requirements of rationality as having a wide or a narrow logical scope. As a consequence, the property of full rationality can guide us in determining what rationality requires – even in cases where we expect a precise answer. (shrink)

We examine the philosophical and ethical issues associated with conjoined twins and their surgical separation. In cases in which there is an extensive sharing of organs, but nevertheless two distinguishable functioning brains, there are a number of philosophical and ethical challenges. This is because such conjoined twins: 1. give rise to puzzles concerning our identity, about whether we are identical to something psychological or biological;2. force us to decide whether what matters from an ethical point of view is the biological (...) life of our organisms or the existence of our consciousness or mind; 3. raise questions concerning when, if ever, it is morally acceptable to sacrifice one of us to save another;4. force us to reflect on the conditions for ownership of organs and the justification of removal of organs for transplantation which causes the death of the donor; 5. raise questions about who should take decisions about life-risking treatments when this cannot be decided by patients themselves.We examine and suggest answers to these questions. (shrink)

In The Gift Relationship, Richard Titmuss argued that the practice of altruistic blood donation fosters social solidarity while markets in blood erode it. This paper considers the implications of this line of argument for the organ market debate. I defend Titmuss’ arguments against a number of criticisms and respond to claims that Titmuss’ work is not relevant to the context of live donor organ transplantation. I conclude that Titmuss’ arguments are more resilient than many advocates of organ markets suggest, and (...) more relevant to the debate than is commonly appreciated. (shrink)

It has recently been suggested that the type/token theorist concerning musical works cannot come up with an adequate semantic theory of those sentences in which we purport to talk about such works. Specifically, it has been claimed that, since types are abstract entities, a type/token theorist can only account for the truth of sentences such as “The 1812 Overture is very loud” and “Bach's Two Part Invention in C has an F-sharp in its fourth measure” by adopting an untenable semantic (...) claim: namely, that the predicates in such sentences, once applied to musical works, undergo a systematic shift in their meanings. This article is a sustained explanation of why our talk about musical works in fact provides no problem for the type/token theorist. First, we demonstrate that the aforementioned “meaning shift” approach to the sentences’ predicates is well motivated and very credible. Second, we explain how the type/token theorist can adopt the best available version of an alternative, generic quantificational approach to such sentences. Third, we establish that other semantic theories, presented as undermining the type/token theory by giving us a reason for adopting eliminativism about types, are much less theoretically virtuous than the two theories that a type/token theorist can freely adopt. (shrink)

A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems (...) with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers to choose the policy supported by the best reasons. (shrink)

Van Inwagen proposes that besides simples only living organisms exist as composite objects. This paper suggests expanding van Inwagen’s ontology by also accepting composite objects in the case that physical bonding occurs (plus some extra conditions). Such objects are not living organ-isms but rather physical bodies. They include (approximately) the complete realm of inanimate ordinary objects, like rocks and tables, as well as inanimate scientific objects, like atoms and mol-ecules, the latter filling the ontological gap between simples and organisms in (...) van Inwagen’s origi-nal picture. We thus propose a compositional pluralism claiming that composition arises if and on-ly if bonding or life occurs. (shrink)

This chapter questions the causal-constitution fallacy raised against the extended mind. It does so by presenting our signature temporal thesis about how to understand constitutive relations in the context of the extended mind, and with respect to dynamical systems, more broadly. We call this thesis diachronic constitution. We will argue that temporalising the constitution relation is not as remarkable (nor problematic) as it might initially seem. It is (arguably) inevitable, given local interactions between microscale and macroscale states of (coupled) dynamical (...) systems. We focus primarily on the metaphysics of the extended mind in this paper. However, we also show how our account of diachronic constitution has important implications for the metaphysics of dependence relations more generally as well as an emerging literature on inter-level explanations in the mechanistic framework applied to the discussion over extended, enactive and embodied cognition. (shrink)

One objection to embryonic stem (ES) cell research is that it ‘cannibalizes’ human beings, that is, kills some human beings to benefit others. I grant for argument’s sake that the embryo is a person. Nonetheless, killing it may be justified. I show this through the Embryonic Stem Cell Lottery. Whether killing a person is justified depends on: (1) whether innocent people at risk of being killed for ES cell research also stand to benefit from the research and (2) whether their (...) overall chances of living are higher in a world in which killing and ES cell research is conducted. I call this kind of killing ‘risk reductive.‘. (shrink)

Dementia is an illness that raises important questions about our own attitudes to illness and aging. It also raises very important issues beyond the bounds of dementia to do with how we think of ourselves as people--fundamental questions about personal identity. Is the person with dementia the same person he or she was before? Is the individual with dementia a person at all? In a striking way, dementia seems to threaten the very existence of the self.LThis book brings together philosophers (...) and practitioners to explore the conceptual issues that arise in connection with this increasingly common illness. Drawing on a variety of philosophers such as Descartes, Lock, Hume, Wittgenstein, the authors explore the nature of personal identity in dementia. They also show how the lives and selfhood of people with dementia can be enhanced by attention to their psychological and spiritual environment. Throughout, the book conveys a strong ethical message, arguing in favor of treating people with dementia with all the dignity they deserve as human beings. The book covers a range of topics, stretching from talk of basic biology to talk of a spiritual understanding of people with dementia. Accessibly written by leading figures in psychiatry and philosophy, the book presents a unique and long overdue examination of an illness that features in so many of our lives. (shrink)

An innovative program recently initiated at the University of California, Los Angeles Medical Center allows people to donate a kidney in exchange for a voucher that a loved one can redeem for a kidney if and when needed. As a relatively new practice, the ethical implications of advanced kidney donation have not yet been widely discussed. This paper reflects on some of the bioethical issues at stake in this new donation program, as well as some broader philosophical issues related to (...) the meaning and moral salience of commodification. I first consider whether the literature on commercial markets in organs––a longstanding topic of bioethical debate––can meaningfully inform ethical analysis of kidney voucher programs. Specifically, I consider whether and to what extent common objections to the exchange of kidneys for cash also apply to the exchange of kidneys for “kidney vouchers.” Second, I argue that the contrast between the ethical issues raised by these two practices highlights the need to understand commodification as existing on a continuum, with different degrees of commodification giving rise to different ethical issues. Doing so can help sharpen our understanding of commodification as a moral concept, as well as its relevance to broader debates about the moral limits of markets. (shrink)

The Montreal Declaration on Animal Exploitation, which has been endorsed by hundreds of influential academic ethicists, calls for establishing a vegan economy by banning what it refers to as all unnecessary animal suffering, including fishing. It does so by appeal to the moral principle of equal consideration of comparable interests. I argue that this principle is misapplied by discounting morally relevant cognitive capacities of self-conscious and volitional personhood as distinguished from merely sentient non-personhood. I describe it as a kind of (...) anthropomorphizing moralism which I call anthropomoralism, defined as the tendency to project morally relevant characteristics of personhood onto merely sentient non-persons by discounting their existing differences with actual persons. I show that this attitude can lend support to the resurgent attempt to treat fetal pain as equally morally considerable to that of childbearing persons they gestate within. I explain that the only sound way to apply the principle of equal consideration of comparable interests is to compare experiences of actual persons. Therefore, while supporting a vegan economy may be morally praiseworthy, it should not be deemed morally obligatory. (shrink)

Scepticism about the possibility of machine consciousness comes in at least two forms. Some argue that our neurobiology is special, and only something sharing our neurobiology could be a subject of experience. Others argue that a machine couldn't be anything else but a zombie: there could never be something it is like to be a machine. I advance a dynamic sensorimotor account of consciousness which argues against both these varieties of scepticism.

The recent judgement in the case of Re:M in which the Court held that it would be unlawful to withdraw artificial nutrition and hydration from a woman in a minimally conscious state raises a number of ethical issues of wide application. Central to these is the extent to which precedent autonomous decisions should be respected in the absence of a legally binding advance decision. Well-being interests can survive the loss of many of the psychological faculties that support personhood. A decision (...) to respect precedent autonomy can contradict the well-being interests of the individual after capacity is lost. These decisions raise difficult questions about personal identity and about the threshold of evidence that is required of an earlier decision in order for it to be respected. (shrink)

Hussain claims that ethical consumers are subject to democratic requirements of morality, whereas ordinary price/quality consumers are exempt from these requirements. In this paper, we demonstrate that Hussain’s position is incoherent, does not follow from the arguments he offers for it, and entails a number of counterintuitive consequences.