The purpose of this research was to explore the concept of collaboration within a specific healthcare context and to include the perspectives of healthcare users, a position largely lacking in previous studies. In applying a critical theoretical approach, the focus was on, as an exemplar, mothers with newborn babies who had spent more than 48 hr in a special care nursery. Semistructured interviews were undertaken with child health nurses, midwives and mothers. The three key theoretical findings on collaboration generated in (...) the study point to layers of meanings around identity, knowledge and institutions of care. Findings from the interview data analysis were further examined through the lens of key policy documents. The research outcomes indicate that the concept of collaboration serves an important function in healthcare in obscuring the complexities and ambiguities that characterise the care continuum. The study concludes the need for a more critical approach to the assumptions that underlie the language of collaboration and the implications for practice in healthcare. (shrink)

Informed consent has passed through three stages. The first paternalistic stage lasted for many centuries: The doctor's diagnosis and healing arts were kept secret, and informing patients was regarded as professionally and ethically wrong. Second came the legal stage, when the right of patients to make informed decisions concerning their own treatment was imposed by the courts and reluctantly tolerated by medical professionals. The third informed consent stage emerged more recently: the general therapy stage. The therapeutic benefits of informed consent (...) have been well established, and informed consent is widely recognized as an important element in sound medical practice. When patients are effectively informed and can exert knowledgeable control over their own treatment decisions and therapy processes, that enhances recovery, strengthens the immune system, promotes better pain tolerance, prevents depression, and encourages patient cooperation and fortitude in treatment, rehabilitation, and preventative procedures. As the medical community has absorbed greater knowledge of this research, informed consent has been recognized as both ethically essential and therapeutically sound: the hallmark of the current general therapy stage of informed consent. (shrink)

Over the past several years, healthcare has been profoundly altered by the growth of managed care. Because managed care integrates the financing and delivery of healthcare services, it dramatically alters the roles and relationships among providers, payers, and patients. While analysis of this change has focused on whether and how managed care can control costs, an increasingly important concern among healthcare providers and recipients is the impact of managed care on the physicianpatient relationship, but little data have been collected and (...) analyzed. We designed a survey for distribution to Wisconsin physicians to analyze the prevalence and types of managed care arrangements in the state, and the impact of these arrangements on physicians and their relationships with patients. (shrink)

For over a decade, managed care has profoundly altered how healthcare is delivered in the United States. There have been concerns that the patient-physician relationship may be undermined by various aspects of managed care, such as restrictions on physician choice, productivity requirements that limit the time physicians may spend with patients, and the use of compensation formulas that reward physicians for healthcare dollars not spent. We have previously published data on the effects of managed care on the physician-patient relationship from (...) the physician's perspective. In 1999, we collected data on the impact of managed care arrangements on the physician-patient relationship from the patient's perspective. This article discusses our collective findings. (shrink)

Over the past two decades ethics committees have proliferated in healthcare institutions across the country. Catalysts for this growth include the endorsement of ethics committees by the New Jersey Supreme Court in the Quinlan case, by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical Research in its report entitled Deciding to Forgo Life Sustaining Medical Treatment, by the U.S. Department of Health and Human Services in its 1985 “Baby Doe” regulations, by numerous other courts in (...) treatment decisionmaking opinions issued after Quinlan, and more recently by the Joint Commission on Accreditation of Healthcare Organizations. (shrink)

The pandemic has been the most vivid agent of change that many of us have known. But it has not changed everything: plenty of the institutions, norms, and practices that sustain racial capitalism, settler colonialism, and cisheteropatriarchy have either weathered the storm of the crisis or been nourished by its effects. And yet enough has changed for us to see that the pandemic has profoundly recontextualised those structures and systems of violence, bringing us into a fresh negotiation with, for example, (...) the question of how we discuss and imagine freedom. Responding in part to this unexpected provocation, activist-scholars Robyn Maynard and Leanne Betasamosake Simpson forged a collaboration from the lockdown of 2020, corresponding by letter to create their forthcoming book, Rehearsals for Living, due to be published by Haymarket Books (US) and Knopf (Canada) in 2022. In this interview, we asked them to explain the epistolary form of the book and expand on the concept of “rehearsal”, before inviting them to reflect on a series of issues that animate our current crises: the politics of recognition; the notion of apocalypse; ways to disrupt linear temporalities; practises of reciprocity against proprietary logics; the gendered violence of state apparatuses; and worldbuilding as a method of resistance. In their expansive answers, Robyn and Leanne draw on their experiences as organisers and educators, commenting on anticolonial struggles, the Movement for Black Lives, and the rise of abolition discourse. Stressing the need to build a multiplicity of shared homespaces in the face of racial/colonial capitalism and organized abandonment, they challenge us to rethink the predicaments and possibilities of the present, enabling us to imagine futures liberated of extractivist, carceral governance – “planting more liberatory futures in the present”, as Robyn puts it. The task of sowing those seeds is a collective praxis of rewriting the narratives that constitute us, refusing to hear that nothing can change and insisting that everything must. (shrink)

Jean-Luc Marion is one of the leading Catholic thinkers of our time: a formidable authority on Descartes and a major scholar in the philosophy of religion. This book presents a concise, accessible, and engaging introduction to the theology of Jean-Luc Marion. Described as one of the leading thinkers of his generation, Marion's take on the postmodern is richly enhanced by his expertise in patristic and mystical theology, phenomenology, and modern philosophy. In this first introduction to Marion's thought, Robyn Horner (...) provides the essential background to Marion's work, as well as analysing the most significant themes for contemporary theology. This book serves as an ideal starting point for students of theology and philosophy, as well as for those seeking to further their knowledge of cutting-edge thinking in contemporary theology. (shrink)

In folie à deux, a ‘primary’ patient transmits a delusional belief to one or more ‘secondary’ patients who then adopt and share the belief. This paper applies the two‐factor theory of delusion to retrospectively analyse published cases of folie à deux. Lessons from this retrospective analysis include, firstly, that two‐factor theorists need to shift their focus from endogenous processes to consider the exogenous source of delusional content in most secondaries. Secondly, secondaries who come to share the belief via normal processes (...) of social contagion only qualify as delusional by virtue of the abnormal persistence of their belief, albeit a temporary persistence in those secondaries who abandon their belief soon after separation from the primary. Underpinning this abnormal persistence may be a form of inhibitory failure—a difficulty with inhibiting a belief to allow reasoning for and against it being true. (shrink)

Merrill, Booker and Fivush examine the social functions associated with transmitting intergenerational narratives to adolescents and emerging adults and how these family stories affect identity formation in early adulthood. Merrill et al. observed that the intergenerational stories of parents’ transgression and proud moments told by adolescents and emerging adults operate as a way to transmit life lessons, strengthen relationships with the parent and give insights into their parents and their self.

As neuroscience has gained an increased ability to enchant the general public, it has become more and more common to appeal to it as an authority on a wide variety of questions about how humans do and should act. This is especially apparent with the question of gender roles. The term ‘neurosexism’ has been coined to describe the phenomenon of using neuroscientific practices and results to promote sexist conclusions; its feminist response is called ‘neurofeminism’. Here, our aim is to survey (...) the phenomena of neurosexism and neurofeminism using a largely philosophical approach, incorporating concepts from the philosophy of mind, the philosophy of science, ethics, and feminist philosophy. First, we delineate how neuroscientific studies purporting to show sex brain differences may be prone to bias at a number of methodological levels – including the choice of categories to be studied, and the choice of tools for data gathering, analysis, and presentation. Then, we show how interpretations of such studies may wrongly assume the notion of ‘hard-wiring’. Furthermore, lack of attention to distinctions within philosophy of mind may result in a mistaken supposition that brain differences lead to mental and/or psychological and/or behavioral ones. It is not difficult to see how these forms of neurosexism, leading to claims of ‘hard-wired’ gender differences that map onto traditional and harmful gender stereotypes, raise ethical questions. We conclude by briefly considering one: are the harms caused by neurosexist studies and their interpretations outweighed by their potential benefits? (shrink)

After reviewing factors implicated in the generation of delusional beliefs, we conclude that whilst a perceptual aberration coupled with a particular type of attri‐butional bias may be necessary to explain the specific thematic content of a bizarre delusion, neither of these factors, whether in isolation or in combination, is sufficient to explain the presence of delusional beliefs. In contrast to bias models (theories which explain delusion formation in terms of extremes of normal reasoning biases), we advocate a deficit model of (...) delusion formation–that is, delusions arise when the normal cognitive system which people use to generate, evaluate, and then adopt beliefs is damaged. Mere bias we think inadequate to explain bizarre delusions which defy commonsense and persist despite overwhelming rational counter‐argument. In particular, we propose that two deficits must be present in the normal cognitive system to explain bizarre delusions: (1) there must be some damage to sensory and/or attentional‐orient‐ing mechanisms which causes an aberrant perception–this explains the bizarre content of the causal hypothesis generated to explain what is happening; and (2) there must also be a failure of normal belief evaluation–this explains why a hypothesis, implausible in the light of general commonsense, is adopted as belief. This latter deficit occurs, we suggest, when an individual is incapable of suspending the natural favoured status of direct first‐person evidence in order to critically evaluate hypotheses, given equal pri‐ority whether based on direct or indirect sources of information. In contrast, delusions with ‘ordinary’ content may arise when a single deficit of normal belief evaluation occurs in the context of an extreme (but normal) attentional bias, thus causing failure to critically evaluate hypotheses based on misperceptions and misintrepretations of ambiguous (but ordinary) first‐person experience. (shrink)

A standard view of the semantics of natural language sentences or utterances is that a sentence has a particular logical structure and is assigned truth-conditional content on the basis of that structure. Such a semantics is assumed to be able to capture the logical properties of sentences, including necessary truth, contradiction and valid inference; our knowledge of these properties is taken to be part of our semantic competence as native speakers of the language. The following examples pose a problem for (...) this view of semantics. (shrink)

Metalinguistic negation is interesting for at least the following two reasons: it is one instance of the much broader, very widespread and various, phenomenon of metarepresentational use in linguistic communication, whose semantic and pragmatic properties are currently being extensively explored by both linguists and philosophers of language; it plays a central role in recent accounts of presupposition-denial cases, such as "The king of France is not bald; there is no king of France". It is this latter employment that discussion of (...) metalinguistic negation has focused on since Horn 's key article on the subject. While Burton- Roberts saw the MN account of presupposition-denials as providing strong support for his semantic theory of presupposition, I have offered a multi-layered pragmatic account of these cases, which also involves MN, but maintains the view that the phenomenon of presupposition is pragmatic. (shrink)

Williams, Robyn I was briefly a religious person - only on a form. When we crossed into Pakistan, having hitch-hiked from London en route to Sydney in 1966, there came a point where you could not just put a line through where it said 'religion'. I suddenly discovered what to do. I wrote 'Congregationalist hedonist'. All the officials loved it. We had lots of fun together.

Birth, in many societies, is considered to be a private affair. Although health and medical professionals usually assist, the only other people who share the birth process with mothers are their nearest and dearest. With the rise of information communication technologies, however, birth is no longer an exclusively private event. Some women are now sharing their birthing experiences with millions of viewers who are part of the online video ‘community’ YouTube Broadcast Yourself. Searching the word ‘birth’ on YouTube results in (...) close to one million ‘hits’. This article is based on a small-scale, qualitative research project, which involved viewing and making notes on several hundred online videos of birth on YouTube and the accompanying posts and commentaries about the videos. These data were analysed through a feminist, poststructuralist and geographical lens. Throughout the article the term ‘cyber/space’ is used to highlight the mutually constituted nature of ‘real’ and virtual spaces. The article concludes that although YouTube has the potential to open up new windows on birth, this potential is not yet being realized. YouTube does not overcome or render insignificant material expressions of power, instead it typically privileges US experiences of birth, reiterates discourses of ‘good’ mothering and censors particular (mainly vaginal) representations of birth. (shrink)

This article examines the return of love in contemporary critical theory. While recent attempts to make sense of a politicized concept of love have focused on its reconciliatory promise for our age, this article considers love as a discourse of edification for a frustrated political subject, one whose radical hopes have been forged in waiting. Those who want to resist the idea that the revolutionary horizon has for ever receded can be easily tempted and sometimes blindly seduced by the force (...) of love. As an upbuilding discourse, the political appeal to love betrays a profound religiosity and a frustrated longing for transcendence, but it functions, also, to feminize political subjectivity, rendering it passive and wholly derivative of the dominant order. Marx’s attack on communist lovesickness and Beauvoir’s portrait of the grande amoureuse provide touchstones for a feminist critique of love, one that refuses its seductions without wholly dispensing with its critical and utopian dimension. Other critical theorists, notably Walter Benjamin and Theodor Adorno, intimate how love furnishes, not the affective grounds for political practice, but the recollection of a poetics of thinking. (shrink)

In our commentary we ask whether we should ultimately endeavour to find the deep causes of behaviours? Then we discuss two extensions of the proposed framework: (1) Mendelian randomisation and (2) hypothesis-free gene–environment interaction (leveraging heterogeneity in genetic associations). These complementary methods help move us towards second-generation causal knowledge, ultimately understanding mechanistic pathways and identifying more effective intervention targets.

A cognitive pragmatic approach is taken to some long-standing problem cases of negation, the so-called presupposition denial cases. It is argued that a full account of the processes and levels of representation involved in their interpretation typically requires the sequential pragmatic derivation of two different propositions expressed. The first is one in which the presupposition is preserved and, following the rejection of this, the second involves the echoic (metalinguistic) use of material falling in the scope of the negation. The semantic (...) base for these processes is the standard anti-presuppositionalist wide-scope negation. A different view, developed by Burton-Roberts (1989a, 1989b), takes presupposition to be a semantic relation encoded in natural language and so argues for a negation operator that does not cancel presuppositions. This view is shown to be flawed, in that it makes the false prediction that presupposition denial cases are semantic contradictions and it is based on too narrow a view of the role of pragmatic inferencing. (shrink)

"At once rigorous, insightful, and accessible.... the most thorough study yet available on the phenomenological treatment of God as gift in Marion and Derrida. Invaluable reading for those concerned with the theological promise of contemporary Continental philosophy."-Thomas A. Carlson, University of California, Santa Barbara.

Belief and credal commitment sometimes seem to make less and less sense in the West. A kind of 'cultural amnesia' has taken hold, where formal religious adherence begins to seem almost unthinkable. This is especially so for the idea of divine revelation. Robyn Horner argues this means we need to re-evaluate how theology proceeds, focusing not so much on beliefs but on experience. Exploring ways in which the experiential might open human beings up to divine possibility, the author turns (...) to phenomenology because it seeks to examine unrestrictedly what is given through involved encounter. Bringing phenomenology and poststructuralism together, Horner develops the idea of revelation as an 'event' wherein God interrupts and exceeds human experience, affecting and transforming it. This striking concept, named but largely unexplored by theology, articulates a notion of supernatural revelation which now starts to appear both coherent and plausible. (shrink)

Empirical research in bioethics has developed rapidly over the past decade, but has largely eschewed the use of technology-driven methodologies. We propose “design bioethics” as an area of conjoined theoretical and methodological innovation in the field, working across bioethics, health sciences and human-centred technological design. We demonstrate the potential of digital tools, particularly purpose-built digital games, to align with theoretical frameworks in bioethics for empirical research, integrating context, narrative and embodiment in moral decision-making. Purpose-built digital tools can engender situated engagement (...) with bioethical questions; can achieve such engagement at scale; and can access groups traditionally under-represented in bioethics research and theory. If developed and used with appropriate rigor, tools motivated by “design bioethics” could offer unique insights into new and familiar normative and empirical issues in the field. (shrink)

If an agent lacks the ability to exercise deliberative agency or moral agency, or otherwise does not believe themselves to have a choice with respect to an action, then that action is amoral. Robyn Gaier argues that actions of suicide are amoral in at least these ways.

Fregoli delusion is the mistaken belief that some person currently present in the deluded person's environment is a familiar person in disguise. The stranger is believed to be psychologically identical to this known person even though the deluded person perceives the physical appearance of the stranger as being different from the known person's typical appearance. To gain a deeper understanding of this contradictory error in the normal system for tracking and identifying known persons, we conducted a detailed survey of all (...) the Fregoli cases reported in the literature since the seminal Courbon and Fail paper. Our preliminary reading of these cases revealed a notable lack of definitional clarity. So, we first formulated a classification scheme of different person misidentification delusions so as to identify those cases that qualified as instances of Fregoli according to the above characterization: the mistaken belief that a known person is present in the environment in a different guise to his or her typical appearance. We identified 38 clear cases of this type and set out to answer a series of questions motivated by current hypotheses about the origin of the Fregoli delusion. We asked whether the patients misidentified particular strangers, made reference to the misidentified known persons using wigs or plastic surgery , misidentified many different strangers or only one, showed other symptoms , and made inferences about the motives of the known persons in disguise. We conclude by discussing the implications of our findings for current hypotheses concerning the origin of the Fregoli delusion. (shrink)

It is widely accepted that there is a distinction to be made between the explicit content and the implicit import of an utterance. There is much less agreement about the precise nature of this distinction, how it is to be drawn, and whether any such two-way distinction can do justice to the levels and kinds of meaning involved in utterance interpretation. Grice’s distinction between what is said by an utterance and what is implicated is probably the best known instantiation of (...) the explicit/implicit distinction. His distinction, along with many of its post-Gricean heirs, is closely entwined with another distinction: that between semantics and pragmatics. Indeed, on some construals they are seen as essentially one and the same; “what is said” is equated with the truthconditional content of the utterance which in turn is equated with (context-relative) sentence meaning, leaving implicatures (conventional and conversational) as the sole domain of pragmatics. (shrink)

This article examines the reparative turn in current queer feminist scholarship by tracking its twin interest in the study of affect and time. By foregrounding Eve Kosofsky Sedgwick’s influential critique of what she called paranoid reading, I am interested in the ways that various critics – Ann Cvetkovich, Heather Love, and Elizabeth Freeman in particular – take up the call for reparative reading by using the temporal frameworks of the everyday, backward feeling, and queer time to reparative ends. In the (...) process, I consider the reparative work being done to reclaim Sedgwick as a major thinker for queer feminist concerns, and speculate on the attraction, in a time of declining economic and cultural support for the interpretative humanities, of a critical practice that seeks to love and nurture its objects of study. (shrink)

There is free thought, free choice, the free world – and then there is free stuff. By tracking the transformations of just one idea, "free," this book describes an arc of thought through a "revaluation of values" and offers its critique in the same gesture.

Philosophy is textual - it is written and it is read - yet today much of philosophy regards itself as a kind of science, sometimes reducing itself to a species of intellectual bureaucracy. It is important to see these qualities as having their own aesthetic. Even realism is a genre. The aesthetic of the empirical and the bureaucratic, the aesthetic of the rhapsodic and of the clinical... in each of these the genres of philosophy are as creative as they ever (...) were. They are productive of worlds, not only worlds of thought, but 'real worlds' enabled by the technological and other changes that thought has envisaged. This book explores genres through the history of philosophy, providing new ways of thinking about philosophical writing. Exploring a wide range of both European and analytic philosophers and their works - including Plato, Aristotle, Hume, Kant, Nietzsche, Deleuze, Wittgenstein, Derrida and Rorty - Genres of Philosophy explores the reading and writing of philosophers who themselves read and write, revealing the textual relation to the history of philosophy. While the focus of the book is in aesthetics, Ferrell reveals that the interest in philosophy's writing turns out to be a metaphysical question. The question becomes one of evaluating the ontological basis for writing - its subject and its means of expression - within a world of thought which is presently captivated by a particular aesthetic, that of the empiricist. Presenting fresh readings of classic texts in aesthetics, and offering an original approach to the question of philosophical writing, this unique analysis will prove of particular interest to readers in European philosophy, the history of philosophy, aesthetics, and literary studies. (shrink)

Within relevance theory the two local pragmatic processes of enrichment and loosening of linguistically encoded conceptual material have been given quite distinct treatments. Enrichments of various sorts, including those which involve a logical strengthening of a lexical concept, contribute to the proposition expressed by the utterance, hence to its truth-conditions. Loosenings, including metaphorical uses, do not enter into the proposition expressed by the utterance or affect its truth-conditions; they stand in a relation of 'interpretive resemblance' with the linguistically encoded concept (...) used to represent them. This asymmetric treatment is questioned here, arguments are given for an account which reflects the complementarity of these processes and several alternative symmetrical treatments are explored. (shrink)

Going beyond the hype of recent fMRI "findings," this interdisciplinary collection examines such questions as: Do women and men have significantly different brains? Do women empathize, while men systematize? Is there a "feminine" ethics? What does brain research on intersex conditions tell us about sex and gender?

The work reported in this paper investigated the putative functional dependence of pragmatic language skills on general mind‐reading capacity by testing theory‐of‐mind abilities and understanding of non‐literal speech in patients with schizophrenia and in healthy controls. Patients showed difficulties with inferring mental states on a false‐belief picture‐sequencing task and with understanding metaphors and irony on a story‐comprehension task. These difficulties were independent of low verbal IQ and a more generalised problem inhibiting prepotent information. Understanding of metaphors and understanding of irony (...) made significant and independent contributions to discriminating patients from controls, suggesting that metaphor and irony make distinct pragmatic demands. (shrink)

I provide an exposition and critique of the ecological ethics of Murray Bookchin. First, I show how Bookchin draws on ecology and evolutionary biology to produce a mutually constraining cluster of ethical guidelines to underpin and justify his vision of a nonhierarchical, ecological society. I then critically examine Bookchin’s method of justification and the normative consequences that flow from his position. I argue that Bookchin’s enticing promise that his ecological ethics offers the widest realm of freedom to all life forms (...) is undermined by the way in which he distinguishes and privileges second nature over first nature. I conclude that Bookchin’s promise can only be delivered by a biocentric philosophy rather than by his own ecological ethics. (shrink)

In Free Will and Luck, Mele presents a case of an agent Ernie, whose zygote was intentionally designed so that Ernie A-s in 30 years, bringing about a certain event E. Mele uses this case of original design to outline the zygote argument against compatibilism. In this paper I criticize the zygote argument. Unlike other compatibilists who have responded to the zygote argument, I contend that it is open to the compatibilist to accept premise one, that Ernie does not act (...) freely and is not morally responsible for anything he does. I argue that compatibilists should deny premise two. Diana’s effective intention to create Ernie’s zygote such that Ernie A-s in 30 years and her intervention to bring about his A-ing mark a significant difference between Ernie and normal agents in a deterministic universe with regard to how their zygotes were created that affects whether those agents act freely and are morally responsible for so acting. (shrink)