Humanitarian health care practitioners working outside familiar settings, and without familiar supports, encounter ethical challenges both familiar and distinct. The ethical guidance they rely upon ought to reflect this. Using data from empirical studies, we explore the strengths and weaknesses of two ethical models that could serve as resources for understanding ethical challenges in humanitarian health care: clinical ethics and public health ethics. The qualitative interviews demonstrate the degree to which traditional teaching and values of clinical health ethics seem insufficient (...) for addressing all the realities of health care practice during humanitarian missions. They equally suggest that greater good orientations of public health ethics can thwart the best intentions of health care professionals wanting to attend to the interests of individual patients. Even though neither is complete on its own for helping guide health professionals on field missions, taken together these models have much to offer. At the same time, the narratives of the humanitarian health care workers illustrate how some of the crucial differences between public health ethics and clinical ethics generate tensions in humanitarian health practice. We offer an analysis of some of the complexities this creates for humanitarian health care ethics, and consider ways of adjudicating between the two models. (shrink)

This article explores the accounts of Canadian-trained health professionals working in humanitarian and development organizations who considered not treating a patient or group of patients because of resource limitations. In the narratives, not treating the patient(s) was sometimes understood as the right thing to do, and sometimes as wrong. In analyzing participants’ narratives we draw attention to how medications and equipment are represented. In one type of narrative, medications and equipment are represented primarily as scarce resources; in another, they are (...) represented as patient care. In the contexts respondents were working, medications and equipment were often both patient care interventions and scarce resources. The analytic point is that health professionals tend to emphasize one conceptualization over the other in coming to assert that not treating is right, or wrong. Rendering tacit ethical frameworks more explicit makes them available for reflection and debate. (shrink)

Academic incivility can create divisiveness and affect learners’ sustainability towards degree attainment. Therefore, there is a need to empirically assess learner views on what constitutes academic incivility in higher education. To fill this gap, we developed the Incivility Indicators Instrument (i3), a multifaceted scale that measures the extent to which students view cumulative behaviors and dynamics as instances of academic incivility. To examine the reliability and factor structure of the i3, we conducted a two-part study with two samples of adults (...) in the United States who were enrolled in higher education programs. In study 1 (N = 342), we conducted an exploratory factor analysis (EFA) and found the initial three-factor structure. In study 2, we administered the instrument to a validating sample (N = 510) and examined the stability of the three-factor model and scores through confirmatory factor analysis (CFA). In this study, we describe the results of the study, provide implications, and discuss future directions. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

Recently, shifting societal attitudes towards animals have resulted in an increasing challenge to the ‘social license’ to use animals in competitive sport. Against that background, this paper explores whether the use of animals in competitive sport is ever justifiable from the perspective of three commonly used ethical theories: deontology, utilitarianism and virtue ethics. In so doing, it recognises the importance of human understanding of animals as sentient beings. The author argues that when deontology, utilitarianism and virtue ethics are each used (...) to consider the question ‘Is the use of animals in sport ethically justifiable?’, only absolutist rights theory leads to a negative conclusion. Specified rights theory, utilitarianism and virtue ethics all allow for the human use of animals in sport. However, the author then goes onto argue that even if one does not accept an absolutist rights point of view and does believe that the use of animals in sport is generally ethically justifiable, that use should be limited by fulfilment of certain ‘qualifying constraints’: (a) minimisation of negative welfare effects and maximisation of positive welfare effects, to enable ‘good lives’ for animals (b) identification of and mitigation against avoidable, unnecessary risk and (c) compliance with governing body regulations and the law. (shrink)

Taking Rom Harré's social constructionism as a focus we point to and discuss the issue of the a priori psychological subject in social constructionist theory. While Harré indicates that interacting, intending beings are necessary for conversation to occur, he assumes that the primary human reality is conversation and that psychological life emerges from this social domain. Nevertheless, we argue that a fundamental and agentive psychological subject is implicit to his constructionist works. Our critical analyses focus upon Harré's understandings of persons, (...) human development and human agency. Our intention is neither to suggest that this latent entity must be understood in a Cartesian sense nor is it to ask for an explicit accounting of an autonomous agent. Rather, our claim is simply that psychological subjectivity is reflexively entailed in Harré's human psychology. We suggest that this pertains more generally to social constructionist theory. (shrink)

Medical discourse in the contemporary United States is rife with military metaphors. These metaphors have come under vigorous criticism over the last few decades but to no avail; the militaristic tendency has proven tenacious. This essay suggests that its tenacity stems, at least in part, from a dualistic understanding of medicine unaddressed by prior criticisms. For an alternative, this essay turns to Augustine of Hippo, balancing close readings of works that deal explicitly with medical themes—The Catholic Way of Life and (...) the Manichean Way of Life (De moribus) and The Nature of the Good (De natura boni)—with a constructive approach. By adapting Augustine's privative account of evil, we can understand disease as a condition of loss and treatment as a task of restoration. This reconfiguration shifts the focus of our interpretive discourses from malicious invaders to a fuller affirmation of the lived experiences of those who are ill. (shrink)

Two complementary biographies of Ayn Rand were published in 2009: Goddess of the Market, by Jennifer Burns, and Ayn Rand and the World She Made, by Anne Heller. Burns focuses on Rand's influence on American political thought, while Heller's concern is Rand the screenwriter, novelist, and author of her personal mythos. Both books are meticulously researched and well written; neither author espouses Rand's philosophy or agrees with her politics. Such books establish that Rand's ideas have become part of American culture (...) and are no longer set over and against it. (shrink)

In her ground-breaking and highly influential book Transformative Experience, L.A. Paul makes two claims: (1) one cannot evaluate and compare certain experiential outcomes (e.g. being a parent and being a non-parent) unless one can grasp what these outcomes are like; and (2) one can evaluate and compare certain intuitively horrible outcomes (e.g. being eaten alive by sharks) as bad and worse than certain other outcomes even if one cannot grasp what these intuitively horrible outcomes are like. We argue that the (...) conjunction of these two claims leads to an implausible discontinuity in the evaluability of outcomes. One implication of positing such a discontinuity is that evaluative comparisons of outcomes will not be proportionally sensitive to variation in the underlying features of these outcomes. This puts pressure on Paul to abandon either (1) or (2). But (1) is central to her view and (2) is very hard to deny. We call this the Shark Problem. (shrink)

Marine ecosystems are under increasing pressure from human activity, yet successful management relies on knowledge. The evidence-based policy (EBP) approach has been promoted on the grounds that it provides greater transparency and consistency by relying on ‘high quality’ information. However, EBP also creates epistemic responsibilities. Decision-making where limited or no empirical evidence exists, such as is often the case in marine systems, creates epistemic obligations for new information acquisition. We argue that philosophical approaches can inform the science-policy interface. Using marine (...) biosecurity examples, we specifically examine the epistemic challenges in the acquisition and acceptance of evidence to inform policy, discussing epistemic due care and biases in consideration of evidence. (shrink)

It is often argued that the indispensability of continuum models comes from their empirical adequacy despite their decoupling from the microscopic details of the modelled physical system. There is thus a commonly held misconception that temperature varying across a region of space or time can always be accurately represented as a continuous function. We discuss three inter-related cases of temperature modelling — in phase transitions, thermal boundary resistance and slip flows — and show that the continuum view is fallacious on (...) the ground that the microscopic details of a physical system are not necessarily decoupled from continuum models. We show how temperature discontinuities are present in both data (experiments and simulations) and phenomena (theory and models) and how discontinuum models of temperature variation may have greater empirical adequacy and explanatory power. The conclusions of our paper are: a) continuum idealisations are not indispensable to modelling physical phenomena and both continuous and discontinuous representations of phenomena work depending on the context; b) temperature is not necessarily a continuously defined function in our best scientific representations of the world; and c) that its continuity, where applicable, is a contingent matter. We also raise a question as to whether discontinuous representations should be considered truly de-idealised descriptions of physical phenomena. (shrink)

RÉSUMÉ: Jaegwon Kim a montré de façon convaincante que les versions habituelles de la survenance décrivent en fait de simples relations de covariance et laissent échapper l’idée de dépendance. Mais puisque la dépendance du mental à l’endroit du physique est requise même par la version la plus faible du physicalisme, il semblerait bien que les notions actuelles de survenance n’accomplissent pas ce qu’on attendait d’elles. Je soutiens qu’en concevant la survenance dans une optique davidsonienne, comme une relation entre prédicats plutôt (...) qu’entre propriétés, on évite les inconvénients des versions plus familières, et que l’on donne prise, de la sorte, à un usage physicaliste de la survenance. (shrink)

This study reexamines the existentialist nature of Walker Percy's fiction, arguing that his debt to Kierkegaard is more substantial than previously acknowledged. Others have noted his employ of Kierkegaardian stages, terminology, and artistic indirection, but they haven't revealed the extent to which his sources lie in Kierkegaard and the action of his novels occurs within the context of a "Kierkegaardian narrative." Prior critics have overstated both the role his protagonist's "searches" and the assistance of others play in their movement to (...) faith. This study rejects the Marcelian reading of Percy's endings and demonstrates that his characters follow a Kierkegaardian path toward faith; they do not move toward faith via the assistance of an other, but subjectively, by despairing of their efforts to find ontological answers in immanent sources and choosing, in the midst of that despair, a paradoxical faith. ;Chapter one pairs Kierkegaardian philosophy with views espoused by Percy in his nonfiction and interviews in order to establish their intellectual affinities: each uses art as a means of responding to the objectifying forces of rationalism and posits a movement toward self which necessitates the embrace of faith after despairing of an aesthetic existence. The second and third chapters provide extended Kierkegaardian readings of The Moviegoer and The Last Gentleman, tracing their sources to his philosophy and demonstrating how each can be read within a Kierkegaardian framework and as a tacit either/or. Percy's protagonists either "come to themselves" by despairing of their own searches and realizing a subjective faith , or they remain in Kierkegaard's aesthetic stage, separated from faith, and thus lost to themselves . Both readings of Percy's novels reveal the ways in which he continually adopts Kierkegaardian categories, images, and details as he works within the larger framework of the paradoxical movement toward faith. The study concludes by emphasizing the Christian character of the narratives of Kierkegaard and Percy and arguing that a strict Kierkegaardian reading of Percy's fiction is more illuminating than the use of multiple existentialist perspectives. (shrink)

This paper offers a defense of naturalism, which might improve its chance of being adopted as a direction, both for theory and for empirical research. This defense responds in particular to three themes:: the emergence of mind , the pervasiveness of nonlinearity in biology and psychology, and the need for levels and degrees of self . Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; (...) mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}. (shrink)

So-called ‘distinctively mathematical explanations’ (DMEs) are said to explain physical phenomena, not in terms of contingent causal laws, but rather in terms of mathematical necessities that constrain the physical system in question. Lange argues that the existence of four or more equilibrium positions of any double pendulum has a DME. Here we refute both Lange’s claim itself and a strengthened and extended version of the claim that would pertain to any n-tuple pendulum system on the ground that such explanations are (...) actually causal explanations in disguise and their associated modal conditionals are not general enough to explain the said features of such dynamical systems. We argue and show that if circumscribing the antecedent for a necessarily true conditional in such explanations involves making a causal analysis of the problem, then the resulting explanation is not distinctively mathematical or non-causal. Our argument generalises to other dynamical systems that may have purported DMEs analogous to the one proposed by Lange, and even to some other counterfactual accounts of non-causal explanation given by Reutlinger and Rice. (shrink)

There are two main questions in epistemology: What is knowledge? And: Do we have any of it? The first question asks after the nature of a concept; the second involves grappling with the skeptic, who believes that no one knows anything. This collection of original essays addresses the themes of knowledge and skepticism, offering both contemporary epistemological analysis and historical perspectives from leading philosophers and rising scholars. Contributors first consider knowledge: the intrinsic nature of knowledge -- in particular, aspects of (...) what distinguishes knowledge from true belief; the extrinsic examination of knowledge, focusing on contextualist accounts; and types of knowledge, specifically perceptual, introspective, and rational knowledge. The final chapters offer various perspectives on skepticism. Knowledge and Skepticism provides an eclectic yet coherent set of essays by distinguished scholars and important new voices. The cutting-edge nature of its contributions and its interdisciplinary character make it a valuable resource for a wide audience -- for philosophers of language as well as for epistemologists, and for psychologists, decision theorists, historians, and students at both the advanced undergraduate and graduate levels. Contributors: Kent Bach, Joseph Keim Campbell, Joseph Cruz, Fred Dretske, Catherine Z. Elgin, Peter S. Fosl, Peter J. Graham, David Hemp, Michael O'Rourke, George Pappas, John L. Pollock, Duncan Pritchard, Joseph Salerno, Robert J. Stainton, Harry S. Silverstein, Joseph Thomas Tolliver, Leora Weitzman The hardcover edition does not include a dust jacket. (shrink)

This chapter contains sections titled: The School in the Garden Prehistory and the Rise of Cities The Locus Amoenus and the Origins of Agriculture Diogenes of Oinoanda and the Future Epicurean Golden Age Notes.

Book reviewed in this article: Practical Medical Ethics. By Alastair Campbell, Grant Gillett, and Gareth Jones. If I Were a Rich Man Could I Buy a Pancreas? and Other Essays on the Ethics of Health Care. By Arthur L. Caplan. Bloomington Ethics on Call: A Medical Ethicist Shows How to Take Charge of Life and Death Choices in Today's Health Care System. By Nancy Dubler and David Nimmons.

There is a major debate as to whether there are non-causal mathematical explanations of physical facts that show how the facts under question arise from a degree of mathematical necessity considered stronger than that of contingent causal laws. We focus on Marc Lange’s account of distinctively mathematical explanations to argue that purported mathematical explanations are essentially causal explanations in disguise and are no different from ordinary applications of mathematics. This is because these explanations work not by appealing to what the (...) world must be like as a matter of mathematical necessity but by appealing to various contingent causal facts. (shrink)

William Connolly, one of the best-known and most important political theorists writing today, is a principal architect of the “new pluralism.” In this volume, leading thinkers in contemporary political theory and international relations provide a comprehensive investigation of the new pluralism, Connolly’s contributions to it, and its influence on the fields of political theory and international relations. Together they trace the evolution of Connolly’s ideas, illuminating his challenges to the “old,” conventional pluralist theory that dominated American and British political science (...) and sociology in the second half of the twentieth century. The contributors show how Connolly has continually revised his ideas about pluralism to take into account radical changes in global politics, incorporate new theories of cognition, and reflect on the centrality of religion in political conflict. They engage his arguments for an agonistic democracy in which all fundamentalisms become the objects of politicization, so that differences are not just tolerated but are productive of debate and the creative source of a politics of becoming. They also explore the implications of his work, often challenging his views to widen the reach of even his most recently developed theories. Connolly’s new pluralism will provoke all citizens who refuse to subordinate their thinking to the regimes in which they reside, to religious authorities tied to the state, or to corporate interests tied to either. _The New Pluralism_ concludes with an interview with Connolly in which he reflects on the evolution of his ideas and expands on his current work. _Contributors_: Roland Bleiker, Wendy Brown, David Campbell, William Connolly, James Der Derian, Thomas L. Dumm, Kathy E. Ferguson, Bonnie Honig, George Kateb, Morton Schoolman Michael J. Shapiro, Stephen K. White. (shrink)

Fractal geometry offers a new approach to describing the morphology of fern leaves. Traditional morphology is based on the Euclidean concept of shape as an area defined by a boundary. This approach has not proven successful with fern leaves because they are so elaborate. Fractal geometry treats forms as relationships between parts rather than as areas. In fern fronds there are often constant relationships between parts. Four fractal methodologies for describing these relations within leaves are explored in this paper. These (...) include recursive line branching algorithms, iterated function systems (IFS), modifications of IFS, and L-systems. The methods are evaluated by comparing their results with measurements and appearances of various ferns. Fractal methods offer objective, quantifiable and succinct descriptions of fern-leaves. We conclude that fractal geometry offers simple descriptions of some elaborate fern shapes and that it will probably have application in investigating different aspects of ferns and other organisms. (shrink)