Abstract: A current debate in semantics and pragmatics is whether all contextual effects on truth-conditional content can be traced to logical form, or 'unarticulated constituents' can be supplied by the pragmatic process of free enrichment. In this paper, I defend the latter position. The main objection to this view is that free enrichment appears to overgenerate, not predicting where context cannot affect truth conditions, so that a systematic account is unlikely (Stanley, 2002a). I first examine the semantic alternative proposed by (...) Stanley and others, which assumes extensive hidden structure acting as a linguistic trigger for pragmatic processes, so that all truth-conditional effects of context turn out to be instances of saturation. I show that there are cases of optional pragmatic contributions to the proposition expressed that cannot plausibly be accounted for in this way, and that advocates of this approach will therefore also have to appeal to free enrichment. The final section starts to address the question of how free enrichment is constrained: I argue that it involves only local development or adjustment of parts of logical form, any global developments being excluded by the requirement for the proposition expressed to provide an inferential warrant for the intended implications of the utterance. (shrink)

The devastating impact of the national opioid epidemic has given rise to hundreds of lawsuits. This article details the extremely broad range of legal claims, compares the opioid cases to other public health litigation efforts, including tobacco, and describes the special mechanism — a multidistrict litigation — through which more than 700 opioid-related cases have been consolidated thus far, with settlement almost certain to follow.

The principle of beneficence directs healthcare practitioners to promote patients’ well-being, ensuring that the patients’ best interests guide treatment decisions. Because there are a number of distinct theories of well-being that could lead to different conclusions about the patient’s good, a careful consideration of which account is best suited for use in the medical context is needed. While there has been some discussion of the differences between subjective and objective theories of well-being within the bioethics literature, less attention has been (...) given to the questions of what work a theory of well-being needs to do in bioethics and which standards of success ought to be used in selecting a theory of well-being for use in medicine. In this article, I argue that traditional theories of well-being developed in philosophy are not well suited to meet the needs of the medical context. For the principle of beneficence to be most useful, the underlying account of well-being should satisfy two conditions: first, it needs to lead to a concrete, action-guiding determination of the patient’s good; and, second, any recommendations it offers need to be justifiable to patients. Standard accounts of well-being have difficulty satisfying both conditions. Exploring the limitations of these theories when applied to treatment dilemmas helps point the way toward the development of an account of well-being better suited to healthcare. (shrink)

This paper is a contribution to the debate about eudaimonism started by Kashdan, Biswas-Diener, King, and Waterman in a previous issue of The Journal of Positive Psychology. We point out that one thing that is missing from this debate is an understanding of the problems with subjective theories of well-being that motivate a turn to objective theories. A better understanding of the rationale for objective theories helps us to see what is needed from a theory of well-being. We then argue (...) that a suitably modified subjective theory can provide what is needed and that this is the theory that ought to be favored by psychologists. Keywords: well-being; happiness; hedonism; eudaimonia; subjective well-being; theory; values.. (shrink)

A major study of Kierkegaard and love exploring his description of love's treachery, difficulty, and hope.

Apart from statics, about which I shall say nothing, there were three chief centres of interest in mechanics in the 1660's: the motions of pendulums; the laws of motion; the free fall of heavy bodies and the motion of projectiles.In the first the influence of Huygens was dominant; I have placed it so because it was of very lively contemporary concern. The second area of interest descended partly from Galileo and partly from Descartes; the third from Galileo alone. Perhaps one (...) should consider adding a fourth area, the investigation of central forces, but this in fact did not attract much attention as yet. (shrink)

It is argued that genuinely subsentential phrases, such as a discourse-initial utterance of “From France” to indicate the provenance of an item, provide evidence for the reality of the pragmatic process of free enrichment. I consider recent attempts to treat such discourse-initial fragments as linguistic ellipsis of some kind while accommodating the difference between these cases and accepted types of ellipsis such as sluicing and gapping. I claim that the mechanisms they posit to save an ellipsis story have no role (...) in an account of performance. An argument against the enrichment approach from the indeterminacy of the content of subsentential utterances is discussed, and refuted, and it is shown how this indeterminacy is accommodated in a contextualist pragmatic theory. (shrink)

The U.S. health care system is ostensibly market based and therefore at least partially reliant on competition and consumer demand to regulate costs. Yet information about an essential feature of market transactions—costs—is typically obscure to patients until long after treatment. When discussing what must be disclosed for informed consent, the same list of required information is often mentioned regardless of the health care system in question, and information about costs rarely merits a place within this list. However, our assumptions about (...) what a moral principle requires need to be responsive to the realities of the health care system in which the principle is applied.This paper explores the moral foundations of disclosure and informed consent to argue that, in a market‐based system of the sort found in the United States, these same considerations support a requirement to disclose out‐of‐pocket costs before patients receive care. Next, I consider two objections to this view: first, that health care practitioners should focus solely on medical considerations in their encounters with patients and, second, that disclosing out‐of‐pocket costs would be too difficult to be mandated. I argue that medical and financial interests are inseparable within the U.S. health care system. If the difficulties in disclosing costs are deemed insurmountable, then the current system may prove unsustainable, both morally and financially, since we face the same practical impediments to implementing any meaningful consumer‐driven, market‐based health care reform. Finally, I explore some of the consequences of failing to disclose costs. The requirements of disclosing costs can be supported by the principle of respect for autonomy, regardless of the consequences, but in light of the consequences of the decision of whether to disclose, a concern about justice provides further support. (shrink)

It was in the closing year of the nineteenth century that Paul Tannery organized at an international historical congress the first international meeting devoted to the history of science. If antiquity would make a scholarly subject respectable, scholarship in the history of science must be beyond reproach; still earlier than Tannery and his colleagues in many European countries were the German historian of chemistry Kopp, and William Whewell, Master of Trinity; the eighteenth century had produced substantial works like those on (...) mathematics and astronomy of Montucla and Delambre; Isaac Vossius and others virtually take these studies back to the Renaissance and Polydore Vergil. Just as in our day such classical scholars as Heiberg, Bailey, Housman, Drachman or Peck have chosen scientific texts as their subjects, so in the past, too, learning and science have met on this common ground. Few creative mathematicians of the seventeenth century thought that attention to the writings of Euclid or Archimedes was a waste of time. (shrink)

Navigating limits to confidentiality with adolescent clients can be ethically and professionally challenging. This study follows on from a previous quantitative survey of psychologists about confidentiality dilemmas with adolescents. The current study used qualitative methods to explore such dilemmas in greater depth. Twenty Australian psychologists were interviewed and asked to describe an ethically challenging past case. Cases were then used to facilitate discussion about the decision-making process and outcomes. Interviews were transcribed and analyzed using interpretive content and thematic analysis. Three (...) key findings are discussed. First, it is of little use to perceive confidentiality dilemmas as binary choices because psychologists described 5 distinct options. These can be conceptualized on a spectrum of varying degrees of client autonomy, ranging from “no disclosure” to “disclosure without the client’s knowledge or consent”. Second, confidentiality dilemmas often involve balancing multiple and conflicting risks regarding both immediate and future harm. Third, a range of strategies are employed by psychologists to minimize potential harms when disclosing information. These are primarily aimed at maintaining the therapeutic relationship and empowering clients. These findings and the case studies described provide a valuable resource for teaching and professional development. (shrink)

A large proportion of hospital inpatients are affected by cognitive impairment, posing challenges in the provision of their care in busy, fast-paced acute wards. Signs and symbols, known as visual identifiers, are employed in many U.K. hospitals with the intention of helping healthcare professionals identify and respond to the needs of these patients. Although widely considered useful, these tools are used inconsistently, have not been subject to full evaluation, and attract criticism for acting as a shorthand for a routinized response. (...) In order for visual identifiers to be used effectively in acute care settings, thorough consideration must be given to the ethical and legal issues that are engaged in this context, and their potential benefits and harms must be weighed and balanced. This paper proposes a set of legal and ethical principles that can be used to guide the implementation of visual identifiers. Together, these principles provide a framework applicable in the design and implementation phases to systematically identify relevant considerations arising from the use of these tools. We outline some tensions that arise between principles and conclude that selecting a preferred moral framework could help to guide decision-making, as does clarity around the purpose and objectives of the identifier. (shrink)

Reply to a commentary by Joseph J. Fins on “Financial Side Effects: Why Patients Should Be Informed of Costs.”.

A review of the literature indicates that faculty, students, and employers recognize the importance of professional behaviors for a successful career. These professional behaviors were defined by business school faculty to include honesty and ethical decision making, regular attendance and punctuality, professional dress and appearance, participation in professional organizations, and appropriate behavior during meetings. This paper presents the results of a survey administered to managers, faculty, and students about how business school professors can teach these professional behaviors. A hypothesis was (...) tested that managers, professors, and students differ in their perceptions about what is appropriate professional behavior. Using a scale of strongly agree to strongly disagree to respond to critical incidents, one-way ANOVA indicated no group differences for items about cheating, plagiarism, and helping students to work projects on schedule. Group differences were found for ethics items (raising course grade for the purpose of tuition reimbursement, stopping excessive use of school printers, simplifying course work to accommodate weaker students), time management items (making accommodations for students unable to regularly attend class, refusing to admit late students), appearance items (requiring students to dress in suits for major presentations, counseling a student with facial piercing), and for items about required activities inside and outside of the classroom. (shrink)

The simple belief that Galileo ‘invented’ dynamics or kinematics was destroyed long ago. Yet there can be no doubt of the revolution in ideas of motion associated with his name. The paper examines some recent work in this field and evaluates the nature and extent of Galileo's contributions.

The Monographs produced by the International Agency for Research on Cancer (IARC) apply rigorous procedures for the scientific review and evaluation of carcinogenic hazards by independent experts. The Preamble to the IARC Monographs, which outlines these procedures, was updated in 2019, following recommendations of a 2018 expert Advisory Group. This article presents the key features of the updated Preamble, a major milestone that will enable IARC to take advantage of recent scientific and procedural advances made during the 12 years since (...) the last Preamble amendments. The updated Preamble formalizes important developments already being pioneered in the Monographs Programme. These developments were taken forward in a clarified and strengthened process for identifying, reviewing, evaluating and integrating evidence to identify causes of human cancer. The advancements adopted include strengthening of systematic review methodologies; greater emphasis on mechanistic evidence, based on key characteristics of carcinogens; greater consideration of quality and informativeness in the critical evaluation of epidemiological studies, including their exposure assessment methods; improved harmonization of evaluation criteria for the different evidence streams; and a single-step process of integrating evidence on cancer in humans, cancer in experimental animals and mechanisms for reaching overall evaluations. In all, the updated Preamble underpins a stronger and more transparent method for the identification of carcinogenic hazards, the essential first step in cancer prevention. (shrink)

When thinking about the intersection of care and Christian bioethics, it is helpful to follow closely the account of Ruth, who turned away from security and walked alongside her grieving mother-in-law to Bethlehem. Remembering Ruth may help one to heed Professor Kaveny?s summoning of Christians to remember ?the Order of Widows? and the church?s historic calling to bring ?the almanahinto its center rather than pushing her to its margins.? Disabled, elderly and terminally ill people often seem, at least implicitly, expendable. (...) By hearing the scriptural account of Jesus? steadfast great-grandmother, readers may recall another way. One may read Ruth?s care for Naomi as a performative, prophetic act of faith. Ruth?s faithful resolve, when set next to Orpah?s prudent way, challenges the notion that a bioethic of care is innately feminine, and may further call women and men corporately to participate in a kind of care that is strenuous work. My thanks to Cathleen Kaveny for allowing me to play off the title of her insightful essay. Thanks also to Willie James Jennings, whose 1998 baccalaureate sermon on Ruth inspired and much informed this essay. I wish also to thank Ellen Davis, who taught me to read Hebrew, and to read Ruth. (shrink)