Objective Gather information from physicians about factors contributing to unnecessary noninvasive imaging and impact of possible solutions. Methods Qualitative study of 14 physicians using a phenomenological approach and the Theoretical Domains Framework. Results Most participants ( n = 9) self-reported that >10% of the imaging tests they order are unnecessary. External sources of pressure included: peer-review, patient demands, nursing expectations, specialist requests (social demands), as well as prior experience with patient advocates, and the compensation and pension system (environmental context). (...) Internal sources of pressure included reliance on anecdote (emotion), self-doubt about diagnoses (beliefs about capabilities), and fear of missing a diagnosis and of professional liability (beliefs about consequences). Participants expressed both optimism and concern about potential solutions, such as adopting decision support software. Conclusion Physicians are under pressure from multiple sources to order unnecessary imaging. Peer review, nursing expectations, and perceptions about Veteran compensation and pension are newly reported contributing factors. (shrink)

Nursing students face various ethical issues, which may cause stress, that require coping strategies. This study investigated the thoughts and feelings underlying the coping behaviors adopted by nursing students when addressing ethical issues. Semi-structured interviews were conducted from September to October 2011 with 11 students enrolled at University A who had completed basic nursing and specialty practicums and consented to participate in the study. Data were analyzed using qualitative methods. The participant narratives about ethical issues encountered during clinical practicums (...) were organized into four themes and 20 scenarios. The ethical issues concerned the attitudes and conduct of nurses, doctors, physical therapists, and other medical professionals. Seven coping behaviors were identified. The results revealed that nursing students waver between valuing their relationships with nurses and their relationships with patients when they encounter an ethical issue. When their relationships with nurses were emphasized, their ethical values were restructured. These findings suggest the need to address the affective domain early on in lectures and in-class practice, and to create an environment in which students taking practicums can easily express their feelings and internal value system changes. (shrink)

The management of an infant after a decision to withdraw active treatment creates dilemmas. Both lingering death and active killing are undesirable, but palliative interventions can hasten death. We investigated what staff on our neonatal unit thought were the limits of acceptable practice and why. We administered a structured interview to elucidate their views, and asked them to justify their answers. The interviews were analysed quantitatively and qualitatively. A total of 25 participants (15 nurses and 10 doctors) were recruited. (...) 80% emphasized the importance of pain relief following withdrawal, 60% mentioned meeting parental needs at that time. 76% agreed that death can be a desired consequence of withdrawal, yet 52% felt that death should never be hastened. 96% felt that morphine is acceptable after withdrawal, and 72% would give a higher than normal dose if necessary. 56% would stop paralysis at extubation but not reverse it, while 24% would continue paralysis. 16% would consider a drug that ended life instantly in some cases. A wide variety of views emerged, but there were two main positions, a cautious majority, and a more proactive minority. Apparent contradictions within the majority position could be explained using the doctrine of double effect and the acts and omissions distinction. (shrink)

We respond to several important and valid concerns about our study (“The Prevalence of Folk Dualism in Early China,”Cognitive Science 35: 997–1007) by Klein and Klein, defending our interpretation of our data. We also argue that, despite the undeniable challenges involved in qualitatively coding texts from ancient cultures, the standard tools used throughout the cognitive sciences—large quantities of data, coders as blind to the hypothesis as possible, intercoder reliability measures, and statistical analysis—allow the noise of randomly distributed interpretative differences to (...) be distinguished from the signal of genuine historical patterns. (shrink)

Context: The need to reinvigorate medical confidentiality protections is recognised as an important objective in building patient trust necessary for successful health outcomes. Little is known about patient understanding and expectations from medical confidentiality.Objective: To identify and describe patient views of medical confidentiality and to assess provisionally the range of these views.Design: Qualitative study using indepth, open ended face-to-face interviews.Setting: Southeastern Pennsylvania and southern New Jersey, USA.Participants: A total of 85 women interviewed at two clinical sites and three community/research (...) centres.Main outcome measures: Subjects’ understanding of medical confidentiality, beliefs about the handling of confidential information and concerns influencing disclosure of information to doctors.Results: The subjects defined medical confidentiality as the expectation that something done or said would be kept “private” but differed on what information was confidential and the basis and methods for protecting information. Some considered all medical information as confidential and thought confidentiality protections functioned to limit its circulation to medical uses and reimbursement needs. Others defined only sensitive or potentially stigmatising information as confidential. Many of these also defined medical confidentiality as a strict limit prohibiting information release, although some noted that specific permission or urgent need could override this limit.Conclusions: Patients share a basic understanding of confidentiality as protection of information, but some might have expectations that are likely not met by current practice nor anticipated by doctors. Doctors should recognise that patients might have their own medical confidentiality models. They should address divergences from current practice and provide support to those who face emotional or practical obstacles to self-revelation. (shrink)

Zu den großen Rätseln der Philosophie des Geistes, ja der Philosophie überhaupt, gehört die folgende Frage: Wie lässt sich der qualitative oder phänomenale Charakter bewusster Erlebnisse beschreiben, erklären oder verstehen? Wie lässt sich beispielsweise erklären, wie es ist, eine Rose zu riechen? Einerseits erscheint angesichts der Erfolgsgeschichte der modernen Naturwissenschaften die Annahme plausibel, dass sich letztlich alles physikalisch erklären lässt, auch bewusste Erlebnisse. Bei dieser Annahme handelt es sich um die physikalistische Intuition, die in der analytischen Philosophie des Geistes (...) die Hauptmotivation der gegenwärtig dominierenden Position darstellt: der Position des Physikalismus. Andererseits stellt der nur subjektiv erfassbare qualitative Charakter bewusster Erlebnisse das Kernproblem für eine physikalische Erklärung des Bewusstseins dar: Wie sollte das Erlebnis von Rosenduft physikalisch erklärbar sein? Dabei handelt es sich um die antiphysikalistische Intuition, auf deren Grundlage in den letzten Jahren verschiedene Argumente gegen den Physikalismus vorgebracht worden sind. Indem in der vorliegenden Studie diesen beiden, zumindest auf den ersten Blick unvereinbar erscheinenden Intuitionen ausführlich und vorbehaltlos Rechnung getragen wird – sie stellen sowohl den Ausgangspunkt als auch den argumentativen Rahmen der Studie dar –, wird untersucht, wie sich der qualitative Charakter bewusster Erlebnisse im Rahmen einer Theorie des Bewusstseins fassen lässt. (shrink)

Qualitative consciousness is conscious experience marked by the presence of sensory qualities, like the experienced painfulness of having a piano dropped on your foot, or the consciousness of seeing the brilliant reds and oranges of a sunset. Over his career, philosopher David Rosenthal has defended an influential theoretical approach to explaining qualitative consciousness. This approach involves the development of two theories – the higher-order thought theory of mental state consciousness and the quality space theory of sensory quality. (...) If the problem of explaining qualitative consciousness is divided into two more manageable pieces, the door opens to a satisfying explanation of what is seen by some to be an intractable explanatory puzzle. This interdisciplinary collection develops, criticizes, and expands upon themes inspired by Rosenthal's work. The result is an exciting collection of new essays by philosophers and scientists, which will be of interest to all those engaged in consciousness studies. (shrink)

Background Empirical studies of surrogate decision-making tend to assume that surrogates should make only a 'substituted judgement'—that is, judge what the patient would want if they were mentally competent. Objectives To explore what people want in a surrogate decision-maker whom they themselves select and to test the assumption that people want their chosen surrogate to make only a substituted judgement. Methods 30 undergraduate students were recruited. They were presented with a hypothetical scenario about their expected loss of mental capacity in (...) the future and asked to answer some questions about their choice of surrogate. These data were analysed qualitatively using thematic content analysis. Results Most respondents talked about choosing someone who was caring and competent in certain ways, giving interesting evidence for their judgements. Surprisingly few highlighted how well they thought their chosen surrogate knew their preferences and would be able to make a substituted judgement. Moreover, few specified that their chosen surrogate had similar attitudes and values to their own and so would make a similar decision to theirs in the circumstances presented. Some respondents also referred to the social role of their chosen surrogate or the social dynamics of their situation which influenced their choices, as well as to ideas of reciprocity and characteristics of honesty and loyalty. Conclusion In the event that they lose mental capacity, many people will not select a surrogate to decide about medical treatments on their behalf solely on the basis that they expect their surrogate to make a substituted judgement. (shrink)

Background Moral distress is a serious problem for health care personnel. Surveys, individual interviews, and focus groups may not capture all of the effects of, and responses to, moral distress. Therefore, we used a new participatory action research approach—moral conflict assessment (MCA)—to characterize moral distress and to facilitate the development of interventions for this problem. Aim To characterize moral distress by analyzing responses of intensive care unit (ICU) personnel who participated in the MCA process. Research Design In this qualitative (...) study, we invited all ICU personnel at 3 urban hospitals to participate in individual or group sessions using the 8-step MCA tool. These sessions were facilitated by either a clinical ethicist or a counseling psychologist who was trained in this process. During each session, one of the researchers took notes and prepared a report for each MCA which were analyzed using qualitative content analysis. Participants and Research Context A total of 24 participants took part in 15 sessions, individually or in groups; 14 were nurses and nurse leaders, 2 were physicians, and 8 were other health professionals. Ethical Considerations This study was approved by the Providence Health Care/University of British Columbia Behavioural Research Ethics Board. Each participant provided written informed consent. Results The main causes of moral distress related to goals of care, communication, teamwork, respect for patient’s preferences, and the managerial system. Suggested solutions included communication strategies and educational activities for health care providers, patients, family members, and others about teamwork, advance directives, and end-of-life care. Participants acknowledged that using the MCA process helped them to reflect on their own thoughts and use their moral agency to turn a distressing situation into a learning and improvement opportunity. Conclusions Using the MCA tool helped participants to characterize their moral distress in a systematic way, and to arrive at new potential solutions. (shrink)

The concept of difference occupies a central place in the philosophy of Gilles Deleuze. In this work, David Bright explores how Deleuze's difference can be put to work in critical qualitative research. The book explores research and writing as a creative process of dynamically pursuing problems. Following Deleuze's advice not tothink of problems in terms of solutions, the book offers important methodological insights into the ways the subjects, objects, and processes of research might be conceived and represented in writing, (...) exploring the problem of thinking and writing about difference in complex ways without reducing thought to static representations of identity. Bright uses the example of foreign teachers and international schooling in Vietnam to show us how Deleuze's difference can be used in critical qualitative research, demonstrating the limits of traditional ways of thinking about difference in learning and teaching. Exploring Deleuze's Philosophy of Differenceis a book that will interest all those with an interest in the application of Deleuze's philosophy to critical qualitative research. Perfect for courses such as: Critical Qualitative Research | Qualitative Inquiry | Post-qualitative Inquiry | Deleuze | Difference | Identity | Ethnography | English Language Teaching | International Education | Writing as a Method of Inquiry. (shrink)

Coastal environments are increasingly shown to have a positive effect on our health and well-being. Various mechanisms have been suggested to explain this effect. However, so far little focus has been devoted to emotions that might be relevant in this context, especially for people who are directly or indirectly exposed to the coast on a daily basis. Our preregistered qualitative study explored how coastal residents experience the emotions they feel at the coast and how they interpret the effect these (...) emotions have on them. We conducted semi-structured interviews with a purposive sample of eight Belgian coastal residents aged 21–25 years old. The interviews were analyzed with the approach of interpretative phenomenological analysis. Five superordinate themes were identified and indicate that, for our participants, the coast represents a safe haven in which they can experience emotional restoration, awe, and nostalgia. These emotional states are accompanied with adaptive emotion regulating strategies, such as reflection and positive reappraisal, that may facilitate coping with difficult thoughts and feelings. Our study demonstrates the importance of investigating specific emotions and related processes triggered at the coast and how these could contribute to the therapeutic value of the coast. (shrink)

Imagination is necessary for scientific practice, yet there are no in vivo sociological studies on the ways that imagination is taught, thought of, or evaluated by scientists. This article begins to remedy this by presenting the results of a qualitative study performed on two systems biology laboratories. I found that the more advanced a participant was in their scientific career, the more they valued imagination. Further, positive attitudes toward imagination were primarily due to the perceived role of imagination (...) in problem-solving. But not all problem-solving episodes involved clear appeals to imagination, only maximally specific problems did. This pattern is explained by the presence of an implicit norm governing imagination use in the two labs: only use imagination on maximally specific problems, and only when all other available methods have failed. This norm was confirmed by the participants, and I argue that it has epistemological reasons in its favour. I also found that its strength varies inversely with career stage, such that more advanced scientists do (and should) occasionally bring their imaginations to bear on more general problems. A story about scientific pedagogy explains the trend away from (and back to) imagination over the course of a scientific career. Finally, some positive recommendations are given for a more imagination-friendly scientific pedagogy. (shrink)

Language fails not because thought fails, but because no verbal symbols can do justice to the fullness and richness of thought. In his later works, more specifically in his seminal 1930 essay “Qualitative Thought”, John Dewey questioned some of the traditional assumptions about the nature and function of the qualitative in inquiry. Dewey foresaw what recent scientific accounts of human thinking are confirming: it is more complex, less linear, more emotional, affective, bodily-based, non-reflective, non-linguistic, non-conscious (...) than philosophers have assumed. Secondary sources on Dewey have emphasized how, contrary to orthodoxy, inquiry is social, instrumental, and experimental, but for... (shrink)

This thought-provoking book challenges the way research is planned and undertaken and equips researchers with a variety of creative and imaginative solutions to the dilemmas of method and representation that plague qualitative research. Fascinating and inspiring reading for any researcher in the Social Sciences this comprehensive collection encourages the reader to imagine the world in evermore complex and interesting ways and discover new routes to understanding. Some of the most influential figures in educational research consider questions such as: (...) How does a socio-political context change the course of our research? What counts as a ‘truthful account’ in qualitative research? How do the voices of theory and the voices of ‘research subjects’ struggle to be heard in our research narratives? How can qualitative researchers ethically navigate the difficult terrain of research relationships? How is the material body rendered in qualitative research? Each chapter reveals a range of troubling dilemmas related to the critical aspects of research methodology in the Social Sciences and uses an illustrative case to elucidate the issues encountered by the researcher. Each writer brings a fierce philosophical spirit to her work, showing how methods or techniques of data-gathering grow from the theory and analysis of how research proceeds. A range of topics are addressed in a cross-disciplinary approach which will appeal to all scholars of qualitative research, undergraduate students in education programs and graduate students in a range of disciplines. (shrink)

Few disputes in the annals of US environmentalism enjoy the pedigree of the conservation-preservation debate. Yet, although many scholars have written extensively on the meaning and history of conservation and preservation in American environmental thought and practice, the resonance of these concepts outside the academic literature has not been sufficiently examined. Given the significance of the ideals of conservation and preservation in the justification of environmental policy and management, however, we believe that a more detailed analysis of the real-world (...) use and understanding of these ideas is needed. In this paper, we describe the results of a qualitative, semantic study of the concepts of conservation and preservation undertaken in the context of the Chattahoochee National Forest (CNF), located in northern Georgia (USA). Thirty in-depth interviews were conducted with scientists and north Georgia residents either interested or involved in the future management of the forest. Respondents were asked to define conservation and preservation in their own words and to indicate which approach they felt was more appropriate for the management of the CNF. Qualitative content analysis was used to elicit a set of recurring themes for each foundational concept. Taken together, these themes help to flesh out the meaning of conservation and preservation for citizens and scientists today, and illustrate the evolving nature of two of the more significant and venerable ideas animating US environmental policy and management. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Somatic Knowledge and Qualitative Reasoning:From Theory to PracticeRichard Siegesmund"Elliot Eisner is a writer to be reckoned with" is how my undergraduate student, Cheyenne, opened her final essay on The Arts and the Creation of Mind. After a semester of using his text in my art education methods class, reckoned seemed an apt word. The dictionary gives the definitions of reckoned as to settle accounts, make calculation, judge, and (...) take into consideration.1 The ideas in The Arts and the Creation of Mind are challenging on multiple levels, and Eisner does not provide any easy answers. There are no pithy how-to-do-it bullet points in the text. The issues he addresses are complex: nonlinguistic meaning, somatic knowledge, qualitative reasoning, the arts as habits of mind that guide experience and inquiry into the world — just to name a few. Nevertheless, in this text he brings these ideas into a format that is accessible to undergraduates entering the profession of teaching and experienced professionals, who wish to reflect on their own practice.The lucidity of Eisner's text can belie the complexity of the issues he addresses. Regrettably, some students only saw the outer shell of the content: the discussion of conceptual approaches to arts education or the delineation of the developmental stages of children's drawing. Yet for these aspects alone, they considered the text to be valuable; however, I was disappointed that they did not go deeper. Some just could not synthesize the big point: that the arts are not simply about mastery of technical skills, but that technical skills are merely a gateway into non-linguistic thinking. Educational objectives that are limited to content and skills are mundane.However, for more thoughtful and reflective students like Cheyenne, who was in her last semester of course work before student teaching in Guadalajara, the book was an inspiration. It provided a more robust conception of arts education that spoke to her feelings that compelled her to be a teacher. She reflected on what she read in The Arts and the Creation of Mind, and saw how an arts educator was more than an activities manager. She discovered she was embarking on a calling that could change minds — and [End Page 80] by changing minds, transform lives. For a young idealist, Eisner articulated her passion to serve. He said what up until that moment she had only felt. She discovered what she had previously sensed — known in her bones — but had not articulated. Eisner was a voice she wanted to take for her own. He provided a vision of the teacher she hoped to be. Indeed, Elliot Eisner is a writer to be reckoned with.Two ideas that my art students want to discuss when they first encounter The Arts and the Creation of Mind are the concepts of somatic knowing and qualitative reasoning. Somatic knowledge is a felt reaction of rightness within an experience. Qualitative reasoning is the ordering of relationships of qualities. Qualitative reasoning produces somatic knowledge. Using my students' questions and classroom discussions as inspiration, I want to explore these ideas for I believe they represent the essence of what is distinctive about learning in the arts. Furthermore, I share Eisner's belief that they provide the foundation on which to make an enduring case for the importance of the arts in education. These ideas reside at the heart of the process of education, which is, as he states, "learning to create ourselves."2It is immensely satisfying as a teacher to see the ah-ha moments in class discussion when students begin to integrate Eisner's ideas into their own experience. It is an even greater satisfaction to work with teachers who find these ideas illuminating for their educational aims and objectives and to see them played out in real classrooms where students flourish. In this essay, I want to try to build on my own experience with these moments to more deeply explore the significance of Eisner's work.To begin, I will briefly revisit the work of John Dewey. I will then discuss how Eisner's previous thinking sets a foundation for The Arts and the Creation of Mind. Finally, on a... (shrink)

A number of philosophers have thought that fair lotteries over countably infinite sets of outcomes are conceptually incoherent by virtue of violating countable additivity. In this article, I show that a qualitative analogue of this argument generalizes to an argument against the conceptual coherence of a much wider class of fair infinite lotteries—including continuous uniform distributions. I argue that this result suggests that fair lotteries over countably infinite sets of outcomes are no more conceptually problematic than continuous uniform (...) distributions. Along the way, I provide a novel argument for a weak qualitative, epistemic version of regularity. (shrink)

This study investigated the beliefs that formed teachers’ intentions to integrate STEM content into their social studies instruction. Participants were 60 elementary, middle, and high school in-service teachers who attended a summer history workshop on Abraham Lincoln. Data were collected by qualitative and quantitative instruments. Beliefs about likely outcomes of integrating STEM, and beliefs about persons who would approve, or disapprove, of STEM integration were elicited from teachers, and content analyzed. The resulting outcome and normative beliefs were used as (...) stems for items in the quantitative instrument. Quantitative data were analyzed primarily by correlation and multiple regression. This study found that attitude toward the behavior, integrating STEM, was formed by 15 outcome beliefs, subjective norm was formed by five normative beliefs, and that attitude and norm predicted behavioral intention. The theory we used enabled us to calculate the numerical contribution of each of the beliefs that were important in forming teachers’ intentions. The results have implications for theory, research, and practice in social studies education. In the realm of practice, these implications are for the initial preparation of, and the subsequent professional development of social studies teachers, both at the elementary and secondary levels. (shrink)

This chapter provides an argument that intentional ascent requires semantic ascent, on the grounds that intentional ascent requires the ability “to hold a thought in mind” in a way that can only be done if the thought is linguistically vehicled. It tries to explain that there is an important class of thoughts that is in principle unavailable to nonlinguistic creatures. It also explores how language can function as a cognitive tool. Many of these functions do not actually require (...) a full-fledged language. If language is to have a distinctive, unique, and essential cognitive function, so that the difference between linguistic and nonlinguistic cognition is qualitative rather than merely quantitative, then it should be investigated further. The chapter takes into account many aspects of language where language functions as a cognitive tool: memory augmentation; environmental simplification; coordination; transcending path-dependent learning; control loops; and data manipulation and representation. (shrink)

BackgroundContradictory evidence exists about the emotional burden of participating in qualitative research for palliative care patients and carers and this raises questions about whether this type of research is ethically justified in a vulnerable population. This study aimed to investigate palliative care patients' and carers' perceptions of the benefits and problems associated with open interviews and to understand what causes distress and what is helpful about participation in a research interview.MethodsA descriptive qualitative study. The data were collected in (...) the context of two studies exploring the experiences of care of palliative care patients and carers. The interviews ended with questions about patients' and carers' thoughts on participating in the studies and whether this had been a distressing or helpful event. We used a qualitative descriptive analysis strategy generated from the interviews and the observational and interactional data obtained in the course of the study.ResultsThe interviews were considered helpful: sharing problems was therapeutic and being able to contribute to research was empowering. However, thinking about the future was reported to be the most challenging. Consent forms were sometimes read with apprehension and being physically unable to sign was experienced as upsetting. Interviewing patients and carers separately was sometimes difficult and not always possible.ConclusionThe open interview enables the perspectives of patients and carers to be heard, unfettered from the structure of closed questions. It also enables those patients or carers to take part who would be unable to participate in other study designs. The context is at least as important as the format of the research interview taking into account the relational circumstances with carers and appropriate ways of obtaining informed consent. Retrospective consent could be a solution to enhancing participants control over the interview. (shrink)

More and more, natural scientists are becoming aware that they must consider the human element as one of the variables in physical measurement. Its measure has usually been hidden in what has been called the error of measurement. Part of its measure has been qualitative for we often hear that Mr. Soandso is a good or a poor experimenter or observer. As we go to engineering research or to any applied field, we become more conscious of the human element. (...) Here, an attempt is made to design apparatus and measuring equipment that will operate or make measurements with minimum variability associated with people. Some problems, such as those dealing with what consumers want, require an even more complete knowledge about the behavior of people. It is not possible to define or to specify a product that will be satisfactory to the consumer if we do not know what the consumer wants. Hence, it is our first observation that the natural scientist needs information about the human element that is always present to some degree in his work. (shrink)

In John Dewey’s logical theory, qualities or qualitative relations account for the capacity to distinguish and associate the objects of reflective thought; they are antecedent to reflective analysis and necessary for coherent processes of inquiry. In Dewey’s writings that are specifically “metaphysical” in orientation, he is much more vague about the function of qualities, but does call them “generic traits of existence.” As such, they appear to be central to his mature ontological theory. In order to more fully (...) understand the metaphysical import of qualitative relations, I first examine the details of Dewey’s logical theory, and then generalize those details in accordance with Dewey’s larger theory of nature. The end result is a novel interpretation of Dewey’s metaphysics. (shrink)

1. Clark’s book is a detailed study of the nature of sensory representation. It is highly informed by empirical results in the psychology of perception, and philosophically rich and significant. I admire the book and learned a great deal from reading it. As it covers a wide range of topics, and as I have no overarching critique to present, in this commentary I will briefly address three issues that come up in the book: Clark’s relational type-identity thesis for sensory qualities, (...) his theory that sensory representations involve proto-singular terms referring to spatio-temporal regions in the subject’s environment, and his interesting proposal concerning color to treat it as “difference coding”. Some of my remarks will be critical, but others will just explore some of the implications of his view. 2. Clark distinguishes “phenomenal properties” from “qualitative properties”, the former being appearance properties of things in the world (their colors, shapes, tastes, odors, etc.) and the latter being the properties of sensations by virtue of which they are sensations of their corresponding phenomenal properties. So when I see a red ball I am “directly” aware of the ball’s redness and roundness - it appears red and round to me. This awareness of the ball’s redness and roundness is accomplished, however, by my having a visual experience with certain qualitative properties; those that are of the sort one has when seeing something as red and round. It is these latter qualitative properties that are the subject of his relational type-identity thesis. Before addressing that thesis, however, I want to quickly note and respond to another point Clark makes concerning the qualitative properties of sensory states. He.. (shrink)

My interactivism holds that content emerges from interactivity of agents and world, that agents entertain contents in virtue of their embodiment of skills which, when embedded in the right context, robustly tie them to objects of their attitudes. This rebels against entrenched Cartesian solipsism about the mental, and, particularly, a vestige of internalism: that there exist naturalistic counterparts of Fregean modes of presentation --reifiable, internalistically constituted entities which account for the ways contents seem . They ought not be coarse-grained , (...) nor fine-grained . But we cannot have it both ways. ;In their place, cognitive significance is explained by context-sensitive ways skills tie agents to objects; and intentional generalizations quantify over skills. Skills are roughly dispositions with intentional identities conferred by function-bestowing causal reasons for their continued presence . Unlike MOPs, skills are world-directed--specified by reference to worldly things--and multiply realizable, since what it takes to be so directed is not fixed. There is no reificational account of what it takes to have skills. ;I apply this interactivist picture to: attitude attributions, arguing that, contrary to many philosophers, ascriptions do not refer to MOPs under which agents entertain contents; and attention to pragmatics explains intuitions upon which contrary views rest; demonstratives, arguing that Kaplan's semantics of character cannot invoke MOPs qualia, arguing that qualitative content is intentional--generated by the perceptual system's retuning of itself to the world, making contents of color experience only specifiable by reference to colors-in-the-world; the worry that intentional properties aren't what drive behavior, arguing that the facts in virtue of which intentional taxonomy applies screen off the efficacy of neurologically or even computationally specified properties; and theories of rationality, arguing that internalism about rationality is wrong; being or failing to be rational depends on factors outside agents' heads. (shrink)

This paper provides an alternative narrative for organizing food systems. It introduces meshwork as a novel theoretical lens to examine the ontological assumptions underlying the shadow and informal dynamics of organizing food. Through a longitudinal qualitative case study, we place relationality and becoming at the centre of organizing food and food systems, demonstrating how entangled relationships can create a complex ontology through the meshwork knots, threads and weave. We show how issues of collective concern come together to form dynamic (...) knots of interactions, how the threads within the meshwork indicate processes of movement, and how the weave suggests degrees of food system resilience—but always in flow. This theoretical approach thus provides a platform for addressing thoughtful concerns about “food matters” including the integrity of our global food system, the negative health and environmental impacts of industrialized food production, and food safety issues. (shrink)

In their practice, nurses make daily decisions that are ethically informed. An ethical decision is the result of a complex reasoning process based on knowledge and experience and driven by ethical values. Especially in acute elderly care and more specifically decisions concerning the use of physical restraint require a thoughtful deliberation of the different values at stake. Qualitative evidence concerning nurses’ decision-making in cases of physical restraint provided important insights in the complexity of decision-making as a trajectory. However a (...) nuanced and refined understanding of the reasoning process in terms of ethical values is still lacking. A qualitative interview design, inspired by the Grounded Theory approach, was carried out to explore nurses’ reasoning process in terms of ethical values. We interviewed 21 acute geriatric nurses from 12 hospitals in different regions in Flanders, Belgium in the period October 2009–April 2011. The Qualitative Analysis Guide of Leuven was used to analyse interview data. Nurses’ decision-making is characterized as an ethical deliberation process where different values are identified and where the process of balancing these values forms the essence of ethical deliberation. Ethical decision-making in cases of physical restraint implies that nurses have to choose which values receive priority in the process, which entails that not all values can be respected to the same degree. As a result, decision making can be experienced as difficult, even as a dilemma. Driven by the overwhelming goal of protecting physical integrity, nurses took into account the values of dignity and justice more implicitly and less dominantly. (shrink)

The paper investigates some mechanisms of thought-experimenting, and explores the role of perspective taking, in particular of mental simulation, in political thought-experiments, focusing for the most part on contractualist ones. It thus brings together two blossoming traditions: the study of perspective taking and methodology of thought-experiments. How do contractualist thought-experiments work? Our moderately inflationist mental modelling proposal is that they mobilize our imaginative capacity for perspective taking, most probably perspective taking through simulation. The framework suggests the (...) answers to questions that are often raised for other kinds of thought-experiments as well, concerning their source of data, heuristic superiority to deduction, experiential, qualitative character and ease in eliminating alternatives. In the case of contractualist political thought-experiments, the data come from perspective taking and the capacity to simulate. Mental simulation is way more accessible to subjects than abstract political reasoning from principles and facts. There is a new experience for the subject, the one of simulating. Simulation normally is quick and effortless; the simulator does not go through alternatives, but is constrained in an unconscious way. We distinguish two kinds of political thought-experiments and two manners of imagining political arrangements, building third-person mental models, and fi rst-person perspective taking. The two mechanisms, the fi rst of inductive model building, the second for simulation, and their combination(s), exhaust the range of cognitive mechanism underlying political thought-experimenting. (shrink)

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in (...) long-term care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

Quantitative and qualitative research writing is thought to differ in a number of ways, which include the visibility given to the human agents involved, that is, writers and participants in the study. However, most studies have so far centred on writer visibility alone, which has been measured principally through personal pronoun use. This paper approaches the issue of writer and participant visibility in one area of research where both quantitative and qualitative methods are frequent, namely health sciences. (...) A new methodology is applied, based on the presence of verbs that imply a human agent and thus potentially offer an opportunity for writer or participant visibility. Two corpora are built to represent quantitative and qualitative research writing in health sciences, and quantitative data are obtained. Exploration of the most frequent human-agent verbs, their active uses and their subjects shows that both quantitative and qualitative researchers in health science maintain low writer visibility, but that both writers and participants are more visible in the case of studies using qualitative methodology. These findings are discussed in the light of the bibliography, and pointers are provided for future research. The contribution of the present paper to corpus-assisted research on academic writing is highlighted. Finally, some applications for teaching scientific writing at graduate level are proposed. (shrink)

Task unrelated thought refers to thought directed away from the current situation; for example, a day dream. Encapsulated models of cognition propose that qualitative changes in consciousness, i.e., the production of TUT, can be explained in terms of changes in the quantity of resources deployed for task completion. In contrast, distributed models of cognition emphasize the importance of holistic processes in the generation and maintenance of task focus and are consistent with the effects of higher order variables (...) such as schemata. Three experiments were conducted on healthy participants using a categorical stimulus organization to contrast distributed and encapsulated views of cognition. Experiments 1 and 2 showed that despite the increased difficulty of the alphabetical verbal fluency task fewer TUTs were produced during category fluency condition. Experiment 3 replicated the categorical suppression of TUT while encoding and recalling information in a memory task. The results of these three experiments support the predictions derived from models of cognition emphasizing the importance of stimulus organization in the generation and maintenance of task focus and have potential importance for the scientific evaluation of cognition. (shrink)

The book examines the emerging approach of using qualitative methods, such as interviews and field observations, in the philosophy of science. Qualitative methods are gaining popularity among philosophers of science as more and more scholars are resorting to empirical work in their study of scientific practices. At the same time, the results produced through empirical work are quite different from those gained through the kind of introspective conceptual analysis more typical of philosophy. This volume explores the benefits and (...) challenges of an empirical philosophy of science and addresses questions such as: What do philosophers gain from empirical work? How can empirical research help to develop philosophical concepts? How do we integrate philosophical frameworks and empirical research? What constraints do we accept when choosing an empirical approach? What constraints does a pronounced theoretical focus impose on empirical work? Nine experts discuss their thoughts and empirical results in the chapters of this book with the aim of providing readers with an answer to these questions. (shrink)

Finding Your Ethical Research Self introduces novice researchers to the need for ethical reflection in practice and gives them the confidence to use their knowledge and skill when, later as researchers, they are confronted by big ethical moments in the field. -/- The 12 chapters build on each other, but not in a linear way. Core ethical concepts like consent and confidentiality once established in the early chapters are later challenged. The new focus becomes how to address qualitative research (...) ethics when confidentiality and consent take on a limited form. This approach helps students understand that the application of concepts always requires thoughtful adaptation in different contexts and the book provides guidance on how to do this. Classroom/workbook exercises develop alternative solutions to create process consent, internal confidentiality, and engage reference groups, as examples. The first eight chapters allow students to develop their ethical research self before thinking through how they might address formal ethics review. Formal ethics review is deliberately not introduced until Chapter 9. Chapter 10 offers practical help to elements of review, before Chapter 11 emphasises the key message by providing examples of researchers' dilemmas in the field using vignettes and discussion. By providing these examples, students become aware that these can arise, explore how they might arise, and recognise how they might deal with them in the moment when they are unavoidable. -/- With numerous examples of ethical dilemmas and issues and questions and exercises to encourage self-reflection, this reflexive, learn-by-doing model of research ethics will be highly useful to the novice researcher, undergraduate, and postgraduate research student. (shrink)

The paper investigates some mechanisms of thought-experimenting, and explores the role of perspective taking, in particular of mental simulation, in political thought-experiments, focusing for the most part on contractualist ones. It thus brings together two blossoming traditions: the study of perspective taking and methodology of thought-experiments. How do contractualist thought-experiments work? Our moderately inflationist mental modelling proposal is that they mobilize our imaginative capacity for perspective taking, most probably perspective taking through simulation. The framework suggests the (...) answers to questions that are often raised for other kinds of thought-experiments as well, concerning their source of data, heuristic superiority to deduction, experiential, qualitative character and ease in eliminating alternatives. In the case of contractualist political thought-experiments, the data come from perspective taking and the capacity to simulate. Mental simulation is way more accessible to subjects than abstract political reasoning from principles and facts. There is a new experience for the subject, the one of simulating. Simulation normally is quick and effortless; the simulator does not go through alternatives, but is constrained in an unconscious way. We distinguish two kinds of political thought-experiments and two manners of imagining political arrangements, building third-person mental models, and fi rst-person perspective taking. The two mechanisms, the fi rst of inductive model building, the second for simulation, and their combination(s), exhaust the range of cognitive mechanism underlying political thought-experimenting. (shrink)

The study examined the question of who should make decisions for a National Health Scheme about the allocation of health resources when the health states of beneficiaries could change because of adaptation. Eight semi-structured small group discussions were conducted. Following focus group theory, interviews commenced with general questions followed by transition questions and ended with a ‘focus’ or ‘key’ question. Participants were presented with several scenarios in which patients adapted to their health states. They were then asked their views about (...) the appropriate role of the public, patients and health professionals in making social judgements of quality of life. After discussion and debate, all groups were asked the key question: ‘In light of adaptation, who should evaluate quality of life for the purpose of setting priorities in the allocation of health care?’ In all groups participants presented strong arguments for and against decision making by patients, the public and health professionals. However, most groups thought a representative body which included a range of perspectives should make the relevant judgements. This is at odds with the recommendations in most national pharmaceutical guidelines. The main conclusion of the paper is that health economists and other researchers should explore the possibility of adopting a deliberative, consensus-based approach to evaluating health-related quality of life when such judgements are to be used to inform priority setting in a public system. (shrink)

Xiong was the originator and founder of Modern Confucianism (xin ruxue ) as well as one of the first Chinese philosophers, who developed his own system of thought, which was based upon classical Confucian concepts and, at the same time, adjusted to the conditions of the New Era. His contribution to the development of modern Chinese philosophy can also be demonstrated in a much broader, general sense. Xiong Shili, namely, also represents one of the first theoretically qualified intellectuals of (...) his age, who didn’t advocate the conservative elitist nationalism, but at the same time opposed the prevailing trends of iconoclastic negation of tradition. Even later on, during the predomination of the so-called communist ideologies, Xiong rather consequently persisted in his—for that time completely unacceptable— standpoints.Thus Xiong Shili, remaining a real Confucian scholar at a time, when Confucianism was everything else but the prevailing state doctrine, doubtless represents a real traditional sage. For him, Confucianism was not solely the predominating system of thought, to which he should formally conform in order to achieve the realization of some privileges and private interests. He was a Confucian scholar by following his own inner conviction, or, with other words, he was a Confucian “inner sage.” Hereby,we encounter an extremely rare kind of Confucian scholars, namely of those, who did not remain limited to a paper-wrapped reproduction of idealistic principles of Confucian thought, but who also tried to perform them in their own life. Xiong’s personal moral was the ethics of a Confucian scholar, who can be a gentle, subtle thinker and a steadfast, consequent rebel at the same time. (shrink)

Studies have shown that students may feel emotional discomfort when they are asked to identify ethical problems which they have encountered during their training. Teachers in medical ethics, however, more often focus on the cognitive and rational ethical aspects and not much on students’ emotions. The purpose of this qualitative study was to explore students’ feelings and emotions when dealing with ethical problems during their clinical training and explore differences between two countries: Indonesia and the Netherlands. We observed a (...) total of eighteen ethics group discussions and interviewed fifteen medical students at two medical schools. Data were interpreted and analyzed using content analysis. We categorized students’ negative emotions based on their objects of reflection and came up with three categories: emotions concerning their own performance, emotions when witnessing unethical behaviors, and emotions related to barriers and limitations of their working environment. Our study suggests that addressing emotional responses in a culturally sensitive way is important to develop students’ self-awareness. Teachers should be able to guide students to reflect on and be critical of their own thoughts and emotions, to understand their own moral values, especially when confronted with other individuals. (shrink)

The article examines education from the perspective of its goals and functions. The development of thinking skills is considered as both the goal and function of education, and the process of thinking as a means of education. Education is broadly understood as the creation of an image, and narrowly as the complex of social institutions that carry out educational activity. As a mechanism of socialization, education is one of the most important historically formed tools for the training and development of (...) thinking ability, which is the main instrument of the evolutionary strategy ofhomo sapiens.The article discusses the ontological status of thought as an attributive property ofhomo sapiensthat defines human being. Thinking is a psychic reality rooted in biological processes, the fundamental basis of all cognitive and human activity-based processes. The author conducts a philosophical analysis of the concepts of thinking, good thinking, qualitative thought, and education. Philosophizing is considered as a special type of thinking, and the article researches its instrumental function, the potential ability to produce sanity, prudence, an analytical approach to any situation, and the ability to make independent decisions. Common to all philosophizing subjects will be that they will act as “demiurges” of their world, which they will be able to fill with their own meanings and values. Philosophical thinking is free thinking, which has a playful character, and therefore it can be defined as a game of meanings. The article describes existing approaches to the development of the philosophical education of children. The author draws attention to the advantage of the Russian system of higher education in connection with the compulsory teaching of philosophy, and argues to develop philosophical education for schoolchildren. The article concludes that the philosophical component of education at all levels, from elementary school to university, is an effective way to form high-quality thinking among students. (shrink)

This bibliographical guide gives a comprehensive overview of the historiography of philosophy and thought in the Japanese language through an extensive and thematically organized collection of relevant literature. Comprising over one thousand entries, the bibliography shows not only how extensive and complex the Japanese tradition of philosophical and intellectual historiography is, but also how it might be structured and analyzed to make it accessible to a comparative and intercultural approach to the historiography of philosophy worldwide. The literature is categorized (...) and organized according to thematic focus areas such as geographical regions and continents, nations or peoples, religious traditions and philosophical teachings such as Buddhism, Islam, Shintō, and Confucianism, as well as disciplines such as ethics, aesthetics, and political thought. The bibliography is accompanied by an introduction outlining the research method as well as quantitative and qualitative approaches to analyzing the material, followed by a chronological overview of the historiography of philosophy and thought in the Japanese language and of the Japanese tradition of writing “world histories of philosophy.” As a first step towards a “history of the historiography of philosophy” in non-European languages, we hope that this guide will provide a useful tool for interculturally oriented scholarship aimed at a non-Eurocentric and diversified historiography of philosophy in a global perspective. (Open access, see link below.). (shrink)

This is a curious and in some ways instructive work. It illustrates both the strengths and weaknesses of the French intellectual style. Traditional Cartesianism comes through strongly with the urge to try to substitute formal for qualitatively real things and properties. Granger is aware of the limitations of this kind of approach and roughly in the manner of someone reinventing the wheel, points out the extent to which what counts as theory in the natural sciences depends on content rather than (...) on logical form. None of the impressive list of Anglo-American writers who have worked out in detail the realist alternative to logicism are so much as mentioned. One can sum up this part of the book in the phrase 'Clever but parochial'. (shrink)

Robert Veatch has proposed a model of the doctor-patient relationship that has as its foundation the sharing of values between the doctor and the patient. This paper uses qualitative research conducted with six doctors involved in the long term, specialised care of HIV positive patients in South Australia to explore the practical application of Veatch’s value sharing model in that setting. The research found that the doctors in this study linked “values” with sexual identity such that they defined value (...) sharing, in part, as a shared set of values and beliefs about sexual identity and practices. They voluntarily identified themselves as either homosexual or heterosexual and they regarded the relation between their own sexual identity and that of their patients as important for the provision of quality care. None of the doctors thought that value sharing, in the way they defined it, was essential to the clinical relationship, but the homosexual doctors attributed a greater degree of importance to it than their heterosexual colleagues. (shrink)

Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...) rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)

Values such as respect for autonomy, safety, enablement, independence, privacy and social connectedness should be reflected in the design of social robots. The same values should affect the process by which robots are introduced into the homes of older people to support independent living. These values may, however, be in tension. We explored what potential users thought about these values, and how the tensions between them could be resolved. With the help of partners in the ACCOMPANY project, 21 focus (...) groups were convened in France, the Netherlands and the UK. These groups consisted of: older people, informal carers and formal carers of older people. The participants were asked to discuss scenarios in which there is a conflict between older people and others over how a robot should be used, these conflicts reflecting tensions between values. Participants favoured compromise, persuasion and negotiation as a means of reaching agreement. Roles and related role-norms for the robot were thought relevant to resolving tensions, as were hypothetical agreements between users and robot-providers before the robot is introduced into the home. Participants’ understanding of each of the values—autonomy, safety, enablement, independence, privacy and social connectedness—is reported. Participants tended to agree that autonomy often has priority over the other values, with the exception in certain cases of safety. The second part of the paper discusses how the values could be incorporated into the design of social robots and operationalised in line with the views expressed by the participants. (shrink)