The Patient Self Determination Act of 1991 brought much needed attention to the importance of advance care planning and surrogate decision-making. The purpose of this law is to ensure that a patient’s preferences for medical care are recognized and promoted, even if the patient loses decision-making capacity. In general, patients are presumed to have DMC. A patient’s DMC may come under question when distortions in thinking and understanding due to illness, delirium, depression or other psychiatric symptoms are identified or suspected. (...) Physicians and other healthcare professionals working in hospital settings where medical illness is frequently comorbid with depression, adjustment disorders, demoralization and suicidal ideation, can expect to encounter ethical tension when medically sick patients who are also depressed or suicidal request do not resuscitate orders. (shrink)

Much of today's writing on medical ethics is strong on philosophical theory or on legal speculation, but weak on practice. In this book, practitioners in a wide range of specialties describe the process of making ethical decisions in their everyday work. A moral philosopher analyzes their conclusions, and the theological implications are developed by a Christian theologian and Rabbinic scholar. Thorough and eclectic, this book should be read by all who seek the good of the profession of medicine.

Contents: Ethical principals for environmental protection / Robert Goodin -- Political representation for future generations / Gregory S. Kavka and Virginia L. Warren -- On the survival of humanity / Jan Narveson -- On deep versus shallow theories of environmental pollution / C.A. Hooker -- Preservation of wilderness and the good life / Janna L. Thompson -- The rights of the nonhuman world / Mary Anne Warren -- Are values in nature subjective or objective? / Holmes Rolston III - (...) Duties concerning islands / Mary Midgley -- Gaia and the forms of life / Stephen R.L. Clark -- Western traditions and environmental ethics / Robin Attfield -- Traditional American Indian and traditional western European attitudes toward nature / J. Baird Callicott -- Roles and limits of paradigms in environmental thought and action / Richard Routley. [Book Synopsis]. (shrink)

Cognitive neuroscience is an interdisciplinary enterprise aimed at explaining cognition and behavior. It appears to be succeeding. What accounts for this apparent explanatory success? According to one prominent philosophical thesis, cognitive neuroscience explains by discovering and describing mechanisms. This "mechanist thesis" is open to at least two interpretations: a strong metaphysical thesis that Carl Craver and David Kaplan defend, and a weaker methodological thesis that William Bechtel defends. I argue that the metaphysical thesis is false and that the methodological thesis (...) is too weak to account for the explanatory promise of cognitive neuroscience. My argument draws support from a representative example of research in this field, namely, the neuroscience of decision-making. The example shows that cognitive neuroscience explains in a variety of ways and that the discovery of mechanisms functions primarily as a way of marshaling evidence in support of the models of cognition that are its principle unit of explanatory significance. -/- The inadequacy of the mechanist program is symptomatic of an implausible but prominent view of scientific understanding. On this view, scientific understanding consists in an accurate and complete description of certain "objective" explanatory relations, that is, relations that hold independently of facts about human psychology. I trace this view to Carl Hempel's logical empiricist reconceptualization of scientific understanding, which then gets extended in Wesley Salmon's causal-mechanistic approach. I argue that the twin objectivist ideals of accuracy and completeness are neither ends we actually value nor ends we ought to value where scientific understanding is concerned. -/- The case against objectivism motivates psychologism about understanding, the view that understanding depends on human psychology. I propose and defend a normative psychologistic framework for investigating the nature of understanding in the mind sciences along three empirically-informed dimensions: 1) What are the ends of understanding? 2) What is the nature of the cognitive strategy that we deploy to achieve those ends; and 3) Under what conditions is our deployment of this strategy effective toward achieving those ends? To articulate and defend this view, I build on the work of Elliot Sober to develop a taxonomy of psychologisms about understanding. Epistemological psychologism, a species of naturalism, is the view that justifying claims about understanding requires appealing to what scientists actually do when they seek understanding. Metaphysical psychologism is the view that the truth-makers for claims about understanding include facts about human psychology. I defend both views against objections. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Living Organ Donors’ Stories: (Unmet) Expectations about Informed Consent, Outcomes, and CareElisa J. Gordon, Symposium EditorKeywordsEthics, informed consent, kidney, liver, living donor, narrative, transplantationLiving donor organ transplantation has become standard treatment for patients with end-stage kidney or end-stage liver disease. Live donors comprised approximately 5,769 (34%) and 247 (4%) of all kidney and liver transplants in 2011, respectively (OPTN/UNOS). The reasons why people donate, the perception that donating (...) does not entail a decision per se, and the attendant fears and anxieties living donors feel about donating, have all been previously well investigated (Lennerling, Forsberg, Meyer, & Nyberg, 2004; Papachristou, Walter, Frommer, & Klapp, 2010). But much less is known about how donors experienced the overall donation process including the donor evaluation, preparation, appreciation of risks, decision-making, informed consent, post-operative, recovery processes, and the impact of donating on all aspects of their life, from their point of view. Thus, a narrative approach is essential for gaining insights into these less well known phenomena.There is good reason to remain concerned about the safety and ethical basis of living donation considering that living donors undergo serious health risks for no direct medical benefit to themselves (Ethics Committee of the Transplantation Society, 2004; Laird, 2012; Neergaard, 2011; Ratner & Sandoval, 2010; Shelton, 2011). The situation raises serious ethical questions specifically about nonmaleficence and informed consent, and more broadly about using people as a means to an end. The absence of long-term information may not undermine a willing donor’s commitment to save a loved one’s life, but is certainly cause for concern among transplant clinicians who want to be sure to disclose information that may be material for donors in order to provide adequate informed consent. In other words, the disjuncture between what transplant clinicians find important to disclose to donors and what prospective donors need to know—which follows along the lines of what Elliot Mishler referred to as the ‘voice of medicine’ versus the ‘voice of the lifeworld’(1984)—seems to complicate donors’ preparation for donation. Donors’ stories are important for addressing these concerns by identifying risks that typically do not get reported in the scientific literature—perhaps owing to a different [End Page 1] conceptualization of what should be construed as noteworthy risks—as well as by demonstrating how personal situations can enhance or detract from the experience overall.This issue of Narrative Inquiry in Bioethics (NIB) affords a unique entrée into both the often heard and unheard stories of living organ donors. A set of topical areas were presented for the authors’ consideration that relate to the donation process in general and the informed consent process more specifically: whether donors were prepared to donate; comprehended what they were told; could have understood the process better, as well as, the impact of donation on health, employment, finances, and personal relationships (Table 1). When soliciting donors’ stories, every effort was made to include a full range of experiences—both good and bad—from a variety of donors: kidney donation, liver donation, adult-to-adult and adult-to-child donation, related, unrelated, directed and anonymous (also known as ‘altruistic’ or ‘good Samaritan’ donors), paired chain exchange, and list exchange (Table 2)—in order to present a balanced perspective on live donation. Additionally, this issue includes a full breadth of stories about the donor experience, ranging from positive to mixed to negative (Table 3). While donors were given tremendous leeway in what stories they told, they were asked to focus their narratives on the lesser known dimensions of donation—the experience of it. While additional stories from liver donors would have helped to underscore common concerns among liver donors, we only received a few. Some of the donors are themselves health care professionals, active in the United Network for Organ Sharing (UNOS) or their local OPO, or have leveraged their experiences to help others by becoming a donor buddy or donor advocate. Given that we received more stories than Click for larger view View full resolutionTable 1.Topical areas to address[End Page 2] Click for larger view View full resolutionTable 2.Forms of Living Donation Click for larger view View... (shrink)

Volume 19, Issue 9, September 2019, Page 54-56.

This is a new edition of the first volume of G.P.Baker and P.M.S. Hacker’s definitive reference work on Wittgenstein’s _Philosophical Investigations_. New edition of the first volume of the monumental four-volume _Analytical Commentary on the Philosophical Investigations._ Takes into account much material that was unavailable when the first edition was written. Following Baker’s death in 2002, P.M.S. Hacker has thoroughly revised the first volume, rewriting many essays and sections of exegesis completely. Part One - the Essays - now includes two (...) completely new essays: 'Meaning and Use' and 'The Recantation of a Metaphysician'. Part Two - Exegesis §§1-184 - has been thoroughly revised in the light of the electronic publication of Wittgenstein’s _Nachlass_, and includes many new interpretations of the remarks, a history of the composition of the book, and an overview of its structure. The revisions will ensure that this remains the definitive reference work on Wittgenstein’s masterpiece for the foreseeable future. (shrink)

In ‘Wittgenstein on Language and Rules’, Professor N. Malcolm took us to task for misinterpreting Wittgenstein's arguments on the relationship between the concept of following a rule and the concept of community agreement on what counts as following a given rule. Not that we denied that there are any grammatical connections between these concepts. On the contrary, we emphasized that a rule and an act in accord with it make contact in language. Moreover we argued that agreement in judgments and (...) in definitions is indeed necessary for a shared language. But we denied that the concept of a language is so tightly interwoven with the concept of a community of speakers as to preclude its applicabilty to someone whose use of signs is not shared by others. Malcolm holds that ‘This is an unwitting reduction of Wittgenstein's originality. That human agreement is necessary for “shared” language is not so striking a thought as that it is essential for language simpliciter .’ Though less striking, we believe that it has the merit of being a true thought. We shall once more try to show both that it is correct, and that it is a correct account of Wittgenstein's arguments. (shrink)

ABSTRACTMemory bias is a risk factor for depression. In two independent studies, the efficacy of one CBM-Memory session on negative memory bias and depressive symptoms was tested in vulnerable samples. We compared positive to neutral CBM-Memory trainings in highly-ruminating individuals and individuals with elevated depressive symptoms. In both studies, participants studied positive, neutral, and negative Swahili words paired with their translations. In five study–test blocks, they were then prompted to retrieve either only the positive or neutral translations. Immediately following the (...) training and one week later, we tested cued recall of all translations and autobiographical memory bias; and also measured mood, depressive symptoms, and rumination. Retrieval practice resulted in training-congruent recall both immediately after and one week after the training. Overall, there was no differential decrease in symptoms or difference in autobiographical memory bias between the tra... (shrink)

This is a much revised and extended new edition of _Part I_ of the first volume of the monumental four-volume _Analytical Commentary on the Philosophical Investigations_. Takes into account much new material that was unavailable when the first edition was written Following Baker’s death in 2002, P.M.S. Hacker has rewritten many essays completely _Part I: Essays_ now includes two completely new essays: 'Meaning and Use' and 'The Recantation of a Metaphysician'; the essays: ‘The Augustinian Conception of Language’, ‘The Language-Game Method’, (...) ‘Contextual Dicta and Contextual Principles’, ‘Philosophy’, ‘Surveyability and Surveyable Representations’, and ‘Truth and the General Propositional Form’ are redrafted and expanded, incorporating new source materials and new arguments, as well as taking into account debates of the last quarter of a century The accompanying _Part II: Exegesis §§1-184_ - has been thoroughly revised in the light of the electronic publication of Wittgenstein’s _Nachlass_, and includes many new interpretations of the remarks, a history of the composition of the _Philosophical Investigations_ and an overview of its structure. The revisions will ensure that this remains the definitive reference work on Wittgenstein’s masterpiece for the foreseeable future. (shrink)

This is the second volume of analytical commentary on Wittgenstein's masterpiece, the Philosophical Investigations. Like the first, it consists of philosophical essays and critical exegesis. The six essays deal comprehensively with various themes in Wittgenstein''s philosophy: the relationship between his mathematics and his philosophy of mind; his conception of grammar and rules of grammar; the relation between a rule and what accords with a rule; the characterization of rule-following as mastery of a technique manifest in practice; his notion of a (...) form of life, and of agreement in definitions and judgements; a comprehensive investigation into his account of logical and mathematical necessity and other topics. (shrink)

There is a debate in Bayesian confirmation theory between subjective and non-subjective accounts of evidence. Colin Howson has provided a counterexample to our non-subjective account of evidence: the counterexample refers to a case in which there is strong evidence for a hypothesis, but the hypothesis is highly implausible. In this article, we contend that, by supposing that strong evidence for a hypothesis makes the hypothesis more believable, Howson conflates the distinction between confirmation and evidence. We demonstrate that Howson’s counterexample fails (...) for a different pair of hypotheses. (shrink)

Distributional semantic models (DSMs) are a primary method for distilling semantic information from corpora. However, a key question remains: What types of semantic relations among words do DSMs detect? Prior work typically has addressed this question using limited human data that are restricted to semantic similarity and/or general semantic relatedness. We tested eight DSMs that are popular in current cognitive and psycholinguistic research (positive pointwise mutual information; global vectors; and three variations each of Skip-gram and continuous bag of words (CBOW) (...) using word, context, and mean embeddings) on a theoretically motivated, rich set of semantic relations involving words from multiple syntactic classes and spanning the abstract–concrete continuum (19 sets of ratings). We found that, overall, the DSMs are best at capturing overall semantic similarity and also can capture verb–noun thematic role relations and noun–noun event-based relations that play important roles in sentence comprehension. Interestingly, Skip-gram and CBOW performed the best in terms of capturing similarity, whereas GloVe dominated the thematic role and event-based relations. We discuss the theoretical and practical implications of our results, make recommendations for users of these models, and demonstrate significant differences in model performance on event-based relations. (shrink)

This important handbook provides a comprehensive, authoritative review of achievement motivation and establishes the concept of competence as an organizing ...

Martin Heidegger devotes extensive discussion to medieval philosophers, particularly to their treatment of Truth and Being. On both these topics, Heidegger accuses them of forgetting the question of Being and of being responsible for subjugating truth to the modern crusade for certainty: ‘truth is denied its own mode of being’ and is subordinated ‘to an intellect that judges correctly’. Though there are some studies that discuss Heidegger’s debt to and criticism of medieval thought, particularly that of Thomas Aquinas, there is (...) no constructive reply to his assertions. As a result, Heidegger’s critique had an unprecedented effect on the credibility of medieval philosophy, whereby great portions of the philosophical community dismiss it altogether as an illegitimate Onto‐Theology. It is the aim of this study to offer a constructive reply that will fundamentally grapple with these allegations. By constructive reply we mean not only a reply that avoids the problems Heidegger raises regarding existence, essence and truth, but more importantly, one that uses Heidegger’s criticism in order to present a more insightful account of these notions. The present study is composed of two parts where the second serves as a sort of addendum. The first part, the core of this study, is an attempt to develop an understanding of the distinction between essence and existence that, on the one hand, accords with Heidegger’s criticism while on the other hand advances our understanding of how we think and understand reality. After presenting Heidegger’s depiction of Aquinas’s distinction between essence and existence (esse) as a real distinction, the study will present several views propounded by scholars of Aquinas regarding the status of this distinction. It will be argued that it is not clear whether the distinction is real, formal or conceptual, and that different types of distinction are applied in different places, particularly in regard to the phantasm that Aquinas considers essential to the human act of thinking. The second part diverges from the first part and focuses on Heidegger’s criticism of Aquinas’s conception of truth as adequation, i.e., what it is that grounds the possibility of truth as adequation. This divergence is necessary in order to present a full metaphysical response to Heidegger’s criticism. Since the aim of the present study is to argue that Aquinas’s philosophical system can contend with Heidegger’s criticism, a partial reply would greatly diminish its effectiveness. (shrink)

This is a new edition of the first volume of G.P.Baker and P.M.S. Hacker’s definitive reference work on Wittgenstein’s _Philosophical Investigations_. Takes into account much material that was unavailable when the first edition was written. Following Baker’s death in 2002, P.M.S. Hacker has thoroughly revised the first volume, rewriting many essays and sections of exegesis completely. Part One – the Essays – now includes two completely new essays: 'Meaning and Use' and 'The Recantation of a Metaphysician'. Part Two – Exegesis (...) §§1–184 – has been thoroughly revised in the light of the electronic publication of Wittgenstein’s _Nachlass_, and includes many new interpretations of the remarks, a history of the composition of the book, and an overview of its structure. The revisions will ensure that this remains the definitive reference work on Wittgenstein’s masterpiece for the foreseeable future. (shrink)

The Second Edition of _Wittgenstein: Rules, Grammar and Necessity_ now includes extensively revised and supplemented coverage of the Wittgenstein's complex and controversial remarks on following rules. Includes thoroughly rewritten essays and the addition of one new essay on communitarian and individualist conceptions of rule-following Includes a greatly expanded essay on Wittgenstein’s conception of logical, mathematical and metaphysical necessity Features updates to the textual exegesis as the result of taking advantage of the search engine for the Bergen edition of the _Nachlass_ (...) Reflects the results of scholarly debates on rule-following that have raged over the past 20 years. (shrink)

Children are not simply molded by the environment; through constant inference and interpretation, they actively shape their own social world. This book is about that process. Elliot Turiel's work focuses on the development of moral judgment in children and adolescents and, more generally, on their evolving understanding of the conventions of social systems. His research suggests that social judgements are ordered, systematic, subtly discriminative, and related to behavior. His theory of the ways in which children generate social knowledge through (...) their social experiences will be of interest to a wide range of researchers and students in child development and education. (shrink)

The notion of a severe test has played an important methodological role in the history of science. But it has not until recently been analyzed in any detail. We develop a generally Bayesian analysis of the notion, compare it with Deborah Mayo’s error-statistical approach by way of sample diagnostic tests in the medical sciences, and consider various objections to both. At the core of our analysis is a distinction between evidence and confirmation or belief. These notions must be kept separate (...) if mistakes are to be avoided; combined in the right way, they provide an adequate understanding of severity. Those who think that the weight of the evidence always enables you to choose between hypotheses “ignore one of the factors (the prior probability) altogether, and treat the other (the likelihood) as though it ...meant something other than it actually does. This is the same mistake as is made by someone who has scruples about measuring the arms of a balance (having only a tape measure at his disposal ...), but is willing to assert that the heavier load will always tilt the balance (thereby implicitly assuming, although without admitting it, that the arms are of equal length!). (Bruno de Finetti, Theory of Probability)2. (shrink)

Summary Benjamin Moore (1867?1922), physiologist and biochemist, was an eminent member of the British scientific and medical community in the early twentieth century. As a founder and president of the State Medical Services Association (SMSA) from its establishment in 1912 until his untimely death in 1922, Moore was a prominent medical services activist and planner in a period of intense debate on health services reform. As a medical scientist, Moore was also a participant in the campaign by laboratory scientists to (...) obtain a larger role in clinical education, research, and medicine in this period. This article examines the medical services activism and ideas of Benjamin Moore. In particular, it seeks to demonstrate how his health services proposals and those he influenced, including SMSA and Labour Party plans, sought to advance the interests of laboratory scientists. (shrink)

This is a much revised and extended new edition of _Part II_ of the first volume of the monumental four-volume _Analytical Commentary on the Philosophical Investigations_. Takes into account much new material that was unavailable when the first edition was written Following Baker’s death in 2002, P.M.S. Hacker has rewritten many sections of exegesis completely _Part II: Exegesis §§1-184_ has been thoroughly revised in the light of the electronic publication of Wittgenstein’s _Nachlass_, and includes many new interpretations of the remarks, (...) a history of the composition of the _Philosophical Investigations_ and an overview of its structure The accompanying _Part I: Essays_ now includes two completely new essays: 'Meaning and Use' and 'The Recantation of a Metaphysician'; the essays: ‘The Augustinian Conception of Language’, ‘The Language-Game Method’, ‘Contextual Dicta and Contextual Principles’, ‘Philosophy’, ‘Surveyability and Surveyable Representations’, and ‘Truth and the General Propositional Form’ are redrafted and expanded, incorporating new source materials and new arguments, as well as taking into account debates of the last quarter of a century The revisions will ensure that this remains the definitive reference work on Wittgenstein’s masterpiece for the foreseeable future. (shrink)

There are three distinct questions associated with Simpson's paradox, (i) Why or in what sense is Simpson's paradox a paradox? (ii) What is the proper analysis of the paradox? (iii) How one should proceed when confronted with a typical case of the paradox? We propose a "formar" answer to the first two questions which, among other things, includes deductive proofs for important theorems regarding Simpson's paradox. Our account contrasts sharply with Pearl's causal (and questionable) account of the first two questions. (...) We argue that the "how to proceed question?" does not have a unique response, and that it depends on the context of the problem. We evaluate an objection to our account by comparing ours with Blyth's account of the paradox. Our research on the paradox suggests that the "how to proceed question" needs to be divorced from what makes Simpson's paradox "paradoxical.". (shrink)

There are three distinct questions associated with Simpson’s paradox. Why or in what sense is Simpson’s paradox a paradox? What is the proper analysis of the paradox? How one should proceed when confronted with a typical case of the paradox? We propose a “formal” answer to the first two questions which, among other things, includes deductive proofs for important theorems regarding Simpson’s paradox. Our account contrasts sharply with Pearl’s causal account of the first two questions. We argue that the “how (...) to proceed question?” does not have a unique response, and that it depends on the context of the problem. We evaluate an objection to our account by comparing ours with Blyth’s account of the paradox. Our research on the paradox suggests that the “how to proceed question” needs to be divorced from what makes Simpson’s paradox “paradoxical.”. (shrink)