The continuing spread and development of electronic data interchange in health care settings is fuelling a significant global debate about the practicality, ethics, and legality of such a practice. The uncertainties implicit in this debate are particularly acute in the context of disease or population groups for whom multidisciplinary, multipleagency teamworking has become acknowledged as the “best practice” for providing effective and timely care or support. The greying of the population is a demographic phenomenon that will have a profound impact (...) on the health care system, social care agencies, and caregivers, and will require a greater degree of service coordination in order to meet the complex care needs of both care-receiver and caregiver. (shrink)

This article draws attention to a pattern of development within science and other intellectual research communities that has received virtually no mention. We propose that subsequent dominance of a research community by a figure responsible for significant innovation often delays progress in the field. During the period in which the revolutionary continues to influence research in a community, far too frequently the effect is to freeze progress within the limited directions which the revolutionary sanctions.

Propositionalism is the view that the contents of intentional attitudes have a propositional structure. Objectualism opposes propositionalism in allowing the contents of these attitudes to be ordinary objects or properties. Philosophers including Talbot Brewer, Paul Thagard, Michelle Montague, and Alex Grzankowski attack propositionalism about such attitudes as desire, liking, and fearing. This article defends propositionalism, mainly on grounds that it better supports psychological explanations.

The claim that addiction is a brain disease is almost universally accepted among scientists who work on addiction. The claim’s attraction rests on two grounds: the fact that addiction seems to be characterized by dysfunction in specific neural pathways and the fact that the claim seems to the compassionate response to people who are suffering. I argue that neural dysfunction is not sufficient for disease: something is a brain disease only when neural dysfunction is sufficient for impairment. I claim that (...) the neural dysfunction that is characteristic of addiction is not sufficient for impairment, because people who suffer from that dysfunction are impaired, sufficiently to count as diseased, only given certain features of their context. Hence addiction is not a brain disease (though it is often a disease, and it may always involve brain dysfunction). I argue that accepting that addiction is not a brain disease does not entail a moralizing attitude toward people who suffer as a result of addiction; if anything, it allows for a more compassionate, and more effective, response to addiction. (shrink)

Introduction: The many faces of human nature / Agustín Fuentes and Aku Visala Chapter 1. Off human nature / Jonathan Marks. Response I. On your marks... get set, we’re off human nature / James M. Calcagno ; Response II. Rethinking human nature : comments on Jonathan Marks’s anti-essentialism / Phillip R. Sloan ; Response III. Off human nature and on human culture : the importance of the concept of culture to science and society / Robert Sussman and Linda Sussman Chapter (...) 2. "To human" is a verb / Tim Ingold. Response I. Free and easy wandering : humans, humane education, and designing in harmony with the nature of the way / Susan D. Blum ; Response II. On human natures : anthropological and Jewish musings / Richard Sosis ; Response III. The humanifying adventure : a response to Tim Ingold / Markus Mühling ; Response IV. The ontogenesis of human moral becoming / Darcia Narvaez Chapter 3. Recognizing the complexity of personhood : complex emergent developmental linguistic relational neurophysiologicalism / Warren Brown and Brad D. Strawn. Response I. "Self-organizing personhood" and many loose ends / Lluis Oviedo ; Response II. A last hurrah for dualism? / Kelly James Clark ; Response III. Why the foundational question about human nature is open and empirical / Carl Gillett Chapter 4. Human origins and the emergence of a distinctively human imagination : theology and the archaeology of personhood / J. Wentzel van Huyssteen. Response I. Constructing the face, creating the collective : Neolithic mediation of personhood / Ian Kuijt ; Response II. Imago Dei and the glabrous ape / Douglas Hedley Chapter 5. What is human nature for? / Grant Ramsey. Response I. The difficulties of forsaking normativity / Neil Arner ; Response II. Some remarks on human nature and naturalism / Aku Visala Epilogues. Putting evolutionary theory to work in investigating human nature / Agustín Fuentes ; Moving us forward? / Celia Deane-Drummond. (shrink)

In recent years there has been an outpouring of work at the intersection of social movement studies and organizational theory. While we are generally in sympathy with this work, we think it implies a far more radical rethinking of structure and agency in modern society than has been realized to date. In this article, we offer a brief sketch of a general theory of strategic action fields (SAFs). We begin with a discussion of the main elements of the theory, describe (...) the broader environment in which any SAF is embedded, consider the dynamics of stability and change in SAFs, and end with a respectful critique of other contemporary perspectives on social structure and agency. (shrink)

On normative order -- On institutional order-- Law and the constitutional state -- A problem : rules or habits? -- On persons -- Wrongs and duties -- Legal positions and relations : rights and obligations -- Legal relations and things : property -- Legal powers and validity -- Powers and public law : law and politics -- Constraints on power : fundamental rights -- Criminal law and civil society : law and morality -- Private law and civil society : law (...) and economy -- Positive law and moral autonomy -- On law and justice -- Law and values : reflections on method. (shrink)

Studies of the regulation of heme oxygenase by synthetic metalloporphyrins reveal that within this group of compounds there exist both inducers and inhibitors of the synthesis of this enzyme or of its catalytic function. The ability of metalloporphyrins to alter heme catabolism is of considerable experimental and clinical interest since such alterations may have consequences for other aspects of heme homeostasis, including its synthesis and its function in the form of cytochrome(s) P‐450. Examples of the metabolic effects – and their (...) potential clinical and pharmacological consequences – produced by two synthetic metalloporphyrins, Sn‐protoporphyrin and Co‐protoporphyrin, are discussed. (shrink)

An account of how a rational agent should revise beliefs in the light of new evidence.

Following a brief summation of the phenomenological method, the paper considers three metaethical positions adopted by phenomenologists and the implications of those positions for a normative ethics. The metaethical positions combine epistemological and ontological viewpoints. They are non-intellectualism and strong value realism as represented by the axiological views of phenomenologists such as Scheler, Meinong, Reinach, Stein, Hartmann, von Hildebrand, and Steinbock; non-intellectualism and anti-realism as represented by the freedom-centered phenomenologies of Sartre, Beauvoir, and Merleau-Ponty; and weak intellectualism and weak value (...) realism as represented by Husserl and Drummond. The paper argues that only the third metaethical view can support a normative ethics that is consistent with the essential features of the phenomenological method, that allows for freedom in an agent’s choosing from a multiplicity of first-order goods, including vocational goods, practical identities, and life plans, available in the agent’s factical circumstances, and that provides norms governing the correctness of our actions and our obligations to others. The normative dimension is introduced, first, by the requirement that the fulfillment of first-order evaluations and choices be truthful, that is, that the evaluations be appropriate and the actions right. Second, transcendental considerations revealed in the phenomenological analysis of intentional experience disclose a notion of second-order goods of agency that universally bind agents in their exercise of freedom and their dealings with others. (shrink)

When a patient lacks sufficient capacity to make a certain treatment decision, whether because of deficits in their ability to make a judgement that reflects their values or to make a decision that reflects their judgement or both, the decision must be made by a surrogate. Often the best way to respect the patient’s autonomy, in such cases, is for the surrogate to make a ‘substituted’ judgement on behalf of the patient, which is the decision that best reflects the patient’s (...) values and identity-infused beliefs as they were when the patient last possessed capacity. It is by now well-known that there is troubling evidence that surrogates do only slightly better than chance at making accurate substituted judgements. The use of a patient preference predictor, an algorithm that predicts patient preferences based on characteristics like the patient’s age, gender, socioeconomic status and education level, could help. Rid and Wendler have done important work making a moral case for using the PPP.1 If it were shown to enhance accuracy, it is not at all obvious what objections there could be to its use. Yet several subtle criticisms of the PPP have emerged in the literature. In their feature article, Jardas, Wasserman and Wendler select six of the most prominent objections to the PPP in the literature and defend the PPP against them.2 Along the way they make significant contributions to broader issues concerning the proper uses of statistical evidence and limits on the kinds of preferences there can be reasons of autonomy to respect. Since I found the authors’ answers to the final two objections—that the PPP relies on naked statistical evidence and that it uses non-endorsed reasons—to be especially interesting and provocative, I will examine those answers and raise a few questions about …. (shrink)

Brown, Neil The Twentieth Century began with Nietzsche's cry, 'God is dead', ringing in its ears. Peter Conrad's chronicle, Modern Times, Modern Places, traces the playing out of that announcement in the literature and arts of the succeeding hundred years, where, with only a few exceptions, such as Schoenberg and Eliot, atheism prevailed, with the result, according to Conrad, that the 'sky from which God was evicted is now thickly layered with data, and satellite dishes relay its messages.' Conrad (...) confidently assumes that at the end of the century God is not only dead, but also buried, and that modern culture has forgotten the place of his burial. (shrink)

Deception is a useful methodological device for studying attitudes and behavior, but deceptive studies fail to fulfill the informed consent requirements in the U.S. federal regulations. This means that before they can be approved by Institutional Review Boards, they must satisfy the four regulatory conditions for a waiver or alteration of these requirements. To illustrate our interpretation, we apply the conditions to a recent study that used deception to show that subjects judged the same wine as more enjoyable when they (...) believed it had a higher price. (shrink)

Today''s headlines suggest that economic criteria alone is the basis for business decision-making. This paper argues that while profitability is a legitimate end of business, it must be moderated by ethical considerations. But can business be both successfuland ethical? Practical examples highlight individuals who chose profitability over ethical responsibility and those who chose and continue to choose both. The authors propose that there is an ethical person profile. Corporate managers can resolve the profits vs ethics dilemma by modeling ethical behavior.

Mitochondrial function is achieved through the cooperative interaction of two genomes: one nuclear (nuDNA) and the other mitochondrial (mtDNA). The unusual transmission of mtDNA, predominantly maternal without recombination is predicted to affect the fitness of male offspring. Recent research suggests the strong sexual dimorphism in aging is one such fitness consequence. The uniparental inheritance of mtDNA results in a selection asymmetry; mutations that affect only males will not respond to natural selection, imposing a male‐specific mitochondrial mutation load. Prior work has (...) implicated this male‐specific mutation load in disease and infertility, but new data from fruit flies suggests a prominent role for mtDNA in aging; across many taxa males almost invariably live shorter lives than females. Here we discuss this new work and identify some areas of future research that might now be encouraged to explore what may be the underpinning cause of the strong sexual dimorphism in aging.Editor's suggested further reading in BioEssays: Mitonuclear match: Optimizing fitness and fertility over generations drives ageing within generations AbstractMitochondrial manoeuvres: Latest insights and hypotheses on mitochondrial partitioning during mitosis in Saccharomyces cerevisiae AbstractMitochondria and the culture of the Borg Abstract. (shrink)

Naïve realism is a theory of perception with great explanatory ambitions. It has been influentially argued that, in order to realize these explanatory ambitions, the naïve realist should say that any perception belongs to just one fundamental kind. I think, however, that adopting this commitment does not particularly help the naïve realist to realize her explanatory ambitions, and so is not warranted. This result is significant because once this commitment about fundamental kinds is relinquished, we see that it is possible (...) to develop some new and surprising forms of naïve realism—most notably, what I call pluralist naïve realism. (shrink)

“Spin” is a pejorative term for a ubiquitous form of communication. Spin is viewed by many as deceptive, and by others as bending or twisting the truth. But spin need not be deceptive and the metaphors are less than clear. The aim here is to clarify what spin is: spin is identified as a form of selective claim-making, where the process of selection is governed by an intention to bring about promotional perlocutionary effects. The process of selection may pertain to (...) aspects of some situation or phenomenon,; or to the lexis used in making the claims. Not all selective promotional communication is spin. Spin involves a distinctive kind of dissociation between the speaker’s first-order interpretation and the constructed interpretation or claim offered to others. With these clarifications in place the discussion turns to the complex connections between spin, truthfulness and deception. Aspect-selective spin can be truthful, and it need not be deceptive in its intentions or effects, but may risk deceiving audiences. Lexical spin is less readily truthful, and both forms of spin prudentially require a distinctive kind of concealment of the speaker’s intentions. The account developed here does not address normative questions about whether, or how, spin might be wrong, but aims to provide a clear and adequate account of spin as a basis for addressing normative questions about spin. (shrink)

“Legalism” is defined as requiring that all matters of legal regulation and controversy ought so far as possible to be conducted in accordance with predetermined rules of considerable generality and clarity. Thus there may be moral limits on governments which ban them from acting on the substantive moral merits of situations with which they have to deal. This is most important in public law, but also applies in private law, e.g., in cases involving property. Hume, Kant, and Hayek are examined (...) in respect of their case for legalism; Alexy and Finnis also reviewed. Autonomy is the foundation for legalism, and justifies “ethical positivism,” in T. Campbell's phrase. Critical legal studies (Unger, Kelman, Kennedy et al.) however challenge legalism's premises. But the “critical” arguments against reification merely raise, they do not settle, the issue about the politics of legalism and the desirability of legal dogmatics. With all faults, legalism is a prerequisite of free government. (shrink)

The historiography of the ‘dark age’ of biochemistry between 1910–1930 is examined. The biochemistry of the period is located within a larger contemporary debate on the interrelationship between structure and function on a submicroscopic level. It is suggested that biocolloid science was an understandable part of the historical development of biochemistry, representing a conceptual bridge between the cell biology of the late nineteenth century, and the era of structural macromolecular studies of proteins that began after 1930.

SummaryI defend a conventionalist view of logical and mathematical truths against the criticisms of Quine and Stroud. Conventionalism is best formulated by appealing to sense‐conferring rules governing important logical and mathematical expressions. Conventional necessity can be understood as arising from these rules in a way that is immune to Quine's and Stroud's criticisms of the earlier formulation of conventionalism, in which stress was incorrectly laid on axiomatic systems of logic.RésuméJe soutiens, en dépit des critiques de Quine et de Stroud, une (...) conception conventionnaliste des vérités logiques et de vérités mathématiques. La meilleure façon de formuler le conventionnalisme est de faire appel à des règies conférant un sens à?on;importantes expressions logiques et mathématiques. La nécessité conventionnelle peut être comprise comme provenant de ces règies par des voies qui ne donnent pas prise aux critiques de Quine et de Stroud ag ľégard de ľancienne formulation du conventionnalisme, dans laquelle ľaccent était mis, a tort, sur les systèmes axiomatiques de la logique.ZusammenfassungGegen Quines und Strouds Kritiken verteidige ich eine konventionalistische Auffassung der logischen und mathematischer Wahrheiten. Der Konventionalismus wird am besten durch Berufung auf bedeutungsstiftende Regeln, die den Gebrauch wichtiger logischer und mathematischer Ausdrücke bestimmen, formuliert. Konventionelle Notwendigkeit kann als von diesen Regeln hervorgebracht verstanden werden – und das zwar auf eine Art, die sie vor Quines und Strouds Anfechtungen schützen. In der von diesen kritisierten, früheren Fassung wurde zu unrecht das Gewicht auf axiomatische Systeme der Logik gelegt. (shrink)

In their recent article “A Gentle Ethical Defence of Homeopathy,” Levy, Gadd, Kerridge, and Komesaroff use the claim that “lack of evidence is not equivalent to evidence of lack” as a component of their ethical defence of homeopathy. In response, this article argues that they cannot use this claim to shore up their ethical arguments. This is because it is false.

Representationalism is, roughly, the view that experiencing is to be analyzed wholly in terms of representing. But what sorts of properties are represented in experience? According to a prominent form of representationalism, objective representationalism, experiences represent only objective (i.e. suitably mind-independent) properties. I explore subjective representationalism, the view that experiences represent at least some subjective (i.e. suitably mind-dependent) properties. Subjective representationalists, but not objective representationalists, can accommodate cases of illusion-free phenomenal inversion. Moreover, subjective representationalism captures the so-called transparency of experience, (...) as it is standardly articulated, just as well as objective representationalism. (shrink)

In English, we use the word "I" to express thoughts that we have about ourselves, and we use the reflexive pronouns "himself" and "herself" to attribute such thoughts to others. Philosophers and linguists call such thoughts, and the statements we use to express them, de se. De se thoughts and statements, although they appear often in our day-to-day lives, pose a series of challenging problems for both linguists and philosophers. This interdisciplinary volume examines the structure of de se thought, various (...) issues concerning the semantics and pragmatics of our discourse about it, and also what it reveals about how humans think about themselves and the world around them. (shrink)

In Silvae 2.1, Statius laments the premature death of the libertus Glaucias, the alumnus of Atedius Melior. This paper examines Statius' response to the rhetorical difficulties posed by Glaucias' status inconsistency and the ambiguous ethical value of fostering in the literary tradition. By presenting alternative models of status, Silvae 2.1 reflects the increasing social power of freedmen and their descendants. Through its representation of Melior's atypical response to orbitas (most attested adoptive and fostering relationships occurred between individuals of similar status), (...) the poem also reflects contemporary demographic and social concerns. (shrink)

Thomas Szasz, the radical critic of state-supported psychiatry, and root and branch sceptic about mental illness, died in September 2012. Based on the obituary1 and editorial comment in The Lancet2 and the response his work commonly elicits, it is evident that there will be mixed reviews of his impact and of the cogency of his position.Certainly, some have seen him as a notable figure from the past. There is a sense in which, as far as Szasz's critique of psychiatry goes, (...) it did not really change at all in its essence from the time it was first explicitly expressed in his writings of the 1960s right up to his last publications and talks in the 2010s. He started his 1960 paper The Myth of Mental Illness3 with the assertion that there is no such thing as mental illness, and this has been an underlying pedal note to all his many pronouncements in this area ever since. Personally, I have always found his written interventions in debates right up to the present to be highly readable and intellectually sharp; he was adept at creating variations on the Szaszian theme. In one of his earlier book length texts, The Manufacture of Madness,4 he likens the contemporary idea that people have mental illness to the historical idea that some people were witches, and he parallels the institutions of modern state-supported psychiatry to those of the Inquisition. In articles he later published in the Journal of Medical Ethics, he likened mental illness to ‘phlogiston’—the non-existent substance that supposedly explained combustion5 and claimed the term ‘mental …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics CommentaryNeil Pickering, Senior LecturerThe underlying problem for Mr. T’s doctors and his wife is that Mr. T seems unable for much of the time to realise that he is ill. This gives his doctors and other mental health workers, and indeed his wife, very little room for manoeuvre with him. His illness apparently makes him dangerous, because of his beliefs that others are involved in conspiracies against him, (...) which seem to arise from his condition, and this danger particularly affects his wife who has been subject to threats by Mr. T. The initial question is whether Mr. T’s doctors should support or collude in Mrs. T’s proposal to medicate her husband surreptitiously — and if not, what is the alternative? A no less important question is how Mrs. T’s safety might be assured. Underlying these issues is a wider question about the relation between the mentally ill and their doctors, relations (partners and other family members) and society. Mr. T’s behaviours threaten to isolate him from his loved ones and from society.Presumably, Mrs. T’s hope is that giving Mr. T medication will keep his symptoms under control, ensuring her safety and enabling him to retain his relationship with her and perhaps with others; in short, maintaining his place in society. There is also strong evidence that a delay in psychiatric treatment is related to poorer outcomes in terms of, for example, increased morbidity.1 Moreover, some form of long-term medication does seem to be the main hope of achieving a desirable outcome in Mr. T’s case. It seems from the case description that some control of Mr. T’s symptoms results from his taking his medication, and his return to delusions comes only when he gives up on it. It is not made clear, however, why he does give up on it. [End Page 212]From the description of Mr. T, one gets the strong impression of behaviours dominated by the command hallucinations and the paranoid delusions that seem to gather around them. However, there are also, perhaps, periods where other motivations and beliefs have some grip on his life. We are told he has a job, and of course he has the relationship with his wife. What seems to happen is that, at least as far as the latter goes, when his illness reasserts itself, the meaning of his wife’s relationship to him becomes changed in his mind, and Mrs. T becomes part of the conspiracy he believes aims to kill him.Nonetheless, it is unacceptable for Mr. T’s doctors to support Mrs. T’s plan or to collude in it. The primary reason for this is not that it will be a potential disaster — though it stands a good chance of failing and going terribly wrong. There may be dangers to those who administer covert medication if discovered by a paranoid patient in addition to dangers for Mr. T who may misinterpret the side effects of the drugs he is unaware he is taking, or take other drugs that may interact with the drug he is receiving covertly.2 The primary objection to psychiatrists’ colluding in this is that using a third person to surreptitiously deliver medication to Mr. T is to betray his trust in the medical profession, and that this is unacceptable.Mr. T seems to have at best an ambivalent relationship with the medical profession. He seems unable to develop any long-term trust in them, and after a short time off his medication, any trust he may have developed disappears and he turns to his own judgement as to whether he is ill or not, ignoring the advice of his psychiatrist. The trust that the medical profession enjoys from patients is partly responsible for giving it its authority over their actions; and is partly why doctors and other health workers are offered great access to details about a person’s private life. Since this is so basic to the success of the doctor-patient relationship, but is also rather fragile, it is incumbent upon doctors to seek to retain their patients’ trust.So, in the usual situation, the patient and doctor... (shrink)

Gewohnheitshandlungen stellen für die kausale Handlungstheorie eine Herausforderung dar: Einerseits werden sie offenkundig auf weite Strecken nicht durch vorgängige bewusste Wünsche gesteuert. Andererseits glauben wir, dass dabei der Akteur in der Regel über sie diejenige Form von Kontrolle ausübt, die sie als seine absichtlichen Handlungen qualifiziert. Somit kann es den Anschein haben, dass Gewohnheitshandlungen entscheidende Gegenbeispiele für eine Theorie liefern, die die für Absichtlichkeit entscheidende Handlungskontrolle an die Verursachung durch bewusste Wünsche bindet. Der Artikel untersucht drei einschlägige Typen von routinemäßig (...) ausgeführten Handlungen: erstens komplexe Alltagshandlungen wie Autofahren oder Ins-Bett-Gehen, die häufig 'geistesabwesend' vollzogen werden; zweitens Routinen, die, wie die Vorführung eines Akrobaten, aus eingeschliffenen körperlichen Sequenzen bestehen, deren erfolgreiche Ausführung die Abwesenheit bewusster Interventionen geradezu erfordert; und drittens 'gedankenlos' ausgeübte Mikrohandlungssequenzen wie das Herumprobieren mit einem Schlüssel im Schlüsselloch. Es zeigt sich nicht nur, dass alle drei Handlungstypen einer kausalen Analyse zugänglich sind, sondern auch dass ihre Analyse wichtige Dimensionen des Phänomens der Handlungskontrolle zutage fördert. (shrink)

Language plays an important role in fashioning the identity of ethnic groups. This article explores a minority language – Irish – in Northern Ireland. Given the society’s longstanding ethnic divisions, matters revolving around the Irish language are capable of generating heated debate. However, unlike some other minority languages, Irish is somewhat peculiar in that it is not used as a form of linguistic communication between speakers on a daily basis. Hence it lacks instrumental (but not symbolic) relevance in this sense (...) and supporters of the language can be observed trying to create rather than maintain a community of speakers. This fact sets Irish apart from some other minority languages which have generated emotive political debate, for example, Afrikaans in South Africa and French in Canada. The article considers the language debate that has emerged in Northern Ireland in the light of such factors. (shrink)

The Lowell Institute in Boston, Massachusetts, founded in 1836, supports an annual series of distinguished lectures. Henry Drummond, the influential Scottish scientist, Free Church minister, explorer and evangelist published his Lowell Lectures as The Ascent of Man in 1894. This provocative book examines Darwinism in a Christian context. It describes the rise of man, who is considered the highest purpose of the universe, and his relations with the lower animals. In particular, it addresses the question of altruism and its (...) role in promoting the survival of the fittest, which Drummond argues had been overlooked. Drummond claims, unlike traditional evolutionary theory, that the force of evolution is not only the struggle for life, but also the struggle for the life of others. His book, which aroused great interest in its time, remains of importance for historians and philosophers of science today. (shrink)

This commentary discusses how Dienes & Perner's theory of implicit and explicit knowledge applies to memory research. As currently formulated, their theory does seem to account simultaneously for population dissociations and dissociations between conceptual and perceptual priming tasks. In addition, the specification of four distinct memorial states (correlated with different recognition test responses) faces important methodological challenges.