Many conditionals seem to convey the existence of a link between their antecedent and consequent. We draw on a recently proposed typology of conditionals to argue for an old philosophical idea according to which the link is inferential in nature. We show that the proposal has explanatory force by presenting empirical results on the evidential meaning of certain English and Dutch modal expressions.

What are the criteria for reasonable clinical judgements? The reasonableness of macro-level decision-making has been much discussed, but little attention has been paid to the reasonableness of applying guidelines generated at a macro-level to individual cases. This paper considers a framework for reasonable clinical decision-making that will capture cases where relevant guidelines cannot reasonably be followed. There are three main sections. (1) Individual claims on healthcare from the point of view of concerns about equity are analysed. (2) The demands of (...) responsibility and equity on professional clinical performance are discussed, and how the combination of these demands emerges into seven requirements that constitute the framework is explored. Since this framework is developed to assist in reasonable clinical decision-making, practical implications of all these requirements are also suggested. (3) Challenges concerning the framework are discussed. First, a crucial presumption that the framework relies upon is considered—namely, clinicians’ willingness to justify their decisions as requested. Then how public deliberation may influence clinical decision-making is discussed. Next is a consideration of how clinicians’ need to have confidence in their own judgements in order to perform in a manner worthy of trust would be compatible with adherence to the framework supported by public deliberation. It is concluded that fair distribution in the interplay between macro- and micro-level considerations can be secured by legitimising procedures on each level, by ensuring well-organised and continuing public debate and by basing individual clinical judgements upon well-justified and principled normative bases. (shrink)

The author introduces and critically analyzes two recent, curious findings and their accompanying explanations regarding how the folk intuits the capabilities of the dead and those in a persistent vegetative state. The dead are intuited to survive death, whereas PVS patients are intuited as more dead than the dead. Current explanations of these curious findings rely on how the folk is said to conceive of death and the dead: either as the annihilation of the person, or that person’s continuation as (...) a disembodied being. The author argues that these two conceptions are incompatible and inconsistent with each other and the evidence. Contrariwise, the author argues that the folk intuition about dead-survivors and the living dead are more easily explained by appealing to cross-culturally established concepts: the folk biological concept of death the existential concept of death, and the concept of social death. (shrink)

Background: Theoretically, the principle of justice is strong in healthcare priorities both nationally and internationally. Research, however, has indicated that questions can be raised as to how this principle is dealt with in clinical intensive care. Objective: The objective of this article is to examine how significant others may affect the principle of justice in the medical treatment and nursing care of intensive care patients. Method: Field observations and in-depth interviews with physicians and nurses in intensive care units (ICU). Emphasis (...) was placed on eliciting the underlying rationale for prioritisations in clinical intensive care with particular focus on clinicians’ considerations when limiting ICU treatment. Results: Significant others could induce an unintentional discrimination of ICU patients. Family members who were demanding received more time and attention for both the patient and themselves. Patients’ and families’ status and position and/or an interesting medical diagnosis seemed to govern the clinicians’ priorities of patients and families—consciously as well as unconsciously. The clinicians emphasised that patient information given through families was important. However, patients’ preferences and values conveyed to clinicians through their families were not always taken seriously. This even applied in cases with very serious prognoses and an explicit patient wish to forego life-prolonging treatment. Conclusion: The principle of justice was violated when qualified attention was given to significant others, and through this also to patients. Attention given to significant others was influenced by the healthcare workers’ professional and personal values, attitudes and interests. (shrink)

Analyses of biological concepts of disease and social conceptions of health indicate that they are structurally interdependent. This in turn suggests the need for a bridge theory of illness. The main features of such a theory are an emphasis on the logical properties of value terms, close attention to the features of the experience of illness, and an analysis of this experience as action failure, drawing directly on the internal structure of action. The practical applications of this theory are outlined (...) for a number of problems in each of the three main practical areas, clinical work, teaching and research. In each case the resources of the theory suggest new models and generate new results. The full practical significance of the theory, however, is shown to consist in the way in which it ties together biological and social theories into an integrated picture of the conceptual structure of medicine as a whole. It is argued, finally, that practical efficiency of this kind is a test of theory not only in the philosophy of medicine but also in general philosophy. (shrink)

Context: Metaphysics of perception explores fundamental questions regarding the structure and status of the perceived world or appearance(s. By virtue of perception, the apparent world comes to existence. This, however, does not mean that the apparent world is a projection of mind, that it exists “in the head.” Implications: PL-metaphysics reconciles realism with constructivism. As such, it might be considered either an alternative to constructivism or an improvement and completion of this position. Constructivist content: The article refers to non-Cartesian movements (...) in contemporary philosophy, including radical constructivism, enactive and embodied cognition. Keywords: Perception, metaphysics, radical constructivism, realism, appearance, Jerzy Perzanowski, Plato, Gottfried Willhelm Leibniz, Ernst von Glasersfeld. (shrink)

This collection examines prevalent assumptions in moral reasoning which are often accepted uncritically in medical ethics. It introduces a range of perspectives from philosophy and medicine on the nature of moral reasoning and relates these to illustrative problems, such as New Reproductive Technologies, the treatment of sick children, the assessment of quality of life, genetics, involuntary psychiatric treatment and abortion. In each case, the contributors address the nature and worth of the moral theories involved in discussions of the relevant issues, (...) and focus on the types of reasoning which are employed. 'Medical ethics is in danger of becoming a subject kept afloat by a series of platitudes about respect for persons or the importance of autonomy. This book is a bold and imaginative attempt to break away from such rhetoric into genuine informative dialogue between philosophers and doctors, with no search after consensus.' Mary Warnock. (shrink)

Harris’ reply to our defence of the National Institute for Clinical Excellence’s (NICE) current cost-effectiveness procedures contains two further errors. First, he wrongly draws a conclusion from the fact that NICE does not and cannot evaluate all possible uses of healthcare resources at any one time and generally cannot know which National Health Service (NHS) activities would be displaced or which groups of patients would have to forgo health benefits: the inference is that no estimate is or can be made (...) by NICE of the benefits to be forgone. This is a non-sequitur. Second, he asserts that it is a flaw at the heart of the use of quality-adjusted life years (QALYs) as an outcome measure that comparisons between people need to be made. Such comparisons do indeed have to be made, but this is not a consequence of the choice of any particular outcome measure, be it the QALY or anything else. (shrink)

There are important ethical issues to be examined before launching any public health intervention, particularly when targeting vulnerable groups. The aim of this article is to identify and discuss ethical concerns that may arise when intervening for health behavior change among adolescents identified as overweight. These concerns originate from an intervention designed to capacitate adolescents to increase self-determined physical activity. Utilizing an ethical framework for prevention of overweight and obesity, we identified three ethical aspects as particularly significant: the attribution of (...) responsibility for health behavior, liberty to choose, and the effect on the participants’ psychosocial well-being. It is discussed whether and how measures can be taken to deal with these aspects. It seems evident that the ethical aspects are mainly concerned with the vulnerability of adolescents identified as overweight. However, we claim that when individual feedback and counseling is provided, tailored interventions have a unique potential to empower adolescents to make ethically anchored decisions about their own health behavior. (shrink)

We examine the emergence of the field of life-history strategies during the 1950s. (We consider a 'field' an area of scientific activity consisting of a theoretical core, a subject of research, a vocabulary and research tools). During the late 1940s and early 1950s, population ecology faced many problems, concerning its conceptual framework, its mathematical models, experimental deficiencies, etc. Research on life-history characteristics remained descriptive, lacking explanations about the causes and significance of phenomena. This was due to the deficiencies of the (...) theoretical framework of population ecology up to the 1950s. The catalyzing factor for the emergence of the new field was the interdisciplinary impacts, and especially the impact of neodarwinism. The elaboration of a new theoretical core, invoking also methodological shifts, was the triggering factor, conditioning the emergence of the new field. (shrink)

In this article cheating in network and specifically online computer games is looked into as a moral offence. Reasons for the public ignoring the issue are brought forth. We present what could be considered as cheating in generic terms and in context. Different kinds of cheating are delineated, and remedies proposed. We also identify what is not cheating.

Successful applications of a conceptually novel setup of Quantum Field Theory, that accounts for all subtheories of the Standard Model (QED, Electroweak Interaction and Higgs, Yang–Mills and QCD) and beyond (Helicity 2), call for a perspective view in a broader conceptual context. The setting is “autonomous” in the sense of being intrinsically quantum. Its principles are: Hilbert space, Poincaré symmetry and causality. Its free quantum fields are obtained from Wigner’s unitary representations of the Poincaré group, with only physical and observable (...) degrees of freedom. A “quantization” of an “underlying” classical theory is not needed. It allows renormalizable perturbation theory with interactions whose detailed structure, and in some cases even the particle content, is predicted by internal consistency. The results confirm and extend observable predictions for the interactions of the Standard Model without assuming a “principle” of gauge invariance. (shrink)

OBJECTIVES: To compare the perceptions of physician executives and clinicians regarding ethical issues in Saudi Arabian hospitals and the attributes that might lead to the existence of these ethical issues. DESIGN: Self-completion questionnaire administered from February to July 1997. SETTING: Different health regions in the Kingdom of Saudi Arabia. PARTICIPANTS: Random sample of 457 physicians (317 clinicians and 140 physician executives) from several hospitals in various regions across the kingdom. RESULTS: There were statistically significant differences in the perceptions of physician (...) executives and clinicians regarding the existence of various ethical issues in their hospitals. The vast majority of physician executives did not perceive that seven of the eight issues addressed by the study were ethical concerns in their hospitals. However, the majority of the clinicians perceived that six of the same eight issues were ethical considerations in their hospitals. Statistically significant differences in the perceptions of physician executives and clinicians were observed in only three out of eight attributes that might possibly lead to the existence of ethical issues. The most significant attribute that was perceived to result in ethical issues was that of hospitals having a multinational staff. CONCLUSION: The study calls for the formulation of a code of ethics that will address specifically the physicians who work in the kingdom of Saudi Arabia. As a more immediate initiative, it is recommended that seminars and workshops be conducted to provide physicians with an opportunity to discuss the ethical dilemmas they face in their medical practice. (shrink)

This article is a response to the proposal, made by Thornton elsewhere in this special issue of PPP, that the "space of reasons" (as defined by the work particularly of Sellars and McDowell) might contain the conceptual resources for naturalizing biological function statements without reducing their ostensibly teleological meanings to the "space of causes". I agree with Thornton, (1) that ordinary reductive naturalism (as in Wakefield's work) is unable to mark the key distinction between a functional system's function(s) and its (...) other properties, and (2) that his proposed non-reductive naturalism (or neo-naturalism) is able to mark this distinction. I disagree with him, though, that neo-naturalism is value-free. The space of reasons certainly contains much that is important for psychopathology (meanings, notably). I argue, though, against Thornton, that neo-naturalism is able to define functions only because the "space of reasons" smuggles into the language of biology an evaluative element of meaning, deeply hidden but still logically operative, in the teleological sense in which biological functions are explanatory. In the final section of the paper, I set Thornton's proposal in a wider historical perspective. (shrink)

In ''''A Defense of Evolutionary Ethics'''' (1986), Robert J. Richardsendeavors to explain how moral ''oughts'' can be derived from thescience of evolutionary biology without committing the dreadednaturalistic fallacy. First, Richards assumes that ''ought'' as usedin ethical discourse bears the same meaning as ''ought'' used anywherein science, indicating merely that certain results or behaviors arepredicted based on prior structured contexts. To this extent, themoral behavior of animals, what they ''ought'' to do, could arguablybe predicted by evolutionary biology as effectively as, say,molecular (...) behavior may be predicted by chemistry. But afteracknowledging that biological inferences to this limited senseof ''ought'' were never contested by Moore''s naturalistic fallacy,Richard proposes to add to evolutionary ethics a decision procedureto determine which members of a set of predicted behaviors arethose which truly ought to occur – in the genuinelyprescriptive sense intended by ethical discourse. But theprocedure which Richards fabricates for this purpose appealsto such alleged ''facts'' as cultural conventions and moral opinionpolling, hardly a secure foundation for the sort of scientific ethics promised by Richards at the outset. (shrink)

This article discusses the British Nationalization of Labour Society , a group formed in response to the political ideas brought forth by Edward Bellamy’s novel Looking Backward. The article traces the roots of this group in British radicalism in general, and in campaigns for land nationalization and the works of Henry George in particular. The NLS were grounded in a deeply materialist and rationalist worldview and the influence of this on their political ideas and practice is shown. Relationships between the (...) ideas of the British Bellamyites and the ideas of British socialists are also discussed. (shrink)

This essay surveys the evolution of historical scholarship on epidemic diseases in the Mediterranean/Islamicate world with a particular focus on plague. Temporally, it covers the scholarship on plague epidemics during the last 1,500 years, surveyed in three major pandemics: first, second, and third pandemics of plague. Geographically, it addresses the Mediterranean basin and its hinterland, including the Middle East and North Africa (MENA), the Anatolian peninsula, the Balkans, and occasionally drawing on adjacent areas such as the Black Sea region and (...) the Persian plateau. It outlines major trends and turning points in the modern historiography; reviews prevailing paradigms, contested issues, and emergent consensuses; and identifies methodologies, sources, and approaches. Whenever possible, it highlights contributions from paleogenetic and other scientific studies, with special reference to the diversity of opinions, actors, and materials in this highly controversial but vigorous field of study. The major goal of this essay is to reunite the divided historiographies of the Mediterranean world, which are typically studied separately in the case of Europe and the Islamicate world, with a view to underscoring their shared epidemiological experiences. (shrink)

Resulting from the perspectivist view, acoording to which the remote apeearances are minified and the close ones magnified, is the author's view of the angels as various personified "-isms" , and of "-isms" as the subjectivized forms of angels. That means that the relation between an angel and an "-ism" is the same as the relation between a contracted form seen from a distance and a microscopic and pluralized form close to our eyes. Since "-isms" are usually connected with various (...) ideologies, the angelology is understood by the author as a science concerning sets of ideas, i. e. ideologies and "-isms". Every "-ism" creates an ideological body, a cultural collective, which is the incarnation of the spirit of the given angel. Thus angels are ideological incarnations with their own ideological rationalities, feelings and wills, which they pursue by help of their adherents. The angels thus dwell in their adherents, which in turn are clothed in angel's ideological apparel. (shrink)