Background Nurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses’ experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral distress, moral injury, moral outrage, and moral courage. We re-analyzed ethics-related findings in light of refined definitions of ethics concepts. Research aim To analyze frontline U.S. nurses’ experiences of ethics during the COVID-19 pandemic. Research design Qualitative analysis using a directed content (...) methodology. Participants and research context The study included 43 nurses from three major metropolitan academic medical centers and one community hospital in the northeastern, mid-Atlantic, midwestern, and western United States. Ethical considerations Participant privacy and data confidentiality were addressed. Findings Moral dilemmas arose from many situations, most frequently related to balancing safety and patient care. Moral uncertainty commonly arose from lacking health information or evidence about options. Moral distress occurred when nurses knew the right thing to do, but were prevented from doing so, including with end-of-life issues. Moral injury (accompanied by suffering, shame, or guilt) occurred after doing, seeing, or experiencing wrongdoing, often involving authority figures. Nurses expressed moral outrage at events and people within and outside healthcare. Despite difficult ethical situations, some nurses exemplified moral courage, sometimes by resisting policies they perceived as preventing compassionate care, guided by thinking about what was best for patients. Discussion This content analysis of ethics-related subthemes revealed conceptual characteristics and clarified distinctions with corresponding exemplars. Conceptual clarity may inform responses and interventions to address ethical quandaries in nursing practice. Conclusions Ethics education in nursing must address the moral dilemmas of pandemics, disasters, and other crises. Nurses need time and resources to heal from trying to provide the best care when no ideal option was available. (shrink)

This chapter presents an overview of the life, work, and philosophical contributions of Śāntarakṣita (c. 725–788), who is known for his synthesis of Nāgārjuna’s Madhyamaka with elements of the Dignāga-Dharmakīrti tradition of logic and epistemology. His two most important independent treatises, the Compendium of True Principles (Tattvasaṃgraha) and the Ornament of the Middle Way (Madhyamakālaṃkāra), are characterized by an emphasis on the indispensable role of rational analysis on the Buddhist path as well as serious and systematic engagement with competing Buddhist (...) and non-Buddhist schools of thought. Śāntarakṣita employs a pedagogical-rhetorical device of provisionally adopting what he deems to be successively more rational views to reject less rational ones. Using this approach, in the Ornament of the Middle Way, he recommends a gradual path to arrive at an understanding of the Madhyamaka ultimate truth by incorporating Yogācāra idealist ontology into his presentation of conventional truth. In this same text, he presents an influential iteration of the neither-one-nor-many argument for the Madhyamaka ultimate truth, the emptiness of intrinsic nature—i.e., the universal negation of ontologically independent being—leaving a lasting and significant impact on both Indian and Tibetan Madhyamaka Buddhist philosophy. (shrink)

According to Madhyamaka Buddhist philosophers, everything depends for its existence on something else. But what would a world devoid of fundamentalia look like? In this paper, I argue that the anti-foundationalist “neither-one-nor-many argument” of the Indian Mādhyamika Śrīgupta commits him to a position I call “metaphysical indefinitism.” I demonstrate how this view follows from Śrīgupta’s rejection of mereological simples and ontologically independent being, when understood in light of his account of conventional reality. Contra recent claims in the secondary literature, I (...) clarify how the Madhyamaka metaphysical dependence structure is not a straightforward infinitism since it does not honor strict asymmetry or transitivity. Instead, its dependence relations are irreflexive and extendable, admitting of dependence chains of indefinite (though not actually infinite) length and dependence loops of non-zero length. Yet, the flexible ontology of Śrīgupta's Madhyamaka can accommodate a contextualist account of asymmetry and support a revisable theory of conventional truth, delivering significant payoffs for the view, including the capacity to accommodate developments in scientific explanation. (shrink)

This monograph includes an analysis of the Commentary on the Introduction to Reality (Tattvāvatāravṛtti) by the Indian Madhyamaka Buddhist philosopher, Śrīgupta (7th/8th century), together with a Tibetan critical edition and annotated translation of this text, which has never before been available in English. In this work, Śrīgupta advances the “neither-one-nor-many argument,” which sets out to prove that all things lack ontological independence, and by implication, that everything depends for its existence on something else. I present a detailed reconstruction and analysis (...) of the argument, showing how Śrīgupta rejects the possibility of ontological independence by way of rejecting the possibility of mereological simples, both material and immaterial. Śrīgupta's other important philosophical contributions are brought to light, including his influential threefold criterion for conventional reality (saṃvṛtisatya) and his argument for the possibility of conceptual enlightened cognition (vikalpajñāna), which is standardly supposed to be non-conceptual. (shrink)

Most medical research and a substantial amount of non-medical research, especially that involving human participants, is governed by some kind of research ethics committee (REC) following the recommendations of the Declaration of Helsinki for the protection of human participants. The role of RECs is usually seen as twofold: firstly, to make some kind of calculation of the risks and benefits of the proposed research, and secondly, to ensure that participants give informed consent. The extent to which the role of the (...) REC includes the former is not uncontroversial. Indeed, the most prevalent debate on the role of RECs sees liberals and strong paternalists arguing over the importance of informed consent given by competent agents versus the significance of making benevolent decisions on behalf of others. On the one hand, liberals argue for the rights of competent adults to decide for themselves the kinds and extents of risks to which they wish to expose themselves. On the other hand, proponents of strong paternalism raise concerns about the likelihood of participants being able to truly understand the complex data involved in research. They support a role for RECs in which they exercise duties of benevolence towards patients and participants by limiting the extent to which they can be exposed to significant, permanent and irreversible harms. In this paper, we will argue that when it comes to decisions about risk it is neither possible nor desirable for RECs to adopt either role. (shrink)

There’s a common line of reasoning which supposes that the phenomenal unity of conscious experience is grounded in a mind-like simple subject. To the contrary, Mādhyamika Buddhist philosophers like Śrīgupta (seventh–eighth century) argue that any kind of mental simple is incoherent and thus metaphysically impossible. Lacking any unifying principle, the phenomenal unity of conscious experience is instead an unfounded illusion. In this paper, I present an analysis of Śrīgupta’s "neither-one-nor-many argument" against mental simples and show how his line of reasoning (...) is driven by a set of implicit questions concerning the nature of and relation between consciousness and its intentional object. These questions not only set the agenda for centuries of intra-Buddhist debate on the topic, but they are also questions to which any defender of unified consciousness or a simple subject of experience arguably owes responses. (shrink)

Who should tax multinationals? National political figures sometimes signal their assumptions by making superior or even exclusive claims about who may tax “their” multinational companies, and it is common to hear such companies or their incomes referred to as “belonging” to one nation or another. The rhetoric reflects conventional wisdom about sovereign nations and their assumed entitlements, and is often invoked to curb or even sanction the seemingly excessive tax jurisdictions of some nations. But this conventional wisdom often ignores the (...) fundamental dependence of multinationals on ongoing, extensive, and multifaceted regulatory cooperation involving most of the nations of the world. The goal of this essay is to demonstrate that given this dependence, there are no clear legal or normative boundaries to virtually any asserted tax jurisdiction. The claim provides a solution for neither double taxation nor the problems associated with excessive tax competition, but the essay concludes that recognizing the dependence of governments and “their” multinationals on multilateral cooperation should lead to an increase in focus on how nations go about negotiating the terms of their cooperation on tax. (shrink)

According to a dominant view of stigma, a person is stigmatized within a community if sufficiently many people within that community hold a bad view of her. I call this the 'Bad View Model'. In this paper, I argue against the Bad View Model on the grounds that such beliefs are neither necessary nor sufficient for stigma, and that the account cannot explain the distinctive phenomenology of stigma, including certain vulnerabilities to shame. I then develop an alternative that explains these (...) features of stigma, which I call the 'Shaming Model'. On this view, a person is stigmatized within a community if she is shamed by members of that community, and this is explained by their belief that she has deviated from some social norm and/or standard. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Explorations in Ancient and Modern Philosophy by Myles F. BurnyeatAllison Piñeros Glasscock and Elizabeth C. Shaw and Staff*BURNYEAT, Myles F. Explorations in Ancient and Modern Philosophy, vol. 4. Cambridge: Cambridge University Press, 2022. xii + 395 pp. Cloth, $120.00The eleven essays in this collection were originally published while Burnyeat was at All Souls College, Oxford (1996–2006) and during his subsequent retirement. Like volume 3 of the same series, (...) the collection was published posthumously, with editorial work undertaken by Carol Atack, Malcolm Schofield, and David Sedley. Part I contains seven essays on topics in ontology and epistemology; part II contains four essays on physics and optics. The figures examined include the usual suspects—Plato and Aristotle (plus an appearance by Aquinas)—but Burnyeat also draws our attention to some less appreciated accomplices to the ancient philosophical project: the Platonist commentator Numenius of Apamea, the Pythagorean Archytas of Tarentum, and Anaxarchus of Abdera, a follower of Democritus. The result is a collection that showcases one of Burnyeat's greatest strengths: his ability to identify the clues left for us in ancient texts and to produce from them compelling and exquisitely detailed accounts of what ancient philosophers were thinking and why.One of the final papers of the volume illustrates Burnyeat's detective acumen. "Archytas and optics" starts from the following question: Why is optics absent from the mathematical curriculum Plato sketches in the Republic? Burnyeat hypothesizes that if mathematical optics existed when the Republic was written, Plato likely excised it from the curriculum on the grounds that the discipline would lead the student to focus on visible things and their appearances. The bulk of the paper is devoted to establishing the antecedent of this conditional. Burnyeat argues that mathematical optics did exist at the time of the Republic's writing, and he posits the noncanonical Pythagorean Archytas as its founder. To recognize the significance of this lacuna in the Republic's curriculum and to provide a persuasive identification of the founder of an entire discipline is already to make a substantial contribution to scholarship. But how Burnyeat arrives at his central conclusion is equally impressive. He takes the reader on a tour of Aristotle, Plato, and Iamblichus, fragment 4 of Archytas, and the Apologia of Apuleius (whom readers might better recognize as the novelist responsible for The Golden [End Page 345] Ass). The result is not only an answer to the paper's central question, but a deeper understanding of the broader intellectual network in which canonical figures like Plato and Aristotle operated.No fragment is too small to catch Burnyeat's notice, nor is any line in a manuscript too faint. Part I of the collection includes Burnyeat's famous paper "Kinēsis vs. energeia: a much-read passage in (but not of) Aristotle's Metaphysics." The central argument is that Metaphysics 9.6.1048b18–35 is out of place. It was written by Aristotle for a different context and should not be printed in book 9. Because this article is so well known, I will not dwell on the details of the argument, but once again Burnyeat's methodology is worthy of comment. The first part of the paper offers a careful examination of the Metaphysics's manuscript tradition that attends both to what is present and to what is absent. For example, we learn that the focus passage is missing from an entire branch of the tradition, which Burnyeat suggests is the result of a learned excision. Later, Burnyeat develops a psychological sketch of the scribe of manuscript Ab beginning from the observation that a faint line is drawn through part of the focus passage. He argues that the scribe's motivation is not disapproval of the passage's contents but a desire to keep his text and commentary in sync. Observations like these provide the foundation for Burnyeat's thesis about the philosophical import of the focus passage, and they demonstrate that the physical record can be just as vital to reconstructions of ancient philosophy as the words that the record preserves.Occasionally, Burnyeat offers more direct admonitions to his readers about how to approach ancient philosophy. A key lesson... (shrink)

Śrīgupta, a Buddhist philosopher in the Middle Way tradition, was born in Bengal in present-day India in the seventh century. He is best known for his Introduction to Reality with its accompanying auto-commentary,1 in which he presents the first Middle Way iteration of the influential "neither-one-nor-many argument."2 This antifoundationalist line of reasoning sets out to prove that nothing enjoys ontologically independent being.Gottfried Wilhelm Leibniz was born some one thousand years later, in the city of Leipzig, situated on the outskirts of (...) European learning and thought. He is best known today for having co-invented the infinitesimal calculus, for his... (shrink)

Olfert argues that Aristotle's account of practical reason pays equal deference to the value of truth and to the value of acting well; she further argues that the key to a proper understanding of the relationship between these two values lies in Aristotle's heretofore overlooked notion of practical truth.Practical truth is not the truth of a motivational state, nor is it a truth that is made true by actions, nor is it even a correct assertion about the means to the (...) obtainment of one's desires, though this last view is closest to Olfert's own. Instead, practical truth is "the truth about what is unqualifiedly good relative to a particular person in a particular situation". In context... (shrink)

We are, as Nietzsche tells us in the Preface to GM, “strangers to ourselves” (GM P:1). The particular shape of this self-estrangement is not, as Nietzsche makes plain, the product of simple neglect; nor is it the result of some lack of ability or competence. Indeed, in Nietzsche’s view, the very disciplines of philosophy, history, and psychology, for example, show us that we are at once eager and capable when it comes to taking ourselves as objects of inquiry. Hence, the (...) aspect of self-estrangement that worries Nietzsche is that the very conceptual and moral framework through which we orient ourselves practically, and through which we measure our praise and blame, remains, itself, stubbornly out of view. Until we... Read More. (shrink)

Organ donation after brain death has been practiced in China since 2003 in the absence of brain death legislation. Similar to international standards, China’s brain death diagnostic criteria include coma, absence of brainstem reflexes, and the lack of spontaneous respiration. The Chinese criteria require that the lack of spontaneous respiration must be verified with an apnea test by disconnecting the ventilator for 8 min to provoke spontaneous respiration. However, we have found publications in Chinese medical journals, in which the donors (...) were declared to be brain dead, yet without an apnea test. The organ procurement procedures started with initiating “intratracheal intubation for mechanical ventilation after brain death,” indicating that a brain death diagnosis was not performed. The purpose of the intubation was not to resuscitate the patient but rather was directly related to facilitating the explantation of organs. Moreover, it was unmistakably stated in two of these publications that the cardiac arrest was induced in these patients without brain death determination by cold St. Thomas cardioplegic solution or other cold myocardial protection solutions. This means that the condition of these donors neither met the criteria of brain death nor that of cardiac death. In other words, the “donor organs” may well have been procured in these cases from living human beings. Thus, brain death definition is abused in China by some individuals for organ harvesting, and a systematic investigation is needed to clarify the situation of organ donation after brain death in China. (shrink)

Despite governmental and private antismoking initiatives, tobacco smoking remains a significant public health and economic challenge. The Centers for Disease Control and Prevention estimates that for each year between 1997 and 2001, cigarette smoking and exposure to secondhand smoke caused approximately 438,000 U.S. residents to die prematurely, resulting in 5.5 million years of potential life lost, and in $92 billion dollars of lost productivity. Also, despite convincing scientific data that laws against indoor smoking protect people from the negative health effects (...) of cigarette smoke, not all states have afforded their residents this protection. As of July 2007, 16 states neither restricted nor banned indoor smoking in restaurants, private worksites, or government worksites, and many state statutes only required separate rooms for smokers rather than eliminating all smoking inside buildings. In several states, local governments have attempted to fill this gap by adopting their own antismoking measures. (shrink)

Pre-Implantation Genetic Diagnosis represents the first fusion of genomics and assisted reproduction and the first reproductive technology that allows prospective parents to screen and select the genetic characteristics of their potential offspring. However, for some, the idea that we can intervene in the mechanisms of human existence at such a fundamental level can be, at a minimum, worrying and, at most, repugnant. Religious doctrines particularly are likely to collide with the rapidly advancing capability for science to make such interventions. This (...) paper focuses on opinions and arguments of selected religious scholars regarding ethical issues pertaining to PGD. In-depth interviews were conducted with religious scholars from three different religious organizations in the Klang Valley, Malaysia. Findings showed that Christian scholars are very sceptical of the long-term use of PGD because of its possible effect on the value of humanity and the parent-children relationship. This differs from Islamic scholars, who view PGD as God-given knowledge in medical science to further help humans understand medical genetics. For Buddhist scholars, PGD is considered to be new medical technology that can be used to save lives, avoid suffering, and bring happiness to those who need it. Our results suggest that it is important to include the opinions and views of religious scholars when it comes to new medical technologies such as PGD, as their opinions will have a significant impact on people from various faiths, particularly in a multi-religious country like Malaysia where society places high value on marital relationships and on the traditional concepts of family. (shrink)

This article aims to explore the ethical issues arising from the sharing of information in the context of interprofessional collaboration. The increased emphasis on interprofessional working has highlighted the need for greater collaboration and sharing of client information. Through the medium of a case study, we identify a number of tensions that arise from collaborative relationships, which are not conducive to supporting interprofessional working in an ethically sound manner. Within this article, it is argued that the way forward within these (...) collaborative relationships is to set clear parameters to the professional-client relationship, paying full regard to the autonomy of both the clients and the professionals involved. We conclude that this approach to working will place the client at the centre of care provision and arguments used for not collaborating that are based on breaches of confidentiality will be negated. Using the approach offered, collaborative working will be not only possible but desirable. (shrink)

It is an observed fact that human populations differ in genetic composition. Some of the inherited diversity is due to combined effects of many genes. Although it would be interesting to know the magnitude and nature of the genetic contribution to some characters under polygenic control, such as intelligence or physique, environmental effects may be so great that no genetic analysis is possible—as Thoday has pointed out earlier in this symposium. With other polygenic characters, such as skin colour, the genetic (...) component is more obvious but still difficult to analyse precisely. The number of genes involved, their frequency and dominance have not been established. This is one of the reasons why selective effects on such characters are not readily measured, although they probably exist. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Truth Will Set You Free, or How a Troubled Philosophical Theory May Help to Understand How People Talk About Their AddictionPatricia A. Ross (bio)Keywordsveridicality of narrative, contingency of theories, belief-behavior, causal connectionConsider the following proposition: If one were to recognize the unsatisfactory implications of maintaining a certain theoretical position, one would thereby be motivated to accept a more adequate theory, which would alter one's beliefs and, in turn, (...) alter the behaviors that are based upon those beliefs. Faith in this proposition is what motivates many of us to teach. But, alas...Allison Mitchell's argument for rethinking addiction intervention—in particular, rethinking twelve-step programs—is premised on this proposition. According to her argument, addicts function with an impoverished sense of self that is reflective of a grossly simplified form of philosophical materialism. By recognizing the limitations of this philosophically unconvincing view, and by, in effect, accepting a better, more complete materialism, addicts can come to modify their self-conception. This modification is instrumental to recovery.A careful consideration of the chain of events being proposed, and the problems with it, is helpful for understanding the limitations of her argument. There are four points that I consider in turn: (1) considering narratives can tell us something about the self-conception of addicts, (2) philosophical materialism can help us to understand and explain something about an addict's self-conception and how it is inadequate, (3) this sense of self is distinct from nonusers and the way in which it is distinct helps to understand the problem of addiction, and (4) a change in self-conception with respect to materialism helps recovery and, thus, our best intervention is one based on having addicts accept a full materialist theory of the self and not a pretheoretic one. [End Page 227]With respect to the first point, it should be noted that Mitchell's overall argument does not depend on whether or not it is true that narratives of addiction tell us something veridical about the self-conception of addicts. Such narratives may simply provide us with a potential theory—a possible worlds scenario—of how addicts conceive of themselves. Mitchell points this out herself. The narratives and the interpretation that she provides of these narrative, "are meant only to highlight a certain pattern of self-expression and conception that may in fact be common in persons who use mind-altering substances; the readings do not establish any empirical matters of fact or philosophical truths, nor do they prove any conclusions about how such persons (must) express themselves or conceive their nature" (Mitchell 2006, 214).Thus, what the argument is actually concerned with are the theoretical claims about the self-conception of addicts that are garnered from these narratives. Nevertheless, because the narratives provide the starting point for Mitchell's argument, it is worth thinking carefully about the epistemic status of this body of literature. In particular, could a consideration of such literature lead us astray in our endeavors to understand how addicts might misconceive of themselves and, if so, in what way? What sort of epistemic status does this information hold?Mitchell is motivated by Wittgensteinian analyses of the relationship between thought and language. The particular idea that she employs from Wittgenstein is that every act of self-expression, whether it is verbal or written narrative, reveals something about the conceptual framework with which the author is working. Thus, one can learn about the author of a narrative—one can acquire a sense of how that individual conceives of him- or herself—by looking at the language that is employed to talk about and describe him- or herself.Mitchell enumerates some problems with this approach. She mentions that the author may fail to make his or her intended sense clear to readers; that the reader's narrative expectations determine the interpretation given to the narrative; that literary narrative may be less direct, less ordinary than everyday uses of language; and that interpreting such narrative via philosophical framework may ascribe to people positions that are more precise and sophisticated than they actually intend (p. 213).Aside from these quite serious problems, it is necessary to recognize... (shrink)

Mood disorders, including major depressive disorder and bipolar disorder, are highly prevalent, frequently disabling, and sometimes deadly. Additional research and more effective medications are desperately needed, but clinical trials research in mood disorders is fraught with ethical issues. Although many authors have discussed these issues, most do so from a theoretical viewpoint. This manuscript uses available empirical data to inform a discussion of the primary ethical issues raised in mood disorders research. These include issues of consent and decision-making capacity, including (...) patients’ motivations for participating in research. We also address drug withdrawals, placebo controls, and the overall safety of research. Finally, we examine the extant literature for studies discussing potential indirect benefits of clinical trials research to participants. Taken together, the evidence suggests that clinical trials research incorporating drug withdrawals and placebo controls can be conducted safely and ethically, even in patients with severe or treatment-resistant mood disorders. In fact, given the dearth of effective treatment options for this population, it is our opinion that a moral imperative exists to extend the offer of research participation to severely ill or treatment-resistant groups. (shrink)

Horizontal gene transfer (HGT) is a major mechanism responsible for the spread of antibiotic resistance. Conversely, it is often assumed that antibiotics promote HGT. Careful dissection of the literature, however, suggests a lack of conclusive evidence supporting this notion in general. This is largely due to the lack of well‐defined quantitative experiments to address this question in an unambiguous manner. In this review, we discuss the extent to which HGT is responsible for the spread of antibiotic resistance and examine what (...) is known about the effect of antibiotics on the HGT dynamics. We focus on conjugation, which is the dominant mode of HGT responsible for spreading antibiotic resistance on the global scale. Our analysis reveals a need to design experiments to quantify HGT in such a way to facilitate rigorous data interpretation. Such measurements are critical for developing novel strategies to combat resistance spread through HGT. -/- . (shrink)

We examine how the shift to remote work altered responsibilities for domestic labor among partnered couples and single parents. The study draws on data from a nationally representative survey of 2,200 US adults, including 478 partnered parents and 151 single parents, in April 2020. The closing of schools and child care centers significantly increased demands on working parents in the United States, and in many circumstances reinforced an unequal domestic division of labor.

This book constitutes one of the most important contributions to recent Kant scholarship. In it, one of the pre-eminent interpreters of Kant, Henry Allison, offers a comprehensive, systematic, and philosophically astute account of all aspects of Kant's views on aesthetics. The first part of the book analyses Kant's conception of reflective judgment and its connections with both empirical knowledge and judgments of taste. The second and third parts treat two questions that Allison insists must be kept distinct: the (...) normativity of pure judgments of taste, and the moral and systematic significance of taste. The fourth part considers two important topics often neglected in the study of Kant's aesthetics: his conceptions of fine art, and the sublime. (shrink)

Training in the responsible conduct of research (RCR) is required for many research trainees nationwide, but little is known about its effectiveness. For a preliminary assessment of the effectiveness of a short-term course in RCR, medical students participating in an NIH-funded summer research program at the University of California, San Diego (UCSD) were surveyed using an instrument developed through focus group discussions. In the summer of 2003, surveys were administered before and after a short-term RCR course, as well as to (...) alumni of the courses given in the summers of 2002 and 2001. Survey responses were analyzed in the areas of knowledge, ethical decision-making skills, attitudes about responsible conduct of research, and frequency of discussions about RCR outside of class. The only statistically significant improvement associated with the course was an increase in knowledge, while there was a non-significant tendency toward improvements in ethical decision-making skills and attitudes about the importance of RCR training. The nominal impact of a short-term training course should not be surprising, but it does raise the possibility that other options for delivering information only, such as an Internet-based tutorial, might be considered as comparable alternatives when longer courses are not possible. (shrink)

Spatial localization, often demarcated by food miles, has emerged as the dominant theme in movements for more socially just and environmentally benign alternative food systems, especially in industrialized countries such as the United States. We analyze how an emphasis on spatial localization, combined with the difficulty of defining and measuring adequate indicators for alternative food systems, can challenge efforts by food system researchers, environmental writers, the engaged public, and advocacy groups wanting to contribute to alternative food systems, and facilitates exploitation (...) by the mainstream players using “localwash” to maintain the status quo. New indicators are urgently needed because research shows that spatial localization in general and minimized food miles in particular are not adequate or even required for most of the goals of alternative food systems. Creating indicators to operationalize goals for alternative, local food systems requires asking the right questions to make sure indicators are not misleading us: What are the goals of alternative food systems? What actions and policies will most effectively achieve those goals? What is the potential of reducing food miles as an action and a policy for achieving goals? What are the best indicators for measuring progress toward goals? We discuss how these questions can be answered for a wide range of alternative food system goals via four categories according to the role of food miles reduction as an action and policy in promoting them: necessary and sufficient, necessary but not sufficient, potentially important, and potentially supportive. (shrink)

The development of genomic technologies has seemed almost magical. Excitement about it, both in medicine and among the public, stems from the belief that genomic techniques will illuminate the causes of health and disease, will lead to effective interventions for both rare and common genetic conditions, and will inform reproductive decision‐making. Novel diagnostic tools, however, are often deployed before targeted therapies are developed, tested, or available and before their psychosocial implications are explored. Newer technologies such as prenatal whole exome screening (...) are seen as offering “decisional autonomy” to expectant parents, although such technologies identify information about genetic sequencing that may not have clear meaning. The “therapeutic gap” between the ability to conduct genetic sequencing and the ability to fully understand what the test results mean, much less what treatments to offer, leaves families with complex and unclear information they cannot act upon with confidence during pregnancy. In this essay, we will consider the psychosocial and ethical implications of such assumptions—and of the uncertain information produced by these technologies—for individuals and families and for societal aspects such as medical service usage and demographic inequities. (shrink)

This paper has both theoretical and practical ambitions. The theoretical ambitions are to explore what would constitute both effective and ethical treatment of Autism Spectrum Disorder.1 However, the practical ambition is perhaps more important: we argue that a dominant form of Applied Behavior Analysis, which is widely taken to be far-and-away the best “treatment”2 for ASD, manifests systematic violations of the fundamental tenets of bioethics. Moreover, the supposed benefits of the treatment not only fail to mitigate these violations, but they (...) often exacerbate them. Warnings of the perils of ABA are not original to us—autism advocates have been ringing this... (shrink)

With an estimated 12.1% of children aged 2–5 years already obese, prevention efforts must target our youngest children. One of the best places to reach young children for such efforts is the early care and education setting. More than 11 million U.S. children spend an average of 30 hours per week in ECE facilities. Increased attention at the national, state, and community level on the ECE setting for early obesity prevention efforts has sparked a range of innovative efforts. To assist (...) these efforts, CDC developed a technical assistance and training framework – the Spectrum of Opportunities for Obesity Prevention in the ECE setting – which also served as the organizing framework for the Weight of the Nation ECE track. Participants highlighted their efforts at national, state, and local levels pursuing opportunities on the Spectrum, the standards and best practices that had been the emphasis of their efforts, and common steps for developing, implementing, and evaluating initiatives. Strong leadership and collaboration among a broad group of stakeholders; systematic assessment of needs, opportunities and resources; funding sources; and training and professional development were reported to be integral for successful implementation of standards and best practices, and sustainability. (shrink)

The shortage of organs for transplantation by its nature prompts ethical dilemmas. For example, although there is an imperative to save human life and reduce suffering by maximising the supply of vital organs, there is an equally important obligation to ensure that the process by which we increase the supply respects the rights of all stakeholders. In a relatively unexamined practice in the USA, organs are procured from unrepresented decedents without their express consent. Unrepresented decedents have no known healthcare wishes (...) or advance care planning document; they also lack a surrogate. The Revised Uniform Anatomical Gift Act of 2006 sends a mixed message about the procurement of organs from this patient population and there are hospitals that authorise donation. In addition, in adopting the RUAGA, some states included provisions that clearly allow organ procurement from unrepresented decedents. An important unanswered question is whether this practice meets the canons of ethical permissibility. The current Brief Report presents two principled approaches to the topic as a way of highlighting some of the complexities involved. Concluding remarks offer suggestions for future research and discussion. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

In 2022, students at North American universities with third-dose COVID-19 vaccine mandates risk disenrolment if unvaccinated. To assess the appropriateness of booster mandates in this age group, we combine empirical risk-benefit assessment and ethical analysis. To prevent one COVID-19 hospitalisation over a 6-month period, we estimate that 31 207–42 836 young adults aged 18–29 years must receive a third mRNA vaccine. Booster mandates in young adults are expected to cause a net harm: per COVID-19 hospitalisation prevented, we anticipate at least (...) 18.5 serious adverse events from mRNA vaccines, including 1.5–4.6 booster-associated myopericarditis cases in males (typically requiring hospitalisation). We also anticipate 1430–4626 cases of grade ≥3 reactogenicity interfering with daily activities (although typically not requiring hospitalisation). University booster mandates are unethical because they: (1) are not based on an updated (Omicron era) stratified risk-benefit assessment for this age group; (2) may result in a net harm to healthy young adults; (3) are not proportionate: expected harms are not outweighed by public health benefits given modest and transient effectiveness of vaccines against transmission; (4) violate the reciprocity principle because serious vaccine-related harms are not reliably compensated due to gaps in vaccine injury schemes; and (5) may result in wider social harms. We consider counterarguments including efforts to increase safety on campus but find these are fraught with limitations and little scientific support. Finally, we discuss the policy relevance of our analysis for primary series COVID-19 vaccine mandates. (shrink)

Dharmakīrti’s (c. seventh century) Examination of Relations (Sambandhaparīkṣā) is unique in the Indian Buddhist canon for its being the only extant root text devoted entirely to the topic of the ontological status of relations. But the core thesis of this treatise—that relations are only nominally real—is in prima facie tension with another claim that is central to Dharmakīrti’s epistemology: that there exists some kind of “natural relation” (svabhāvapratibandha) that reliably underwrites inferences. Understanding how Dharmakīrti can consistently rely on natural relations (...) to prop up his presentation of inferential reasoning while at the same time advancing an anti-realist account of relations is critical for making sense of his system of logic and epistemology, which came to be nearly universally adopted in Tibetan Buddhism cutting across traditions. Chomden Rikpé Reldri (1227–1305), who was perhaps the most prolific commentator on logic and epistemology in the history of Tibetan philosophy, composed two texts commenting on the Examination of Relations, neither of which have received any scholarly attention to date. In this paper, I provide an introduction to Chomden Reldri’s two commentaries and consider how they may illuminate Dharmakīrti’s text and also what they reveal about the understanding of Dharmakīrti’s account of relations in early Tibetan scholasticism. I then present a translation of Dharmakīrti’s Examination of Relations together with Chomden Reldri’s commentary, Annotations and Topical Outline of the Examination of Relations (’Brel pa brtag pa’i mchan dang sa bcad gnyis). (shrink)

Is conceptual engineering feasible? Answering that question requires a theory of semantic change, which is sometimes thought elusive. Fortunately, much is known about semantic change as it occurs in the wild. While usage is chaotic and complex, changes in a word’s use can produce changes in its meaning. There are several under-appreciated empirical constraints on how meanings change that stem from the following observation: word use finely reflects equilibrium between various communicative pressures. Much of the relevant work in linguistics has (...) employed the methods of empirical pragmatics and diachronic semantics. In this way, the study of meaning change can be brought to bear on the conceptual engineer’s normative project. The picture that emerges tells against the sorts of engineering projects most likely to appeal to philosophers. Some may stand to succeed, but they have significantly different contours than the typical ones. (shrink)

The purpose of our article is to describe the initial development process of the subordinate influence ethics (SIE) measure, an instrument that was crossculturally conceived, designed, and validity tested to measure upward influence ethics strategies of professional subordinates across different societies, as well as within a single society. Development of the SIE began by defining the SIE constructs through theoretical review and empirical (nominal group technique) assessments in Germany, France, Hong Kong, and the U. S. In the present measurement development (...) phase, the SIE has been found to consist of three distinct dimensions: pro-organizational behaviors, self-serving behaviors, and maliciously intended behaviors. The construct validity of the SIE was examined across 4113 subjects from 30 countries. A reduced model of the SIE was developed empirically to represent the "best model" for the three-factor scale. (shrink)

There is convincing evidence of the transmission of anxiety and depression from parents to children; however, mechanisms by which this vulnerability is passed on are unclear. Cognitive models and a small body of cross-sectional research suggest that parental attention biases may be one mechanism involved in transmission. Longitudinal associations of maternal and offspring ABs with offspring symptoms have been scarcely studied. Forty-three mothers–child dyads were included. All children were diagnosis-free while 24 mothers had a lifetime emotional disorder and 19 mothers (...) had no psychiatric diagnoses. This study examined cross-sectional and longitudinal associations of maternal and child AB and child anxiety symptomology at initial and 12-month assessments. ABs were assessed using a visual-probe task with emotional faces. There was a significant cross-sectional but not longitudinal association of increased child anxiety symptoms with increased maternal threat AB for HR but not LR dyads. At the cross-sectional level, increases in HR but not LR offspring anxiety symptomology were associated with maternal threat AB. Larger longitudinal studies are required that examine the interplay between parent–child variables and include multiple time-points of assessment and measures of AB. (shrink)

This paper seeks to defend Philosophy’s account of true happiness in Boethius’ Consolation of Philosophy. Although philosopher John Marenbon claims that Philosophy provides Boethius with two conflicting accounts of happiness, this paper argues that she consistently advocates a single account of true happiness. Ultimately, the paper claims that Marenbon is mistaken in his interpretation of Philosophy account of true happiness. What Marenbon interprets as an alternate account of the nature of true happiness is actually a component of Philosophy’s dialectical method (...) and not a separate account. (shrink)

This study is an analysis of surrogate-focused ethics consultations in the Intensive Care Unit (ICU) and the general wards (Ward) of a large community hospital in Northern California. We identified the major themes of surrogate-focused ethics consultations to better understand the root cause of surrogate conflicts, and identified the similarities and differences between surrogate-based conflicts in the two settings. Consults requested because the surrogate had desires that conflicted with the physicians medical opinion of ‘best interest’, or cases involving surrogates not (...) upholding a patient’s known values reflected the root cause of the majority of surrogate conflicts (72.7% ICU, 83.3% Ward). (shrink)

Longchen Rabjampa (1308–64), scholar of the Tibetan Buddhist Nyingma tradition, presents a novel doxographical taxonomy of the so-called Svātantrika branch of Madhyamaka Buddhist philosophy, designating the Indian Mādhyamika Śrīgupta (c. 7th/8th century) as the exemplar of a Svātantrika sub-school which maintains that appearance and emptiness are metaphysically distinct. This paper compares Longchenpa’s characterization of this “distinct-appearance-and-emptiness” view with Śrīgupta’s own account of the two truths. I expose a significant disconnect between Longchenpa’s Śrīgupta and Śrīgupta himself and argue that the impetus (...) for Longchenpa’s doxographical innovation originates not in Buddhist India, but within his own Tibetan intellectual milieu, tracing back to his twelfth-century Sangpu Monastery predecessors, Gyamarwa and Chapa. (shrink)

Applying Jewish Ethics: Beyond the Rabbinic Tradition is a groundbreaking collection that introduces the reader to applied ethics and examines various social issues from contemporary and largely under-represented, Jewish ethical perspectives.

When I classify Fluffy as a cat, I appear to do so out of an appreciation of a prior metaphysical fact, namely, that she has a nature or essence common to creatures we classify as cats. Locke turns this picture on its head. Our actual practices of naming and sorting individuals into kinds proceed according to ideas in the mind. As Locke puts it, species (kinds) are ‘the Workmanship of the Understanding,’ not the workmanship of nature, because their essences consist (...) in abstract ideas, or ‘nominal essences,’ we make. Many take Locke to mean that the observable similarities and differences between things leave it undetermined how we are to group and distinguish them, so that classification is, and must be, a matter of convention. And while Locke never denies that individuals have real essences, it is argued that knowledge of them would not reveal natural boundaries, either. On this influential reading, nature does not draw boundaries between kinds, and she makes this fact apparent to us. I argue that Locke’s claim that nature does not determine the ‘Boundaries of the Species of Things’ should be understood as the claim that nature does not draw the variable boundaries set out in the nominal essences we make. Differences in our nominal essences reflect differences in speakers’ knowledge of external ‘standards,’ which we latch on to by way of their ‘leading’ qualities, which present the mind with a limited number of unique and highly salient bases for classification. On my reading, nature may very well draw boundaries of her own. (shrink)

This exploratory study assessed the use of functional Near Infrared Spectroscopy (fNIRS) to examine hemodynamic response patterns during sentence processing. Four groups of participants: monolingual English children, bilingual Chinese-English children, bilingual Chinese-English adults and monolingual English adults were given an agent selection syntactic processing task. Bilingual child participants were classified as simultaneous or sequential bilinguals to examine the impact of first language, age of second-language acquisition (AoL2A), and the length of second language experience on behavioral performance and cortical activation. Participants (...) were asked to select the agent of four types of sentences: subject-verb-object (SVO), passive (PAS), subject-extracted relative clause (SR), and object-extracted relative clause (OR) adopted from the “Whatdunit” task by Montgomery et al. (2016). Semantic cues were removed by using inanimate nouns for agents and patients, which constrained participants to make decisions based on syntactic knowledge. Behavioral results showed greater accuracy for canonical SVO and SR sentence types than for noncanonical OR and PAS sentence types, which aligns with prior studies. Neuroimaging results revealed greater hemodynamic responses to relative clauses (i.e., SR and OR sentences) than to simple sentences (SVO and PAS), especially for Chinese-English bilinguals suggesting first-language transfer influencing sentence processing in English. The effects AoL2A and the length of second language experience showed no significant differences between simultaneous and sequential bilinguals or between bilingual adults and children for identifying the correct agent in each sentence. However, neuroimaging results demonstrated greater hemodynamic responses in right dorsolateral prefrontal cortex (DLPFC) and left inferior parietal lobule (IPL) in simultaneous bilinguals compared to sequential bilinguals and greater hemodynamic responses in left and right DLPFC and left IPL among bilingual adults. Different behavioral and neural hemodynamic response patterns afford new insights into the effects of syntactic knowledge on sentence processing. (shrink)

The inclusion of engineering standards in US science education standards is potentially important because of how limited engineering education for K-12 learners is, despite the ubiquity of engineering in students’ lives. However, the majority of learners experience science education throughout their compulsory schooling. If improved engineering literacy is to be achieved, then its inclusion in science curricula is perhaps the most efficient means. One significant challenge that arises, however, is in the framing of engineering relative to science by both teachers (...) and curriculum. Science and engineering are both distinct and interdependent. The nature of the contributions of science and engineering to one another has been an area of some examination in philosophy of technology and engineering, but little framing of this relationship has been conducted with K-12 science and engineering education contexts in mind. Nature of science is a critical layer of scientific understanding that has been used to explicitly support literacy in K-16 science classrooms for decades. However, engineering cannot be authentically and appropriately supported by NOS framing. There is an immediate need for discourse on the nature of engineering knowledge but not in isolation of NOS. Given the increasing inclusion of engineering in science classrooms, relationships between NOS and NOEK are in need of explication and argument. Our purpose is to promote a discussion about NOS, engineering, and the relationship between them without misrepresenting engineering as a subdomain of science or as an oversimplification of itself. (shrink)