Background Older patients are often vulnerable and highly dependent on healthcare professionals’ assessment in the event of acute illness. In the context of ambulance services, this poses challenges as the assessment is normally conducted with a focus on identifying life-threatening conditions. Such assessment is not fully satisfactory in a patient relationship that also aims to promote and protect patient autonomy. Aim To describe ambulance clinicians’ understanding of older patients’ self-determination when the patient’s decision-making ability is impaired. Research design A qualitative (...) design with an inductive approach, guided by descriptive phenomenology. Participants In total, 30 ambulance clinicians, comprised of 25 prehospital emergency nurses, 1 nurse and 4 emergency medical technicians participated in 15 dyadic interviews. Ethical considerations The research was conducted in accordance with the Declaration of Helsinki, and permission was granted by the Swedish Ethical Review Authority. Findings The findings are presented in two themes: (1) Movement between explicit and implicit will; and (2) Contradictions about the patient’s best interests. The clinicians’ interpretations are based on an understanding of the patient’s situation using substitute decision-making in emergency situations and conversations that reveal the patient’s explicit wishes. Sometimes the clinicians collaborate to validate the patient’s implicit will, while they at other times subordinate themselves to others’ opinions. The clinicians find themselves in conflict between personal values and organisational values as they try to protect the patient’s self-determination. Conclusion The results indicate that older patients with an impaired decision-making ability risk losing the right to self-determination in the context of ambulance services. The clinicians face challenges that significantly affect their ability to handle the older patient’s unique needs based on a holistic perspective and their ability to be autonomous. (shrink)

ABSTRACTAbel Evans's poem Vertumnus celebrates Jacob Bobart the Younger, second keeper of the Oxford Physick Garden, as a model monarch to his botanical subjects. This paper takes Vertumnus as a point of departure from which to explore the early history of the Physick Garden, situating botanical collections and collecting spaces within utopian visions and projects as well as debates about order more widely in the turbulent seventeenth-century. Three perspectives on the Physick Garden as an ordered collection are explored: the architecture (...) of the quadripartite Garden, with particular attention to the iconography of the Danby Gate; the particular challenges involved in managing living collections, whose survival depends on the spatial order regulating the microclimates in which they grow; and the taxonomic ordering associated with the hortus siccus collections. A final section on the ideal ‘Botanick throne’ focuses on the metaphor of the state as a garden in the period, as human and botanical subjects resist being order and can rebel, but also respond to right rule and wise cultivation. However, the political metaphor is Evans’s; there is little to suggest that Bobart himself was driven by utopian, theological and political visions. (shrink)

The purpose of this article is to explore structural preconditions for occupational well-being among blue-collar temporary agency workers within the Swedish manufacturing industry based on managers’ views and expectations of the worker. Through 25 interviews, we investigate how blue-collar temporary agency workers are seen by management using critical realism and the concept of ‘norm circles’ to analyse spatial, relational, sociotechnical and normative structures. We show how structures and norm circles possess alienating or dealienating mechanisms that precondition blue-collar temporary agency workers’ (...) occupational well-being. The findings indicate management’s role as an important gatekeeper in determining structural preconditions for blue-collar temporary agency workers’ occupational well-being. By introducing aspects of skill and acquired skill, along with social aspects changing over time, this article contributes to the existing literature on blue-collar temporary agency workers’ occupational well-being. (shrink)

Contributing Authors: Lilli Alanen & Frans Svensson, David Alm, Gustaf Arrhenius, Gunnar Björnsson, Luc Bovens, Richard Bradley, Geoffrey Brennan & Nicholas Southwood, John Broome, Linus Broström & Mats Johansson, Johan Brännmark, Krister Bykvist, John Cantwell, Erik Carlson, David Copp, Roger Crisp, Sven Danielsson, Dan Egonsson, Fred Feldman, Roger Fjellström, Marc Fleurbaey, Margaret Gilbert, Olav Gjelsvik, Kathrin Glüer & Peter Pagin, Ebba Gullberg & Sten Lindström, Peter Gärdenfors, Sven Ove Hansson, Jana Holsanova, Nils Holtug, Victoria Höög, Magnus Jiborn, Karsten Klint (...) Jensen, Sigurður Kristinsson, Isaac Levi, Kasper Lippert-Rasmussen, David Makinson, Anna-Sofia Maurin, Philippe Mongin, Kevin Mulligan, Lennart Nordenfelt, Jonas Olson, Erik J. Olsson, Ingmar Persson, Johannes Persson, Björn Petersson, Philip Pettit, Hans Rott, Toni Rønnow-Rasmussen, Krister Segerberg, John Skorupski, Howard Sobel, Fredrik Stjernberg, Fred Stoutland, Caj Strandberg, Pär Sundström, Folke Tersman, Torbjörn Tännsjö, Peter Vallentyne, Bruno Verbeek, Stella Villarmea, and Michael J. Zimmerman. (shrink)

Understanding life through its origins reveals the groundwork underlying the differentiations of its autonomous generative matrixes. Following the primogenital matrix of generation, the three generative matrixes of the specifically human sense of life establish humanness within the creative human condition as the existential sphere of sharing-in-life.

This paper traces the intellectual trajectories of the first stand-alone theories of action, understood as both axiologically neutral and quasi-scientific from a methodological point of view. I argue that the rise of action theory of this kind corresponds to a particular moment of dissatisfaction within Western thought, and as such, it tells us far more about the history of philosophy than the subject itself. I conclude by explaining why subsequent failures to provide an acceptable theory of action are not accidental. (...) On the contrary, such failures owe themselves probably to the fact that formulating a theory of action is neither propitious nor useful. Thus, the most valuable lesson we can learn from philosophical desires for a theory of action is that we should take co-action as the starting point in our normative investigations, rather than positing action simpliciter as a problem to solve. That is, we should move away from propounding a theory of action, and instead focus on a paradigm shift, whereby we move away from a representational, towards a co-actional, model of action. (shrink)

Let us assume that the expression A is a segment of the expression B. Now, let us assume that we try to transform the expression B into the expression B', removing A from B or replacing A with another expression, say A'. When shall we say that A is irremovable or occurs in B essentially? We shall do it, if we can neither remove A from B nor replace A with A', not influencing upon important properties of B. On the (...) other hand, when shall we say that the occurrence A in B is essential? We shall do it, if we can transform B into B' changing no properties of B. Let us say it more precisely. Let us assume - as concerns expressions x, y, x' and y' - that: (a) x occurs in y; (b) the only structural difference between y and y' is that x does not occur in y', or x' occurs in y instead of x. Then: x occurs in y inessentially-with-respect-to-w of y, iff y' is the same as y with respect to p. Correspondingly: x occurs in y essentially-with-respect-to-w of y, iff y' is different as y with respect to p. The occurrence x in y may be essential or inessential with respect to syntactic, semantic or pragmatic properties of y. In my paper, I discuss a variety of detailed concepts of the (in)essential occurrence of expressions in another expressions with respect to semantic properties of these expressions, i.e. with respect to semantic category, logical value, denotation and connotation. I also discuss some philosophical and methodological implications of presented solutions of the problem. (shrink)

Si la praxéologie mérite aujourd’hui notre attention, c’est parce qu’elle permet de remonter aux origines des « théories de l’action », des sociologies de l’action ou des philosophies de l’action qui ont marqué le xxe siècle. Que veut dire, au fond, étudier l’action, en proposer ensuite une théorie, à visée soit descriptive soit normative? Dans ce qui suit, on va étudier la question en compagnie de Tadeusz Kotarbiński (1886-1981), philosophe analytique, et de Harold Garfinkel (1917-2011), sociologue hétérodoxe. Ce texte défend (...) l’idée selon laquelle parmi les conséquences les plus marquantes du travail de Garfinkel se trouve la démystification de la « théorie de l’action », et que certaines intuitions similaires sont déjà très présentes chez Kotarbiński (dont les travaux sur l’action constituent, selon Garfinkel, un « échec extrêmement important »). La praxéologie chez les deux auteurs n’est pas une discipline, mais une façon de voir la pratique étudiée comme un tout, à l’instar des recherches menées par les théoriciens de la Gestalt. La dimension athéorique de l’étude de l’action humaine proposée ici permet d’espérer qu’un jour, les phénomènes qui nous entourent vont pouvoir être étudiés pour ce qu’ils sont, et non pas pour ce qu’une théorie élégante permet d’en dire. (shrink)

This paper argues that the function of moral education in the biomedical context should be exactly the same as in a general, philosophical framework: it should not provide ready-to-use kits of moral principles; rather, it must show the history, epistemology and conceptual structure of moral theories that would enable those who have to make decisions to be as informed and as responsible as possible. If this complexity cannot be attained, an incomplete product—i.e. bioethics or bioethical principles—should not be seen as (...) a viable substitute. This theoretical position is subsequently illustrated by a case study involving research ethics committees. It is argued that within these committees, that are carefully formed multidisciplinary bodies, what makes competent decision-making possible is not a bioethical theory, nor even a sound philosophical ethics, but the dynamics of the discussion of a number of experts coming from different disciplines. This multidisciplinary expertise is necessary and sufficient to undertake the challenges of complex decisions in the biomedical context. (shrink)

Nabataean history is significantly overlooked in the works of ancient historians. Josephus is an exception to this, as he includes several important events from Nabataean history in De Bello Judaico and Antiquitates Judaicae. However, his retelling of these events differs between the two works. In this paper, I argue that Josephus became more “pro-Roman” over time and eventually overshadowed an accurate portrayal of Nabataean history in his later narrative. He undermined moments of tension between Rome and Nabataea in order to (...) showcase Roman power in the Near East, even beyond reality. In support of this argument, I analyze the Nabataean sections of Josephus’ works, as each passage has overlapping details, but significantly different emphasis, characterization, and perspective through variations in terminology, imagery, and tone. Though problematic, Josephus has preserved a unique look into Roman-Nabataean relations in the two centuries prior to the incorporation of Nabataea into the Empire. (shrink)

In the first part of the article true expressions and false expressions are presented that served A. W. Burks to build a formal system of logic of causal propositions along with considering their later use in the system built in 1963. In the second part of the article the possibility of conducting an axiomatic proof of the theorem on adding a superfluous condition is analyzed. The consequences are also shown of substituting a negation of the same prepositional variable for the (...) propositional variable and conditions are analyzed of substitution for propositional variables and possibilities of avoiding those difficulties. (shrink)

This paper takes its departure from a cluster of approaches to Intentionality that could be headed under the title “Naturalizing Intentionality.” The author groups them into two different arguments: The defenders of the Original-Derived Intentionality argument hold that while there may be such a thing as originalintentionality understood in Brentano’s sense which applies to the mental, we usually extend this intentionality to processes, machines and all sorts of other things. The defenders of the Basic-Higher Order Intentionality argument on the other (...) hand claim that it is physical objects that display basic intentionality, while the human mind has intentionality of a higher order. For both approaches the aim is to show that intentionality can be understood as something exhibitedby non-mental items and thus it can be claimed that what thoughts or bits of language are about is physical in the last instance. The author argues that both arguments are merely inversions of each other and cannot successfully naturalize the phenomenon of intentionality as about-ness of physical items. Furthermore it is exactly the cooperation between the mental and the physical and no reduction of one to the other that can explain the phenomenon of intentionality. Subsequently the author will discuss John McDowell’s Kantian approach to intentionality, which may at first look like a version of the Basic-Higher Order argument, since McDowell distinguishes first and second nature. However, the author shows that already McDowell’s first nature is imbued with conceptuality in that he starts with receptivity in operation. For McDowell, not intentionality of the mind is naturalized, but nature is always already intellectualized or intentionalized. (shrink)

In this dissertation, I develop a post-reflexive philosophical account of self-knowing subjectivity. I argue that ambiguity, not clarity, is the hallmark of intersubjective being and knowing, and that ambiguous being is particularly evident precisely where subjectivity occupies a central place: in theory. To illustrate this claim, I turn to the ubiquitous and indispensable technology of the glassy mirror, a material object and discursive trope which I use to enliven the Beauvoirean concept of situation: a lived ambiguity of being both subject (...) and object, both universal and particular, both for-self and for-others. Far from eschewing the historical importance of precision and determinacy in Western views of knowing well, my appeal to mirrors in this project allows me to read such values as sedimented in knowers’ ways of making sense of the world – of themselves and their objects of knowledge, as these are expressed through theoretical engagements. (shrink)

This article reviews the book The Philosophy of Early Christianity, by George E. Karamanolis.

The article aims at challenging the very idea of bioethics. Starting with a thought experiment which puts into perspective relations between law and ethics, a reflexion on founding moments of bioethics as a distinctive discipline will be proposed in order to contest some of its assumptions. Less traditional ways of seeing the field will be subsequently analyzed, yet the conclusion of this exploration will remain critical: we should rather think of an alternative way of seeing moral expertise in the biomedical (...) sphere, founded on plural knowledge of diverse agents who leave their moral presuppositions aside as much as this is possible. (shrink)

The concept of enhypostaton was introduced into theological discourse during the sixth-century Christological debates, and aimed to elucidate the orthodox doctrine of the unity of two natures in the singular hypostasis of Christ. In spite of the fact that the conceptual content of the term is recognized by contemporary scholarship as pertaining to the core of Christology, the notion of enhypostaton is often described as obscure and not clearly defined. The coining of the term is often ascribed to Leontius of (...) Byzantium, whereas in fact he only followed and developed solutions already introduced into Christological discourse by John the Grammarian. The article aims to clarify the notion by offering a philosophical account of the meaning and theoretical origins of “enhypostaton,” as introduced by John the Grammarian in the context of his discussion of substance as en-hypostatical being. Enhypostaton emerges as the proper way of describing the ontological complements of a particular entity. This seems to be a significant development in the philosophical explanation of substance. (shrink)

The article reviews the book Orthodox Readings of Aquinas, by Marcus Plested.

The patterns of physical growth (stature, BMI, subscapular and arm fat-fold thickness, upper and lower extremity length, chest circumference, arm, and hip breadth, and age at menarche) were studied in 857 of Maya and Mestizo girls and 1314 of Creole girls aged 6-18 years. Data were collected between 1998-2001 in primary, secondary, and high schools of Merida, Capital City of the Yucatan State, Mexico. The ethnicity of girls was defined using their two surnames (from the father and mother side). The (...) results show that Creoles are taller, have more abundant fat tissue, and greater BMI, especially at the age of 11 years, which means that they are better prepared to start pubertal spurt. Maya girls have relatively longer upper extremities to lower ones, greater biacromial breadth, and chest circumference to stature than Creoles, which shows their more stocky body build. The adolescent (pubertal) spurt in height starts earlier in Creoles (9-10 years) and its rate is greater (max. = 7.48 cm/ year) than in Maya and Mestizos girls (10-11 years; max. = 6.25 cm/year). In Mayas and Mestizos, there is only a slight difference between the rate of changes before and during the pubertal spurt. There are no significant differences in age at menarche between girls from both ethnic groups (11.96 in Mayas and Mestizos and 12.04 in Creoles), but there are statistically significant differences between age at menarche of studied girls and their mothers (12.4 for both groups) in each ethnic group. There is evidence that the onset of pubertal spurt in height and its rate may depend on ethnicity. Creoles may lead to a more “westernized” style of life than the Maya and Mestizos girls. (shrink)

Moral particularism is commonly presented as an alternative to ‘principle- or rule-based’ approaches to ethics, such as consequentialism or Kantianism. This paper argues that particularists' aversions to consequentialism stem not from a structural feature of consequentialismper se, but from substantial and structural axiological views traditionally associated with consequentialism. Given a particular approach to (intrinsic) value, there need be no conflict between moral particularism and consequentialism. We consider and reject a number of challenges holding that there is after all such a (...) conflict. We end by suggesting that our proposed position appears quite appealing since it preserves attractive elements from particularism as well as consequentialism. (shrink)

"Die Unterscheidung in Haupt- und Nebensache ist ein kulturabhängiges ästhetisches Konstrukt, das immer wieder neu ausgehandelt wird. Dieser Band erschließt die Ästhetik des Beiwerks in der Bild- und Textkultur des Quattrocento über den historischen Begriff Parergon (dt. Beiwerk) folglich auch innerhalb einer Normen- und Rezeptionsgeschichte. Der Topos von der potentiellen Gefährdung des Werkes durch übermäßiges Beiwerk prägt seit der Antike westliche kunsttheoretische, theologische und nicht zuletzt auch wissenschaftliche Diskurse. In eingehenden Analysen verfolgt dieser Band das Phänomen aus der Perspektive von (...) Künstlern des ausgehenden 15. Jahrhunderts, die das scheinbar Nebensächliche als konstitutiv anerkennen und dergestalt produktiv einsetzen. Maler wie Francesco del Cossa, Carlo Crivelli oder Vittore Carpaccio schöpfen aus dem prekären Verhältnis von Ergon und Parergon, indem sie dieses visuell reflektieren und dabei gerade im sakralen Tafelbild das Beiwerk als Ort elaborierter ästhetischer Auseinandersetzungen entdecken."--P. [4] of cover. (shrink)