Recent frameworks, models, and reports highlight the critical need to address social determinants of health for achieving health equity in the United States and around the globe. In the United States, data play an important role in better understanding community‐level and population‐level disparities particularly for local health departments. However, data‐driven decision‐making—the use of data for public health activities such as program implementation, policy development, and resource allocation—is often presented theoretically or through case studies in the literature. We sought to develop (...) a preliminary model that identifies the factors that contribute to data‐driven decision‐making in US local health departments and describe relationships between them. Guided by implementation science literature, we examined organizational‐level capacity and individual‐level factors contributing to using data for decision‐making related to social determinants of health and the reduction of county‐level disparities. This model has the potential to improve implementation of public health interventions and programs aimed at upstream structural factors, by elucidating the factors critical to incorporating data in decision‐making. (shrink)

There are two main ways of understanding the function of surrogate decision making in a legal context: the Best Interests Standard and the Substituted Judgment Standard. First, we will argue that the Best Interests Standard is difficult to apply to unconscious patients. Application is difficult regardless of whether they have ever been conscious. Second, we will argue that if we accept the least problematic explanation of how unconscious patients can have interests, we are also obliged to accept that the Substituted (...) Judgment Standard can be coherently applied to patients who have never been conscious at the same extent as the Best Interests Standard. We then argue that acknowledging this result is important in order to show patients respect. (shrink)

This article discusses two normative questions raised by cases of colonial settlement. First, is it sometimes wrong to migrate and settle in a previously inhabited land? If so, under what conditions? Second, should settler countries ever take steps to undo wrongful settlement, by enforcing repatriation and return? The article argues that it is wrong to settle in another country in cases where one comes with intent to colonize the population against their will, or one possesses an adequate territorial base somewhere (...) else, lacks an urgent interest in moving, and seeks to settle in a new place under conditions where settlement would severely harm the practices of prior occupants. It also argues for a presumption of repatriation and return in the first generation of wrongful settlement and holds that these remedies may be extended to second and higher generations in some – but not all – cases. (shrink)

This chapter contains sections titled: The Saying and the Said Subjectivity as Sensibility Ethics of Difference or an Ethics of Truths? Reading Levinas with Badiou: Impossibly Demanding? An Impossibly Demanding Education Notes.

SummaryIan Hunter's normative commitment is to civil philosophy. His sustained critique of metaphysical philosophy is to be understood in the context of his proposition that civil and moral philosophy are at war. Since civil philosophy is the only guarantor of social peace, the stakes are high.

Over the last decade, states have increasingly emphasised the importance of integration, and translated it into legal regulations that demand integration from immigrants. This paper criticises a specific aspect to this development, namely the tendency to make permanent residency dependent on language skills and, as such, seeks to raise doubts as to the moral acceptability of the requirement of linguistic integration. The paper starts by arguing that immigrants after a relatively short period of time acquire a moral claim to permanent (...) residency in their host country. Accordingly, states may not limit residency at their discretion. Nevertheless, three arguments may seem promising for defending the requirement of linguistic integration: that the immigrants’ moral claim conflicts with a stronger moral claim on the part of the larger society, and this makes an infringement of the immigrants’ claim proportionate; that language requirements may be legally demanded as a precondition for permanent residency for the immigrants’ own sake; and that language requirements are defensible, as far as immigrants may be understood to have consented to such regulation upon entry to the country. This paper argues that all three must be rejected. (shrink)

The Brentanian idea that every state of consciousness involves a consciousness or awareness of itself (Brentano 1874), which has been a central tenet of the phenomenological school, is a current topic in contemporary philosophical debates about consciousness and subjectivity, both in the continental and the analytic tradition. Typically, the self-awareness that accompanies every state of consciousness is char­acterized as pre-reflective. Most theorists of pre-reflective self-awareness seem to converge on a negative characterization: pre-reflective self-awareness is not a kind of reflective awareness. (...) Whereas reflective self-awareness is attentive and descriptive, pre-reflective self-awareness is non-attentive and non-descriptive.This paper aims to show that the reflective/pre-reflective dichotomy overlooks a finer-grained distinction. The first part is devoted to arguing that the typical use of the adjective ‘pre-reflective’ conflates two properties (non-attentiveness and non-descriptiveness), which are in fact separable. Accordingly, not only can there be non-descriptive and non-attentive self-consciousness (i.e. pre-reflective self-awareness), but also non-descriptive but attentive self-consciousness. I call the latter primitive introspection. The second part of the paper is devoted to arguing that, whereas both pre-reflective self-awareness and primitive introspection enable the subject to apprehend the phenomenology of their experience, the kind of apprehension each allows for is different. By analyzing the notion of apprehension in terms of information acquisition and personal-level availability of information, it is proposed that, although both pre-reflective self-awareness and primitive introspection allow for acquisition of the maximal amount of information about the experience, only primitive introspection makes all such information personal-level available. (shrink)

It is well known that languages differ in how they encode motion. Languages such as English use verbs that communicate the manner of motion (e.g., climb, float), while languages such as Greek often encode the path of motion in verbs (e.g., advance, exit). In two studies with English- and Greek-speaking adults and 5-year-olds, we ask how such lexical constraints are used in combination with structural cues in hypothesizing meanings for novel motion verbs cross-linguistically. We show that lexicalization biases affect the (...) interpretations of motion verbs in both young children and adults across different languages; furthermore, their scope of application is larger than previously thought, since they also extend to the domain of caused motion events. Crucially, we find that the language-specific effects of such biases interact with universal mappings between syntactic structure and semantic content. Finally, we demonstrate that the combined effects of lexical and structural cues shift non-linguistic biases observed during event categorization: even though speakers of English and Greek share non-linguistic preferences in categorizing spontaneous and caused motion, they focus on different components of motion events when building hypotheses about the meaning of novel motion verbs. (shrink)

This paper aims to critique the phenomenon of advanced patient autonomy and choice in healthcare within the specific context of self-testing devices. A growing number of self-testing medical devices are currently available for home use. The premise underpinning many of these devices is that they assist individuals to be more autonomous in the assessment and management of their health. Increased patient autonomy is assumed to be a good thing. We take issue with this assumption and argue that self-testing provides a (...) specific example how increased patient autonomy and choice within healthcare might not best serve the patient population. We propose that current interpretations of autonomy in healthcare are based on negative accounts of liberty to the detriment of a more relational understanding. We also propose that Kantian philosophy is often applied to the healthcare arena in an inappropriate manner. We draw on the philosophical literature and examples from the self-testing process to support these claims. We conclude by offering an alternative account of autonomy based on the interrelated concepts of relationality, care and responsibility. (shrink)

A co-actor’s intentionality has been suggested to be a key modulating factor for joint action effects like the joint Simon effect (JSE). However, in previous studies intentionality has often been confounded with agency defined as perceiving the initiator of an action as being the causal source of the action. The aim of the present study was to disentangle the role of agency and intentionality as modulating factors of the JSE. In Experiment 1, participants performed a joint go/nogo Simon task next (...) to a co-actor who either intentionally controlled a response button with own finger movements (agency+/intentionality+) or who passively placed the hand on a response button that moved up and down on its own as triggered by computer signals (agency-/intentionality-). In Experiment 2, we included a condition in which participants believed that the co-actor intentionally controlled the response button with a Brain-Computer Interface while placing the response finger clearly besides the response button, so that the causal relationship between agent and action effect was perceptually disrupted (agency-/intentionality+). As a control condition, the response button was computer controlled while the co-actor placed the response finger besides the response button (agency-/intentionality-). We observed a JSE when the co-actor responded intentionally and the causal relationship between co-actor and action effect could be perceived, but not when the co-actor did not respond intentionally and the causal relationship was disrupted (Experiment 1). When the intentionality of the co-actor was maintained but the perception of the causal relationship between co-actor and action effect destroyed, the JSE was absent (Experiment 2). Our findings clearly indicate a vital role of a co-actor’s agency for the JSE and suggest that the ascription of agency is strongly perceptually grounded. (shrink)

Languages differ systematically in how they map path and manner of motion onto lexical and grammatical structures (Talmy, 1985). Manner languages (e.g., English, German and Russian) typically code manner in the verb (cf. English skip, run, hop, jog), and path in a variety of other devices such as particles (out), adpositions (into the room), verb affixes, etc. Path languages (e.g., Modern Greek, Romance, Turkish, Japanese and Hebrew) typically code path in the verb (cf. Greek vjeno ‘exit’, beno ‘enter’, ftano ‘reach’, (...) aneveno ‘ascend’, diashizo ‘cross’), and manner in adverbials (trexontas ‘running’, me ta podia ‘on foot’, jrigora ‘quickly’). The distinction is not meant to imply that the relevant languages lack certain kids of verb altogether. For instance, English has path verbs, such as enter, exit, ascend and descend, and Greek has manner verbs, such as treho ‘run’, kilao.. (shrink)

One of the tasks of language learning is the discovery of the intricate division of labour between the lexical-semantic content of an expression and the pragmatic inferences the expression can be used to convey. Here we investigate experimentally the development of the semantics– pragmatics interface, focusing on Greek-speaking five-year-olds’ interpretation of aspectual expressions such as arxizo (‘ start ’) and degree modifiers such as miso (‘ half ’) and mexri ti mesi (‘ halfway ’). Such expressions are known to give (...) rise to scalar inferences crosslinguistically : for instance, start, even though compatible with expressions denoting completion (e.g. finish), is typically taken to implicate non-completion. Overall, our experiments reveal that children have limited success in deriving scalar implicatures from the use of aspectual verbs but they succeed with ‘ discrete ’ degree modifiers such as ‘ half ’. Furthermore, children are better at spontaneously computing scalar implicatures than judging the pragmatic appropriateness of scalar statements. Finally, children can suspend scalar implicatures in environments where they are not supported. We discuss implications of these results for the scope and limitations of children’s ability to both acquire the lexical semantics of aspectuals and to compute implicatures as part of what the speaker means. (shrink)

Midwest Studies In Philosophy, Volume 44, Issue 1, Page 195-212, December 2019.

It is widely assumed in the developmental literature that certain classes of modal expression appear later in language acquisition than others; specifically, epistemic interpretations lag behind non-epistemic interpretations. An explanation for these findings is proposed in terms of the child’s developing theory of mind, i.e. the ability to attribute to oneself and others mental representations, and to reason inferentially about them. It is hypothesized that epistemic modality crucially implicates theory-of-mind abilities and is therefore expected to depend on prior developments in (...) the child's ability to handle representations of mental representations. In support of this hypothesis, it is shown that autistic individuals have difficulty with epistemics. (shrink)

Wittgenstein likens philosophy both to an illness and to a therapy. The reflections he dedicates to mental disturbance in On Certainty shed some light on this ambivalence, by pointing at the intertwined themes of common sense, doubt, mistake, reasonableness, and normality. Wittgenstein’s remarks have sometimes been compared to the description of the symptoms of what psychopathologists have called the loss of natural self-evidence, or the loss of common sense. Besides briefly recalling some of the outcomes of this debate in literature, (...) I focus on Wittgenstein’s conception of “hinges”, the basic practical certainties which patients suffering from the loss of common sense seem to lack. By working on this comparison, I offer an interpretation of Wittgenstein’s idea of philosophy that clarifies both its insane and its therapeutic side. (shrink)

This article explores the influence of Émile Durkheim on the philosophy of Emmanuel Levinas in order both to open up the political significance of Levinas’s thought and to develop more expansive meanings of moral and political community within education. Education was a central preoccupation for both thinkers: Durkheim saw secular education as the site for promoting the values of organic solidarity, while Levinas was throughout his professional life engaged in debates on Jewish education and conceptualized ethical subjectivity as a condition (...) of being taught. Durkheim has been accused of dissolving the moral into the social, and his view of education as a means of imparting a sense of civic republican values is sometimes seen as conservative, while Levinas’s argument for an ‘unfounded foundation’ for morality is sometimes seen as paralyzing the impetus for concrete political action. Against these interpretations, I argue that their approaches present provocative challenges for conceptualizing the nature of the social, offering theoretical resources to deepen understanding of education as the site of an everyday ethics and a prophetic politics opening onto more compelling ideals for education than those dominant within standard educational discourses. (shrink)

In this paper, a rights-based argument for the impermissibility of abortion, infanticide and neglect of some pre-natal organisms and infants/children is advanced. I argue, in opposition to most rights-ethicists, that the potentiality for autonomous agency gives individuals negative rights. I also examine the conjecture that potential autonomous agents have positive rights in virtue of their vulnerability. According to this suggestion, once an individual obtains actual autonomous agency, he or she has merely negative rights. Possible solutions to conflicts of rights between (...) parents and their offspring are investigated. Finally, I discuss a lexical order between positive and negative rights, which may solve conflicts between the rights of potential autonomous agents and actual autonomous agents. (shrink)

Self‐care, or self‐management, is presented in healthcare policy as a precursor to patient empowerment and improved patient outcomes. Alternatively, critiques of the self‐care agenda suggest that it represents an over‐reliance on individual autonomy and responsibility, without adequate support, whereby ‘self‐care’ is potentially unachievable and becomes ‘care left undone’. In this sense, self‐care contributes to a blame culture where ill‐health is attributed to personal behaviours or lack thereof. Furthermore, self‐care may represent a covert form of rationing, as the fiscal means to (...) enable effective self‐care and supplement, or replace, self‐care capacities, is not provided. This paper explores these arguments through a contemporary ethical analysis of the self‐care agenda. The terms self‐care and self‐management are used interchangeably throughout whereby self‐management is understood as a point in the wider self‐care continuum. (shrink)

Cet article commence par revenir sur certains thèmes et enjeux des contributions présentées dans le volume. Il évoque ensuite les problèmes liés aux paradigmes épistémologiques employés dans l’étude du rapport entre animaux et religions antiques, en proposant quelques pistes de réflexion pour la recherche sur ce thème.

Introduction:Healthcare workers facing the threatening COVID-19 can experience severe difficulties. Despite the need to evaluate both the psychological distress and positive protective resources, brief and reliable assessment tools are lacking.Aim:Study 1 aimed at developing a new assessment tool to measure psychological distress and esteem in healthcare workers during the COVID-19 pandemic. Study 2 aimed to explore and compare the psychological reactions of healthcare workers of the COVID-19 and the non-COVID-19 wards.Methods:In Study 1, psychologists created 25 items based on their clinical (...) experience. A preliminary qualitative evaluation selected the best 15 items for the new tool assessing the COVID-19 psychological impact with 2 scales: psychological distress and esteem. The CPI-HP was administered to 110 healthcare professionals to study its psychometric properties and the internal structure with exploratory graph analysis and confirmatory factor analysis. Study 2 compared two groups of healthcare professionals of the COVID-19 and non-COVID-19 departments.Results:In Study 1, the CPI-HP showed satisfying psychometric properties, and the two-factor structure was confirmed with good fit indices. In Study 2, the two groups of healthcare workers showed comparable levels of psychological distress and resilient coping, but the COVID-19 group displayed significantly higher esteem and appreciation of the experience.Discussion:All operators showed high psychological distress during the emergency, but the COVID-19 group reported higher resources, probably due to stronger group cohesion and greater esteem, perceived meaning, and own work value.Conclusion:Assessing the psychological distress and resources of healthcare professionals with specific tools is important. Psychological interventions should promote their psychological health. (shrink)

For the past two decades, speech-act theory has been one of the basic tools for studying pragmatics from both a theoretical and an experimental perspective. In this paper, I want to discuss certain aspects of the theory with respect to data from early communication in children. My aim will be to show that some of the central assumptions of the speech-act model of utterance comprehension need to be rethought. In the second part of the paper, I will outline a different (...) pragmatic approach to verbal understanding and present a preliminary application of this approach to the developmental data. (shrink)

What is the nature of the underlying representations and mechanisms which allow very young children to acquire the words and structures of their native language? Our research looks especially at children between the ages of 3-5 when language acquisition still proceeds rapidly and uses multiple methodologies, including act-out tasks, truth value judgment tasks, and elicited imitation and production tasks.

The article discusses the importance of practice for conducting research on digital culture. It poses questions about whether one should possess technical competences in the field of digital humanities and in what way they can facilitate research attempting to describe the contemporary world. This issue is analysed using the theory of the third culture developed by Charles Percy Snow. The argument also focuses on other researchers representing various strategies for combining practice with theory, such as: Lev Manovich, Alexander R. Galloway, (...) Jan Stasieńko and Mirosław Filiciak. The aim of the article is to describe the emerging, new image of a humanist studying digital culture, whose new competence may be seen as a remedy for the ongoing crisis of the humanities. (shrink)

This article is the first indepth ethical analysis of empirical studies that support the claim that children born without major parts of their cerebral cortex are capable of conscious experiences and have a rudimentary capacity for agency. Congenitally decorticate children have commonly been classified as persistently vegetative, with serious consequences for their well-being and opportunities to flourish. The paper begins with an explication of the rights-based normative framework of the argument, including conceptual analysis of the terms ‘agency’, ‘potentiality for agency’ (...) and ‘gradual approach of agency’. It critically examines Alan Gewirth’s account of the criteria for being a rights bearer and principles for settling rights conflicts between agents and potential agents. It then applies the rights-based normative framework to the ethical challenges associated with care for congenitally decorticate children. It argues that recent empirical studies support the claim that the concepts ‘potential for agency’ and ‘capacity for rudimentary agency’ apply to children who are born without major parts of their cerebral cortex. The article finally discusses important medical ethical implications of these results. It specifically focuses on congenitally decorticate children’s preparatory rights to a stimulating intellectual and social environment. (shrink)

Background: Although attention to healthcare ethics in rural areas has increased, specific focus on rural palliative care is still largely under-studied and under-theorized. The purpose of this study was to gain a deeper understanding of the values informing good palliative care from rural individuals' perspectives. Methods: We conducted a qualitative ethnographic study in four rural communities in Western Canada. Each community had a population of 10, 000 or less and was located at least a three hour travelling distance by car (...) from a specialist palliative care treatment centre. Data were collected over a 2-year period and included 95 interviews, 51 days of field work and 74 hours of direct participant observation where the researchers accompanied rural healthcare providers. Data were analyzed inductively to identify the most prevalent thematic values, and then coded using NVivo. Results: This study illuminated the core values of knowing and being known, being present and available, and community and mutuality that provide the foundation for ethically good rural palliative care. These values were congruent across the study communities and across the stakeholders involved in rural palliative care. Although these were highly prized values, each came with a corresponding ethical tension. Being known often resulted in a loss of privacy. Being available and present created a high degree of expectation and potential caregiver strain. The values of community and mutuality created entitlement issues, presenting daunting challenges for coordinated change. Conclusions: The values identified in this study offer the opportunity to better understand common ethical tensions that arise in rural healthcare and key differences between rural and urban palliative care. In particular, these values shed light on problematic health system and health policy changes. When initiatives violate deeply held values and hard won rural capacity to address the needs of their dying members is undermined, there are long lasting negative consequences. The social fabric of rural life is frayed. These findings offer one way to re-conceptualize healthcare decision making through consideration of critical values to support ethically good palliative care in rural settings. (shrink)