Having visited Ireland regularly during the 1930s, Ludwig Wittgenstein resigned his Cambridge philosophy professorship in 1947 and moved there, living in a fishing village on the Atlantic coast and hotels in Dublin and the Wicklow Mountains. Although Wittgenstein spent some time out of the country, Ireland was effectively his base for three very productive years during which he worked on what would become one of his key books, the posthumously published Philosophical Investigations. Wittgenstein in Ireland represents the first sustained account (...) of Wittgenstein's time in Ireland, placing it in its historical context. Wall pays a good deal of attention to the representation of the Irish landscape in which the Austrian philosopher found himself able to work; a large part of his writings were produced in the bleak landscapes of Ireland and Norway. (shrink)

Jerry L. Walls, the author of books on hell and heaven, completes his tour of the afterlife with a philosophical and theological exploration and defense of purgatory, the traditional teaching that most Christians require a period of postmortem cleansing and purging of their sinful dispositions and imperfections before they will be fully made ready for heaven. He examines Protestant objections to the doctrine and shows that the doctrine of purgatory has been construed in different ways, some of which are (...) fully compatible with Protestant theology. In particular, while purgatory has often been understood as matter of punishment in order to make satisfaction for sins that have not been fully remitted, it can also be seen as the completion of the sanctification process, an account of the doctrine that is fully consistent with the Protestant doctrine of justification by faith. Purgatory assumes not only continuity of personal identity but also gradual moral and spiritual growth between death and resurrection. Different theories of personal identity are examined and assessed in light of these assumptions. Walls also shows that the traditional doctrine of purgatory is not understood as a second chance for salvation, but goes on to argue that it should be modified to allow for postmortem repentance. He concludes with an examination of C.S. Lewis's writings on purgatory, and suggests that Lewis can be a model for evangelicals and other Protestants to engage the doctrine of purgatory in a way that is true to their theology. (shrink)

Most donated organs in the United States come from brain dead donors, while a small percentage come from patients who die in “controlled,” or expected, circumstances, typically after the family or surrogate makes a decision to withdraw life support. The number of organs available for transplant could be substantially if donations were permitted in “uncontrolled” circumstances–that is, from people who die unexpectedly, often outside the hospital. According to projections from the Institute of Medicine, establishing programs permitting “uncontrolled donation after circulatory (...) determination of death,” or uDCDD, throughout the United States has the potential to provide 22,000 more donation opportunities annually. In contrast, U.S. controlled donation after circulatory determination of death, or cDCDD, cases have increased progressively over the past decade from 87 to 848 donors, but currently account for only 10.6 percent of all deceased donors. Following the IOM recommendations, several projects exploring the feasibility of uDCDD were funded by the federal government, including a grant from the Health Resources and Services Administration that supported a pilot project in New York City in which the authors of this article participated.A key feature of our protocol, and indeed of many uDCDD protocols, is the initiation of preservation methods such as chest compressions and extracorporeal membrane oxygenation shortly after death in order to perfuse and preserve the donor's organs. Critics of uDCDD argue that the means of determining death deviates from generally ascribed principles. They assert that reinstituting circulation in order to preserve organs has the effect of “undoing” the prior determination of death. The result is that cDCDD is widely accepted and practiced routinely even though it only marginally increases the number of organs available for transplantation, and uDCDD is widely considered unacceptable despite being ethically embraced and proven to significantly increase organ donation opportunities in other countries. This article explores the evolution of this counterintuitive state of affairs and calls for a policy that, in line with the IOM report, allows for both cDCDD and uDCDD protocols. (shrink)

Paul Ricoeur's understanding of the relations of faith, love, and hope suggests a unique approach to theological ethics, one that holds fresh promise for bringing together considerations of the good (teleology) and the right (deontology) around the notion of an "economy of the gift." The economy of the gift articulates Ricoeur's distinctively dialectical understanding of the relation of the human and the divine, and the resulting dialectical moral relation of the self and the other. Despite our fallen condition, Ricoeur suggests, (...) we are called by the divine to embrace the radical possibility of the reconciliation of human goods under the requirement of accountability to human diversity and otherness. (shrink)

Vesicovaginal fistula was a catastrophic complication of childbirth among 19th century American women. The first consistently successful operation for this condition was developed by Dr J Marion Sims, an Alabama surgeon who carried out a series of experimental operations on black slave women between 1845 and 1849. Numerous modern authors have attacked Sims’s medical ethics, arguing that he manipulated the institution of slavery to perform ethically unacceptable human experiments on powerless, unconsenting women. This article reviews these allegations using primary historical (...) source material and concludes that the charges that have been made against Sims are largely without merit. Sims’s modern critics have discounted the enormous suffering experienced by fistula victims, have ignored the controversies that surrounded the introduction of anaesthesia into surgical practice in the middle of the 19th century, and have consistently misrepresented the historical record in their attacks on Sims. Although enslaved African American women certainly represented a “vulnerable population” in the 19th century American South, the evidence suggests that Sims’s original patients were willing participants in his surgical attempts to cure their affliction—a condition for which no other viable therapy existed at that time. (shrink)

INTRODUCTION Linguists who work within the tradition of transformational generative grammar tend to regard semantics as an intractable, perhaps ultimately ...

Jerry L. Walls argues that the doctrine of heaven is ripe for serious reconsideration. He contends not only that the orthodox view of heaven can be defended from objections commonly raised against it, but also that heaven is a powerful resource for addressing persistent philosophical problems, not the least of which concern the ground of morality and the meaning of life. Walls shows how heaven is integrally related to central Christian doctrines, particularly those related to salvation, and tackles (...) the difficult problem of why faith in Christ is necessary to save us from our sins. In addition, heaven is shown to illumine thorny problems of personal identity and to be an essential component of a satisfactory theodicy. Walls goes on to examine data from near-death experiences from the standpoint of some important recent work in epistemology and argues that they offer positive evidence for heaven. He concludes that we profoundly need to recover the hope of heaven in order to recover our very humanity. (shrink)

In this study I defend an account of 'dispositional coercion' and coercive offers which hinges primarily on the intentions of both the coercer and the victim. In doing so I argue against various baseline accounts of coercion. ;Baseline accounts center on the victim's estimation of a proposal's effect, the determination of coercive threats and offers primarily hinging on the victim's beliefs and preferences. I believe that it is the intended action of the individual making the proposal that provides the core (...) consideration for defining coercive threats and offers. ;The following is my set of jointly necessary and sufficient conditions for 'dispositional coercion' wherein X coerces Y to do A: X threatens Y, that is, X intentionally attempts to create the belief in Y that X will be responsible for harm coming to Y should Y fail to do A. X's motive for attempting to create this belief is his desire to bring about a state of affairs in which Y's recognition of this possible harm to himself influences Y to do A. X successfully creates the belief in Y that Y may be harmed if he fails to do A, that is, X is successful in causing Y to recognize that harm may come to him should he fail to do A. Y intends to do A, and Y's motive for intending to do A is Y's desire to avoid harm to himself. Y does A. ;I also argue that X makes Y a coercive offer if and only if: ; X either intentionally attempts to create the following beliefs in Y, or for cases in which X believes that Y already holds beliefs and , attempts to create belief in Y: X is able to prevent some harm from coming to Y. Y needs X's assistance in preventing this harm. X will not assist Y in preventing this harm if Y does not do A. ; X's motive for attempting to create beliefs - in Y, or for cases in which Y already holds beliefs and , to attempt to create belief in Y is his desire to bring about a state of affairs in which Y's recognition of this possible harm to himself influences Y to do A. (shrink)

While popular cultural representations portray the “new father” of the past two decades as more involved, more nurturing, and capable of coparenting, many argue that actual fathering conduct has not kept pace. Others, however, question the extent to which the culture of fatherhood does indeed support involved fathering and, if so, what this involvement entails. This study aims to contribute to the exploration of the culture of fatherhood through an analysis of a yearlong Canadian newspaper series dedicated to family issues. (...) Findings suggest that through representations of parental guilt, parental responsibility, work—family balance issues, and hegemonic masculinity, mothers continue to be positioned as primary parents. Support for father involvement, to the extent that it exists, occurs within the framework of fathers as part-time, secondary parents whose relationship with children remains less important than mothers'. (shrink)

In 1866, the young John Venn published The Logic of Chance, motivated largely by the desire to correct what he saw as deep fallacies in the reasoning of historical determinists such as Henry Buckle and in the optimistic heralding of a true social science by Adolphe Quetelet. Venn accepted the inevitable determinism implied by the physical sciences, but denied that the stable social statistics cited by Buckle and Quetelet implied a similar determinism in human actions. Venn maintained that probability statements (...) were intelligible solely as projections of the ultimate frequency of an outcome in an unlimited series of trials and therefore led to no inferences about free will. An issue here was Venn's claim that although the aggregate probability may be stable, the individual events were completely irregular and, in fact, displayed randomness. Venn's concept of randomness was really apparent, or pseudo-, randomness, which could be totally determined. Ironically, Venn's frequentist position was very useful to the growing field of statistics, which could develop correlations and predictive models empirically without having to address implications for personal freedom or fatalism. (shrink)

Abstractabstract:This article provides an in-depth ethical analysis of living donor uterus transplantation, incorporating clinical, psychological, and qualitative study data into the discussion. Although the concept of living organ donors as patients in their own right has not always been present in the field of transplantation, this conceptualization informs the framework for living donor ethics that we apply to living uterus donation. This framework takes root in the principles of research ethics, which include respect for persons, beneficence, and justice. It incorporates (...) an analysis based on eight potential vulnerabilities of living donors: capacitational, juridic, deferential, social, medical, situational, allocational, and infrastructural. Finally, it recognizes that special relationships—such as that of the living donor advocate with the potential donor—require special responsibilities, including identifying vulnerabilities and engaging donors in a shared decision-making process. Directed and non-directed uterus donors require separate ethical analyses because their different relationships with recipients will influence the types of vulnerabilities, they are subject to as well as the potential benefits they may gain from donation. (shrink)

Since at least the 1970s in Canada, there have been calls for health system reforms based on innovative roles and expanded scopes of practice for nurses. Professional regulatory organizations, through legislation, define the standards and parameters of professional nursing practice. Nursing regulators emphasize public protection over the advancement of nursing; regulatory processes and decisions tend to be conservative and risk‐averse. This study explored the impact that regulatory processes have on innovation in nursing roles. Nurses in a range of unique practice (...) situations were interviewed, including nurses in non‐traditional roles and/or settings, those with cross‐jurisdictional career histories, and those working in interdisciplinary practices and educational settings. For these nurses, nursing practice was viewed through a traditional clinical lens, which did not fit for them. They experienced hassle, delay, and inconsistencies in regulatory practices. They felt mistreated and fearful of the regulator and lamented the ways in which ambitious, creative, capable nurses were stymied in attempting new applications for nursing knowledge. Nursing is constraining its own mandate to contribute to health care through stringent licensing processes. Healthcare reform provides an opportunity for nursing regulators to rethink their processes and provide the latitude for nurse‐driven change. (shrink)

Doing research with young children can be challenging for many reasons, but this book provides clear guidance on how to engage in appropriate methods. Focusing on researching through play, careful consideration is given to: · the founding principles of playful research · understanding young children's perspectives · prioritising the rights of the child and the voice of the child · examples of innovative research methods Real life examples and research projects are presented, to enable common challenges to be anticipated and (...) to showcase successful creative approaches, and to inspire new paths in research. (shrink)

Are liberalism and perfectionism compatible? In this study Steven Wall presents and defends a perfectionist account of political morality that takes issue with many currently fashionable liberal ideas but retains the strong liberal commitment to the ideal of personal autonomy. He begins by critically discussing the most influential version of anti-perfectionist liberalism, examining the main arguments that have been offered in its defence. He then clarifies the ideal of personal autonomy, presents an account of its value and shows that a (...) strong commitment to personal autonomy is fully compatible with an endorsement of perfectionist political action designed to promote valuable pursuits and discourage base ones. (shrink)

John Venn is known as one of the clearest expounders of the interpretation of probability as the frequency of a particular outcome in a potentially unlimited series of possible events. This view he held to be incompatible with the alternate interpretation of probability as a measure of the degree of belief that would rationally be held about a certain outcome based upon the reliability of testimony and other prior information. This paper explores the reasons why Venn may have been so (...) opposed to the degree-of-belief interpretation and suggests that it may have been a way for him to resolve a conflict in his own mind between his ideas of proper scientific methods of inference and the religious beliefs that he held as a young man. (shrink)

This paper articulates and defends a novel hybrid account of well-being. We will call our view a Robust Hybrid. We call it robust because it grants a broad and not subservient role to both objective and subjective values. In this paper we assume, we think plausibly but without argument, that there is a significant objective component to well-being. Here we clarify what it takes for an account of well-being to have a subjective component. Roughly, we argue, it must allow that (...) favoring attitudes that are not warranted by the lights of objective values can ground benefits. Given this understanding, we show that there is an important and unrecognized expansion in the resources available to fully objectivist views: namely that such views can help themselves to the value of warranted love of objective goods. Such a move by the objectivist can help them respond to concerns that, on their view, a person’s well-being can be too alien to them. We next argue that, nonetheless, such objectivist views are still unconvincing due to their lack of a subjective component. This motivates a move from fully objective accounts to hybrid accounts. We show that many prominent hybrid theories in the literature are inadequate because they implausibly minimize the subjective component. This motivates a move to a robust hybrid view that has an expanded subjectivist component. We conclude with some remarks about the interrelation between the subjective and objective components in the hybrid account that we favor and a role for resonance in a theory of well-being other than serving as a hard constraint on any benefit. (shrink)

Emotion regulation is one of the major foci of study in the fields of emotion and emotional development. This article proposes that to properly study emotion regulation, one must consider not only an intrapersonal view of emotion, but a relational one as well. Defining properties of intrapersonal and relational approaches are spelled out, and implications drawn for how emotion regulation is conceptualized, how studies are designed, how findings are interpreted, and how generalizations are drawn. Most research to date has been (...) conducted from an intrapersonal perspective, and the shortcomings of this approach for understanding emotion regulation are highlighted. The article emphasizes major conceptual and methodological steps required for a fuller description of the process of emotion regulation. (shrink)

Many writers claim that democratic government rests on a principled commitment to the ideal of political equality. The ideal of political equality holds that political institutions ought to be arranged so that they distribute political standing equally to all citizens. I reject this common view. I argue that the ideal of political equality, under its most plausible characterizations, lacks independent justificatory force. By casting doubt on the ideal of political equality, I provide indirect support for the claim that democratic government (...) is only instrumentally justified. (shrink)

Empathy is an extensively studied construct, but operationalization of effective empathy is routinely debated in popular culture, theory, and empirical research. This article offers a process-focused approach emphasizing the relational functions of empathy in interpersonal contexts. We argue that this perspective offers advantages over more traditional conceptualizations that focus on primarily intrapsychic features. Our aim is to enrich current conceptualizations and empirical approaches to the study of empathy by drawing on psychological, philosophical, medical, linguistic, and anthropological perspectives. In doing so, (...) we highlight the various functions of empathy in social interaction, underscore some underemphasized components in empirical studies of empathy, and make recommendations for future research on this important area in the study of emotion. (shrink)

Social referencing informs and regulates one’s relation with the environment as a function of the perceived appraisals of social partners. Increased emphasis on relational and social contexts in the study of emotion makes this interpersonal process particularly relevant to the field. However, theoretical conceptualizations and empirical operationalizations of social referencing are disjointed across domains and populations of study. This article seeks to unite and refine the study of this construct by providing a clear and comprehensive definition of social referencing. Our (...) perspective presents social referencing and social appraisal as coterminous processes and emphasizes the importance of a relational and interpersonal approach to the study of emotion. We conclude by outlining possible lines of research on this construct. (shrink)

:The ideal of public justification holds, at a minimum, that the most fundamental political and legal institutions of a society must be publicly justified to each of its members. This essay proposes and defends a new account of this ideal. The account defended construes public justification as an ideal of rational justification, one that is grounded in the moral requirement to respect the rational agency of persons. The essay distinguishes two kinds of justifying reasons that bear on politics and shows (...) how they inform the ideal of public justification. It also decouples public justification from contractualist political morality. The result is a novel account of public justification that departs markedly from how the ideal is commonly characterized, but shows how it retains its distinctiveness as an ideal of politics. View HTML Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.THE PURE THEORY OF PUBLIC JUSTIFICATIONVolume 32, Issue 2Steven Wall DOI: https://doi.org/10.1017/S0265052516000170Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. THE PURE THEORY OF PUBLIC JUSTIFICATIONVolume 32, Issue 2Steven Wall DOI: https://doi.org/10.1017/S0265052516000170Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. THE PURE THEORY OF PUBLIC JUSTIFICATIONVolume 32, Issue 2Steven Wall DOI: https://doi.org/10.1017/S0265052516000170Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation Request permission. (shrink)

Drawing the line on physician assistance in physician-assisted death continues to be a contentious issue in many legal jurisdictions across the USA, Canada and Europe. PAD is a medical practice that occurs when physicians either prescribe or administer lethal medication to their patients. As more legal jurisdictions establish PAD for at least some class of patients, the question of the proper scope of this practice has become pressing. This paper presents an argument for restricting PAD to the terminally ill that (...) can be accepted by defenders as well as critics of PAD for the terminally ill. The argument appeals to fairness-based paternalism and the social meaning of medical practice. These two considerations interact in various ways, as the paper explains. The right way to think about the social meaning of medical practice bears on fair paternalism as it relates to PAD and vice versa. The paper contends that these considerations have substantial force when directed against proposals to extend PAD to non-terminally ill patients, but considerably less force when directed against PAD for the terminally ill. The paper pays special attention to the case of non-terminally ill patients who suffer from treatment-resistant depression, as these patients present a potentially strong case for extending PAD beyond the terminally ill. (shrink)

ABSTRACTInfants readily re-enact others’ intended actions during the second year of life. However, the role of emotion in appreciating others’ intentions and how this understanding develops in infa...

Editors provide a substantive introduction to the history and theories of perfectionism and neutrality, expertly contextualizing the essays and making the collection accessible.

Objective The study evaluated patient informed consent for the Quad screen and examined differences in IC between test acceptors and test refusers. A multidimensional model of IC was used. Methods Women seeking prenatal care at nine obstetrics clinics in a large Midwestern city completed surveys between February and December 2006. Surveys contained measures for three dimensions of IC: intention, understanding and controlling influence. Results 56.2% of women did not meet criteria for all three of our dimensions of IC and therefore (...) failed to give it. The failure rate was higher among women who choose to screen than women who choose not screen. Women who met all criteria for IC were over three times less likley to choose to screen ) than women who did not meet criteria for IC. Conclusion The decision to screen for fetal anomalies is less of a deliberated action than the decision not to screen. Women who lack a fundamental understanding of the purpose and nature of the screen may be operating on the belief that the screen is part of standard care and presents no need to deliberate. (shrink)

This article reports the findings of a qualitative study that explored the organizational influences on moral distress for health professionals working in pediatric intensive care units across Canada. Participants were recruited to the study from PICUs across Canada. The PICU is a high-tech, fast-paced, high-pressure environment where caregivers frequently face conflict and ethical tension in the care of critically ill children. A number of themes including relationships with management, organizational structure and processes, workload and resources, and team dynamics were identified. (...) This study provides a rare and important multi-disciplinary perspective on this topic and the findings have implications for administrators and leaders who seek to improve the moral climate of healthcare delivery. (shrink)

This paper proposes a new definition of vocation that honors the concept’s ancient roots, is consistent with how the term is used in modern contexts, and also expands the concept for greater versatility. We discuss the centrality of service in the concept of vocation locating it as part of the bridge between a student’s core values and their embodiment in community life. The commitment to one’s profession begins before independent status as a practitioner of that profession. It begins in training (...) during which service-learning is a laudable and increasingly popular way to connect to the charitable aspects of professionalism. We further discuss how the concept of vocation is especially appropriate in the context of citizenship. Citizenship is a way of belonging to a community. It is a relationship that requires giving and taking. Service-learning is an ideal way to practice good citizenship on a local scale, and prepare future professionals for understanding their communities and commitments morebroadly. We discuss how these concepts are being emphasized in the medical informatics master’s degree program at Saint Louis University through the incorporation of a service-learning module. We describe the module, discussing how it can be applied to curricula at other institutions and modified for inclusion in other types of courses. (shrink)

This paper proposes a new definition of vocation that honors the concept’s ancient roots, is consistent with how the term is used in modern contexts, and also expands the concept for greater versatility. We discuss the centrality of service in the concept of vocation locating it as part of the bridge between a student’s core values and their embodiment in community life. The commitment to one’s profession begins before independent status as a practitioner of that profession. It begins in training (...) during which service-learning is a laudable and increasingly popular way to connect to the charitable aspects of professionalism. We further discuss how the concept of vocation is especially appropriate in the context of citizenship. Citizenship is a way of belonging to a community. It is a relationship that requires giving and taking. Service-learning is an ideal way to practice good citizenship on a local scale, and prepare future professionals for understanding their communities and commitments morebroadly. We discuss how these concepts are being emphasized in the medical informatics master’s degree program at Saint Louis University through the incorporation of a service-learning module. We describe the module, discussing how it can be applied to curricula at other institutions and modified for inclusion in other types of courses. (shrink)