Although tissue plasminogen activator (tPA) is the only medication approved by the United States Food and Drug Administration (FDA) for acute ischemic stroke, there is no consensus about the need for informed consent for its use. As a result, hospitals throughout the U.S. have varying requirements regarding obtaining informed consent from patients for the use of tPA, ranging from no requirement for informed consent to a requirement for verbal or written informed consent. We conducted a study to (1) determine current (...) beliefs about obtaining patients’ informed consent for tPA among a large group of stroke clinicians and (2) identify the ethical, clinical, and organizational factors that influence tPA consent practices. Semi-structured interviews were conducted by trained and experienced investigators and research staff to identify key barriers to implementing acute stroke services. Part of the interview explored current beliefs and practices around informed consent for tPA.This was a multicenter study that included 38 Veterans Health Administration (VHA) hospital locations. Participants were 68 stroke team clinicians, serving primarily on the neurology (35 percent) or emergency medicine (41 percent) service. We conducted thematic analysis based on principles of grounded theory to identify codes about consent for tPA. We used interpretive convergence to ensure consistency among the individual investigators’ codes and to ensure that all of the investigators agreed on coding and themes.We found that 38 percent of the stroke clinicians did not believe any form of consent was necessary for tPA, 47 percent thought that some form of consent was necessary, and 15 percent were unsure. Clinicians who believed tPA required informed consent were divided on whether consent should be written (40 percent) or verbal (60 percent). We identified three factors describing clinicians’ attitudes about consent: (1) legal and policy factors, (2) ethical factors, and (3) medical factors.The lack of consensus regarding consent for tPA creates the potential for delays in treatment, uneasiness among clinicians, and legal liability. The identified factors provide a potential framework to guide discussions about developing a standard of care for acquiring the informed consent of patients for the administration of tPA. (shrink)

Individuals with a balanced time perspective, which includes good thoughts about the past, awareness of present constraints and adaptive planning for a positive future, are more likely to report optimal wellbeing. However, people who have had traumas such as adverse childhood experiences (ACEs) are likely to have less balanced time perspectives and lower overall wellbeing when compared to those with fewer or no ACEs. Time perspective can be improved viatime-travel narrativesthat support people in feeling connected to a wise and loving (...) future version of themselves, an approach that has until now only been provided in counseling contexts. Our team used an iterative inclusive design process to shape a scalable time-travel narrative tool – a responsive and progressive web application calledTime Machine.Among other functionalities, Time Machine allowed people to record and listen to messages as if they were from and to their past and future selves. Using pre-planned as well aspost-hocanalyses, we analyzed quantitative and qualitative data from 96 paid design partners (participants) who were taken through a 26-day pilot study of the technology. Among other effects, the results revealed: (1) high engagement throughout the design process, (2) improvements in self-reported time perspective and overall wellbeing scores that were greater for those using Time Machine during an optional-use period, (3) twice as much improvement in overall wellbeing scores for design partners with high ACEs (16%) versus low ACEs (8%), and (4) feelings of unconditional love apparently mediating the relationship between scores on time perspective and overall wellbeing measures. We discuss the limitations of these results as well as implications for the future role of spiritually informed scalable time-travel narrative technologies in healthcare and wellness. (shrink)

While Kierkegaard creates characters who represent various ways of existing as lovers in the aesthetic and the ethical spheres, namely, Johannes the Seducer and Judge William, he does not have a corresponding character for love in the religious sphere. Is there truly only marginal space for romantic love in Kierkegaard’s religious sphere, or did his own personal history prevent him from being able to imagine what that might look like? This paper examines a commonly overlooked discourse, “On the Occasion of (...) a Wedding,” for Kierkegaardian insights on erotic love in the religious sphere. Against understanding erotic love as a moment (in the aesthetic sphere), or a duty (in the ethical sphere), this paper explores how “On the Occasion of a Wedding” recasts erotic love as gift. Kierkegaard stages the “imagined occasion” of a wedding as a phenomenological reduction through which love presents itself with gift‐like characteristics. Respecting the gift‐status of love transforms the lover into a grateful recipient rather than a seducer or a conqueror. This paper concludes that the proper response to love as gift would be neither to refuse it in favor of nihilistic uncertainty nor to possess it through triumphalistic objectivity, but to humbly embrace both its “already” and its “not yet” dimensions. (shrink)

In what follows, I draw on things I have found in Japanese discussions of bioethics in order to clarify some aspects of the ethics of biotechnological enhancement. In doing so it will, I hope, become evident that what we might call a “religious” component is in Japan somewhat differently construed than in the contexts with which we are more likely to be familiar in North America. And in the end an attempt will be made here to show that the materials (...) considered give us all – not just the Japanese – reasons for going forward with biological enhancement technologies only on condition that extreme caution be exercised. The fast-moving, oncoming traffic in this domain ought to be forced, these materials suggest, to come up to a caution-demanding signal – not a green light but one that is unambiguously amber. Caution and perhaps even a full stop appear to be in order. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reading Audio BooksWilliam IrwinI hide my audio book habit because most of my colleagues, and even some of my snobbier students, regard audio books as a sign of an impending dark age of mass illiteracy. Feeling uneasy, I wonder: when The Brothers Karamazov comes up in conversation am I obliged to "confess" that I listened to the unabridged audio book, but did not silently read the massive tome? Is (...) there a difference that makes a difference between listening to an audio book and reading a printed book?IPeople read less today, partly because reading silently is not social; we crave the company of loved ones at the end of the day, and so prefer to watch television with them. Silent reading does not fit today's multitasking lifestyle; you can listen to music while you drive or jog, but you cannot read a book. Or, then again, perhaps you can, if listening to an audio book is reading after all. Time does not need to be specifically set aside for an audio book the way it does with a conventional book—the lights don't even have to be on. And surprisingly, it is satisfying to listen to a book ten minutes at a time while running errands. Perhaps this is because getting started is as easy as pressing a button. By contrast, few people read printed books in ten minute blocks, presumably because it takes something for most people to warm up to reading. If they are going to read, then they are going to do it for a sustained time—something longer than a ten-minute block. It is easier to "push through" and finish an audio book. I nearly gave up on Catch-22; it's too thick and over the top with satire for my taste. And I surely would have given up on it if I had been reading the book silently. I stuck with [End Page 358] the audio book, however, largely because it was easy to continue; I just pressed play every time I got in my car.Books on tape have been available for quite some time, but, despite often being abridged, they were too clunky and cumbersome for most people. The availability of books on CD and for MP3 download makes it all much more convenient. Audio books are now the fastest growing segment of the book industry and are likely to become even more common and popular, perhaps some day eclipsing the sale of conventional books, perhaps some day becoming the normal way of "reading" literature. And far from being abridged, some audio books today include extras. For example, the audio version of The Amber Spyglass includes epigrams before each chapter that are not in the print version.IIHarold Bloom says, "Deep reading really demands the inner ear as well as the outer ear. You need the whole cognitive process, that part of you which is open to wisdom. You need the text in front of you."1 Before listening to audio books myself I would have agreed with Bloom; but now I suspect he simply has never listened to an audio book. Skeptical of literature on audio, I started my audio experience with nonfiction. Pleasantly surprised with nonfiction, I tried listening to fiction and found the presentation very different. Nonfiction books are simply read, whereas works of fiction are typically performed—characters get distinct voices and the reader really puts on a show. Most audio book performances of literature are much like a one-man play, taking us back to the days of traveling bards and rhapsodes.In The Performance of Reading Peter Kivy highlights that for most of its history Western literature has been experienced out loud.2 As is well known, Homer's Iliad and Odyssey were performed out loud by bards, as Beowulf was centuries later. But less well known is the fact that even after the invention of the printing press, when books were still scarce and expensive, even people in possession of books generally read them out loud to themselves and to others. So it is odd that along with Harold Bloom, my colleagues and students, look with mistrust at... (shrink)

The claim that happiness and virtue ought to be proportionate to one another has often been expressed in the idea of a future world of divine justice, despite many moral difficulties with this idea. This paper argues that human efforts to enact such a proportionment are, ironically, justified by the same reasons that make the idea of divine justice seem so problematic. Moralists have often regarded our frailty and fallibility as reasons for abstaining from the judgment of others; and doubts (...) about our deserving some proportionment of happiness or unhappiness often arise insofar as virtue and vice may be explained on a causal basis. This paper argues that our fallibility and our susceptibility to social influence render judgment and response indispensable, because – given these characteristics – our actions and responses decide the morality that we actually share with one another. In this situation, to ‘judge not’ is to abandon the field to those with no such scruples. (shrink)

Bernard Williams is remembered as one of the most brilliant and original philosophers of the past fifty years. Widely respected as a moral philosopher, Williams began to write about politics in a sustained way in the early 1980s. There followed a stream of articles, lectures, and other major contributions to issues of public concern--all complemented by his many works on ethics, which have important implications for political theory. This new collection of essays, most of them previously unpublished, addresses (...) many of the core subjects of political philosophy: justice, liberty, and equality; the nature and meaning of liberalism; toleration; power and the fear of power; democracy; and the nature of political philosophy itself. A central theme throughout is that political philosophers need to engage more directly with the realities of political life, not simply with the theories of other philosophers. Williams makes this argument in part through a searching examination of where political thinking should originate, to whom it might be addressed, and what it should deliver. Williams had intended to weave these essays into a connected narrative on political philosophy with reflections on his own experience of postwar politics. Sadly he did not live to complete it, but this book brings together many of its components. Geoffrey Hawthorn has arranged the material to resemble as closely as possible Williams's original design and vision. He has provided both an introduction to Williams's political philosophy and a bibliography of his formal and informal writings on politics. Those who know the work of Bernard Williams will find here the familiar hallmarks of his writing--originality, clarity, erudition, and wit. Those who are unfamiliar with, or unconvinced by, a philosophical approach to politics, will find this an engaging introduction. Both will encounter a thoroughly original voice in modern political theory and a searching approach to the shape and direction of liberal political thought in the past thirty-five years. (shrink)

First published in 2000. Routledge is an imprint of Taylor & Francis, an informa company.

Bernard Williams; XIV*—The Truth in Relativism, Proceedings of the Aristotelian Society, Volume 75, Issue 1, 1 June 1975, Pages 215–228, https://doi.org/10.1093.

What can--and what can't--philosophy do? What are its ethical risks--and its possible rewards? How does it differ from science? In Philosophy as a Humanistic Discipline , Bernard Williams addresses these questions and presents a striking vision of philosophy as fundamentally different from science in its aims and methods even though there is still in philosophy "something that counts as getting it right." Written with his distinctive combination of rigor, imagination, depth, and humanism, the book amply demonstrates why Williams (...) was one of the greatest philosophers of the twentieth century. Spanning his career from his first publication to one of his last lectures, the book's previously unpublished or uncollected essays address metaphysics, epistemology, and ethics, as well as the scope and limits of philosophy itself. The essays are unified by Williams's constant concern that philosophy maintain contact with the human problems that animate it in the first place. As the book's editor, A. W. Moore, writes in his introduction, the title essay is "a kind of manifesto for Williams's conception of his own life's work." It is where he most directly asks "what philosophy can and cannot contribute to the project of making sense of things"--answering that what philosophy can best help make sense of is "being human." Philosophy as a Humanistic Discipline is one of three posthumous books by Williams to be published by Princeton University Press. In the Beginning Was the Deed: Realism and Moralism in Political Argument was published in the fall of 2005. The Sense of the Past: Essays in the History of Philosophy is being published shortly after the present volume. (shrink)

‘Responsibilist' approaches to epistemology link knowledge and justification with epistemically responsible belief management, where responsible management is understood to involve an essential element of guidance by recognized epistemic norms. By contrast, reliabilist approaches stress the de facto reliability of cognitive processes, rendering epistemic self-consciousness as inessential. I argue that, although an adequate understanding of human knowledge must make room for both responsibility and reliability, philosophers have had a hard time putting them together, largely owing to a tendency, on the part (...) of responsibilists, to adopt an overly demanding, hyperintellectualized conception of what epistemic responsibility demands. I trace this tendency towards hyper-intellectualism to a wish to meet scepticism head on, a wish that enforces adherence to a particular model of the structure of epistemic justification. I argue that a more humanly reasonable conception of epistemic justification suggests an alternative model. With this model in hand, we can both deflect sceptical problems and combine responsibility with reliability in a satisfying way. Philosophical Papers Vol. 37 (1) 2008: pp. 1-26. (shrink)

The rapid implementation and continuing expansion of forensic DNA databases around the world has been supported by claims about their effectiveness in criminal investigations and challenged by assertions of the resulting intrusiveness into individual privacy. These two competing perspectives provide the basis for ongoing considerations about the categories of persons who should be subject to non-consensual DNA sampling and profile retention as well as the uses to which such profiles should be put. This paper uses the example of the current (...) arrangements for forensic DNA databasing in England and Wales to discuss the ways in which the legislative and operational basis for police DNA databasing is reliant upon continuous deliberations over these and other matters by a range of key stakeholders. We also assess the effects of the recent innovative use of DNA databasing for “familial searching” in this jurisdiction in order to show how agreed understandings about the appropriate uses of DNA can become unsettled and reformulated even where their investigative effectiveness is uncontested. We conclude by making some observations about the future of what is recognized to be the largest forensic DNA database in the world. (shrink)

There has been a renewed interest in psychology and anthropology in the idea of altered states of consciousness. This paper begins by examining the meaning of this term and the extent to which such experiences are reported globally. The topic of shamanism is then discussed, first with respect to its social functions, and then to what is known about its psychological aspects (which is little). Far more is known about altered states of consciousness (ASCs) as they are expressed in meditation, (...) trance and possession, and channeling, and a number of studies are reviewed, both of individuals and of groups, which illustrate the full extent of ASCs. The following section then goes more deeply into the stimulus situations that are associated with ASCs. This brings the discussion into drugs, attempts at altering the sensorium (music and imagery in particular) and recent technological innovations, peculiar to our time, which deliberately alter our usual state of awareness through feedback principles. In the final section, what is known about the physiology of ASCs is reviewed and also the extent to which these phenomena, including shamanism, are regarded as pathological. As a great number of people across the world utilize the healing aspects of trance, possession and shamanic practices, this aspect is discussed, and lastly the adaptive functions of ASCs are considered, with their context in the history of psychology. (shrink)

"Translated with an uncanny sense for the overall point of Augustine's doctrine. In short, a very good translation. The Introduction is admirably clear." --Paul Vincent Spade, Indiana University.

When it first appeared in 1979, Philosophy and the Mirror of Nature hit the philosophical world like a bombshell. In it, Richard Rorty argued that, beginning in the seventeenth century, philosophers developed an unhealthy obsession with the notion of representation: comparing the mind to a mirror that reflects reality. Rorty's book is a powerful critique of this imagery and the tradition of thought that it spawned. Thirty years later, the book remains a must-read and stands as a classic of twentieth-century (...) philosophy. Its influence on the academy, both within philosophy and across a wide array of disciplines, continues unabated. This edition includes new essays by philosopher Michael Williams and literary scholar David Bromwich, as well as Rorty's previously unpublished essay "The Philosopher as Expert.". (shrink)

New foreword written by HeritageMom, Amber O'Neal Johnston. "During a time when the United States needed to be reminded of the contributions Black people have made to its democracy, freedom, music, literature, and more, W.E.B. Du Bois took on the task of enumerating the gifts that we've provided to our country. "When I began reading The Gift of Black Folk...the story that unfolded was one that I had never anticipated. We the People of the United States, all of us, (...) have left our indelible mark on America the Beautiful." -Amber O'Neal Johnston In 1924, William Edward Burghardt (W.E.B.) Du Bois (1868-1963) penned The Gift of Black Folk in response to systemic racism in the United States, showing that "...the American spirit is a new and interesting result of diverse threads of thought and feeling coming not only from America but from Europe and Asia and indeed from Africa." Du Bois was the first African American to earn a Ph.D. from Harvard University, and later became a professor of history, sociology, and economics at Atlanta University. In 1909 he co-founded the NAACP. Du Bois was a lifelong leader and proponent of civil rights. Amber O'Neal Johnston is a writer, speaker, and home educator who blends life-giving books with a culturally-rich environment for her four children and others. She's the author of A Place to Belong, a guide for families of all backgrounds to celebrate cultural heritage and embrace inclusivity in the home and beyond, and she's known for sharing literary "mirrors and windows" on HeritageMom.com. (shrink)

Inclusive fitness theory provides a compelling explanation for the evolution of altruism among kin. However, a completely satisfactory account of non-kin altruism is still lacking. The present study compared the level of altruism found among siblings with that found among friends and mates and sought to reconcile the findings with an evolutionary explanation for human altruism. Participants (163 males and 156 females) completed a questionnaire about help given to a sibling, friend, or mate. Overall, participants gave friends and mates as (...) much or more help than they gave siblings. However, as the cost of help increased, siblings received a progressively larger share of the help, whereas friends and mates received a progressively smaller share, despite the fact that participants were closer emotionally to friends and mates than they were to siblings. These findings help to explain the relative standing of friends and mates as recipients of altruistic aid. (shrink)

Volume 34, Issue 8, December 2020, Page 1632-1645.

If you accept evolutionary theory, can you also believe in God? Are human beings superior to other animals, or is this just a human prejudice? Does Darwin have implications for heated issues like euthanasia and animal rights? Does evolution tell us the purpose of life, or does it imply that life has no ultimate purpose? Does evolution tell us what is morally right and wrong, or does it imply that ultimately 'nothing' is right or wrong? In this fascinating and intriguing (...) book, Steve Stewart-Williams addresses these and other fundamental philosophical questions raised by evolutionary theory and the exciting new field of evolutionary psychology. Drawing on biology, psychology and philosophy, he argues that Darwinian science supports a view of a godless universe devoid of ultimate purpose or moral structure, but that we can still live a good life and a happy life within the confines of this view. (shrink)

What is the real significance of covariance anyway, and why should it be regarded as so fundamental ? What we mean by a covariant expression is one whose ...

Research in education and cognitive development suggests that explaining plays a key role in learning and generalization: When learners provide explanations—even to themselves—they learn more effectively and generalize more readily to novel situations. This paper proposes and tests a subsumptive constraints account of this effect. Motivated by philosophical theories of explanation, this account predicts that explaining guides learners to interpret what they are learning in terms of unifying patterns or regularities, which promotes the discovery of broad generalizations. Three experiments provide (...) evidence for the subsumptive constraints account: prompting participants to explain while learning artificial categories promotes the induction of a broad generalization underlying category membership, relative to describing items (Exp. 1), thinking aloud (Exp. 2), or free study (Exp. 3). Although explaining facilitates discovery, Experiment 1 finds that description is more beneficial for learning item details. Experiment 2 additionally suggests that explaining anomalous observations may play a special role in belief revision. The findings provide insight into explanation’s role in discovery and generalization. (shrink)

Williams did not think of political problems as a mere adjunct to ethical questions. He believed that there can be no timeless justification of political power, which he takes Kant and Rawls to aim at. Likewise, liberalism ignores that legitimation depends on historical circumstances. Williams’s historical relativism comes hand in hand with a realism that makes him object to utopian theories. To him, political projects are “essentially conditioned, not just in their background intellectual conditions but as a matter (...) of empirical realism, by their historical circumstances.”. (shrink)

People’s perception of their own efficacy is a critical precursor for adaptive behavioural responses to the threat posed by climate change. The present study investigated whether components of climate efficacy could be enhanced by short video messages. An online study (N = 161) compared groups of participants who received messages focusing on individual or collective behaviour. Relative to a control group, these groups showed increased levels of response efficacy but not self-efficacy. However, this did not translate to increased climate commitment; (...) mediation analysis suggested that the video messages, while increasing efficacy, may also have had a counterproductive effect on behavioural intentions, possibly by reducing the perceived urgency of action. This finding reinforces the challenge faced by climate communicators seeking to craft a message that boosts efficacy and simultaneously motivates adaptive responses to the climate crisis. (shrink)

This article discusses a Leverhulme residency undertaken by the author Julie Brixey-Williams in 2003–4 at the Association of Anaesthetists of Great Britain and Ireland. Notions of medical visibility were explored through practice-led investigations under the umbrella title, Traces of the Invisible, that concentrated on making concrete, visible responses to the hidden or intangible elements of the anesthetist’s working life in areas such as sleep, breath, pain and genetic markers. Rosebud is a unique nine-foot concertina bookwork created after reading the (...) entire story of The Sleeping Beauty into an anesthetic machine. This essay expands upon the concepts and material responses that led to the making of the book with particular reference to how the book’s structure forms a relationship to language and the body-as-site, whilst operating as a sculptural object that raises the visibility of the anesthetic profession. Fairy tales and their telling, including stories of enchanted sleep, transformational qualities, magical languages and shaman healers, will be examined alongside. (shrink)

Can we understand what makes someone the same person without understanding what it is to be a person? Prereflectively we might not think so, but philosophers often accord these questions separate treatments, with personal-identity theorists claiming the first question and free-will theorists the second. Yet much of what is of interest to a person—the possibility of survival over time, compensation for past hardships, concern for future projects, or moral responsibility—is not obviously intelligible from the perspective of either question alone. Marya (...) Schechtman encourages us to adopt a more unified perspective. (shrink)

Frontiers in Belief Revision is a unique collection of leading edge research in Belief Revision. It contains the latest innovative ideas of highly respected and pioneering experts in the area, including Isaac Levi, Krister Segerberg, Sven Ove Hansson, Didier Dubois, and Henri Prade. The book addresses foundational issues of inductive reasoning and minimal change, generalizations of the standard belief revision theories, strategies for iterated revisions, probabilistic beliefs, multiagent environments and a variety of data structures and mechanisms for implementations. This book (...) is suitable for students and researchers interested in knowledge representation and in the state of the art of the theory and practice of belief revision. (shrink)

This article starts from the assumption that there are various innate contributions to our view of the world and explores the epistemological implications that follow from this. Specifically, it explores the idea that if certain components of our worldview have an evolutionary origin, this implies that these aspects accurately depict the world. The simple version of the argument for this conclusion is that if an aspect of mind is innate, it must be useful, and the most parsimonious explanation for its (...) usefulness is that it accurately depicts the world. There are a number of important criticisms of this argument. These include the idea that evolutionary justifications are circular, that evolved mental content and principles are not necessarily accurate, and that, if the argument is taken seriously, it has some highly dubious consequences. These criticisms necessitate various qualifications to the initial argument. Nonetheless, it is argued that, in some cases, important conclusions can be drawn about the world from an analysis of evolved contributions to our view of the world. An evolutionary approach cannot provide an ultimate justification for any belief; however, in certain circumstances, it supports the conclusion that a given belief is a reasonable first approximation. To the extent that innate content and principles pertain to topics in metaphysics, they can be viewed as a naturalistic source of metaphysical knowledge. (shrink)

I formulate a counterfactual version of the notorious 'Ramsey Test'. Whereas the Ramsey Test for indicative conditionals links credence in indicatives to conditional credences, the counterfactual version links credence in counterfactuals to expected conditional chance. I outline two forms: a Ramsey Identity on which the probability of the conditional should be identical to the corresponding conditional probabihty/expectation of chance; and a Ramsey Bound on which credence in the conditional should never exceed the latter.Even in the weaker, bound, form, the counterfactual (...) Ramsey Test makes counterfactuals subject to the very argument that Lewis used to argue against the indicative version of the Ramsey Test. I compare the assumptions needed to run each, pointing to assumptions about the time-evolution of chances that can replace the appeal to Bayesian assumptions about credence update in motivating the assumptions of the argument.I finish by outlining two reactions to the discussion: to indicativize the debate on counterfactuals; or to counterfactualize the debate on indicatives. (shrink)

Each of the three volumes of Erasmus Francisci’s Acerra Exoticorum (1672-74), a collection of stories and reports from all corners of the known world, begins with a Vorrede to the reader. These texts address the rationale for his work, apologize for errors in spelling and/or meaning, and outline his thinking about stories and histories, or more precisely, the difference between reports of current events and histories proven true by the test of time. Each of the three tomes offers stories from (...) all over the known world, gathered and arranged without any easily perceptible organizing principle. Still, some of the narratives do suggest a teaching or moralizing function, while others seem to serve mostly to inform and entertain introducing the reader to »meldungswürdige Sitten/ Gewonheiten / so wol als andrer anmercklicher Sachen außheimischer Sachen,« as truthfully and historically accurate as possible. Francisci presents his Acerra Exoticorum as a receptacle of events outside of Germany. He will inform the reader about old and new »Ordnungen und Gewohnheiten,« corroborated by the writings of trusted authors. While paying special attention to the programmatic Vorreden of the three Acerra-volumes, I will examine how Francisci handles both textual and narrative varieties, news reports and historical texts, and what this tells us about his historical, cultural, and geographic reach. (shrink)