Background: Dementia care at home often involves decisions in which the caregiver must weigh safety concerns with respect for autonomy. These dilemmas can lead to situations where caregivers provide care against the will of persons living with dementia, referred to as involuntary treatment. To prevent this, insight is needed into how family caregivers of persons living with dementia deal with care situations that can lead to involuntary treatment. Objective: To identify and describe family caregivers’ experiences regarding care decisions for situations (...) that can lead to involuntary treatment use in persons living with dementia at home. Research design: A qualitative descriptive interview design. Data were analysed using the Qualitative Analysis Guide of Leuven. Participants and research context: A total of 10 family caregivers providing care for 13 persons living with dementia participated in in-depth semi-structured interviews. Participants were recruited by registered nurses via purposive sampling. Ethical consideration: The study protocol was approved by the Ethics Committee of the University Hospitals Leuven and the Medical Ethical Test Committee Zuyderland. Findings: Family caregivers experience the decision-making process concerning care dilemmas that can lead to involuntary treatment as complicated, stressful and exhausting. Although they consider safety and autonomy as important values, they struggle with finding the right balance between them. Due to the progressive and unpredictable nature of dementia, they are constantly seeking solutions while they adapt to new situations. Family caregivers feel responsible and experience social pressure for the safety of persons living with dementia. They may be blamed if something adverse happens to the persons living with dementia, which increases an already stressful situation. Their experience is influenced by characteristics of the care triad (persons living with dementia, professional and family caregivers) such as practical and emotional support, knowledge, and previous experiences. Discussion and conclusion: To prevent involuntary treatment, professionals need to proactively inform family caregivers, and they need to support each other in dealing with complex care situations. (shrink)

We describe and analyse how large herbivores strongly diminished a woody vegetation, dominated by the unpalatable shrub Sambucus nigra L. and changed it into grassland. Density of woody species and cover of vegetation were measured in 1996, 2002 and 2012 in the grazed Oostvaardersplassen. In 2002 and 2012 we also measured density and cover in an ungrazed control site. In 2002 we measured intensity of browsing and bark loss of Sambucus shrubs in the grazed and control sites. In the grazed (...) site the density of Sambucus and Salix spp. declined significantly between 1996 and 2012, and large areas changed into grassland. In the control site the density of Sambucus increased significantly during this period, the density of Salix spp. did not change, and the vegetation consisted of a mixture of woody species and a field layer dominated by tall herbs. In 2002 and 2012 the percentages of dead Sambucus shrubs were significantly higher in the grazed site than in the control site. In 2002 the percentages of twigs browsed and ring barked stems of Sambucus shrubs were significantly higher in the grazed site than in the control site. Our results show that debarking caused mature Sambucus shrubs to die, but that heavy browsing may have helped this process. Our results also point to a significant neighbour effect on the break down of Sambucus, suggesting that Aggregational Resistance and Associational Palatability were both active. Essential conditions for the break down of this woody vegetation were the presence of large herbivores, the low ratio between the areas of summer and winter feeding habitats and the competition amongst herbivores. Browsing may have been responsible for seedling death, as seedlings were found only in the control site and not on the old and newly established grasslands in the grazed site. (shrink)

"The studies collected in this book are all concerned with aspects of the Platonic tradition, either in its own internal development in the Hellenistic age and the period of the Roman Empire, or with the influence of Platonism, in one or other of its forms, on other spiritual traditions, especially that of Christianity." [Book jacket].

Epistemic decision theorists aim to justify Bayesian norms by arguing that these norms further the goal of epistemic accuracy—having beliefs that are as close as possible to the truth. The standard defense of Probabilism appeals to accuracy dominance: for every belief state that violates the probability calculus, there is some probabilistic belief state that is more accurate, come what may. The standard defense of Conditionalization, on the other hand, appeals to expected accuracy: before the evidence is in, one should expect (...) to do better by conditionalizing than by following any other rule. We present a new argument for Conditionalization that appeals to accuracy‐dominance, rather than expected accuracy. Our argument suggests that Conditionalization is a rule of coherence: plans that conflict with Conditionalization don't just prescribe bad responses to the evidence; they also give rise to inconsistent attitudes. (shrink)

The need for informed analyses of health policy is now greater than ever. The twelve essays in this volume show that public debates routinely bypass complex ethical, sociocultural, historical, and political questions about how we should address ideals of justice and equality in health care. Integrating perspectives from the humanities, social sciences, medicine, and public health, this volume illuminates the relationships between justice and health inequalities to enrich debates. Understanding Health Inequalities and Justice explores three questions: How do scholars approach (...) relations between health inequalities and ideals of justice? When do justice considerations inform solutions to health inequalities, and how do specific health inequalities affect perceptions of injustice? And how can diverse scholarly approaches contribute to better health policy? From addressing patient agency in an inequitable health care environment to examining how scholars of social justice and health care amass evidence, this volume promotes a richer understanding of health and justice and how to achieve both. -/- The contributors are Judith C. Barker, Paula Braveman, Paul Brodwin, Jami Suki Chang, Debra DeBruin, Leslie A. Dubbin, Sarah Horton, Carla C. Keirns, J. Paul Kelleher, Nicholas B. King, Eva Feder Kittay, Joan Liaschenko, Anne Drapkin Lyerly, Mary Faith Marshall, Carolyn Moxley Rouse, Jennifer Prah Ruger, and Janet K. Shim. (shrink)

Part of the Studies in Crime and Public Policy series, this book, written by one of the top philosophers of punishment, examines the main trends in penal theorizing over the past three decades. Duff asks what can justify criminal punishment, and then explores the legitimacy of actual practices by examining what would count as adequate justification for them. Duff argues that a "communicative conception of punishment," which he presents as a third way between consequentialist and retributive theories, offers the most (...) fruitful way of understanding punishment's meaning and justification. Duff addresses such questions as how much sentences should be constrained by proportionality requirements; what modalities of punishment best communicate their intended meaning; and what decisionmaking procedures he envisions. This book will appeal to criminologists, philosophers, and others interested in theories of punishment. (shrink)

We show that five important elements of the ‘nomological package’— laws, counterfactuals, chances, dispositions, and counterfactuals—needn’t be a problem for the Growing-Block view. We begin with the framework given in Briggs and Forbes (in The real truth about the unreal future. Oxford studies in metaphysics. Oxford University Press, Oxford, 2012 ), and, taking laws as primitive, we show that the Growing-Block view has the resources to provide an account of possibility, and a natural semantics for non-backtracking causal counterfactuals. We show (...) how objective chances might ground a more fine-grained concept of feasibility, and furnished a places in the structure where causation and dispositions might fit. The Growing-Block view, thus understood, provides the resources to explain the close link between modality and tense, so that it predicts modal change as time passes. This account lets us capture not only what the future might hold for us, and also what might have been. (shrink)

On the basis of a communicative theory of criminal punishment, I show how mercy has a significant but limited role to play in the criminal law—in particular (although not only) in criminal sentencing. Mercy involves an intrusion into the realm of criminal law of values and concerns that are not themselves part of the perspective of criminal law: a merciful sentencer acts beyond the limits of her legal role, on the basis of moral considerations that conflict with the demands of (...) penal justice. Sometimes, however (but in a decent system of law in a decent society, rarely), that is how citizens should act. Finally, I discuss, and criticise, two attempts to find a place for mercy within a communicative conception of punishment, and argue that repentance is not an appropriate ground for leniency or mercy in sentencing. (shrink)

This article draws on scientific explanations of obesity to motivate the creation of a system of paternalistic public health interventions into the obesity epidemic. Libertarian paternalists argue that paternalism is warranted in light of the cognitive limits of human decision-making abilities. There are further, specific biological limits on our capacity to choose and maintain a healthy diet. These biological facts strengthen the general motivation for libertarian paternalism. As a consequence, the creation of a system of paternalistic public health interventions into (...) the obesity epidemic is warranted. (shrink)

Three arguments are proposed against the idea that ordinary talk about the mind constitutes a folk psychology, a sort of prescientific theory which explains human behaviour and which is ripe for replacement by a neurological or computational theory with better scientific credentials. First, not all talk of the mind is introduced to explain in the way assumed by those who think that mental talk hypothesizes inner processes to explain behaviour. Second, the individuation of the behaviour which is explained by the (...) inner processes itself requires reference to ?mental? states such as intentions or desires. Consequently the project is circular. Finally, scientific theory is a practice with a history which may be matched in the case of ordinary talk of the mind. Certainly ordinary talk of motives, intentions, and thoughts may be infected by the theorizing of economists and sociologists et al., but it is impossible that all talk of the mind should be theoretical in this way. (shrink)

He then proceeds with an examination of the picture theory developed by Wittgenstein, Carnap, and Goodman, and concludes with an examination of Patricia Churchland, Ruth Millikan, Robert Cummins, and Mark Rollins. The use of the historical development of representationalism to pose a central problem in contemporary cognitive science is unique.

Discussions of responsibility typically focus on the person who is held responsible: what are the conditions or criteria of responsibility; what can be done to or demanded of a person who is responsible? This paper shifts focus onto those who hold, rather than those who are held, responsible: what do we owe to those whom we hold responsible? After distinguishing responsibility as answerability from responsibility as liability, it attends mainly to the former, and points out the ways in which it (...) is multiply relational: I am responsible for something to someone who has the standing to call me to account for it, under the norms of some particular practice. Responsibility as thus understood is also reciprocal: if you are to be answerable to me, I must treat you with a certain respect, attend seriously to your answer, and be ready to answer to you myself. The paper explores some of the implications of this point both for our moral dealings with each other, and for criminal law and the criminal trial. (shrink)

The focus of this paper is one of James Prescott Joule’s scientific contributions: the laws of heat production by electric currents in conductors. In 1841, the 22 years old Joule published a paper with the title “On the heat evolved by metallic conductors of electricity, and in the cells of a battery during electrolysis” where he presented an experimental study of that phenomenon and proposed two laws that were allegedly supported by his trials. On closer inspection, both his laboratory work (...) and his inferences can be challenged. The emphasis of this article is an attempt to understand Joule’s experimental undertaking, its highpoints and shortcomings, by a detailed analysis of this specific episode and by studying the precedents of his work and subsequent advancements. It is possible to point out several serious deficiencies of that investigation, and Joule’s contemporaries, such as Edmond Becquerel and Heinrich Lenz, did criticize some of his flaws and undertook new experiments to provide a sound basis for those laws. Besides providing a historical examination of that specific episode, this article uses this case study to tackle some features of the nature of science that may contribute to scientific education. (shrink)

I begin by discussing the ways in which a would-be blamer's own prior conduct towards the person he seeks to blame can undermine his standing to blame her. This provides the basis for an examination of a particular kind of 'bar to trial' in the criminal law – of ways in which a state or a polity's right to put a defendant on trial can be undermined by the prior misconduct of the state or its officials. The examination of this (...) often neglected legal phenomenon illuminates some central features of the criminal law and the criminal process, and some of the preconditions for the legitimacy of the criminal law in a liberal republic. (shrink)

Introduction, by R. A. Markus.--St. Augustine and Christian Platonism, by A. H. Armstrong.--Action and contemplation, by F. R. J. O'Connell.--St. Augustine on signs, by R. A. Markus.--The theory of signs in St. Augustine's De doctrina Christiana, by B. D. Jackson.--Si fallor, sum, by G. B. Matthews.--Augustine on speaking from memory, by G. B. Matthews.--The inner man, by G. B. Matthews.--On Augustine's concept of a person, by A. C. Lloyd.--Augustine on foreknowledge and free will, by W. L. Rowe.--Augustine on free will (...) and predestination, by J. M. Rist.--Time and contingency in St. Augustine, by R. Jordan.--Empiricism and Augustine's problems about time, by H. M. Lacey.--Political society, by P. R. L. Brown.--The development of Augustine's ideas on society before the Donatist controversy, by F. E. Cranz.--De Civitate Dei, XV, 2, and Augustine's idea of the Christian society, by F. E. Cranz.--Chronological table.--Note on further reading (p. [422]-423). (shrink)

R. A. Sharpe; VIII*—Art and Expertise, Proceedings of the Aristotelian Society, Volume 85, Issue 1, 1 June 1985, Pages 133–148, https://doi.org/10.1093/aristote.

The fourth volume in the Criminalization series, this volume explores some of the most general principles and theories of criminalization. It includes not only philosophical work, but also historical, legal, and sociological investigations into criminalization, clarifying the state of the discipline today.

The human person makes great demands on the physician and calls for unique attention. Hence the doctor-patient relationship calls for the highest ideals of kindness, patience, trustworthiness, generosity and skill. The Catholic physician brings to these demands a specific meaning: ministering to the sick is to see Christ in them and to show Him to them.

First paragraph: Some reasons for action are relational. I have a relational reason to Φ when I have reason to Φ in virtue of a relationship in which I stand, or a role that I fill; absent that relationship or that role I would not have that reason to Φ ; others who do not stand in that relationship or fill that role do not have that reason to Φ . I have a relational reason to feed this child -- (...) that he is my child: absent that parental relationship, I might still have a reason to feed him, as might others who are not his parents -- for instance that he is starving; but absent that relationship, I would not have and others cannot have that specific relational reason to feed this child. I have a relational reason to respond to this person's philosophical queries -- that she is my student: absent that pedagogical relationship, I might still have reason to respond to her questions, as might others who are not her teachers -- for instance that it is good to help such seekers after philosophical insight; but absent that relationship, I would not have and others cannot have that specific relational reason to respond to her queries. I have relational reason to pay John ￡10 -- that I borrowed it from him and promised to repay him today: absent that promissory relationship I might still have, and others might have, reason to give him ￡10 -- for instance that he is impoverished and I am (or they are) rich; but absent that promissory relationship, neither I nor others could have that specific relational reason to give him ￡10. (shrink)

In _Sentient Flesh _R. A. Judy takes up freedman Tom Windham’s 1937 remark “we should have our liberty 'cause... us is human flesh" as a point of departure for an extended meditation on questions of the human, epistemology, and the historical ways in which the black being is understood. Drawing on numerous fields, from literary theory and musicology, to political theory and phenomenology, as well as Greek and Arabic philosophy, Judy engages literary texts and performative practices such as music and (...) dance that express knowledge and conceptions of humanity appositional to those grounding modern racialized capitalism. Operating as critiques of Western humanism, these practices and modes of being-in-the-world—which he theorizes as “thinking in disorder,” or “poiēsis in black”—foreground the irreducible concomitance of flesh, thinking, and personhood. As Judy demonstrates, recognizing this concomitance is central to finding a way past the destructive force of ontology that still holds us in thrall. Erudite and capacious, _Sentient Flesh _offers a major intervention in the black study of life. (shrink)

Aim To study the views of people in a largely Muslim country, Kuwait, of the acceptability of a life-ending action such as physician-assisted suicide (PAS). Method 330 Kuwaiti university students judged the acceptability of PAS in 36 scenarios composed of all combinations of four factors: the patient's age (35, 60 or 85 years); the level of incurability of the illness (completely incurable vs extremely difficult to cure); the type of suffering (extreme physical pain or complete dependence) and the extent to (...) which the patient requests a life-ending procedure, euthanasia or PAS (no request, some form of request, repeated requests). In all scenarios, the patients were women who were receiving the best possible care. The ratings were subjected to cluster analysis and analyses of variance. Results Five clusters were found. For 44%, PAS was always very unacceptable, no matter what the circumstances. For 23%, it was unacceptable, but less so if the patient was older or requested it repeatedly. For 16%, it was unacceptable if the patient was young but was acceptable if the patient was elderly. For 5%, it was unacceptable if the patient had extreme pain but was acceptable if completely dependent. For 11%, it was unacceptable if the patient did not request it but acceptable if she did. Conclusion The majority of the Kuwaiti university students opposed PAS either categorically or with a slight variation according to circumstances. Nonetheless, a minority approved of PAS in some cases, particularly when the patient was elderly. (shrink)

Marcia Baron has offered an illuminating and fruitful discussion of extra-legal excuses. What is particularly useful, and particularly important, is her focus on our excusatory practices—on the ways and contexts in which we make, offer, accept, bestow and reject excuses: if we are to reach an adequate understanding of excuses, their implications and their grounds, we must attend to the roles that they can play in our human activities and relationships—and to the complexities and particularities of those roles. However, I (...) want to focus my comments less on the details of Baron’s discussions of excuses in extra-legal contexts than on the implications of her discussion for our understanding of excuses in the criminal law. What light (if any, a sceptic might add) can such analyses of our extra-legal concepts and practices throw on legal concepts and doctrines? (shrink)