In this article, we examine the inter-relationship between moral theory and the unpredictable and complex world of primary health care, where the values of patient and doctor, or groups of patients and doctors, may often clash. We introduce complexity science and its relevance to primary care; going on to explore how it can assist in understanding ethical decision making, as well as considering implications for clinical practice. Throughout the article, we showcase aspects and key concepts using examples and a case (...) study developed from our day-to-day experience working as clinical practitioners in primary care. (shrink)

Primary health care is characterised by timely and appropriate health care access, delivered continuously over time to a specific population, providing a comprehensive service, with coordination of care for those that need it. Practitioners deal with a multiplicity of clinical issues within longitudinal relationships, embedded in the context of families and communities. We propose that these aspects of primary care have a bearing on how matters of decision making are considered and implemented. Further, the standard account of autonomous decision making (...) is not wholly adequate when applied to clinician–patient encounters in primary care. We add considerations of the impact of illness (however defined) and self-identity as also relevant to a more measured and full account. The context of primary care is quite different from that of secondary care. Although there are generalists who work in hospitals, we argue that this aspect and the other attributes of primary care generate special ethical considerations. One of these is how autonomy, or more fully, how respect for the principle of autonomy is considered and operationalised in community practice. In this study, we describe some theoretical aspects of autonomy and seek to apply, and challenge, these aspects in the context of clinical work in primary care. In doing so we will review the descriptors of primary care: why in essence it is different from other contexts of clinical work. (shrink)

Believing that p, assuming that p, and imagining that p involve regarding p as true—or, as we shall call it, accepting p. What distinguishes belief from the other modes of acceptance? We claim that conceiving of an attitude as a belief, rather than an assumption or an instance of imagining, entails conceiving of it as an acceptance that is regulated for truth, while also applying to it the standard of being correct if and only if it is true. We argue (...) that the second half of this claim, according to which the concept of belief includes a standard of correctness, is required to explain the fact that the deliberative question whether to believe that p is transparent to the question whether p. This argument raises various questions. Is there such a thing as deliberating whether to believe? Is the transparency of the deliberative question whether to believe that p the same as the transparency of the factual question whether I do believe that p? We will begin by answering these questions and then turn to a series of possible objections to our argument. (shrink)

Why, when asking oneself whether to believe that p, must one immediately recognize that this question is settled by, and only by, answering the question whether p is true? Truth is not an optional end for first-personal doxastic deliberation, providing an instrumental or extrinsic reason that an agent may take or leave at will. Otherwise there would be an inferential step between discovering the truth with respect to p and determining whether to believe that p, involving a bridge premise that (...) it is good (in whichever sense of good one likes, moral, prudential, aesthetic, allthings-considered, etc.) to believe the truth with respect to p. But there is no such gap between the two questions within the first-personal deliberative perspective; the question whether to believe that p seems to collapse into the question whether p is true. (shrink)

This experiment investigated the effect of format (line vs. bar), viewers’ familiarity with variables, and viewers’ graphicacy (graphical literacy) skills on the comprehension of multivariate (three variable) data presented in graphs. Fifty-five undergraduates provided written descriptions of data for a set of 14 line or bar graphs, half of which depicted variables familiar to the population and half of which depicted variables unfamiliar to the population. Participants then took a test of graphicacy skills. As predicted, the format influenced viewers’ interpretations (...) of data. Specifically, viewers were more likely to describe x–y interactions when viewing line graphs than when viewing bar graphs, and they were more likely to describe main effects and “z–y” (the variable in the legend) interactions when viewing bar graphs than when viewing line graphs. Familiarity of data presented and individuals’ graphicacy skills interacted with the influence of graph format. Specifically, viewers were most likely to generate inferences only when they had high graphicacy skills, the data were familiar and thus the information inferred was expected, and the format supported those inferences. Implications for multivariate data display are discussed. (shrink)

When we deliberate whether to believe some proposition, we feel immediately compelled to look for evidence of its truth. Philosophers have labelled this feature of doxastic deliberation 'transparency'. I argue that resolving the disagreement in the ethics of belief between evidentialists and pragmatists turns on the correct explanation of transparency. My hypothesis is that it reflects a conceptual truth about belief: a belief that p is correct if and only if p. This normative truth entails that only evidence can be (...) a reason for belief. Although evidentialism does not follow directly from the mere psychological truth that we cannot believe for non-evidential reasons, it does follow directly from the normative conceptual truth about belief which explains why we cannot do so. (shrink)

Writing the Mughal World: Studies on Culture and Politics. Muzzafar Alam and Sanjay Subrahmanyam. New York: Columbia University Press, 2011. Pp. xviii + 516. $89.50, £62 ; $29.50, £20.50.

This important and comprehensive work of 18th-century Islamic religious thought written in Arabic by a pre-eminent South Asian scholar provides an extensive and detailed picture of Muslim theology and interpretive strategies on the eve of the modern period.

In many regions around the world, those at highest risk for acquiring HIV are young adults and adolescents. Young men who have sex with men in the USA are the group at greatest risk for HIV acquisition, particularly if they are part of a racial or ethnic minority group.1 Adolescent girls and young women have the highest incidence rates of any demographic subgroup in sub-Saharan Africa.2 To reverse the global AIDS pandemic’s toll on these high-risk groups, it is important to (...) deploy the most effective HIV prevention tools to young MSM in the USA, to adolescent girls and young women in sub-Saharan Africa, and to any other adolescents and young adults at high risk for HIV as products are proven to be safe and efficacious. Although prevention interventions with proven efficacy, such as oral pre-exposure prophylaxis, are available,3–8 they have not been sufficient to stem the tide and an expanded prevention toolkit is urgently needed to serve these populations. The field of HIV prevention continues to identify promising leads in the development of new biomedical prevention products, either delivering antiviral drug topically or systemically. The dapivirine ring has been shown to provide modest protection and is currently being tested in open label studies while injectable cabotegravir is being tested in a large efficacy trial for preventing HIV acquisition. Advances in the field of HIV prevention mean that scientists and regulators must plan for how they will bring prevention tools to populations at high risk for HIV as they conduct efficacy and effectiveness trials. For instance, safety data from younger age groups can also be used in combination with efficacy data from adult studies, where appropriate, as bridging studies to expand labelling to younger ages. If these …. (shrink)

In his influential paper, 'Why Was the Logic of Discovery Abandoned?', Laudan contends that there has been no philosophical rationale for a logic of discovery since the emergence of consequentialism in the 19th century. It is the purpose of this paper to show that consequentialism does not involve the rejection of all types of logic of discovery. Laudan goes too far in his interpretation of the historical shift from generativism to consequentialism, and his claim that the context of pursuit belongs (...) to neither discovery nor justification is based on narrow interpretations of the contexts of discovery and justification. As a result, Laudan draws unwarranted conclusions concerning both the early and contemporary defenders of a logic of discovery. A methodological logic of discovery - which involves self-corrective methods of hypothesis generation that promote the long-term goals of science and which require consequential support for justification - is a type of logic of discovery that survives the shift to consequentialism. (shrink)

Visual masking of primes lowers prime visibility but spares processing of primes as reflected in prime–target congruence and prime–response compatibility effects. However, the question is how to appropriately measure prime visibility. Here, we tested the influence of three procedural variables on prime visibility measures: prime–target similarity, prime–response similarity, and the variability of prime–response mappings. Our results show that a low prime–target similarity is a favorable condition for a prime visibility measure because it increases the sensitivity of this measure in comparison (...) to a high prime–target similarity. (shrink)

This paper proposes two formal models for understanding real-life dialogues, aimed at capturing argumentative structures performatively enacted during conversations. In the course of the investigation, two types of discourse with a high degree of well-structured argumentation were chosen: moral debate and financial communication. The research project found itself confronted by a need to analyse, structure and formally describe large volumes of textual data, where this called for the application of computational tools. It is expected that the results of the proposed (...) research will make a contribution to formal systems modelling and the evaluation of communication from the point of view of argument soundness. (shrink)

Why can't deliberation conclude in an intention except by considering whether to perform the intended action? I argue that the answer to this question entails that reasons for intention are determined by reasons for action. Understanding this feature of practical deliberation thus allows us to solve the toxin puzzle.

It is common for philosophers to claim that doxastic voluntarism, the view that an agent can form beliefs voluntarily, is false, and therefore that agents do not have the kind of control over their beliefs required for a straightforward application of deontological concepts such as obligation or duty in the domain of epistemology. The role that the denial of doxastic voluntarism plays in an argument to the effect that agents do not have obligations with respect to belief is simply this.

The Handbook considers the State of Qur'anic Studies; Historical Setting; Textual Transmission and Codification; Structural and Literary Features; Content and Concepts; Applied Discourses; and an Overview of Qur'anic Interpretation.

Workers can be fired from jobs, citizens sent to jail, and adolescents more likely to experience depression, all because of algorithms. Algorithms have considerable impacts on our lives. To increase user satisfaction and trust, the most common proposal from academics and developers is to increase the transparency of algorithmic design. While there is a large body of literature on algorithmic transparency, the impact of unethical data collection practices is less well understood. Currently, there is limited research on the factors that (...) affect users’ trust in data collection practices and algorithmic transparency. In this research, we explore the relative impact of both factors as they relate to important outcome measures such as user’s trust, comfort level, and moral acceptability. We conducted two pilot studies to learn what real users consider to be ethical and unethical data collection practices, as well as high and low transparency for algorithms. We then used these findings in a 2 × 2 design to examine how transparency and the acceptability of data collection practices impact users’ acceptance, comfort, and trust in algorithms. Our results suggest that the singular emphasis on algorithmic transparency may be misplaced. Given the difference in their impact to increase acceptance, trust, and user satisfaction, a more effective strategy would be to also understand and abide by users’ views of ethical data collection practices. (shrink)

Heidegger’s reading of Kant is deciphered to have illuminated his own project concerning the basic question of Ontology, Time, Space and History [Temporality, Spatiality and Historicity] embodying the novel description of Human reality in terms of Mit-Dasein and Mit-welt [Subjectivity with the public face]. Kant’s Critique of Pure Reason led Heidegger develop his own project of Existential Phenomenology contrary to Husserilian Phenomenology. We will discuss the Kantian Heidegger following the two main issues: one, Heidegger appreciates Kant on his identifying and (...) exploring the difference of ontic/ontological. Two, Kant prioritizes time over space. Heidegger would explore the subject of ontic/ontological difference in the sense that ontic knowledge is the knowledge of particular beings, whereas ontological knowledge is described as the a priori condition inferring the ontic knowledge. In this sense ontological knowledge pertains to question of being rather than beings. This is how Heidegger’s Kant interpretation would differ from the Neo-Kantianism of Marburg School which argued that Critique of Pure Reason is a work of epistemology. In contrast to this position, Heidegger held that Critique is a unique work of transcendental philosophy; it is theory of ontological knowledge but not ontic knowledge. Ontic knowledge of beings must conform to Being of beings [ontological foundation]. Heidegger holds that this should be Kant’s “Copernican Revolution”. However, Heidegger would appropriate the Kantian notion of time in the form of temporality of Dasein. Being manifests itself on beings through Being-there [Human reality] who purely understands Being. For Heidegger, temporality of Dasein is the foundation of ontological knowledge indeed. (shrink)

The research on the dark side of leadership is still in its infancy. We have contributed to this line of research by proposing that work alienation acts as an underlying mechanism through which aversive leadership results in reduced job performance. We further propose that psychological capital acts as an important personal resource that reduces the negative effects of aversive leadership in the form of work alienation. The proposed model gets its support from the conversation of resources theory given by Hobfoll (...) (1981) which suggests that stressful situation like an aversive leadership results in the loss of employee resources as a result of that he/she indulges in work alienation and shows poor job performance to retain back the lost resources. People with better personal resources in the form of psychological capital are better able to cope-up with the aversive leader behavior and make them able to avoid work alienation. It is a time-lagged study. The data for the current study was collected from 321 employees working in the service sector organizations, particularly universities, banks and telecom organizations, through personally administered questionnaires. The results supported the mediation and moderation hypothesis. Limitations and future research along with theoretical and practical implications are given at the end. (shrink)

Ethical consumerism has been dramatically increasing in recent decades, but in service sector, fewer research has been conducted especially in the fast-food industry. In this paper, we determined empirically the consumer perceived ethicality effects on repurchase intentions as well as on word of mouth through brand image partial mediation and customer expertise moderation in fast-food sector. The data were collected from 307 consumers of the fast-food restaurants through self-administered questionnaires. Common method variance and social desirability bias were measured before testing (...) hypotheses, and the data were investigated by SPSS and AMOS 21st version. The empirical results demonstrated that consumer perceived ethicality effects on repurchase intentions directly and through brand image partial mediation indirectly. Moreover, the direct and positive effects of repurchase intentions on word of mouth were experienced. This study generalized the results of previous studies of consumer perceived ethicality conducted in western culture in Pakistani fast-food sector. This study also proposed that firms should tackle ethical concerns at corporate and operational strategy levels to improve consumers’ behavioral intentions. (shrink)

Mark Schroeder has recently presented apparent counterexamples to the standard account of the distinction between the right and the wrong kinds of reasons. We argue that these examples appear to refute the standard account only because they blur the distinction between two kinds of reasoning: reasoning about whether to intend or believe that p and reasoning about whether to take up the question of whether to intend or believe that p.

Medical student and resident participation in global health experiences (GHEs) has significantly increased over the last decade. In response to growing student interest and the proven impact of such experiences on the education and career decisions of resident physicians, many medical schools have begun to establish programmes dedicated to global health education. For the innumerable benefits of GHEs, it is important to note that medical students have the potential to do more harm than good in these settings when they exceed (...) their actual capabilities as physicians-in-training. While medical training programmes are beginning to provide students with the knowledge to put their GHEs in context, they must remember that they also bear the responsibility of training their students in a framework to approach these experiences in a principled and professional way. It is necessary that these institutions provide adequate and formalised preparation for both clinical and ethical challenges of working in resource-poor settings. This paper outlines potential benefits and risks of GHEs and delineates recommendations to some of the current issues. (shrink)

The American Journal of Bioethics, Volume 12, Issue 7, Page 58-59, July 2012.

The proposed study would be a single-arm interventional trial in a community where HIV is endemic. The proposed observational design can provide confirmatory data for the initial clinical observation, data that would be necessary before considering whether a randomized controlled trial is appropriate. A previous ethical analysis has argued for conducting such a study in a country with limited resources and with higher HIV prevalence, and to recruit those with the highest risk of transmission. The primary rationale was to address (...) the scientific question in the most efficient timeframe and to expose the smallest number of infants to the uncertain benefits and risks of the study. However, there are.. (shrink)