Background Advance Care Planning via Group Visits (ACP-GV) is a patient-centered intervention facilitated by a clinician using a group modality to promote healthcare decision-making among veterans. Participants in the group document a “Next Step” to use in planning for their future care needs. The next step may include documentation of preferences in an advance directive, discussing plans with family, or anything else to fulfill their ACP needs. This evaluation seeks to determine whether there are identifiable subgroups of group participants with (...) differing needs prior to delivery of the ACP-GV program and, if so, to use information about the subgroups to enhance the program offered to veterans in United States Department of Veterans Affairs (VA) healthcare settings. Methods We conducted a secondary analysis of national data from a quality improvement evaluation. Patient- and provider-level data from administrative healthcare records for VA users in all 50 states, territories, and the District of Columbia provides data on veterans attending ACP-GV during federal fiscal years 2018–2022 (N = 26,857). Latent class analysis seeks to identify the various subgroups of veterans based on their level of ACP self-efficacy before attending ACP-GV and any demographic differences across the resulting subgroups of veterans attending ACP-GV. ACP self-efficacy is derived from seven items obtained from a participant worksheet used during the group. Results Analysis revealed two distinct groups of veterans, distinguishable by their pre-ACP-GV levels of one aspect of ACP self-efficacy: prior knowledge of ACP. Veterans with higher prior knowledge of ACP are associated with an identified next step focused on checking their current AD status and updating it, and veterans with lower ACP prior knowledge are associated with identifying a next step to discuss ACP more fully with family. Differences in age, sex, race, ethnicity, and marital status exist across subgroups of veterans. Conclusion Greater attention must be paid to ACP and veterans’ prior knowledge of ACP to consistently encourage annual review and status updates. (shrink)

Here I explore the prospects for fictionalism about the mental, modeled after fictionalism about possible worlds. Mental fictionalism holds that the mental states posited by folk psychology do not exist, yet that some sentences of folk psychological discourse are true. This is accomplished by construing truths of folk psychology as “truths according to the mentalistic fiction.” After formulating the view, I identify five ways that the view appears self-refuting. Moreover, I argue that this cannot be fixed by semantic ascent or (...) by a kind of primitivism. Even so, I also show that the “self-refutation” charges are subtly question-begging. Nevertheless, the reply reveals that a mental fictionalist ought to be a kind of quietist. (shrink)

This careful and engaging introduction to Aristotle equips readers of ancient philosophy and classics with an intellectual map that will guide their further exploration within the terrains of Aristotelian philosophy and logic. The book does not seek to provide a verdict or to persuade the reader of the usefulness of Aristotle's ideas. Instead it offers a comprehensive introduction to key philosophical areas while situating the reader within the ongoing intellectual debates on Aristotle's significance and relevance. Crowley's book allows an overview (...) of Aristotle's contributions and includes discussions on the Organon, the epitome of his logical treatises, his works on biology, nature and causation, metaphysics, citizenship, ethics and eudaimonia. The book is a valuable tool for readers interested in becoming acquainted with the work of Aristotle but most importantly for those who are keen to understand his many interpretations. (shrink)

This article presents a novel defense of Sartrean ethics based on the concept of interpersonal recognition. The immediate post-war texts Anti-Semite and Jew, What is Literature? and Notebooks for an Ethics express Sartre's inchoate yet ultimately defensible view of obligations to others. Such obligations are not best understood as Kantian duties, but rather as Hegelian obligations of mutual recognition. The emerging portrait of Sartrean ethics offers a strong reply to the classical criticism that authenticity would license vicious lifestyles like serial (...) killing. In addition to acting with clarity and responsibility, existentially authentic individuals must respect others. (shrink)

Terms such as ‘exist’, ‘actual’, etc., (hereafter, “ontic terms”) are recognized as having uses that are not ontologically committing, in addition to the usual commissive uses. (Consider, e.g., the Platonic and the neutral readings of ‘There is an even prime’.) In this paper, I identify five different noncommissive uses for ontic terms, and (by a kind of via negativa) attempt to define the commissive use, focusing on ‘actual’ as my example. The problem, however, is that the resulting definiens for the (...) commissive ‘actual’ is itself equivocal between a commissive and a noncommissive reading. I thus consider other proposals for defining the commissive use, including two proposals from David Lewis. However, each proposal is found to be equivocal in the same way—and eventually I argue that it is impossible to define an ontic term unequivocally. Even so, this is not meant to overshadow that we can understand an ontic term as univocally commissive, in certain conversational contexts. I close by illustrating the import of these observations for the Hirsch–Sider debate in metaontology. (shrink)

Experience, it is widely agreed, constrains our thinking and is also thoroughly theory-laden. But how can it constrain our thinking while depending on what it purports to constrain? To address this issue, I revisit and carefully analyze the account of observation provided by Norwood Russell Hanson, who introduced the term ‘theory-ladenness of observation’ in the first place. I show that Hanson’s account provides an original and coherent response to the initial question and argue that, if suitably developed, his account provides (...) a distinctive, powerful, and attractive alternative to relationalist and standard representationalist conceptions of experience. (shrink)

Greek art and literature follow parallel courses through the long period from Homer to Euripides. Homer and Euripides, Dipylon vases and the latest white lekythoi are as far apart from each other as it is possible for works in the same medium to be. The distance can only be explained by a similar change in the views of artists, writers, and their public.

In The Theatre of Dionysus in Athens Dr. Pickard-Cambridge includes a most useful and convenient collection of south Italian vase-paintings which have been held to throw light on the stage-settings of Greek tragedy. He concludes that they give no evidence for Athens in the fifth century and in particular do not justify the assumption that interior scenes were played in a porch in front of the central door. The second conclusion is true, but some of the vases do show that (...) the central doors could be thrown wide open to display an interior scene. The first conclusion is formally correct, but it should be remembered that the “plays came from Athens, and it is at least possible that the south Italian producers modelled themselves on Athenian producers. In any case these vases are worthy of further consideration. (shrink)

Here I first raise an argument purporting to show that Lewis’ Modal Realism ends up being entirely trivial. But although I reject this line, the argument reveals how difficult it is to interpret Lewis’ thesis that possibilia “exist.” Five natural interpretations are considered, yet upon reflection, none appear entirely adequate. On the three different “concretist” interpretations of ‘exist’, Modal Realism looks insufficient for genuine ontological commitment. Whereas, on the “multiverse” interpretation, Modal Realism acknowledges physical possibilities only--and worse, (assuming either axiom (...) S5 or axiom B) each possibilium ends up as a necessary physical existent. Finally, on the “broadly Actualist” of ‘exist’, Modal Realism is either inconsistent or it mistakenly identifies the unrestricted quantifier with the unrestricted Actualist quantifier. The upshot is that it remains obscure in what non-trivial sense Lewisian possibilia “exist.”. (shrink)

This draft now appears (in revised form) as the Preamble to _Self-Reflection for the Opaque Mind_. See http://philpapers.org/rec/PARSFT-3.

Oppenheimer & Zalta have re-formulated their non-modal version of the ontological argument, with the help of PROVER9, an automated reasoning engine. The authors end up rejecting the new argument; however, the theist has a rejoinder worth considering. But after presenting the rejoinder, I highlight that the conceivability of the being does not imply its possibility. One lesson is that even non-modal ontological arguments must engage modal matters concerning God. Another lesson is that if PROVER9 is able to derive a conclusion (...) from fewer premises, the proof is sometimes inferior as an argument. (shrink)

Many people, failing to understand the theories of such ethical relativists as William Graham Sumner, Ruth Benedict and Edward Westermarck, have thought that various findings of the social sciences establish these theories. They regard the problem of ethical relativism, or the problem of determining whether or not any of these theories is sound, as a scientific problem. And they often think of ethical relativism as a scientific theory which explains these findings. In particular, it is widely thought that anthropologists have (...) amassed overwhelming evidence to prove that the moral beliefs of peoples of different cultures conflict or are diverse in such a way that this diversity of morals raises the problem of ethical relativism. And many have thought and continue to think that ethical relativism is demonstrated by this evidence and is a scientific hypothesis which accounts for the diversity of morals. The argument from the diversity of morals is the most popular argument for ethical relativism based on the data of the social sciences. (shrink)

The article examines the issue of public health and medical services in Algeria and analyses the role of the public and private sectors in supporting and promoting public health. Our study is based on an analysis of legal texts that highlight Algeria’s health policies. Some significant aspects of the article are: the Algerian policy of opening health services up to private investment; the lack of contribution of private health institutions in the field of medical education; and issues surrounding the organisation (...) of blood donation. The article also notes the absence of foreign investment in Algerian hospitals. (shrink)

Commentary, with Bengali translation, of Anumānakhaṇḍa, a portion of Tattvacintamaṇi, basic work on the neo-Nyaya school in Hindu philosophy, by Gaṅgeśa, 13th century.

On the Hindu philosophical tradition in the light of Yoga and Hindu rituals.

This is a condensed description of the contents and overarching argument found in Hippocrates’ Oath and Asclepius’ Snake: The Birth of the Medical Profession. In that work, I maintain that the basic medical ethical problem concerns iatrogenic harm. I focus particularly on what I refer to as ‘role-conflation’. This most egregious form of iatrogenic harm occurs when a physician deliberately adopts the role of wounder. A contemporary practice such as physician-assisted suicide exemplifies a doctor’s deliberate wounding. I argue that the (...) author of the Hippocratic Oath – aware of the chronic risk of role-conflation – responds to this threat by having the oath-taker specifically forswear signal acts that wound the sick, such as giving a deadly drug even if asked, giving an abortifacient, sexual predation, and gossiping. I argue that by means of the Oath, Hippocrates founds medicine as a profession, a practice intimately involving promising. (shrink)

I distinguish two claims about human ‘dominion’ over nature: (1) Humans have the right to supervise, manage, and direct the rest of nature; (2) Humans have a special value, superior to the rest of nature. I discuss some ways of rejecting either or both claims, and point to some surprising consequences of such rejections. Then I compare the ways in which Aristotelianism and sentientism might try to keep hold of both claims. This produces two surprising and unwelcome results for sentientism, (...) and one surprising and welcome result for Aristotelianism (namely, an alliance with Kantianism). And God blessed them, and God said unto them, Be fruitful, and multiply, and replenish the earth, and subdue it: and have dominion over the fish of the sea, and over the fowl of the air, and over every living thing that moveth upon the earth. (Genesis 1.28). (shrink)

We describe a unification of old and recent ideas for formulating graphical models to explain time series data, including Granger causality, semi-automated search procedures for graphical causal models, modeling of contemporaneous influences in times series, and heuristic generalized additive model corrections to linear models. We illustrate the procedures by finding a structure of exogenous variables and mediating variables among time series of remote geospatial indices of ocean surface temperatures and pressures. The analysis agrees with known exogenous drivers of the indices, (...) not assumed in the analysis. Automated search applied to the residuals after regressing each series on its lags and the lags of its Granger causes yields a graphical model of “comtemporaneous” causal relations identical with the qualitative graphical relations from the time series. A similar analysis produces reasonable results when applied to candidate climate indices obtained by a clustering method from sea surface temperature and sea level pressure data. (shrink)

Male superiority in mathematical ability (along with female superiority in verbal fluency) may reflect the operation of an X-Y homologous gene (the right-shift-factor) influencing the relative rates of development of the cerebral hemispheres. Alleles at the locus on the Y chromosome will be selected at a later mean age than alleles on the X, and only by females.

Open peer commentary on the article “Constructivist Model Building: Empirical Examples From Mathematics Education” by Catherine Ulrich, Erik S. Tillema, Amy J. Hackenberg & Anderson Norton. Upshot: I look at the different possibilities offered by the trajectory of second-order models in mathematics education. It seems to me that although possibilities are extended as models become more elaborate, this is only the case if teacher/researchers remain cognisant of a radical constructivist perspective. I also suggest that broad-ranging research on the models affords (...) insight into the “big” mathematical ideas to which all students should have access. (shrink)