Background: This study attempts to understand if medical providers beliefs about the moral permissibility of honoring patient-directed refusals of life-sustaining treatment (LST) are tied to their beliefs about the patient’s decision-making capacity. The study aims to answer: 1) does concern about a patient’s treatment decision-making capacity relate to beliefs about whether it is morally acceptable to honor a refusal of LST, 2) are there differences between provider types in assessments of decision-making capacity and the moral permissibility to refuse LST, and (...) 3) do provider demographics impact beliefs about decision-making capacity and the moral permissibility to refuse LST. Methods: A mixed-methods survey using Likert assessment and vignette-based questions was administered to medical providers within a single health system in the upper Midwest (N = 714) to assess their perspectives on the moral acceptance and decision-making capacity in cases of withholding and withdrawing treatment and suicide. Results: Behavioral health providers report accepting of the moral permissibility of suicide (91.2%) more than either medical providers (77.2%) or surgeons (74.4%) (n = 283). Decision-making capacity was questioned more in the vignettes of the patients refusing life-saving surgery (36%) and voluntarily starvation (40.8%) than in the vignette of the patient requesting to deactivate a pacemaker (13%) (n = 283). Behavioral health providers were more concerned about the capacity to refuse life-saving surgery (55.9%) than medical providers (33.8%) or surgeons (23.1%) (n = 283). Conclusions: Respondents endorse the moral permissibility of persons to withhold or withdraw from treatment regardless of motive. Clinical concerns about a patient’s treatment decision-making capacity do not strongly correlate to views about the moral permissibility of honoring refusals of LST. Different provider types appear to have different thresholds for when to question treatment decision-making capacity. Behavioral health providers tend to question treatment decision-making capacity to refuse LST more than non-behavioral health providers. (shrink)

This paper proposes a model of human uniqueness based on an unusual distinction between two contrasted kinds of political competition and political status: (1) antagonistic competition, in quest of dominance (antagonistic status), a zero-sum, self-limiting game whose stake—who takes what, when, how—summarizes a classical definition of politics (Lasswell 1936), and (2) synergistic competition, in quest of merit (synergistic status), a positive-sum, self-reinforcing game whose stake becomes “who brings what to a team’s common good.” In this view, Rawls’s (1971) famous virtual (...) “veil of ignorance” mainly conceals politics’ antagonistic stakes so as to devise the principles of a just, egalitarian society, yet without providing any means to enforce these ideals (Sen 2009). Instead, this paper proposes that human uniqueness flourished under a real “adapted veil of ignorance” concealing the steady inflation of synergistic politics which resulted from early humans’ sturdy egalitarianism. This proposition divides into four parts: (1) early humans first stumbled on a purely cultural means to enforce a unique kind of within-team antagonistic equality—dyadic balanced deterrence thanks to handheld weapons (Chapais 2008); (2) this cultural innovation is thus closely tied to humans’ darkest side, but it also launched the cumulative evolution of humans’ brightest qualities—egalitarian team synergy and solidarity, together with the associated synergistic intelligence, culture, and communications; (3) runaway synergistic competition for differential merit among antagonistically equal obligate teammates is the single politically selective mechanism behind the cumulative evolution of all these brighter qualities, but numerous factors to be clarified here conceal this mighty evolutionary driver; (4) this veil of ignorance persists today, which explains why humans’ unique prosocial capacities are still not clearly understood by science. The purpose of this paper is to start lifting this now-ill-adapted veil of ignorance, thus uncovering the tight functional relations between egalitarian team solidarity and the evolution of human uniqueness. (shrink)

Most arguments about conscientious objections in medicine fail to capture the full scope and complexity of the concept before drawing conclusions about their permissibility in practice. Arguments favoring and disfavoring the accommodation of conscientious objections in practice tend to focus too narrowly on prima facie morally contentious treatments and religious claims of conscience, while further failing to address the possibility of moral perspectives changing over time. In this paper, I argue that standard reasons against permitting conscientious objections in practice—that their (...) permission may result in harm to patients, the idea that medical providers willingly enter into the medical field, and that conscientious objections stand contrary to medical professionalism—do not apply in all cases and that the medical field and health systems in which many physicians now practice should continue to tolerate conscientious objections in practice. (shrink)

Some people commonly know a proposition just in case they all know it, they all know that they all know it, they all know that they all know that they all know it, and so on. They commonly believe a proposition just in case they all believe it, they all believe that they all believe it, they all believe that they all believe that they all believe it, and so on. A long tradition in economic theory, theoretical computer science, linguistics (...) and philosophy has held that people have some approximation of common knowledge or common belief in a range of circumstances, for example, when they are looking at an object together, or when they have just discussed something explicitly in conversation. In this paper, I argue that people do not have any approximation of common knowledge or common belief in these circumstances. The argument suggests that people never have any approximation of common knowledge or common belief. (shrink)

Meta-programs, which treat other computer programs as data, include compilers, editors, simulators, debuggers, and program transformers. Because of the wide ranging applications, meta-programming has become a subject of considerable practical and theoretical interest. This book provides the first comprehensive view of topics in the theory and application of meta-programming, covering problems of representation and of soundness and correctness of interpreters, analysis and evaluation of meta-logic programs, and applications to sophisticated knowledge-based systems.Harvey Abramson is Reader in Computer Science at the (...) University of Bristol, England; M. H. Rogers is Professor of Computer Science, also at the University of Bristol. Meta-Programming in Logic Programming is in the series Logic Programming Research Reports and Notes, edited by Ehud Shapiro. (shrink)

Are LLMs cultural technologies like photocopiers or printing presses, which transmit information but cannot create new content? A challenge for this idea, which we call bibliotechnism, is that LLMs generate novel text. We begin with a defense of bibliotechnism, showing how even novel text may inherit its meaning from original human-generated text. We then argue that bibliotechnism faces an independent challenge from examples in which LLMs generate novel reference, using new names to refer to new entities. Such examples could be (...) explained if LLMs were not cultural technologies but had beliefs, desires, and intentions. According to interpretationism in the philosophy of mind, a system has such attitudes if and only if its behavior is well explained by the hypothesis that it does. Interpretationists may hold that LLMs have attitudes, and thus have a simple solution to the novel reference problem. We emphasize, however, that interpretationism is compatible with very simple creatures having attitudes and differs sharply from views that presuppose these attitudes require onsciousness, sentience, or intelligence (topics about which we make no claims). (shrink)

Volume 20, Issue 7, July 2020, Page 139-141.

European Journal of Philosophy, EarlyView.

This article presents a new interpretation of the great Ming dynasty philosopher Wang Yangming’s celebrated doctrine of the “unity of knowledge and action”. Wang held that action was not unified with all knowledge, but only with an elevated form of knowledge, which he sometimes called “genuine knowledge”. I argue for a new interpretation of this notion, according to which genuine knowledge requires freedom from a form of doxastic conflict. I propose that, in Wang’s view, a person is free from this (...) form of doxastic conflict if and only if they are acting virtuously. (shrink)

Near-death experiences are a big challenge to the fields of science and philosophy; termed as hallucinatory by neurologists and “stuff of which fantasies are made off” by sceptics, there are some unique near-death experiences which defy these claims. Memories generated during these experiences are of specific interest as they are created without a body and can be recalled post the experience. Call it the mind, soul, psyche or consciousness, if deliberated as a form of quantum generated energy, a strong correlation (...) under a reductionist based perspective can be obtained. Life at a macroscopic level may not be similar to life at a quantum level, and has been proved in quantum physics through its spooky properties like quantum entanglement. Self-sustaining quantum generated energy through entanglement is the answer to all mystical realties and the answer lies in believing in its existence in and around us. It is this energy that brings in the awareness of one’s existence and which performs tasks beyond the imagination of the current self; an energy created at the creation of all that exists; a true supernatural force. This paper reviews a unique void near-death experience and hypothesizes quantum entanglement to be involved in the conception and storage of these energy-based memories in a quantum subatomic cloud which can be restated if returned back to the body or lost to the environment upon death. (shrink)

Whether upheld as heroic or reviled as terrorism, people have been willing to lay down their lives for the sake of their groups throughout history. Why? Previous theories of extreme self-sacrifice have highlighted a range of seemingly disparate factors, such as collective identity, outgroup hostility, and kin psychology. In this paper, I attempt to integrate many of these factors into a single overarching theory based on several decades of collaborative research with a range of special populations, from tribes in Papua (...) New Guinea to Libyan insurgents and from Muslim fundamentalists in Indonesia to Brazilian football hooligans. These studies suggest that extreme self-sacrifice is motivated by identity fusion, a visceral sense of oneness with the group, resulting from intense collective experiences or from perceptions of shared biology. In ancient foraging societies, fusion would have enabled warlike bands to stand united despite strong temptations to scatter and flee. The fusion mechanism has often been exploited in cultural rituals, not only by tribal societies but also in specialized cells embedded in armies, cults, and terrorist organizations. With the rise of social complexity and the spread of states and empires, fusion has also been extended to much larger groups, including doctrinal religions, ethnicities, and ideological movements. Explaining extreme self-sacrifice is not only a scientific priority but also a practical challenge as we seek a collective response to suicide, terrorism, and other extreme expressions of outgroup hostility that continue to bedevil humanity today. (shrink)

I present a new puzzle about choice under uncertainty for agents whose preferences are sensitive to multiple dimensions of outcomes in such a way as to be incomplete. In response, I develop a new theory of choice under uncertainty for incomplete preferences. I connect the puzzle to central questions in epistemology about the nature of rational requirements, and ask whether it shows that preferences are rationally required to be complete.

This paper studies one aspect of the great Ming dynasty philosopher Wang Yangming’s (王陽明 1472-1529) celebrated doctrine of the unity of knowledge and action (zhi xing he yi 知行合一). Wang states that his doctrine does not apply to all knowledge, but only to an elevated form of knowledge, which he sometimes calls “genuine knowledge” (zhen zhi 真知). But what is “genuine knowledge”? I develop and compare four different interpretations of this notion: the perceptual, practical, normative and introspective models. The main (...) aim of the paper is to develop these models in more detail than has been done before. But at the end of the paper I argue that the introspective model is to be preferred over the alternatives. (shrink)

We review the dynamical approach to spacetime theories---in particular, its origins in the development of special relativity, its opposition to the contemporary `geometrical' approach, and the manner in which it plays out in general relativity. In addition, we demonstrate that the approach is compatible with the `angle bracket school'.

The quantum theory of de Broglie and Bohm solves the measurement problem, but the hypothetical corpuscles play no role in the argument. The solution finds a more natural home in the Everett interpretation.

The coordinated attack scenario and the electronic mail game are two paradoxes of common knowledge. In simple mathematical models of these scenarios, the agents represented by the models can coordinate only if they have common knowledge that they will. As a result, the models predict that the agents will not coordinate in situations where it would be rational to coordinate. I argue that we should resolve this conflict between the models and facts about what it would be rational to do (...) by rejecting common knowledge assumptions implicit in the models. I focus on the assumption that the agents have common knowledge that they are rational, and provide models to show that denying this assumption suffices for a resolution of the paradoxes. I describe how my resolution of the paradoxes fits into a general story about the relationship between rationality in situations involving a single agent and rationality in situations involving many agents. (shrink)

Events have beginnings, ends, and often overlap in time. A major question is how perceivers come to parse a stream of multimodal information into meaningful units and how different event boundaries may vary event processing. This work investigates the roles of these three types of event boundaries in constructing event temporal relations. Predictions were made based on how people would err according to the beginning state, end state, and overlap heuristic hypotheses. Participants viewed animated events that include all the logical (...) possibilities of event temporal relations, and then made temporal relation judgments. The results showed that people make use of the overlap between events and take into account the ends and beginnings, but they weight ends more than beginnings. Neural network simulations showed a self‐organized distinction when learning temporal relations between events with overlap versus those without. (shrink)

Beginning with a discussion of the Informal Logic Movement and the renewed interest in critical thinking in education, this book critically assesses the work of Robert Ennis, Richard Paul and John McPeck.

Robert Aumann presents his Agreement Theorem as the key conditional: “if two people have the same priors and their posteriors for an event A are common knowledge, then these posteriors are equal” (Aumann, 1976, p. 1236). This paper focuses on four assumptions which are used in Aumann’s proof but are not explicit in the key conditional: (1) that agents commonly know, of some prior μ, that it is the common prior; (2) that agents commonly know that each of them updates (...) on the prior by conditionalization; (3) that agents commonly know that if an agent knows a proposition, she knows that she knows that proposition (the “K K” principle); (4) that agents commonly know that they each update only on true propositions. It is shown that natural weakenings of any one of these strong assumptions can lead to countermodels to Aumann’s key conditional. Examples are given in which agents who have a common prior and commonly know what probability they each assign to a proposition nevertheless assign that proposition unequal probabilities. To alter Aumann’s famous slogan: people can “agree to disagree”, even if they share a common prior. The epistemological significance of these examples is presented in terms of their role in a defense of the Uniqueness Thesis: If an agent whose total evidence is E is fully rational in taking doxastic attitude D to P, then necessarily, any subject with total evidence E who takes a different attitude to P is less than fully rational. (shrink)

It is argued that Minkowski space-time cannot serve as the deep structure within a ``constructive'' version of the special theory of relativity, contrary to widespread opinion in the philosophical community.

People are typically grateful for medical technologies used in the treatment of illness or injury. This chapter explores how Lucas has led Star Wars audiences astray into accepting false beliefs and fallacies about the value of technology, particularly in a medical context. Via the naturalistic fallacy, Lucas conveys the false belief that most technology is “unnatural” and so is bad, harmful, or associated with the dark side. Lucas is not wrong that technology can be fearful, but its value depends in (...) part on how it's intended to be used. Even the use of some medical technologies that can extend life raise questions about whether they should be used in all cases. Many bioethical conflicts center around whether a seriously ill or injured person would want certain medical interventions used to extend their life, given potential trade‐offs. Lucas's portrayal of technology in Star Wars is biased against its true value in societies. (shrink)

Top-down dynamical models of cognitive processes, such as the one presented by Thelen et al., are important pieces in understanding the development of cognitive abilities in humans and biological organisms. Unlike standard symbolic computational approaches to cognition, such dynamical models offer the hope that they can be connected with more bottom-up, neurologically inspired dynamical models to provide a complete view of cognition at all levels. We raise some questions about the details of their simulation and about potential limitations of top-down (...) dynamical models. (shrink)

This article deals with two types of Christian faith in the light of the challenges posed by the ethics of belief. It is proposed that the difficulties with Clifford’s formulation of that ethic can best be handled if the ethic is interpreted in terms of role-specific intellectual integrity. But the ethic still poses issues for the traditional interpretation of Christian faith when it is conceived as a series of discrete but related propositions, especially historical propositions. For as so conceived, the (...) believer makes claims that fall within the province of an intellectual discipline, history, that requires evidence and rules of procedure for the adjudication of such claims. It is noteworthy how few Christian theologians and philosophers of religion deal with the issue in these terms. Alvin Plantinga is a noteworthy exception and his views are examined and criticized because, among other things, his conclusion is that any believer without having any training in biblical languages or historical studies can know that the New Testament narratives are true. The article then considers a second conception of Christian faith in which this conflict does not arise. One finds it in the works of Schleiermacher, Wittgenstein, and, surprisingly, in the conception of faith found in the early writings of Karl Barth. (shrink)

I observe that the “concept-generator” theory of Percus and Sauerland (2003), Anand (2006), and Charlow and Sharvit (2014) does not predict an intuitive true interpretation of the sentence “Plato did not believe that Hesperus was Phosphorus”. In response, I present a simple theory of attitude reports which employs a fine-grained semantics for names, according to which names which intuitively name the same thing may have distinct compositional semantic values. This simple theory solves the problem with the concept-generator theory, but, as (...) I go on to show, it has problems of its own. I present three examples which the concept-generator theory can accommodate, but the simple fine-grained theory cannot. These examples motivate the full theory of the paper, which combines the basic ideas behind the concept-generator theory with a fine-grained semantics for names. The examples themselves are of interest independently of my theory: two of them constrain the original concept-generator theory more tightly than previously discussed examples had. (shrink)

An opinionated introduction to philosophical issues connected to common knowledge.

Crossing the Stream, Leaving the Cave brings philosophers from two of the world's great philosophical traditions--Platonic and Indian Buddhist--into joint inquiry on topics in metaphysics, epistemology, mind, language, and ethics. An international team of scholars address selected questions of mutual concern to Buddhist and Platonist: How can knowledge of reality transform us? Will such transformation leave us speechless, or disinterested in the world around us? What is cause? What is self-knowledge? And how can dreams shed light on waking cognition? What (...) do the paradoxes thrown up by abstract thought about fundamental notions such as being and unity reveal? Is it possible to attain unity in ourselves, and should we even try? Would doing so make us happy--and is such happiness consistent with both contemplation of reality and action in the world? With close readings of texts by Buddhaghosa, Nagarjuna, Vasubandhu, Dignaga, Bhaviveka, Santideva; by Plato, Plotinus, Porphyry, Olympiodorus, and Damascius (among others), these studies consider not just the different answers Buddhists and Platonists might give to these questions, but also the criticisms they might bring to each other's positions, the sort of arguments they use, and the use they put these arguments to. Bringing Platonic and the Buddhist perspectives jointly to bear creates a cosmopolitan philosophical exchange which yields greater conceptual clarity on the questions and the terms in which they are cast, reveals unnoticed conceptual connections, and opens up new possibilities for addressing central philosophical concerns. (shrink)

There is an ongoing concern about workplace ethics. Many voices say that our educational system ought to do something about it, but they do not agree about how to do this. By the time students reach post‐secondary education, they will have already developed a general moral sense. The concern is whether their moral sense is sufficient for ethical situations in the workplace. If not, post‐secondary education is expected to close the gap. In order to do this, educators need information about (...) what is missing. Educators can set clear, work‐related objectives and use classroom activities to reach those objectives based on an identification of these gaps. (shrink)

We expand on the article “Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force” to consider the ways in which rural...

The American Journal of Bioethics, Volume 11, Issue 9, Page 12-13, September 2011.

Part of the Renaissance genius was to look at familiar things in unfamiliar ways.1 Although a variety of approaches to the study of leadership are becoming familiar, it still helps to consider new ones. Of use in such moments are the works of unfamiliar writers who have spent considerable energy thinking from an alien perspective. One does not have to accept their assertions uncritically in order to profit from reading them, yet it does take courage sometimes to start down a (...) strange path. In the spirit of applying new ideas to familiar themes, this article interprets volume one of Georges Bataille’s The Accursed Share2 in the light of the phenomenon we refer to as leadership. Bataille, who was born in 1897 and died in 1962, certainly qualifies as a writer with an alien perspective. He has the potential to offend. At times, he becomes positively cryptic, as in asserting ‘that the sexual act is in time what the tiger is in space’. Nonetheless, the book itself develops a plausible line of reasoning. Society, it argues, is determined by how it disposes of energy. And since energy that cannot be used will be squandered, it matters how a society chooses to do this. Bataille argues further that moments of true ‘sovereignty’ occur when we squander what would otherwise have been useful. This paper summarizes the argument of The Accursed Share and applies it to the outpourings that followers make to leaders. Rather than regard these uneven relationships as examples of utilitarian reciprocity, perhaps we can tap into the idea that attentiveness to leadership is more in the form of an offering or sacrifice to something that expresses us, as an excuse to display exuberance. This approach promises insight into issues of charisma, followership as self-denial, and mass psychology. It also pertains to the tendency of followers to turn against leaders in ritual sacrifice as meaningful superfluity.3. (shrink)

The focus on translational research in clinical trials has the potential to generate clinically relevant genetic data that could have importance to patients. This raises challenging questions about communicating relevant genetic research results to individual patients. An exploratory pharmacogenetic analysis was conducted in the international ovarian cancer phase III trial, AGO-OVAR 16, which found that patients with clinically important germ-line BRCA1/2 mutations had improved progression-free survival prognosis. Mechanisms to communicate BRCA results were evaluated, because these findings may be beneficial to (...) patients and their families. Communicating individual BRCA results was not anticipated during clinical trial design. Consequently, options were not available for patients to indicate their preference for receiving their individual results when they signed pharmacogenetic informed consent. Differences in local requirements, clinical practice, and opinion regarding the ethical aspects of how to convey genetic results to patients are all potential barriers to returning individual BRCA results to patients. Communicating the aggregate BRCA result from this study provided clinical investigators with a mechanism to disseminate the overall study finding to patients while taking individual circumstances, local guidelines and clinical practice into account. This study illustrates the importance of increasing the clarity and scope of informed consent and the need for patient engagement to ensure clinical trial participants can indicate their preference regarding receipt of potentially important individual pharmacogenetic results. This study was registered in the NCT Clinical Trial Registry under NCT00866697 on March 19, 2009, following approval from participating ethics committees. (shrink)

This paper aims to demonstrate how public disclosure can be used to balance physicians9 conscientious objections with their professional obligations to patients – specifically respect for patient autonomy and informed consent. It is argued here that physicians should be permitted to exercise conscientious objections, but that they have a professional obligation to provide advance notification to patients about those objections. It is further argued here that public disclosure is an appropriate and ethically justifiable limit to the principle of advance notification. (...) The argument for publicly disclosing physicians9 conscientious objections is made in this paper by discussing three practical benefits of public disclosure in medicine, and then addressing how publicly disclosing physicians9 conscientious objections is not an undue invasion of privacy. Three additional concerns with public disclosure of physicians9 conscientious objections are briefly addressed – potential harassment of physicians, workplace discrimination, and mischaracterising physicians9 professional aptitude – concluding that each of these concerns requires further deliberation in the realm of business ethics. (shrink)