Benardete paradoxes involve infinite collections of Grim Reapers, assassins, demons, deafening peals, or even sentences. These paradoxes have recently been used in arguments for finitist metaphysical theses such as temporal finitism, causal finitism, and discrete views of time. Here we develop a new _finite_ Benardete-like paradox. We then use this paradox to defend a companions in guilt argument that challenges recent applications of patchwork principles on behalf of the aforementioned finitist arguments. Finally, we develop another problem for those applications by (...) examining the notion of exact duplication. (shrink)

In this paper, I endorse the idea that age is a defensible criterion for eligibility to vote, where age is itself a proxy for having a broad set of cognitive and motivational capacities. Given the current (and defeasible) state of developmental research, I suggest that the age of 16 is a good proxy for such capacities. In defending this thesis, I consider alternative and narrower capacity conditions while drawing on insights from a parallel debate about capacities and age requirements in (...) the criminal law. I also argue that the expansive capacity condition I adopt satisfies a number of powerful and complementary rationales for voting eligibility, and conclude by addressing challenging arguments that, on the one hand, capacity should not underlie voting eligibility in the first place, and, on the other, that capacity should do so directly and not via any sort of proxy, including age. (shrink)

In the two feature articles for this volume, Gruber et al and Buonomano & Rovelli focus on what the former call the 'two-times problem', in short, the apparent lack of fit between time as described by physical science and our own temporal experience, where 'experience' involves things like memory, anticipation, and perception of change and motion. In this short note I'll make the case that the twotimes problem is less serious than it is often made out to be in the (...) specific case of features like 'passage ' and 'presentness' that are central to the 'A-theory' of time ---the theory that holds time to be composed of dynamic regions of 'past', 'present' and future', and for time to genuinely flow or pass.My contention is three-fold: (1) the two-times problem is better understood as a three-times problem: rather than a conflict between 'physical' and 'manifest' time, what we have in the case of time is differences between the time of physics, the time of experience, and the 'folk' concept of time. (2) Understanding the problem in this way helps deflate certain problems about the relationship of these three pictures; the time of experience and the time of physics are less obviously in a problematic conflict than often supposed; and the folk concept of time is what brings in problematic features of time hard to fit with either the time of physics of experience. (3) Understanding the time of experience as independent from the folk concept of time better fits the actual aims of the... (shrink)

It is often said that the world is explained by laws of nature together with initial conditions. But does that mean initial conditions don’t require further explanation? And does the explanatory role played by initial conditions entail or require that time has a preferred direction? This chapter looks at the use of the ‘initialness defence’ in physics, the idea that initial conditions are intrinsically special in that they don’t require further explanation, unlike the state of the world at other times. (...) Such defences commonly assume a primitive directionality of time to distinguish between initial and final conditions. Using the case study of the time-asymmetry of thermodynamics and the so-called ‘past hypothesis’ — the hypothesis that the early universe was in a state of very low entropy —, I outline and support a deflationary account of the initialness defence that does not pre- suppose a basic directionality of time, and argue that there is a relevant explanatory asymmetry between initial conditions and the state of systems at other times only if certain causal conditions are satisfied. Hence, the initialness defence is available to those who reject a fundamental direction of time. (shrink)

Socrates engages his audience in Phaedrus with speeches that include revised or newly composed myths that express his theory of philosophical eros. The aim of the speeches is to generate a love for truth that spills over into dialogue. Speeches are a starting point for dialogue, just like physical attraction is the beginning of love. In the case of Phaedrus, the beginning of philosophy is portrayed using playful and rhetorically rich speeches that serve as "love potions" awakening the novice's soul, (...) and ultimately leading Phaedrus to higher rungs on the ladder of love through the palinode, a medicinal speech. It is thinking about speeches, not the speeches themselves, which moves Socrates' student Phaedrus from the love of speeches to the love of Beauty itself. This is a stark contrast to the purpose of speechmaking for the sophist. The sophist seeks to enchant the soul, while the philosopher seeks to charm the soul into loving wisdom through stimulating discussions. Socrates also uses role reversals in the lover-beloved relationship to model the soul's ascent, contrasting the traditional roles with the way the lover and beloved are presented in Socrates' speeches. The novice must actively recollect Beauty itself in order to ascend, rather than passively listening to speeches that provide an image of beauty. Socrates' interlocutors must move themselves up the ladder of love from their own philosophical eros; wisdom is not attained by merely being pushed all the way up the ladder of love. (shrink)

Cognitive science has recently made some startling discoveries about temporal experience, and these discoveries have been drafted into philosophical service. We survey recent appeals to cognitive science in the philosophical debate over whether time objectively passes. Since this research is currently in its infancy, we identify some directions for future research.

This paper considers the responsibilities of the FDA with regard to disseminating information about the benefits and harms of e-cigarettes. Tobacco harm reduction advocates claim that the FDA has been overcautious and has violated ethical obligations by failing to clearly communicate to the public that e-cigarettes are far less harmful than cigarettes. We argue, by contrast, that the FDA’s obligations in this arena are more complex than they may appear at first blush. Though the FDA is accountable for informing the (...) public about the health risks and benefits of products it regulates, it also has other roles that inform when and how it should disseminate information. In addition to being a knowledge purveyor, it is also a knowledge producer, an advisor to the public, and a practical agent shaping the material conditions in which people make health-related choices. In our view, those other roles call for caution in the way the FDA interprets and communicates the available evidence. (shrink)

A deeply personal reckoning with family, mental illness, and suicide, Dana Trusso captures the meaning of Nietzsche's armor fati--to love one's fate--through her surreal imagery and longing to heal intergenerational wounds. Lines are drawn from Lars von Trier's Melancholia, Sonic Youth's Experimental Jet Set, Trash and No Star, and lines she read from her aunt's journals as a child. -/- The photo is a sculpture of an earth goddess by Jean-Philippe Richard located in the botanical gardens of Èze, France. (...) Nearby is Le Chemin de Nietzsche, a steep hike from the seaside to mountainous ruins that is said to have inspired Thus Spoke Zarathustra. (shrink)

Heron Heart is a poem born out of reflecting on the nature of existence during long stretches of isolation, where the boundary of what is and is not a living being was challenged—the nonhuman more alive than the human. It evokes the absurdity of the banal out of the confusion and beauty of sensory experience, with hints of nostalgia for a mythological world that never existed but is ever-present.

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

In The Second Sex, Simone de Beauvoir diagnoses “woman” as the “lost sex,” torn between her individual autonomy and her “feminine destiny.” Becoming a “real woman” in patriarchal societies demands that women lose their authentic, autonomous selves to become the “inessential Other” for Man. To better understand this diagnosis and how women might refind themselves, I rehabilitate the influence of Søren Kierkegaard and his concept of repetition as what must be lost to be found again in Beauvoir’s account of freedom (...) and, specifically, the liberation of women. Beauvoir offers a dual account of repetition, that of mundane repetition and sacrificial repetition, bringing them to bear both on her diagnosis of women’s oppression and her theorization of our liberation. Sacrificial repetition becomes a temporality for freedom—one must be able to repeat or retake their autonomy continuously toward an open future. For this to happen concretely, Beauvoir insists that we must sacrifice the (racist, classist) patriarchal ideals of the “real woman” and “real man” as we retake our autonomy and reconfigure the meaning of sex difference anew. (shrink)

Hannah Arendt's rich and varied political thought is more influential today than ever before, due in part to the collapse of communism and the need for ideas that move beyond the old ideologies of the Cold War. As Dana Villa shows, however, Arendt's thought is often poorly understood, both because of its complexity and because her fame has made it easy for critics to write about what she is reputed to have said rather than what she actually wrote. Villa (...) sets out to change that here, explaining clearly, carefully, and forcefully Arendt's major contributions to our understanding of politics, modernity, and the nature of political evil in our century.Villa begins by focusing on some of the most controversial aspects of Arendt's political thought. He shows that Arendt's famous idea of the banality of evil--inspired by the trial of Adolf Eichmann--does not, as some have maintained, lessen the guilt of war criminals by suggesting that they are mere cogs in a bureaucratic machine. He examines what she meant when she wrote that terror was the essence of totalitarianism, explaining that she believed Nazi and Soviet terror served above all to reinforce the totalitarian idea that humans are expendable units, subordinate to the all-determining laws of Nature or History. Villa clarifies the personal and philosophical relationship between Arendt and Heidegger, showing how her work drew on his thought while providing a firm repudiation of Heidegger's political idiocy under the Nazis. Less controversially, but as importantly, Villa also engages with Arendt's ideas about the relationship between political thought and political action. He explores her views about the roles of theatricality, philosophical reflection, and public-spiritedness in political life. And he explores what relationship, if any, Arendt saw between totalitarianism and the "great tradition" of Western political thought. Throughout, Villa shows how Arendt's ideas illuminate contemporary debates about the nature of modernity and democracy and how they deepen our understanding of philosophers ranging from Socrates and Plato to Habermas and Leo Strauss.Direct, lucid, and powerfully argued, this is a much-needed analysis of the central ideas of one of the most influential political theorists of the twentieth century. (shrink)

This essay explores a conception of responsibility at work in moral and criminal responsibility. Our conception draws on work in the compatibilist tradition that focuses on the choices of agents who are reasons-responsive and work in criminal jurisprudence that understands responsibility in terms of the choices of agents who have capacities for practical reason and whose situation affords them the fair opportunity to avoid wrongdoing. Our conception brings together the dimensions of normative competence and situational control, and we factor normative (...) competence into cognitive and volitional capacities, which we treat as equally important to normative competence and responsibility. Normative competence and situational control can and should be understood as expressing a common concern that blame and punishment presuppose that the agent had a fair opportunity to avoid wrongdoing. This fair opportunity is the umbrella concept in our understanding of responsibility, one that explains it distinctive architecture. (shrink)

When people are making certain medical decisions – especially potentially transformative ones – the specter of regret may color their choices. In this paper, I ask: can predicting that we will regret a decision in the future serve any justificatory role in our present decision-making? And if so, what role? While there are many pitfalls to such reasoning, I ultimately conclude that considering future retrospective emotions like regret in our decisionmaking can be both rational and authentic. Rather than indicating that (...) one is about to make a mistake or that there is some underlying value that one already cares about but is overlooking, the prediction that one will regret a decision in the future makes one confront how her present values and priorities may change as a result of her choice in ways she cannot presently anticipate. (shrink)

Background: Current practice frequently fails to provide care consistent with the preferences of decisionally-incapacitated patients. It also imposes significant emotional burden on their surrogates. Algorithmic-based patient preference predictors (PPPs) have been proposed as a possible way to address these two concerns. While previous research found that patients strongly support the use of PPPs, the views of surrogates are unknown. The present study thus assessed the views of experienced surrogates regarding the possible use of PPPs as a means to help make (...) treatment decisions for decisionally-incapacitated patients. -/- Methods: This qualitative study used semi-structured interviews to determine the views of experienced surrogates [n=26] who were identified from two academic medical centers and two community hospitals. The primary outcomes were respondents’ overall level of support for the idea of using PPPs and the themes related to their views on how a PPP should be used, if at all, in practice. -/- Results: Overall, 21 participants supported the idea of using PPPs. The remaining five indicated that they would not use a PPP because they made decisions based on the patient’s best interests, not based on substituted judgment. Major themes which emerged were that surrogates, not the patient’s preferences, should determine how treatment decisions are made, and concern that PPPs might be used to deny expensive care or be biased against minority groups. -/- Conclusions: Surrogates, like patients, strongly support the idea of using PPPs to help make treatment decisions for decisionally-incapacitated patients. These findings provide support for developing a PPP and assessing it in practice. At the same time, patients and surrogates disagree over whose preferences should determine how treatment decisions are made, including whether to use a PPP. These findings reveal a fundamental disagreement regarding the guiding principles for surrogate decision-making. Future research is needed to assess this disagreement and consider ways to address it. (shrink)

We often find ourselves in situations where it is up to us to make decisions on behalf of others. How can we determine whether such decisions are morally justified, especially if those decisions may change who it is these others end up becoming? In this paper, I will evaluate one plausible kind of justification that may tempt us: we may want to justify our decision by appealing to the likelihood that the other person will be glad we made that specific (...) choice down the line. Although it is tempting, I ultimately argue that we should reject this sort of appeal as a plausible justification for the moral permissibility of our vicarious decisions. This is because the decisions that we make on behalf of another may affect the interests and values that that person will hold in the future. As I will show, this complicates the justificatory relationship between present decisions and future attitudes, since the latter can depend on the former. This is not to say that the predicted future attitudes of others can play no significant role in justifying our decisions on others’ behalf. Rather, appealing to the future attitudes in our moral justifications may play an important role in our practical thinking but only when we consider the future attitudes of all relevant possible futures. (shrink)

Many people view disabilities as misfortunes, call this the standard view. In this paper, I examine one criticism that has been launched against the Standard View. Rather than determine in advance whether having a disability is good or bad for a person, some critics argue that the Standard View is reflective of and brings about inappropriate emotional responses toward people with disabilities and their circumstances. For instance, philosophers have recently argued that in holding the standard view, we become prone to (...) a destructive kind of unwarranted pity or that the view leads us to hold certain untenable or inappropriate hopes for our children and for our society. I think this sort of challenge to the Standard View has a lot of appeal, but I worry that if it is not properly articulated, the approach is vulnerable to what has been known as “The Wrong Kind of Reason” problem. The paper highlights and addresses this worry. (shrink)

What would it be for a process to happen backwards in time? Would such a process involve different causal relations? It is common to understand the time-reversal invariance of a physical theory in causal terms, such that whatever can happen forwards in time can also happen backwards in time. This has led many to hold that time-reversal symmetry is incompatible with the asymmetry of cause and effect. This article critiques the causal reading of time reversal. First, I argue that the (...) causal reading requires time-reversal-related models to be understood as representing distinct possible worlds and, on such a reading, causal relations are compatible with time-reversal symmetry. Second, I argue that the former approach does, however, raise serious sceptical problems regarding the causal relations of paradigm causal processes and as a consequence there are overwhelming reasons to prefer a non-causal reading of time reversal, whereby time reversal leaves causal relations invariant. On the non-causal reading, time-reversal symmetry poses no significant conceptual nor epistemological problems for causation. _1_ Introduction _1.1_ The directionality argument _1.2_ Time reversal _2_ What Does Time Reversal Reverse? _2.1_ The B- and C-theory of time _2.2_ Time reversal on the C-theory _2.3_ Answers _3_ Does Time Reversal Reverse Causal Relations? _3.1_ Causation, billiards, and snooker _3.2_ The epistemology of causal direction _3.3_ Answers _4_ Is Time-Reversal Symmetry Compatible with Causation? _4.1_ Incompatibilism _4.2_ Compatibilism _4.3_ Answers _5_ Outlook. (shrink)

Experiences of motion and change are widely taken to have a ‘flow-like’ quality. Call this ‘temporal qualia’. Temporal qualia are commonly thought to be central to the question of whether time objectively passes: (1) passage realists take temporal passage to be necessary in order for us to have the temporal qualia we do; (2) passage antirealists typically concede that time appears to pass, as though our temporal qualia falsely represent time as passing. I reject both claims and make the case (...) that passage-talk plays no useful explanatory role with respect to temporal qualia, but rather obfuscates what the philosophical problem of temporal qualia is. I offer a ‘reductionist’ account of temporal qualia that makes no reference to the concept of passage and argue that it is well motivated by empirical studies in motion perception. (shrink)

“The universe is expanding, not contracting.” Many statements of this form appear unambiguously true; after all, the discovery of the universe’s expansion is one of the great triumphs of empirical science. However, the statement is time-directed: the universe expands towards what we call the future; it contracts towards the past. If we deny that time has a direction, should we also deny that the universe is really expanding? This article draws together and discusses what I call ‘C-theories’ of time — (...) in short, philosophical positions that hold time lacks a direction — from different areas of the literature. I set out the various motivations, aims, and problems for C-theories, and outline different versions of antirealism about the direction of time. (shrink)

Democratizing the syllabus has been discussed in the fields of sociology and political science but rarely in philosophy. In this paper I will draw upon my experience of teaching Philosophy of Love in an online modality to examine the impact on motivation when students fill in the gaps presented in a democratic syllabus.

Abstract: This research paper presents a novel approach to predict audit risks using a neural network model. The dataset used for this study was obtained from Kaggle and comprises 774 samples with 18 features, including Sector_score, PARA_A, SCORE_A, PARA_B, SCORE_B, TOTAL, numbers, marks, Money_Value, District, Loss, Loss_SCORE, History, History_score, score, and Risk. The proposed neural network architecture consists of three layers, including one input layer, one hidden layer, and one output layer. The neural network model was trained and validated, achieving (...) an impressive accuracy of 100% and an average error of 0.000015, indicating its robust predictive capability. Moreover, we conducted feature importance analysis to identify the most influential features for predicting audit risk. The key features found to be critical for classifying fraudulent activities in audit risk prediction are Sector_score, PARA_A, SCORE_A, PARA_B, SCORE_B, TOTAL, numbers, marks, Money_Value, District, Loss, Loss_SCORE, History, and History_score. This research contributes to the field of audit risk prediction by demonstrating the effectiveness of a neural network-based approach and highlighting the importance of specific features in detecting fraudulent activities. The findings have significant implications for auditors and organizations seeking to enhance their audit risk assessment processes, ultimately leading to improved financial transparency and fraud detection. (shrink)

Modern physics has provided a range of motivations for holding time to be fundamentally undirected. But how does a temporally adirectional metaphysics, or ‘C-theory’ of time, fit with the time of experience? In this chapter, I look at what kind of problem human time poses for C-theories. First, I ask whether there is a ‘hard problem’ of human time: whether it is in principle impossible to have the kinds of experience we do in a temporally adirectional world. Second I consider (...) the ‘easy problem’: how specific directed aspects of our temporal experience are to be explained by C-theorists. This leads to a greater issue: is there such a thing as an experience of time direction at all to even be explained? I show how the kinds of experience we have that we typically associate with the idea of time being directed can be accommodated within a directionless picture of time. (shrink)

Bertrand Russell famously argued that causation is not part of the fundamental physical description of the world, describing the notion of cause as “a relic of a bygone age”. This paper assesses one of Russell’s arguments for this conclusion: the ‘Directionality Argument’, which holds that the time symmetry of fundamental physics is inconsistent with the time asymmetry of causation. We claim that the coherence and success of the Directionality Argument crucially depends on the proper interpretation of the ‘ time symmetry’ (...) of fundamental physics as it appears in the argument, and offer two alternative interpretations. We argue that: if ‘ time symmetry’ is understood as the time -reversal invariance of physical theories, then the crucial premise of the Directionality Argument should be rejected; and if ‘ time symmetry’ is understood as the temporally bidirectional nomic dependence relations of physical laws, then the crucial premise of the Directionality Argument is far more plausible. We defend the second reading as continuous with Russell’s writings, and consider the consequences of the bidirectionality of nomic dependence relations in physics for the metaphysics of causation. (shrink)

This paper assesses branching spacetime theories in light of metaphysical considerations concerning time. I present the A, B, and C series in terms of the temporal structure they impose on sets of events, and raise problems for two elements of extant branching spacetime theories—McCall’s ‘branch attrition’, and the ‘no backward branching’ feature of Belnap’s ‘branching space-time’—in terms of their respective A- and B-theoretic nature. I argue that McCall’s presentation of branch attrition can only be coherently formulated on a model with (...) at least two temporal dimensions, and that this results in severing the link between branch attrition and the flow of time. I argue that ‘no backward branching’ prohibits Belnap’s theory from capturing the modal content of indeterministic physical theories, and results in it ascribing to the world a time-asymmetric modal structure that lacks physical justification. (shrink)

Abstract: Each affective state has distinct motor-expressions, sensory perceptions, autonomic, and cognitive patterns. Panksepp (1998) proposed seven neural affective systems of which the SEEKING system, a generalized approach-seeking system, motivates organisms to pursue resources needed for survival. When an organism is presented with a novel stimulus, the dopamine (DA) in the nucleus accumbens septi (NAS) is released. The DA circuit outlines the generalized mesolimbic dopamine-centered SEEKING system and is especially responsive when there is an element of unpredictability in forthcoming rewards. (...) We propose that when the outcome of this interaction is unexpected or unanticipated then Panksepp’s “cognitive or expectancy reset” mechanism involving the cognitive dissonance would yield the subjective emotion of surprise. In order to appropriately react to the environment’s stimuli one needs fundamental processes that would enable one to distinguish between what is novel and what has been already experienced, as well as the different degrees of novelty. Novel events are those whose essential features of the representation (visceral and perceptual) are altered and being discrepant provoke more sustained attention. Novelty arises from salient and arousing events and the organism experiences surprise, as coming out of a habitual state. In this framework, we shall look at established theories of emotions and propose a different approach to their taxonomy. (shrink)

In what sense is the direction of time a matter of convention? In 'The Direction of Time', Hans Reichenbach makes brief reference to parallels between his views about the status of time’s direction and his conventionalism about geometry. In this article, I: (1) provide a conventionalist account of time direction motivated by a number of Reichenbach’s claims in the book; (2) show how forwards and backwards time can give equivalent descriptions of the world despite the former being the ‘natural’ direction (...) of time; and (3) argue that this offers an important middle-ground position between existing realist and antirealist accounts of the direction of time. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

The aesthetics of body and dress are in a continuous flux. The body, being the locus where fashion challenges the traditional norms, escapes from the narrow boundaries of the conventionally beautiful; the disgusting soma, in the realm of Negative Aesthetics, takes its place. In this paper, I attempt to define what is disgusting fashion and how can contribute to the deliberation of the body from the restricting margins of the aesthetically beautiful. The distorted imagery of the feminine soma is the (...) center of the analysis of the non-beautiful as an aesthetically pleasing phenomenon. Different examples of repulsive clothing are analyzed from a philosophical point of view, in order to understand the relation between the negative emotional responses towards disgusting fashion and its aesthetic value. -/- . (shrink)

Starting from the notion of the Ideal Feminine, this paper discusses the representation of trauma and the portrayal of women as open wounds in the designs of Alexander McQueen and John Galliano. Particularly, I explore how the McQueen’s Deadly Woman and Galliano’s Doll question the boundaries between mortality, sexuality and decay. By examining the relationship between fear, desire and disgust in the aesthetic representation of the wounded fashioned body, I argue that in their works disgust functions as an empowering emotion, (...) contributing to the perception of the aversive fashioned body as a feministic act. (shrink)

Recreational Drugs European Network (ReDNet) project aims to use the Psychonaut Web Mapping Project database (Psychonaut Web Mapping Group, 2009) containing novel psychoactive compounds usually not mentioned in the scientific literature and thus unknown to clinicians as a unique source of information. The database will be used to develop an integrated ICT prevention approach targeted at vulnerable individuals and focused on novel synthetic and herbal compounds and combinations. Particular care will be taken in keeping the health professionals working directly with (...) young people showing problematic behaviors regularly updated in terms of novel compounds and combinations as well. A user-friendly project website will be developed aimed primarily at delivering the information/prevention approaches, but will also be a way of communicating with project partners and relevant stakeholders (e.g. thematic forum facilities, instant messages, blogs, video chat, wikiblog, newsletters distributed via mailing list). The website will support various ICT prevention tools, including an SMS alert service. Different areas and sections will be aimed specifically at the different target groups. -/- . (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

Abstract: All major systems of belief claim to have a distinctive understanding and relation to whatever they may consider the unseen divine entity. Present neuropsychological theories are divided between the possible existence of “God-modules” hardwired in the brain, on one hand, and God as a construction of the brain’s incapacity to explain unknown and unidentified events. In Theravāda Buddhism there is no personal deity; one experiences the ultimate as impersonal. The idea of self is also rejected and a Buddhist identity (...) is pointing out towards “othoproxy”, “the right practice”, what could be called “action identity”. (shrink)

This paper discusses the concept of Dána or charity as the foundation of Indian Social life. Dána has been in vogue in India since the Vedic times, but it was codified by the smritis which prescribe do’s and don’ts of the life of the individual. Limiting its scope to Yagnavalkya smriti the paper analyses the significance of Dána as a regulative principle of accumulation of wealth.

Layunin ng pag-aaral na mailahad at matukoy ang kahalagahan ng sikolohiya, implikasyon, at mga danas at lakbayin ng “Sunod” sa pangkat ng Biga at mga karatig tribo nito sa Tabuk City, Kalinga. Ang nasabing pananaliksik ay sumailalim sa Kuwalitatibo at Deskriptibong pag-aaral na nilapatan ng Sikolohiyang pagdulog, Sosyolohiya, at Etnograpiya, tinalakay ang mga kulturang kinagisnan ng isang pangkat. Mga piling “Pangat” o pinuno at matatanda sa pangkat Biga ang mga kalahok sa pananaliksik na nagbigay ng kani-kanilang mga karunungan, karanasan at (...) lakbayin sa pagdalumat ng “Sunod” sa buhay. Ang resulta ng pag-aaral sa mga Ibiga at mga karatig tribo ay may maayos na ugnayan at mapayapang pamumuhay. Malakas ang tungkulin ng pamilya sa pagbibigay ng disiplina at pagtutulungan sa bawat miyebro. Lumitaw rin na hindi kailangang magkadugo ang maituturing na “sunod” kundi lahat ng katribo at mga karatig tribo. Dahil dito ay naiiwasan ang mga di-kanais- nais na kaganapan o mga kaguluhan sa pagitan ng bawat isa. Matatag na kanilang sinusunod ang kahalagahan ng relasyong “sunod” sa bawat araw ng kanilang pakikibaka sa buhay. Napatunayan din na malakas ang kapangyarihan ng mg “Pangat” o “Tribal elders” at ibang matatanda sa pagpapanatili ng kaayusan. (shrink)

Layunin ng komemoratibong pag-aaral na ito, gamit ang isang naratibong pagsusuri, ang pagturol sa danas at alaala ng mga Marikeño sa panahon ng pananalasa at/o pagbahang idinulot ng Ondoy (Ketsana) noong 2009 at sa mga panahong pagkatapos nito. Habang sentro ng pag-aaral na ito ang apat na barangay ng lungsod o ang mga tinatawag na “tabing-ilog”—Nangka, Tumana, Malanday, at Concepcion Uno—gumamit ang pananaliksik ng dalawang pangunahing método, pakikipagpanayam at pakikipagkuwentuhan. Sa kinasapitan, nakapagluwal ang pananaliksik na ito ng dalawang pangunahing bahagi: (...) una, mga naratibo ng danas at alaala sa panahon ng pananalasa ng Ondoy at ikalawa, pagsisiyasat sa mga sumunod na panahon. Sa kabuoan, nakapaglatag ang pag-aaral na ito ng pitong dalumat ukol sa kahulugan, kabuluhan, at konteksto ng Ondoy sa pananaw ng mga Marikeño: (1) delubyo, (2) kaparusahan, (3) kaligtasan, (4) pagtulong, (5) palatandaan, (6) takot, at (7) kasanayan. Hatid ng pag-aaral na ito ang isang implikasyong magpapahalaga sa dalawang bagay—(1) Araling at Kasaysayang Pangkapaligiran o isang subdisiplinang kakanlong sa pag-aaral ng kasaklawan ng kalikasan at kapaligirang Pilipino at (2) Kasaysayang Pampook o pagsasalaysay ng kasaysayan ukol sa isang partikular na pook. Samakatwid, ang kabuoang implikasyon ay magbibigay-linaw at ambag sa saysay ng Ondoy bílang bahagi ng kalikasan at kapaligirang Marikeño sa unang banda at ang saysay ng Marikina bílang pook sa kabilang banda. (shrink)

D’après Heidegger, chaque époque/épochè est caractérisé par un certain mode de révélation des étants, qui est à la fois une dissimulation d’une façon de l’Être. Ce mode particulier paraît ne venir de nulle part en ce qu’il se base sur un certain oubli. Dana S. Belu le met en scène pour son livre en faisant valoir la tendance de Heidegger « to treat the history of being (Seinsgeschichte) as a noncausal succession of universal principles of intelligibility that presupposes the (...) forgetting (Seinsvergessenheit) of the clearing (die Lichtung) as their source » (p. 15). L’oubli de notre époque est marqué par une divulgation technologique dans le mode de l’arraisonnement (Gestell) où les étants se révèlent comme partie du fonds (Bestand) d’être calculés, manipulés, exploités, et mis en réserve pour un usage ultérieur. La phénoménologie féministe de l’A. essaie de faire sens à la gestation, la maternité et la procréation médicalement assistée (PMA) qui font aux femmes faire partie de ce fonds et ouvre, parmi les paramètres du Gestell, la porte à une ère « sans mère ». (shrink)

Aktuelna pandemija virusa korona navela je mnoge pojedince da preispitaju usvojene obrasce ponašanja. Savremeni čovek, naviknut da najčešće odlučuje i dela u skladu sa sopstvenim interesima i željama, suočava se danas sa zahtevom da svoje postupke podredi opštem dobru. U doba pandemije kada svaki vid neopreznog i nesavesnog delanja može predstavljati opasnost kako po samog delatnika, tako i po njegove bližnje, postavlja se pitanje: kako treba postupati i u skladu sa kojim načelima? Odgovor na ovu važnu nedoumicu možemo pronaći ispitivanjem (...) etičke doktrine Imanuela Kanta. Jedna od glavnih odlika njegove etike jeste eksplicitna zabrana postavljanja pojedinca i njegovih ličnih težnji i ciljeva u prvi plan. Kantov vrhovni moralni princip nije utemeljen u čulima i iskustvu, nego u čovekovoj racionalnoj prirodi i njegovom umu, što mu daje opšte važenje. Ovaj princip važi jednako za sva racionalna bića. Cilj ovog teksta je da pokaže kako Kantov vrhovni moralni princip (izražen u formi kategoričkog imperativa) i čuveni test univerzalizacije mogu da nam posluže kao neka vrsta vodiča za ispravno postupanje. Videćemo da prilikom svakog odlučivanja moramo prvo da se zapitamo šta bi se desilo kada bismo svi postupili na određeni način, odnosno, da li možemo hteti da živimo u svetu koji bi u tom slučaju nastao. Ukoliko je odgovor potrvdan, onda je predloženi postupak moralno ispravan. (shrink)

The topical theme of this paper explores the ethical principles of Mahayana Buddhism, based on Bodhicaryavatara(BC) of Santideva(7thcentury A.D.). According to him, only generation of enlightened mind (bodhicitta-intellect) and virtuous actions are not sufficient to attain the main objective i.e. Buddha-hood, the state of perfect enlightenment. But, for the fulfillment of this goal one must have to gain perfection to engage in the performance of six actions, termed as –Sadparmitas. It is necessary to stop present and future sufferings, and to (...) bring eternal pleasure, for all sentient beings. For this self-attitude and behavior in everyday affairs towards other beings is necessary. Thus, the ethics in Buddhism is directly associated with theory of Karman (action). Here, ethics means not only pure observance of virtuous actions but also good performance of one’s own duty and good actions in all affairs. It means while we work and act must be abstain from negative thinking doing harm for other beings. Therefore, Santideva emphasizes on applied form of teachings of the ethical theory. According to him, who has proper vision and understanding can act, of the work of compassionate, beyond the ethical code of conduct prescribed by the scriptures as warranted by circumstances and conditions for the sake of others. Thus, the ethical theory is based on good or bad intention of mind of an individual. This is so as what is virtuous and non-virtuous actions are not so easy to understand because it depends on purity of mind. In fact, nothing is good and nothing is bad, circumstances and intentions make it so. (shrink)

In 1982 Jackson introduced the Knowledge Argument to elucidate the phenomenal, interior aspects of experience. In 1908 McTaggart defined two series that characterize one dimension of time, the A-series and the B-series. The A-series is usually thought to be phenomenal [Farr 2019], [Dainton 2018]. Thus there is the possibility of giving a Knowledge Argument for time [Merriam 2012, 2022a]. One (informal) statement of the classical Knowledge Argument might be “Mary knows all the facts about color qualia but lives in (...) a black-and-white room. Upon being released into a colorful world, it would seem she learns something new.” The analogous Knowledge Argument for Time (KAT) would be “Nathan knows all the facts about time but lives in a B-series room. Upon being released into a world that has both an A-series and a B-series it would seem he learns something new.” I give variations of the KAT based on various distinctions. I don’t give any particular proposed solutions to the Knowledge Arguments for Time. Rather, the point is to state the Arguments (or indicate how they may be stated). It may be hoped that these will help clarify some issues in the philosophy of time and lead to a cross-fertilization between the philosophy of time and the philosophy of mind. (shrink)

Jackson (1982) introduced the Knowledge Argument to elucidate the phenomenal, interior aspects of experience. In 1908 McTaggart defined two series that characterize one dimension of time, the A-series and the B-series. The A-series is usually thought to be phenomenal Farr (2019), SEP (2018). Thus there is the possibility of giving a Knowledge Argument for time. One (informal) statement of the classical Knowledge Argument might be “Mary knows all the facts about color qualia but lives in a black-and-white room. Upon (...) being released into a colorful world, it would seem she learns something new.” The analogous Knowledge Argument for Time (KAT) would be “Nathan knows all the facts about time but lives in a B-series room. Upon being released into a world with both an A-series and a B-series it would seem he learns something new.” I give variations of the KAT based on various distinctions. I don’t give any particular proposed solutions to the Knowledge Arguments for Time. Rather, the point is to state the Arguments (or indicate how they may be stated). It may be hoped that these will help clarify some issues in the philosophy of time and lead to a cross-fertilization between the philosophy of time and the philosophy of mind. (shrink)

One challenge in providing an adequate definition of physical disability is unifying the heterogeneous bodily conditions that count as disabilities. We examine recent proposals by Elizabeth Barnes (2016), and Dana Howard and Sean Aas (2018), and show how this debate has reached an impasse. Barnes’ account struggles to deliver principled unification of the category of disability, whilst Howard and Aas’ account risks inappropriately sidelining the body. We argue that this impasse can be broken using a novel concept: marginalised functioning. (...) Marginalised functioning concerns the relationship between a person’s bodily capacities and their social world: specifically, their ability to function in line with the default norms about how people can typically physically function that influence the structuring of social space. We argue that attending to marginalised functioning allows us to develop, not one, but three different models of disability, all of which—whilst having different strengths and weaknesses—unify the category of disability without sidelining the body. (shrink)

La Educación Sensible es ayuda para que el “yo” habite en su “hogar interior” y crezca hacia su “apoteosis original” en el “nosotros”, donde se hace cocreador de belleza con libertad, sabiduría y amor. La educación sensible es pedagogía no invasiva pero radicalmente exigente para que la persona acepte desplegar su versión original y vivir con gozo en un “nosotros-maduro”. No es una pedagogía que protege a los sensibles; es una educación que atiende a todas las personas, independientemente de su (...) grado de sensibilidad: alta, media o baja (como intervalos comunes que se manejan en las ciencias de la sensibilidad). La sensibilidad personal es capaz de captar la propia originalidad y disponerse para interpretarla en los dos sentidos: comprenderla y actuarla. La sensibilidad humana necesita la educación sensible para que sea punto de partida de un desarrollo personal auténtico y pleno de la propia originalidad que es alterada y altera la de los “yoes” con quien habita la existencia formando “nosotros”, que a su vez, se impactan con interdependencia. Además de al “yo”, la educación sensible se orienta al “nosotros”, que será tanto más “sensible” en la medida que altera la intimidad de la persona con “amor-maduro” que es fuente de gozo, a pesar de los pesares. Sin educación sensible la vida daña y cuanta mayor es la sensibilidad de la persona, mayor es el daño, pero también es mayor la capacidad para detectarlo cicatrizarlo y ayudar a otros con educación sensible. Así, la educación sensible se manifiesta de tres maneras: como acción sanadora de la persona, destrucción creadora para evolucionar en el tiempo, como la crisálida se transforma en mariposa, y acción desarrollante del propio potencial con originalidad. (shrink)