In the last two decades, the term “quality-of-life” has become popular in medicine and health care. There are, however, important differences in the meaning and the use of the term. The message of all quality-of-life talk is that medicine and health care are not valuable in themselves. They are valuable to the extent that they contribute to the quality of life of patients. The ultimate aims of medicine and health care are not health or prolongation of life as such, but (...) preservation or improvement of the quality of life. The primary aims of medicine and health care, such as the prolongation of life, can – but need not always – come into conflict with the ultimate ones: medical treatments do not always benefit a patient. In this article I will, first, summarize the results of my explorations of the use and the meaning of the term “quality-of-life.” The use and the meaning of the term turn out to depend on the contexts of medical decisionmaking in which it is used. I will show that there are at least three different concepts of quality-of-life. Second, I will argue that the different concepts of quality-of-life are not unrelated. They point to different components of and/or conditions for happiness. Third, I will analyze the relation between the three concepts of qualityof-life, health and happiness. (shrink)

Albert Musschenga | : The central question of this article is, Are animals morally responsible for what they do? Answering this question requires a careful, step-by-step argument. In sections 1 and 2, I explain what morality is, and that having a morality means following moral rules or norms. In sections 3 and 4, I argue that some animals show not just regularities in their social behaviour, but can be rightly said to follow social norms. But are the norms they (...) follow also moral norms? In section 5, I contend, referring to the work of Shaun Nichols, that the basic moral competences or capacities are already present in nonhuman primates. Following moral rules or norms is more than just acting in accordance to these norms; it requires being motivated by moral rules. I explain, in section 6, referring to Mark Rowlands, that being capable of moral motivation does not require agency; being a moral subject is sufficient. Contrary to moral agents, moral subjects are not responsible for their behaviour. Stating that there are important similarities between animal moral behaviour and human, unconscious, automatic, habitual behaviour, I examine in section 7 whether humans are responsible for their habitual moral behaviour, and if they are, what then the grounds are for denying that moral animals are responsible for their behaviour. The answer is that humans are responsible for their habitual behaviour if they have the capacity for deliberate intervention. Although animals are capable of intervention in their habitual behaviour, they are not capable of deliberate intervention. | : La question centrale dans cet article est celle de savoir si les animaux sont moralement responsables de ce qu’ils font. Répondre à cette question nécessite une argumentation minutieuse et progressive. Dans les sections 1 et 2, j’explique ce qu’est la moralité, et qu’être doté de moralité signifie de se conformer à des règles ou à des normes morales. Dans les sections 3 et 4, je pose que certains animaux ne se contentent pas de montrer des régularités dans leur comportement social, mais qu’ils suivent aussi véritablement des normes sociales. Toutefois, les normes qu’ils suivent sont-elles morales? Dans la section 5, je prétends, en me référant aux travaux de Shaun Nichols, que les compétences ou capacités morales de base sont déjà présentes chez les primates non humains. Respecter des règles ou des normes morales est bien plus que d’agir conformément à ces normes; cela requiert d’être motivé par des règles morales. Dans la section 6, me référant à Mark Rowlands, j’explique que d’être capable de motivation morale ne nécessite pas d’être un agent moral; le fait d’être un sujet moral suffit. Contrairement aux agents moraux, les sujets moraux ne sont pas responsables de leur comportement. Affirmant qu’il y a de grandes similitudes entre le comportement moral d’un animal et le comportement inconscient, automatique et habituel d’un humain, je me penche, dans la section 7, sur la question de savoir si les humains sont responsables de leur comportement moral habituel, et si tel est le cas, sur quelle base on peut alors nier le fait que les animaux sont eux aussi responsables de leur comportement. La réponse à cette question est que les humains sont responsables de leur comportement habituel s’ils disposent d’une capacité d’intervention réfléchie, délibérée. Bien que les animaux soient capables d’intervenir dans leurs comportements habituels, ils ne peuvent le faire de manière réfléchie, délibérée. (shrink)

According to some proponents of an empirical medical ethics, medical ethics should take the experience, insights, and arguments of doctors and other medical practitioners as their point of departure. Medical practitioners are supposed to have ‘moral wisdom.’ In this view, the moral beliefs of medical practitioners have a special status. In sections I-IV, I discuss two possible defences of such a status. The first defence is based on the special status of the moral beliefs of the health professional as an (...) expert in medical ethics, and the second defence on the special status of the health professional’s moral beliefs as a practitioner. The first defence is built up around the opposition between experts and laypersons, while the second defence rests on the opposition between practitioners and theorists. In sections V and VI, I examine the interrelations between empirical ethics and anti-theory in ethics. Some regard empirical ethics as a laudable alternative to theory-driven normative ethics. I explore their objections against ethical theory and ethical theorising, and conclude that they are not valid. In the last section, VII, I discuss the role of ethicists in medical practice. (shrink)

In this article, I discuss whether intuitive moral judgements have epistemic value. Are they mere expressions of irrational feelings that should be disregarded or should they be taken seriously? In section 2, I discuss the view of some social psychologists that moral intuitions are, like other social intuitions, under certain conditions more reliable than conscious deliberative judgements. In sections 3 and 4, I examine whether intuitive moral judgements can be said not to need inferential justification. I outline a concept of (...) moral intuition as a seeming whose seemingness resides in special, phenomenological features such as a felt veridicality, appropriateness, familiarity, or confidence, and whose justificatory force is influenced by the reliability of the belief-producing procedures and by a subject's competence in applying moral concepts. I argue that subjects can come to realise that the beliefs expressed in their intuitive judgements evoke a sense of non-inferential credibility. In section 5, I first discuss the contribution of moral expertise to the non-inferential credibility of a person's intuitions. Subsequently, I discuss whether Walter Sinnott-Armstrong is right in saying that we can never claim non-inferential justification for our intuitions because they are subject to all kinds of distorting influences. (shrink)

This paper focuses on coherence and consistency as elements of moral integrity, arguing that several kinds of—mostly second-order—virtues contribute to establishing coherence and consistency in a person's judgements and behaviour. The virtues relevant for integrity always accompany other, substantive virtues, and their associated values, principles and rules. In moral education we teach children all kinds of substantive virtues with integrity as our goal. Nevertheless, many adults do not attain moral integrity, although they are clearly not immoral. What precisely are they (...) lacking? Education for moral integrity should focus on strengthening motivational self-sufficiency, furthering critical and imaginative thinking and promoting moral unity. (shrink)

There is an ongoing debate in animalethics on the meaning and scope of animalwelfare. In certain broader views, leading anatural life through the development of naturalcapabilities is also headed under the conceptof animal welfare. I argue that a concern forthe development of natural capabilities of ananimal such as expressed when living freelyshould be distinguished from the preservationof the naturalness of its behavior andappearance. However, it is not always clearwhere a plea for natural living changes overinto a plea for the preservation (...) of theirnaturalness or wildness. In the first part ofthis article, I examine to what extent theconcerns for natural living meet ``theexperience requirement.'' I conclude that someof these concerns go beyond welfare. In thesecond part of the article. I ask whether wehave moral reasons to respect concernsfor the naturalness of an animal's living thattranscend its welfare. I argue that the moralrelevance of such considerations can be graspedwhen we see animals as entities bearingnon-moral intrinsic values. In my view the``natural'' appearance and behavior of an animalmay embody intrinsic values. Caring for ananimal's naturalness should then be understoodas caring for such intrinsic values. Intrinsicvalues provide moral reasons for action iffthey are seen as constitutive of the good lifefor humans. I conclude by reinterpreting,within the framework of a perfectionist ethicaltheory, the notion of indirect dutiesregarding animals, which go beyond andsupplement the direct duties towardsanimals. (shrink)

How do artifacts get their functions? It is typically thought that an artifact’s function depends on its maker’s intentions. This chapter argues that this common understanding is fatally flawed. Nor can artifact function be understood in terms of current uses or capacities. Instead, it proposes that we understand artifact function on the etiological model that Ruth Millikan and others have proposed for the biological realm. This model offers a robustly normative conception of function, but it does so naturalistically by employing (...) our best scientific theories, in particular natural selection. To help make this case, it proposes “living artifacts” (organisms designed for human purposes through artificial selection) as a bridge between the artifactual and the biological realms. (shrink)

This essay constitutes an attempt to probe the very idea of a saying/showing distinction of the kind that Wittgenstein advances in the Tractatus—to say what such a distinction consists in, to say what philosophical work it has to do, and to say how we might be justified in drawing such a distinction. Towards the end of the essay the discussion is related to Wittgenstein’s later work. It is argued that we can profitably see this work in such a way that (...) a saying/showing distinction arises there too. In particular, in the final sub-section of the essay, it is suggested that we can see in Wittgenstein’s later work an inducement to say what we are shown. (shrink)

How, if at all, are we to distinguish between the works that we call ‘art’ and those that we call ‘pornography’? This question gets a grip because from classical Greek vases and the frescoes of Pompeii to Renaissance mythological painting and sculpture to Modernist prints, the European artistic tradition is chock-full of art that looks a lot like pornography. In this paper I propose a way of thinking about the distinction that is grounded in art historical considerations regarding the function (...) of erotic images in 16 th -century Italy. This exploration suggests that the root of the erotic art/pornography distinction was—at least in this context—class: in particular, the need for a special category of unsanctioned illicit images arose at the very time when print culture was beginning to threaten elite privilege. What made an erotic representation exceed the boundaries of acceptability, I suggest, was not its extreme libidinosity but, rather, its widespread availability and, thereby, its threat to one of the mechanisms of sustaining class privilege. (shrink)

In this essay, we aim to provide an overview of the political and philosophical issues pertaining to asexuality. The first section, “What Is Asexuality?,” offers an account of asexuality. The second section, “Asexuality as a Unique Sexual Orientation,” argues that asexuality should be understood as a unique sexual orientation. The third section, “Asexuality and Oppression,” discusses the various forms of oppression facing asexual persons today. The fourth section, “The Goods of Asexuality,” articulates some goods that asexuality brings to human lives, (...) and we do this with an eye toward conceiving of asexuality as something other than a mere deficit. (shrink)

This chapter offers a critical overview of recent philosophical literature on erotic art and pornography as well as some suggestions about new directions for inquiry, all with an eye toward ethical issues that arise in these areas. The first section surveys philosophical discussions of the purported distinction between art and pornography. The next section considers new areas of inquiry that arise once we shift focus to the connections and similarities between erotic art and pornography. Once we put the pornography literature (...) and the aesthetics- and- ethics literature into conversation with one another, new areas of inquiry open up, including: the harms and benefits that come from engaging with libidinous representations, applications of speech act theory to libidinous representations, and philosophical and ethical issues pertaining to fiction, imagination, and fantasy. Finally, the chapter concludes with a discussion of sex positivity and social justice issues related to libidinous representations. (shrink)

This essay involves exploration of certain repercussions of Bernard Williams’ view that there is, in Wittgenstein’s later work, a transcendental idealism akin to that found in the Tractatus—sharing with it the feature that it cannot be satisfactorily stated. It is argued that, if Williams is right, then Wittgenstein’s later work precludes a philosophically substantial theory of meaning; for such a theory would force us to try to state the idealism. In a postscript written for the reprint of the essay, reasons (...) are given for thinking that Williams is not right: Wittgenstein’s later work actually helps us to repudiate as ill-conceived all those questions whose answers invite us to embrace any such idealism. But the main thesis of the essay remains intact. Indeed the idea that Wittgenstein’s later work precludes a philosophically substantial theory of meaning is reinforced. (shrink)

An interpretation of Kant's first antinomy is defended whereby both its thesis and its antithesis depend on a common basic principle that Kant endorses, namely that there cannot be an ‘infinite contingency’, by which is meant a contingent fact about how an infinite region of space or time is occupied. The greatest problem with this interpretation is that Kant explicitly declines to apply counterparts of the temporal arguments in the antinomy to the world’s future, even though, if the interpretation is (...) correct, such arguments are clearly there to be applied. This problem, it is argued, is surmountable. (shrink)

There is a current debate about the grammar of intention: do I intend to φ, or that I φ? The equivalent question in Aristotle relates especially to choice. I argue that, in the context of practical reasoning, choice, as also wish, has as its object an act. I then explore the role that this plays within his account of the relation of thought to action. In particular, I discuss the relation of deliberation to the practical syllogism, and the thesis that (...) the conclusion of the second is an action. (shrink)

In this essay I focus on the idea of the univocity of being, championed by Duns Scotus and given prominence more recently by Deleuze. Although I am interested in how this idea can be established, my primary concern is with something more basic: how the idea can even be properly thought. In the course of exploring this issue, which I do partly by borrowing some ideas about logical syntax from Wittgenstein's Tractatus, I try to show how there can be dialogue (...) between analytic philosophers and those of other traditions. (shrink)

It is argued that, although there are no ineffable truths, the concept of ineffability nevertheless does have application—to certain states of knowledge. Towards the end of the essay this idea is related to religion: it is argued that the language that results from attempting (unsuccessfully) to put ineffable knowledge into words is very often of a religious kind. An example of this is given at the very end of the essay. This example concerns the Euthyphro question: whether what is right (...) is right because God wills it, or whether God wills it because it is right. (shrink)

Wrong beliefs, known by some as ‘alternative facts’, have proliferated lately in important areas of human life, including social, political, and public health domains. This can be and has been damaging. This brief article proposes an epistemological category classification of these wrong beliefs, with the following mappings: a) ‘No-Information’ marked by willful blindness produces ‘Empty Beliefs’; b) ‘Mis-Information’ yields ‘Mis(taken) Beliefs’; and c) ‘Dis-Information’ predicated on blatant distortions produces ‘Dis(torted) Beliefs’. This simple classification system, is perhaps epistemologically satisfying, and moreover (...) could have positive policy implications. (shrink)

The aim of this essay is to characterize the issue whether tense is real. Roughly, this is the issue whether, given any tensed representation, its tense corresponds in some suitably direct way to some feature of reality. The task is to make this less rough. Eight characterizations of the issue are considered and rejected, before one is endorsed. On this characterization, the unreality of tense is equivalent to the unity of temporal reality. The issue whether tense is real, so characterized, (...) is then related to Kant’s deduction of the categories in his Critique of Pure Reason. It is argued that Kant’s deduction does not provide the argument for the unreality of tense that it may appear to. The conclusion drawn at the end of the essay is that the unreality of tense cannot be argued for—not because tense is real, but because, even if it is unreal, its unreality is basic. (shrink)

This essay is concerned with solipsism, understood as the extreme sceptical view that I have no knowledge except of my subjective state. A less rough formulation of the view is mooted, inspired by a Quinean combination of naturalism and empiricism. An objection to the resultant position is then considered, based on Putnam’s argument that we are not brains in vats. This objection is first outlined, then pitted against a series of counter-objections. Eventually it is endorsed, but only at the price (...) of exposing the formulation of solipsism in question as not, after all, a satisfactory formulation. This leads to further speculation about the status of solipsism itself. Two of the possibilities that are considered are, firstly, that it is incoherent and, secondly, that it is inexpressible. (shrink)

It is argued that the use/mention distinction, if it is to be a clear-cut one, cannot have the significance that it is usually thought to have. For that significance attaches to the distinction between employing an expression in order to draw attention to, or to talk about, some aspect of the world, as determined by the expression’s meaning, and employing it in order to draw attention to, or to talk about, the expression itself—and this distinction is not a clear-cut one. (...) In the final section of the essay this argument is extended to cast doubt on a rather glib appeal to the use/mention distinction that is frequently made in the philosophy of language. (shrink)

This essay is concerned with Graham Bird’s treatment, in The Revolutionary Kant, of Kant’s mathematical antinomies. On Bird’s interpretation, our error in these antinomies is to think that we can settle certain issues about the limits of physical reality by pure reason whereas in fact we cannot settle them at all. On the rival interpretation advocated in this essay, it is not true that we cannot settle these issues. Our error is to presuppose that the concept of the unconditioned has (...) application to physical reality. Once this presupposition has been abandoned, we can retrieve sound arguments from the antinomies, not indeed to demonstrate that the views originally being defended are correct, but to demonstrate that the views originally being attacked are incorrect. The essay concludes with some comments concerning how this disagreement relates to a broader disagreement about the best way to understand Kant. (shrink)

Two of Quine's most familiar doctrines are: that there is a distinction between underdetermination and indeterminacy; and that there is no distinction between analytic and synthetic truths. An argument is given that these two doctrines are incompatible. In terms wholly acceptable to Quine and based on the underdetermination/indeterminacy distinction, an exhaustive and exclusive distinction is drawn between two kinds of true sentences, which, it is argued, corresponds to the traditional analytic/synthetic distinction. An appendix is used to develop one aspect of (...) the underdetermination/indeterminacy distinction, as construed here, and to discuss, in passing, some of Quine’s more general views on truth. (shrink)

This essay is concerned with six linguistic moves that we commonly make, each of which is considered in turn. These are: stating rules of representation; representing things categorically; mentioning expressions; saying truly or falsely how things are; saying vaguely how things are; and stating rules of rules of representation. A common-sense view is defended of what is involved in our doing each of these six things against a much more sceptical view emanating from the idea that linguistic behavior is fundamentally (...) messy. Both the fifth move and the sixth move involve vague concepts, and much of the essay is concerned with developing an approach to various problems and puzzles that attach to such concepts, most notably the sorites paradoxes. (shrink)

This essay appeared as a contribution to a special issue of European Journal of Philosophy to mark the fiftieth anniversary of the publication of P. F. Strawson’s The Bounds of Sense. In that book Strawson asks whether we should agree with Kant's claim, in his Critique of Pure Reason, that there can be only one world. What Kant means by this claim is that the four-dimensional realm that we inhabit must constitute the whole of empirical reality. Strawson gives reasons for (...) challenging this claim. This essay raises the question whether, even if Strawson is right, we may nevertheless have reason to believe that there can be only one world on a broader understanding of ‘world’. The aim is as much to clarify the issue as to settle it, although an attempt is made to motivate the view that there can indeed be only one world on this broader understanding. (shrink)

In this article I examine the consequences of the dominance of intuitive thinking in moral judging and deciding for the role of moral reasoning in moral education. I argue that evidence for the reliability of moral intuitions is lacking. We cannot determine when we can trust our intuitive moral judgements. Deliberate and critical reasoning is needed, but it cannot replace intuitive thinking. Following Robin Hogarth, I argue that intuitive judgements can be improved. The expertise model for moral development, proposed by (...) Hubert and Stuart Dreyfus, not only teaches us how we acquire intuitive moral judgements, it also shows the interconnectedness of intuitive thinking and deliberate reasoning. Analysing the expertise model in more detail, I show that it cannot do justice to the importance of reasoning skills. Reasoning skills are needed because we expect people to be able to argue for their standpoints. I conclude that moral education should not only aim at improving intuitive moral judgements, but also at acquiring reasoning skills. (shrink)

We present counterexamples to the widespread assumption that Moorean sentences cannot be rationally asserted. We then explain why Moorean assertions of the sort we discuss do not incur the irrationality charge. Our argument involves an appeal to the dual-process theory of the mind and a contrast between the conditions for ascribing beliefs to oneself and the conditions for making assertions about independently existing states of affairs. We conclude by contrasting beliefs of the sort we discuss with the structurally similar but (...) rationally impermissible beliefs of certain psychiatric patients. (shrink)

(2002). Phantasy and Wish: A Proper Function Account for Human A-Rational Primary Process Mediated Mentation. Australasian Journal of Philosophy: Vol. 80, No. 1, pp. 1-16.

This essay is a contribution to a symposium on Barry Stroud’s book The Quest for Reality. It exploits various analogies between tense and colour to defend the idea, about which Stroud is deeply sceptical, that we can successfully undertake what Stroud calls ‘the philosophical quest for reality’—more specifically, to defend the idea that we can do this by arguing that any fact can be represented from no point of view.

This essay is a critical notice of Thomas Nagel’s The Last Word. Though the essay evidences broad sympathy with the spirit of Nagel’s book, its main burden is to query the letter of the book. Nagel’s defence of the view that there are certain beliefs and ways of thinking that are not from any point of view, or that are ‘objective’ in his own terms, is criticized on the grounds that it is too facile. It is also criticized for not (...) being pitted against a critique of beliefs and ways of thinking that are from some point of view, or that are ‘subjective’ in his terms. (shrink)

Freud proposes that in unconscious processing, logical connections are also (heavily) based upon phonological similarities. Repressed concerns, for example, would also be expressed by way of phonologic ambiguity. In order to investigate a possible unconscious influence of phonological similarity, 31 participants were submitted to a tachistoscopic subliminal priming experiment, with prime and target presented at 1ms. In the experimental condition, the prime and one of the 2 targets were phonological reversed forms of each other, though graphemically dissimilar (e.g., “nice” and (...) “sign”); in the control condition the targets were pseudo-randomly attributed to primes to which they don’t belong. The experimental task was to “blindly” pick the choice most similar to the prime. ERPs were measured with a focus on the N320, which is known to react selectively to phonological mismatch in supraliminal visual word presentations. The N320 amplitude-effects at the electrodes on the midline and at the left of the brain significantly predicted the participants’ net behavioral choices more than half a second later, while their subjective experience is one of arbitrariness. Moreover, the social desirability score (SDS) significantly correlates with both the behavioral and the N320 brain responses of the participants. It is proposed that in participants with low SDS the phonological target induces an expected reduction of N320 and this increases their probability to pick this target. In contrast, high defensive participants have a perplexed brain reaction upon the phonological target, with a negatively peaking N320 as compared to control and this leads them to avoid this target more often. Social desirability, which is understood as reflecting defensiveness, might also manifest itself as a defense against the (energy-consuming) ambiguity of language. The specificity of this study is that all of this is happening totally out of awareness and at the level of very elementary linguistic distinctions. (shrink)

Our approach is based on a tri-partite method of integrating psychodynamic hypotheses, cognitive subliminal processes, and psychophysiological alpha power measures. We present ten social phobic subjects with three individually selected groups of words representing unconscious conflict, conscious symptom experience, and Osgood Semantic negative valence words used as a control word group. The unconscious conflict and conscious symptom words, presented subliminally and supraliminally, act as primes preceding the conscious symptom and control words presented as supraliminal targets. With alpha power as a (...) marker of inhibitory brain activity, we show that unconscious conflict primes, only when presented subliminally, have a unique inhibitory effect on conscious symptom targets. This effect is absent when the unconscious conflict primes are presented supraliminally, or when the target is the control words. Unconscious conflict prime effects were found to correlate with a measure of repressiveness in a similar previous study (Shevrin et al., 1992, 1996). Conscious symptom primes have no inhibitory effect when presented subliminally. Inhibitory effects with conscious symptom primes are present, but only when the primes are supraliminal, and they did not correlate with repressiveness in a previous study (Shevrin et al., 1992, 1996). We conclude that while the inhibition following supraliminal conscious symptom primes is due to conscious threat bias, the inhibition following subliminal unconscious conflict primes provides a neurological blueprint for dynamic repression: it is only activated subliminally by an individual's unconscious conflict and has an inhibitory effect specific only to the conscious symptom. These novel findings constitute neuroscientific evidence for the psychoanalytic concepts of unconscious conflict and repression, while extending neuroscience theory and methods into the realm of personal, psychological meaning. (shrink)

The double subjectivity of conscience and the need to test conscientious objections -/- Abstract In spite of the collapse of the traditional objective concept of conscience and the subsequent subjectivation of conscience, conscientious objections are still often considered as a valid ground for exemption from legal and professional obligations. Conscientious objections are seen as more serious than ordinary moral objections. It is not evident why this is so. I argue, with Niklas Luhmann, that the function of conscience is to protect (...) the moral core of a person’s identity. Overruling conscientious objections threatens this core. Claims of conscience are usually founded on the right of freedom of conscience. This right is not absolute. I discuss the view of Richard Arneson who rejects the right of freedom of conscience and defends the right against conscience. I agree with Arneson that, at the one hand, conscientious objectors may constitute a threat to the social and legal order when their objections are not recognised and, at the other hand, too easy giving in to conscientious objections may also threaten the viability of social and legal order. That is why it is needed to determine when conscientious objections cannot be taken at face value, but should be subjected to a series of tests. The aim of these tests is to contain the number of objectors. I discuss 6 criteria for determining whether conscientious objections ground an exemption to legal and professional obligations. At the end of the article I discuss the conscientious objections of medical doctors. (shrink)

In medical ethics, business ethics, and some branches of political philosophy (multi-culturalism, issues of just allocation, and equitable distribution) the literature increasingly combines insights from ethics and the social sciences. Some authors in medical ethics even speak of a new phase in the history of ethics, hailing "empirical ethics" as a logical next step in the development of practical ethics after the turn to "applied ethics." The name empirical ethics is ill-chosen because of its associations with "descriptive ethics." Unlike descriptive (...) ethics, however, empirical ethics aims to be both descriptive and normative. The first question on which I focus is what kind of empirical research is used by empirical ethics and for which purposes. I argue that the ultimate aim of all empirical ethics is to improve the context-sensitivity of ethics. The second question is whether empirical ethics is essentially connected with specific positions in meta-ethics. I show that in some kinds of meta-ethical theories, which I categorize as broad contextualist theories, there is an intrinsic need for connecting normative ethics with empirical social research. But context-sensitivity is a goal that can be aimed for from any meta-ethical position. (shrink)

Does ethics have adequate general theories? Our analysis shows that this question does not have a straightforward answer since the key terms are ambiguous. So we should not concentrate on the answer but on the question itself. “Ethics” stands for many things, but we let that pass. “Adequate” may refer to varied arrays of methodological principles which are seldom fully articulated in ethics. “General” is a notion with at least three meanings. Different kinds of generality may be at cross-purposes, so (...) we must not expect theories to be general in sundry senses. “Theory,” for that matter, is itself ambiguous. Some thinkers say that ethics cannot have theories, while others deny it. We doubt whether opposing parties are talking about the same things.No wonder, then, that controversies in ethics are long-lasting and unproductive. We hope that the methodology we have presented will alleviate some of them. The examples we chose show that this is feasible. Views such as Hare's and Jonsen and Toulmin's which are seemingly wide apart, show convergence if we put them in a methodological perspective.Our analysis also suggests that many alleged differences between science and ethics could fade away if methodology is brought to bear on them. Specifically, the idea that ethics compares poorly with science in view of limited generality, or poor means of justification, is unfounded. Those who defend this view over-rate the powers of science. (shrink)

Results: We analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only 2% of (...) CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19. (shrink)

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

Public discourse is often caustic and conflict-filled. This trend seems to be particularly evident when the content of such discourse is around moral issues (broadly defined) and when the discourse occurs on social media. Several explanatory mechanisms for such conflict have been explored in recent psychological and social-science literatures. The present work sought to examine a potentially novel explanatory mechanism defined in philosophical literature: Moral Grandstanding. According to philosophical accounts, Moral Grandstanding is the use of moral talk to seek social (...) status. For the present work, we conducted six studies, using two undergraduate samples (Study 1, N = 361; Study 2, N = 356); a sample matched to U.S. norms for age, gender, race, income, Census region (Study 3, N = 1,063); a YouGov sample matched to U.S. demographic norms (Study 4, N = 2,000); and a brief, one-month longitudinal study of Mechanical Turk workers in the U.S. (Study 5, Baseline N = 499, follow-up n = 296), and a large, one-week YouGov sample matched to U.S. demographic norms (Baseline N = 2,519, follow-up n = 1,776). Across studies, we found initial support for the validity of Moral Grandstanding as a construct. Specifically, moral grandstanding motivation was associated with status-seeking personality traits, as well as greater political and moral conflict in daily life. (shrink)

There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings. This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters (WIISARD).

Understanding the autonomic nervous system and homeostatic changes associated with emotions remains a major challenge for neuroscientists and a fundamental prerequisite to treat anxiety, stress, and emotional disorders. Based on recent publications, the inter-relationship between respiration and emotions and the influence of respiration on autonomic changes, and subsequent widespread membrane potential changes resulting from changes in homeostasis are discussed. We hypothesize that reversing homeostatic alterations with meditation and breathing techniques rather than targeting neurotransmitters with medication may be a superior method (...) to address the whole body changes that occur in stress, anxiety, and depression. Detrimental effects of stress, negative emotions, and sympathetic dominance of the autonomic nervous system have been shown to be counteracted by different forms of meditation, relaxation, and breathing techniques. We propose that these breathing techniques could be used as firstline and supplemental treatments for stress, anxiety, depression, and some emotional disorders. (shrink)

The current study is a pilot trial to examine the effects of a nonelective, classroom-based, teacher-implemented, mindfulness meditation intervention on standard clinical measures of mental health and affect in middle school children. A total of 101 healthy sixth-grade students (55 boys, 46 girls) were randomized to either an Asian history course with daily mindfulness meditation practice (intervention group) or an African history course with a matched experiential activity (active control group). Self-reported measures included the Youth Self Report (YSR), a modified (...) Spielberger State-Trait Anxiety Inventory, and the Cognitive and Affective Mindfulness Measure –Revised. Both groups decreased significantly on clinical syndrome subscales and affect but did not differ in the extent of their improvements. Meditators were significantly less likely to develop suicidal ideation or thoughts of self-harm than controls. These results suggest that mindfulness training may yield both unique and non-specific benefits that are shared by other novel activities. (shrink)

Audience segmentation is necessary in health communications to ensure equitable resource distribution. Peer crowds, which are macro-level teen subcultures, are effective psychographic segments for health communications because each crowd has unique mindsets, values, norms, and health behavior profiles. These mindsets affect behaviors, and can be used to develop targeted health communication campaigns to reach those in greatest need. Though peer crowd research is plentiful, no existing peer crowd measurement tool has been formally validated. As such, we developed and validated Virginia's (...) Mindset Lens Survey (V-MLS), a mindset-based teen peer crowd segmentation survey to support health communication efforts. Using an online convenience sample of teens (N = 1,113), we assessed convergent and discriminant validity by comparing the V-MLS against an existing, widely-used peer crowd survey (I-Base Survey®) utilizing a multi-trait multi-method matrix. (shrink)

Pranayamic breathing, defined as a manipulation of breath movement, has been shown to contribute to a physiologic response characterized by the presence of decreased oxygen consumption, decreased heart rate, and decreased blood pressure, as well as increased theta wave amplitude in EEG recordings, increased parasympathetic activity accompanied by the experience of alertness and reinvigoration. The mechanism of how pranayamic breathing interacts with the nervous system affecting metabolism and autonomic functions remains to be clearly understood. It is our hypothesis that voluntary (...) slow deep breathing functionally resets the autonomic nervous system through stretchinduced inhibitory signals and hyperpolarization currents propagated through both neural and non-neural tissue which synchronizes neural elements in the heart, lungs, limbic system and cortex. During inspiration, stretching of lung tissue produces inhibitory signals by action of slowly adapting stretch receptors (SARs) and hyperpolarization current by action of fibroblasts. Both inhibitory impulses and hyperpolarization current are known to synchronize neural elements leading to the modulation of the nervous system and decreased metabolic activity indicative of the parasympathetic state. In this paper we propose pranayama’s physiologic mechanism through a cellular and systems level perspective,involving both neural and non-neural elements. This theoretical description describes a common physiological mechanism underlying pranayama and elucidate the role of the respiratory and cardiovascular system on modulating the autonomic nervous system. Along with facilitating the design of clinical breathing techniques for the treatment of autonomic nervous system and other disorders, this model will also validate pranayama as a topic requiring more research. (shrink)

Most models of generational succession in sexually reproducing populations necessarily move back and forth between genic and genotypic spaces. We show that transitions between and within these spaces are usually hidden by unstated assumptions about processes in these spaces. We also examine a widely endorsed claim regarding the mathematical equivalence of kin-, group-, individual-, and allelic-selection models made by Lee Dugatkin and Kern Reeve. We show that the claimed mathematical equivalence of the models does not hold. *Received January 2007; revised (...) April 2008. †To contact the authors, please write to: Elisabeth Lloyd, Department of History and Philosophy of Science, 130 Goodbody Hall, Indiana University, Bloomington, IN 47405; e-mail: [email protected]; Richard Lewontin, Department of Organismic and Evolutionary Biology, Harvard University, 26 Oxford Street, Cambridge, MA 02138; Marcus Feldman, Department of Biological Sciences, Stanford University, Stanford, CA 94305; e-mail: [email protected]. (shrink)

ABSTRACT Objectives There is little research on moral uncertainties and distress of palliative and hospice care providers (PHCPs) working in jurisdictions anticipating legalising voluntary assisted dying (VAD). This study examines the perception and anticipated concerns of PHCPs in providing VAD in the State of Queensland, Australia prior to legalisation of the practice in 2021. The findings help inform strategies to facilitate training and support the health and well-being of healthcare workers involved in VAD. Design The study used a qualitative approach (...) to examine and analyse the perception and anticipated concerns of PHCPs regarding challenges of providing assisted dying in Queensland. Fourteen PHCPs were recruited using a purposive sampling strategy to obtain a broad representation of perspectives including work roles, geographical locations and workplace characteristics. Data were collected via one in-depth interview per participant. The transcripts were coded for patterns and themes using an inductive analysis approach following the tradition of Grounded Theory. Setting The study was conducted in hospital, hospice, community and residential aged care settings in Queensland, Australia. These included public and private facilities, secular and faith-based facilities, and regional/rural and urban facilities. Participants Interviews were conducted with fourteen PHCPs: 10 nurses and 4 physicians; 11 female and 3 male. The median number of years of palliative care practice was 17, ranging from 2 to 36 years. For inclusion, participants had to be practising palliative and hospice care providers. Results PHCPs are divided on whether VAD should be considered part of palliative care. Expectations of moral distress and uncertainty about practising VAD were identified in five areas: handling requests, assessing patient capacity, arranging patient transfers and logistical issues, managing unsuccessful attempts, and dealing with team conflicts and stigma. Conclusions The possibility of having to practise VAD causes moral distress and uncertainty for some PHCPs. Procedural clarity can address some uncertainties; moral and psychological distress, however, remains a source of tension that needs support to ensure ongoing care of both patients and PHCPs. The introduction of VAD post-legalisation may present an occasion for further moral education and development of PHCPs. (shrink)

Precision Medicine is driven by the idea that the rapidly increasing range of relatively cheap and efficient self-tracking devices make it feasible to collect multiple kinds of phenotypic data. Advocates of N = 1 research emphasize the countless opportunities personal data provide for optimizing individual health. At the same time, using biomarker data for lifestyle interventions has shown to entail complex challenges. In this paper, we argue that researchers in the field of precision medicine need to address the performative dimension (...) of collecting data. We propose the fun-house mirror as a metaphor for the use of personal health data; each health data source yields a particular type of image that can be regarded as a ‘data mirror’ that is by definition specific and skewed. This requires competence on the part of individuals to adequately interpret the images thus provided. (shrink)