Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/UWS more respondents agreed with treatment withdrawal when they considered that VS/UWS patients did not feel pain (77%) as compared to those who thought VS/UWS did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/uws) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/uws more respondents agreed with treatment withdrawal when they considered that VS/uws patients did not feel pain (77%) as compared to those who thought VS/uws did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

This essay explores the role of God’s omnipresence in Newton’s natural philosophy, with special emphasis placed on how God is related to space. Unlike Descartes’ conception, which denies the spatiality of God, or Gassendi and Charleton’s view, which regards God as completely whole in every part of space, it is argued that Newton accepts spatial extension as a basic aspect of God’s omnipresence. The historical background to Newton’s spatial ontology assumes a large part of our investigation, but with attention also (...) focused on the details of Newton’s unique approach to these traditional Scholastic conceptions. (shrink)

By building upon Raz's analysis of the spectrum of voluntary obligations, the author produces a typology of agreements, and then assesses the extent to which these different kinds of agreements underpin the common law of contract. While recognizing that the law of contract purports to deal with a broad range of voluntarily undertaken obligations, the typology of agreements suggests that the present law is primarily suited to dealing only with bargains. This suggests that there are situations in which agreements should (...) be legally recognized, but which should not be dealt with by all of the conceptual tools of contract law, for these agreements and voluntary undertakings serve the interests of those undertaking them in significantly different ways than do bargains. (shrink)

This paper explores The New Rhetoric’s concept of universal audience in the contexts of philosophical and traditional rhetorical discourse. It argues that, since Perelman’s final English-language article, published in 1984 to clarify misunderstandings among rhetorical scholars about his theory, rhetorical scholars have persisted in three primary misconceptions of the concept of universal audience: appeals to the real are made only to universal audiences, only universal audiences are qualified to establish the reasonableness of arguments, and only universal audiences prevent The New (...) Rhetoric’s rhetorical theory from degenerating into relativism. It explains why each of these misconceptions is inaccurate and provides a corrected view of universal audience that places it exclusively in the province of philosophical discourse. Finally, it questions whether constructed audiences in general add explanatory power to rhetorical analyses or are merely unnecessary constructs that should be dispensed with for the sake of theoretical parsimony. (shrink)

We study the relationship between various properties of the real numbers and weak choice principles.

This study investigated the use of mobile telephones by males and females in a public bar frequented by professional people. We found that, unlike women, men who possess mobile telephones more often publicly display them, and that these displays were related to the number of men in a social group, but not the number of women. This result was not due simply to a greater number of males who have telephones: we found an increase with male social group size in (...) the proportion of available telephones that were on display. Similarly, there was a positive relationship between the number of visible telephones and the ratio of males to females. Our results further show that the increased display of telephones in groups with more males is not due to the ostensive function of these devices (i.e., the making and receiving of calls), although single males tended to use their phones more. We interpret these results within the framework of male-male competition, with males in larger group sizes functioning in an increasingly competitive environment. This competitive environment is suggested to be akin to a lek mating system in which males aggregate and actively display their qualities to females who assess males on a number of dimensions. We suggest that mobile telephones might be used by males as an indicator of their status and wealth (sensu “cultural ornaments”). (shrink)

Written over the last 18 months of his life and inspired by his interest in G. E. Moore's defence of common sense, this much discussed volume collects Wittgenstein's reflections on knowledge and certainty, on what it is to know a proposition for sure.

He is the darling of naturalism or the bogeyman of scepticism, a friend to virtue or an unwitting party to incipient nihilism. He is politically conservative, or a liberator from old views. He is a fideist, an advocate of faith over reason, or a precursor of Richard Dawkins.

This article analyses the conception of virtue and vice in early modern Europe. It explains that there were two movements in conceptions of virtue during this period. The first is the Cartesian tradition wherein virtue is intimately related to the control of the passions and the other is the continuation of this theme in Britain in a more aesthetic version. This article describes how the concepts of virtue and vice were softened by an awakening interest in the social emotions and (...) in the relationship between moral goodness and happiness. (shrink)

This chapter contains sections titled: Faith and Reason God's Existence The Names of God Theology and Metaphysics How We Know Universals Individuation Conclusion.