Background In May 2020, England moved to an opt-out organ donation system, meaning adults are presumed to be an organ donor unless within an excluded group or have opted-out. This change aims to improve organ donation rates following brain or circulatory death. Healthcare staff in the UK are supportive of organ donation, however, both healthcare staff and the public have raised concerns and ethical issues regarding the change. The #options survey was completed by NHS organisations with the aim of understanding (...) awareness and support of the change. This paper analyses the free-text responses from the survey. Methods The #options survey was registered as a National Institute of Health Research (NIHR) portfolio trial [IRAS 275992] 14 February 2020, and was completed between July and December 2020 across NHS organisations in the North-East and North Cumbria, and North Thames. The survey contained 16 questions of which three were free-text, covering reasons against, additional information required and family discussions. The responses to these questions were thematically analysed. Results The #options survey received 5789 responses from NHS staff with 1404 individuals leaving 1657 free-text responses for analysis. The family discussion question elicited the largest number of responses (66%), followed by those against the legislation (19%), and those requiring more information (15%). Analysis revealed six main themes with 22 sub-themes. Conclusions The overall #options survey indicated NHS staff are supportive of the legislative change. Analysis of the free-text responses indicates that the views of the NHS staff who are against the change reflect the reasons, misconceptions, and misunderstandings of the public. Additional concerns included the rationale for the change, informed decision making, easy access to information and information regarding organ donation processes. Educational materials and interventions need to be developed for NHS staff to address the concepts of autonomy and consent, organ donation processes, and promote family conversations. Wider public awareness campaigns should continue to promote the positives and refute the negatives thus reducing misconceptions and misunderstandings. Trial registration National Institute of Health Research (NIHR) [IRAS 275992]. (shrink)

The question of whether humans represent grammatical knowledge as a binary condition on membership in a set of well-formed sentences, or as a probabilistic property has been the subject of debate among linguists, psychologists, and cognitive scientists for many decades. Acceptability judgments present a serious problem for both classical binary and probabilistic theories of grammaticality. These judgements are gradient in nature, and so cannot be directly accommodated in a binary formal grammar. However, it is also not possible to simply reduce (...) acceptability to probability. The acceptability of a sentence is not the same as the likelihood of its occurrence, which is, in part, determined by factors like sentence length and lexical frequency. In this paper, we present the results of a set of large-scale experiments using crowd-sourced acceptability judgments that demonstrate gradience to be a pervasive feature in acceptability judgments. We then show how one can predict acceptability judgments on the basis of probability by augmenting probabilistic language models with an acceptability measure. This is a function that normalizes probability values to eliminate the confounding factors of length and lexical frequency. We describe a sequence of modeling experiments with unsupervised language models drawn from state-of-the-art machine learning methods in natural language processing. Several of these models achieve very encouraging levels of accuracy in the acceptability prediction task, as measured by the correlation between the acceptability measure scores and mean human acceptability values. We consider the relevance of these results to the debate on the nature of grammatical competence, and we argue that they support the view that linguistic knowledge can be intrinsically probabilistic. (shrink)

This article reports on research that examines newly qualified UK nurses’ experiences of implementing their ideals and values in contemporary nursing practice. Findings are presented from questionnaire and interview data from a longitudinal interpretive study of nurses’ trajectories over time. On qualification nurses emerged with a coherent and strong set of espoused ideals around delivering high quality, patient‐centred, holistic and evidence‐based care. These were consistent with the current UK nursing mandate and had been transmitted and reinforced throughout their ‘prequalification’ programmes. (...) The existence of professional and organisational constraints influenced their ability to implement these ideals and values once in practice. Data analysis revealed that within 2 years in practice the newly qualified nurses could be categorised as sustained idealists, compromised idealists, or crushed idealists. The majority experienced frustration and some level of ‘burnout’ as a consequence of their ideals and values being thwarted. This led to disillusionment, ‘job‐hopping’ and, in some cases, a decision to leave the profession. These data are explored and discussed to inform the question of whether the current nursing mandate is sustainable. (shrink)

Some Philosophical Prehistory of General Relativity As history, my remarks will form rather a medley. If they can claim any sort of unity (apart from a ...

Using Gebharter’s representation, we consider aspects of the problem of discovering the structure of unmeasured submechanisms when the variables in those submechanisms have not been measured. Exploiting an early insight of Sober’s, we provide a correct algorithm for identifying latent, endogenous structure—submechanisms—for a restricted class of structures. The algorithm can be merged with other methods for discovering causal relations among unmeasured variables, and feedback relations between measured variables and unobserved causes can sometimes be learned.

Although personal attributes have gained recognition as an important area of effective corporate governance, scholarship has largely overlooked the value and implications of individual virtue in governance practice. We explore how authenticity—a personal and morally significant virtue—affects the primary monitoring and strategy functions of the board of directors as well as core processes concerning director selection, cultivation, and enactment by the board. While the predominant focus in corporate governance research has been on structural factors that influence firm financial outcomes, this (...) paper shifts attention to the role of authenticity and its relationship to individual board member qualities and collective board activities. We explore how authenticity has the potential to influence board dynamics and decision making and to enhance transparency and accountability. (shrink)

The dominance of agency theory can reduce our collective scope to analyse private equity in all its diversity and depth. We contribute to theorisation of private equity by developing a contrasting perspective that draws on a rich tradition of virtue ethics. In doing so, we juxtapose 'private equity' with 'public good' to develop points of rhetorical and analytical contrast. We develop a typology differentiating various forms of private equity, and focus on the 'take private' form. These takeovers are where private (...) equity funds are used to buy all a firm's publicly listed shares. Take private deals reduce reporting requirements and lessen the amount of public scrutiny a firm comes under. They allow greater control of a firm's assets and resources but also have effects in terms of the wider social fabric. The 'public good' and virtue ethics offer an alternative basis for theorisation of these deals. This provides a needed contrast to accounts of private equity based on agency theory. (shrink)

Rid and Wendler propose the development of a Patient Preference Predictor (PPP), an actuarial model for predicting incapacitated patient’s life-sustaining treatment preferences across a wide range of end-of-life scenarios. An actuarial approach to end-of-life decision making has enormous potential, but transferring the logic of actuarial prediction to end-of-life decision making raises several conceptual complexities and logistical problems that need further consideration. Actuarial models have proven effective in targeted prediction tasks, but no evidence supports their effectiveness in the kind of broad (...) spectrum prediction task that is the proposed goal of the PPP. We argue that a more focused approach, targeting specific medical conditions and generating treatment predictions based on the preferences of individuals with actual disease experience, is both more firmly grounded in past research and is a more prudent initial strategy for exploring the efficacy of actuarial prediction in end-of-life decision making. (shrink)

Rather than focusing on the legal and political questions that surround genocidal rape, in this paper I treat a vital area of inquiry that has received much less attention: the moral significance of genocidal rape. My aim is to augment existing moral accounts of rape in order to address the specific contexts of genocidal rape. I move beyond understanding rape primarily as a violation of an individual's interests or agential abilities. The account I offer builds on these approaches (as well (...) as on a pluralist approach), by arguing that rape, as a moral injury, negatively affects the very human dignity of victims. My account also emphasizes the relational harm that marks genocidal rape. (shrink)

Objectives: To analyse legislation and medical professional positions concerning the doctor’s role in assisted dying in western Europe, and to discuss their implications for doctors.Method: This paper is based on country-specific reports by experts from European countries where assisted dying is legalised , or openly practiced , or where it is illegal .Results: Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide is not illegal in either Germany or Switzerland, but a doctor’s (...) participation in Germany would violate the code of professional medical conduct and might contravene of a doctor’s legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not.Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This “neutral” stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a “medical end-of-life decision” since the 1970s.Conclusion: A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions. (shrink)

ABSTRACTClose relationship partners often respond to happiness expressed through smiles with capitalization, i.e. they join in attempting to up-regulate and prolong the individual’s positive emotion, and they often respond to crying with interpersonal down-regulation of negative emotions, attempting to dampen the negative emotions. We investigated how people responded when happiness was expressed through tears, an expression termed dimorphous. We hypothesised that the physical expression of crying would prompt interpersonal down-regulation of emotion when the onlooker perceived that the expresser was experiencing (...) negative or positive emotions. When participants were asked how they would behave when faced with smiles of joy, we expected capitalization responses, and when faced with tears of joy, we expected down-regulation responses. In six experimental studies using video and photographic stimuli, we found support for our hypotheses. Throughout our investigations we test and discuss boundaries of and poss... (shrink)

The recent revival of the theme of hospitality in the humanities and social sciences reflects a shared concern with issues of belonging, identity and placement that arises out of the experience of globalized social life. In this context, migration — or spatial dislocation and relocation — is often equated with demands for hospitality. There is a need to engage more carefully with the ‘proximities’ that prompt acts of hospitality and inhospitality; to attend more closely to their spatial and temporal dimensions. (...) Is the stranger or the Other primarily one who is recognisably ‘out of place’? Or is there more to being estranged than moving from one territory to another? This brings us to the question of human finitude, and to the possibility of encounters with others that do not simply only occur in time or space, but are themselves generative of new times and spaces. (shrink)

In this article, I seek to address an aspect of the general inattention to miscarriage by examining a pressing topic: the moral meanings of pregnancy loss. I focus primarily on the import of such meanings for women in their ethical relationship with themselves, while also finding significant the meaning of miscarriage in community, that is, for our shared moral lives. Exploring miscarriage as a moral phenomenon is critical for figuring out miscarriage’s impact on our ethical self-conception—on how we understand ourselves (...) as moral agents—and in forming and deforming how we understand one another in the broader context of our moral communities—in intimate realms, in public realms, and in various realms in between. -/- I begin by articulating the need for a dedicated perinatal ethics, then developing an overview of this approach. It is against this backdrop that miscarriage’s complex moral meaning can best emerge. I then consider a few promising yet problematic concepts for comprehending the moral meanings of miscarriage, including moral agency, reactive attitudes (in this case, betrayal and guilt), moral responsibility, and moral standing. (shrink)

The Treatment Escalation Plan (TEP) was introduced into our trust in an attempt to improve patient involvement and experience of their treatment in hospital and to embrace and clarify a wider remit of treatment options than the Do Not Resuscitate (DNR) order currently offers. Our experience suggests that the patient and family are rarely engaged in DNR discussions. This is acutely relevant considering that the Mental Capacity Act (MCA) now obliges these discussions to take place. The TEP is a form (...) that the doctor completes, ideally with the competent patient or close relative, documenting what treatment options would be appropriate if that patient were to become acutely unwell. Ventilation of the lungs, cardiac resuscitation, renal replacement therapy, intravenous fluids and antibiotics are all discussed. The study evaluated patient and relative experiences with the TEP. 55 patients or their relatives were interviewed regarding their experience of the TEP and thoughts regarding the process. 96% of patients and relatives evaluated thought that the TEP was a good idea. Free text comments were all positive and only 34% of patients claimed to feel anxious when completing the form. Following this study, the TEP has been expanded hospital wide and into the community within our trust. Discussions are currently taking place in hospitals within our region to introduce the TEP form into other local trusts. (shrink)

Responding to claims of Anthropocene geoscience that humans are now geological agents, social scientists are calling for renewed attention to the social, cultural, political and historical differentiation of the Anthropos. But does this leave critical social thought’s own key concepts and categories unperturbed by the Anthropocene provocation to think through dynamic earth processes? Can we ‘socialize the Anthropocene’ without also opening ‘the social’ to climate, geology and earth system change? Revisiting the earth science behind the Anthropocene thesis and drawing on (...) social research that is using climatology and earth systems thinking to help understand socio-historical change, this article explores some of the possibilities for ‘geologizing’ social thought. While critical social thought’s attention to justice and exclusion remains vital, it suggests that responding to Anthropocene conditions also calls for a kind of ‘geo-social’ thinking that relates human diversity and social difference to the potentiality and multiplicity of the earth itself. (shrink)

In this essay, I develop the duty to care. I argue that certain needs do require a moral response. Under the duty to care, moral individuals must act so as to bolster and safeguard the agency of those in need. Substantively, the duty to care features five qualities. It endorses a wide variety of forms of care. It does not demand that caretakers feel certain emotions for their charges. It places limits on the extent of self-sacrifice involved in meeting others’’ (...) needs. It is action oriented. Finally, it is nonpaternalistic. I take a unique approach to develop the duty to care, bringing Kantian ethics and feminist care ethics into conversation with one another in order to highlight the exciting contributions that both have to offer this account. I propose that building on the Kantian duty of beneficence, one can articulate a duty that explains why we are obligated to respond to certain needs found in others. Although the Kantian duty of beneficence provides some resources to use in developing this explanation, I also employ a care ethics perspective to offer an important angle of critique through which one can see both moments when Kant’s account fails (which I consider in a series of four objections) and why care ethics must be incorporated into any worthwhile discussion of meeting needs. Thus the duty to care, while drawing upon the duty of beneficence for its foundation, moves beyond it. Demonstrated through the duty to care’s responsiveness to perceptive objections that care ethicists might raise, the duty to care emerges as a distinctive duty in its own right, one sensitive to the moral concerns of agency, need, and care. (shrink)

The question of whether grammaticality is a binary categorical or a gradient property has been the subject of ongoing debate in linguistics and psychology for many years. Linguists have tended to use constructed examples to test speakers’ judgements on specific sorts of constraint violation. We applied machine translation to randomly selected subsets of the British National Corpus (BNC) to generate a large test set which contains well-formed English source sentences, and sentences that exhibit a wide variety of grammatical infelicities. We (...) tested a large number of speakers through (filtered) crowd sourcing, with three distinct modes of classification, one binary and two ordered scales. We found a high degree of correlation in mean judgements for sentences across the three classification tasks. We also did two visual image classification tasks to obtain benchmarks for binary and gradient judgement patterns, respectively. Finally, we did a second crowd source experiment on 100 randomly selected linguistic textbook example sentences. The sentence judgement distributions for individual speakers strongly resemble the gradience benchmark pattern. This evidence suggests that speakers represent grammatical well-formedness as a gradient property. (shrink)

By combining experimental interventions with search procedures for graphical causal models we show that under familiar assumptions, with perfect data, N - 1 experiments suffice to determine the causal relations among N > 2 variables when each experiment randomizes at most one variable. We show the same bound holds for adaptive learners, but does not hold for N > 4 when each experiment can simultaneously randomize more than one variable. This bound provides a type of ideal for the measure of (...) success of heuristic approached in active learning methods of casual discovery, which currently use less informative measures. (shrink)

O trabalho tem como objeto o exame da questão da omissão legislativa dos entes federativos quanto aos reajustes anuais dos servidores públicos e as suas consequências quanto à aplicação do artigo 37, X da Constituição brasileira de 1988, bem como o cabimento ou não de responsabilização civil desses entes da federação face à referida omissão. A pesquisa é eminentemente documental, estribando-se na doutrina, legislação e jurisprudência pátria, possuindo como marco teórico os ensinamentos sobre a Regra da Indexação do Prof. Washington (...) Peluso Albino de Souza, introdutor do Direito Econômico no Brasil. (shrink)

Late Antique Epistemology explores the techniques used by late antique philosophers to discuss truth. Non-rational ways to discover truth, or to reform the soul, have usually been thought inferior to the philosophically approved techniques of rational argument, suitable for the less philosophically inclined, for children, savages or the uneducated. Religious rituals, oracles, erotic passion, madness may all have served to waken courage or remind us of realities obscured by everyday concerns. What is unusual in the late antique classical philosophers is (...) that these techniques were reckoned as reliable as reasoned argument, or better still. Late twentieth century commentators have offered psychological explanations of this turn, but only recently had it been accepted that there might also have been philosophical explanations, and that the later antique philosophers were not necessarily deluded. (shrink)

Labioplasty is a surgical procedure performed to alter the size and shape of the labia minora. The reasons for women requesting this procedure remain largely unknown and recently girls and young women under the age of 18 years have been requesting this type of surgery. This paper examines the ethical acceptability of performing this procedure on under 18s. We will first discuss whether labioplasty can be considered to be a therapeutic technique. We will claim that, while it is difficult to (...) offer a definitive definition of what constitutes a therapeutic technique, in our view labioplasty cannot be considered as such. This conclusion has relevance for the ethical acceptability of the procedure, its legal status in regard to the Female Genital Mutilation Act and the debates over who can give consent for it. It will be concluded that in our current state of knowledge, the benefits of labioplasty are far from clear, whereas the harms are demonstrable and therefore this procedure should not be offered to those aged under 18 years. (shrink)

Convergent realists desire scientific methods that converge reliably to informative, true theories over a wide range of theoretical possibilities. Much attention has been paid to the problem of induction from quantifier-free data. In this paper, we employ the techniques of formal learning theory and model theory to explore the reliable inference of theories from data containing alternating quantifiers. We obtain a hierarchy of inductive problems depending on the quantifier prefix complexity of the formulas that constitute the data, and we provide (...) bounds relating the quantifier prefix complexity of the data to the quantifier prefix complexity of the theories that can be reliably inferred from such data without background knowledge. We also examine the question whether there are theories with mixed quantifiers that can be reliably inferred with closed, universal formulas in the data, but not without. (shrink)

This is a study of the relationship between postmodernism and post-enlightenment German thought reading the contemporary theoretical scene through its nineteenth-century counterpart and examining the intersections.