RATIONALE, AIM AND OBJECTIVE: Factors influencing doctors in prescribing of drugs have mostly been studied in primary care. Studies performed in hospital care have primarily focused on new drugs, not prescribing in general. An in-depth understanding of the prescribing process in the more specialized secondary care is not only important for secondary care itself, but because it also influences prescribing in primary care. The aim of this study is therefore to identify factors that secondary care doctors believe influence them in (...) prescribing drugs, using a qualitative approach. (shrink)

Psychiatry today is mainly practised within a curative framework. However, many mental disorders are persistent and negatively affect quality of life as well as life expectancy. This tension between treatment goals and the actual illness trajectory has evoked a growing academic interest in ‘palliative psychiatry’, namely the application of a palliative care approach in patients with severe persistent mental illness. Recently, Trachsel et al presented a working definition of palliative psychiatry. This first official attempt to capture the concept is based (...) on WHO’s widely accepted definition of palliative care but modified and limited to include only severe persistent psychiatric illness. While this is a welcome step in the discussion on palliative care approaches in psychiatry, it also opens up for new questions. One of the most evident is whether psychiatry actually needs its own definition of palliative care or, put differently, whether there is something about mental disorders that differs so radically from other medical conditions that it calls for a separate definition. We acknowledge the need to discuss the goals of psychiatric care in patients with severe persistent psychiatric illness. However, we question whether a separate definition of palliative care exclusive to psychiatry is the right way to go. In this paper, we discuss why. (shrink)

Objectives To explore attitudes and reasoning among Swedish physicians and the general public regarding the withdrawal of life-sustaining treatment at a competent patient's request. Design A vignette-based postal questionnaire including 1202 randomly selected individuals in the county of Stockholm and 1200 randomly selected Swedish physicians with various specialities. The vignettes described patients requesting withdrawal of their life-sustaining treatment: (1) a 77-year-old woman on dialysis; (2) a 36-year-old man on dialysis; (3) a 34-year-old ventilator-dependent tetraplegic man. Responders were asked to classify (...) the act of terminating treatment and to prioritise arguments for/against. Results A majority in both groups prioritised arguments in favour of terminating treatment and classified the act as defensible in all vignettes. However, among the general public, 16% classified the act as euthanasia in all vignettes; among physicians this view was most expressed regarding ventilator treatment (26%). Some who classified the act as euthanasia prioritised arguments in favour of terminating treatment: among physicians 18% in vignette 1, 19% in vignette 2 and 34% in vignette 3; among the general public 35% in vignette 1, 20% in vignette 2 and 48% in vignette 3. Conclusion There is a widespread consensus regarding competent patients' right to abstain from life-sustaining treatment. An association between the hastening of death, caused by the withdrawal of life-sustaining treatment and the concept of euthanasia is proposed. The results also suggest that classifying the withdrawal of life-sustaining treatment as ‘euthanasia’ does not necessarily mean that the act is interpreted as ethically unacceptable. (shrink)

Crick and Koch’s 1990 “neurobiological theory of consciousness” sparked the race for the physical correlates of subjective experience. 30 years later, cognitive sciences trend toward consideration of the brain’s electromagnetic field as the primary seat of consciousness, the “to be” of the individual. Recent advancements in laboratory tools have preceded an influx of studies reporting a synchronization between the neuronally generated EM fields of interacting individuals. An embodied and enactive neuroscientific approach has gained traction in the wake of these findings (...) wherein consciousness and cognition are theorized to be regulated and distributed beyond the individual. We approach this frontier to extend the implications of person-to-person synchrony to propose a process of combination whereby coupled individual agents merge into a hierarchical cognitive system to which they are subsidiary. Such is to say, the complex mammalian consciousness humans possess may not be the tip of the iceberg, but another step in a succeeding staircase. To this end, the axioms and conjectures of General Resonance Theory are utilized to describe this phenomenon of interpersonal resonant combination. Our proposal describes a coupled system of spatially distributed EM fields that are synchronized through recurrent, entraining behavioral interactions. The system, having achieved sufficient synchronization, enjoys an optimization of information flow that alters the conscious states of its merging agents and enhances group performance capabilities. In the race for the neurobiological correlates of subjective experience, we attempt the first steps in the journey toward defining the physical basis of “group consciousness.” The establishment of a concrete account of the combination of consciousness at a scale superseding individual human consciousness remains speculation, but our suggested approach provides a framework for empirical testing of these possibilities. (shrink)

The Rule of Double Effect (RDE) holds that it may be permissible to harm an individual while acting for the sake of a proportionate good, given that the harm is not an intended means to the good but merely a foreseen side-effect. Although frequently used in medical ethical reasoning, the rule has been repeatedly questioned in the past few decades. However, Daniel Sulmasy, a proponent who has done a lot of work lately defending the RDE, has recently presented a reformulated (...) and more detailed version of the rule. Thanks to its greater precision, this reinvented RDE avoids several problems thought to plague the traditional RDE. Although an improvement compared with the traditional version, we argue that Sulmasy's reinvented RDE will not stand closer scrutiny. Not only has the range of proper applicability narrowed significantly, but, more importantly, Sulmasy fails to establish that there is a morally relevant distinction between intended and foreseen effects. In particular, he fails to establish that there is any distinction that can account for the alleged moral difference between sedation therapy and euthanasia. (shrink)

Since Hilary Putnam and Saul Kripke's first attacks on traditional, descriptivist theories of natural kind terms, it has become customary to speak of the ‘Putnam-Kripke’ view of meaning and reference. This article argues that this is a mistake, and that Putnam's account of natural kind terms is importantly different from that of Kripke. In particular, Putnam has from the very start been sceptical of Kripke's modal claims, and in later papers he explicitly rejects the proposal that theoretical identity statements are (...) metaphysically necessary (if true). I suggest that this is wholly in line with Putnam's earlier, Quine-inspired writings on general terms, and his preoccupation with the philosophy of science. Moreover, I argue that the picture of general terms that emerges from Putnam's writings is more plausible than that suggested by Kripke. However, contrary to Putnam, I also suggest that Putnam's later views on natural kinds and natural kind terms do not support standard Twin Earth externalism. (shrink)

La presente investigación, tiene por objeto delimitar las consideraciones epistemológicas de la contabilidad ambiental desde tres categorías: funcionalista, interpretativo y crítico, cada una de ellas con 16 subcategorías. La metodología utilizada es de carácter exploratoria, cualitativa, basada en un análisis documental de artículos científicos arbitrados en la más alta exigencia científica (SCOPUS), bajo filtros de búsqueda exacta, con procesamiento sistemático a través de ATLAS.ti9. Los resultados muestran un mayor enraizamiento en el enfoque crítico, destacando el impulso al cambio, los estudios (...) de conflictos, la desigualdad estructural; seguido del enfoque funcionalista, donde predomina el interés por la claridad, el rigor conceptual, así como la pretensión demostrativa y el espíritu de precisión y certeza; finalmente, en el enfoque interpretativo se buscan prácticas racionalizadoras, con una intención comprensiva que impulse a un proceso de resolución. (shrink)

To explore Swedish physicians’ arguments and values for and against physician-assisted suicide (PAS) extracted from the free-text comments in a postal survey. A random selection of approximately 240 physicians from each of the following specialties: general practice, geriatrics, internal medicine, oncology, surgery and psychiatry. All 123 palliative care physicians in Sweden. A qualitative content analysis of free-text comments in a postal questionnaire commissioned by the Swedish Medical Society in collaboration with the Karolinska Institute in Stockholm. The total response rate was (...) 59.2%. Of the 933 respondents, 1107 comments were provided. The free-text comments entailed both normative and factual arguments for and against PAS. The analysis resulted in two main categories: (1) “Safe implementation of PAS is unachievable” (with subcategories “Criteria of PAS difficult to fulfil” and “PAS puts societal norms and values at risk”) and (2) “The role of PAS in healthcare” (with subcategories “No medical need for PAS”, “PAS is not a task for physicians”, “No ethical difference to other end-of-life decisions” and “PAS is in the patient’s best interest”). The respondents brought up well-known arguments from academic and public debate on the subject. Comments from physicians against PAS were more often emotionally charged and used devices like dysphemisms and slippery-slope arguments. (shrink)

This article discusses the thesis that a subject can have a concept, think thoughts containing it, that she incompletely understands. The central question concerns how to construe the distinction between having a concept and understanding it. Two important versions of the thesis are distinguished: a metasemantic version and an epistemic version. According to the first, the subject may have concept C without being a fully competent user, in virtue of deference to other speakers or to the world. According to the (...) second, the subject may have a concept without being able to provide a proper explication of it. It is argued that whereas the epistemic version is plausible, the metasemantic version faces some challenges. First, it needs to be explained precisely how deference enables a speaker to have C. Second, metasemantic incomplete understanding is in tension with the idea that concepts serve to capture the subject’s cognitive perspective. (shrink)

We introduce a new approach to the model theory of metric structures by defining the notion of a metric abstract elementary class (MAEC) closely resembling the notion of an abstract elementary class. Further we define the framework of a homogeneous MAEC were we additionally assume the existence of arbitrarily large models, joint embedding, amalgamation, homogeneity and a property which we call the perturbation property. We also assume that the Löwenheim-Skolem number, which in this setting refers to the density character of (...) the set instead of the cardinality, is ${\aleph_0}$ . In these settings we prove an analogue of Morley’s categoricity transfer theorem. We also give concrete examples of homogeneous MAECs. (shrink)

My paper examines the popular idea, defended by Kripke, that meaning is an essentially normative notion. I consider four common versions of this idea and suggest that none of them can be supported, either because the alleged normativity has nothing to do with normativity or because it cannot plausibly be said that meaning is normative in the sense suggested. I argue that contrary to received opinion, we don’t need normativity to secure the possibility of meaning. I conclude by considering the (...) repercussions of rejecting semantic normativity on three central issues: justification, communication, and naturalism. (shrink)

The question of whether content externalism poses a threat to the traditional view of self-knowledge has been much debated. Compatibilists have tried to diffuse the threat by appealing to the self-verifying character of reflexive judgments about our own thoughts, while incompatibilists have strenuously objected that this does not suffice. In my paper I argue that this debate is fundamentally misconceived since it is based, on both sides, on the problematic notion of ‘knowledge of content’. What this shows, I argue, is (...) not that content externalism is unobjectionable, but that the real challenge to content externalism is not an epistemological one. The real difficulty concerns the content externalist’s seemingly necessary commitment to the idea that individuals have an incomplete grasp of the concepts that go into their own thoughts. This idea poses a threat not to self-knowledge, I argue, but rather to our first- and second-order reasoning abilities. (shrink)

As meaning's claim to normativity has grown increasingly suspect the normativity thesis has shifted to mental content. In this paper, we distinguish two versions of content normativism: 'CE normativism', according to which it is essential to content that certain 'oughts' can be derived from it, and 'CD normativism', according to which content is determined by norms in the first place. We argue that neither type of normativism withstands scrutiny. CE normativism appeals to the fact that there is an essential connection (...) between content and correctness conditions. But, we argue, this fact is by itself normatively innocent, and attempts to add a normative dimension via the normativity of belief ultimately fail. CD normativism, in turn, falls prey to the 'dilemma of regress and idleness': the appeal to rules either leads to some form of regress of rules, or the notion of rule-following is reduced to an idle label. We conclude by suggesting that our arguments do not support naturalism: it is a mistake to assume that normativism and naturalism are our only options. (shrink)

In Morality and Socially Constructed Norms, Laura Valentini poses and answers this overall question: When and why, if at all, are socially constructed norms morally binding? Valentini develops an original account, the agency-respect view, that offers an answer to this general question by offering a moral criterion in terms of agency respect. I agree with the criterion proposed by the agency-respect view, given the account of socially constructed norms that it assumes. However, its account of socially constructed norms seems too (...) narrow to answer the general question. More specifically, I argue that the account of social norms is too narrow, even according to Valentini’s own standard, since it does not account for teleological social norms, which are about standards of excellence rather than standards of behavior. Taking teleological social norms into account calls the moral criterion proposed by the agency-respect view into question: it is plausible concerning the type of social norm assumed by the agency-respect view, but not for teleological social norms. Hence, the general question has not been fully answered. (shrink)

Background: In end of life care, ethical problems often come to the fore. Little research is performed on ways or strategies for handling those problems and even less on obstacles to and possibilities of using such strategies. A previous study illuminated stroke team members’ experiences of ethical problems and how the teams managed the situation when caring for patients faced with sudden and unexpected death from stroke. These findings have been further explored in this study. Objective: The aim of the (...) study was to illuminate obstacles and possibilities perceived by stroke team members in using strategies for handling ethical problems when caring for patients afflicted by sudden and unexpected death caused by stroke. Research design: A qualitative method with combined deductive and inductive content analysis was utilized. Participants and research context: Data were collected through individual interviews with 15 stroke team members working in stroke units of two associated county hospitals in western Sweden. Ethical considerations: The study was approved by the Regional Ethics Review Board, Gothenburg, Sweden. Permission was also obtained from the director of each stroke unit. Findings: All the studied strategies for handling of ethical problems were found to have both obstacles and possibilities. Uncertainty is shown as a major obstacle and unanimity as a possibility in the use of the strategies. The findings also illuminate the value of the concept “the patient’s best interests” as a starting point for the carers’ ethical reasoning. Conclusion: The concept “the patient’s best interests” used as a starting point for ethical reasoning among the carers is not explicitly defined yet, which might make this value difficult to use both as a universal concept and as an argument for decisions. Carers therefore need to strengthen their argumentation and reflect on and use ethically grounded arguments and defined ethical values like dignity in their clinical work and decisions. (shrink)

Through these books, scholars, interpreters, students, and non-academics alike can see the thoughts and beliefs of Americans who came before us.".

Cultural evolution, the propagation and transfer of ideas from generation to generation, as well as from one person to another and from one culture to another, is much faster than normal, genetic evolution. This could account for the speedy proliferation of humankind on this planet, at the expense of other life forms.

In order to reach a more comprehensive understanding of the dynamics in violent situations in institutional care for elderly people the aim of this study was to explore involved parties’ positions, and to illuminate forces and moves related to these positions. One involved care provider's narrative was analysed using narrative analysis and positioning theory. In the narrative the involved parties’ positions were fluid and often overlapping, and not exclusively as victim or perpetrator. Across the narrative the narrator altered the involved (...) parties’ positions by using available discourses. We understand that the altered positions were a salient way for the care provider to make sense of her experiences. By reading the care provider's narrative we further understand that she was much more than just a perpetrator, which was the origin for her narrative. This study led us to two assumptions important for implications in nursing practice. First, it is of significance how we position ourselves and others in narratives and conversations. Second, there is a difference between being categorised in advance and getting the opportunity to narrate one's own story. (shrink)

« Nous sommes tous sur le même bateau », s’écrient les collapsologues, comme s’il s’agissait d’un scoop. Seulement, ces catastrophes annoncées, ou déjà bien amorcées, sont principalement causées par l’Occident et son système économique destructeur. Il s’agit ici de s’interroger sur l’effondrement en adoptant une perspective inversée et d’exposer la démarche de l’autrice de science-fiction Octavia Butler et des continuatrices de son œuvre, qui excellent à rendre possible des histoires alternatives. L’effondrement peut être l’occasion rêvée de changer d’angle et d’échelle (...) et de revenir à l’essentiel. (shrink)

Military activities with the framework of the IDF [Israel Defense Force] is carried out by citizens in a variety of positions. In addition to the ordinary positions of career officers and NCOs, the IDF consists of conscripted men and women as well as reservists. Some of the latter serve under an ordinary command to serve for a certain relatively short period. Other reservists, including pilots and special forces officers have served since they volunteered to serve. Facing the political clash between (...) the government, who have been viewed as trying to change the democratic nature of the state, and the popular opposition, who have tried to protect the judiciary and other elements of democracy, many officers who belong to the latter reservist group have suspended their voluntary service or even retired. Their decision has raised the obvious issue of whether such decisions can be justified, morally, ethically, and democratically. This is the topic of the present paper. (shrink)

The present paper is devoted to a detailed presentation of a new Military Ethics doctrine of fighting terror. It is proposed as an extension of the classical Just War Theory, which has been meant to apply to ordinary international conflicts. Since the conditions of a fight against terror are essentially different from the conditions that are assumed to hold in the classical war (military) paradigm or in the law enforcement (police) paradigm, a third model is needed. The paper proposes such (...) a model in the form of principles that should govern the activity of a democratic state when faced with terror. Eleven principle are proposed. Two are on the level of the state, including the Principle of Self-Defense Duty. Six are related to military preventive acts against activities of terror, including new formulations of a Principle of Military Necessity, a Principle of Distinction, and a Principle of Military Proportionality. Principles of Low Probabilities, Time Span Considerations and Professional Understanding are also included. Finally, three principles that are related to consciousness-directed activities against terror are added: a Principle of Permanent Notice, a Principle of Compensation, and a Principle of Operational Deterrence. The exposition of the principles is accompanied by arguments about their moral justification. The doctrine has been developed on the background of the IDF fight against acts and activities of terror performed by Palestinian individuals and organizations. (shrink)

The paper discusses the thesis of extended belief and its implications for the possibility of extending ordinary, personal level knowledge. A common worry is that knowledge will overextend, that there will be ‘cognitive bloat’. If the subject’s standing beliefs can be realized in devices such as notebooks and smart phones, what is there to prevent the conclusion that she knows everything stored on such devices? One response to this worry is to block the move from belief to knowledge, and argue (...) that these externally stored beliefs, although reliable, do not qualify as knowledge. I argue, instead, that the fundamental problem arises at the level of belief. We prevent bloating of knowledge by preventing the bloating of belief. To do so, I argue, we need to take seriously Clark and Chalmers’ suggestion that what is distinctive of belief is its role in folk psychological explanations. Paying attention to this role shows that the usual examples, such as Otto’s notebook information, do not qualify as beliefs. To qualify, the external information would have to be much more directly connected to, and deeply integrated into, the subject’s overall system of beliefs and desires. (shrink)

Externalism is widely endorsed within contemporary philosophy of mind and language. Despite this, it is far from clear how the externalist thesis should be construed and, indeed, why we should accept it. In this entry I distinguish and examine three central types of externalism: what I call foundational externalism, externalist semantics, and psychological externalism. I suggest that the most plausible version of externalism is not in fact a very radical thesis and does not have any terribly interesting implications for philosophy (...) of mind, whereas the more radical and interesting versions of externalism are quite difficult to support. (shrink)

© 2013 The Editors of The Philosophical QuarterlyOpening this book the philosopher might expect a treatise on self‐knowledge. However, despite its title, this is not a book on knowledge of our own minds, or even on self‐consciousness in the usual sense of being conscious of oneself. Rather, it is a book on developmental psychology, spelling out the fascinating details of the development of the human mind with a particular focus on the emergence of human consciousness. The question Radu J. Bogdan (...) raises is why, and how, consciousness develops in human beings. His central hypothesis is that consciousness is a bi‐product of the executive abilities that a small child develops in response to the complex socio‐cultural situation that she finds herself in. The executive abilities, Bogden argues, are assembled by the child's intuitive psychology, or theory of mind, which allows her to interact and coregulate with others. The origins of... (shrink)

Background: Ethical problems are a universal phenomenon but rarely researched concerning patients dying from acute stroke. These patients often have a reduced consciousness from stroke onset and thereby lack ability to convey their needs and could be described as ‘incompetent’ decision makers regarding their own care. Objective: The aim of the study was to deepen the understanding of stroke team members’ reasoning about truth-telling in end-of-life care due to acute stroke. Research design: Qualitative study based on individual interviews utilizing combined (...) deductive and inductive content analysis. Participants and research context: A total of 15 stroke team members working in stroke units of two associated county hospitals in western Sweden participated. Ethical considerations: The study was approved by the Regional Ethics Review Board, Gothenburg, Sweden. Findings: The main findings were the team members’ dynamic movement between the categories ‘Truth above all’ and ‘Hide truth to protect’. Honesty was highly valued and considered as a reason for always telling the truth, with the argument of truth as common morality. However, the carers also argued for hiding the truth for different reasons such as not adding extra burden in the sorrow, awaiting a timely moment and not being a messenger of bad news. Withholding truth could both be seen as a way of protecting themselves from difficult conversations and to protect others. Discussion: The results indicate that there are various barriers for truthfulness. Interpreted from a virtue of ethics perspective, withholding of truth might also be seen as an expression of sound judgement to put the patient’s best interest first. Conclusion: The carers may need support in the form of supervision to be given space to reflect on their experience and thereby promote ethically justified care. Here, the multi-professional team can be of great value and contribute through inter-professional sharing of knowledge. (shrink)

The aim of the present study was to analyse family dinners as context of argumentation and argumentative development by using a context-sensitive model of basic argumentative structures in every day conversations. The data consisted of 40 argumentative sequences in dinner conversations in twenty Swedish families with children aged 7 to 17 years. The families were divided in two groups depending on the children's ages (10–11 years with younger siblings and 10–12 years with older siblings). The model revealed characteristic structures of (...) argumentation appearing as co-text and suggested differences between family groups depending on contextual factors such as age of the children. The groups of older children produced longer argumentative sequences, more exchanges per sequence and higher rate of turns. The older children also engaged in non-instrumental deliberations and disputations significantly more often and they performed more elaborated expansions (through a higher quantity of backing arguments). The groups of younger children on the other hand were more often involved in negotiations on topics relevant in the immediate context. Less expected was, however, the lack of more complex and varied arguments, even in the groups of older children. (shrink)

Volume: v. 1 General Books publication date: 2009 Original publication date: 1824 Original Publisher: Printed at the Mirror Office Subjects: Philosophy / Ethics.

Longitudinal qualitative research in nursing is rare but becoming more common. Data collection and analysis over time provide some intriguing possibilities to better understand processes, development, and change in illness experience, healthcare organizations, and self‐management. This paper aims to present a process for analyzing qualitative longitudinal data material, namely the Pattern‐Oriented Longitudinal Analysis approach (POLA). We developed this approach after synthesizing experiences from two longitudinal qualitative projects and comparing our procedures and reflections with the relevant literature. Using the POLA approach, (...) researchers can describe complexity and variation in changes over time. During the analysis process, emphasis is put on visualizing and identifying change at both an individual and a group level. Ontological and epistemological assumptions for the approach are also described. The benefit of this approach is the possibility to describe complexity and diversity in processes over time, which is important for the development of nursing knowledge. The analysis approach can be further used and developed by researchers seeking to understand variance or contextual features in processes and changes over time. (shrink)

How ethical praxis is shaped by different contexts and situations has not been widely studied. We performed a follow-up study on stroke team members’ experiences of ethical problems and how the teams managed the situation when caring for patients faced with sudden and unexpected death from stroke. A number of ways for handling ethical problems emerged, which we have now explored further. Data were collected through a three-part form used as base for individual interviews with 15 stroke team members and (...) analyzed using both quantitative and qualitative content analysis. In the analysis, the approaches in the form were condensed into strategies, and the two different ways those strategies were preferred and used by the team members were shown. Hindrances perceived by the team members to impede them from working the preferred way were also revealed and grouped into eight categories. (shrink)

At the time that Quine wrote "Two Dogmas" an attack on analyticity was considered a simultaneous attack on the very idea of necessary truth. This all changed with Kripke's revival of a non-epistemic, non-linguistic notion of necessity. My paper discusses the question whether we can take Kripke one step further and free analyticity from its epistemic ties, thereby reinstating a notion of analyticity that is immune to Quine's attack, and compatible with his epistemic holism. I discuss this question by examining (...) Tyler Burge's claim that truths of meaning depend on features of the external environment and are a posteriori. I argue that although Burge's construal of analyticity circumvents Quine's objections, it is not well-motivated philosophically and has problematic implications. Kripke's strategy with respect to necessity, I conclude, is not easily transferable to analyticity. (shrink)

Electromagnetic field oscillations produced by the brain are increasingly being viewed as causal drivers of consciousness. Recent research has highlighted the importance of the body’s various endogenous rhythms in organizing these brain-generated fields through various types of entrainment. We expand this approach by examining evidence of extracerebral shared oscillations between the brain and other parts of the body, in both humans and animals. We then examine the degree to which these data support one of General Resonance Theory’s principles: the Slowest (...) Shared Resonance principle, which states that the combination of micro- to macro-consciousness in coupled field systems is a function of the slowest common denominator frequency or resonance. This principle may be utilized to develop a spatiotemporal hierarchy of brain-body shared resonance systems. It is predicted that a system’s SSR decreases with distance between the brain and various resonating structures in the body. The various resonance relationships examined, including between the brain and gastric neurons, brain and sensory organs, and brain and spinal cord, generally match the predicted SSR relationships, empirically supporting this principle of GRT. (shrink)

Abstract:Hume’s theory of pride has been dismissed due to the contingent relation between passion and object. But why did Hume state the theory as he did? Why did he give two accounts of pride, one holistic and one atomistic? This paper considers Hume’s reasons for giving two accounts, and how he unified them. The holistic account enables Hume to explain how moral distinctions are made, whereas the atomistic allows him to anchor morality in human nature. The accounts are unified by (...) the distinction of feeling pride and being proud: a steady passion of pride would not count as that if it did not contain feelings of pride identified by their introspective quality, and would not be a state of pride without the causal relation of ideas. (shrink)