Decision-making competence in later adulthood is affected by declines in cognitive skills, and age-related changes in affect and experience can sometimes compensate. However, recent findings suggest that age-related changes in motivation also affect the extent to which adults draw from experience, affect, and deliberative skills when making decisions. To date, relatively little attention has been given to strategies for addressing age-related changes in motivation to promote better decisions in older adults. To address this limitation, we draw from diverse literatures to (...) suggest promising intervention strategies for motivating older recipients’ motivation to make better decisions. We start by reviewing the life-span developmental literature, which suggests that older adults’ motivation to put effort into decisions depends on the perceived personal relevance of decisions as well as their self-efficacy (i.e., confidence in applying their ability and knowledge). Next, we discuss two approaches from the health intervention design literature, the mental models approach and the patient activation approach, which aim to improve motivation for decision making by improving personal relevance or by building self-efficacy or confidence to use new information and skills. Using examples from these literatures, we discuss how to construct interventions to motivate good decisions in later adulthood. (shrink)

The medical ethicist is a fairly recent addition to the clinical setting. The following four potential roles of the clinical ethicist are identified and discussed: consultant in difficult cases, educator of health care providers, counselor for health care providers and finally patient advocate to protect the interests of patients. While the various roles may sometimes overlap, the roles of educator and counselor are viewed as being more congruent with the education and training of medical ethicists than are the roles of (...) consultant and patient advocate. (shrink)

ABSTRACT In this commentary I evaluate what McGowan’s project would conclude with respect to the treatment of professional Australian Football League player Adam Goodes, who was incessantly ‘booed’ by crowds for the final two years of his career. Analysing Goodes’ case in light of McGowan’s argument leads me to two observations. First, McGowan’s norm-enactment approach is incredibly useful because it explains how words like ‘boo’ (with unstable meaning) can constitute actionable discrimination. Second, however, I wonder if a narrow focus on (...) whether such speech is legally actionable might encourage an overestimation of the power of laws to shepherd new g-norms into social practices. (shrink)

This reissued work, originally published in 1985, is a uniquely broad and original survey of theories and beliefs about the growth, behaviour, performance and reform of the governments of modern Western democracies. After analysing the external pressures which have shaped modern governments, the author examines four different schools of political thought which seek to explain the behaviour and performance of governments, and which offer different remedies for the pluralism, corporatism and bureaucracy. To examine and test these general theories, the author (...) looks closely at how governments actually work. The book is illustrated with examples drawn from various Western societies. The final chapters present the author’s own conclusion about the future role of government, the limits of market philosophy, the future of politics, and the principles and problems of institutional reform. (shrink)

This study investigates the three major educational philosophies behind the medical humanities programs in the United States. It summarizes the characteristics of the Cultural Transmission Approach, the Affective Developmental Approach, and the Cognitive Developmental Approach. A questionnaire was sent to 415 teachers of medical humanities asking for their perceptions of the amount of time and effort devoted by their programs to these three philosophical approaches. The 234 responses constituted a 54.6% return. The approximately 80:20 gender ratio of males to females (...) and other demographic data on age and educational background were consistent with other studies of the field of medical humanities.Reflections on the results in Table II indicate that some changes need to take place in the teaching of the medical humanities if the perceived ideal is to be achieved. In order for the current teachers of the medical humanities to think that the appropriate philosophies behind the teaching of the medical humanities are being implemented as they should be, much less time and effort need to be devoted to the Cultural Transmission Approach. With no other published reports on the educational philosophies behind the medical humanities programs, this study created a new knowledge base about this relatively young and rapidly emerging field. (shrink)

This article identifies five genres of anti-queer hate speech found in The Australian’s Facebook comments sections, exposing and analyzing the ways in which such comments are used to derogate cisgender and (often) heterosexual women. One may be tempted to think of cis-het women as third-party victims of queerphobia; however, this article argues that these genres of anti-queer speech are, in fact, misogynistic. Specifically, it argues that these are instances of cis-hetero-misogynistic hate speech. Cis-hetero-misogyny functions as the “law enforcement branch” of (...) a cis-hetero-patriarchal gender order. Given the existence of such an order, it is clear that cis-het women’s liberation is inextricable from queer liberation (and vice versa). This article argues that to facilitate allyship and challenge this gender order—the order that elicits such hate speech acts—we need an epistemological revolution in the way we recognize and re-cognize human difference. (shrink)

A study of clinical medical ethicists was conducted to determine the various philosophical positions they hold with respect to ethical decision making in medicine and their various positions' relationship to the subjective-objective controversy in value theory. The study consisted of analyzing and interpreting data gathered from questionnaires from 52 clinical medical ethicists at 28 major health care centers in the United States. The study revealed that most clinical medical ethicists tend to be objectivists in value theory, i.e., believe that value (...) judgments are knowledge claims capable of being true or false and therefore expressions of moral requirements and normative imperatives emanating from an external value structure or moral order in the world. In addition, the study revealed that most clinical medical ethicists are consistent in the philosophical foundations of their ethical decision making, i.e., in decision making regarding values they tend not to hold beliefs which are incompatible with other beliefs they hold about values. (shrink)

The enormous growth in medical humanities programs during the past decade has resulted in an extensive literature concerning the content of the discipline and the issues that have been addressed. Comparatively little attention, however, has been devoted to the structure of the discipline of medical humanities concerning the process or the theoretical aspects of the pedagogy of teaching the discipline. This report explicitly addresses the pedagogical aspects of the discipline by comparing and contrasting two different basic approaches to the discipline (...) referred to as the classical humanities approach and the humanistic psychology approach which roughly approximate the cognitive and affective approaches respectively. These two approaches are compared and contrasted in terms of their goals, objectives, methods of implementation, philosophical assumptions and evaluational techniques. (shrink)

After noting why the issue of the use of animals in medical education and research needs to be addressed, this article briefly reviews the historical positions on the role of animals in society and describes in more detail the current positions in the wide spectrum of positions regarding the role of animals in society. The spectrum ranges from the extremes of the animal exploitation position to the animal liberation position with several more moderate positions in between these two extremes. Then (...) the philosophical issue of the moral agency of animals is discussed in terms of an explication of the concept of rights and the concept of personhood. Further research is suggested concerning institutional policies regarding medical students who refuse to do physiology dog labs or other assignments which involve the suffering and/or death of animals. (shrink)

In contrast to theoretical discussions about potential professional liability of clinical ethicists, this report gives the results of empirical data gathered in a national survey of clinical medical ethicists. The report assesses the types of activities of clinical ethicists, the extent and types of their professional liability coverage, and the influence that concerns about legal liability has on how they function as clinical ethicists. In addition demographic data on age, sex, educational background, etc. are reported. The results show that while (...) nearly one third (28.9%) of the ethicists regularly make recommendations about patient care, only 10.8% of them regularly make entries in the medical record; only approximately half (53.0%) of them are covered by professional liability (malpractice) insurance; and the vast majority (84.3%) of them say that concerns about legal liability do not influence the way they function as clinical ethicists. (shrink)

High moral standards and adherence to a moral code have long been strong tenets of the profession of medicine, even though there have been occasional lapses that have led to renewed calls for a revitalization of moral integrity in medicine. Certainly, a moral component has generally been held to be an important aspect of the concept of a physician.

The prominent call to legalise same-sex marriage in Australia raises questions concerning whether its achievement will result in amplified societal acceptance of lesbian, gay, bisexual, and transgender (LGBT) people, and on what grounds this acceptance will take place. Same-sex marriage may not challenge heteronormative and patriarchal features typically associated with marriage, and may serve to reinforce a hierarchy that promotes traditional marriage as the ideal relationship structure. This may result in only assimilationist acceptance of LGBT people. However, the consequence of (...) inclusion to marriage ought to reflect social acceptance of LGBTs as people worthy of equal treatment in dignity and in rights, regardless of perceived differences or similarities to a supposed majority standard. This article argues that justice would be best served by introducing and promoting a variety of State-sanctioned unions whilst simultaneously introducing same-sex marriage. This ‘pluralisation strategy’ would increase awareness and legitimacy of other relationship-recognition options, promoting respectful acceptance of LGBT and heterosexual people alike. (shrink)

Hate speech is one of the most important conceptual categories in anti‐oppression politics today; a great deal of energy and political will is devoted to identifying, characterizing, contesting, and penalizing hate speech. However, despite the increasing inclusion of gender identity as a socially salient trait, antipatriarchal politics has largely been absent within this body of scholarship. Figuring out how to properly situate patriarchy‐enforcing speech within the category of hate speech is therefore an important politico‐philosophical project. My aim in this article (...) is twofold: first, I argue that sexist speech, though oppressive, is not hate speech. Second, I argue that misogynistic speech is hate speech, even when it is intradivisional. This is important because recognizing that the concepthate speechapplies to certain forms of patriarchy‐enforcing speech is another step in clarifying what is wrong with the practice, and how bad it is in relation to other abuses. Consequently, this article provides a more nuanced account of the kinds of expressions that can and should count as instances of hate speech. (shrink)

The most important distinction in value theory is the subjective-objective distinction which determines the epistemological status of value judgments about medical intervention. Ethical decisions in medical intervention presuppose one of three structures of justification — namely, an inductive approach, a deductive approach which can be either consequentialist or non-consequentialist, and a uniquely ethical approach. Inductivism and deductivism have been discussed extensively in the literature and are only briefly described here. The uniquely ethical approach which presupposes value objectivism is analyzed in (...) detail. This method involves a purely ethical inference which moves from facts to values directly with an emphasis on reason which involves a non-logical justification (as opposed to illogical). It involves the use of natural practical arguments which have an imperative conclusion but no imperative premise and exhibit a value-requiredness between two states of affairs. (shrink)

Increasing use is made of techniques which are supposed to make policy decisions more ‘rational’. Rather little attention, however, has been paid to the relation between these techniques and the logic of choice, the political process, value judgements and assumptions. This short paper will investigate these questions in relation to a particularly fashionable technique, that of cost-benefit analysis.

The authors address problems with “compulsory” arbitration clauses in contracts. Specifically, they note that consumers are misguided about their rights in such cases. In addition, arbitration clauses do not allow the press to cover any proceedings that may result. The arbitration clauses in contracts are written in legalese that consumers do not understand. The authors found that even university students had difficulty understanding the information in such clauses. An example of an actual case is included.

Background The fourth section of the 1967 Abortion Act states that individuals (including health care practitioners) do not have to participate in an abortion if they have a conscientious objection. A conscientious objection is a refusal to participate in abortion on the grounds of conscience. This may be informed by religious, moral, philosophical, ethical, or personal beliefs. Currently, there is very little investigation into the impact of conscientious objection on service users in Britain. The perspectives of service users are imperative (...) in understanding the real-world consequences and potential impact of conscientious objection and should be considered when creating and reviewing policies and guidelines. This research provided a platform for women and those who can become pregnant to share their experiences and opinions at a time when these voices are largely excluded in the great tradition of Western political philosophy and law-making processes. Method Five service users were interviewed using a narrative interview approach to uncover their abortion journeys and experiences of conscientious objection. Findings The findings were presented as found poems and uncovered that doctors are not always: informing service users that they have a conscientious objection to abortion, giving service users enough information to access abortion (indirect referral), treating them non-judgmentally, and providing medically correct information. Service users did not experience burdens such as long waiting times and were still able to access legal abortion. However, service users did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred and/or were mistreated. Conclusions Findings indicate that conscientious objection could work in practice. However, it is currently failing some individuals on an emotional level, as not all doctors are adhering to guidelines. Conscientious objection in Britain needs to be addressed, to ensure service users receive fair, impartial, non-judgmental care. (shrink)

In the wake of a pilot study that indicated that the experience of medical education appears to Inhibit moral development In medical students, increased attention needs to be given to the structure of medical education and the Influence it has on medical students. Interest in ethics and moral reasoning has become widespread in many aspects of professional and public life. Society has exhibited great interest in the ethical issues confronting physicians today. Considerable effort has been undertaken to train medical students, (...) interns, and residents In how to reason through medical-ethical dilemmas. Media attention has focused on Issues such as abortion, euthanasia, care of severely handicapped infants, organ transplantation, and so forth, producing heated debates in both the professional and lay literature over the morality of the various positions. The curriculum of medical education has paralleled and reflected this general Interest in medical ethics. Most medical schools now offer, and frequently require, course work in ethics. However, further research Is needed to better characterize and understand the relationship of medical education to moral development. (shrink)

This book aims to understand why women are the targets of online hate speech and how we can stop this from occurring. -/- Why are women so frequently targeted with hate speech online and what can we do about it? Psychological explanations for the problem of woman-hating overlook important features of our social world that encourage latent feelings of hostility toward women, even despite our consciously-held ideals of equality. Louise Richardson-Self investigates the woman-hostile norms of the English-speaking internet, the (...) ‘rules’ of engagement in these social spaces, and the narratives we tell ourselves about who gets to inhabit such spaces. It examines the dominant imaginings (images, impressions, stereotypes, and ideas) of women that are shared in acts of hate speech, highlighting their ‘emotional stickiness’. But offering strategies through which we may reimagine our norms of online engagement, the stories that justify those norms, and the logic that makes sense of it all, this book shows how we can create alternative visions of what it means to take up online space as a woman and to ensure that women are seen as entitled to be there. By exploring aspects of ‘social imaginaries’ theory and applying it to the problem of hate speech against women online, this book illuminates why woman-hating has become such a prominent feature of this environment and how we can make these spaces safer for women. (shrink)

Does a liberal state, dedicated to the principles of freedom and equality, have a moral right to exclude? In her book, Liberal Self-Determination in a World of Migration, Luara Ferracioli makes a c...

The authors address problems with “compulsory” arbitration clauses in contracts. Specifically, they note that consumers are misguided about their rights in such cases. In addition, arbitration clauses do not allow the press to cover any proceedings that may result. The arbitration clauses in contracts are written in legalese that consumers do not understand. The authors found that even university students had difficulty understanding the information in such clauses. An example of an actual case is included.

Self‐explaining is an effective metacognitive strategy that can help learners develop deeper understanding of the material they study. This experiment explored if the format of material (i.e., text or diagrams) influences the self‐explanation effect. Twenty subjects were presented with information about the human circulatory system and prompted to self‐explain; 10 received this information in text and 10 in diagrams. Results showed that students given diagrams performed significantly better on post‐tests than students given text. Diagrams students also generated (...) significantly more self‐explanations that text students. Furthermore, the benefits of self‐explaining were much greater in the diagrams condition. To discover why diagrams can promote the self‐explanation effect, results are interpreted with reference to the multiple differences in the semantic, cognitive and affective properties of the texts and diagrams studied. (shrink)

In The Quantum Self, Danah Zohar argues that the insights of modem physics can illuminate our understanding of everyday life -- our relationships to ourselves, to others, and to the world at large. Guiding us through the strange and fascinating workings of the subatomic realm to create a new model of human consciousness, the author addresses enduring philosophical questions. Does the new physics provide a basis by which our consciousness might continue beyond death? How does the material world (for (...) instance, ugly inner cities) impinge upon our sense of self? Is there a subatomic wellspring from which our creativity, our empathy with others, and our feelings of unity with the inanimate world originate?Most important, Zohar shows how the vitality of the new physics combats the alienation and fragmentation of twentieth-century life, and replaces it with a model of reality in which the universe itself may possess a type of consciousness, of which human consciousness is one expression. (shrink)

In recent years, the theoretical work of Gilligan in women's psychological development has led to the development of the concept of moral orientation or moral voice in contrast to the concept of moral reasoning or moral judgment developed by Kohlberg. These concepts have been of particular interest in gender studies, especially as applied to adolescence. These concepts of moral orientation and moral reasoning are being increasingly employed in healthcare ethics studies in a wide variety of settings. The recent work has (...) included studies of physicians, nurses, dentists, veterinarians, social workers, teachers of medical ethics, and hospital ethics committees. However, the study of moral development in healthcare providers has been hampered because collecting the necessary data from healthcare workers has been labor intensive and extremely time consuming. More efficient methods are needed. (shrink)

The past two decades have been a time of heightened interest in the moral aspects of the practice of medicine. This interest has been reflected in medical education by the establishment of medical humanities programs in both preclinical and clinical education in many medical schools. It has also been reflected in the literature with a dramatic increase in journal articles on medical ethics as well as the development of medical ethics in textbooks. A number of journals have developed that are (...) specifically devoted to medical ethics, including The Journal of Medical Ethics, The Journal of Medicine and Philosophy, The Journal of Medical Humanities, Theoretical Medicine, Cambridge Quarterly of Healthcare Ethics, just to name a few. The literature includes both theoretical foundations and conceptual analyses of particular issues as well as practical advice and general suggestions for how to implement programs in medical humanities. (shrink)

Philosophers and psychologists have advanced a plethora of explanations of the self in relation to narratives, positing varying degrees of connection between them. For some, narratives created by a subject about herself shape her self-constitution (Flanagan 1991; Fivush 1994). For others, they help the subject to participate in social cognition (Hutto 2008). Some represent narratives as merely one basis of personal identity and consider them cognitive tools used by the subject to construct self-concepts (Neisser 1997; Tekin 2011); (...) others render narratives the basis for self-constitution (Dennett 1992; MacIntyre 1981; Schechtman 1996). Some require that the subject create her ‘whole life narrative’ unifying her .. (shrink)

Our approach bases on the explication of Rosanov’s creativity as the special intention, that implements the unspeakable Self-Selfness of Vasiliy Rosanov. The ineffability of Self-Selfness can be dialectical expressed by Rosanov through phenomena, of that consists the Rosanov’s world. This ineffability actualizes by Rosanov by means of understanding as a filled emptiness, that determinates the specialties and the structure of the understood objects. The exposition of this emptiness conditions the antinomies of Rosanov’s creativity: one sides is understanding by (...) Rosanov the closed world, other sides it corresponds with the world of things. Rosanov mythically fills the void, using the intimate personal contact with the things. We consider the creativity of Rosanov as the synthesis of both this global directions of Rosanov’s theory: the vision of understanding through things, this vision causes the special perception of things by Rosanov. The things are by Rosanov neither material objects, nor the ideal essences. This are by Rosanov the givens, inherent to the understanding. At the same time Rosanov examines the things through understanding, including it with help of the carnivalisation in his own special world. This method defines in our opinion style and content of Rosanov’s works. The thinker realizes by means of the carnivalisation the understanding, according to the concrete things, creating the special world of life (reality). For Rosanov this world is the second world. (shrink)

The Norman Rockwell image of the American physician who fixed the broken arm of a child, treated the father for hypertension, and brought an unborn child into this world is now almost nonexistent. Since the time of the Rockwell portrait, a highly technical medical industry has evolved. Now two-thirds of physicians are board certified in subspecialties, and patients visit an average of 3–4 different physicians per year. Today's physicians see themselves less as “benevolent and wise counselors overseeing the patient's welfare (...) and more as objective scientists applying the latest technical methods to bring about the desired end.” The intimate patient-physician relationship that was once the norm in our society is rapidly disappearing. (shrink)

This paper focuses on the question of whether and, if so, when people can be responsible for their self-deception and its consequences. On Intentionalist accounts, self-deceivers intentionally deceive themselves, and it is easy to see how they can be responsible. On Motivationist accounts, in contrast, self-deception is a motivated, but not intentional, and possibly unconscious process, making it more difficult to see how self-deceivers could be responsible. I argue that a particular Motivationist account, the Desire to (...) Believe account, together with other resources, best explains how there can be culpable self-deception. In the process, I also show how self-deception is a good test case for deciding important questions about the nature of moral responsibility. (shrink)

In this article I analyse two complaints of white vilification, which are increasingly occurring in Australia. I argue that, though the complainants (and white people generally) are not harmed by such racialized speech, the complainants in fact harm Australians of colour through these utterances. These complaints can both cause and constitute at least two forms of epistemic injustice (willful hermeneutical ignorance and comparative credibility excess). Further, I argue that the complaints are grounded in a dual misrecognition: the complainants misrecognize themselves (...) in their own privileged racial specificity, and they misrecognize others in their own marginal racial specificity. Such misrecognition preserves the cultural imperialism of Australia’s dominant social imaginary—a means of oppression that perpetuates epistemic insensitivity.Bringing this dual misrecognition to light best captures the indignity that is suffered by the victims of the aforementioned epistemic injustices. I argue that it is only when we truly recognize difference in its own terms, shifting the dominant social imaginary, that “mainstream Australians”can do their part in bringing about a just society. (shrink)

Only recently have ethicists been invited into the clinical setting to offer recommendations about patient care decisions. This paper discusses this new role for ethicists from the perspective of content and process issues. Among content issues are the usual ethical dilemmas such as the aggressiveness of treatment, questions about consent, and alternative treatment options. Among process issues are those that relate to communication with the patient. The formal ethics consult is discussed, the steps taken in such a consult, and whether (...) there should be a fee charged. We conclude with an examination of the risks and benefits of formal ethics consults. (shrink)

What started as a second edition of Theorizing Gender: An Introduction (co-authored by Annette Fitzsimons and Rosalind Minsky) instead became this self-conscious address on the metaphysics of sex and gender. The title of the book is telling. We are indeed doing gender theory in troubled times, and these troubled times are not separable from gender theory as it has developed over the decades.

According to the Stoics, ordinary unified bodies—animals, plants, and inanimate natural bodies—each have a single cause of unity and being: pneuma. Pneuma itself has no distinct cause of unity; on the contrary, it acts as a cause of unity and being for itself. In this paper, I show how pneuma is supposed to be able to unify itself and other bodies in virtue of its characteristic tensile motion (τονικὴ κίνησις). Thus, we will see how the Stoics could have hoped to (...) account for corporeal unity by positing another body (pneuma) apparently itself in need of unification. (shrink)