Formal training in clinical ethics must become a central part of residency curricula to prepare practitioners to manage the ethical dimensions of patient care. Residency educators must ground their teaching in an understanding of the conceptual, biomedical, and psychosocial aspects of the important ethical issues that arise in that field of practice. Four aspects of professional competence in clinical ethics provide a useful framework for curricular planning. The physician should learn to: (1) recognize ethical issues as they arise in clinical (...) care and identify hidden values and unacknowledged conflicts; (2) think clearly and critically about these issues in ways that lead to ethically justifiable courses of action; (3) apply those practical skills needed to implement an ethically justifiably course of action; and (4) judge when the management of a clinical situation requires consultation with individuals or institutional bodies with additional expertise or authority. We argue that these practical goals can be accomplished with a relatively modest emphasis on the theoretical aspects of medical ethics. (shrink)

Few residency training programmes explicitly require substantive exposure to issues in medical ethics and fewer still have a formal curriculum in this area. Traditional undergraduate medical ethics courses teach preclinical students to identify ethical issues and analyse them at a theoretical level. Residency training, however, is the ideal time to establish the critical behavioural link which makes ethics truly useful in clinical medicine. The General Internal Medicine Residency Training Program at Rhode Island Hospital has developed an integrated, three-year curriculum with (...) the goals of helping residents to perceive ethical issues in clinical practice, to utilise basic philosophical principles in resolving ethical dilemmas and to communicate these issues clearly and sensitively to patients. The curriculum has been well received by residents and has had a hospital-wide impact. We believe that training residents in medical ethics and communication skills is an effective approach to developing physicians' humane qualities. (shrink)

Adequate epistemic justification is best conceived as the appearance, over time, of knowledge to the subject. ‘Appearance’ is intended literally, not as a synonym for belief. It is argued through consideration of examples that this account gets the extension of ‘adequately justified belief’ at least roughly correct. A more theoretical reason is then offered to regard justification as the appearance of knowledge: If we have a knowledge norm for assertion, we do our best to comply with this norm when we (...) express as assertions only beliefs that appear to us to be knowledge. If we are doing our best, there is little point in further sanctions. So a norm of knowledge for assertion would lead to a secondary norm of justified belief as the appearance of knowledge, marking a point at which our assertions may be corrected but should not be blamed. (shrink)

The familiar Cartesian sceptical arguments all involve an explanation of our experiences. An account of the persuasive power of the sceptical arguments should explain why this is so. This supports a diagnosis of the error in Cartesian sceptical arguments according to which they mislead us into regarding our perceptual beliefs as if they were justified as inferences to the best explanation. I argue that they have instead a perceptual justification that does not involve inference to the best explanation and that (...) should not be put in doubt by the sceptical hypotheses. (shrink)

Objection to Quine's argument for the inscrutability of reference. The proxy functions don't preserve the relations to experience, contrary to Quine's claims.

Based on his theory of animalrights, Regan concludes that humans are morallyobligated to consume a vegetarian or vegandiet. When it was pointed out to him that evena vegan diet results in the loss of manyanimals of the field, he said that while thatmay be true, we are still obligated to consumea vegetarian/vegan diet because in total itwould cause the least harm to animals (LeastHarm Principle, or LHP) as compared to currentagriculture. But is that conclusion valid? Isit possible that some other (...) agriculturalproduction alternatives may result in leastharm to animals? An examination of thisquestion shows that the LHP may actually bebetter served using food production systemsthat include both plant-based agriculture and aforage-ruminant-based agriculture as comparedto a strict plant-based (vegan) system. Perhapswe are morally obligated to consume a dietcontaining both plants and ruminant(particularly cattle) animal products. (shrink)

Previous research has shown that emotionally-valenced words are given higher judgements of learning (JOLs) than are neutral words. The current study examined potential explanations for this emotional salience effect on JOLs. Experiment 1 replicated the basic emotionality/JOL effect. In Experiments 2A and 2B, we used pre-study JOLs and assessed memory beliefs qualitatively, finding that, on average, participants believed that positive and negative words were more memorable than neutral words. Experiment 3 utilised a lexical decision task, resulting in lower reaction times (...) (RTs) for positive words than for neutral words, but equivalent RTs for negative and neutral words, suggesting that processing fluency may partially account for higher JOLs for positive words, but not for negative words. Finally, we conducted a series of moderation analyses in Experiment 4 which assessed the relative contributions of fluency and beliefs to JOLs by measuring both factors in the same participants, showing that RTs made no significant contribution to JOLs for either positive or negative words. Our findings suggest that although positive words may be more fluently processed than neutral words, memory beliefs are the primary factor underlying higher JOLs for both positive and negative words. (shrink)

Various considerations are adduced toshow that we require that a testifier know hertestimony. Such a requirement apparentlyimproves testimony. It is argued that the aimof improving testimony explains why we have anduse our concept of knowledge. If we were tointroduce a term of praise for testimony, usingit at first to praise testimony that apparentlyhelped us in our practical projects, it wouldcome to be used as we now use the word``know''.

Written by epidemiologists, ethicists and legal scholars, this book provides an in-depth account of the moral problems that often confront epidemiologists, including both theoretical and practical issues. The first edition has sold almost three thousand copies since it was published in 1996. This edition is fully revised and includes three new chapters:Ethical Issues in Public Health Practice, Ethical Issues in Genetic Epidemiology, and Ethical Issues in International Health Research and Epidemiology. These chapters collectively address important developments of the past decade. (...) Three chapters from the first edition have also been reorganized: Ethicall Optimized Study Deisgns in Epidemiology, Ethical Issues in Epidemiologic Research with Children, and The Ethics of Epidemiologic Research with Older Populations. Instead of standing alone, these chapters have been integrated into chapters on informed consent, confidentiality and privacy protection, and community-based intervention studies. (shrink)

Non-propositional experiences can help justify beliefs, contrary to recent claims made by Donald Davidson and Laurence Bonjour. It is argued that a perceptual belief is justified if there are no undermining beliefs and it was arrived at in response to an experience through an adequate exercise of properly learned recognitional skills.

Cognitive science is transforming our understanding of the mind. New discoveries are changing how we comprehend not just language, but thought itself. Yet, surprisingly little of the new learning has penetrated discussions and analysis of the most important social institution affecting our lives-the law. Drawing on work in philosophy, psychology, anthropology, linguistics, and literary theory, Steven L. Winter has created nothing less than a tour de force of interdisciplinary analysis. A Clearing in the Forest rests on the simple notion (...) that the better we understand the workings of the mind, the better we will understand all its products-especially law. Legal studies today focus on analytic skills and grand normative theories. But, to understand how real-world, legal actors reason and decide, we need a different set of tools. Cognitive science provides those tools, opening a window on the imaginative, yet orderly mental processes that animate thinking and decisionmaking among lawyers, judges, and lay persons alike. Recent findings about how humans actually categorize and reason make it possible to explain legal reasoning in new, more cogent, more productive ways. A Clearing in the Forest is a compelling meditation on both how the law works and what it all means. In uncovering the irrepressibly imaginative, creative quality of human reason, Winter shows how what we are learning about the mind changes not only our understanding of law, but ultimately of ourselves. He charts a unique course to understanding the world we inhabit, showing us the way to the clearing in the forest. (shrink)

The novel coronavirus has not only brought along disruptions to daily socio-economic activities, but sickness and deaths due to its high contagion. With no widely acceptable pharmaceutical cure, the best form of prevention may be precautionary measures which will guide against infections and curb the spread of the disease. This study explored the relationship between COVID-19 knowledge, risk perception, and precautionary behavior among Nigerians. The study also sought to determine whether this relationship differed for men and women. A web-based cross-sectional (...) design approach was used to recruit 1,554 participants from all geopolitical zones in Nigeria, through social media platforms using a snowball sampling technique. Participants responded to web-based survey forms comprising demographic questions and adapted versions of the Ebola knowledge scale, SARS risk perception scale, and precautionary behavior scale. Moderated mediation analysis of the data showed that risk perception mediated the association between COVID-19 knowledge and precautionary behavior and this indirect effect was in turn moderated by gender. Results indicate that having adequate knowledge of COVID-19 was linked to higher involvement in precautionary behavior through risk perception for females but not for males. It was also noted that awareness campaigns and psychological intervention strategies on COVID-19 related activities may be particularly important for males more than females. Drawing from the health belief model, we recommend that COVID-19 awareness campaigns should target raising more awareness of the risks associated with the infection to make individuals engage more in precautionary behaviors. (shrink)

Imagining that I am Napoleon is not (normally) imagining an impossibility. It is (or at least may be) just adopting a first person way of imagining Napoleon. The images and bits of narrative using 'I' are intended to refer to Napoleon and his surroundings, in something like the way that a salt shaker can stand for a regiment of troops when the general says "This is the third regiment' while explaining his plans at the breakfast table.

Of the various loci of systematic theology that call for sustained philosophical investigation, the doctrine of sanctification stands out as a prime candidate. In response to that call, William Alston developed three models of the sanctifying work of the Holy Spirit: the fiat model, the interpersonal model, and the sharing model. In response to Alston’s argument for the sharing model, this paper offers grounds for a reconsideration of the interpersonal model. We close with a discussion of some of the implications (...) of one’s understanding of the transforming work of the Holy Spirit for practical Christian spirituality. (shrink)

This paper discusses Plato’s question from the Meno : Why should we prefer knowledge that p over mere true belief that p? I find I just do prefer knowledge, and not for any further benefit that I am aware of in the particular case. But I should have that preference, because given our practice of approving of testimony only if uttered with knowledge, I could fail to prefer knowledge, when other things seem to me to be equal, only by having (...) the sorts of serious social or psychological defects that would make me unresponsive to the approval of others. Finally, the social practice that produces this particular preference is good for all of us because it improves the average quality of the testimony we receive, which results in greater success in our projects. (shrink)

Nevin & Grace's behavioral-momentum model accommodates a large body of data. This commentary highlights some experimental findings that the model does not always predict. The model does not consistently predict resistance to change when response-independent food is delivered simultaneously with response-contingent food, when drugs are used as response disrupters, and when responding is reinforced under single rather than multiple schedules of reinforcement.

Between 300,000 and 250,000 years ago early humans in Africa and Eurasia began to use durable material substances and objects as media for signaling. Initially material signals were confined to ochre and other pigments, but over time objects such as beads were also added as technologies for sending messages. Changes in the types of materials used, their durability and costs, and the contexts of their disposal indicate a series of transitions in how early humans employed signaling media. Signaling theory from (...) biology suggests that shifts in technologies over the course of the Pleistocene reflect problems in coordinating action and resolving conflicts within increasingly large and internally differentiated societies. (shrink)

In this volume, author Steven L. Bindeman presents a survey of the key figures in postmodern antiphilosophy. Noting that the main thrust of their work can be found in their need to respond to the threat of nihilism, he is guided by the question, if the path to abstract truth is no longer viable, what then? He shows how the antiphilosophers turn their focus on the complexity of lived experience in place of the search for certainty, which was in (...) their view what previously had guided the dominating discourse of the modernist philosophical tradition. Through close examination of a broad variety of texts, Bindeman illuminates how the antiphilosophers initiate a new way of doing philosophy, one which prefers to examine the question, Does it work? instead of, Is it true? Moreover, Bindeman demonstrates how the antiphilosophers are united in questioning the centrality of the great cornerstones of western metaphysics - time, self, universe, and God - because of their insistence that there is no way to reach beyond any of these words to the actual things to which they refer. Utilizing the exposed, significant fault in the foundation of all philosophical systems, "The Antiphilosophers" delivers new insight concerning the issue of how we should relate to the resultant chaos. Written with a rare combination of philosophical rigor and clarity of expression, Bindeman's work will be of interest to students and scholars of postmodern philosophy. (shrink)

Phenomenology and the Creative Process explpores the subject of creativity from a vast range of perspectives. While the emphasis is placed on fundamental ideas taken from phenomenological philosophy and its precursors, the book also engages with related issues from the fields of psychology, physics, narrative studies, art, literature, cognitive science and neuroscience. Author Steven L. Bindeman's objective is to employ an analysis of creativity from the dual perspectives of "identity" and "difference," in order to develop a pluralistic and open-ended (...) understanding of the creative process. His central position is that while creativity can and should be studied as a physical, measurable phenomenon, we need to integrate quantitative studies with a phenomenological perspective that enables us to appreciate the distinctive experiential features of creative activities in order to fully appreciate the complex nature of the creative process. Bindeman's approach is important in that it recognizes the value of phenomenological studies without being afraid to draw insights from other fields of inquiry. This book thus offers unique analysis of creative individuals and works, applying insights from phenomenological philosophers to enrich our understanding of the creative processes of great artists, philosophers, and scientists. (shrink)

This paper attempts to give an experiential explanation of the phenomenon of immunity to error through misidentification in some of our judgments about ourselves. The main idea is that in most of these judgments we respond to the type of presentation -- e.g., proprioceptive -- and not to presented properties of the perceived object.

A recent account of the meaning of 'real' leads to a view of what anti-realism should be that resembles fictionalism, while not being committed to fictionalism as such or being subject to some of the more obvious objections to that view. This account of anti-realism explains how we might 'make up' what is true in areas such as mathematics or ethics, and yet these made-up truths are resistant to alterations, even by our collective decisions. Finally it is argued that the (...) sort of anti-realism suggested explains the appearance that the ethical domain supervenes on the naturalistic. (shrink)

Abstract. The Western conception of the individual as a rational, self-directing agent is a mythology that organizes and distorts religion, science, economics, and politics. It produces an abstracted and atomized form of engagement that is fatal to collective self-governance. And it turns democracy into the enemy of equality. Considering the meaning of democracy and autonomy from a perspective that takes the subject as truly social would refocus our attention on the constitutive contexts and practices necessary for the production of citizens (...) who are capable of meaningful self-governance. Under modern conditions, it is in the development of sexual autonomy that we learn how to take initiative with respect to our well-being and do so in concert with others. Where the view of rational agency as the defining characteristic of humanity yields a deracinated view of autonomy, a more realistic, humanistic view that we are, necessarily, social beings yields a view of freedom and self-governance as social phenomena that require empathy, negotiation, compromise, cooperation, and mutual recognition and respect. (shrink)

Spinoza's ethics is founded on the idea that we are egoists who should do nothing but search our own advantage , but that in doing so, this is when we are most virtuous, most moral, and most social . Community, taken in any sense stronger than a mere collection of things, only occurs, then, when each is drawn to seek his self-interest. ;Spinoza would hold that no study of ethics can be done in a metaphysical vacuum . To discuss the (...) ethics of an individual existing in community, one must first address the metaphysical foundations of the individual, its rights, and its place in community. To this end, the greater part of this work examines just those metaphysical bases which define an individual and how it relates in community. The analysis is textually based; focusing on how Spinoza uses certain terms , we attempt to understand what Spinoza understood to be an individual, community, right, etc. Then, because society affects an individual and the individual in turn affects society, the study looks at human individuals and their affects, that is, how humans affect and are affected by other humans. Just as a group of rocks makes only a pile and not what might be called a community, so too a group of human individuals does not necessarily make a society. The move from many individuals to one community is examined. ;Finally, after the metaphysical and psychological considerations are established, the study addresses its main question, that is, the value that should be accorded to a particular human life vis-a-vis the society in which the person lives. The study touches, therefore, questions concerning capital punishment, euthanasia, assisted suicide, and even abortion. The surprising conclusion is that Spinoza's ethics do allow for and can support what could be called a consistent human life ethic in which the right to life remains primary. (shrink)

It is proposed that cortical activity is normally coordinated across synaptically connected areas and that this coordination supports cognitive coherence relations. This view is consistent with the NMDA- hypoactivity hypothesis of the target article in regarding disorganization symptoms in schizophrenia as arising from disruption of normal interareal coordination. This disruption may produce abnormal contextual effects in the cortex that lead to anomalous cognitive coherence relations.

This study examines the conditions under which apologies help to elicit forgiveness and restore trust following trust violations between leaders and followers. The intentionality and severity of violations are examined in a critical incident study and a laboratory study. The results support a model in which forgiveness mediates the relation of apology quality and trust. More importantly, the moderation–mediation model shows that apology quality influenced forgiveness and subsequent trust following violations that were moderate in severity–intentionality combination. The effect of apologizing (...) affects trust directly without forgiveness when the severity–intentionality combination held minor or extreme intensity. The results suggest a range in which apologies are effective and enrich understanding of the conditions under which trust can be recovered through an apology–forgiveness process in leader–follower relationships. The contribution of the study lies in elucidating that the combination of severity and intentionality of leaders’ trust violations has greater importance than either one separately. (shrink)

The self-interest paradigm predicts that unethical behavior occurs when such behavior benefits the actor. A recent model of lying behavior, however, predicts that lying behavior results from an individual''s inability to meet conflicting role demands. The need to reconcile the self-interest and role conflict theories prompted the present study, which orthogonally manipulated the benefit from lying and the conflicting role demands. A model integrating the two theories predicts the results, which showed that both elements — self benefit and role conflict (...) — influenced lying, separately and interactively. Additionally, the relative strength of the roles in conflict affected their level of influence. Theoretical and practical implications are discussed. (shrink)

In an attempt to revive discussion of the argument from illusion this paper amends the classic version of the argument to avoid Austin's main objection. It then develops and defends a version of the intentional object reply to the argument, arguing that an "unendorsed story" account of reports of dreams and hallucinations avoids commitment to nonexistent objects.

This chapter contains sections titled: References.

In a study of the kin investment of aunts and uncles we show that the laterality effect expected as a result of paternity uncertainty is statistically reliable but somewhat smaller than the sex effect. Matrilateral aunts invest significantly more than patrilateral aunts, and the same is true for uncles. Regardless of laterality, however, aunts invest significantly more than uncles. Multivariate controls show that the matrilateral bias is fully independent of any age or distance confounds that might result from sex differences (...) in age at marriage or dispersal. We discuss our results in relation to recent findings on the kin investment of grandparents (Euler and Weitzel 1996). In addition, we propose a simple method for estimating the level of paternity uncertainty from kin investment data; application of this method to our data on aunts and uncles suggests that between 13% and 20% of children are not the offspring of their putative father. Our parallel analyses of Euler and Weitzel’s (1996) data on grandparental investment suggest a similar estimate, that paternity uncertainty lies between 9% and 17%. (shrink)

Control of our own beliefs is allegedly required for the truth of epistemic evaluations, such as S ought to believe that p , or S ought to suspend judgment (and so refrain from any belief) whether p . However, we cannot usually believe or refrain from believing at will. I agree with a number of recent authors in thinking that this apparent conflict is to be resolved by distinguishing reasons for believing that give evidence that p from reasons that make (...) it desirable to believe that p whether or not p is true. I argue however that there is a different problem, one that becomes clearer in light of this solution to the first problem. Someone’s approval of our beliefs is at least often a non-evidential reason to believe, and as such cannot change our beliefs. Ought judgments aim to change the world. But ‘ought to believe’ judgments can’t do that by changing the belief, if they don’t give evidence. So I argue that we should instead regard epistemic ought judgments as aimed mainly at influencing assertions that express the belief and other actions based on the belief, in accord with recent philosophical claims that we have epistemic norms for assertion and action. (shrink)