In most children’s hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians (...) about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children’s hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are ethics committee meetings, Nursing Ethics Forum, ethics Brown Bag workshops, PICU ethics rounds, Grand Rounds, NICU Comprehensive Care Rounds, Palliative Care Team case conferences, multidisciplinary consults in Fetal Health Center, and ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of “core competencies” than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple “moral spaces” in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set out to do than in the role of the typical hospital ethics consultant today. (shrink)

The healthcare ethics consultant holds a widely described role in the modern American hospital. S/he may practice within a clinical discipline and be trained in bioethics, or be a trained phi...

Counseling parents on the cusp of delivering an extremely preterm infant is performed thousands of times every year in North America, Europe, Japan and in centers situated in other countries around...

(2009). Mellow Monday and furious Friday: The approach-related link between anger and time representation. Cognition & Emotion: Vol. 23, No. 6, pp. 1166-1180.

For a minority of children managed in the NICU, there is a need for more complex technologic assistance in order to sustain life, mitigate a more chronic debilitation from a pervasive life-limiting condition, or provide a bridge from life-sustaining therapy to a more semi-permanent treatment such as organ transplantation. This chapter will address two major types of technology assistance for infants and children—tracheostomy and assisted home ventilation, and dialysis—and the myriad complications and considerations that they raise. Some attention to why (...) clinicians may be so inclined to impose technology as a solution to life-limiting conditions will be noted, as well as why some parents may seem to insist on pursuing technology. (shrink)

Fetal medicine is an emerging field that raises unique ethical concerns. Our children’s hospital started a Fetal Health Center 10 years ago. In this specialized setting, a multidisciplinary t...

Pope Francis beautifully describes how the perinatal journey starts in mystery. Doctors may forget this. We focus on the science that may partially explain how conception and implantation occur, how the placenta functions, and the gradual development of embryo and fetus. But science cannot address that meta-physical—or spiritual—reality. The question of “why?” is never too far away from the minds of expectant parents. Why now? Why me? Why did my baby develop these terrible problems? Why is my life being challenged (...) in this way? Maternal-fetal “cross-talk” is a reality that cannot be denied. It occurs both when the fetus is quiet and when the fetus is active. It may be facilitated by fetal imaging—an ultrasound of... (shrink)

ArgumentsPhysicians who counsel expectant parents about the needs for resuscitation and intensive care for an extremely preterm infant must be able to address many clinical facts and be prepared to face several ethical considerations. Such counseling is generally more than an acquisition of informed consent. It must be guided by ethical principles, values held dear by parents, relational priorities and directed toward an informed and shared decision-making process. Parents may come with a need for clinical facts, a desire that they (...) be heard as they express their values, and to help physicians realize that many are determined to follow a certain path well before such counseling occurs. They may well not be moved by counseling of the physician but still desire to be heard, respected, and allowed to contribute to their newborn’s care plans.ConclusionsRealizing this, the physician can be accepting and develop a trusting relationship with the parents that will be of value throughout the hospitalization regardless of outcome. (shrink)

Bioethical decision‐making in pediatrics diverges from similar decisions in other medical domains because the young child is not an autonomous decision‐maker, while the teen is developing—and should be encouraged to develop—autonomy and decisional capacity. Thus the balance between autonomy and beneficence is fundamentally different in pediatrics than in adult medicine. While ethical dilemmas that reflect these fundamental issues are common, many pediatric physician and nursing training programs do not delve into the issues or offer specific training about how to deal (...) with borderline cases.To meet this need, the Children's Mercy Bioethics Center in Kansas City, Missouri, created a program specifically dedicated to serving practicing, experienced pediatric health professionals. Our students come from various professional disciplines: they are doctors, nurses, social workers, chaplains, lawyers, psychologists, counselors, and hospital administrators practicing in pediatrics. (shrink)

The Spring 1999 issue of CambridgeQuarterly adds to the growing body of academic inquiry into the goals of neonatal intensive care practices. Muraskas and colleagues thoughtfully presented the possibility of nontreatment for neonates born at or under 24 weeks gestation. Jain, Thomasma, and Ragas explained that quality of future life must not be ignored in clinical deliberation. And Hefferman and Heilig described once again the dilemmas nurses face when caring for potentially devastated neonates kept alive by technology. These authors take (...) brave steps by publicly questioning the trend of intensive medical support for most every American-born product of conception. But many questions addressing the goals of neonatal intensive care remain, and few authors have actually tried to distill these goals. (shrink)

Brian Earp and colleagues argue that the major harms associated with the use of illicit drugs largely arise from, or are at least exacerbated by, the fact that their use attracts criminal pe...

_Talking Books_ sets out to show how some of the leading children's authors of the day respond to these and other similar questions. The authors featured are _ Neil Ardley, Ian Beck, Helen Cresswell, Gillian Cross, Terry Deary, Berlie Doherty, Alan Durant, Brian Moses, Philip Pullman, Celia Rees, Norman Silver, Jacqueline Wilson, and Benjamin Zephaniah_. They discuss with great enthusiasm: *their childhood reading habits *how they came to be published *how they write on a daily basis *how a particular (...) book came together *a type of writing that they are especially known for. Through in-depth interviews, they each reveal their approach to their craft. Much is know and spoken of the product that is the children's book, but it is rare that writers are given the opportunity to talk at length about the process of writing for children. _Talking Books_ redresses the balance by presenting a wide selection of authors reflecting upon the joys and challenges of the craft, creativity and process of writing for children. (shrink)

Should we regard Jennifer Lackey’s ‘Creationist Teacher’ as understanding evolution, even though she does not, given her religious convictions, believe its central claims? We think this question raises a range of important and unexplored questions about the relationship between understanding, factivity and belief. Our aim will be to diagnose this case in a principled way, and in doing so, to make some progress toward appreciating what objectual understanding—i.e., understanding a subject matter or body of information—demands of us. Here is the (...) plan. After some ground clearing in §1, §2 outlines and motivates a plausible working model—moderate factivity—for characterising the sense in which objectual understanding should be regarded as factive. §3 shows how the datum that we can understand false theories can, despite initial suggestions to the contrary, be assimilated straightforwardly within the moderate factivity model. §4 highlights how the inverse kind of case to that explored in §3—viz., a variant of Lackey’s creationist teacher case—poses special problems for moderate factivity. With reference to recent work on moral understanding by Hills, §5 proposes a solution to the problem, and §6 attempts to diagnose why it is that we might originally have been led to draw the wrong conclusion. (shrink)

Authors have a lot of leeway with regard to what they can make true in their story. In general, if the author says that p is true in the fiction we’re reading, we believe that p is true in that fiction. And if we’re playing along with the fictional game, we imagine that, along with everything else in the story, p is true. But there are exceptions to these general principles. Many authors, most notably Kendall Walton and Tamar Szabó Gendler, (...) have discussed apparent counterexamples when p is “morally deviant”. Many other statements that are conceptually impossible also seem to be counterexamples. In this paper I do four things. I survey the range of counterexamples, or at least putative counterexamples, to the principles. Then I look to explanations of the counterexamples. I argue, following Gendler, that the explanation cannot simply be that morally deviant claims are impossible. I argue that the distinctive attitudes we have towards moral propositions cannot explain the counterexamples, since some of the examples don’t involve moral concepts. And I put forward a proposed explanation that turns on the role of ‘higher-level concepts’, concepts that if they are satisfied are satisfied in virtue of more fundamental facts about the world, in fiction, and in imagination. (shrink)

This book presents a contextual study of the life and work of the Cambridge Platonist Ralph Cudworth (1617-1688). Focusing on the theological basis of Cudworth's ethical philosophy, this book unlocks the hitherto ignored political aspect to Cudworth's ethical philosophy. Through a detailed examination of Cudworth's published works - particularly his voluminous "True intellectual system of the Universe" -, his posthumously published writings, and his 'freewill' manuscripts Benjamin Carter argues that the ethical and political arguments in Cudworth's philosophy develop out (...) of Cudworth's Trinitarian theology. Carter traces the link between Cudworth's trinitarianism and his ethical and political ideas by placing Cudworth's work in the turbulent religious and intellectual context of seventeenth-century England, and the University of Cambridge in particular. (shrink)

Normative Externalism argues that it is not important that people live up to their own principles. What matters, in both ethics and epistemology, is that they live up to the correct principles: that they do the right thing, and that they believe rationally. This stance, that what matters are the correct principles, not one's own principles, has implications across ethics and epistemology. In ethics, it undermines the ideas that moral uncertainty should be treated just like factual uncertainty, that moral ignorance (...) frequently excuses moral wrongdoing, and that hypocrisy is a vice. In epistemology, it suggests we need new treatments of higher-order evidence, and of peer disagreement, and of circular reasoning, and the book suggests new approaches to each of these problems. Although the debates in ethics and in epistemology are often conducted separately, putting them in one place helps bring out their common themes. One common theme is that the view that one should live up to one's own principles looks less attractive when people have terrible principles, or when following their own principles would lead to riskier or more aggressive action than the correct principles. Another common theme is that asking people to live up to their principles leads to regresses. It can be hard to know what action or belief complies with one's principles. And now we can ask, in such a case should a person do what they think their principles require, or what their principles actually require? Both answers lead to problems, and the best way to avoid these problems is to simply say people should follow the correct principles. (shrink)

We provide a new interpretation of Zeno’s Paradox of Measure that begins by giving a substantive account, drawn from Aristotle’s text, of the fact that points lack magnitude. The main elements of this account are (1) the Axiom of Archimedes which states that there are no infinitesimal magnitudes, and (2) the principle that all assignments of magnitude, or lack thereof, must be grounded in the magnitude of line segments, the primary objects to which the notion of linear magnitude applies. Armed (...) with this account, we are ineluctably driven to introduce a highly constructive notion of (outer) measure based exclusively on the total magnitude of potentially infinite collections of line segments. The Paradox of Measure then consists in the proof that every finite or potentially infinite collection of points lacks magnitude with respect to this notion of measure. We observe that the Paradox of Measure, thus understood, troubled analysts into the 1880’s, despite their knowledge that the linear continuum is uncountable. The Paradox was ultimately resolved by Borel in his thesis of 1893, as a corollary to his celebrated result that every countable open cover of a closed line segment has a finite sub-cover, a result he later called the “First Fundamental Theorem of Measure Theory.” This achievement of Borel has not been sufficiently appreciated. We conclude with a metamathematical analysis of the resolution of the paradox made possible by recent results in reverse mathematics. (shrink)

The philosophical case for extended cognition is often made with reference to ‘extended-memory cases’ ; though, unfortunately, proponents of the hypothesis of extended cognition as well as their adversaries have failed to appreciate the kinds of epistemological problems extended-memory cases pose for mainstream thinking in the epistemology of memory. It is time to give these problems a closer look. Our plan is as follows: in §1, we argue that an epistemological theory remains compatible with HEC only if its epistemic assessments (...) do not violate what we call ‘the epistemic parity principle’. In §2, we show how the constraint of respecting the epistemic parity principle stands in what appears to be a prima facie intractable tension with mainstream thinking about cases of propositional memory. We then outline and evaluate in §3 several lines of response. (shrink)

A conspicuous oversight in recent debates about the vexed problem of the value of knowledge has been the value of knowledge-how. This would not be surprising if knowledge-how were, as Gilbert Ryle [1945, 1949] famously thought, fundamentally different from knowledge-that. However, reductive intellectualists [e.g. Stanley and Williamson 2001; Brogaard 2008, 2009, 2011; Stanley 2011a, 2011b] maintain that knowledge-how just is a kind of knowledge-that. Accordingly, reductive intellectualists must predict that the value problems facing propositional knowledge will equally apply to knowledge-how. (...) We show, however, that this is not the case. Accordingly, we highlight a value-driven argument for thinking that knowledge-how and knowledge-that come apart. (shrink)

Social and moral issues in business have drawn attention to a gap between theory and practice and fueled the search for a reconciling perspective. Finding and establishing an alternative remains a critical initiative, but a daunting one. In what follows, the assumptions of two prominent contenders are considered before introducing a third in the form of Aristotle’s ancient theory of virtue. Comparative case studies are used to briefly illustrate the practical implications of each paradigm. In the quest for a better (...) sense-making and sense-giving lens, this paper refines and encourages the search by highlighting some of the key features required of a worthy paradigmatic challenge. The author proceeds to identify a particular type of institutional community, and a promising champion, for the practical unification of strategic and normative excellence. (shrink)

Epistemology and Relativism Epistemology is, roughly, the philosophical theory of knowledge, its nature and scope. What is the status of epistemological claims? Relativists regard the status of epistemological claims as, in some way, relative— that is to say, that the truths which epistemological claims aspire to are … Continue reading Epistemology and Relativism →.

The role of competitive funds as a source of funding for academic research has increased in many countries. For the individual researcher, the receipt of a grant can influence both scientific production and career paths. This paper focuses on the importance of the receipt of a research grant for researchers’ academic career paths utilizing a mixed methods approach that combines econometric analysis with in-depth qualitative interviews. The analysis has novel elements both in terms of its subject (impact of funding grants (...) on individuals’ academic career paths) and approach. The results of this study indicate that while research grants have a positive impact on the research performed under the grant itself, there are very important secondary effects on research performance through positive effects on academic career advancement. The probability of obtaining a full professorship for grant recipients is almost double that for rejected applicants, 16 percent compared to 9 percent. The probability for career advancement in general is about 9 percentage points higher for grant recipients. Qualitative interviews support these quantitative results by providing insights into how grants impact research careers, through heightened status, recognition, networking and other factors. (shrink)

Duncan Pritchard (2008, 2009, 2010, forthcoming) has argued for an elegant solution to what have been called the value problems for knowledge at the forefront of recent literature on epistemic value. As Pritchard sees it, these problems dissolve once it is recognized that that it is understanding-why, not knowledge, that bears the distinctive epistemic value often (mistakenly) attributed to knowledge. A key element of Pritchard’s revisionist argument is the claim that understanding-why always involves what he calls strong cognitive achievement—viz., cognitive (...) achievement that consists always in either (i) the overcoming of a significant obstacle or (ii) the exercise of a significant level of cognitive ability. After outlining Pritchard’s argument, we show (contra Pritchard) that understanding-why does not essentially involve strong cognitive achievement. Interestingly, in the cases in which understanding-why is distinctively valuable, it is (we argue) only because there is sufficiently rich objectual understanding in the background. If that’s right, then a plausible revisionist solution to the value problems must be sensitive to different kinds of understanding and what makes them valuable, respectively. (shrink)

Recent work in the philosophy of mind and cognitive science (e.g., Clark and Chalmers 1998; Clark 2010a; Clark 2010b; Palermos 2014) can help to explain why certain kinds of assertions—made on the basis of information stored in our gadgets rather than in biological memory—are properly criticisable in light of misleading implicatures, while others are not.

Scientific Essentialism defends the view that the fundamental laws of nature depend on the essential properties of the things on which they are said to operate, and are therefore not independent of them. These laws are not imposed upon the world by God, the forces of nature or anything else, but rather are immanent in the world. Ellis argues that ours is a dynamic world consisting of more or less transient objects which are constantly interacting with each other, and whose (...) identities depend on their roles in these processes. Natural objects must behave as they do, because to do otherwise would be contrary to their natures. The laws of nature are, therefore, metaphysically necessary, and consequently, there are necessary connections between events. Brian Ellis calls for the rejection of the theory of Humean Supervenience and an implementation of a new kind of realism in philosophical analysis. (shrink)

This book demonstrates pride's unique profile in philosophical theory as both an emotion and an element of human virtue, and includes a range of represented perspectives: psychology; philosophy; sociology; and anthropology.

The relation between the Greek and Judeo-Christian traditions is "the great problem" of Western philosophy, according to Emmanuel Levinas. In this book Brian Schroeder, Silvia Benso, and an international group of philosophers address the relationship between Levinas and the world of ancient thought. In addition to philosophy, themes touching on religion, mythology, metaphysics, ontology, epistemology, ethics, and politics are also explored. The volume as a whole provides a unified and extended discussion of how an engagement between Levinas and thinkers (...) from the ancient tradition works to enrich understandings of both. This book opens new pathways in ancient and modern philosophical studies as it illuminates new interpretations of Levinas' ethics and his social and political philosophy. (shrink)

We live in a world of crowds and corporations, artworks and artifacts, legislatures and languages, money and markets. These are all social objects — they are made, at least in part, by people and by communities. But what exactly are these things? How are they made, and what is the role of people in making them? In The Ant Trap, Brian Epstein rewrites our understanding of the nature of the social world and the foundations of the social sciences. Epstein (...) explains and challenges the three prevailing traditions about how the social world is made. One tradition takes the social world to be built out of people, much as traffic is built out of cars. A second tradition also takes people to be the building blocks of the social world, but focuses on thoughts and attitudes we have toward one another. And a third tradition takes the social world to be a collective projection onto the physical world. Epstein shows that these share critical flaws. Most fundamentally, all three traditions overestimate the role of people in building the social world: they are overly anthropocentric. Epstein starts from scratch, bringing the resources of contemporary metaphysics to bear. In the place of traditional theories, he introduces a model based on a new distinction between the grounds and the anchors of social facts. Epstein illustrates the model with a study of the nature of law, and shows how to interpret the prevailing traditions about the social world. Then he turns to social groups, and to what it means for a group to take an action or have an intention. Contrary to the overwhelming consensus, these often depend on more than the actions and intentions of group members. (shrink)

The human is supposed to be top animal, but every one of these true stories shows how ridiculous that idea can be... As an RSPCA Inspector based in North Yorkshire in the 1980s, Carter Langdale found himself at the heart of rural life. Part doctor, part vicar, part undertaker - you name it, the locals decided that he was the man to help them and their animals. Each day brought a new, and often absurd, challenge. Whether he was rescuing (...) a cow stuck halfway down a ravine, a tortoise trying to cross the road, or being presented with an injured owl at his door, Carter never knew what was coming next. Evoking James Herriot's classic memoirs as well as My Family and Other Animals, Langdale's stories, some hilarious, some likely to bring a tear to the eye, are told with great humour and sympathy. For animal lovers, this is an absolute treat. (shrink)

Despite the profound potential of MacIntyre’s revolutionary virtue paradigm, management scholars have struggled to make sense of one of the most contentious and insightful philosophers of our time. This conceptual paper attempts to move past the transliteration of MacIntyre in favour of a translation of his contribution in a manner than retains something closer to its full meaning, while helpfully guiding empirical efforts to apply this emerging paradigm to modern organisations. This translation entails a dismissal of MacIntyre’s hypercritical bias in (...) order to accommodate an expansion of his ideas into the language and logic of management theory and practice. Schein’s methodological roadmap for deciphering culture is offered, as is theory-building using comparative case research, as offering two particularly promising directions for future empirical studies that seek to use the theory of virtue in order to reconceptualise and study the modern organisation. (shrink)

Despite the profound potential of MacIntyre’s revolutionary virtue paradigm, management scholars have struggled to make sense of one of the most contentious and insightful philosophers of our time. This conceptual paper attempts to move past the transliteration of MacIntyre in favour of a translation of his contribution in a manner than retains something closer to its full meaning, while helpfully guiding empirical efforts to apply this emerging paradigm to modern organisations. This translation entails a dismissal of MacIntyre’s hypercritical bias in (...) order to accommodate an expansion of his ideas into the language and logic of management theory and practice. Schein’s methodological roadmap for deciphering culture is offered, as is theory-building using comparative case research, as offering two particularly promising directions for future empirical studies that seek to use the theory of virtue in order to reconceptualise and study the modern organisation. (shrink)

At the start of the twenty-first century, warnings have been raised in some quarters about how - by intent or by mishap - advances in biotechnology and related ...

Alan Carter; XIII*—Moral Theory and Global Population, Proceedings of the Aristotelian Society, Volume 99, Issue 1, 1 June 1999, Pages 289–314, https://doi.org/.

This article compares and contrasts the interwar political commentary of the English historian Christopher Dawson (1889-1970) and the French philosopher Jacques Maritain (1882-1971), two of the most widely read Catholic writers of the 1930s. The reasons for the similarities and differences between their perspectives on democracy, fascism, and the Spanish civil war are discussed. The article concludes with a brief evaluation of how their views were reflected in post-World War Two Catholic thought, and a summary of their legacies as twentieth-century (...) Catholic intellectuals. (shrink)

Which intermediate propositional logics can prove their own completeness? I call a logic reflexive if a second-order metatheory of arithmetic created from the logic is sufficient to prove the completeness of the original logic. Given the collection of intermediate propositional logics, I prove that the reflexive logics are exactly those that are at least as strong as testability logic, that is, intuitionistic logic plus the scheme $\neg φ ∨ \neg\neg φ. I show that this result holds regardless of whether Tarskian (...) or Kripke semantics is used in the definition of completeness. I also show that the operation of creating a second-order metatheory is injective, thereby insuring that I am actually considering each logic independently. (shrink)

This paper is about the relevance, to the definition of freedom, of values or goods other than freedom. In this respect,its subject matter is not at all new. However, I do believe that new light can be thrown on the nature of this relationship by paying more attention to another relationship – one which exists within the concept of freedom itself. There are two senses in which we can be said to possess freedom. Firstly, there is the sense in which (...) we can be said to be free to do a certain particular thing. Secondly,there is the sense in which we can be said to possess a certain ‘amount’,‘degree’ or ‘quantity’ of freedom, in some overall sense. 1 I believe that most recent accounts of the relationship between freedom and other goods are inconsistent, because they see those other goods as affecting the truth value of claims about freedom in the second sense, but not in the first. (shrink)