This paper advances a new paradigm in clinical ethics education that not only emphasizes development of individual cli but also focuses on the institutional context within which health care professionals work. This approach has been applied to the goal of improving the care provided to critically and terminally ill adults. The model has been adopted by about thirty hospitals and nursing homes; additional institutions will soon join the program, entitled Decisions Near the End of Life. Here, we describe the history (...) and rationale for this approach, its goals, pedagogical assumptions, and design. (shrink)

Rebecca Roache’s recent critique of David Lewis’s cohabitation view assumes that a person cannot be properly concerned about something that rules out that she ever exists. In this brief response, I argue against this assumption.

Attention is essential to the life of the mind, a central topic in cognitive science, neuroscience, and psychology. Traditional debates in philosophy stand to benefit from greater understanding of the phenomenon, whether on the nature of the self, the foundation of knowledge, the natural basis of consciousness, or the origins of action and responsibility. This book is at the crossroads of philosophy of mind and cognitive science, offering a new theoretical stance on the concept of attention and how it intersects (...) with other functions of the mind, such as perception, consciousness, and action. It presents attention as directed by a subject, essential for perception, but not consciousness or action. By taking seriously the existence of a subject it stands against current trends in philosophy and cognitive science. This book offers an account of the subject and its role in attention that will both help motivate a subject-centered account and avoid some of the common criticisms regarding its existence. It engages with work by many philosophers, psychologists, and neuroscientists, including Block, Campbell, Dickie, Husserl, James, Koch, Mack and Rock, Merleau-Ponty, Treisman, and Wu. (shrink)

I explore how gender can shape the pragmatics of speech. In some circumstances, when a woman deploys standard discursive conventions in order to produce a speech act with a specific performative force, her utterance can turn out, in virtue of its uptake, to have a quite different force—a less empowering force—than it would have if performed by a man. When members of a disadvantaged group face a systematic inability to produce a specific kind of speech act that they are entitled (...) to perform—and in particular when their attempts result in their actually producing a different kind of speech act that further compromises their social position and agency—then they are victims of what I call discursive injustice. I examine three examples of discursive injustice. I contrast my account with Langton and Hornsby's account of illocutionary silencing. I argue that lack of complete control over the performative force of our speech acts is universal, and not a special marker of social disadvantage. However, women and other relatively disempowered speakers are sometimes subject to a distinctive distortion of the path from speaking to uptake, which undercuts their social agency in ways that track and enhance existing social disadvantages. (shrink)

ABSTRACT:Democracy—as a form of governance, a moral community, and a way of life—is under great stress. The prospects for democracy and bioethics are linked because bioethics relies on an open society and a democratic cultural environment in order to flourish. For its part, democracy can be restored and strengthened by widespread cultural and psychological support for the values of mutual recognition, equal dignity and respect for persons, and solidarity, interdependence, and the common good. Promoting values such as these is in (...) keeping with the founding vision of bioethics, which was a civic vision. At the present time, bioethics can and should continue to be a bioethics for democracy by engaging directly in civic learning and civic place-making. These have a significant impact on health as well as on democracy. (shrink)

In this paper I examine the attempts of Susan Wolf and John Christman to rescue efforts to characterise the concept of autonomy from the difficulties faced by so-called subjective theories of autonomy – theories which treat agent’s own appraisals of their desires as final arbiters with regard to the assessment of whether or not they are autonomous. I conclude that Wolf’s view either ends up falling foul of her own objections to subjective theories or ends up describing virtuous, as opposed (...) to autonomous, agents. But I also conclude that Christman’s combines the virtues of the subjective and objective views of autonomy. His view represents an advance on subjective views in that it explains why certain obviously sick selves which subjective views must regard as autonomous are excluded from the status of autonomy. (shrink)

This paper explores whether consciousness can exist without attention. This is a hot topic in philosophy of mind and cognitive science due to the popularity of theories that hold attention to be necessary for consciousness. The discovery of a form of consciousness that exists without the influence of attention would require a change in the way that many global workspace theorists, for example, understand the role and function of consciousness. Against this understanding, at least three forms of consciousness have been (...) argued to exist without attention: perceptual gist, imagistic consciousness, and phenomenal consciousness. After first arguing that the evidence is inconclusive on the question of whether these forms of consciousness exist without attention, I here present a fourth form of consciousness that is likely to be more successful: conscious entrainment. I argue that conscious entrainment is a form of consciousness associated with skilled behavior in which attention is sometimes absent. (shrink)

Wayne Wu argues that attention is necessary for action: since action requires a solution to the ‘Many–Many Problem’, and since only attention can solve the Many–Many Problem, attention is necessary for action. We question the first of these two steps and argue that it is based on an oversimplified distinction between actions and reflexes. We argue for a more complex typology of behaviours where one important category is action that does not require a solution to the Many–Many Problem, and so (...) does not require attention. (shrink)

Some of the oldest and deepest questions in philosophy fall under the umbrella of consciousness and mind: What is the mind and how is it related to the body? What provides our thoughts with content? How is consciousness related to the natural world? Do we have distinctive causal powers? Analytic philosophers have made significant progress on these and related problems in the last century. Given the high volume of work on such topics, this chapter is necessarily selective. It offers major (...) touchstones but is slanted in favor of work that touches base with the sciences. The chapter starts by describing the progression of thought on the mind-body problem, from dualism and behaviorism to non-reductive materialism. It then describes the problem of intentionality, with a focus on partial solutions from Dretske and Millikan, ending with a brief discussion of 4E theories of mental content. The section on the problem of consciousness starts with the well-known knowledge and modal arguments before describing some attempted initial solutions, such as eliminative materialism and panpsychism. Finally, there is a brief section on agency and free will, which focuses on the link between free will and consciousness. (shrink)

History's judgment on the success of bioethics will not depend solely on the conceptual creativity and innovation in the field at the level of ethical and political theory, but this intellectual work is not insignificant. One important new development is what I shall refer to as the relational turn in bioethics. This development represents a renewed emphasis on the ideographic approach, which interprets the meaning of right and wrong in human actions as they are inscribed in social and cultural practices (...) and in structures of lived meaning and interdependence; in an ideographic approach, the task of bioethics is to bring practice into theory, not the other way around. The relational turn in bioethics may profoundly affect the critical questions that the field asks and the ethical guidance it offers society, politics, and policy. The relational turn provides a way of correcting the excessive atomism of many individualistic perspectives that have been, and continue to be, influential in bioethics. Nonetheless, I would argue that most of the work reflecting the relational turn remains distinctively liberal in its respect for the ethical significance of the human individual. It moves away from individualism, but not from the value of individuality.In this review essay, I shall focus on how the relational turn has manifested itself in work on core concepts in bioethics, especially liberty and autonomy. Following a general review, I conclude with a brief consideration of two important recent books in this area: Jennifer Nedelsky's Law's Relations and Rachel Haliburton's Autonomy and the Situated Self. (shrink)

Regulations implemented by World Athletics (WA) require female athletes with differences of sexual development to suppress their blood testosterone levels in order to participate in certain women’s sporting competitions. These regulations have been justified by reference to fairness. In this paper, we reconstruct WA’s understanding of fairness, which requires a “level playing field” where no athlete should have a significant performance advantage based on factors other than talent, dedication, and hard work over an average athlete in their category. We demonstrate (...) that by placing regulations only on testosterone levels, while ignoring physical as well as socioeconomic advantages, WA consistently fails to meet its own definition of fairness. We then discuss several ways in which this definition could be met. Our analysis shows that a categorical system, in which athletes are divided into categories based on properties leading to significant performance advantages, is best suited for meeting WA’s definition of fairness. (shrink)

Center for Humans and Nature, 109 West 77th Street, Suite 2, New York, NY 10024, USA. Tel.: 212 362 7170; Fax: 212 362 9592; Email: brucejennings{at}humansandnature.org ' + u + '@' + d + ' '//--> . Abstract A fundamental question for the ethical foundations of public health concerns the moral justification for limiting or overriding individual liberty. What might justify overriding the individual moral claim to non-interference or to self-realization? This paper argues that the libertarian justification for limiting individual (...) liberty known as the ‘harm principle’ or the ‘Millian paradigm’ is inadequate as a basis of public health ethics and policy. But simply pitting some collectivist value or utilitarian criterion over against individual liberty is not theoretically satisfactory, either. John Stuart Mill himself was not a Millian, in this sense, and his utilitarianism does not pit itself against individual liberty as a situation of balancing conflicting values. A reconsideration of Mill, particularly in light of the later work of Berlin on liberty, points toward a conception of relational liberty that is crucial for public health ethics because it contains within itself the basis for its own moral limitation. CiteULike Connotea Del.icio.us What's this? (shrink)

The absence of a common understanding of attention plagues current research on the topic. Combining the findings from three domains of research on attention, this paper presents a univocal account that fits normal use of the term as well as its many associated phenomena: attention is a process of mental selection that is within the control of the subject. The role of the subject is often excluded from naturalized accounts, but this paper will be an exception to that rule. The (...) paper aims to show how we might reinstate the subject into the act of attention, endorsing the ordinary notion that attention is a direction of the mind by the subject, rather than a mere occurrence or happening. To do so, it lays out the best work of phenomenology, psychology, and neuroscience on specifying the nature of attention and, in finding them individually wanting, combines them into a unified view that avoids the problems of each. (shrink)

Mental control refers to the ability we have to control our own minds. Its primary expression—attention—has become a popular topic for philosophers in the past few decades, generating the need for a primer on the concept. It is related to self-control, which typically refers to the maintenance of preferred behavior in the face of temptation. While a distinct concept, criticisms of self-control can also be applied to mental control, such as that it implies the existence of an unscientific homunculus-like agent (...) or is not a natural kind. Yet, as this Element suggests, a scientifically-grounded account of mental control remains possible. The manuscript is organized into five main sections, which cover 1) the concept of mental control, 2) the relationship between mental control and attention, 3) the phenomena of meditation and mindwandering, 4) attention deficit hyperactivity disorder, and 5) emergence-based accounts of mental control, including an original account by the author. (shrink)

The chapter provides an overview of the structure and content of the textbook to help situate the reader. It begins by introducing this unique collaborative project, including a general introduction to the fields of philosophy, cognitive science, and neuroscience. It then segues into explaining the structural features of each chapter that provide uniformity across the textbook. The chapter concludes with an overview of the content provided in the textbook. Through a survey of the major themes and their interconnections the reader (...) will be better able to appreciate the rich interplay between philosophy and cognitive neuroscience in each of the topical chapters. (shrink)

Do you want to make sure you · Don’t invest your money in the next Enron? · Don’t go to work for the next WorldCom right before the crash? · Identify and solve problems in your organization before they send it crashing to the ground? Marianne Jennings has spent a lifetime studying business ethics---and ethical failures. In demand nationwide as a speaker and analyst on business ethics, she takes her decades of findings and shows us in The Seven Signs (...) of Ethical Collapse the reasons that companies and nonprofits undergo ethical collapse, including: · Pressure to maintain numbers · Fear and silence · Young ’uns and a larger-than-life CEO · A weak board · Conflicts · Innovation like no other · Belief that goodness in some areas atones for wrongdoing in others Don’t watch the next accounting disaster take your hard-earned savings, or accept the perfect job only to find out your boss is cooking the books. If you’re just interested in understanding the (not-so) ethical underpinnings of business today, The Seven Signs of Ethical Collapse is both a must-have tool and a fascinating window into today’s business world. (shrink)

Attention has a long history in philosophy, despite its near absence in the twentieth century. This chapter provides an overview of philosophical research on attention. It begins by explaining the concept of "selection from limitation," contrasting it with the more recent "selection for action." It reviews historical texts that discuss attention, focusing on those in the Western canon whose understanding of "attention" aligns with contemporary usage. It then describes the differential treatment of attention in phenomenology and behaviorism in the last (...) century. Finally, it discusses contemporary research by topic: attention, perception, and knowledge; attention and consciousness; attention and action; and attention and the self. It includes work by Allport,Aristotle, Astell, Augustine, Bergson, Berkeley, Block, Bradley, Buddhaghosa, Campbell, Cherry, De Brigard, Dehaene and Naccache, Descartes, Dickie, Du Bois, Ganeri, Hegel, Heidegger, James, Kant, Koch and Tsuchiya, LaBerge, Locke, Mack and Rock, Malebranche, Merleau-Ponty, Mole, Montemayor and Haladjian, Neumann, Pashler, Posner, Prinz, Reid, Rensink, Reynolds and Heeger, Treisman, Watzl, Wittgenstein, Wollstonecraft, and Wu. (shrink)

Corporate change and employee dislocation are inevitable in a free market. However, the current employment relationship in the U.S. that affords a perceived employment safety net is contrary to the natural canon of honesty. Employees cannot be guaranteed employment when a company fails or a product is no longer viable. Attempts to provide costly employment safety nets cause a firm to allocate resources to nonproductive programs that may ultimately cause a loss of competitiveness. These strategies to provide alternate employment may (...) provide only short-term solutions. But even short-term safety nets against unemployment may be sending employees unrealistic messages ... a permanent safety net against unemployment. As a result, employees may lose incentive to be innovative in creating their own personal safety nets. The resolution is candor about the risk of employment. A false employment safety net is not what employees want or need and in the long run it may be detrimental to American competitiveness. (shrink)

The principle of informed consent obligates physicians to explain possible side effects when prescribing medications. This disclosure may itself induce adverse effects through expectancy mechanisms known as nocebo effects, contradicting the principle of nonmaleficence. Rigorous research suggests that providing patients with a detailed enumeration of every possible adverse event—especially subjective self-appraised symptoms—can actually increase side effects. Describing one version of what might happen (clinical “facts”) may actually create outcomes that are different from what would have happened without this information (another (...) version of “facts”). This essay argues that the perceived tension between balancing informed consent with nonmaleficence might be resolved by recognizing that adverse effects have no clear black or white “truth.” This essay suggests a pragmatic approach for providers to minimize nocebo responses while still maintaining patient autonomy through “contextualized informed consent,” which takes into account possible side effects, the patient being treated, and the particular diagnosis involved. (shrink)

It is argued that the preservation of truth by an inference relation is of little interest when premiss sets are contradictory. The notion of a level of coherence is introduced and the utility of modal logics in the semantic representation of sets of higher coherence levels is noted. It is shown that this representative role cannot be transferred to first order logic via frame theory since the modal formulae expressing coherence level restrictions are not first order definable. Finally, an inference (...) relation, calledyielding, is introduced which is intermediate between the coherence preservingforcing relation introduced elsewhere by the authors and the coherence destroying, inference relation of classical logic. (shrink)

How does attention contribute to perceptual experience? Within cognitive science, attention is known to contribute to the organization of sensory features into perceptual objects, or “object-based organization.” The current paper tackles a different type of organization and thus suggests a different role for attention in conscious perception. Within every perceptual experience we find that more subjectively interesting percepts stand out in the foreground, whereas less subjectively interesting percepts are relegated to the background. The sight of a sycamore often gains the (...) visual foreground for a nature lover, whereas the sound of a violin often gains the auditory foreground for a music lover, but not necessarily vice versa. How does the perceptual system organize early sensory processing according to the subject’s interests? The current paper reveals how this subject-based organization is brought about and maintained through top-down attention. In fact, the current paper argues that top-down attention is necessary for conscious perception in so far as it is necessary for bringing about and maintaining the subject-based organization of perceptual experience. (shrink)

This article defends ‘relational theorizing’ in bioethics and public health ethics and describes its importance. It then offers an interpretation of solidarity and care understood as normatively patterned and psychologically and socially structured modes of relationality; in a word, solidarity and care understood as ‘practices.’ Solidarity is characterized as affirming the moral standing of others and their membership in a community of equal dignity and respect. Care is characterized as paying attention to the moral being of others and their needs, (...) suffering, and vulnerability. The wager of relational theorizing in health care and public health is that substantive ethical visions of solidarity and care will provide support for more just and egalitarian health care and public health policies. (shrink)

Assuming that the purpose of research ethics review is to support the ethical conduct and dissemination of good quality research, a question can be raised concerning whether ethics review of research really improves the practice of researchers. Specifically, we might distinguish the activities that go on as part of the review process from those activities that constitute the data collection phase of the research, and ask under what conditions the former have a positive impact on the latter. Two different models (...) of ethics review can be distinguished, term them ‘compliance’ and ‘reflexivity’-based reviews. Compliance-based models of review require researchers to show how they are complying with a given set of rules or protocols for research. Reflexivity-based models require researchers to articulate the ethical issues involved in their research and to explain and justify the way in which they plan to manage them. It is suggested here that there is reason to think that reflexivity-based models of ethics review are more likely to have a positive effect on the practice of social science research than compliance-based reviews. (shrink)

In Explaining Attitudes, Baker argues that we should treat our everyday practices as relevant to metaphysical debates, resulting in a stance of realism with respect to intentional explanations. In this chapter I will argue that if one is going to be a practical realist about anything, it should be the self, or subject of attention. I will use research on attention combined with the stance of practical realism to argue in favor of a substantive self. That is, I will present (...) an account of the self that directs and controls attention, in line with our everyday view of the self. I will contrast this account with what I call the “illusion view,” which presents the self and its apparent causal power in the case of attention as an illusion. My account of the self will make use of several of Baker's ideas, including non-reductive materialism and broad supervenience. (shrink)

No single concept has been more important in the contemporary development of bioethics, and the revival of medical ethics, than the concept of autonomy, and none better reflects both the philosophical and the political currents shaping the field. This article proposes to consider autonomy in three of its facets and functions: first, as a concept in ethical theory; second, as a concept in applied ethics; and finally, as what might be called an ideological concept — that is, one that both (...) draws from and reinforces non-philosophical interests at work in the profession of medicine, biomedical science and technology, and the broader liberal individualistic culture of Anglophone countries, particularly the United States, where a bioethical discourse centred on autonomy has flourished. (shrink)

This article is concerned primarily to re-discover the contours of a doctrine -- Winock's �nationalisme ouvert� -- that (however unsuccessfully and for however short a time) intended to combine liberalism and nationalism. To that end it will concentrate upon the period that surrounded the birth of the July Monarchy in 1830 and specifically upon the writings of Armand Carrel, founder (with Thiers and Mignet) of Le National and supporter of the nationalist causes in Belgium, Poland and Italy. Other writers --ost (...) notably Lamennais, founder of L'Avenir, and Jules Michelet -- could have been taken as representatives of this body of opinion but Carrel, not merely upon the legitimate grounds of rescuing him from undeserved obscurity, especially merits our attention. (shrink)

In this paper I argue that the prioritization of sensory input by top-down attention is constitutive of and essential to conscious perception. Specifically, I argue that top-down attention is required to provide informational integration at the level of the subject, which can be contrasted with integration at the level of features and objects. Since the informational content of conscious perception requires integration at the level of the subject, top-down attention is necessary for conscious perception as we know it. I present (...) this argument through a theory, which I call the “Standard Theory.” According to this theory, top-down attention brings about subject-level integration for sensory input by prioritizing that input with respect to a subject-level standard. (shrink)

Tim Jennings, one of America's top psychiatrists, here reveals how our brains and bodies thrive when we have a healthy understanding of who God is. Exposing how different God concepts affect the brain differently, Dr. Jennings forges surprising new connections between neuroscience, health and right belief.

It is unclear whether someone’s responsibility for developing a disease or maintaining his or her health should affect what healthcare he or she receives. While this dispute continues, we suggest that, if responsibility is to play a role in healthcare, the concept must be rethought in order to reflect the sense in which many health-related behaviours occur repeatedly over time and are the product of more than one agent. Most philosophical accounts of responsibility are synchronic and individualistic; we indicate here (...) what paying more attention to the diachronic and dyadic aspects of responsibility might involve and what implications this could have for assessments of responsibility for health-related behaviour. (shrink)

During 1995, there was a major shift in the United Kingdom in the debate of whether it is right for nurses to strike. The Royal College of Nursing, the former advocate of a non-industrial action policy, moved towards the UNISON position that industrial action is ethical in some circumstances, as well as the necessary thing to do. The authors, both nurses and UNISON officials, look at the reasons for this change and why UNISON’s historical position sees industrial action as an (...) effective weapon in defending services, as well as wages and jobs. It can be right to strike. (shrink)