According to the doctrine of informed consent medical procedures are morally permissible when a patient has consented to the treatment. Problematically it is possible for a patient to consent to or refuse treatment which consequently leads to a decline in her best interests. Standardly, such conflicts are resolved by prioritising the doctrine of informed consent above the requirement that the medical practitioner acts in accordance with the duty of care. This means that patient free choice is respected regardless as to whether her choice leads to a decline in her best interests, since to disrespect patient choice would be an instance of ‘unwarranted’ paternalism. This thesis defends the claim that in cases where patient consent comes into conflict with her best interests, paternalistic interference is in fact justified. The ambition of the thesis is thus twofold: in the first place I argue that the doctrine of informed consent cannot be used as an ethical guarantor for medical decision making. Secondly I will conclude that hard paternalism is justified in medical practice, thereby calling for a reversal of the prioritisation of informed consent procedures over the medical practitioner’s duty of care.

In this thesis I propose a new way of understanding depressive illness as not exclusively harmful, but as related to particular, empirically evidenced, epistemic and pragmatic benefits for the subject, alongside the associated costs. For each of the benefits considered, I provide and concisely analyse the empirical evidence both in its favour and against it, suggest ways in which these benefits could apply in the circumstances presented, discuss some outstanding problems for that application as stated, and describe potential implications. The issues discussed involve topics in cognitive psychology as well as in ethics, which I regard as complementary to the debate. I take the view that depression related phenomena such as low mood, low self-esteem, and mood-congruent delusions offer potential benefits to a subject under certain circumstances, but not under others. In discussing the hypotheses presented, I argue for a more complex view of depression, which includes its potential epistemic and pragmatic benefits as well as its costs and I propose possible directions for future research.

To date, no research has examined the presence of challenging behaviour in Phelan McDermid syndrome (PMS). In this paper, study one adopts a questionnaire methodology to delineate the prevalence and aetiology of challenging behaviour in thirty participants with PMS. Study two adopts an interview methodology to examine the form, frequency, severity and function of this behaviour in eighteen participants. Responses to the Challenging Behaviour Questionnaire indicated that, thirteen (43.3%) participants with PMS showed self-injurious behaviour, thirteen (43.3%) showed physical aggression, and twenty (66.7%) showed destruction of property. Examination of associated characteristics indicated that self-injury was associated with impulsivity; aggression was associated with younger age and compulsive behaviour; and destruction of property was associated with impulsivity and stereotyped behaviour. In study two, responses to the Challenging Behaviour Interview highlighted multiple topographies of challenging behaviour. The behaviour of most concern typically occurred every fifteen minutes. Examination of behavioural function showed that self-stimulation was the predominant function for self-injury and destruction of property. However, many behaviours were found to serve multiple functions. The results of this paper emphasise the importance of building causal models of challenging behavior that incorporates both person characteristics and environmental factors. Limitations and areas for future research are discussed.

The achievement of Immanuel Kant lies in demonstrating the law-giving power of the human intellect in the metaphysical basis of human cognition and in defence of human freedom. The power of reason was his response to the mechanical view of nature and scepticism in morals, aesthetics and religion. While reason extended over theory and practice, it was, he insisted, one reason: a unity. I advocate the unity of reason as key to understanding Kant's philosophical project. Given his huge output, this is an inevitably incomplete ambition. After an introductory chapter (ch1), comes an explication of the key role of the maxim (ch2) followed by proposing a three-fold understanding of reason itself (ch3) with its ideas and postulates (ch4). These extend our theoretical and practical knowledge in reason's differing interests (ch5), albeit with conceptual difficulties in motivation and respect (ch6). Despite different faculties, theoretical and practical reason cannot conflict for there are not two reasons. One must have primacy which is shown to be the practical (ch7). The latter doctrine has implications for Kant's rational theology and his broader world view. Morality's supreme principle, a product of universalised reason, highlights the destiny of humankind and leads to a moral faith unique to humans. By virtue of reason, we have the will to realise our final end. The justification of reason's unity (ch8) leads to the regulative idea of a highest intelligence as a heuristic. Kant's moral philosophy culminates in the concept of the highest good as the final end of human life (ch9). I discuss its secular and religious interpretations before concluding that, for Kant, we belong not only in the world of nature but in a noumenal world in which God and a future life may be the hope of our finite reason.

This thesis studies the historical and intellectual backgrounds of some influential movements in Saudi Arabia, within a binary framework of liberal/conservative or modernist/fundamentalist. Thus, I have to examine the religious and intellectual differences of those movements that may lead to creating conflicts between them. In addition, this study provides possible solutions to conflicts and schism between schools of thought in Saudi Arabia, by focusing particularly on moderate Islamic thought as a new movement that may promote greater harmony. This thesis concludes that moderate Islamic thought can allow us to obtain a clear and better understanding of the main reasons for the struggle between different movements, and apply that on Saudi society, instead of attacking others who have opposing attitudes or different beliefs. It is also important to mention that this plurality of thought is very important for developing the freedom to express opinions within the confines of the law in the application of religious or philosophical ideas. The thesis also concludes that such approaches will help promote dialogue and understanding between different groups or schools of thought. It is hoped that this can also develop cognitive skills, through the exchange of ideas and views between different schools and intellectual movements.

The broad aim of this thesis is to explore fruitful connections between ideology theory and the philosophy of possible worlds (PW). Ideologies are full of modal concepts, such as possibility, potential, necessity, essence, contingency and accident. Typically, PWs are articulated for the analysis and illumination of modal concepts. That naturally suggests a method for theorising ideological modality, utilising PW theory. The specific conclusions of the thesis proffer a number of original contributions to knowledge: 1) PWs should only be used for explication and not as (intrinsic) evidence or criteria of assessment in ideology theory. The estimation of (e.g.) utopian possibilities, human essences and freedoms must be determined by extrinsic criteria. PWs can serve only as a window or means of expression but not as a set of evaluative premises. 2) For this purpose, a modified version of Lewisian genuine realism (GR), with its device of counterpart theory, is the best approach; the alternative theories risk constricting possibilities or smuggling in assumptions that ought to be objects of analysis in ideology theory. This is instructive, since ideology theorists are prone to pick and choose favoured aspects of modal philosophy without further argument. 3) Conclusions (1) and (2) suggest the adoption of GR or fictionalist GR. Overall, the actualist options are less adequate. Fictionalism, by contrast, is a worthwhile contender, but it too presents comparative weaknesses which reinforce GR’s standing as a potent challenger to the modal metaphysician. Therefore, this thesis presents additional reasons (to Lewis’s) to think GR true. The conclusions are not knockdown, and I draw out incentives and consequences for adopting alternative stances. The various chapters also provide specific details for comprehending and debating ideological modals.

Physical object ontology is a sub-branch of ontology which is primarily concerned with three interrelated issues. These are the composition, material constitution, and manner of persistence for physical objects. Philosophers who take up positions on such issues often disagree over what objects they think the world contains – for example a mereological nihilist will argue that there are no composite objects, and thus would say that the ordinary objects that appear to be all around us do not actually exist. Such disputes are thought to be substantive and depend for their truth on what the world itself is actually like. Against this Eli Hirsch develops a meta-ontological argument which states that the debates in physical object ontology are merely verbal, and that what is going in these debates is that each side is simply speaking an alternate language in which their claims come out trivially true and the claims of their opponent come out trivially false. Thus there is no actual disagreement over the facts. This position of Hirsch’s I call semanticism. The purpose of this thesis is to articulate Hirsch’s position, demonstrating its Carnapian roots, but also showing how Hirsch, by making several key commitments, intends his position to be distinctive from a thoroughgoing Carnapianism and its potentially unattractive commitments to anti-realism and/or verificationism. However, in this thesis I develop a number of problems for Hirsch’s position, showing that his modified version of Carnapianism is untenable, and that he is forced between giving up his central contention or retreating into a more thoroughgoing Carnapianism.

No description available.

No description available.

This thesis engages with the following three questions. First, how should the presence of risk and ambiguity affect how we distribute a benefit to which individuals have competing claims? (In line with common use in decision theory, a case involves risk when we can assign at least subjective probabilities to outcomes and it involves ambiguity when we cannot assign such probabilities.) Second, what is it about the imposition of a risk of harm itself (that is, independently of the resulting harm), such as the playing of Russian roulette on strangers, which calls for justification? Third, in the pursuit of the greater (expected) good, when is it permissible to foreseeably generate harms for others through enabling the agency of evildoers? Chapters 1 through 3 of the thesis provide an answer the first question. Chapter 1 defends the importance of a unique complaint of unfairness that arises in risky distributive cases: that sometimes individuals are better off at the expense of others. Chapter 2 defends a view called Fairness as Proper Recognition of Claims which guides how a decision-maker ought to act in cases where individuals have unequal claims to a good. Chapter 3 considers how the presence of ambiguity affects distributive fairness, and defends an egalitarian account of the evaluation of ambiguous prospects. Chapter 4 provides an answer to the second question through a defence of the Insecurity Account, which is a unique way in which impositions of risks of harm can be said to harm individuals, namely by rendering the victim’s interests less secure. Chapter 5 provides an answer to the third question by defending what I call the Moral Purity Account, to explain when it is permissible to provide aid in cases where individuals are harmed as a foreseeable consequence of the provision of such aid.