Don’t Think Twice, It’s Alright

We arrive at most of our beliefs unreflectively. As we navigate the world, beliefs about our surroundings are, inevitably, simply produced in us. Similarly, the vast majority of our actions are unreflective. We don’t have to think about every little thing we do; we simply act. But we also, at times, stop to reflect: Is this what I should believe? Is this what I should do? What does such reflective activity achieve? Some philosophers have suggested that reflecting about what we should believe is necessary if our beliefs are to be justified. In the case of action, some philosophers have suggested that reflecting about what one should do is necessary for freedom of the will. One might think that there are more humble benefits as well. Beliefs which are the product of reflective activity are more likely to be true than beliefs unreflectively arrived at; actions reflectively produced are more likely to be successful in achieving their goals than unreflective actions. This is just, it seems, good common sense. This paper challenges both common sense views about the benefits of reflection as well as a good deal of recent philosophical thinking. It would be silly to think that reflection is never valuable, but I will argue that both common sense, and much philosophical thought about the nature and importance of reflection, have vastly overestimated its value

Naturalism and the Intellectual Legitimacy of Philosophy

There is a worry about the intellectual legitimacy of philosophy. Although the sciences have a progressive history, with later theories largely building on earlier ones, and a tremendous amount of agreement within the scientific community about the approximate truth of current theory, philosophy is different. We do not see a progressive history of philosophical theorizing, and there is little agreement within the philosophical community about which theories are even roughly correct. This not only encourages a certain skepticism about the possibility of philosophical knowledge, but a real question about whether the activity of philosophical theorizing is intellectually legitimate. It is argued here that there are features of a naturalistic methodology in philosophy which have the resources to respond to these concerns

Study protocol to investigate the effect of a lifestyle intervention on body weight, psychological health status and risk factors associated with disease recurrence in women recovering from breast cancer treatment

Background Breast cancer survivors often encounter physiological and psychological problems related to their diagnosis and treatment that can influence long-term prognosis. The aim of this research is to investigate the effects of a lifestyle intervention on body weight and psychological well-being in women recovering from breast cancer treatment, and to determine the relationship between changes in these variables and biomarkers associated with disease recurrence and survival. Methods/design Following ethical approval, a total of 100 patients will be randomly assigned to a lifestyle intervention (incorporating dietary energy restriction in conjunction with aerobic exercise training) or normal care control group. Patients randomised to the dietary and exercise intervention will be given individualised healthy eating dietary advice and written information and attend moderate intensity aerobic exercise sessions on three to five days per week for a period of 24 weeks. The aim of this strategy is to induce a steady weight loss of up to 0.5 Kg each week. In addition, the overall quality of the diet will be examined with a view to (i) reducing the dietary intake of fat to ~25% of the total calories, (ii) eating at least 5 portions of fruit and vegetables a day, (iii) increasing the intake of fibre and reducing refined carbohydrates, and (iv) taking moderate amounts of alcohol. Outcome measures will include body weight and body composition, psychological health status (stress and depression), cardiorespiratory fitness and quality of life. In addition, biomarkers associated with disease recurrence, including stress hormones, estrogen status, inflammatory markers and indices of innate and adaptive immune function will be monitored. Discussion This research will provide valuable information on the effectiveness of a practical, easily implemented lifestyle intervention for evoking positive effects on body weight and psychological well-being, two important factors that can influence long-term prognosis in breast cancer survivors. However, the added value of the study is that it will also evaluate the effects of the lifestyle intervention on a range of biomarkers associated with disease recurrence and survival. Considered together, the results should improve our understanding of the potential role that lifestyle-modifiable factors could play in saving or prolonging lives

Acceptability of the Distress Thermometer and Problem List to community-based telephone cancer helpline operators, and to cancer patients and carers

Background Cancer can be a distressing experience for cancer patients and carers, impacting on psychological, social, physical and spiritual functioning. However, health professionals often fail to detect distress in their patients due to time constraints and a lack of experience. Also, with the focus on the patient, carer needs are often overlooked. This study investigated the acceptability of brief distress screening with the Distress Thermometer (DT) and Problem List (PL) to operators of a community-based telephone helpline, as well as to cancer patients and carers calling the service. Methods Operators (n = 18) monitored usage of the DT and PL with callers (cancer patients/carers, >18 years, and English-speaking) from September-December 2006 (n = 666). The DT is a single item, 11-point scale to rate level of distress. The associated PL identifies the cause of distress. Results The DT and PL were used on 90% of eligible callers, most providing valid responses. Benefits included having an objective, structured and consistent means for distress screening and triage to supportive care services. Reported challenges included apparent inappropriateness of the tools due to the nature of the call or level of caller distress, the DT numeric scale, and the level of operator training. Conclusions We observed positive outcomes to using the DT and PL, although operators reported some challenges. Overcoming these challenges may improve distress screening particularly by less experienced clinicians, and further development of the PL items and DT scale may assist with administration. The DT and PL allow clinicians to direct/prioritise interventions or referrals, although ongoing training and support is critical in distress screening

Epistemic Justification and Reflection

Smithies presents an account of justification that ties it to an idealized view of reflection. I argue that no such account can work. More than this, I argue that the kind of idealization which Smithies offers loses contact with the very phenomenon of reflection which he intends to illuminate. I also discuss how Smithies's view bears on the internalism/externalism controversy

Where Does Moral Knowledge Come From?

Sarah McGrath offers an account of moral knowledge which, she says, is "economical," that is, it draws on no subject-matter specific mental faculty. In order to defend such a claim, I argue, more attention needs to be paid to the available psychological literature. That literature is far from definitive on this question, but, I suggest, there is some real reason to think that an extravagant account of moral knowledge, one which posits a subject-matter specific moral faculty, may account for the origins of our moral knowledge. More than this, there is even reason to think that non-human animals may have some moral knowledge as well. I briefly explore what the implications of such a view would be for questions about responsibility