Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions - not all - are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and (...) knowledge, and are not likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time. (shrink)

This work, which questions the medical model of psychiatry as the basis of psychotherapy, seeks to help professionals return their field to an activity that is ...

Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions—not all—are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and knowledge, and are not (...) likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time. (shrink)

La présente contribution propose une étude de la périphérie gauche au sein d’un corpus oral multigenres, représentant douze activités de communication orale, annoté syntaxiquement et prosodiquement. La segmentation discursive du corpus en unités de base du discours (BDU) résulte d’une coïncidence entre unités syntaxiques et prosodiques, correspondant à des encodages linguistiques distincts mais complémentaires. Partant du postulat selon lequel ces unités discursives remplissent une fonction cognitive dans la planification et l’interprétation du discours, nous nous intéressons à l’étude de leur périphérie (...) gauche. Ce lieu, qui constitue le point d’ancrage du message, joue en effet un rôle important dans la négociation de la structure discursive. Dans l’objectif d’étudier les stratégies discursives à l’œuvre dans les différents genres du corpus, nous faisons l’inventaire des types formels observés et étudions finalement les fonctions discursives que ces éléments périphériques peuvent revêtir. (shrink)

The ethical conduct of research in any setting hinges on the voluntary and informed consent of research participants. Working towards consent that is truly voluntary and informed, however, is far from straightforward, and requires attention to contextual factors that may complicate achievement of this ideal in specific research settings. This paper is based on Madagascar’s first “Consent complexities in health research in Madagascar” workshop, held in Antananarivo, Madagascar, in October 2018. It identifies a number of challenges encountered by individuals responsible (...) for the conduct or oversight of health research in Madagascar related to informed and voluntary consent. Key challenges identified included: adaptation of consent tools into local dialects and for limited literacy populations; perceived acquiescence of potential participants regardless of actual preference based on cultural norms; perceived time pressures within tight project timelines to collect data as quickly as possible, limited time for consent processes; fears and taboos related to specific research procedures or topics; and, uncertainty about how best to approach and verify the validity of individual consent in contexts where traditional leaders’ influence is conventionally sought out and respected. Potential strategies for responding to each of these challenges are proposed, as are key questions meriting further study. (shrink)

Intent and mitigating circumstances play a central role in moral and legal assessments in large-scale industrialized societies. Al- though these features of moral assessment are widely assumed to be universal, to date, they have only been studied in a narrow range of societies. We show that there is substantial cross-cultural variation among eight traditional small-scale societies (ranging from hunter-gatherer to pastoralist to horticulturalist) and two Western societies (one urban, one rural) in the extent to which intent and mitigating circumstances influence (...) moral judgments. Although participants in all societies took such factors into account to some degree, they did so to very different extents, varying in both the types of considerations taken into account and the types of violations to which such considerations were applied. The particular patterns of assessment characteristic of large-scale industrialized societies may thus reflect relatively recently culturally evolved norms rather than inherent features of human moral judgment. (shrink)

Decades of research conducted in Western, Educated, Industrialized, Rich, & Democratic (WEIRD) societies have led many scholars to conclude that the use of mental states in moral judgment is a human cognitive universal, perhaps an adaptive strategy for selecting optimal social partners from a large pool of candidates. However, recent work from a more diverse array of societies suggests there may be important variation in how much people rely on mental states, with people in some societies judging accidental harms just (...) as harshly as intentional ones. To explain this variation, we develop and test a novel cultural evolutionary theory proposing that the intensity of kin-based institutions will favor less attention to mental states when judging moral violations. First, to better illuminate the historical distribution of the use of intentions in moral judgment, we code and analyze anthropological observations from the Human Area Relations Files. This analysis shows that notions of strict liability—wherein the role for mental states is reduced—were common across diverse societies around the globe. Then, by expanding an existing vignette-based experimental dataset containing observations from 321 people in a diverse sample of 10 societies, we show that the intensity of a society's kin-based institutions can explain a substantial portion of the population-level variation in people's reliance on intentions in three different kinds of moral judgments. Together, these lines of evidence suggest that people's use of mental states has coevolved culturally to fit their local kin-based institutions. We suggest that although reliance on mental states has likely been a feature of moral judgment in human communities over historical and evolutionary time, the relational fluidity and weak kin ties of today's WEIRD societies position these populations' psychology at the extreme end of the global and historical spectrum. (shrink)

To deal with the upcoming challenges and complexity of the nursing profession, it is deemed important to reflect on our current organization of care. However, before starting to rethink the organization of nursing care, an overview of important elements concerning nursing care organization, more specifically nursing models, is necessary. The aim of this study was to conduct a mapping review, accompanied by an evidence map to map the existing literature, to map the field of knowledge on a meta‐level and to (...) identify current research gaps concerning nursing models in a hospital setting. Next to nursing models, two other organizational correlates seem to be of importance when looking at the organization of nursing care: nurse staffing and skill mix. Although it seems that in recent research, the theoretical focus on the organization of nursing care has been left behind, the increasingly complex healthcare environment might gain from the use of nursing theory, or in this case, care delivery models. As almost no fundamental studies have been done toward the combination of care delivery models, nurse staffing, and skill mix, those elements should be taken into account to fully capture the organization of nursing care in future research. (shrink)

This paper explores the question of whether there is a conceptual distinction between romantic love and friendship and whether such a distinction would support the normative conclusion that friends should not be lovers. Laurence Thomas has argued that, given an egalitarian conception of romantic love, there is no such distinction between romantic love and friendship. This paper shows that equally egalitarian alternatives to Thomas’s conceptions of love and friendship do suggest that friends should not be lovers. Moreover, the alternative (...) view of romantic love defended in the paper supports a link between romantic love and sexual exclusivity. (shrink)

At the end of the sixth volume of The Life and Opinions of Tristram Shandy, Laurence Sterne’s irremediably digressive narrator looks back over the story he has told so far. He presents to the reader five horizontal lines drawn on the page, each of which is the line taken by the narrative in one of the preceding five volumes of the novel.1 Each of the lines is interrupted at intervals by a series of fantastical loops and squiggles, darting forward (...) or back for anticipations and flashbacks, dented by brief subplots, or ballooning outward in wild-goose chases, extended commentaries, and stories within stories. He claims his storytelling is improving: while his distraction in the first volume “led us a vagary some. (shrink)

Moral Problems in Higher Education brings together key essays that explore ethical issues in academia. The editor and contributors-all noted philosophers and educators-consider such topics as academic freedom and tenure, free speech on campus, sexual harassment, preferential student admissions, affirmative action in faculty appointments, and the ideal of a politically neutral university. Chapters address possible restrictions on research because of moral concerns, the structure of peer review, telling the truth to colleagues and students, and concerns raised by intercollegiate athletics. Cahn (...) selects two key readings in each area to offer a readable introductory guide to these critical subjects for students studying academic ethics and higher education policy. In addition to the selections and a general introduction, Cahn provides study questions for use in the classroom. Contributors include Scott F. Aikin, Derek Bok, William G. Bowen, Myles Brand, Richard T. DeGeorge, Paul D. Eisenberg, Leslie Pickering Francis, Martin P. Golding, Philip Kitcher, Charles R. Lawrence III, David Lewis, Paul J. Olscamp, Nancy Tuana, David Shatz, George Sher, Robert L. Simon, Robert B. Talisse, Stephan Thernstrom, Abigail Thernstrom, Laurence Thomas, Robert Paul Wolff, and the editor. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume XXVI, Number 1, April 2000, pp. 129-142 Hume on ''Greatness of Soul" GRAHAM SOLOMON The "great-souled man" was first described in detail in Book iv of Aristotle's Nicomachean Ethics. Simon Blackburn concisely summarizes Aristotle's portrait of this "lofty character": "The great-souled man is of a distinguished situation, worthy of great things, 'an extreme in respect of the greatness of his claims, but a mean in (...) respect of the Tightness of them', perfectly virtuous, good at conferring benefits but ashamed of receiving them, neither humble nor vain. The combination involves proper pride or magnanimity." Such men will enter politics with the aim of preserving justice and working for the good of society, or they will exhibit great personal courage in battle, or, more generally, they will aim at virtuous action at all times, even when faced with painful choices and life-threatening circumstances. Historians disagree about whether Aristotle held that the great-souled man is motivated in part by a desire to be admired by others, but certainly he held that the great-souled man was capable of performing great and virtuous actions that would be admired.1 By the mid-eighteenth century, greatness of soul could be found in much less distinguished situations. Consider, for example, Laurence Sterne's Tristram Shandy. Tristram attributes greatness of soul to his mother for wanting to give birth to him under the care of a midwife rather than a doctor. His father thinks that turning down a large purse of money offered in exchange for naming one's son Judas is an act of greatness of mind. And Tristram says his friend Jenny exhibited greatness of soul by purchasing a much less expensive piece of silk than the one she initially wanted, deferring to Tristram's unvoiced but Graham Solomon is at the Philosophy Department,Wilfrid Laurier University,Waterloo, Ontario, Canada N2L 3C5. e-mail: [email protected] 130 Graham Solomon obvious judgment.2 For an example from the nineteenth century, consider the following passage from the novel The Wrecker (1891) by Robert Louis Stevenson and Lloyd Osbourne. The narrator, a wealthy young American, is slumming as a bohemian art student in the Latin Quarter of Paris: "I always looked with awful envy... on a certain countryman of my own, who had a studio in the Rue Monsieur Ie Prince, wore boots, and long hair in a net, and could be seen tramping off, in this guise, to the worst eating-house of the quarter, followed by a Corsican model, his mistress, in the conspicuous costume of her race and calling. It takes some greatness of soul to carry even folly to such heights as these."3 There the character's greatness of soul seems to involve an ability to ignore or overlook or misinterpret the opinions others might have of him. While the phrase "greatness of soul" or "greatness of mind" is not commonly used nowadays,4 the Latin form "magnanimity" is still in use in ordinary, everyday, reasonably educated discourse. And occasionally "highmindedness " is used. The capacity to make magnanimous gestures is still widely felt to be a virtue. "Magnanimity" nowadays refers to a mix of unselfishness, generosity, the capacity to rise above petty feelings of resentment and revenge, and more generally and vaguely to a kind of nobility of heart and mind. These are features that Aristotle would recognize. But, it seems to me, we are prepared to apply the term to a far wider class of people than Aristotle would. Magnanimity is nowadays thought to be a virtue that can be exhibited by almost anyone. The first extended discussion in English-language philosophy of the concept of greatness of soul or mind is in David Hume's Treatise III iii 2, a section titled "Of greatness of mind." Hume's discussion contributed to a domesticated and democratized understanding of the concept, a more serious ancestor of the concept found in Tristram Shandy5 and The Wrecker. Donald Siebert argues in the chapter "In Search of the Hero of Feeling" in The Moral Animus of David Hume6 that after the initial exploration of the concept in the Treatise, Hume eventually settled in The History... (shrink)

Wide-ranging essays making up the first major study of Nietzsche and the classical tradition in a quarter of a century. This volume collects a wide-ranging set of essays examining Friedrich Nietzsche's engagement with antiquity in all its aspects. It investigates Nietzsche's reaction and response to the concept of "classicism," with particular reference to his work on Greek culture as a philologist in Basel and later as a philosopher of modernity, and to his reception of German classicism in all his texts. (...) The book should be of interest to students of ancient history and classics, philosophy, comparative literature, and Germanistik. Taken together, these papers suggest that classicism is both a more significant, and a more contested, concept for Nietzsche than is often realized, and it demonstratesthe need for a return to a close attention to the intellectual-historical context in terms of which Nietzsche saw himself operating. An awareness of the rich variety of academic backgrounds, methodologies, and techniques of reading evinced in these chapters is perhaps the only way for the contemporary scholar to come to grips with what classicism meant for Nietzsche, and hence what Nietzsche means for us today. The book is divided into five sections -- The Classical Greeks; Pre-Socratics and Pythagoreans, Cynics and Stoics; Nietzsche and the Platonic Tradition; Contestations; and German Classicism -- and constitutes the first major study of Nietzsche and the classical tradition in a quarter of a century. Contributors: Jessica N. Berry, Benjamin Biebuyck, Danny Praet and Isabelle Vanden Poel, Paul Bishop, R. Bracht Branham, Thomas Brobjer, David Campbell, Alan Cardew, Roy Elveton, Christian Emden, Simon Gillham, John Hamilton, Mark Hammond, Albert Henrichs, Dirk t.D. Held, David F. Horkott, Dylan Jaggard, Fiona Jenkins, Anthony K. Jensen, Laurence Lampert, Nicholas Martin, Thomas A. Meyer, Burkhard Meyer-Sickendiek, John S. Moore, Neville Morley, David N. McNeill, James I. Porter, Martin A. Ruehl, Herman Siemens, Barry Stocker, Friedrich Ulfers and Mark Daniel Cohen, and Peter Yates. Paul Bishop is William Jacks Chair of Modern Languages at the University of Glasgow. (shrink)

1 Knowledge and Justification This book is an investigation of one central problem which arises in the attempt to give a philosophical account of empirical ...

The book was planned and written as a single, sustained argument. But earlier versions of a few parts of it have appeared separately. The object of this book is both to establish the existence of the paradoxes, and also to describe a non-Pascalian concept of probability in terms of which one can analyse the structure of forensic proof without giving rise to such typical signs of theoretical misfit. Neither the complementational principle for negation nor the multiplicative principle for conjunction applies (...) to the central core of any forensic proof in the Anglo-American legal system. There are four parts included in this book. Accordingly, these parts have been written in such a way that they may be read in different orders by different kinds of reader. (shrink)

This book offers a unique synthesis of past and current work on the structure, meaning, and use of negation and negative expressions, a topic that has engaged thinkers from Aristotle and the Buddha to Freud and Chomsky. Horn's masterful study melds a review of scholarship in philosophy, psychology, and linguistics with original research, providing a full picture of negation in natural language and thought; this new edition adds a comprehensive preface and bibliography, surveying research since the book's original publication.

One of the many problems that would have t o be solved by a satisfactory theory of empirical knowledge, perhaps the most central is a general structural problem which I shall call the epistemic regress problem: the problem of how to avoid an in- finite and presumably vicious regress of justification in ones account of the justifica- tion of empirical beliefs. Foundationalist theories of empirical knowledge, as we shall see further below, attempt t o avoid the regress by locating a (...) class of empirical beliefs whose justification does not depend on that of other empirical beliefs. Extemalist theories, the topic of the present paper, represent one species of foundationalism. (shrink)

ONE Introduction The history of psychology in the twentieth century is a story of the divorce and remarriage of psychology and philosophy. ...

In this incisive new book one of Britain's most eminent philosophers explores the often overlooked tension between voluntariness and involuntariness in human cognition. He seeks to counter the widespread tendency for analytic epistemology to be dominated by the concept of belief. Is scientific knowledge properly conceived as being embodied, at its best, in a passive feeling of belief or in an active policy of acceptance? Should a jury's verdict declare what its members involuntarily believe or what they voluntarily accept? And (...) should statements and assertions be presumed to express what their authors believe or what they accept? Does such a distinction between belief and acceptance help to resolve the paradoxes of self-deception and akrasia? Must people be taken to believe everything entailed by what they believe, or merely to accept everything entailed by what they accept? Through a systematic examination of these problems, the author sheds new light on issues of crucial importance in contemporary epistemology, philosophy of mind, and cognitive science. (shrink)

Given the fundamental role that concepts play in theories of cognition, philosophers and cognitive scientists have a common interest in concepts. Nonetheless, there is a great deal of controversy regarding what kinds of things concepts are, how they are structured, and how they are acquired. This chapter offers a detailed high-level overview and critical evaluation of the main theories of concepts and their motivations. Taking into account the various challenges that each theory faces, the chapter also presents a novel approach (...) to concepts that is organized around two ideas. The first is a pluralistic view of differing types of conceptual structure. The second is a model that treats concepts as atomic representations that are linked to various types of conceptual structures. (shrink)

This book is concerned with the alleged capacity of the human mind to arrive at beliefs and knowledge about the world on the basis of pure reason without any dependence on sensory experience. Most recent philosophers reject the view and argue that all substantive knowledge must be sensory in origin. Laurence BonJour provocatively reopens the debate by presenting the most comprehensive exposition and defence of the rationalist view that a priori insight is a genuine basis for knowledge. This important (...) book will be at the centre of debate about the theory of knowledge for many years to come. (shrink)

Noam Chomsky's Poverty of the Stimulus Argument is one of the most famous and controversial arguments in the study of language and the mind. Though widely endorsed by linguists, the argument has met with much resistance in philosophy. Unfortunately, philosophical critics have often failed to fully appreciate the power of the argument. In this paper, we provide a systematic presentation of the Poverty of the Stimulus Argument, clarifying its structure, content, and evidential base. We defend the argument against a variety (...) of philosophical criticisms, new and old, and argue that the Poverty of the Stimulus Argument continues to deserve its guiding role in the study of language and the mind. (shrink)

In Epistemology, Laurence Bonjour introduces the serious philosophy student to the history and concepts of epistemology, while simultaneously challenging them to take an active part in its ongoing debates. The text reflects BonJour's conviction that the place to start any discussion of the theories of knowledge is with the classical problems, beginning with and centered around Descartes.

Johnathan Cohen's book provides a lucid and penetrating treatment of the fundamental issues of contemporary analytical philosophy. This field now spans a greater variety of topics and divergence of opinion than fifty years ago, and Cohen's book addresses the presuppositions implicit to it and the patterns of reasoning on which it relies.

Conceptual analysis is undergoing a revival in philosophy, and much of the credit goes to Frank Jackson. Jackson argues that conceptual analysis is needed as an integral component of so-called serious metaphysics and that it also does explanatory work in accounting for such phenomena as categorization, meaning change, communication, and linguistic understanding. He even goes so far as to argue that opponents of conceptual analysis are implicitly committed to it in practice. We show that he is wrong on all of (...) these points and that his case for conceptual analysis doesn't succeed. At the same time, we argue that the sorts of intuitions that figure in conceptual analysis may still have a significant role to play in philosophy. So naturalists needn't disregard intuitions altogether. (shrink)

Radical concept nativism is the thesis that virtually all lexical concepts are innate. Notoriously endorsed by Jerry Fodor (1975, 1981), radical concept nativism has had few supporters. However, it has proven difficult to say exactly what’s wrong with Fodor’s argument. We show that previous responses are inadequate on a number of grounds. Chief among these is that they typically do not achieve sufficient distance from Fodor’s dialectic, and, as a result, they do not illuminate the central question of how new (...) primitive concepts are acquired. To achieve a fully satisfactory response to Fodor’s argument, one has to juxtapose questions about conceptual content with questions about cognitive development. To this end, we formulate a general schema for thinking about how concepts are acquired and then present a detailed illustration. (shrink)

First published in 1969, this volume presents a survey of the contemporary national education system in Latin American countries. Laurence Gale describes the uneven provision of schools for different sections of the community and the problems which arise with the racial, cultural and geographical difficulties. He examines the main features in education throughout Latin America, areas of co-operation and agreement and differences of policy and provision.

Originally published in 1973. This book presents a valid mode of reasoning that is different to mathematical probability. This inductive logic is investigated in terms of scientific investigation. The author presents his criteria of adequacy for analysing inductive support for hypotheses and discusses each of these criteria in depth. The chapters cover philosophical problems and paradoxes about experimental support, probability and justifiability, ending with a system of logical syntax of induction. Each section begins with a summary of its contents and (...) there is a glossary of technical terms to aid the reader. (shrink)

In non-ideal theory, the political philosopher seeks to identify an injustice, synthesize social scientific work to diagnose its underlying causes, and propose morally permissible and potentially efficacious remedies. This paper explores the role in non-ideal theory of the identification of a plausible agent of change who might bring about the proposed remedies. I argue that the question of the agent of change is connected with the other core tasks of diagnosing injustice and proposing practical remedies. In this connection, I criticize (...) two linked postures that nonideal theorists sometimes adopt: a technocratic mode of neutral policy recommendation, whereby philosophers say what “we” must do to address some problem, without attending to the way agency enters the problem and its possible resolution; and the tendency to treat non-ideal theory as primarily consisting int eh enumeration of duties we are failing to fulfill, and specification of who is under what additional duties in light of this shortfall. My argument is that these tendencies fail to register in a coherent way the practical character of political philosophy. (shrink)

My aim in this paper is to explore the dispute between foundationalism and coherentism and attempt a resolution. I will begin by considering the origin of the issue in the famous epistemic regress problem. Next I will explore the central foundationalist idea and the most central objections that have been raised against foundationalist views. This will lead to a consideration of the main contours of the coherentist alternative, and eventually to a discussion of objections to coherentism – including several specific (...) ones that I now judge to be clearly fatal, especially when taken together. This will motivate, finally, a reconsideration of foundationalism. I will argue that the dialectically most serious objection to foundationalism can be successfully answered. While the answer that I will suggest admittedly carries with it the price of aggravating certain other difficulties, especially the venerable problem of showing how belief in an external world of physical objects can be justified, it still seems to me to leave foundationalism as by far the more defensible and promising of the two alternatives. (shrink)

One of the most important abilities we have as humans is the ability to think about number. In this chapter, we examine the question of whether there is an essential connection between language and number. We provide a careful examination of two prominent theories according to which concepts of the positive integers are dependent on language. The first of these claims that language creates the positive integers on the basis of an innate capacity to represent real numbers. The second claims (...) that language’s function is to integrate contents from modules that humans share with other animals. We argue that neither model is successful. (shrink)