The authors argue against direction of fit accounts of the distinction between belief and desire.

The direct social perception thesis claims that we can directly perceive some mental states of other people. The direct perception of mental states has been formulated phenomenologically and psychologically, and typically restricted to the mental state types of intentions and emotions. I will compare DSP to another account of mindreading: dual process accounts that posit a fast, automatic “Type 1” form of mindreading and a slow, effortful “Type 2” form. I will here analyze whether dual process accounts’ Type 1 mindreading (...) serves as a rival to DSP or whether some Type 1 mindreading can be perceptual. I will focus on Apperly and Butterfill’s dual process account of mindreading epistemic states such as perception, knowledge, and belief. This account posits a minimal form of Type 1 mindreading of belief-like states called registrations. I will argue that general dual process theories fit well with a modular view of perception that is considered a kind of Type 1 process. I will show that this modular view of perception challenges and has significant advantages over DSP’s phenomenological and psychological theses. Finally, I will argue that if such a modular view of perception is accepted, there is significant reason for thinking Type 1 mindreading of belief-like states is perceptual in nature. This would mean extending the scope of DSP to at least one type of epistemic state. (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)

Direct Social Perception (DSP) is the idea that we can non-inferentially perceive others’ mental states. In this paper, I argue that the standard way of framing DSP leaves the debate at an impasse. I suggest two alternative interpretations of the idea that we see others’ mental states: others’ mental states are represented in the content of our perception, and we have basic perceptual beliefs about others’ mental states. I argue that the latter interpretation of DSP is more promising and examine (...) the kinds of mental states that plausibly could satisfy this version of DSP. (shrink)

What does Wittgenstein say about the learning child? In the Philosophical Investigations, he writes, ‘An important part … will consist in the teacher’s pointing to the objects, directing the child’s attention to them, and at the same time uttering a word.’ Here Wittgenstein is describing what is called ‘joint attention’ which is agreed to be a rich resource for learning in children. In this essay, I explore the developmental significance of this passage particularly with regards the learning that occurs in (...) the pre-linguistic child during joint attention. I refer to critical remarks elsewhere in the PI which can help further convey what Wittgenstein means when he talks about attentional capacities and how they develop, including the relevant ability for responsiveness required for the learning to proceed. These considerations should motivate a defence of the social initiation model of learning contra Luntley’s mentalist-individualist account, this despite conceding that certain prior capacities do play a role, though not a central one since these do not pick out the relevant ability (responsiveness) required for learning to take place in the child. (shrink)

In this paper, I show that we should understand the direction of fit of beliefs and desires in normative terms. After rehearsing a standard objection to Michael Smith’s analysis of direction of fit, I raise a similar problem for Lloyd Humberstone’s analysis. I go on to offer my own account, according to which the difference between beliefs and desires is determined by the normative relations such states stand in. I argue that beliefs are states which we have reason (...) to change in light of the world, whereas desires are states that give us reason to change the world. After doing this, I show how the view avoids various objections, including two from David Sobel and David Copp. The paper ends by briefly discussing the relevance of the view to the Humean theory of motivation. (shrink)

I argue that the concept of direction of fit is best seen as picking out a certain inferential property of a psychological attitude. The property in question is one that believing shares with assuming and fantasizing and fails to share with desire. Unfortunately, the standard analysis of DOF obscures this fact because it conflates two very different properties of an attitude: that in virtue of which it displays a certain DOF, and that in virtue of which it displays certain (...) revision conditions. I claim that the latter corresponds with the aim of an attitude, not its DOF. In order to remedy this failure of the standard analysis, I offer an alternative account of DOF, which I refer to as the two-content analysis. (shrink)

In the past couple of decades, there were a few major attempts to establish the thesis of pragmatic infringement – that a significant pragmatic ingredient figures significantly in the truth-conditions for knowledge-ascriptions. As candidates, epistemic contextualism and Relativism flaunted conversational standards, and Stanley's SSI promoted stakes. These conceptions were propelled first and foremost by obviously pragmatic examples of knowledge ascriptions that seem to require a pragmatic component in the truth-conditions of knowledge ascriptions in order to be accounted for. However, if (...) such examples can be adequately explained purely pragmatically, the need that such examples seem to invoke in such a pragmatic component is undermined. Here I lay out a new pragmatic account – of action-directed pragmatics, offering a different account of such examples and their pragmatic flavor. If adequate, it obviates the above need for pragmatic enrichment. Specifically, I develop and I argue for a well-entrenched pragmatic feature – that of a steering role. The assertions of knowledge ascriptions and their denials as well as of simple assertions (that don't invoke knowledge) play a pragmatic role of steering audiences in joint deliberational setups toward, or away from, the speaker's preferred action (as well as in assertions of 'I am sure', of epistemic modals, taste assertions, causal assertions, and more.) Various features and consequences of this account are drawn. Specifically, I explain why in the bank example (and related ones) the husband, in denying the knowledge ascription, neither lies nor misleads. (shrink)

In this chapter I defend a methodological view about how we should conduct substantive ethical inquiries in the fields of normative and practical ethics. I maintain that the direct plausibility and implausibility of general ethical principles – once fully clarified and understood – should be foundational in our substantive ethical reasoning. I argue that, in order to expose our ethical intuitions about particular cases to maximal critical scrutiny, we must determine whether they can be justified by directly plausible principles. To (...) expose apparently plausible principles to maximal critical scrutiny, we must determine whether their direct plausibility can survive careful clarification of what they are really saying. This means that intuitions about cases are useful only in (a) suggesting principles that must stand on their own two feet, and (b) illustrating or otherwise helping us clarify what a principle is really saying. We should not reject principles that seem most directly plausible after we have fully clarified their content simply because they conflict with our intuitions about cases, because to do so is to side with uncritical prejudices over the teachings of critical scrutiny. (shrink)

Most direct reference theorists about indexicals and proper names have adopted the thesis that singular propositions about physical objects are composed of physical objects and properties.1 There have been a number of recent proponents of such a view, including Scott Soames, Nathan Salmon, John Perry, Howard Wettstein, and David Kaplan.2 Since Kaplan is the individual who is best known for holding such a view, let's call a proposition that is composed of objects and properties a K-proposition. In this paper, I (...) will attempt to show that a direct reference view about the content of proper names and indexicals leads very naturally to the position that all singular propositions about physical objects are K-propositions.3 Then, I will attempt to show that this view of propositions is false. I will spend the bulk of the paper on this latter task. My goal in the paper, then, is to show that adopting the direct reference thesis comes at a cost problems the view has with problems such as opacity and the significance of some identity statements; it comes at even more of a cost). (shrink)

The notion of empathy has been explicated in different ways in the current debate on how to understand others. Whereas defenders of simulation-based approaches claim that empathy involves some kind of isomorphism between the empathizer’s and the target’s mental state, defenders of the phenomenological account vehemently deny this and claim that empathy allows us to directly perceive someone else’s mental states. Although these views are typically presented as being opposed, I argue that at least one version of a simulation-based approach—the (...) account given by de Vignemont and Jacob—is compatible with the direct-perception view. My argument has two parts: My first step is to show that the conflict between these accounts is not—as it seems at first glance—a disagreement on the mechanism by which empathy comes about. Rather, it is due to the fact that their proponents attribute two very different roles to empathy in understanding others. My second step is to introduce Stein’s account of empathy. By not restricting empathy to either one of these two roles, her process model of empathy helps to see how the divergent intuitions that have been brought forward in the current debate could be integrated. (shrink)

The personal identity relation is of great interest to philosophers, who often consider fictional scenarios to test what features seem to make persons persist through time. But often real examples of neuroscientific interest also provide important tests of personal identity. One such example is the case of Phineas Gage – or at least the story often told about Phineas Gage. Many cite Gage’s story as example of severed personal identity; Phineas underwent such a tremendous change that Gage “survived as a (...) different man.” I discuss a recent empirical finding about judgments about this hypothetical. It is not just the magnitude of the change that affects identity judgment; it is also the negative direction of the change. I present an experiment suggesting that direction of change also affects neuroethical judgments. I conclude we should consider carefully the way in which improvements and deteriorations affect attributions of personal identity. This is particularly important since a number of the most crucial neuroethical decisions involve varieties of cognitive enhancements or deteriorations. (shrink)

When an agent’s motivation is sensitive to how his supervisor thinks about the agent’s competence, the supervisor has to take into account both informational and expressive contents of her message to the agent. This paper shows that the supervisor can credibly express her trust in the agent’s ability only by being un- clear about what to do. Suggesting what to do, i.e., “directives,” could reveal the supervisor’s “distrust” and reduce the agent’s equilibrium effort level even though it provides useful information (...) about the decision environment. There is also an equilibrium in which directives are neutral in expressive content. However, it is shown that neologism proofness favors equilibria in which directives are double- edged swords. (shrink)

I will use three simple arguments to refute the thesis that I appear to directly perceive a mind-independent material object. The theses I will use are similar to the time-gap argument and the argument from the relativity of perception. The visual object of imagination and the object of experience are in the same place. They also share common qualities such as the content, subjectivity, change in virtue of conditions of observers, and the like. This leads to the conclusion that both (...) a tree-image and a tree-experience are distinct from a material tree. Perception of an object is caused by human nature, the senses and consciousness, and mind may prevent the direct perception of the external world. The strongest objection against that consequence is that there is no extra entity called sense-datum or appearance between a subject-in-itself and a real external thing-in-itself. That is, we see books, not book-images. The possible reply would be that a person sees no mental pictures except that which they see via pictures. (shrink)

One branch of the responsible innovation literature involves the direction of innovation: if the public or decision-makers can or should direct innovation, how should innovation be directed? This paper explicates a case study where directionality – the plurality of plausible values for innovation – is directly implicated. In this case, a key technology may require a strategy for innovation, but there are contrasting normative reasons to drive that innovation in different ways, reflecting two distinct moral values, ‘effectiveness’ and responsiveness (...) to ‘need’. In this case, carbon dioxide removal, these values may well conflict. Strategically deploying carbon dioxide removal in a cost-effective manner would tend to support siting it in regions where there are significant oil and gas operations. In contrast, strategically deploying carbon dioxide removal in response to need would tend to support siting it in regions where expected demand for the technology is required for development. [Open access]. (shrink)

In this commentary, I critique three aspects of Emily Walsh's proposal to reduce the moral and legal weight of advance directives: (1) the ambiguity of its initial thesis, (2) its views about the ethics and legality of clinical practice, and (3) its interpretation and application of Ronald Dworkin’s account of advance directives and L.A. Paul's view on transformative experience. I also consider what Walsh’s proposal would mean for people facing the prospect of dementia. I conclude that our reasons to honor (...) many advance directives survive the move to a transformative experience framework. (shrink)

The controversy over the old ideal of “value-free science” has cooled significantly over the past decade. Many philosophers of science now agree that even ethical and political values may play a substantial role in all aspects of scientific inquiry. Consequently, in the last few years, work in science and values has become more specific: Which values may influence science, and in which ways? Or, how do we distinguish illegitimate from illegitimate kinds of influence? In this paper, I argue that this (...) problem requires philosophers of science to take a new direction. I present two case studies in the influence of values on scientific inquiry: feminist values in archaeology and commercial values in pharmaceutical research. I offer a preliminary assessment of these cases, that the influence of values was legitimate in the feminist case, but not in the pharmaceutical case. I then turn to three major approaches to distinguish legitimate from illegitimate influences of values, including the distinction between epistemic and non-epistemic values and Heather Douglas’ distinction between direct and indirect roles for values. I argue that none of these three approaches gives an adequate analysis of the two cases. In the concluding section, I briefly sketch my own approach, which draws more heavily on ethics than the others, and is more promising as a solution to the current problem. This is the new direction in which I think science and values should move. (shrink)

This paper comments on Gallagher’s recently published direct perception proposal about social cognition [Gallagher, S.. Direct perception in the intersubjective context. Consciousness and Cognition, 17, 535–543]. I show that direct perception is in danger of being appropriated by the very cognitivist accounts criticised by Gallagher. Then I argue that the experiential directness of perception in social situations can be understood only in the context of the role of the interaction process in social cognition. I elaborate on the role of social (...) interaction with a discussion of participatory sense-making to show that direct perception, rather than being a perception enriched by mainly individual capacities, can be best understood as an interactional phenomenon. (shrink)

Moral enhancement is an ostensibly laudable project. Who wouldn’t want people to become more moral? Still, the project’s approach is crucial. We can distinguish between two approaches for moral enhancement: direct and indirect. Direct moral enhancements aim at bringing about particular ideas, motives or behaviors. Indirect moral enhancements, by contrast, aim at making people more reliably produce the morally correct ideas, motives or behaviors without committing to the content of those ideas, motives and/or actions. I will argue, on Millian grounds, (...) that the value of disagreement puts serious pressure on proposals for relatively widespread direct moral enhancement. A more acceptable path would be to focus instead on indirect moral enhancements while staying neutral, for the most part, on a wide range of substantive moral claims. I will outline what such indirect moral enhancement might look like, and why we should expect it to lead to general moral improvement. (shrink)

The Great Divide in metaphysical debates about laws of nature is between Humeans, who think that laws merely describe the distribution of matter, and non-Humeans, who think that laws govern it. The metaphysics can place demands on the proper formulations of physical theories. It is sometimes assumed that the governing view requires a fundamental / intrinsic direction of time: to govern, laws must be dynamical, producing later states of the world from earlier ones, in accord with the fundamental (...) class='Hi'>direction of time in the universe. In this paper, we propose a minimal primitivism about laws of nature (MinP) according to which there is no such requirement. On our view, laws govern by constraining the physical possibilities. Our view captures the essence of the governing view without taking on extraneous commitments about the direction of time or dynamic production. Moreover, as a version of primitivism, our view requires no reduction / analysis of laws in terms of universals, powers, or dispositions. Our view accommodates several potential candidates for fundamental laws, including the principle of least action, the Past Hypothesis, the Einstein equation of general relativity, and even controversial examples found in the Wheeler-Feynman theory of electrodynamics and retrocausal theories of quantum mechanics. By understanding governing as constraining, non-Humeans who accept MinP have the same freedom to contemplate a wide variety of candidate fundamental laws as Humeans do. (shrink)

I argue that directing is a more fundamental kind of speech act than asserting, in the sense that the conditions under which an act counts as an assertion are sufficient for that act to count as a directive. I show how this follows from a particular way of conceiving intentionalism about speech acts, on which acts of assertion are attempts at changing a common body of information – or conversational common ground – maintained by conversational participants’ practical attitude of acceptance. (...) I suggest that the function of assertion is not to share information, but to signal that we can be relied on to act as though some information is true, and to foster that same reliability in others. (shrink)

In the early 1980’s van Inwagen presented the Direct Argument for the incompatibility of determinism with moral responsibility. In the course of the ensuing debate, Fischer, McKenna and Loewenstein have replied, each in their own way, that versions of the Direct Argument do not pose even a prima facie threat to compatibilism. Their grounds were that versions of the Direct Argument all use the “Transfer NR” inference rule in a dialectically problematic way. I rebut these replies here. By so doing, (...) I hope to set the Direct Argument debate on a more fruitful path. (shrink)

Predictive approaches to the mind claim that perception, cognition, and action can be understood in terms of a single framework: a hierarchy of Bayesian models employing the computational strategy of predictive coding. Proponents of this view disagree, however, over the extent to which perception is direct on the predictive approach. I argue that we can resolve these disagreements by identifying three distinct notions of perceptual directness: psychological, metaphysical, and epistemological. I propose that perception is plausibly construed as psychologically indirect on (...) the predictive approach, in the sense of being constructivist or inferential. It would be wrong to conclude from this, however, that perception is therefore indirect in a metaphysical or epistemological sense on the predictive approach. In the metaphysical case, claims about the inferential properties of constructivist perceptual mechanisms are consistent with both direct and indirect solutions to the metaphysical problem of perception (e.g. naïve realism, representationalism, sense datum theory). In the epistemological case, claims about the inferential properties of constructivist perceptual mechanisms are consistent with both direct and indirect approaches to the justification of perceptual belief. In this paper, I demonstrate how proponents of the predictive approach have conflated these distinct notions of perceptual directness and indirectness, and I propose alternative strategies for developing the philosophical consequences of the approach. (shrink)

Peter van Inwagen's Direct Argument (DA) purports to establish the incompatibility of determinism and moral responsibility, without appealing to the notion of avoidability, a notion on whose analysis compatibilists and incompatibilists disagree. Van Inwagen intended DA to refute compatibilism, or at least to shift the burden of proof onto the compatibilist. In this paper, we offer a critical assessment of DA. We examine a variety of objections to DA due to John Fischer and Mark Ravizza, Ishtiyaque Haji, Seth Shabo, Michael (...) McKenna, and David Widerker. We divide these objections into those based on dialectical considerations (section 1), and objections in the form of counterexamples to a central principle which the Direct Argument employs (sec 2). The conclusion we reach is that the proponent of DA can deal plausibly with these objections, thus establishing DA as a powerful argument in favor of incompatibilism. (shrink)

The purpose of this chapter is to describe what we see as several important new directions for philosophy of medicine. This recent work (i) takes existing discussions in important and promising new directions, (ii) identifies areas that have not received sufficient and deserved attention to date, and/or (iii) brings together philosophy of medicine with other areas of philosophy (including bioethics, philosophy of psychiatry, and social epistemology). To this end, the next part focuses on what we call the “epistemological turn” in (...) recent work in the philosophy of medicine; the third part addresses new developments in medical research that raise interesting questions for philosophy of medicine; the fourth part is a discussion of philosophical issues within the practice of diagnosis; the fifth part focuses on the recent developments in psychiatric classification and scientific and ethical issues therein, and the final part focuses on the objectivity of medical research. (shrink)

It is well known that there are, at least, two sorts of cases where one should not prefer a direct inference based on a narrower reference class, in particular: cases where the narrower reference class is gerrymandered, and cases where one lacks an evidential basis for forming a precise-valued frequency judgment for the narrower reference class. I here propose (1) that the preceding exceptions exhaust the circumstances where one should not prefer direct inference based on a narrower reference class, and (...) (2) that minimal frequency information for a narrower (non-gerrymandered) reference class is sufficient to yield the defeat of a direct inference for a broader reference class. By the application of a method for inferring relatively informative expected frequencies, I argue that the latter claim does not result in an overly incredulous approach to direct inference. The method introduced here permits one to infer a relatively informative expected frequency for a reference class R', given frequency information for a superset of R' and/or frequency information for a sample drawn from R'. (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)

My main point is that the creation of a free public time implies the creation of a democratic collective inspired by the project of social ecology. The first and second parts of this article focus on the modern social phenomena correlated to the general crisis and the emergence of the Internet Age (Castells, 2012). The third and fourth parts focus on new significations that seem to inspire modern social movements and the challenges that modern democratic ecological collectivities face. I use (...) the term “social ecology” as defined by Murray Bookchin: “Social ecology is based on the conviction that nearly all of our present ecological problems originate in deep-seated social problems” (Bookchin, 2006, p. 19). And I use the term “democracy” exclusively in the original, true meaning, of direct democracy where society is self-governed by the equal participation of every individual to political decisions and functions, as opposed to a modern representative democracy or republic, where political decisions rest in the hands of an oligarchy. In this sense, a truly democratic political collectivity is a truly ecological collectivity and vice versa. (shrink)

We can readily identify goal-directed systems and distinguish them from non-goal-directed systems. A woodpecker hunting for grubs is the first, a pendulum returning to rest is the second. But what is it to be a goal-directed system? Perhaps the dominant answer to this question, inspired by systems theories such as cybernetics, is that goal-directed systems are distinguished by their tendency to seek, aim at, or maintain some more-or-less easily identifiable goal. Cybernetics and the like would hold that physical systems subject (...) only to physical laws can exhibit such behavior. If sound, this systems approach to teleology would unify a diverse range of goal-directed phenomena and neatly side-step many traditional bogey-men of teleology, such as anthropomorphism and future causation. Goal-directed phenomena would be a normal feature of the natural causal world that could be described in purely descriptive and quantitative terms, and receive ordinary causal explanations. Thus, the systems approach promises to provide a naturalistic-cum-descriptive account of teleology suitable for use in naturalistic accounts of other phenomena, including the intentionality of mental states and even self-consciousness. (shrink)

The use of language in hate speech is understandably offensive. Though words do not kill, they convey an alarming message that can harm the victim. To understand how words can harm, it is necessary to understand the nature of the meaning of pejoratives or slurs that are used in hate speech. Pejoratives are undeniably offensive. However, they are puzzling as they can be used in two directions, namely, the offensive power preservation and the offensive power destruction. This paper proposes that (...) the direct reference theory of pejoratives can solve the puzzle. A characterization of pejoratives is that it has the property of immediacy. They refer directly to the object of speech. Grounding on a shared context, any descriptions are unnecessary for understanding the offensive message of pejoratives. In this sense, pejoratives have indexical content as it is context-sensitive. The kind of indexical content that pertains to pejoratives is action-oriented. However, its object of reference is empty. In discussing pejoratives that are used in hate speech, some examples of Thai slurs are shown. (shrink)

Hastings Center Report, Volume 52, Issue 1, Page 32-41, January/February 2022.

An account of what sort of causal integration is necessary for an agent to exercise agency is offered in support of a soft-line response to Derk Pereboom’s four-case argument against source-compatibilism. I argue that, in cases of manipulation, the manipulative activity affects the identity of the causal process of which it is a part. Specifically, I argue that causal processes involving direct manipulation fail to count as exercises of intentional agency because they involve heteromesial causal deviance. In contrast, standard deterministic (...) causal processes do not involve heteromesial causal deviance and are agency-preserving. The upshot is that there is a relevant difference between a causal process involving direct manipulation by another agent and a deterministic causal process that involves no such intervention. If this is right, then Pereboom’s four-case argument does not pose a threat to source-compatibilist theories of free will and moral responsibility. (shrink)

This article presents phenomenological meta-analysis of Tymieniecka's phenomenology of life with regard to its strategies of knowledge. The novelty of phenomenology of life consists in special orientation of direct intuition of Tymieniecka's insight. The analysis suggests that the positioning of the direct intuition differes from philosopher to philosopher. Even though this perspective pays attention to individual differences in philosophical thinking, this view has to be distinguished froll1 psychologism as criticized by Husser!. and rather, seen as a development of Husserl 's (...) lheory of direct intuition. A framework for such analysis can be also found in Islamic philosophies of Suhrawardi and Ibn 'Arabi, who introduced the concepts of individual predisposition, modes of knowledge, and self-knowledge mediated by knowledge by presence. These concepts can be applied to understanding of the origins of philosophical insight. The paper examines in depth the workings of direct, or presentive, intuition in Tymieniecka's descriptions of the phenomenal field of life, and of life per se as a dynamic object. It demonstrates the dialogical nature of interrogation, and the sentience of logos as a horizon of philosophical inquiry. Finally, the paper introduces the concept of process phenomenology, and suggests directions of future research with regard to phenomenology of imagination. (shrink)

Peter van Inwagen's Direct Argument (DA) for incompatibilism purports to establish incompatibilism with respect to moral responsibility and determinism without appealing to assumptions that compatibilists usually consider controversial. Recently, Michael McKenna has presented a novel critique of DA. McKenna's critique raises important issues about philosophical dialectics. In this article, we address those issues and contend that his argument does not succeed.

Advance directives typically have two defects. First, most advance directives fail to enable people to effectively avoid unwanted medical intervention. Second, most of them have the potential of ending your life in ways you never intended, years before you had to die.

Background: Critically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers can vary between the (...) different diseases. -/- Methods: We calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients. -/- Results: ICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity. -/- Conclusion: This study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care. (shrink)

This paper argues that there are two importantly distinct normative relations that can be referred to using phrases like ‘X is obligated to Y,’ ‘Y has a right against X,’ or ‘X wronged Y.’ When we say that I am obligated to you not to read your diary, one thing we might mean is that I am subject to a deontological constraint against reading your diary that gives me a non‐instrumental, agent‐relative reason not to do so, and which you are (...) typically in a unique position to waive with consent. I call this first relation the constraint relation. A second thing we might mean is that you are in a position to fittingly hold me personally accountable for reading your diary by demanding that I not read your diary, resenting me if I do so without excuse, and deciding whether to forgive me for this afterwards. I call this second relation the accountability relation. Though these two kinds of directed obligation often coincide, I argue that they are extensionally dissociable and play different normative roles. We cannot provide an adequate theory of ‘obligation to’ until we recognize that this phrase denotes not one relation, but two. (shrink)

I begin by distinguishing between what I will call a pure Fregean theory of reference and a theory of direct reference. A pure Fregean theory of reference holds that all reference to objects is determined by a sense or content. The kind of theory I have in mind is obviously inspired by Frege, but I will not be concerned with whether it is the theory that Frege himself held.1 A theory of direct reference, as I will understand it, denies that (...) all reference to objects is determined by sense or content. We will also distinguish between a theory of reference for thought, and for language. This gives us a fourfold classification of theories. What is puzzling about direct reference theories is not that the semantics of an expression in a public language should assign as its semantic value just a referent, but how such facts could be understood to reflect an underlying feature of thought. There are two interconnected aspects to this.. (shrink)

Direct realist versions of foundationalism have recently been advocated by Pryor, Huemer, Alston, and Plantinga. DRF can hold either that our foundational observation beliefs are about the simple perceptible qualities of objects, or that our foundational observation beliefs are more complex ones about objects in the world. I will show that whether our observational beliefs are simple or complex, the agent must possess other epistemically significant states in order for these observational beliefs to be justified. These other states are therefore (...) epistemically prior to observation belief, and prevent them from being epistemically foundational. (shrink)

The status of indirect discrimination is ambiguous in the current literature. This paper addresses two contemporary and related debates. First, for some, indirect discrimination is not truly a distinct kind of discrimination, but it is simply a legal construct designed to address distributive inequalities between groups. Second, even if one accepts that indirect discrimination is a distinct type of discrimination, the connection between the two kinds of discrimination, direct and indirect, is debated. For some, they are distinct act-types, while for (...) others, indirect discrimination should be conceived as a side effect of prior cases of direct discrimination. In this paper, I argue that indirect discrimination is a distinct act-type that can take place without being connected to prior instances of direct discrimination. (shrink)

What is it for a duty or obligation to be directed? Thinking about paradigmatic cases such as the obligations generated by promises will take us only so far in answering this question. This paper starts by surveying several approaches for understanding directed duties, as well as the challenges they face. It turns out that shared agency features something similar to the directedness of duties. This suggests an account of directedness in terms of shared agency – specifically, in terms of the (...) so-called practical intimacy that holds between individuals when they act together. The final section addresses a challenge to the shared agency approach posed by legal wronging in tort law. (shrink)

The truthmaker literature has recently come to the consensus that the logic of truthmaking is distinct from classical propositional logic. This development has huge implications for the free will literature. Since free will and moral responsibility are primarily ontological concerns (and not semantic concerns) the logic of truthmaking ought to be central to the free will debate. I shall demonstrate that counterexamples to transfer principles employed in the direct argument occur precisely where a plausible logic of truthmaking diverges from classical (...) logic. Further, restricted transfer principles (like the ones employed by McKenna, Stump, and Warfield) are as problematic as the original formulation of the direct argument. (shrink)

Expressivists claim that normative judgments (NJ) are non-cognitive states. But what kind of states are they, exactly? Expressivists need to provide us with an adequate account of their nature. Here, I argue that there are structural features that render this task rather daunting. The worry takes the form of a looming dilemma: NJ are either conative states (i.e. states with a world-to-mind direction of fit) or they are not. If they are, then they are either attitudes de se (i.e. (...) attitudes about oneself) or they are not. If they are, then they’re unable to account for disagreement. If they are not, then they're unable to account for agent-relative NJ. So NJ cannot be conative states (they cannot have a world-to-mind direction of fit). On the other hand, however, if NJ are not conative states (if they are states without a direction of fit, like affective or other sui generis non-cognitive, non-conative attitudes) then it remains a mystery how they support relations of disagreement. (shrink)

Direct reference theory faces serious prima facie counterexamples which must be explained away (e.g., that it is possible to know a priori that Hesperus = Phosphorus). This is done by means of various forms of pragmatic explanation. But when those explanations that provisionally succeed are generalized to deal with analogous prima facie counterexamples concerning the identity of propositions, a fatal dilemma results. Either identity must be treated as a four-place relation (contradicting what just about everyone, including direct reference theorists, takes (...) to be essential to identity). Or direct reference theorists must incorporate a view that was rejected in pretty much our first lesson about identity—namely, that Hesperus at twilight is not identical to Hesperus at dawn. One way of the other, the direct reference theory is thus inconsistent with basic principles concerning the logic of identity, which nearly everyone, including direct reference theorists, take as starting points. (shrink)

The existence of big bang relic neutrinos—exact analogues of the big bang relic photons comprising the cosmic microwave background radiation—is a basic prediction of standard cosmology. The standard big bang theory predicts the existence of 1087 neutrinos per flavour in the visible universe. This is an enormous abundance unrivalled by any other known form of matter, falling second only to the cosmic microwave background (CMB) photon. Yet, unlike the CMB photon which boasts its first (serendipitous) detection in the 1960s and (...) which has since been observed and its properties measured to a high degree of accuracy in a series of airborne/satellite and ground based experiments, the relic neutrino continues to be elusive in the laboratory. The chief reason for this is of course the feebleness of the weak interaction. At present, the observational evidence for their existence rests entirely on cosmological measurements, such as the light elemental abundances, anisotropies in the cosmic microwave background, and the large-scale matter power spectrum. In this paper we argue that Direct Detection of relic neutrino background is indeed impossible by any means, because of two chief reasons: (a) there was no such thing of cosmic singularity, hence the hot big bang/primeval atom model was based on false premises (quantum birth assumption); (b) the neutrino existence itself is not unquestionable, in particular if we consider a realism view of vector potential, A, in classical electrodynamics. (shrink)

Two meta-analyses were conducted to examine two potential sources of spatial orientation biases in human profile drawings by brain-intact individuals. The first examined profile facing direction as function of hand used to draw. The second examined profile facing direction in relation to directional scanning biases related to reading/writing habits. Results of the first meta-analysis, based on 27 study samples with 4171 participants, showed that leftward facing of profiles (from the viewer's perspective) was significantly associated with using the right (...) hand to draw. The reading/writing direction meta-analysis, based on 10 study samples with 1552 participants, suggested a modest relationship between leftward profile facing and primary use of a left-to-right reading/writing direction. These findings suggest that biomechanical and cultural factors jointly influence hand movement preferences and in turn the direction of facing of human profile drawings. -/- . (shrink)

When you have a perceptual experience of a given physical object that object seems to be immediately present to you in a way it never does when you consciously think about or imagine it. Many philosophers have claimed that naïve realism (the view that to perceive is to stand in a primitive relation of acquaintance to the world) can provide a satisfying account of this phenomenological directness of perceptual experience while the content view (the view that to perceive is to (...) represent the world to be a certain way) cannot. I argue that this claim is false. Specifically, I maintain that the only acceptable naïve realist account of the relevant phenomenology is circular and that the content view can provide a similar account. In addition, I maintain that a certain specific variety of the content view provides a non-circular and thus more satisfactory account of this phenomenology. If so, then contrary to what is commonly assumed there are powerful phenomenological grounds for preferring the content view to naïve realism. (shrink)

A high level of confidence in the identity of individuals is required to let them die as ordered by an advance directive. Thus, if we are animalists, then we should lack the confidence required to apply lethal advance directives to the cheerfully demented, or so I argue. In short, there is consensus among animalists that the best way to avoid serious objections to their account is to adopt an ontology that denies the existence of brains, hands, tables, chairs, iced-tea, and (...) lemonade. The adoption of such an ontology reduces the justificatory force of commonsense, which is key in arguing that we are animals and that we persist as long as we are biologically alive. With this loss of justification comes the loss of a high level of confidence that Quinn-pre-dementia’s lethal advanced directive applies to Quinn-post-dementia, via identity. If we do not have a high level of confidence that Quinn-pre-dementia’s advanced directive applies to Quinn-post- dementia, then it is not enough (on its own) to let Quinn-post-dementia die. (shrink)