Volume 20, Issue 3, March 2020, Page 37-39.

Uterine transplantation could give women who suffer from uterine factor infertility the possibility of experiencing gestation. Much of the ethical discussion about uterine transplantation has focused on whether research on it should even be pursued, but researchers are nevertheless moving forward with several uterine transplant research protocols. Scholars should therefore already be identifying and engaging in an intimate examination of the ethical realities of offering uterine transplantation in a clinical setting. Given the potential for the procedure to expand reproductive options (...) for women, reproductive autonomy has been a primary principle underlying much of the ethical discourse about the hypothetical impact of uterine transplantation. Yet the factors that will affect whether uterine transplants promote or undermine a patients’ reproductive autonomy if the procedure is integrated into clinical practice have yet to be rigorously explored. Focusing on the clinical realities of patient autonomy, I argue that empirical data exploring prospective recipients’ motivations and their perceptions of the benefits of the procedure in the context of their lived experiences are critical to a robust analysis of the ethical dimensions of uterine transplantation. (shrink)

Within this paper, we discuss Moral Distress Reflective Debriefs as a promising approach to address and mitigate moral distress experienced by healthcare professionals. We briefly review the empirical and theoretical literature on critical incident stress debriefing and psychological debriefing to highlight the potential benefits of this modality. We then describe the approach that we take to facilitating reflective group discussions in response to morally distressing patient cases (“Moral Distress Reflective Debriefs”). We discuss how the debriefing literature and other clinical ethics (...) activities influenced the development of our approach. In particular, we focus on the role of the clinical ethicist as a facilitator with particular emphasis on encouraging perspective-taking and nurturing ethical attunement in a supportive manner. We suggest that this approach reduces the narrowing effects of frustration and anger that are often reported when individuals experience moral-constraint distress. Finally, we provide an example of Moral Distress Reflective Debriefs, elucidating how this supportive process complements ethics consultation and can mitigate the negative effects of moral distress. (shrink)

While the phenomenon of ‘moral distress’ has been of interest to the nursing community since Jameton first described it in 1984, moral distress is now understood to effect healthcare professionals...

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

Decisions related to births in the “gray zone” of periviability are particularly challenging. Despite published management guidelines, clinicians and families struggle to negotiate care management plans. Stakeholders must reconcile conflicting values in the context of evolving circumstances with a high degree of uncertainty within a short time period. Even skilled clinicians may struggle to guide the patient in making value–laden decisions without imposing their own values. Exploring the experiences of one pregnant woman and her caregivers, this case study highlights how (...) bias may undermine caregivers’ ability to meet their obligation to enhance patient autonomy and the moral distress they may experience when a patient’s values do not align with their own. Management strategies to mitigate the potential impact of bias and related moral distress are identified. The authors then describe one management strategy used in this case, facilitated ethics consultation, which is focused on thoughtful consideration of the patient’s perspective. (shrink)

Undergraduate students with no prior classroom instruction in mathematical logic will benefit from this evenhanded multipart text by one of the centuries greatest authorities on the subject. Part I offers an elementary but thorough overview of mathematical logic of first order. The treatment does not stop with a single method of formulating logic; students receive instruction in a variety of techniques, first learning model theory (truth tables), then Hilbert-type proof theory, and proof theory handled through derived rules. Part II supplements (...) the material covered in Part I and introduces some of the newer ideas and the more profound results of logical research in the twentieth century. Subsequent chapters introduce the study of formal number theory, with surveys of the famous incompleteness and undecidability results of Godel, Church, Turing, and others. The emphasis in the final chapter reverts to logic, with examinations of Godel's completeness theorem, Gentzen's theorem, Skolem's paradox and nonstandard models of arithmetic, and other theorems. Unabridged republication of the edition published by John Wiley & Sons, Inc. New York, 1967. Preface. Bibliography. Theorem and Lemma Numbers: Pages. List of Postulates. Symbols and Notations. Index. (shrink)

A mass problem is a set of Turing oracles. If P and Q are mass problems, we say that P is weakly reducible to Q if for all Y ∈ Q there exists X ∈ P such that X is Turing reducible to Y. A weak degree is an equivalence class of mass problems under mutual weak reducibility. Let [Formula: see text] be the lattice of weak degrees of mass problems associated with nonempty [Formula: see text] subsets of the Cantor (...) space. The lattice [Formula: see text] has been studied in previous publications. The purpose of this paper is to show that [Formula: see text] partakes of hyperarithmeticity. We exhibit a family of specific, natural degrees in [Formula: see text] which are indexed by the ordinal numbers less than [Formula: see text] and which correspond to the hyperarithmetical hierarchy. Namely, for each [Formula: see text], let hα be the weak degree of 0, the αth Turing jump of 0. If p is the weak degree of any mass problem P, let p* be the weak degree of the mass problem P* = {Y | ∃X ⊆ BLR )} where BLR is the set of functions which are boundedly limit recursive in X. Let 1 be the top degree in [Formula: see text]. We prove that all of the weak degrees [Formula: see text], [Formula: see text], are distinct and belong to [Formula: see text]. In addition, we prove that certain index sets associated with [Formula: see text] are [Formula: see text] complete. (shrink)

I discuss a puzzle that shows there is a need to develop a new metaphysical interpretation of mathematical theories, because all well-known interpretations conflict with important aspects of mathematical activities. The new interpretation, I argue, must authenticate the ontological commitments of mathematical theories without curtailing mathematicians' freedom and authority to creatively introduce mathematical ontology during mathematical problem-solving. Further, I argue that these two constraints are best met by a metaphysical interpretation of mathematics that takes mathematical entities to be constitutively constructed (...) by human activity in a manner similar to the constitutive construction of the US Supreme Court by certain legal and political activities. Finally, I outline some of the philosophical merits of metaphysical interpretations of mathematical theories of this type. (shrink)

The UK government has recently taken steps to exclude certain groups of migrants from free treatment under the National Health Service, most controversially from treatment for HIV. Whether this discrimination can have any coherent ethical basis is questioned in this paper. The exclusion of migrants of any status from any welfare system cannot be ethically justified because the distinction between citizens and migrants cannot be an ethical one.

Stephen Cole Kleene was one of the greatest logicians of the twentieth century and this book is the influential textbook he wrote to teach the subject to the next generation. It was first published in 1952, some twenty years after the publication of Godel's paper on the incompleteness of arithmetic, which marked, if not the beginning of modern logic. The 1930s was a time of creativity and ferment in the subject, when the notion of computable moved from the realm (...) of philosophical speculation to the realm of science. This was accomplished by the work of Kurt Gode1, Alan Turing, and Alonzo Church, who gave three apparently different precise definitions of computable. When they all turned out to be equivalent, there was a collective realization that this was indeed the right notion. Kleene played a key role in this process. One could say that he was there at the beginning of modern logic. He showed the equivalence of lambda calculus with Turing machines and with Godel's recursion equations, and developed the modern machinery of partial recursive functions. This textbook played an invaluable part in educating the logicians of the present. It played an important role in their own logical education.". (shrink)

The sociological models of functionalism and conflict are introduced and utilized to analyze professionalism in the accounting profession as it is manifest in the American Institute of Certified Public Accountant's Code of Conduct. Rule 203 of the Code and provisions of the Code related to the public interest are examined using semiotic analysis to determine if they are most consistent with the functionalist or conflict models. While the analysis does not address intent of the Code, it is determined that the (...) Code contains semantic defects which result in different interpretations of the Code to different readers. The defects found are most consistent with the conflict model of professionalism. This has implications for the public and for individuals within the profession, making the Code less useful to both groups. The defects are seen as a potential battleground for the self-interest vs the public interest orientation of the accounting profession. (shrink)

Robert Pippin has recently raised what he calls ‘the Montaigne problem’ for Nietzsche's philosophy: although Nietzsche advocates a ‘cheerful’ mode of philosophizing for which Montaigne is an exemplar, he signally fails to write with the obvious cheerfulness attained by Montaigne. We explore the moral psychological structure of the cheerfulness Nietzsche values, revealing unexpected complexity in his conception of the attitude. For him, the right kind of cheerfulness is radically non-naïve; it expresses the overcoming of justified revulsion at calamitous aspects of (...) life through a reflective, higher-order affirmative attitude. This complex notion of cheerfulness turns out to have roots in Montaigne himself, and it must be thought of as a kind of second nature cultivated through practice, as a kind of second nature. Understanding the meaning of cheerfulness thereby sheds light on the conception of philosophy as a way of life in both Nietzsche and Montaigne. (shrink)

I argue that God’s holiness as conceived in Hebrew Scripture grounds human obligations to obey divine commands. To disobey the commands of a holy God would disrespect a basic good, which we have decisive reason to avoid doing. God’s holiness may be a somewhat obscure property––though I propose transcendence and perfect morality as necessary conditions––but His omniscience and perfect morality guarantee that He would not command human beings to do things that His holiness would not ground His authority to command. (...) I conclude by replying to objections. (shrink)

Previous research on linguistic relativity and economic decisions hypothesized that speakers of languages with obligatory tense marking of future time reference (FTR) should value future rewards less than speakers of languages which permit present tense FTR. This was hypothesized on the basis of obligatory linguistic marking (e.g., will) causing speakers to construe future events as more temporally distal and thereby to exhibit increased “temporal discounting”: the subjective devaluation of outcomes as the delay until they will occur increases. However, several aspects (...) of this hypothesis are incomplete. First, it overlooks the role of “modal” FTR structures which encode notions about the likelihood of future outcomes (e.g., might). This may influence “probability discounting”: the subjective devaluation of outcomes as the probability of their occurrence decreases. Second, the extent to which linguistic structures are subjectively related to temporal or probability discounting differences is currently unknown. To address these, we elicited FTR language and subjective ratings of temporal distance and probability from speakers of English, which exhibits strongly grammaticized FTR, and Dutch, which does not. Several findings went against the predictions of the previous hypothesis: Framing an FTR statement in the present (“Ellie arrives later on”) versus the future tense (“…will arrive…”) did not affect ratings of temporal distance; English speakers rated future statements as relatively more temporally proximal than Dutch speakers; and English and Dutch speakers rated future tenses as encoding high certainty, which suggests that obligatory future tense marking might result in less discounting. Additionally, compared with Dutch speakers, English speakers used more low-certainty terms in general (e.g., may) and as a function of various experimental factors. We conclude that the prior cross-linguistic observations of the link between FTR and psychological discounting may be caused by the connection between low-certainty modal structures and probability discounting, rather than future tense and temporality. (shrink)

The research discussed in this paper centers around the convergence of extended reality (XR) platforms, computational design, digital fabrication, and critical urban study practices. Its aim is to cultivate interdisciplinary and multiscalar approaches within these domains. The research endeavor represents a collaborative effort between two primary disciplines: critical urban studies, which prioritize socio-environmental justice, and integrated digital design to production, which emphasize the realization of volumetric or voxel-based structural systems. Moreover, the exploration encompasses augmented reality to assess its utilization in (...) both the assembly process of the structures and the integration of phygital (physical and digital) data with the physical environment. Within the context of these research scopes, this paper introduces FabriCity-XR as an interactive phygital installation. In addition to presenting an overview of the integrated research driven and performative design to production methodologies, the project showcases the practical implementation of web-based augmented reality trails, eliminating the requirement for external applications for interaction. This approach allows users to seamlessly navigate and engage with phygital content overlaid on physical objects using their personal smart devices. The result is a captivating and immersive user experience that effectively merges the physical and digital realms. (shrink)

The question of language development and origin is a subject that is vital to our understanding of what it means to be human. This is reflected in the large range of academic disciplines that are dedicated to the subject. Language development has in particular been related to studies in cognitive capacity and the ability for mind reading, often termed a theory of mind. The Social Brain Hypothesis has been the only attempt to correlate a cognitive scale of complexity incorporating a (...) theory of mind and intentionality orders to the archaeological record and hominin phylogeny. However, a method is still lacking that allows a correlation of the orders of intentionality (and by inference a theory of mind and language development) to the archaeological signatures that represent the physical expression of hominin behaviour. This paper is primarily concerned with introducing a new theoretical perspective – termed the identity model – which facilitates such a correlation between a scale of cognitive acuity, hominin behaviour through the archaeological record and subsequently language development within an evolutionary context. (shrink)

Vols. for 1972- include papers from the Summer Linguistics Conference, University of California, Santa Cruz.

In December 2007 it was revealed that the British government is considering the exclusion of certain groups of migrants—those considered to be present “illegally”—from primary health care provided by the National Health Service. At present, practitioners have discretion to accept any individual for NHS treatment regardless of their status. A joint Home Office and Department of Health review is examining this access for foreign nationals, and the likely outcome is the restriction of access to irregular migrants, which would, according to (...) the Institute of Public Policy Research, affect around 390,000 people. In 2004 such groups were excluded from NHS secondary care, most controversially from treatment for HIV, and so the present proposal would bar them from all but emergency health treatment. (shrink)

Simon Blackburn’s supervenience argument—focusing on the mysterious “ban on mixed worlds”—is still subject to a variety of conflicting interpretations. In this paper, I hope to provide a defense of the argument that clarifies both the argument and the objections it must overcome. Many of the extant objections, I will argue, fail to engage the argument in its true form. And to counter the more compelling objections, it will be necessary to bring in additional argumentation that Blackburn himself does not clearly (...) provide. One important upshot of this discussion is that moral realism is not the only target of the argument: it raises trouble for a variety of metaethical views wed to realist-friendly construals of moral evaluation. Rightly understood, this argument not only survives the prominent responses, but turns out to be more powerful than his critics and Blackburn himself have recognized. (shrink)

Until comparatively recently, say the middle of the last century, spinal cord injury was fatal as pressure sores and other infections took their toll. Those with severe brain injuries, unable to move or even communicate, fared even worse; without movement or feeding such patients were nursed until nature took its course. Over the last few decades medical and nursing advances have enabled some of these vegetative patients to survive for considerable time, provoking, at times, ethical and legal dilemmas. Though they (...) survived, without overt behaviour or clear communication their carers were frequently unsure how much residual function remained. Now real progress is occurring in this area thanks to the application of neuro-scientific methods by some outstanding groups of workers. Subjects with severe brain injury may begin in complete, unresponsive coma but then ‘lighten’ to one of three categories. In vegetative state (VS), patients are apparently awake but without evidence of voluntary behaviour and have no apparent awareness of self or environment, whilst in minimally conscious state (MCS) patients have some behaviour beyond the reflex but are not able to communicate effectively. These conditions usually result from widespread brain damage at either or both cortical and subcortical levels due to injury or anoxia, though they can also be seen in end stage neurological conditions like Alzheimer’s. In locked in syndrome (LIS), patients ‘awake’ from coma, usually due to stroke, aware of their surroundings and their situation but unable to speak or move, beyond eye lid control and eye movement. For many, LIS will be recognised from Bauby’s extraordinary account in ‘The Diving Bell and the Butterfly,’ though, incidentally, it was presaged in Samuel Beckett’s novella ‘The Unnameable.’ LIS reflects a profound disconnection between brain and body, except for the upper cranial nerves involved in eyelid movement. The overriding question is how much awareness these patients have.. (shrink)

Within Germany, Carl Schmitt's status as a political thinker is on a par with Machiavelli and Hobbes. With the rise in neo-conservatism and authoritarian liberalism in less developed countries such as Chile and Singapore, Renato Christi believes Schmitt's theories will become of considerable importance. Nazi Third Reich. His political theories provide an insight into the nature of Conservatism. well as extrapolate possibilities for the future.

Thomas Aquinas, one of the "founding fathers" of just war theory, offers an account of virtuous warfare in practice. The author argues that Aquinas's approach to warfare, with its emphasis on justice and charity, is helpful in providing a coherent moral account of war to which Christians can subscribe. Particular attention is given to the role of charity, since this virtue is the distinguishing characteristic of the Christian soldier. Charity compels him to soldier justly, and by fighting justly, he is (...) elevated by God to friendship with God. Notable features of this approach are its emphasis on the criteria for judging whether a war is just and its relativizing of the criteria for proper combat behavior. (shrink)

Much of Edmonton’s municipal past lacked any overarching development plan. Once such absentee municipal planning gave way to more concrete forms of municipal planning in terms of shaping the urban environment, conflicting goals soon emerged. Between 1949 and the early 1980s a conflict in planning goals within both the Edmonton District Planning Commission and the City of Edmonton, at this time governed with a commission board became apparent. Often this conflict played out in Edmonton’s river valley with competing visions of (...) preservation and freeway construction. River valley neighborhoods were threatened with land acquisition policies that viewed the river valley as the sole domain of parkland. Concurrently, those neighborhoods and much of the river valley were also threatened by the Metropolitan Edmonton Transportation Study. Citizen engagement in an otherwise politically apathetic city led to its demise, although the threat of large-scale removal of river valley parks and homes throughout the city loomed for some time. The period between 1949 and 1983 represents a period in Edmonton’s history where environmental protection policy clashed with transportation policy that advocated for the wholesale destruction of the river valley and countless homes. It is this conflict that led to increased political awareness that directly contributed to the demise of the METS scheme and gave rise to renewed support for river valley protection while making rapid transit a possibility for Edmonton. (shrink)

La disputa por configurar una escena y un discurso de la multitud en Chile constituye uno de los rasgos principales de la prensa obrera y, más tarde, de la literatura de Nicomedes Guzmán. Es por ello que se propone repensar la multitud como “pueblo que falta”, fuerza colectiva que posee una presencia activa en la historia. Para ello se aborda la concepción de multitud en el naciente imaginario nacional y se analiza la relación de pueblo y multitud para liberar la (...) potencia vital de esta última. (shrink)

Reinhold Niebuhr, approaching the ethical field as a theologian rather than as a philosopher, has maintained that the Christian ethic is not single and indivisible, but that, on the contrary, it consists of what one might call an absolute ethic and a kind of interim ethic in which the notion of justice is prominent. Without commenting on Niebuhr's work I wish to put forward a view which, although more general than his, is perhaps not without a superficial resemblance to it.