Background and Objectives: Stress is a ubiquitous aspect of modern life that affects both mental and physical health. Clinical care settings can be particularly stressful for both patients and providers. Kindness and compassion are buffers for the negative effects of stress, likely through strengthening positive interpersonal connection. In previous laboratory-based studies, simply watching kindness media uplifts viewers, increases altruism, and promotes connection to others. The objective of the present study is to examine whether kindness media can affect viewers in a (...) real-world, pediatric healthcare setting.Methods: Parents and staff in a pediatric dental clinic were studied. Study days were randomized for viewers to watch either original kindness media or the standard televised children’s programming that the clinic shows. Participants scored self-rated pre-media emotions in a survey, watched either media type for 8 min, and then completed the survey. All participants were informed that they would receive a gift card for their participation. After completion of the survey, participants were asked if they wanted to keep the card or donate it to a family in need.Results: Fifty participants completed the study; 28 were parents and 22 were staff. In comparison to viewers of children’s programming, participants who watched kindness media had significant increases in feeling happy, calmer, more grateful, and less irritated, with trends observed in feeling more optimistic and less anxious. Kindness media caused marked increases in viewers’ reports of feeling inspired, moved, or touched. No change was observed in self-reported compassion, although baseline levels were self-rated as very high. People who watched kindness media were also more generous, with 85% donating their honoraria compared to 54% of Standard viewers.Conclusions: Kindness media can increase positive emotions and promote generosity in a healthcare setting. (shrink)

John Finnis's powerfully and deservedly influential modern classic, Natural Law and Natural Rights, expounds a theory of law and morality that is based on a picture of “persons” using practical reason to pursue certain “basic goods.” While devoting much attention to practical reason and to the goods, however, Finnis says little about the nature of personhood. This relative inattention to what “persons” are creates a risk—one that Finnis himself notices—of assuming or importing an inadequate anthropology. This essay suggests that the (...) “new natural law” developed by Finnis suffers in places from the inadvertent adoption of a flawed anthropology—an anthropology under the thrall of modern individualistic commitments. To explain this suspicion, this article discusses three difficulties in his natural law theory: difficulties in accounting for the basic good of friendship, for obligations we owe to others, and for legal authority. These difficulties may seem disconnected, but this article suggests that they may all reflect an inadequate anthropology—one that Finnis does not exactly embrace but that is pervasive today and that in places may affect his theorizing. (shrink)

The ethics of care still appeals to many in spite of penetrating criticisms of it which have been presented over the past 15 years or so. This paper tries to offer an explanation for this, and then to critically engage with three versions of an ethics of care. The explanation consists firstly in the close affinities between nursing and care. The three versions identified below are by Gilligan (1982 ), a second by Tronto (1993 ), and a third by Gastmans (...) (2006 ), see also Little (1998 ). Each version is described and then subjected to criticism. It is concluded that where the ethics of care is presented in a distinctive way, it is at its least plausible; where it is stated in more plausible forms, it is not sufficiently distinct from nor superior to at least one other common approach to nursing ethics, namely the much-maligned 'four principles' approach. What is added by this paper to what is already known: as the article tries to explain, in spite of its being subjected to sustained criticism the ethics of care retains its appeal to many scholars. The paper tries to explain why, partly by distinguishing three different versions of an ethics of care. It is also shown that all three versions are beset with problems the least serious of which is distinctiveness from other approaches to moral problems in health care. (shrink)

Is it true that an ethics of care offers something distinct from other approaches to ethical problems in nursing, especially principlism? In this article an attempt is made to clarify an ethics of care and then to argue that there need be no substantial difference between principlism and an ethics of care when the latter is considered in the context of nursing. The article begins by considering the question of how one could in fact differentiate moral theories. As is explained, (...) this cannot be done merely in light of the moral judgements they defend, nor their ontological commitments (e.g. their view of the nature of persons). Following these methodological beginnings, care-based ethics is described and critically discussed. It is shown that ontological commitments embraced within care ethics do not themselves show that care ethics is distinct from other approaches. The idea of ‘psychological care’ is also discussed, which stems from the work of Margaret Little. Her claim that the ‘gestalts’ of justice and care cannot be combined is rejected in favour of an approach that does just that and which has been developed by Joan Tronto. It is then claimed that the moral commitments of principlism are certainly not incompatible with those of an ethics of care in the nursing context. A challenge to the idea that principlism and ethics of care might be compatible is anticipated in the work of Eva Feder Kittay. This challenge is responded to and it is concluded that care considered as a moral orientation and the moral values embedded in principlism are best combined in the nursing context. Care provides a moral orientation over which the obligations referred to in principlism can be laid. (shrink)

This paper is prompted by the charge that the prevailing Western paradigm of medical knowledge is essentially Cartesian. Hence, illness, disease, disability, etc. are said to be conceived of in Cartesian terms. The paper attempts to make use of the critique of Cartesianism in medicine developed by certain commentators, notably Leder (1992), in order to expose Cartesian commitments in conceptions of disability. The paper also attempts to sketch an alternative conception of disability — one partly inspired by the work of (...) Merleau-Ponty. In particular, three key Cartesian claims are identified and subjected to criticism. These are as follows: (a) The claim that the body is an object, (b) what is termed here ‘the modularity thesis’, and (c) the claim that the body cannot be constitutive of the self (i.e. since the soul/mind/brain is). In opposition to these claims, it is argued that the body is properly viewed as a subject; that there are neither purely mental, nor purely physical disabilities; and that selves are constituted, at least in part, by their bodies. (shrink)

This article discusses the question of whether, as is often claimed, nursing is properly described as an art. Following critical remarks on the claims of Carper, Chinn and Watson, and Johnson, the account of art provided by RG Collingwood is described, with particular reference to his influential distinction between art and craft. The question of whether nursing is best described as an art or a craft is then discussed. The conclusion is advanced that nursing cannot properly be described as an (...) art, given acceptance of Collingwood’s influential definition of art. Moreover, it is shown that, due to difficulties inherent in specifying the ‘ends’ of nursing, nursing is only problematically described as a craft. (shrink)

Sports Medicine as an apparent sub-class of medicine has developed apace over the past 30 years. Its recent trajectory has been evidenced by the emergence of specialist international research journals, standard texts, annual conferences, academic appointments and postgraduate courses. Although this field of enquiry and practice lays claim to the title ‘sports medicine’ this paper queries the legitimacy of that claim. Depending upon how ‘sports medicine’ and ‘medicine’ are defined, a plausible-sounding case can be made to show that sports medicine (...) is not in fact a branch of medicine. Rather, it is sometimes closer to practices such as non-therapeutic cosmetic surgery. The argument of the paper is as follows. It begins with a brief statement concerning methodology. We then identify and subscribe to a plausible defining goal of medicine taken from a recognised authority in the field. Then two representative, authoritative, definitions of sports medicine are discussed. It is then shown that acceptance of these definitions of sports medicine generates a problem in that if they are accepted, no necessary commitment to the defining goal of medicine is present within sports medicine. It seems to follow that sports medicine is not medicine. In the final part of the paper a critical response to that conclusion is presented and rebutted. The response is one which rejects the identification of the defining goal of medicine upon which our argument rests. (shrink)

Sets out to show that externalism is a more plausible theory of intentional content than internalism. The book describes a physicalist version of externalism, and explains the individuation conditions of demonstrative thoughts and thoughts which concern natural kinds.

It was reported in 2006 that a regime of ‘supervised self harm’ had been implemented at St George’s Hospital, Stafford. This involves patients with a history of self-harming behaviour being offered both emotional and practical support to enable them to do so. This support can extend to the provision of knives or razors to enable them to self-harm while they are being supervised by a nurse. This article discusses, and evaluates from an ethical perspective, three competing responses to self-harming behaviours: (...) to prevent it; to allow it; and to make provision for supervised self-harm. It is argued that of these three options the prevention strategy is the least plausible. A tentative conclusion is offered in support of supervised self-harm. (shrink)

This paper is an attempt to provide a critical evaluation of the theory of disability put forward by Lennart Nordenfelt. The paper is in five sections. The first sets out the main elements of Nordenfelt's theory. The second section elaborates the theory further, identifies a tension in the theory, and three kinds of problems for it. The tension derives from Nordenfelt's attempt to respect two important but conflicting constraints on a theory of health. The problems derive from characterisation of the (...) goals of persons; the difficulty which Nordenfelt has in respecting the plausible view that there is a distinction between illness and disability; and the presence in the theory of other strongly counter-intuitive implications. In section three a defence of Nordenfelt is attempted from within the resources available within his own theory. This defence seeks to exploit his distinctions between a person who is ill and one who is generally disabled and that between first- and second-order disabilities. However, it is concluded that there are insufficient resources within Nordenfelt's theory to fend off the criticisms developed in section two. The fourth section of the paper attempts a defence of Nordenfelt. It is claimed that introduction of the concept of capacity helps to explain differences between problem cases in the theory. Finally, it is shown that at least two important constraints on any theory of disability emerge from the preceding discussion. (shrink)

The grand and sweeping claims of many relativists might seem to amount to the argument that everything is relative--except the thesis of relativism. In this book, Steven Hales defends relativism, but in a more circumscribed form that applies specifically to philosophical propositions. His claim is that philosophical propositions are relatively true--true in some perspectives and false in others. Hales defends this argument first by examining rational intuition as the method by which philosophers come to have the beliefs they do. (...) Analytic rationalism, he claims, has a foundational reliance on rational intuition as a method of acquiring basic beliefs. He then argues that there are other methods that people use to gain beliefs about philosophical topics that are strikingly analogous to rational intuition and examines two of these: Christian revelation and the ritual use of hallucinogens. Hales argues that rational intuition is not epistemically superior to either of these alternative methods. There are only three possible outcomes: we have no philosophical knowledge ; there are no philosophical propositions ; or there are knowable philosophical propositions, but our knowledge of them is relative to doxastic perspective. Hales defends relativism against the charge that it is self-refuting and answers a variety of objections to this account of relativism. Finally, he examines the most sweeping objection to relativism: that philosophical propositions are not merely relatively true, because there are no philosophical propositions--all propositions are ultimately empirical, as the naturalists contend. Hales's somewhat disturbing conclusion--that intuition-driven philosophy does produce knowledge, but not absolute knowledge--is sure to inspire debate among philosophers. (shrink)

Current UK guidelines regarding clinical research on children permit research that is non-therapeutic from the perspective of that particular child. The guidelines permit research interventions that cause temporary pain, bruises or scars. It is argued here that such research conflicts with the Declaration of Helsinki according to which the interests of the research subject outweigh all other interests. Given this, in the context of clinical research, who is best placed to protect the child from this kind of exploitation? Is it (...) the medical researcher, the child’s parents or the nurse advocate? This article describes the problem, possible responses to it, and closes with a consideration of, and rejection of, a defence of current guidelines that claims moral parity between clinical research and clinical education. (shrink)

This paper evaluates a number of closure principles (for both knowledge and justification) that have appeared in the literature. Counterexamples are presented to all but one of these principles, which is conceded to be true but trivially so. It is argued that a consequence of the failure of these closure principles is that certain projects of doxastic logic are doomed, and that doxastic logic is of dubious merit for epistemologists interested in actual knowers in the actual world.

For more than 15 years Professor Per Nortvedt has been arguing the case for moral realism in nursing and the health‐care context more generally. His arguments focus on the clinical contexts of nursing and medicine and are supplemented by a series of persuasive examples. Following a description of moral realism, and the kinds of considerations that support it, criticisms of it are developed that seem persuasive. It is argued that our moral responses are explained by our beliefs as opposed to (...) moral realities. In particular, two key arguments presented by Nortvedt are challenged: the so‐called argument from convergence and the argument from clinical sensitivity. Both of these key planks in the case for moral realism are rejected, and an alternative ‘social conditioning’ account briefly sketched, which, it is claimed, has the same explanatory power as Nortvedt's thesis but does not rest on an appeal to independently existing moral properties. (shrink)

_A Companion to Relativism_ presents original contributions from leading scholars that address the latest thinking on the role of relativism in the philosophy of language, epistemology, ethics, philosophy of science, logic, and metaphysics. Features original contributions from many of the leading figures working on various aspects of relativism Presents a substantial, broad range of current thinking about relativism Addresses relativism from many of the major subfields of philosophy, including philosophy of language, epistemology, ethics, philosophy of science, logic, and metaphysics.

Humanity has thrown everything we have at implacable luck—novel theologies, entire philosophical movements, fresh branches of mathematics—and yet we seem to have gained only the smallest edge on the power of fortune. The Myth of Luck tells us why we have been fighting an unconquerable foe. Taking us on a guided tour of one of our oldest concepts, we begin in ancient Greece and Rome, considering how Plato, Plutarch, and the Stoics understood luck, before entering the theoretical world of probability (...) and exploring how luck relates to theology, sports, ethics, gambling, knowledge, and present-day psychology. As we travel across traditions, times and cultures, we come to realize that it’s not that as soon as we solve one philosophical problem with luck that two more appear, like heads on a hydra, but rather that the monster is altogether mythological. We cannot master luck because there is nothing to defeat: luck is no more than a persistent and troubling illusion. By introducing us to compelling arguments and convincing reasons that explain why there is no such thing as luck, we finally see why in a very real sense we make our own luck, that luck is our own doing. The Myth of Luck helps us to regain our own agency in the world - telling the entertaining story of the philosophy and history of luck along the way. (shrink)

The present paper offers an analogical support for the use of rational intuition, namely, if we regard sense perception as a mental faculty that (in general) delivers justified beliefs, then we should treat intuition in the same manner. I will argue that both the cognitive marks of intuition and the role it traditionally plays in epistemology are strongly analogous to that of perception, and barring specific arguments to the contrary, we should treat rational intuition as a source of prima facie (...) justified beliefs. There are two main arguments against the intuition-perception analogy that I will consider and find lacking. First is that while we do use perceptions as evidence to believe certain propositions, in fact no one ever does use intuition evidentially. The second argument, stemming from experimental philosophy, grants that philosophers do use intuitions evidentially, but this practice is fatally unlike that of perception, in that perception yields warranted beliefs and intuition does not. (shrink)

There are three theories of luck in the literature, each of which tends to appeal to philosophers pursuing different concerns. These are the probability, modal, and control views. I will argue that all three theories are irreparably defective; not only are there counterexamples to each of the three theories of luck, but there are three previously undiscussed classes of counterexamples against them. These are the problems of lucky necessities, skillful luck, and diachronic luck. I conclude that a serious reevaluation of (...) the role of luck in philosophy is called for. (shrink)

In the restoration of art and artifacts there are three salient types of value to consider: relic, aesthetic, and practical. Relic value includes an object’s age, aura, originality, authenticity, and epistemic value. Aesthetic value is connected to how an object looks, sounds, or tastes. Practical value involves whether a thing can be used as designed—whether a book can be read, a building occupied, a car driven. I argue that while these are all legitimate values, it is impossible for a restorer (...) to maximize them all. I conclude that restoration inexorably involves aesthetic choices; there is no supreme value to be maximized and we should be pluralists about the right balance of values. Restoration is like baking a cake; there are many wrong ways to do it, but there are many right ways as well. (shrink)

If we agree, along with Arnauld, Berkeley, Descartes, Hume, Leibniz, and others that our occurrent phenomenal states serve as sources of epistemic certainty for us, we need some explanation of this fact. Many contemporary writers, most notably Roderick Chisholm, maintain that there is something special about the phenomenal states themselves that allows our certain knowledge of them. I argue that Chisholm's view is both wrong and irreparable, and that the capacity of humans to know these states with certainty has to (...) do with the contingent cognitive capacities and abilities people have. (shrink)

The present paper is a response to the criticisms that Mark McLeod-Harrison makes of my book Relativism and the Foundations of Philosophy. If secular, intuition-driven rationalist philosophy yields a belief that p, and Christian, revelation-driven epistemic methods yield a belief that not-p, what should we do? Following Alston, McLeod-Harrison argues that Christian philosophers need do nothing, and remains confident that their way is the best. I argue that this is a serious epistemic mistake, and that relativism about philosophical propositions is (...) a superior approach. McLeod-Harrison also raises two objections to my account of relativism, the first against my rejection of the skeptical alternative, and the second attempting to show that I am committed to an epistemic theory of truth. I rebut both arguments. (shrink)

This commentary on Isabelle Stengers's article, “Comparison as a Matter of Concern” is an assessment of her stance toward experimental psychology. At the various points in her work where she considers that discipline, she tends to accuse it of failing to embrace the “risk” that she sees as defining the “collective games” of science. Brown invokes the behavioral approach to experimental psychology of the early to mid-twentieth century to contextualize Stengers's treatment of continuous comparison conducted by scientists around “matters of (...) concern.” Her use of the metaphor of predator/prey relationships between practices is seen as reversing the usual direction of critique within psychology, such that experimental psychology appears to have, in the Wistar rat, an object grounding a community that is capable of performing continuous comparison, which its critics contrastingly lack. Stengers's ecological view of practices may then ultimately lead to a reappraisal of branches of the human sciences, such as experimental psychology, which she tends, on occasion, to dismiss. (shrink)

The conventional paradigm for developing new treatments for disease mainly involves either the discovery of new drug targets, or finding new, improved drugs for old targets. However, an ion channel found only in invertebrates offers the potential of a completely new paradigm in which an established drug target can be re‐engineered to serve as a new candidate therapeutic agent. The L‐glutamate‐gated chloride channels (GluCls) of invertebrates are absent from vertebrate genomes, offering the opportunity to introduce this exogenous, inhibitory, L‐glutamate receptor (...) into vertebrate neuronal circuits either as a tool with which to study neural networks, or a candidate therapy. Epileptic seizures can involve L‐glutamate‐induced hyper‐excitation and toxicity. Variant GluCls, with their inhibitory responses to L‐glutamate, when engineered into human neurons, might counter the excitotoxic effects of excess L‐glutamate. In reviewing recent studies on model organisms, it appears that this approach might offer a new paradigm for the development of candidate therapeutics for epilepsy. (shrink)

In "Nietzsche's Perspectivism", Steven Hales and Rex Welshon offer an analytic approach to Nietzsche's important idea that truth is perspectival. Drawing on Nietzsche's entire published corpus, along with manuscripts he never saw to press, they assess the different perspectivisms at work in Nietzsche's views with regard to truth, logic, causality, knowledge, consciousness, and the self. They also examine Nietzsche's perspectivist ontology of power and the attendant claims that substances and subjects are illusory while forces and alliances of power constitute (...) the only reality. Hales and Welshon present Nietzsche's treatment of perspectivism as both more complex and more fruitful than the common view of it as a doctrine that truth is not objective. Neither a metaphor nor a methodology, perspectivism emerges as a protean concept akin to a unifying theme; an alternative to the absolutism that recurs in science, philosophy, and religion; and a technique for revealing the unimagined possibilities open to every individual. (shrink)

The ‘mathematical imaginary’ at work in psychology is central to the contingent history of the discipline, but is also responsible for considerable confusion and ambiguity around the ontological assumptions of psychological theories and models. Rather than reject the mathematical altogether, this article argues for an alternative form of mathematical description in psychology through the use of topology. Drawing on DeLanda’s topological account of the virtual, the relationship between psychology and ontology is progressively questioned in relation to memory. Henri Bergson’s conception (...) of duration and the pure past is juxtaposed with the topological psychology of Kurt Lewin and its notion of life space as a manifold with n-dimensions. Using a diagrammatic strategy developed by Mullarkey, an actualist account of the virtual is used to hold these distinct bodies of work together. Psychological events may be given a ‘thick description’ through the identification of topological relations and invariants. The interplay between the actual entities that are afforded in experience can be seen to be virtualized as planes of irreality. A topological approach to psychology offers the opportunity of replacing the taxonomy of essences common to the discipline with a dynamic account of invariance through homeomorphism. (shrink)

This paper recounts the events surrounding the case of Ashley X, a severely disabled young girl whose parents opted for oestrogen therapy, a hysterectomy and breast removal – the so-called ‘Ashley treatment’ – in order to reduce her projected adult weight and improve her quality of life. Following a description of the events leading up to the procedure itself, and the worldwide debate which ensued, the main arguments in favour and against the procedures are presented. The paper also critically engages (...) with a recent defence of the treatments presented by one of those closely involved with the case – Dr D Diekema. Finally, the recommendations of a report which criticizes procedures at the hospital in which the treatments took place are described, and it is argued that the main recommendation regarding the constitution of the Hospital Ethics Committee (HEC) is ill-thought through and is unlikely to have made any difference to the decision taken by the HEC to approve the Ashley treatments. (shrink)

There is no such thing as moral luck or everyone is profoundly mistaken about its nature and a radical rethinking of moral luck is needed. The argument to be developed is not complicated, and relies almost entirely on premises that should seem obviously correct to anyone who follows the moral luck literature. The conclusion, however, is surprising and disturbing. The classic cases of moral luck always involve an agent who lacks control over an event whose occurrence affects her praiseworthiness or (...) blameworthiness. Close examination of what it is to have control or to lack it reveals the logical space for counterexamples that do not fit the pattern constitutive of moral luck, and so unravel the whole. (shrink)