Introduction Understanding the views of the public is essential if generally acceptable policies are to be devised that balance research access to general practice patient records with protection of patients' privacy. However, few large studies have been conducted about public attitudes to research access to personal health information. Methods A mixed methods study was performed. Informed by focus groups and literature review, a questionnaire was designed which assessed attitudes to research access to personal health information and factors that (...) influence these. A postal survey was conducted of an electoral roll-based sample of the adult population of Ireland. Results Completed questionnaires were returned by 1575 (40.6%). Among the respondents, 67.5% were unwilling to allow GPs to decide when researchers could access identifiable personal health information. However, 89.5% said they would agree to ongoing consent arrangements, allowing the sharing by GPs of anonymous personal health information with researchers without the need for consent on a study-by-study basis. Increasing age (by each 10-year increment), being retired and primary level education only were significantly associated with an increased likelihood of agreeing that any personal health information could be shared on an ongoing basis: OR 1.39 (95% CI 1.18 to 1.63), 2.00 (95% CI 1.22 to 3.29) and 3.91 (95% CI 1.95 to 7.85), respectively. Conclusions Although survey data can be prone to response biases, this study suggests that prior consent agreements allowing the supply by GPs of anonymous personal health information to researchers may be widely supported, and that populations willing to opt in to such arrangements may be sufficiently representative to facilitate valid and robust consent-dependent observational research. (shrink)

Biometric technologies are becoming more pervasive in the workplace, augmenting managerial processes such as hiring, monitoring and terminating employees. Until recently, these devices consisted mainly of GPS tools that track location, software that scrutinizes browser activity and keyboard strokes, and heat/motion sensors that monitor workstation presence. Today, however, a new generation of biometric devices has emerged that can sense, read, monitor and evaluate the affective state of a worker. More popularly known by its commercial moniker, Emotional AI, the technology stems (...) from advancements in affective computing. But whereas previous generations of biometric monitoring targeted the exterior physical body of the worker, concurrent with the writings of Foucault and Hardt, we argue that emotion-recognition tools signal a far more invasive disciplinary gaze that exposes and makes vulnerable the inner regions of the worker-self. Our paper explores attitudes towards empathic surveillance by analyzing a survey of 1015 responses of future job-seekers from 48 countries with Bayesian statistics. Our findings reveal affect tools, left unregulated in the workplace, may lead to heightened stress and anxiety among disadvantaged ethnicities, gender and income class. We also discuss a stark cross-cultural discrepancy whereby East Asians, compared to Western subjects, are more likely to profess a trusting attitude toward EAI-enabled automated management. While this emerging technology is driven by neoliberal incentives to optimize the worksite and increase productivity, ultimately, empathic surveillance may create more problems in terms of algorithmic bias, opaque decisionism, and the erosion of employment relations. Thus, this paper nuances and extends emerging literature on emotion-sensing technologies in the workplace, particularly through its highly original cross-cultural study. (shrink)

Interviews were carried out with 979 women attending a clinic for birth control advice. Most of the patients were single, middle-class women who worked in central London offices. More than 600 had never approached their GP for advice; of these, about 200 were reluctant to do so because of embarrassment or fear of the reception they might get. Those that did visit a GP intially tended to complain of a lack of interest. Fewer patients who had sought help from a (...) local family planning clinic expressed a similar dissatisfaction but one-third did criticize the facilities and service provided. Two-thirds of the patients were surprisingly ignorant about the contraceptive facilities available in the areas in which they lived. (shrink)

This paper draws on qualitative research using focus groups involving 38 general practitioners (GPs). It explores their attitudes and feelings about (over-)medicalisation. Our main findings were that GPs had a complex representation of (over-)medicalisation, composed of many professional, social, technological, economic and relational issues. This representation led GPs to feel uncomfortable. They felt pressure from all sides, which led them to question their social roles and responsibilities. We identified four main GP-driven proposals to deal with (over-)medicalisation: (1) focusing on (...) the communication in doctor–patient relationships; (2) grounding practices in evidence-based medicine; (3) relying on clinical skills, experience and intuition; and (4) promoting training, leadership bodies and social movements. Drawing on these proposals, we identify and discuss five paradigms that underpin GPs’ attitudes toward (over-)medicalisation: underlying social factors, preventing medicalisation, managing uncertainties, sharing medical decision-making and thinking about care as a rationale. We suggest that these paradigms constitute a defensive posture against GPs’ uncomfortable feelings. All five defensive paradigms were identified in our focus groups, echoing contemporary political debates on public health. This non-exhaustive framework forms the outline of what we call _ordinary defensive medicine_. GPs’ uncomfortable feelings are the origin of their defensive solutions and the manifestation of their vulnerability. This professional vulnerability can be shared with the patient’s vulnerability. In our view, this creates an opportunity to rediscover patient–doctor relationships and examine patients’ and doctors’ vulnerabilities together. “There are many cases in which—though the signs of a confusion of tongues between the patient and his doctor are painfully present—there is apparently no open controversy. Some of these cases demonstrate the working of two other, often interlinked, factors. One is the patient’s increasing anxiety and despair, resulting in more and more fervently clamouring demands for help. Often the doctor’s response is guilt feelings and despair that his most conscientious, most carefully devised examinations do not seem to throw real light on the patient’s “illness”, that his most erudite, most modern, most circumspect therapy does not bring real relief.” (Balint M. The Doctor, His Patient and the Illness. New York: International Universities; 2005. [1957].) “Theories about care put an unprecedented emphasis on vulnerability—taking up that challenge to transform what really counts in today’s hospitals implies letting colleagues inside previously closely guarded professional boundaries” (2, our translation). (shrink)

BackgroundWe aim to further develop an index for detecting disguised paternalism, which might influence physicians’ evaluations of whether or not a patient is decision-competent at the end of life. Disguised paternalism can be actualized when physicians transform hard paternalism into soft paternalism by questioning the patient’s decision-making competence. MethodsA previously presented index, based on a cross-sectional study, was further developed to make it possible to distinguish between high and low degrees of disguised paternalism using the average index of the whole (...) sample. We recalculated the results from a 2007 study for comparison to a new study conducted in 2020. Both studies are about physicians’ attitudes towards, and arguments for or against, physician-assisted suicide. ResultsThe 2020 study showed that geriatricians, palliativists, and middle-aged physicians (46–60 years old) had indices indicating disguised paternalism, in contrast with the results from the 2007 study, which showed that all specialties (apart from GPs and surgeons) had indices indicating high degrees of disguised paternalism.ConclusionsThe proposed index for identifying disguised paternalism reflects the attitude of a group towards physician assisted suicide. The indices make it possible to compare the various medical specialties and age groups from the 2007 study with the 2020 study. Because disguised paternalism might have clinical consequences for the rights of competent patients to participate in decision-making, it is important to reveal disguised hard paternalism, which could masquerade as soft paternalism and thereby manifest in practice. Methods for improving measures of disguised paternalism are worthy of further development. (shrink)

Introduction. Healthcare workers (HCWs) should theoretically have the necessary education and environment to adopt a healthy lifestyle, and they supposedly also should have a higher participation rate in WHP programmes. HCWs are, for several reasons, considered to be a key group in health promotion, especially due to the fact that the healthcare system reaches a substantial number of people in need of lifestyle changes such as increased physical activity (PA) [5]. Furthermore, healthcare professionals are considered to be the most credible (...) source of health information [6]. HCWs' lifestyles can play an important role in increasing awareness among patients regarding lifestyle changes, because HCWs' own lifestyle habits and interests in lifestyle behaviour have been shown to positively influence their counselling practices and attitudes [6–7]. The international movement 'Health Promoting Hospitals and Health Services', which was initiated by the World Health Organization (WHO), highlights the importance of also focusing on the health and lifestyle of the employees. Methods. We conducted survey based on a standardized and adapted questionnaire that included socio-demographic data and points related to healthy lifestyle. We adhered to the latest recommendations on designing and reporting survey studies. Before conducting the study, the questionnaire was pretested among 5 experts and revised twice. The survey was conducted in Kazakh / Russian for respondents who speak two languages fluently at the choice of participants. The filling of the questionnaire took on average 45 minutes. We reported absolute numbers and percentages. Chi-square tests were used to compare responses between groups. Results were considered significant at a P value of < 0.05. Statistical analyses were performed using the application SAS OnDemand for academia (version 3.81, Carry, North Carolina, USA). Results. Our data revealed that nurses were more likely to adhere to healthy eating principles and to have a regular diet at home. GPs were more likely to consume fast food and add salt when food is not salted enough. Nurses were more likely to eat greens regularly. GPs had a stronger belief in the impact of diet on health. More nurses rated their diet as healthy. Media promotion significantly influenced GPs for changing diet towards healthier options. Eating patterns vary according to the risk of stress. Research shows that chronic stress influences the amount and types of consumed food, contributing to both overeating and malnutrition, and that stress hormones can lead to the development of obesity. GPs are more likely to have used tobacco products compared to nurses. GPs are more likely to smoke more than 10 cigarettes per day. GPs have a slightly higher belief in the necessity of a healthy lifestyle compared to nurses. GPs and nurses have different testing frequencies for Hepatitis B and C, with nurses testing more frequently. GPs are more likely to have sexual activity after drinking alcohol. Conclusion. It is known that a healthy lifestyle of doctors affects the attitude of patients and their motivation to change their lifestyle. Thus, the lifestyle patterns of health workers, as well as the understanding of the motivation of these patterns, are more likely to affect public health. (shrink)

Mental disorders such as depression and anxiety are increasingly common. Yet there are too few specialists to offer help to everyone, and negative attitudes to psychological problems and their treatment discourage people from seeking it. As a result, many people never receive help for these problems. The Oxford Guide to Low Intensity CBT Interventions marks a turning point in the delivery of psychological treatments for people with depression and anxiety. Until recently, the only form of psychological intervention available for (...) patients with depression and anxiety was traditional one-to-one 60 minute session therapy - usually with private practitioners for those patients who could afford it. Now Low Intensity CBT Interventions are starting to revolutionize mental health care by providing cost effective psychological therapies which can reach the vast numbers of people with depression and anxiety who did not previously have access to effective psychological treatment. The Oxford Guide to Low Intensity CBT Interventions is the first book to provide a comprehensive guide to Low Intensity CBT interventions. It brings together researchers and clinicians from around the world who have led the way in developing evidence-based low intensity CBT treatments. It charts the plethora of new ways that evidence-based low intensity CBT can be delivered: for instance, guided self-help, groups, advice clinics, brief GP interventions, internet-based or book-based treatment and prevention programs, with supported provided by phone, email, internet, sms or face-to-face. These new treatments require new forms of service delivery, new ways of communicating, new forms of training and supervision, and the development of new workforces. They involve changing systems and routine practice, and adapting interventions to particular community contexts. The Oxford Guide to Low Intensity CBT Interventions is a state-of-the-art handbook, providing low intensity practitioners, supervisors, managers commissioners of services and politicians with a practical, easy-to-read guide - indispensible reading for those who wish to understand and anticipate future directions in health service provision and to broaden access to cost-effective evidence-based psychological therapies. (shrink)

In the Netherlands, in 2002, euthanasia became a legitimate medical act, only allowed when the due care criteria and procedural requirements are met. Legally, an Advanced Euthanasia Directive can replace direct communication if a patient can no longer express his own wishes. In the past decade, an exponential number of persons with dementia share a euthanasia request with their physician. The impact this on physicians, and the consequent support needs, remained unknown. Our objective was to gain more insight into the (...) experiences and needs of Dutch general practitioners and elderly care physicians when handling a euthanasia request from a person with dementia. We performed a qualitative interview study. Participants were recruited via purposive sampling. The interviews were transcribed verbatim, and analyzed using the conventional thematic content analysis. Eleven general practitioners and elderly care physicians with a variety of experience and different attitudes towards euthanasia for PWD were included. Euthanasia requests appeared to have a major impact on physicians. Difficulties they experienced were related to timing, workload, pressure from and expectations of relatives, society’s negative view of dementia in combination with the ‘right to die’ view, the interpretation of the law and AEDs, ethical considerations, and communication with PWD and relatives. To deal with these difficulties, participants need support from colleagues and other professionals. Although elderly care physicians appreciated moral deliberation and support by chaplains, this was hardly mentioned by GPs. Euthanasia requests in dementia seem to place an ethically and emotionally heavy burden on Dutch GPs and elderly care physicians. The awareness of, and access to, existing and new support mechanisms needs further exploration. (shrink)

Background The aim of this study was to investigate whether physicians who felt strongly for or against a treatment, in this case a moderately life prolonging non-curative cancer treatment, differed in their estimation of medical indication for this treatment as compared to physicians who had no such sentiment. A further aim was to investigate how the notion of medical indication was conceptualised. Methods A random sample of GPs, oncologists and pulmonologists comprised the study group. Respondents were randomised to receive either (...) version of a case presentation; in one version, the patient had smoked and in the other version she had never smoked. The physicians were labelled value-neutral and value-influenced on the basis of their attitude towards the treatment. Results In the ‘value-influenced’ group, there was a significant difference in the estimation of medical indication for treatment depending upon whether the patient had smoked or never smoked ). There was no such difference in the ‘value-neutral’ group. Conclusion This study shows that compared to value-neutral physicians, value-influenced physicians are more likely to base decisions of medical indication on medically irrelevant factors. Moreover, medical indication is used in an ambiguous manner. Hence, we recommend that the usage of ‘medical indication’ be disciplined. (shrink)

Objectives: To develop and pilot a questionnaire based assessment of the importance patients place on medical confidentiality, whether they support disclosure of confidential information to protect third parties, and whether they consider that this would impair full disclosure in medical consultations.Design: Questionnaire administered to 30 consecutive patients attending a GP surgery.Results: Overall patients valued confidentiality, felt that other patients might be deterred from seeking treatment if it were not guaranteed, but did not think that they would withhold information for this (...) reason themselves.Conclusions: When presented with brief details of five clinical situations in which a breach of confidentiality might be considered, a clear majority of subjects believed that doctors should disclose information in two of the situations, but subjects were not confident that doctors would do so. In three situations, about half felt that disclosure was justified—these included the only scenario in which disclosure was clearly mandated by statute. There was little change in patients’ general attitude to confidentiality after considering the scenarios. However, the views expressed were often inconsistent with responses to the clinical scenarios, suggesting that complex opinions were not accurately reflected in the responses. The format of the questionnaire has been amended, and the study will be repeated with other groups of patients. (shrink)

Background In 2002, Belgium set a legal framework for euthanasia, whereby granting and performing euthanasia is entrusted entirely to physicians, and—as advised by Belgian Medical Deontology—in the context of a trusted patient–physician relationship. Euthanasia is, however, rarely practiced, so the average physician will not attain routine in this matter. Aim To explore how general practitioners in Flanders (Belgium) deal with euthanasia. This was performed via qualitative analysis of semistructured interviews with 52 general practitioners (GPs). Results Although GPs can understand a (...) patient's request for euthanasia, their own willingness to perform it is limited, based on their assumption that legal euthanasia equates to an injection that ends life abruptly. Their willingness to perform euthanasia is affected by the demanding nature of a patient's request, by their views on what circumstances render euthanasia legitimate and by their own ability to inject a lethal dose. Several GPs prefer increasing opioid dosages and palliative sedation to a lethal injection, which they consider to fall outside the scope of euthanasia legislation. Conclusions Four attitudes can be identified: (1) willing to perform euthanasia; (2) only willing to perform as a last resort; (3) feeling incapable of performing; (4) refusing on principle. The situation where GPs have to consider the request and—if they grant it—to perform the act may result in arbitrary access to euthanasia for the patient. The possibility of installing transparent referral and support strategies for the GPs should be further examined. Further discussion is needed in the medical profession about the exact content of the euthanasia law. (shrink)

In a Swedish setting physicians are unlikely to give explicitly paternalistic reasons when asked about their attitudes towards patients’ involvement in decision-making. There is considerable risk that they will disguise their paternalism by giving ‘socially correct answers’. We suggest that disguised paternalism can be revealed with the help of indexes based on certain responses in postal questionnaires. The indexes were developed using material from a study examining attitudes of Swedish physicians to physician-assisted suicide (PAS). Apart from being asked (...) about their attitudes, they were asked to prioritise between different arguments for and against PAS. One argument for PAS was: “PAS should be permitted out of respect for patients’ autonomy”. One argument against PAS was: “PAS should not be permitted since the non-maleficence principle in this case takes precedence over respecting patients’ autonomy”. Responses to the latter argument formed the cornerstone of a disguised-paternalism index, while an autonomy index was based on answers to the former argument. Applying our indexes to data from the PAS survey, we found that female GPs, surgeons, and older male physicians were least paternalistic. Among female physicians one finds both the most autonomy-respecting groups (female surgeons and GPs) and the least autonomy-respecting groups (female oncologists and psychiatrists); together with older male physicians in general, female GPs are the group displaying least disguised paternalism. We suggest that questionnaires exploring paternalism might be improved by including case-specific questions or statements by which to explore disguised paternalism. Here our indexes might be useful tools. (shrink)

OBJECTIVES: To study and report the attitudes of patients and general practitioners (GPs) concerning the obligation of doctors to act for the good of their patients, and to provide a practical account of beneficence in general practice. DESIGN: Semi-structured interviews administered to GPs and patients. SETTING AND SAMPLE: Participants randomly recruited from an age and gender stratified list of GPs in a geographically defined region of South Australia. The sample comprised twenty-one general practitioners and seventeen patients recruited by participating (...) GPs. RESULTS: In practice, acting for the good of the patient not only accommodates the views of patients and GPs on expertise and knowing best, but also responds to the particular details of the clinical situation. Patients had a complex understanding of the expertise necessary for medical practice, describing a contextual domain in which they were expert, and which complemented the scientific expertise of their GPs. General practitioners identified multiple sources for their expertise, of which experience was the most significant. The role of the GP included responding to individual patients and particular clinical problems and ranged from the assumption of responsibility through to the proffering of medical advice. CONCLUSION: This study found that GPs acting for the good of their patients covered a variety of GP actions and patient preferences. Beneficence was not justified by presumed patient vulnerability or the inability of patients to understand medical problems, but furthered through a recognition of the different areas of expertise contributed by both parties to the consultation. (shrink)

Despite the great expansion and many benefits of information and communication technologies in healthcare, the attitudes of Polish general practitioners to e-health have not been explored. The aim of this study was to determine the GPs’ perception of ICT use in healthcare and to identify barriers to the adoption of EMR in the Podlaskie Voivodeship. Online and telephone surveys were conducted between April and May 2013. Responses from 103 GP practices, 43% of all practices in the region, were analysed. (...) The results showed that 67% of the respondents agreed that IT systems improve quality of healthcare services. In the GP group who declared at least partial EMR implementation, 71.4% see the positive impact of IT on practice staff processes and 66.1% on personal working processes. In this group, more than three-quarters of GPs did not see any positive impact of ICT on the average number of patients treated per day, number of patients within the practice or scope of services. The four most common barriers to EMR implementation were: lack of funds, risk of a malfunction in the system, resistance to change, and lack of training and proper information. Although the use of ICT by Polish GPs is limited, their attitude to e-health is generally positive or neutral and resembles the overall pattern in Europe. Barriers identified by GPs need to be taken into account to ensure the effective implementation of e-health across the country. (shrink)

Medical students may fear that their training leeches away the caring attitudes which attracted them to medicine. Some research suggests they are right. The medical school has a duty to support and encourage their values, but the reverse may happen. Students are taught about legal consent but not ethical consent. They may see or participate in concealment of medical mistakes and learn to practise deceit. The use of unconscious females for gynaecology teaching may encourage the wrong attitudes to (...) patients. Trainee GPs may learn that the doctors' rights are more important than those of the patient. Measuring patients' views should be included in research protocols. (shrink)

Background: Health researchers must weigh the benefits and risks of publishing their findings.Objective: To explore differences in decision making between rural health researchers and managers on the publication of research from small identifiable populations.Method: A survey that investigated the attitudes of Australian rural general practitioners to nurse practitioners was explored. Decisions on the study’s publication were analysed with bioethical principles and health service management ethical decision-making models.Results: Response rate was 78.5% . 84–94% of GP responders considered it to be (...) undesirable for nurse practitioners to initiate referrals to medical specialists , to initiate diagnostic imaging and to prescribe medication .Bioethical analysis: It was concluded that the principle of beneficence outweighed the principle of non-maleficence and that a valid justification for the publication of these results existed.Decision-making models of health service managers: On the basis of models of ethical decision making in health service management, the decisions of the area’s health managers resulted in approval to publish this project’s results being denied. This was because the perceived risks to the health service outweighed benefits. Confidentiality could not be ensured by publication under a regional nom de plume.Conclusions: A conflict of interests between rural researchers and health managers on publication of results is shown by this case study. Researchers and managers at times owe competing duties to key stakeholders. Both weigh the estimated risks and benefits of the effect of research findings. This is particularly true in a rural area, where identification of the subjects becomes more likely. (shrink)

Society in the 21st century is in many ways different from society in the 1950s, the 1960s or the 1970s. Two of the most important changes relate to the level of education in the population and the balance between work and private life. These days a large percentage of people are highly educated. Partly as a result of economic progress in the 1950s and the 1960s and partly due to the fact that many women entered the labour force, people started (...) searching for ways to combine their career with family obligations and a private life (including hobbies, outings and holidays). Medical professional ethics, more specifically: professional attitudes towards patients and colleagues, is influenced by developments such as these, but how much and in what way? It was assumed that surgery ethics would be more robust, resistant to change and that general practitioner (GP) ethics would change more readily in response to a changing society, because surgeons perform technical work in operating theatres in hospitals whereas GPs have their offices in the midst of society. The journals of Dutch surgeons and GPs from the 1950s onwards were studied so as to detect traces of change in medical professional ethics in The Netherlands. GP ethics turned out to be malleable compared with surgery ethics. In fact, GP medicine proved to be an agent of change rather than merely responding to it, both with regard to the changing role of patients and with regard to the changing work life balance. (shrink)

Issues recognized as having ethical or moral components are becoming increasingly common, for society in general, the health care system and for general practitioner/family physicians in particular. Some of the peculiar problems for GP's relate to the provision of continuing, comprehensive, primary medical care to large numbers of individuals who provide extensive potential for conflict between all the involved elements: patients, physicians, families, consultants and societal attitudes. There is a need for more formal education programs.

A lively topic of debate in decision theory over recent years concerns our understanding of the different risk attitudes exhibited by decision makers. There is ample evidence that risk-averse and risk-seeking behaviours are widespread, and a growing consensus that such behaviour is rationally permissible. In the context of clinical medicine, this matter is complicated by the fact that healthcare professionals must often make choices for the benefit of their patients, but the norms of rational choice are conventionally grounded in (...) a decision maker’s own desires, beliefs and actions. The presence of both doctor and patient raises the question of whose risk attitude matters for the choice at hand and what to do when these diverge. Must doctors make risky choices when treating risk-seeking patients? Ought they to be risk averse in general when choosing on behalf of others? In this paper, I will argue that healthcare professionals ought to adopt a deferential approach, whereby it is the risk attitude of the patient that matters in medical decision making. I will show how familiar arguments for widely held anti-paternalistic views about medicine can be straightforwardly extended to include not only patients’ evaluations of possible health states, but also their attitudes to risk. However, I will also show that this deferential view needs further refinement: patients’ higher-order attitudes towards their risk attitudes must be considered in order to avoid some counterexamples and to accommodate different views about what sort of attitudes risk attitudes actually are. (shrink)

In this paper I take up the question of the nature of the doxastic attitudes we entertain while inquiring into some matter. Relying on a distinction between two stages of open inquiry, I urge to acknowledge the existence of a distinctive attitude of cognitive inclination towards a proposition qua answer to the question one is inquiring into. I call this attitude “hypothesis”. Hypothesis, I argue, is a sui generis doxastic attitude which differs, both functionally and normatively, from suspended judgement, (...) full belief, credences, and acceptance. In closing, I point to the epistemological significance of hypothesis. More specifically, I contend that holding an attitude of hypothesis enables us to respond rationally to peer disagreement, and I suggest that such an attitude offers a suitable articulation of the view, originally put forward by Philip Kitcher, that cognitive diversity in inquiry has epistemic benefits. (shrink)

This is a prepublication version of my book Objects and Attitudes (please cite the pbished version!). The book develops a novel semantics of attitude reports, modal sentences, and quotation based on the view that sentences semantically act as predicates of various attitudinal and modal objects, entities like claims, requests, promises, obligations, and permissions, rather than standing for abstract propositions playing the role of objects. The approach develops truthmaker semantics for attitudinal and modal objects and has a wide range of (...) applications to issues in philosophy of language, semantics, and philosophy of mind. (shrink)

In this paper I argue that there is a class of attitudes that have questions (rather than propositions or something else) as contents.

We present an abstract model of rationality that focuses on structural properties of attitudes. Rationality requires coherence between your attitudes, such as your beliefs, values, and intentions. We define three 'logical' conditions on attitudes: consistency, completeness, and closedness. They parallel the familiar logical conditions on beliefs, but contrast with standard rationality conditions like preference transitivity. We establish a formal correspondence between our logical conditions and standard rationality conditions. Addressing John Broome's programme 'rationality through reasoning', we formally characterize (...) how you can (not) become more logical by reasoning. Our analysis connects rationality with logic, and enables logical talk about multi-attitude psychology. (shrink)

This book is a systematic treatment-perhaps the first-of “attitudes of the heart”-remorse (versus guilt), love, trust, gratitude, personal anger (versus righteous anger), jealousy, and others-and their role in mediating personal relationship, attachment, and connection. This is obviously interesting in its own right, but it also shows how heartfelt attitudes mirror more extensively studied “reactive attitudes” of guilt, resentment, and blame (“attitudes of the will”). Whereas the latter mediate moral relations of mutual respect and accountability, attitudes (...) of the heart are the currency of heartfelt connection and personal relationship. (shrink)

This paper offers a comparison of three different kinds of collective attitudes: aggregate, common, and corporate attitudes. They differ not only in their relationship to individual attitudes—e.g., whether they are “reducible” to individual attitudes—but also in the roles they play in relation to the collectives to which they are ascribed. The failure to distinguish them can lead to confusion, in informal talk as well as in the social sciences. So, the paper’s message is an appeal for (...) disambiguation. (shrink)

Are LLMs cultural technologies like photocopiers or printing presses, which transmit information but cannot create new content? A challenge for this idea, which we call bibliotechnism, is that LLMs generate novel text. We begin with a defense of bibliotechnism, showing how even novel text may inherit its meaning from original human-generated text. We then argue that bibliotechnism faces an independent challenge from examples in which LLMs generate novel reference, using new names to refer to new entities. Such examples could be (...) explained if LLMs were not cultural technologies but had beliefs, desires, and intentions. According to interpretationism in the philosophy of mind, a system has such attitudes if and only if its behavior is well explained by the hypothesis that it does. Interpretationists may hold that LLMs have attitudes, and thus have a simple solution to the novel reference problem. We emphasize, however, that interpretationism is compatible with very simple creatures having attitudes and differs sharply from views that presuppose these attitudes require onsciousness, sentience, or intelligence (topics about which we make no claims). (shrink)

According to relationism, for Alice to believe that some rabbits can speak is for Alice to stand in a relation to a further entity, some rabbits can speak. But what could this further entity possibly be? Higher-order metaphysics seems to offer a simple, natural answer. On this view (roughly put), expressions in different syntactic categories (for instance: names, predicates, sentences) in general denote entities in correspondingly different ontological categories. Alice's belief can thus be understood to relate her to a sui (...) generis entity denoted by "some rabbits can speak", belonging to a different ontological category than Alice herself. This straightforward account of the attitudes has historically been deemed so attractive that it was seen as providing an important motivation for higher-order metaphysics itself (Prior [1971]). But I argue that it is not as straightforward as it might seem, and in fact that propositional attitudes present a foundational challenge for higher-order metaphysics. (shrink)

Sustainability managers represent a key stakeholder in implementing and diffusing sustainability initiatives. However, there is a significant gap in the literature examining the impact of greenwashing on sustainability managers. This research examines the effects of greenwashing on sustainability managers' job satisfaction, commitment, turnover intentions, and job performance from a social identity/person–organization (P‐O) fit perspective. Our sample consists of practicing sustainability managers (n = 125) in high‐ (77%) or mid‐level (23%) positions. Results indicate that perceived greenwashing negatively affects the attitudinal outcomes (...) and job performance of sustainability managers. The results also indicate that for sustainability managers whose social responsibility identity is higher than that of their firm, greenwashing has a significant association with lower satisfaction and job performance and higher intentions to leave. However, for managers whose social responsibility identity is lower than that of their firm, employer greenwashing had no effect on the sustainability managers' attitudes, even though they recognized their own poor job performance. The cumulative effect may be a situation in which managers in the best position to enhance a firm's CSR leave the firm, and vice versa. (shrink)

Artificial Intelligence (AI) systems are ubiquitous. From social media timelines, video recommendations on YouTube, and the kinds of adverts we see online, AI, in a very real sense, filters the world we see. More than that, AI is being embedded in agent-like systems, which might prompt certain reactions from users. Specifically, we might find ourselves feeling frustrated if these systems do not meet our expectations. In normal situations, this might be fine, but with the ever increasing sophistication of AI-systems, this (...) might become a problem. While it seems unproblematic to realize that being angry at your car for breaking down is unfitting, can the same be said for AI-systems? In this paper, therefore, I will investigate the so-called “reactive attitudes”, and their important link to our responsibility practices. I then show how within this framework there exist exemption and excuse conditions, and test whether our adopting the “objective attitude” toward agential AI is justified. I argue that such an attitude is appropriate in the context of three distinct senses of responsibility (answerability, attributability, and accountability), and that, therefore, AI-systems do not undermine our responsibility ascriptions. (shrink)

How can the propositional attitudes of several individuals be aggregated into overall collective propositional attitudes? Although there are large bodies of work on the aggregation of various special kinds of propositional attitudes, such as preferences, judgments, probabilities and utilities, the aggregation of propositional attitudes is seldom studied in full generality. In this paper, we seek to contribute to filling this gap in the literature. We sketch the ingredients of a general theory of propositional attitude aggregation and (...) prove two new theorems. Our first theorem simultaneously characterizes some prominent aggregation rules in the cases of probability, judgment and preference aggregation, including linear opinion pooling and Arrovian dictatorships. Our second theorem abstracts even further from the specific kinds of attitudes in question and describes the properties of a large class of aggregation rules applicable to a variety of belief-like attitudes. Our approach integrates some previously disconnected areas of investigation. (shrink)

Psychological-epistemic accounts take scientific progress to consist in the development of some psychological-epistemic attitude. Disagreements over what the relevant attitude is – true belief, knowledge, or understanding – divide proponents of thesemantic,epistemic,andnoeticaccounts of scientific progress, respectively. Proponents of all such accounts face a common challenge. On the face of it, only individuals have psychological attitudes. However, as I argue in what follows, increases in individual true belief, knowledge, and understanding are neither necessary nor sufficient for scientific progress. Rather than (...) being fatal to the semantic, epistemic, and noetic accounts, this objection shows that these accounts are most plausible when they take the psychological states relevant to scientific progress to be states of communities, rather than individuals. I draw on recent work in social epistemology to develop two ways in which communities can be the bearers of irreducible psychological-epistemic states. Each way yields a strategy by which proponents of one of the psychological-epistemic accounts might attempt to account for the social dimensions of scientific progress. While I present serious reasons for concern about the first strategy, I argue that the second strategy, at least, offers a promising path forward for a psychological-epistemic account of scientific progress. (shrink)

Are doubt and suspension of judgment similar attitudes? In the burgeoning literature on suspension of judgment, the notion of doubt is curiously absent. This paper aims to argue for the plausibility of an identity claim, which I term the “No-Difference View.” This view suggests that there is no substantial difference between being in doubt and suspending judgment. The argument will draw on historical and systematic considerations that support the No-Difference View as a plausible view within the logical space of (...) positions. (shrink)

I argue that the problem of responsibility for attitudes is best understood as a puzzle about how we are responsible for responding to our object-given reasons for attitudes – i.e., how we are responsible for being (ir)rational. The problem can be solved, I propose, by understanding the normative force of reasons for attitudes in terms of blameworthiness. I present a puzzle about the existence of epistemic and mental blame which poses a challenge for the very idea of (...) reasons for attitudes. We are left with three options: denying that there are any reasons for attitudes, opting for pragmatism about reasons for attitudes, or arguing that the challenge rests on a misunderstanding of the normative force of reasons for attitudes. I finally suggest a version of the last strategy. We can understand the normative force of reasons for attitudes, and thereby solve the problem of mental responsibility, by acknowledging that the way we blame each other for failing to respond correctly to our reasons for attitudes is different from the way we blame each other when one failed to respond correctly to reasons for action. (shrink)

This study examines the direct impact of three dimensions of the institutional environment on managerial attitudes toward the natural environment and the direct influence of the latter on the environmental sustainability orientation (ESO) of small firms. We contend that when the institutional environment is perceived by owner–managers as supportive of sound natural environment management practices, they are more likely to develop a positive attitude toward natural environment issues and concerns. Such owner–manager attitudes are likely to lead to a (...) positive and proactive orientation of their firms toward environmental sustainability. The study uses survey data from 166 small manufacturing firms located in three Philippine cities. First, the study develops and tests the measurement models to examine the validity of the constructs representing the firm’s institutional environment, managerial attitudes toward the natural environment and the ESO of firms. Second, the study develops and tests the structural models examining the institutional environment–managerial attitudes–ESO linkages. Multi-sample invariance structural model analysis shows the mediating role of managerial attitudes in the institutional environment–ESO nexus. The findings show that ESO is a construct comprising three dimensions: knowledge of environmental issues, sustainable practices and commitment toward environmental sustainability. The cognitive, regulatory and normative elements of the institutional environment are strongly linked to positive managerial attitudes toward environmental sustainability, which in turn, positively influences the firm’s overall ESO. Managerial attitudes play a mediating role in the institutional environment–ESO linkages. The managerial, practical, research and policy implications of the research findings are discussed. (shrink)

When is it (epistemically) rational to suspend judgment on a proposition? Before addressing this question, one has to clarify what suspension of judgment (in short: suspension) is and establish rationality standards for the attitudes that constitute suspension. Ideally, suspending can be reduced to attitudes for which one already has established rationality standards. This paper distinguishes two kinds of suspension, weak and strong, and offers a reductionist account of suspension based on credence. However, it does not reduce suspension to (...) credence alone but takes a higher-order perspective on credence into account. Other doxastic attitudes such as belief and doubtful belief are also reexamined and defined in the light of this higher-order perspective. (shrink)

1. Over the last 50 years or so, and especially over the last few decades, the U.S. and many other societies have undergone a large, rapid, and broad decline in anti-gay attitudes. The magnitude, s...

Artificial intelligence represents a key technology being inbuilt into evermore products. Research investigating attitudes towards artificial intelligence surprisingly is still scarce, although it becomes apparent that artificial intelligence will shape societies around the globe. To better understand individual differences in attitudes towards artificial intelligence, the present study investigated in n = 351 participants associations between the Affective Neuroscience Personality Scales (ANPS) and the Attitudes towards Artificial Intelligence framework (ATAI). It could be observed that in particular higher levels (...) of SADNESS were associated with higher negative attitudes towards AI (fearing AI). The findings are discussed in this work from an evolutionary perspective because primary emotional systems—according to Affective Neuroscience Theory—represent tools for survival, which have been homologously conserved across mammalian species including homo sapiens. (shrink)