The legal and ethical asymmetry between honoring positive claims of conscience versus negative claims of conscience was recently analyzed by several articles in this journal. The first author of this article (ALB) identified unique but defeasible reasons against honoring positive claims of conscience, such as the greater threat they post to institutional values and institutional resources than negative claims of conscience. However, ALB wrote, when these reasons can be overcome, positive claims of conscience should enjoy the same ethical and legal (...) respect as negative claims of conscience. This article argues that the prescription of birth control by non-Roman Catholic physicians in Roman Catholic institutions is an example of a positive claim of conscience that can overcome concerns of institutional values and resources, and therefore ought to receive the same ethical respect and legal protection as negative claims of conscience. In making this argument, this article also responds to several of the thoughtful comments raised by Alberto Giubilini and Dominic Wilkinson. (shrink)

"Blending literary and photo-journalism, history, and storytelling, essays examine eighteen Texas dance halls in terms of their music, culture, and community. Also considers the predominantly Czech and German heritage from which these halls evolved, as we.

Pulvermüller's work in extending Hebb's theory into the realm of language is exciting. However, we feel that what he characterizes as a single cell assembly is actually a set of cooperating cell assemblies that form parts of larger cognitive structures. These larger structures account more easily for a variety of phenomena, including the psycholinguistic.

Page's target article makes a good case for the strength of localist models. This can be characterized as an issue of where new information is integrated with respect to existing knowledge structures. We extend the analysis by discussing the dimension of when this integration takes place, the implications, and how they guide us in the creation of cognitive models.

Although Glenberg 's theory benefits from the incorporation of a suppression concept, a more differentiated view of suppression would be even more effective. We propose such a concept, showing how it accounts for phenomena that Glenberg describes and also for phenomena that he ignores.

Doctors’ strikes are legally permissible in the UK, with the situation differing in other countries. But are they morally permissible? Doug McConnell and Darren Mann have systematically attempted to dismiss the arguments for the moral impermissibility of doctors’ strikes and creatively attempted to provide further moral justification for them. Unfortunately for striking doctors, they fail to achieve this. Meanwhile, junior doctors’ strikes have continued in the UK through 2023 and have now extended into 2024. In this response, which focuses on (...) the UK situation and specifically junior doctors’ strikes in the National Health Service (NHS) in England, I will demonstrate a central problem with their arguments—namely that they underplay the harms caused by prolonged doctors’ strikes by ignoring the harms to patients with cancer. This weakens their conclusion that strikes are morally permissible in terms of the conditions and thresholds they set. I then provide a psychological critique of their justification for strikes in terms of the interests of the public. It follows that invoking the controversial concept of supererogatory action is ungrounded but also absurd when you consider time-critical cancer care. If those representing striking doctors wish to maintain a modicum of moral respectability, they should mitigate for patients with cancer and negotiate reasonably and with urgency. (shrink)

Here is a thoroughly updated edition of a classic in palliative medicine. Two new chapters have been added to the 1991 edition, along with a new preface summarizing where progress has been made and where it has not in the area of pain management. This book addresses the timely issue of doctor-patient relationships arguing that the patient, not the disease, should be the central focus of medicine. Included are a number of compelling patient narratives. Praise for the first edition "Well (...) written. . .should be read by everyone in medical practice or considering a career in medicine."---JAMA. "Memorable passages, important ideas, and critical analysis. This is a book that clinicians and educators should read."---New England Journal of Medicine. (shrink)

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

RésuméLa philosophie autochtone du XVIIe siècle et des siècles précédents est souvent considérée comme irrécupérable en raison du manque d’œuvres existantes. Il y a au moins deux raisons pour lesquelles ce point de vue est erroné. Premièrement, cela néglige le rôle que les traditions orales ont joué dans la préservation de la pensée des peuples autochtones d'Amérique du Nord. Deuxièmement, certains penseurs autochtones ont vu leurs opinions philosophiques enregistrées par des interlocuteurs européens peu de temps après le contact. Avec ces (...) sources, les mêmes techniques que celles utilisées pour récupérer les opinions de philosophes comme le sophiste Prodicus, dont les œuvres sont perdues, peuvent être appliquées aux penseurs autochtones. En reconstruisant une partie de la philosophie de Kondiaronk, je montre comment cela peut être fait. (shrink)

The syllabus presented here is designed for use in the training of researchers and research ethics committee members throughout the European Union and beyond. It is intended to be accessible to scientific and lay readers, including those with no previous experience of ethical theory and analysis. The syllabus will cover key issues in the ethics of research involving human participants, including the ethical issues associated with new technologies.

“What is the structure of thought?” is as central a question as any in cognitive science. A classic answer to this question has appealed to a Language of Thought (LoT). We point to emerging research from disparate branches of the field that supports the LoT hypothesis, but also uncovers diversity in LoTs across cognitive systems, stages of development, and species. Our letter formulates open research questions for cognitive science concerning the varieties of rules and representations that underwrite various LoT-based systems (...) and how these variations can help researchers taxonomize cognitive systems. (shrink)

Clinical ethics consultation is largely outside the scope of regulation and oversight, despite its importance. For decades, the bioethics community has been unable to reach a consensus on whether there should be accountability in this work, as there is for other clinical activities that influence the care of patients. The American Society for Bioethics and Humanities, the primary society of bioethicists and scholars in the medical humanities and the organizational home for individuals who perform CEC in the United States, has (...) initiated a two‐step quality attestation process as a means to assess clinical ethics consultants and help identify individuals who are qualified to perform this role. This article describes the process. (shrink)

" Dr. Cassell discusses the world of the sick, the healing connection and healer's battle, the role of omnipotence in the healer's art, illness and disease, and ...

Neuroethics is an interdisciplinary field that arose in response to novel ethical challenges posed by advances in neuroscience. Historically, neuroethics has provided an opportunity to synergize different disciplines, notably proposing a two-way dialogue between an ‘ethics of neuroscience’ and a ‘neuroscience of ethics’. However, questions surface as to whether a ‘neuroscience of ethics’ is a useful and unified branch of research and whether it can actually inform or lead to theoretical insights and transferable practical knowledge to help resolve ethical questions. (...) In this article, we examine why the neuroscience of ethics is a promising area of research and summarize what we have learned so far regarding its most promising goals and contributions. We then review some of the key methodological challenges which may have hindered the use of results generated thus far by the neuroscience of ethics. Strategies are suggested to address these challenges and improve the quality of research and increase neuroscience's usefulness for applied ethics and society at large. Finally, we reflect on potential outcomes of a neuroscience of ethics and discuss the different strategies that could be used to support knowledge transfer to help different stakeholders integrate knowledge from the neuroscience of ethics. (shrink)

Attempts to explain emotion typically emphasize the interaction of evolutionary and socialization processes. However, in describing this interplay the role of the person is typically underemphasized or unaccounted for. This paper lays out empirical and theoretical rationale for considering the person as a major contributor to emotion generation and development.

The theory and practice of history and its relevance to the modern world, by Britains greatest radical historian.

The language of “participant-driven research,” “crowdsourcing” and “citizen science” is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists. Originally, these labels were invoked by volunteer research efforts propelled by amateurs outside of traditional research institutions and aimed at appealing to those looking for more “democratic,” “patient-centric,” or “lay” alternatives to the professional science establishment. As mainstream translational biomedical research requires increasingly larger participant pools, however, corporate, academic and governmental research programs (...) are embracing this populist rhetoric to encourage wider public participation. We examine the ethical and social implications of this recruitment strategy. We begin by surveying examples of “citizen science” outside of biomedicine, as paradigmatic of the aspirations this democratizing rhetoric was originally meant to embody. Next, we discuss the ways these aspirations become articulated in the biomedical context, with a view to drawing out the multiple and potentially conflicting meanings of “public engagement” when citizens are also the subjects of the science. We then illustrate two uses of public engagement rhetoric to gain public support for national biomedical research efforts: its post-hoc use in the “care.data” project of the National Health Service in England, and its proactive uses in the “Precision Medicine Initiative” of the United States White House. These examples will serve as the basis for a normative analysis, discussing the potential ethical and social ramifications of this rhetoric. We pay particular attention to the implications of government strategies that cultivate the idea that members of the public have a civic duty to participate in government-sponsored research initiatives. We argue that such initiatives should draw from policy frameworks that support normative analysis of the role of citizenry. And, we conclude it is imperative to make visible and clear the full spectrum of meanings of “citizen science,” the contexts in which it is used, and its demands with respect to participation, engagement, and governance. (shrink)

In early 2020, a number of countries developed and published intensive care triage guidelines for the pandemic. Several of those guidelines, especially in the UK, encouraged the explicit assessment...

This interdisciplinary work is a collection of major essays on reasoning: deductive, inductive, abductive, belief revision, defeasible, cross cultural, conversational, and argumentative. They are each oriented toward contemporary empirical studies. The book focuses on foundational issues, including paradoxes, fallacies, and debates about the nature of rationality, the traditional modes of reasoning, as well as counterfactual and causal reasoning. It also includes chapters on the interface between reasoning and other forms of thought. In general, this last set of essays represents growth (...) points in reasoning research, drawing connections to pragmatics, cross-cultural studies, emotion and evolution. (shrink)

BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)

Uncertainty and affect are fundamental and interrelated aspects of the human condition. Uncertainty is often associated with negative affect, but in some circumstances it is associated with positive affect. In this paper, we review different explanations for the varying relationship between uncertainty and affect. We identify “mental simulation” as a key process that links uncertainty to affective states. We suggest that people have a propensity to simulate negative outcomes, which results in a propensity towards negative affective responses to uncertainty. We (...) also propose the existence of several important moderators of this process, including context and individual differences such as uncertainty tolerance, as well as emotion regulation strategies. Finally, we highlight important knowledge gaps and promising areas for future research, both empirical and conceptual, to further elucidate the relationship between uncertainty and affect. (shrink)

Decisions about providing life-sustaining treatments for extremely premature infants born after preterm labor are complex, contested, and fraught. They are medically uncertain—the outcome of embark...

If philosophical moral reflection tends to improve moral behaviour, one might expect that professional ethicists will, on average, behave morally better than non-ethicists. One potential source of insight into the moral behaviour of ethicists is philosophers' opinions about ethicists' behaviour. At the 2007 Pacific Division meeting of the American Philosophical Association, we used chocolate to entice 277 passers-by to complete anonymous questionnaires without their knowing the topic of those questionnaires in advance. Version I of the questionnaire asked respondents to compare, (...) in general, the moral behaviour of ethicists to that of philosophers not specializing in ethics and to non-academics of similar social background. Version II asked respondents similar questions about the moral behaviour of the ethics specialist in their department whose name comes next in alphabetical order after their own. Both versions asked control questions about specialists in metaphysics and epistemology. The majority of respondents expressed the view that ethicists do not, on average, behave better than non-ethicists. Whereas ethicists tended to avoid saying that ethicists behave worse than non-ethicists, non-ethicists expressed that pessimistic view about as often as they expressed the view that ethicists behave better. (shrink)

Extracorporeal membrane oxygenation (ECMO) is currently reserved predominantly for bridging patients to a different destination therapy, but the use of ECMO as a destination therapy itself (ECMO-DT...