Dementia patients in the moderate-late stage of the disease can, and often do, express different preferences than they did at the onset of their condition. The received view in the philosophical literature argues that advance directives which prioritize the patient’s preferences at onset ought to be given decisive moral weight in medical decision-making. Clinical practice, on the other hand, favors giving moral weight to the preferences expressed by dementia patients after onset. The purpose of this article is to show that (...) the received view in the philosophical literature is inadequate and is out of touch with real clinical practice. I argue that having dementia is a cognitive transformative experience and that preference changes which result from this are legitimate and ought to be given moral weight in medical decision-making. This argument ought to encourage us to reduce our confidence in the moral weight of advance directives for dementia patients. (shrink)

An epistemic account of constitutive relevance lists the criteria by which scientists can identify the components of mechanisms in empirical practice. Three prominent claims from Craver form a promising basis for an account. First, constitutive relevance is established by means of interlevel experiments. Second, interlevel experiments are executions of interventions. Third, there is no interlevel causation between a mechanism and its components. Currently, no account on offer respects all three claims. I offer my causal situationist account of constitutive relevance that (...) respects the claims. By situating a part of a mechanism on the causal chain between the mechanism’s input and output, components can be identified with interventions, without the interventions suggesting interlevel causation. The causal situationist account is the only account on offer so far that clearly fits within Craver’s framework. (shrink)

We agree with McCullough, Coverdale and Chervenak1 that ‘medical educators and academic leaders are in a pivotal and powerful position to role model’ to counter ‘incivility’ in medicine, which can include ‘dismissing’ or ‘demeaning others’. They note that ‘women may be at greater risk for experiencing incivility compared with men’, as may other individuals who experience ‘patterns of disrespect based on minority status’. The authors promote ‘professionalism’ and ‘etiquette’ to foster civility within medicine. Yet theory and experience suggest that medical (...) educators and academic leaders are also in powerful positions to mobilise these concepts to perpetuate exclusions from, and biases within, medicine, upholding racist, sexist and ableist norms. Feminist methodology reveals how ethical theorising historically excluded views and experiences of marginalised individuals and groups and provides frameworks for interrogating supposedly universal norms. Presuming dominant values and experiences reflect universal ones can further marginalise already oppressed groups and individuals. A feminist analysis reveals how ‘professionalism’ or ‘etiquette’ are historically shaped by white or male identity and experience, including norms of attire, hair, accessories, speech or behaviour. Part of the hidden curriculum of medicine becomes intuiting how leaders implicitly or explicitly define ‘professionalism’. McCullough et al define ‘professionalism’ in medicine as ‘sustained commitments to scientific and clinical excellence… making the protection and promotion of health-related interest the physician’s primary concern …. (shrink)

It's well-known that Kant believed that intuition was central to an account of mathematical knowledge. What that role is and how Kant argues for it are, however, still open to debate. There are, broadly speaking, two tendencies in interpreting Kant's account of intuition in mathematics, each emphasizing different aspects of Kant's general doctrine of intuition. On one view, most recently put forward by Michael Friedman, this central role for intuition is a direct result of the limitations of the syllogistic logic (...) available to Kant. On this view, Kant's reasons for introducing intuition are taken to be logical or mathematical, rather than philosophical. The other tendency, which I shall try to develop here, emphasizes an epistemological or phenomenological role for intuition in mathematics arising out of what may loosely be called Kant's ‘antiformalism.’This paper, which focuses specifically on the case of geometry, falls into two parts. First, I consider Kant's discussion of intuition in the Metaphysical Exposition of the concept of space. (shrink)

The Buddhist construct of mindfulness is a central element of mindfulness-based interventions and derives from a systematic phenomenological programme developed over several millennia to investigate subjective experience. Enthusiasm for ?mindfulness? in Western psychological and other science has resulted in proliferation of definitions, operationalizations and self-report inventories that purport to measure mindful awareness as a trait. This paper addresses a number of seemingly intractable issues regarding current attempts to characterize mindfulness and also highlights a number of vulnerabilities in this domain that (...) may lead to denaturing, distortion, dilution or reification of Buddhist constructs related to mindfulness. Enriching positivist Western psychological paradigms with a detailed and complex Buddhist phenomenology of the mind may require greater study and long-term direct practice of insight meditation than is currently common among psychologists and other scientists. Pursuit of such an approach would seem a necessary precondition for attempts to characterize and quantify mindfulness. (shrink)

Students with autism spectrum disorder are accessing college in increasing numbers. Within this cohort are students who are twice exceptional—those who are both academically talented and diagnosed with ASD. Little is known about factors and experiences that impact their successful transition to college. Parents play a critical role in the secondary transition process, but currently, there is a paucity of research that examines their perceptions of this experience. This study presents the results of semi-structured interviews with the parents of 10 (...) college students with ASD who were enrolled in postsecondary institutions in the United States. The parents provided perceptions of their student’s best and most challenging aspects of high school, as well as of the transition preparation the student received. Suggestions were offered in regard to how transition services can be improved for this group of students. Implications for planning and practice are presented. (shrink)

Super-substantivalism is the thesis that space is identical to matter; it is currently under discussion ? see Sklar (1977, 221?4), Earman (1989, 115?6) and Schaffer (2009) ? in contemporary philosophy of physics and metaphysics. Given this current interest, it is worth investigating the thesis in the history of philosophy. This paper examines the super-substantivalism of Samuel Alexander, an early twentieth century metaphysician primarily associated with (the movement now known as) British Emergentism. Alexander argues that spacetime is ontologically fundamental and it (...) gives rise to an ontological hierarchy of emergence, involving novel properties such as matter, life and mind. Alexander's super-substantivalism is interesting not just because of its historical importance but also because Alexander unusually attempts to explain why spacetime is identical to matter. This paper carefully unpacks that explanation and shows how Alexander is best read as conceiving of spacetime as a Spinozistic substance, worked upon by evolution. (shrink)

Mr. Rivers’ case offers an example of how a caregiver may perceive the concept of moral distress. The nurse is experiencing what is described as moral distress at the prospect of participating in C...

Despite frequent calls by players, managers and fans, FIFA's resistance to the implementation of goal-line technology (GLT) has been well documented in national print and online media as well as FIFA's own website. In 2010, FIFA president Sepp Blatter outlined eight reasons why GLT should not be used in football. The reasons given by FIFA can be broadly separated into three categories; those dealing with the nature and value of the game of football, those related to issues of justice, and (...) those concerned with the practical implementation of GLT. This paper intends to evaluate these eight reasons in order to assess whether there are, indeed, any good arguments against GLT in football. (shrink)

Our in-the-moment experience of the world can feel vivid and rich, even when we cannot describe our experience due to limitations of attention, memory or other cognitive processes. But the nature of visual awareness is quite sparse, as suggested by the phenomena of failures of awareness, such as change blindness and inattentional blindness. I will argue that once failures of memory or failures of comparison are ruled out as explanations for these phenomena, they present strong evidence against rich awareness. To (...) accommodate and explain these massive failures of awareness, any theory of phenomenal consciousness must downgrade phenomenology to a degree where it is functionless or, ironically, does not reflect what we experience. (shrink)

In the year 1308, Cardinal Giacomo Colonna was a tremendously busy man. He had returned to Rome only a few years earlier in the aftermath of a devastating papal war waged against his family by Boniface VIII. The papal court had been absent from the city for years, leaving an administrative void in Rome as it established itself first in Poitiers, then in Avignon from 1308 under the leadership of the Gascon pope Clement V. In 1306 Giacomo was fully reinstated (...) to the cardinalate, and set about rebuilding his family's fortunes and reputation, as well as a number of the city's churches. He commissioned a new mosaic facade for the basilica of Santa Maria Maggiore, and in 1308 he oversaw repairs... (shrink)

This article contributes to a growing conversation about the role of numbers in promoting gendered agendas in potentially contradictory ways. Drawing from interviews with gender advisors—the professionals tasked with mainstreaming gender in development projects—in an East African country, I begin from the paradox that gender advisors articulate a strong preference for qualitative data to best capture the lives of the women they aim to assist while voicing a need for quantitative metrics. I demonstrate that gender advisors come to imagine metrics (...) as expeditious bureaucratic tools able to inspire cooperation from otherwise reluctant coworkers. I argue that development organizations are gendered in ways—acutely seen in how advisors struggle, are sidelined, and attempt to advance their goals with numbers—that lead to the utility of valuing quantitative metrics over qualitative ones. I establish two theoretical contributions: Gendered organizations theory is essential to understanding the adoption and globalization of performance metrics, and in an age of evidence-based decision making, the utility of quantified data to garner resources is heightened, rewarding those who adopt quantified knowledge production. I coin the term “the paradox of quantified utility” to describe how these material advantages encourage even skeptics to value quantitative metrics. (shrink)

Perhaps the most striking phenomenon of visual awareness is inattentional blindness (IB), in which a surprisingly salient event right in front of you may go completely unseen when unattended. Does IB reflect a failure of perception, or only of subsequent memory? Previous work has been unable to answer this question, due to a seemingly intractable dilemma: ruling out memory requires immediate perceptual reports, but soliciting such reports fuels an expectation that eliminates IB. Here we introduce a way of evoking repeated (...) IB in the same subjects and the same session: we show that observers fail to report seeing salient events’ not only when they have no expectation, but also when they have the wrong expectations about the events nature. This occurs when observers must immediately report seeing anything unexpected, even mid-event. Repeated IB thus demonstrates that IB is aptly named: it reflects a genuine deficit in moment-by-moment conscious perception, rather than a form of inattentional amnesia. (shrink)

It is widely conceded by liberals that institutions alone are insufficient to ensure that citizens behave in the ways required for a liberal state to flourish, be stable, or function at all. A popular solution proposes cultivating virtues in order to secure the desired behaviours of citizens, where institutions alone would not suffice. A range of virtues are proposed to fill a variety of purported gaps in the liberal political order. Some appeal to virtues in order to secure state stability; (...) Rawls, for instance, claims that ‘citizens must have a sense of justice and the political virtues that support political and social institutions’ in order to ensure an ‘enduring society’. For Galston, citizens must possess a range of virtues in order for the state to function, including the virtues of courage, independence, tolerance, willingness to engage in public discourse, and law-abidingness. (shrink)

Providing nursing care for people with dementia residing in long-term care facilities poses specific challenges regarding pain practices. With underlying communication barriers unique to dementia pathologies, this population is often unable to communicate verbal sentiments and descriptions of pain. In turn, nurses caring for older persons with dementia have difficulty assessing, managing and treating pain. Objectivity is an imperative factor in healthcare pain practices; however, it is difficult to objectively evaluate someone who cannot accurately communicate their experience of pain. Therefore, (...) the authors believe that subjectivity is also an essential part of evaluating the person with dementia's experience of pain. In this critical reflection, the authors explore objectivity and subjectivity in relation to pain practices for dementia in long-term care. A historical summary of pain is provided outlining the evolution of objectivity and subjectivity related to pain practices. The authors discuss the complexities of assessing and managing pain and offer a new perspective about the role of objectivity (and co-existence of subjectivity) for nurses treating pain in the older adults with dementia. (shrink)

In this fascinating collection of essays, an international group of scholars explores the sonic consequences of transcultural contact in the early modern period. They examine how cultural configurations of sound impacted communication, comprehension, and the categorisation of people. Addressing questions of identity, difference, sound, and subjectivity in global early modernity, these authors share the conviction that the body itself is the most intimate of contact zones, and that the culturally contingent systems by which sounds made sense could be foreign to (...) early modern listeners and to present day scholars. Drawing on a global range of archival evidence--from New France and New Spain, to the slave ships of the Middle Passage, to China, Europe, and the Mediterranean court environment--this collection challenges the privileged position of European acoustical practices within the discipline of global-historical musicology. The discussion of Black and non-European experiences demonstrates how the production of 'the canon' in the cosmopolitan centres of colonial empires was underpinned by processes of human exploitation and extraction of resources. As such, this text is a timely response to calls within the discipline to decolonise music history and to contextualise the canonical works of the European past. This volume is accessible to a wide and interdisciplinary audience, not only within musicology, but also to those interested in early modern global history, sound studies, race, and slavery."--Publisher's website. (shrink)

Alfred Wainwright was arguably the best known British guidebook writer of the20th century, and his work has been highly influential in promoting and directing fell-walking in northern Britain, in particular in the English Lake District. His work has, however, received little critical attention. This paper represents an initial attempt to undertake such a study. We examine Wainwright’s work through the lens of the landscape values and aesthetics that, we suggest,underpins it, and by an exploration of what might be called Wainwright’s (...) ‘environmental identity’. We argue that Wainwright manifests a strikingly contemporary embodied landscape aesthetic and a strongly place-attached environmental identity. We consider some possiblei mplications of this landscape aesthetic and place attached identity, including their relation to broader environmental commitments and the possibility that the endorsement of such values may have exclusionary consequences for members of ‘outsider’ groups. (shrink)

In this article, we want to show the relevance and importance of melancholy as an aesthetic emotion. Melancholy often plays a role in our encounters with art works, and it is also present in some of our aesthetic responses to the natural environment. Melancholy invites aesthetic considerations to come into play not only in well-defined aesthetic contexts but also in everyday situations that give reason for melancholy to arise. But the complexity of melancholy, the fact that it is fascinating in (...) itself, suggests the further thought that it may be considered as an aesthetic emotion per se. To this end, we argue that it is the distinctive character of melancholy, its dual character and its differences from sadness and depression, which distinguishes it as an aesthetic emotion. (shrink)

Mindfulness, derived from Buddhist psychology and philosophy, has gained broad popularity in the last decades, due importantly to scientific interest and findings. Yet Buddhist mindfulness developed in Asian pre-scientific culture and religion, and is predicated upon long-term cultivation of introspective awareness of lived experience, not highly accessible to empirical study. Further complicating the ‘science' of mindfulness, mindfulness's very definition is multifaceted, resistant to dismantling and requires substantial amounts of personal practice to gain expertise. Most scientists investigating mindfulness have not achieved (...) a high level of this expertise. Here I address how mindfulness is currently being invented as a scientific fact or object of inquiry. The intrinsic porosity of subjective and objective factors influencing the investigation of mindfulness is highlighted: the evolving body of ‘scientific' experts, instruments used to measure mindfulness, the alliances of funders and other supporters of mindfulness research, and the public representation of the related findings. (shrink)

In June 2015, the major North American and European critical care societies released new joint guidelines that delineate a process-based approach to resolving intractable conflicts over the appropriateness of providing or continuing LST.2 This article frames the new guidelines within the history, ethical arguments, legal landscape, and empirical evidence regarding limitation of LST without surrogate consent in cases of intractable conflict.

Recent research into how musicians coordinate their expressive timing, phrasing, articulation, dynamics, and other stylistic characteristics during performances has highlighted the role of predictive processes, as musicians must anticipate how their partners will play in order to be together. Several studies have used information flow techniques such as Granger causality to show that upcoming movements of a musician can be predicted from immediate past movements of fellow musicians. Although musicians must move to play their instruments, a major goal of music (...) making is to create a joint interpretation through the sounds they produce. Yet, information flow techniques have not been applied previously to examine the role that fellow musicians' sound output plays in these predictive processes and whether this changes as they learn to play together. In the present experiment, we asked professional violinists to play along with recordings of two folk pieces, each eight times in succession, and compared the amplitude envelopes of their performances with those of the recordings using Granger causality to measure information flow and cross-correlation to measure similarity and synchronization. In line with our hypotheses, our measure of information flow was higher from the recordings to the performances than vice versa, and decreased as the violinists became more familiar with the recordings over trials. This decline in information flow is consistent with a gradual shift from relying on auditory cues to predict the recording to relying on an internally-based (learned) model built through repetition. There was also evidence that violinists became more synchronized with the recordings over trials. These results shed light on the planning and learning processes involved in the aligning of expressive intentions in group music performance and lay the groundwork for the application of Granger causality to investigate information flow through sound in more complex musical interactions. (shrink)

At the center of many critiques of liberalism is liberal neutrality, which is attacked on two fronts. First, it is argued that neutrality yields a restrictive sphere of public reason. Contentious views—like those endorsed by citizens with marginalized comprehensive doctrines—are outlawed from public consideration. Second, state policies must have neutral effects, lest they differentially impact those with unpopular views. Contentious state actions—like those endorsed by citizens with marginalized moral views—are outlawed from implementation. It is this combination of demands for neutrality (...) at the individual and state levels that produces the concern: if marginalized comprehensive doctrines cannot be discussed in the realm of public reason, and if marginalized moral views cannot be acted upon by the state, how will we ever achieve the goals of feminism, itself a marginalized moral view? Does liberal neutrality prohibit progress toward gender equality? In this paper, I argue to the contrary. Many objections regarding liberalism’s supposed failure to secure gender justice rely on a conception of neutrality as neutrality of effect. But at both the individual and state levels, liberalism’s demand for neutrality is about justification. Liberalism, specifically political liberalism, requires neither neutral content of public reasons nor neutral effects of state policies. (shrink)

Focus on the evolutionary origins of musicality has been neglected relative to attention on language, so these new proposals are welcome stimulants. We argue for a broad comparative approach to understanding how the elements of musicality evolved, and against the use of overly simplistic evolutionary accounts.

Introduction: The man who drank the hemlock -- Socrates' philosophy -- Politics and society -- Plato and others : who created the death of Socrates? -- 'A Greek chatterbox' : the death of Socrates in the Roman Empire -- Pain and revelation : the death of Socrates and the death of Jesus -- The apotheosis of philosophy : from enlightenment to revolution -- Talk, truth, totalitarianism : the problem of Socrates in modern times.

An inquiry into the current ways of knowing, their ramifications, and institutional and noninstitutional artistic practices that provide channels for education from below. Artistic Ecologies: New Compasses and Tools aims to both analyze and speculate about potentials of artistic ecologies, collective learning, and engaged pedagogies to engender new institutionalities. Going beyond tensions between individuals and institutions, Artistic Ecologies examines avenues for collective learning. If learning for life is emancipation—understood not just as a matter of power but of freedom—the essential question (...) that emerges is: What knowledge makes us free and how can institutions help produce it? In search of an answer, this publication’s textual and visual contributions explore sites and practices through which new institutionalities can emerge. Artistic Ecologies comprises essays analyzing current ways of knowing and their ramifications (Marina Garcés, Yayo Herrero and Pirate Care) and portraying alternative ways of forming knowledge through institutional and non-institutional artistic practices (DAAR—Decolonizing Architecture Art Research, Yael Davids, Max Jorge Hinderer Cruz, The Sensing Salon). Artistic contributions in various formats—poems, drawings, visual essays—by Luna Acosta, CAConrads, Eva Ďurovec, Teuta Gatolin, Margherita Isola, and Jammers illustrate heterodox channels for questioning the dominant forms of knowledge and educating from below. (shrink)

IN THE UNITED STATES, 25 PERCENT OF PEOPLE LIVING WITH HIV/AIDS HAVE spent time in the correctional system. HIV is known to spread among incarcerated individuals through high-risk behaviors including unprotected sex, injection drug use, tattooing, and body piercing. When released from prison, persons living with HIV can spread the disease in the wider community. This essay explores the complex problem of HIV infection among US prisoners from a common good approach rooted in Catholic social teachings by examining available data (...) on US prison populations, describing recent trends in the prosecution of drug-related crimes, and proposing concrete policy recommendations for HIV prevention interventions in US prisons. (shrink)

This article briefly considers current positions about whether the inclusion of the perspectives and interests of marginalised groups in the construction of knowledge is of epistemic value. It is then argued that applied social epistemology is the proper epistemic stance to take in evaluating this question. Theorists who have held that diversity makes an epistemic contribution are interpreted as attempting to reform social pathways to knowledge in ways that make true belief more likely. Thus, the demand for diversity challenges the (...) individualistic and a priori nature of traditional epistemology. This stance has consequences for education. It supports greater attention to helping students examine the testimonial bases for their beliefs. And it prepares students for their role as citizens in supporting policies that maintain credible inclusive institutions of public knowledge. (shrink)