David Ray Griffin develops a third form of realism, one that resolves the basic problem (common to dualism and materialism) of the continued acceptance of the Cartesian view of matter.

Chronic pain is one of the most disabling medical conditions globally, yet, to date, we lack a satisfying theoretical framework for research and clinical practice. Over the prior decades, several frameworks have been presented with biopsychosocial models as the most promising. However, in translation to clinical practice, these models are often applied in an overly reductionist manner, leaving much to be desired. In particular, they often fail to characterize the complexities and dynamics of the lived experience of chronic pain. Recently, (...) an enactive, affordance-based approach has been proposed, opening up new ways to view chronic pain. This model characterizes how the persistence of pain alters a person’s field of affordances: the unfolding set of action possibilities that a person perceives as available to them. The affordance-based model provides a promising perspective on chronic pain as it allows for a systematic investigation of the interactive relation between patients and their environment, including characteristic alterations in the experience of their bodies and the space they inhabit. To help bridge the gap from philosophy to clinical practice, we unpack in this paper the core concepts of an affordance-based approach to chronic pain and their clinical implications, highlighting aspects that have so far received insufficient attention. We do so with an analogy to playing video games, as we consider such comparative illustration a useful tool to convey the complex concepts in an affordance-based model and further explore central aspects of the lived experience of chronic pain. (shrink)

Over 100 million Americans suffer from chronic pain, which causes more disability than any other medical condition in the United States at a cost of $560–$635 billion per year. Opioid analgesics are frequently used to treat CP. However, long term use of opioids can cause brain changes such as opioid-induced hyperalgesia that, over time, increase pain sensation. Also, opioids fail to treat complex psychological factors that worsen pain-related disability, including beliefs about and emotional responses to pain. Cognitive behavioral therapy can (...) be efficacious for CP. However, CBT generally does not focus on important factors needed for long-term functional improvement, including attainment of personal goals and the psychological flexibility to choose responses to pain. Acceptance and Commitment Therapy has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions. However, little is known about the neurologic mechanisms underlying ACT. We conducted an ACT intervention in women with chronic musculoskeletal pain. Functional magnetic resonance imaging data were collected pre- and post-ACT, and changes in functional connectivity were measured using Network-Based Statistics. Behavioral outcomes were measured using validated assessments such as the Acceptance and Action Questionnaire, the Chronic Pain Acceptance Questionnaire, the Center for Epidemiologic Studies Depression Scale, and the NIH Toolbox Neuro-QoLTM scales. Results suggest that, following the 4-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection, emotion, and cognitive control. These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies. (shrink)

Clear, accessible, and meticulously annotated, Tracing the Path of Yoga offers a comprehensive survey of the history and philosophy of yoga that will be invaluable to both specialists and to nonspecialists seeking a deeper understanding of this fascinating subject. Stuart Ray Sarbacker argues that yoga can be understood first and foremost as a discipline of mind and body that is represented in its narrative and philosophical literature as resulting in both numinous and cessative accomplishments that correspond, respectively, to the attainment (...) of this-worldly power and otherworldly liberation. Sarbacker demonstrates how the yogic quest for perfection as such is situated within the concrete realities of human life, intersecting with issues of politics, economics, class, gender, and sexuality, as well as reflecting larger Indic religious and philosophical ideals. (shrink)

_Threshold Concepts on the Edge_ explores new directions in threshold concept research and practice and is of relevance to teachers, learners, educational researchers and academic developers.

This chapter contains sections titled: Works cited.

PurposeThe main purpose of this study is to assess the effects of COVID-19 on the restaurant businesses of Bangladesh. It examines the socio-economic impacts of the humanitarian disaster of the COVID-19 pandemic from the perspective of restaurant owners. The study also intends to provide recommendations to mitigate effects on the restaurant business.Design/Methodology/ApproachA qualitative research approach was adopted to explore the effects of the COVID-19 pandemic on the restaurant businesses of Bangladesh. A total of 22 in-depth interviews were conducted with the (...) top-ranked restaurant owners in the Rajshahi City Corporation area of Bangladesh. Thematic analysis technique was applied for analyzing the collected data.FindingsThe study found that the restaurant owners were compelled to reduce their number of employees, and forced to ensure social distancing and proper sanitization which increased the expenses. Although online orders and home delivery services have increased significantly, restaurant business operation is gradually turning critical owing to the lack of financial support. Thus, restaurant owners urge the govenrment for financial assistance.Research Limitations/ImplicationsSince this research only focused on one city in Bangladesh, the outcomes of study may have a dearth of generalizability. Hence, the investigators are encouraged to extend the study area.Practical ImplicationsThis study will help restaurant owners and policymakers in formulating contemporary business policies and strategies. Thus, it will be supportive of improving the present condition of the restaurant businesses in developing countries like Bangladesh.Originality/ValueThis paper identified the truculent scenario of the restaurant business during the COVID-19 pandemic. (shrink)

An influential view about the relationship between publicity and linguistic meaning is brought into question. It has been thought that since public languages are essentially public, linguistic meaning is subject to a kind of epistemic cap so that there can be nothing more to linguistic meaning than can be determinately known on the basis of publicly available evidence (Epistemic Thesis). Given the thinness of such evidence, a well-known thesis follows to the effect that linguistic meaning is substantially indeterminate. In this (...) paper, we consider the sort of reasons offered for the Epistemic Thesis and uncover an unexamined presupposition about the epistemic requirements of communication and the establishment of meaning conventions. We show this presupposition is undermined by independently motivated considerations about communication and convention, giving us good reason to reject the Epistemic Thesis and its corollary about indeterminacy. (shrink)

Willem Drees endorses not only minimal naturalism, understood as the rejection of supernatural interruptions of the world's normal causal processes, but also maximal naturalism, with its reductionistic materialism. Besides arguing that this reductionistic naturalism provides the best framework for interpreting science, he believes that it is compatible with religion (albeit of a minimalist sort). The “richer” naturalism advocated by Whiteheadians is, accordingly, unnecessary. Drees's position, however, cannot do justice to a number of “hard‐core commonsense notions,” which we inevitably presuppose in (...) practice and thereby in science as well as religion. His naturalism is too poor, in particular, to account for subjectivity, freedom, and mathematical, religious, and moral experience. (shrink)

This article presents the findings of qualitative research which explored, from the mothers’ perspective, the process of decision-making about mode of delivery for a subsequent birth after a previous Caesarean Section. In contradiction to the clinical literature, the majority of mothers in this study were strongly of the opinion that a vaginal birth after caesarean (VBAC) posed a higher risk than an elective caesarean (EC). From the mothers’ perspective, risk discussions were primarily valuable for gaining support for their pre-determined choice, (...) rather than obtaining information. The findings posit ethical concerns with regards to informed consent and professional obstetric practice at a time when there is a documented and worrying trend towards an increase in births by caesarean section (CS). (shrink)

Spanning forty years of Ray's career, these essays, for the first time collected in one volume, present the filmmaker's reflections on the art and craft of the cinematic medium and include his thoughts on sentimentalism, mass culture, ...

T. A. Cavanaugh defends double-effect reasoning (DER), also known as the principle of double effect. DER plays a role in anti-consequentialist ethics (such as deontology), in hard cases in which one cannot realize a good without also causing a foreseen, but not intended, bad effect (for example, killing non-combatants when bombing a military target). This study is the first book-length account of the history and issues surrounding this controversial approach to hard cases. It will be indispensable in theoretical ethics, (...) applied ethics (especially medical and military), and moral theology. It will also interest legal and public policy scholars. (shrink)

This article articulates the Hippocratic medical ethic found in the Oath and the Christian medical ethic as exemplified in the parable of the Good Samaritan. It proposes that the Oath has a natural-law-based deontological character (as understood by Aquinas) that governs friendships of utility (as understood by Aristotle) between student and teacher and physician and patient. The article elaborates on the Samaritan’s conduct as exemplifying Christian agapeic-love. It contrasts agapeic-love with friendship-love, while noting that the Samaritan relies on friendship-love (as (...) found between the Samaritan and the innkeeper) to realize agapeic-love towards the robbers’ victim. It concludes with noting that the grace-based Christian medical ethic perfects the nature-based Hippocratic ethic not by destroying it, but, rather, by employing it. (shrink)

T. A. Cavanaugh's Hippocrates' Oath and Asclepius' Snake: The Birth of the Medical Profession articulates the Oath as establishing the medical profession's unique internal medical ethic - in its most basic and least controvertible form, this ethic mandates that physicians help and not harm the sick. Relying on Greek myth, drama, and medical experience (e.g., homeopathy), the book shows how this medical ethic arose from reflection on the most vexing medical-ethical problem -- injury caused by a physician -- and (...) argues that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession. The book argues that medicine as a profession necessarily involves stating before others what one stands for: the good one seeks and the bad one seeks to avoid on behalf of the sick, and rejects the view that medicine is purely a technique lacking its own unique internal ethic. It concludes noting that medical promising (as found in the White Coat Ceremony through which U. S. medical students matriculate) implicates medical autonomy which in turn merits respect, including honoring professional conscientious objections. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Positive Change in Perception and Care for a Difficult PatientMelissa CavanaughIf you asked any healthcare professional if they had ever cared for a difficult patient, I am certain the answer would be a resounding "Yes!" I have encountered many over my forty-two years as an RN. The story of Ms. E. is one of exceptional challenge and, I hope, success.I met Ms. E. in 2012 when I took a (...) nursing position in an outpatient primary care Geriatric Clinic. The clinic was located within an inner city, Level 1 Trauma health system whose mission is to care for the underserved. This organization had cared for the most vulnerable in the area for decades. The clinic model is unique in that it provides a "one-stop shop" for the common medical needs of the older adult. Other specialties, including podiatry, rheumatology, dementia care, and stroke, held appointments in this clinic area. The supporting staff team members assisted in each of these clinics, leading them to interact with the same patients frequently.Most of my previous experiences had been in inpatient units with a quick turnover of patients. There was no time or need to develop a long-term relationship with the patients in these settings. However, the comprehensive services found in this clinic coupled with the low staff turnover, led to a stable group of seniors receiving care in this office. Many of these individuals had been attending this clinic for over twenty years.I heard about Ms. E. before I ever met her. She was well known to the clinic team as a "problem" patient. The general response when she was on the schedule was eye rolling and audible moans. I soon learned that in addition to her scheduled visits, she would randomly appear outside the full glass interior doors. She would hover in the area, tapping on the glass to get the attention of a staff member. She did not hesitate to interrupt staff and other patients to make her needs known when she was in the exam room hallway. Often team members would scatter and hide to avoid dealing with her. If she was not in the building, she was on the triage line with a question or physical complaint. To complicate matters even further, her husband was our patient as well, and they always attended appointments together.Ms. E. suffered from common geriatric chronic diseases such as hypertension, diabetes, and osteoarthritis. Her morbid obesity complicated her diagnoses. Though she was able to safely ambulate with an assistive device such as a cane or walker, she routinely used a motorized chair. She and her husband admitted visiting fast food restaurants often even though they had met with a dietician for counseling on several occasions. They often requested help obtaining medications, yet related stories about visiting the local casino. Ms. E. spoke with a small, weak voice that added to the countenance of helplessness and pity. Unfortunately, these behaviors of noncompliance, attention seeking, and dependency on others extended to her immediate community, and she is estranged from family and friends who may have been a source of support to her. [End Page E1]Ms. E.'s appointments were scheduled at the end of the day due to the expectation and pattern of the extended time they would take. No matter her expressed concerns or needs, our recommendations and interventions were never enough. She continually questioned the assessment information and did not want to accept the education and orders given as the correct response to her problems. As one can see, her appointments could be exhausting!Ms. E. certainly deserved the best and most comprehensive care available from our team. Developing a more therapeutic relationship for her within the clinic became a priority for me. However, it was a daunting task to provide this level of care and to convince her that she deserved and was receiving such care. She presented a laundry list of characteristics that could lead to biases from the staff. Overcoming such individual biases toward her may be a barrier as well. These included her obesity, her lack of initiative, her self-centered behaviors, and her constant need for attention.As healthcare professionals... (shrink)

Many of us not part of the “old Burhoe gang” are nonetheless deeply influenced by the ideas of Ralph Wendell Burhoe, albeit in indirect ways. This remembrance summarizes six such ways: Three are “procedural” influences, namely (1) that dialogue is most valuable, especially in the science/religion interface, when carried on among those who may not agree; (2) that scholarship is necessary to refine and improve preliminary opinions; and (3) that organizations are crucial to accomplishing the first two tasks. The three (...) “substantive” influences are (4) Burhoe's focus on human values; (5) his work in defining God; and (6) his contribution to defining what it means to be human. As is well known, his emphasis in all three substantive cases was on the power and nuances of biological and social evolution, especially on the dynamics of natural selection. (shrink)

Language and Materiality integrates linguistic anthropological and sociolinguistic scholarship on a range of topics: semiotic approaches to language, language commodification, sound, embodiment, mediatization, and aesthetics. Empirically rigorous, the volume engages scholars and students interested in language, its use, and meanings. It consists of three sections - 'Texts, Objects, Mediality', 'Sound, Aesthetics, Embodiment', and 'Time, Place, Circulation' - containing chapters and short commentaries, framed by a curated conversation about semiotics and materiality in anthropology. Each section theorizes intersections, connections, and relationships between (...) language and materiality across diverse topics and ethnographic contexts. The volume shows that materiality may be approached as a feature of political economy, sensual experience, aesthetics, and affective relationships in its relation to language as talk, register, genre, ideology, and acoustic object. It consists of new perspectives on materiality as a vital dimension of social life and signification in global capitalism, connecting inquiries on subjects as diverse as food, media, fonts, and music. (shrink)

This chapter contains sections titled: Two Views of Authenticity Being a Real Father Notes.

Double-effect reasoning (DER) is attributed to Aquinas "tout court". Aquinas's account, however, differs from contemporary DER insofar as Thomas considers the ethical status of "risking" an assailant's life while contemporary accounts focus on actions causing harm inevitably. Since one cannot claim to risk the inevitable, and since there is a significant difference between risking harm and causing harm inevitably. Thomas's account does not extend to cases of inevitable harm. Thus, the received understanding of Aquinas's account is flawed and leads to (...) untenable attributions of the direction of intention to Aquinas and to misunderstandings of contemporary DER. (shrink)

In “Modern Moral Philosophy” Anscombe argues that the distinction between intention of an end or means and foresight of a consequentially comparable outcome proves crucial in act-evaluation. The deontologist J. J. Thomson disagrees. She asserts that Anscombe mistakes the distinction’s moral import; it bears on agent-evaluation, not act-evaluation. I map out the contours of this dispute. I show that it implicates other disagreements, some to be expected and others not to be expected. Amongst the expected, one finds the ethicists’ accounts (...) of action and understanding of how agent-assessment relates to act-assessment. Amongst the unexpected, one finds the moralists’ views about the possibility of self-imposed moral dilemmas and allied positions concerning temporal aspects of “ought implies can.” Anscombe’s employment of the distinction in act-evaluation withstands close scrutiny; Thomson’s denial of it does not. (shrink)

This book emphasizes the role of semantics as a bridge between the theory of language and the theories of other cognitive capacities such as visual perception...

Common morality endorses some form of an exceptionless prohibition against killing innocents. Natural lawyers employ double-effect reasoning to address hard cases involving deaths of the innocent. Current deontologists criticize DER-proponents as conflating act-with agent-evaluations. Scanlon develops this critique extensively. I respond to his criticism. He maintains that the DER-advocate tells a badly-motivated agent to refrain from an obligatory act. Thus, he asserts, the natural lawyer who employs DER errs. Instead, Scanlon proposes, one ought to assess the act as permissible while (...) blaming the agent. I argue that DER does not succumb to this critique. Moreover, Scanlon’s particular criticism nicely shows the reasonableness of the approach the DER-thinker takes, namely, that defective agents produce defective acts. Thus, employing DER does not lead to a confusion of act-with agent-evaluations. Rather, it results in coherent assessments of both. (shrink)

Among the oldest extant medical ethics, the Hippocratic Oath prohibits the giving of a deadly drug, regarding this act as an egregious violation of a medical ethic that is exclusively therapeutic. Proportionate palliative sedation involves the administration of a deadly drug. Hence it seems to violate the venerable Hippocratic promise associated with the dawn of Western medicine not to give a deadly drug. Relying on distinctions commonly employed in the analysis and evaluation of human actions, this article distinguishes physician-assisted suicide (...) and euthanasia, as acts that necessarily violate the prohibition against giving a deadly drug, from proportionate palliative sedation, as an act that does not. (shrink)

In contemporary ethical discourse generally, and in discussions concerning the legalization of physician‐assisted suicide (PAS) and voluntary active euthanasia (VAE) specifically, recourse is sometimes had to the Nazi! accusation. Some disputants charge that such practices are or will become equivalent to the Nazi ‘euthanasia’ program in which over 73,000 handicapped children and adults were killed without consent. This paper reflects on the circumstances that lead to the use of this charge and offers reasons for putting the Nazi! charge aside in (...) contemporary discussions of PAS and VAE. A number of the philosophical presuppositions common to both the Nazi ‘euthanasia’ program and the currently proposed practices of PAS and VAE are examined. Noting that racist ideology and violent coercion characterized the Nazi program, the paper concludes with a cautionary consideration of the current circumstances that would specify PAS and VAE in the US. (shrink)

We examine the question of which aspects of language are uniquely human and uniquely linguistic in light of recent suggestions by Hauser, Chomsky, and Fitch that the only such aspect is syntactic recursion, the rest of language being either specific to humans but not to language (e.g. words and concepts) or not specific to humans (e.g. speech perception). We find the hypothesis problematic. It ignores the many aspects of grammar that are not recursive, such as phonology, morphology, case, agreement, and (...) many properties of words. It is inconsistent with the anatomy and neural control of the human vocal tract. And it is weakened by experiments suggesting that speech perception cannot be reduced to primate audition, that word learning cannot be reduced to fact learning, and that at least one gene involved in speech and language was evolutionarily selected in the human lineage but is not specific to recursion. The recursion-only claim, we suggest, is motivated by Chomsky’s recent approach to syntax, the Minimalist Program, which de-emphasizes the same aspects of language. The approach, however, is sufficiently problematic that it cannot be used to support claims about evolution. We contest related arguments that language is not an adaptation, namely that it is “perfect,” non-redundant, unusable in any partial form, and badly designed for.. (shrink)

Evolutionary scepticism holds that the evolutionary account of the origins of the human cognitive apparatus has sceptical implications for at least some of our beliefs. A common target of evolutionary scepticism is moral realism. Scientific realism, on the other hand, is much less frequently targeted, though the idea that evolutionary theory should make us distrustful of science is by no means absent from the literature. This line of thought has received unduly little attention. I propose to remedy this by advancing (...) what I will call an evolutionary sceptical challenge to scientific realism. I argue that, given standard evolutionary theory, our possession of sound innate metaphysical intuitions would have taken an epistemically problematic ‘lucky accident’. This, as I will show, entails that scientific realism is a self-undermining position. I discuss objections to my argument’s two premises, including ones that appeal to the success of the sciences and to the possibility that sound innate metaphysical intuitions evolved as an evolutionary ‘by-product’. I then draw out an advantage of my argument over a similar one recently put forward by Graber and Golemon. I finish by submitting that scientific realism, given the soundness of my argument, is faced with a new ‘Darwinian Dilemma’, and briefly address the significance of this for the debate between realists and anti-realists in the philosophy of science. (shrink)

Examining one of the fundamental issues in cognitive psychology: How does our conscious experience come to be the way it is?