The ideal moral standard for surgical informed‐consent calls upon surgeons to carry out a disclosure dialogue with patients so they have as full as possible an understanding of the procedure before they sign the informed‐consent form. This study is the first to empirically explore patient preferences regarding disclosure dialogue. Twelve Israelis who underwent life‐saving surgeries participated in a narrative study. Three themes emerged from the analysis: objectification of patients, anxiety provoking processes and information, and lack of information that was essential (...) for patients. Findings contribute to existing debates among surgeons regarding the scope and importance of some disclosure components. Analysis led to our formulation of an augmented subjective model of information disclosure that participants prefer, which extends beyond the immediate present of the surgery to the period after discharge, and until return to routine. Surgeons should be aware of patient preferences in disclosure, and gaps between perceptions of surgeons, and preferences and needs of patients. (shrink)

Background There is little dispute that the ideal moral standard for surgical informed consent calls for surgeons to carry out a disclosure dialogue with patients before they sign the informed consent form. This narrative study is the first to link patient experiences regarding the disclosure dialogue with patient-surgeon trust, central to effective recuperation and higher adherence. Methods Informants were 12 Israelis, aged 29–81, who underwent life-saving surgeries. A snowball sampling was used to locate participants in their initial recovery process upon (...) discharge. Results Our empirical evidence indicates an infringement of patients’ right to receive an adequate disclosure dialogue that respects their autonomy. More than half of the participants signed the informed consent form with no disclosure dialogue, and thus felt anxious, deceived and lost their trust in surgeons. Surgeons nullified the meaning of informed consent rather than promoted participants’ moral agency and dignity. Discussion Similarity among jarring experiences of participants led us to contend that the conduct of nullifying surgical informed consent does not stem solely from constraints of time and resources, but may reflect an underlying paradox preserving this conduct and leading to objectification of patients and persisting in paternalism. We propose a multi-phase data-driven model for informed consent that attends to patients needs and facilitates patient trust in surgeons. Conclusions Patient experiences attest to the infringement of a patient’s right to respect for autonomy. In order to meet the prima facie right of respect for autonomy, moral agency and dignity, physicians ought to respect patient’s needs. It is now time to renew efforts to avoid negligent disclosure and implement a patient-centered model of informed consent. (shrink)

Go to John Cantwell’s response to the original paper from here › Go to Grazia Ietto-Gillies’ original paper from here ›.

The last couple of decades has brought a renewed interest in American conservatism among historians. Yet most recent studies have focused on the emergence of neoconservatism after World War II and virtually no recent scholarly work has pursued the history of conservatism before the 1920s. Both Richard Hofstadter and Clinton Rossiter agreed that the late nineteenth century was an important watershed in the evolution of American conservative thought. Hofstadter argued that the new laissez-faire conservatism that became dominant during the Gilded (...) Age was remarkable in that “it lacked many of the signal characteristics of conservatism as it is usually found.” Yet some conservatives refused to accept key features of what Clinton Rossiter once branded this new “contradictory conservatism.” This essay focuses mostly on Protestant clerical intellectuals who dissented from the new orthodoxy and attempted to preserve older conservative principles. Against the laissez-faire conservatives' hyperindividualism, these dissenting conservatives stressed an organic view of the social order and the importance of mediating institutions such as family and church. To the others' secularism, they offered a social theory suffused with evangelical Protestantism. This analysis highlights where these dissidents differed from their fellow conservatives and seeks also to elucidate their alternative conservative vision of the American republic. Such a study serves to clarify just how profound an ideological shift occurred among conservatives during the Gilded Age and illuminates some of the persistent tensions within American conservatism still evident today. (shrink)

The Twentieth Century has seen a dramatic rise in the use of probability and statistics in almost all fields of research. This has stimulated many new philosophical ideas on probability. _Philosophical Theories of Probability_ is the first book to present a clear, comprehensive and systematic account of these various theories and to explain how they relate to one another. Gillies also offers a distinctive version of the propensity theory of probability, and the intersubjective interpretation, which develops the subjective theory.

Archaeological discoveries, unless of unusual beauty, are generally of less inherent interest than the conclusions to which they point. Not that they are merely evidence in the court-room sense of the word; they certainly spur the imagination, and provide tangible links with those vast, unknown areas of human knowledge which scholarship seeks to restore to us. The public interest in recovered documents of the past, however, seems mainly in the discovery of the objects themselves rather than in the interpretation of (...) those objects. It is as if proving there was a past at a given date is of more interest than the life which made up that past.It is evident, for example, that public interest in the Dead Sea Scrolls is fading, now that publication of some of the new texts contained in them allows a preliminary assessment of their significance. Contact with the minds of men who composed them seems to be of lesser moment to many than the physical existence of manuscripts written and made use of two thousand years ago. (shrink)

The simplest story about modals—might, must, possibly, necessary, have to, can, ought to, presumably, likelier, and the rest—is also the canon: modals are context-dependent quantifiers over a domain of possibilities. Different flavors of modality correspond to quantification over different domains of possibilities. Logical modalities quantify over all the possibilities there are, physical modalities over possibilities compatible with the..

Counterfactuals are typically thought--given the force of Sobel sequences--to be variably strict conditionals. I go the other way. Sobel sequences and (what I call) Hegel sequences push us to a strict conditional analysis of counterfactuals: counterfactuals amount to some necessity modal scoped over a plain material conditional, just which modal being a function of context. To make this worth saying I need to say just how counterfactuals and context interact. No easy feat, but I have something to say on the (...) matter. (shrink)

There has been a long history of idealism concerning the potential of economic and political developments in Africa, the latest iteration of which emerged around the time of the 2007–8 global financial crisis. Here, Clive Gabay takes a historical approach to questions concerning change and international order as these apply to Africa in Western imaginaries. Challenging traditional postcolonial accounts that see the West imagine itself as superior to Africa, he argues that the centrality of racial anxieties concerning white supremacy (...) make Africa appear, at moments of Western crisis, as the saviour of Western ideals, specifically democracy, bureaucracy, and neoclassical economic order. Uncommonly, this book turns its lens as much inwards as outwards, interrogating how changing attitudes to Africa over the course of the twentieth and early twenty-first centuries correspond to shifting anxieties concerning whiteness, and the growing hope that Africa will be the place where the historical genius of whiteness might be saved and perpetuated. (shrink)

Understanding Animal Abuse and How to Intervene with Children and Young People offers a positive, compassion-based and trauma-informed approach to understanding and intervening in animal abuse. It provides an accessible cross-disciplinary synthesis of current international evidence on animal abuse, and a toolkit for professionals working with people and/or animals to help them understand, prevent, and intervene in cases of animal abuse. With contributions from experts in the field, this essential text offers ten user-friendly chapters with questions for reflection and key (...) summary points. It offers a definition of animal abuse, synthesises the latest research on children, young people and animal abuse, and explores the link between animal abuse and other forms of abuse, and legal perspectives on animal abuse. The second half of the book presents a practical toolkit for professionals, offering guidance and strategies for prevention of and intervention in cases of animal abuse. It provides multidisciplinary perspectives on interventions; from teachers' and social workers roles in detection and intervention of childhood animal abuse, to the roles of enforcement agencies and veterinarians in legal cases of adult animal abuse. Together with a final chapter proposing new directions for research, policy, and practice, this guide is for all who work with children, young people and/or animals, including psychologists, social workers, veterinarians, education professionals, and animal welfare educators. It is also key reading for those involved in legal and policy issues relating to animal welfare. (shrink)

Teaching children to ask and answer questions is critically important if they are to learn to talk and reason effectively together, particularly during inquiry-based science where they are required to investigate topics, consider alternative propositions and hypotheses, and problem-solve together to propose answers, explanations, and prediction to problems at hand. This study involved 108 students (53 boys and 55 girls) from seven, Year 7 teachers’ classrooms in five primary schools in Brisbane, Australia. Teachers were randomly allocated by school to one (...) of two conditions: the metacognitive questioning condition (Trained condition) or the prescriptive questioning condition (Untrained condition). Data on students’ discourse and reasoning and problem-solving (RP-S) were collected across Times 1 and 2. The results showed that while there were significant differences in the discourse categories of the students in the two conditions at Time 1, the only significant difference was in questioning behaviour at Time 2 with the students in the trained condition continuing to ask more questions than their untrained peers. Given that these students had been taught to specifically ask ‘thinking’ questions that probed and interrogated information, these results are not surprising. A follow-up examination of students’ discourse during their small group discussions illustrated how these students interacted with each other to probe and interrogate information by providing explanations and reasons to make their thinking explicit and by using analogies to verbally represent concepts they were trying to express. Results on the follow-up reasoning and problem-solving (RP-S) tasks indicated that students in the Trained and Untrained conditions improved their scores from Time 1 to Time 2 although the change was not significantly different between conditions. (shrink)

. Caring at a Distance: partiality, Moral Motivation and the Ethics of Representation - Moral Motivation - How Far Can You Travel in Five Minutes? Ethics, Place & Environment: Vol. 3, No. 3, pp. 319-322.

Evidence-based medicine (EBM) makes use of explicit procedures for grading evidence for causal claims. Normally, these procedures categorise evidence of correlation produced by statistical trials as better evidence for a causal claim than evidence of mechanisms produced by other methods. We argue, in contrast, that evidence of mechanisms needs to be viewed as complementary to, rather than inferior to, evidence of correlation. In this paper we first set out the case for treating evidence of mechanisms alongside evidence of correlation in (...) explicit protocols for evaluating evidence. Next we provide case studies which exemplify the ways in which evidence of mechanisms complements evidence of correlation in practice. Finally, we put forward some general considerations as to how the two sorts of evidence can be more closely integrated by EBM. (shrink)

Commentator: Mark Purvis Commentator: Sheena McMain Commentator: Clare Connolly Commentator: Maggie Eisner Commentator: Shirley Brierley Commentator: Becky Ship.

The paper briefly summarises the historical evolution of transnational corporations and their activities. It then introduces the major theories developed to explain the TNC. There is an attempt to place the theories historically, within the context of the socio-economic … More ›.

The creation of poetry can be an intensely healing process, as therapeutic as the other arts and talking therapies. This paper examines three areas. First, it sets out some opinions about the specific qualities of poetry that make it particularly valuable as part of a therapeutic process. It goes on to give exemplified information about how poetry is used within healthcare in Britain. Finally, it indicates the current growth of interest in this area, with brief descriptions of pilot research studies (...) where poetry has been offered by a writing therapist, or by nursing or medical practitioners. (shrink)

Epistemic modals are standardly taken to be context-dependent quantifiers over possibilities. Thus sentences containing them get truth-values with respect to both a context and an index. But some insist that this relativization is not relative enough: `might'-claims, they say, only get truth-values with respect to contexts, indices, and—the new wrinkle—points of assessment (hence, CIA). Here we argue against such "relativist" semantics. We begin with a sketch of the motivation for such theories and a generic formulation of them. Then we catalogue (...) central problems that any such theory faces. We end by outlining an alternative story. (shrink)

What we want to be true about ordinary indicative conditionals seems to be more than we can possibly get: there just seems to be no good way to assign truth-conditions to ordinary indicative conditionals. Some take this argument as reason to make our wantings more modest. Others take it to show that indicative conditionals don't have truth-conditions in the first place. But we have overlooked two possibilities for assigning truth-conditions to indicatives. What's more, those possibilities deliver what we want and (...) turn out to be equivalent. CiteULike Connotea Del.icio.us Digg Reddit Technorati What's this? (shrink)

It is a recurring mantra that epistemic must creates a statement that is weaker than the corresponding flat-footed assertion: It must be raining vs. It’s raining. Contrary to classic discussions of the phenomenon such as by Karttunen, Kratzer, and Veltman, we argue that instead of having a weak semantics, must presupposes the presence of an indirect inference or deduction rather than of a direct observation. This is independent of the strength of the claim being made. Epistemic must is therefore quite (...) similar to evidential markers of indirect evidence known from languages with rich evidential systems. We work towards a formalization of the evidential component, relying on a structured model of information states (analogous to some models used in the belief dynamics literature). We explain why in many contexts, one can perceive a lack of confidence on the part of the speaker who uses must. (shrink)

According to current hierarchies of evidence for EBM, evidence of correlation (e.g., from RCTs) is always more important than evidence of mechanisms when evaluating and establishing causal claims. We argue that evidence of mechanisms needs to be treated alongside evidence of correlation. This is for three reasons. First, correlation is always a fallible indicator of causation, subject in particular to the problem of confounding; evidence of mechanisms can in some cases be more important than evidence of correlation when assessing a (...) causal claim. Second, evidence of mechanisms is often required in order to obtain evidence of correlation (for example, in order to set up and evaluate RCTs). Third, evidence of mechanisms is often required in order to generalise and apply causal claims. While the EBM movement has been enormously successful in making explicit and critically examining one aspect of our evidential practice, i.e., evidence of correlation, we wish to extend this line of work to make explicit and critically examine a second aspect of our evidential practices: evidence of mechanisms. (shrink)

ObjectiveIndividuals with an evening chronotype prefer to sleep later at night, wake up later in the day and perform best later in the day as compared to individuals with morning chronotype. Thus, college students without ADHD symptoms with evening chronotypes show reduced cognitive performance in the morning relative to nighttime. In combination with symptoms presented in attention deficit hyperactivity disorder, we predicted that having evening chronotype renders impairment in attention during the morning, when students require optimal performance, amplifying desynchrony.MethodFour hundred (...) college students were surveyed for evening chronotype and symptoms of ADHD. Of those surveyed, 43 students with evening chronotype performed laboratory attention tasks and were queried about fatigue during morning and evening sessions.ResultsStudents with ADHD symptoms demonstrated a greater decrement in sustained attentional vigilance when abstaining from stimulants and asked to perform cognitive tests at times misaligned with natural circadian rhythms in arousal compared to their non-ADHD counterparts with the same chronotype. While individuals with ADHD symptoms had slower reaction-times during sustained attention tasks in the morning session compared to those without symptoms, there was no significant group difference in working memory performance, even though both groups made more errors in the morning session compared to the evening session.ConclusionThese findings suggest that evening chronotype students with ADHD symptoms are at a greater disadvantage when having to perform sustained attention tasks at times that are not aligned to their circadian rhythm compared to their neuro-typical peers. The implications of this finding may be useful for the provision of disability accommodations to college age students with ADHD when they are expected to perform tasks requiring sustained attention at times misaligned with their circadian rhythms. (shrink)

Recently, indigenous struggles against ongoing colonial violence have become prominent in the context of growing environmental destruction and the ascendancy of the far right in the United States and parts of South America. This article suggests that European radical theory is not always equipped to provide normative frameworks of allyship with such struggles. Exploring the ‘messianic tone’ in European radical theory, and in particular the works of Jacques Derrida and Giorgio Agamben, the article argues that the analytical tendency to render (...) the subject entirely dissolute acts against indigenous demands for justice built around the latter’s sovereignty. In an effort to excavate a ‘European’ tradition that might enable relations of allyship between those in relatively privileged positions and indigenous peoples, the article foregrounds the life and thought of Gustav Landauer, a German, Jewish, anarchist revolutionary who lost his life during the 1919 German revolution. Landauer’s anarchism was suffused with his reading of his Jewishness, and as such, although he prefigures Derrida and Agamben in many ways, he ultimately refused to completely reject the sovereignty of the subject, providing a means by which to engage European political theory with indigenous struggles in the world today. (shrink)

The European Enlightenment in the latter half of the eighteenth century heralded a grave conflict between theological and scientific modes of thought, starkly revealing the ancient tensions between spiritual knowledge and rationalism. Yet there was another, lesser-known movement during this time---a "covert" Enlightenment---that sought to bring fresh perspectives on the soul, and by extension, on the human mind and on consciousness. This work examines the influence of Emanuel Swedenborg and Anton Mesmer on the budding movement toward psychology in the late-eighteenth (...) century and also spiritualism and millennialism in the nineteenth century. (shrink)

Journal of Human Values, Volume 28, Issue 2, Page 115-128, May 2022. Is emotional labour a burden or a boon to service providers who have greater workplace spirituality? We test a moderated mediation model in which emotional exhaustion mediates the conjoint effect of WS and emotional labour on job satisfaction. Linking conservation of resources theory with the mechanism of ‘value congruence’ in person–environment fit theory, we theorize that spiritual values are a key factor in generating necessary resource gains for deep (...) acting due to the value fit of these two motivational vectors. As a boundary condition for use of the benefits of DA, WS can bridge the gap between theoretical assumptions concerning the benefits of DA and the lack of empirical evidence that DA mitigates emotional exhaustion. Concurrently, we challenge the perception of WS as universally beneficial to employees’ wellbeing by proposing that WS amplifies the detrimental effects of surface acting because the externalized and inauthentic nature of this type of emotional regulation transgresses basic spiritual values. Our hypotheses find support in a study of 196 Israeli service providers at inbound call centres. (shrink)

In "*Must* ...stay ...strong!" (von Fintel & Gillies 2010) we set out to slay a dragon, or rather what we called The Mantra: that epistemic *must* has a modal force weaker than expected from standard modal logic, that it doesn't entail its prejacent, and that the best explanation for the evidential feel of *must* is a pragmatic explanation. We argued that all three sub-mantras are wrong and offered an explanation according to which *must* is strong, entailing, and the felt indirectness (...) is the product of an evidential presupposition carried by epistemic modals. Mantras being what they are, it is no surprise that each of the sub-mantras have been given new defenses. Here we offer them new problems and update our picture, concluding that *must* is (still) strong. (shrink)