Abstract Context: Established in 1997, Summa Health System’s Medical Ethics Committee (EC) serves as an educational, supportive, and consultative resource to patients/families and providers, and serves to analyze, clarify, and ameliorate dilemmas in clinical care. In 2009 the EC conducted its 100th consult. In 2002 a Palliative Care Consult Service (PCCS) was established to provide supportive services for patients/families facing advanced illness; enhance clinical decision-making during crisis; and improve pain/symptom management. How these services affect one another has thus far been (...) unclear. Objectives: This study describes EC consults: types, reasons, recommendations and utilization, and investigates the impact the PCCS may have on EC consult requests or recommendations. Methods: Retrospective reviews of 100 EC records explored trends and changes in types of consults, reasons for consults, and EC recommendations and utilization. Results: There were 50 EC consults each in the 6 years pre- and post-PCCS. Differences found include: (1) a decrease in number of reasons for consult requests (133–62); (2) changes in top two reasons for EC consult requests from ‘Family opposed to withdrawing life-sustaining treatment (LST)’ and ‘Patient capacity in question’ to ‘Futility’ and ‘Physician opposed to providing LST’; (3) changes in top two recommendations given by the EC from ‘Emotional Support for Patient/Family’ and ‘Initiate DNR Order’ to ‘Comfort Care’ and ‘Withdraw Treatment.’ Overall, 88% of recommendations were followed. Conclusion: PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined. Content Type Journal Article Pages 1-16 DOI 10.1007/s10730-011-9170-9 Authors Jessica Richmond Moeller, Department of Psychiatry and Behavioral Sciences, Akron General Medical Center, 400 Wabash Ave, Akron, OH 44307, USA Teresa H. Albanese, Health Services Research and Education Institute, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Kimberly Garchar, Kent State University, 6000 Frank Ave., N.W, North Canton, OH 44720, USA Julie M. Aultman, Department of Family and Community Medicine, Northeast Ohio Medical University, P.O. Box 95, Rootstown, OH 44272, USA Steven Radwany, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Dean Frate, Internal Medicine, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737. (shrink)

How should physical entities be characterized? Physicalists, who have most to do with the notion, usually characterize the physical by reference to two components: 1. The physical entities are the entities treated by fundamental physics with the proviso that 2. Physical entities are not fundamentally mental (that is, do not individually possess or bestow mentality) Here I explore the extent to which the appeals to fundamental physics and to the NFM (“no fundamental mentality”) constraint are appropriate for characterizing the physical, (...) especially for purposes of formulating physicalism. Ultimately, I motivate and defend a version of an account incorporating both components: The physics-based NFM account: An entity existing at a world w is physical iff (i) it is treated, approximately accurately, by current or future (in the limit of inquiry, ideal) versions of fundamental physics at w, and (ii) it is not fundamentally mental (that is, does not individually either possess or bestow mentality). (shrink)

Self-control is integral to successful human agency. Without it we cannot extend our agency across time and secure central social, moral, and personal goods. But self-control is not a unitary capacity. In the first part of this paper we provide a taxonomy of self-control and trace its connections to agency and the self. In part two, we turn our attention to the external conditions that support successful agency and the exercise of self-control. We argue that what we call moral security (...) is a critical foundation for agency. Parts three and four explore what happens to agency when moral security is lacking, as in the case of those subject to racism, and those living in poverty. The disadvantages suffered by those who are poor, in a racial minority or other oppressed group, or suffering mental illness or addiction, are often attributed to a lack of individual self-control or personal responsibility. In particular, members of these groups are often seen as irresponsibly focused on short-term pleasures over long-term good, a view underwritten by particular psychological theories of self-control. We explore how narratives about racism and poverty undermine moral security, and limit and distort the possibility of synchronic and diachronic self-control. Where moral security is undermined, the connection between self-control and diachronic goods often fails to obtain and agency contracts accordingly. We close with some preliminary reflections on the implications for responsibility. (shrink)

In the Critique of Judgment, Kant claims that genius is a talent for art, but not for science. Despite his restriction of genius to the domain of fine art, several recent interpreters have suggested that genius has a role to play in Kant’s account of cognition in general and scientific practice in particular. In this paper, I explore Kant’s reasons for excluding genius from science as well as the reasons that one might nevertheless be tempted to think that his account (...) allows room for the scientific genius. I then argue that Kant’s concerns are not only epistemic, but also moral, and together, they give us good reason for resisting the veneration of genius. (shrink)

Shows how John Dewey’s visit to China from 1919 to 1921 influenced his social and political thought.

Prison as a Torturous Institution Philosophers working on torture have largely failed to address the widespread use of torture in the U.S. prison system. Drawing on a victim-focused definition of torture, I argue that the U.S. prison system is a torturous institution in which direct torture occurs (the use of solitary confinement) and in which torture is allowed to occur through the toleration of sexual assault of inmates and the conditions of mass incarceration. The use and toleration of torture expresses (...) and reinforces the moral exclusion of those subjected to it, particularly African Americans. Importantly, this moral exclusion and the experience of torture may be created and reinforced through institutional practices independently of the intentions of individuals acting within those institutions. By prioritizing torture victims’ experiences and severing the link between torture and intention, my account forces a recognition that, far from being inconsistent with U.S. values, torture is deeply embedded within U.S. institutions. (shrink)

As the first poem of the last book of Ovid'sAmores, 3.1 parallels the programmaticrecusatioof the first two books, which present the traditional opposition of elegy to epic. InAmores3.1, the personified Elegy and Tragedy compete for Ovid's poetic attention, and scholars have accordingly scrutinized the generic tension between elegy and tragedy in this poem. My study, by contrast, focusses on the import of the metapoeticlocusin which Ovid sets his contest between the two genres, by considering the linguistic and allusive play in (...) the opening lines. Ovid exploits the metaphor of literary tradition as an ancient and sacred forest to transform an author's choice of poetic genre into a walk in the woods. Moreover, allusions to Virgil'sAeneid6.179 and Ennius'Annales175 (Sk.) in the first line guide Ovid's audience to expect the more traditional opposition of elegy and epic. The less conventional contest between the genres of elegy and tragedy soon overturns this expectation; nevertheless, elegy's customary opposite, epic, maintains a presence in the form of a woodland context for Ovid's innovative generic opposition. (shrink)

Arguably no concept is more fundamental to science than that of causality, for investigations into cases of existence, persistence, and change in the natural world are largely investigations into the causes of these phenomena. Yet the metaphysics and epistemology of causality remain unclear. For example, the ontological categories of the causal relata have been taken to be objects (Hume 1739), events (Davidson 1967), properties (Armstrong 1978), processes (Salmon 1984), variables (Hitchcock 1993), and facts (Mellor 1995). (For convenience, causes and effects (...) will usually be understood as events in what follows.) Complicating matters, causal relations may be singular (Socrates’s drinking hemlock caused Socrates’s death) or general (Drinking hemlock causes death); hence the relata might be tokens (e.g., instances of properties) or types (e.g., types of events) of the category in question. Other questions up for grabs are: Are singular causes metaphysically and/or epistemologically prior to general causes or vice versa (or neither)? What grounds the intuitive asymmetry of the causal relation? Are macro-causal relations reducible to micro-causal relations? And perhaps most importantly: Are causal facts (e.g., the holding of causal relations) reducible to non-causal facts (e.g., the holding of certain spatiotemporal relations)? (shrink)

Liberal democracies who perpetrate torture represent an apparent paradox: a flagrant violation of human rights by states supposedly dedicated to protecting human rights. In liberal democracies, the political, social, and legal narratives used to justify torture portray torture as an individual act motivated by important moral values. This individualized torture narrative then shapes the moral framework through which the public, policy-makers, and individual torturers view torture, and masks the institutional nature of torture perpetration. It is this interaction between an individualized (...) torture narrative and the moral framework of torture that distinguishes democratic perpetrators (Critchell et al. 2017, 9-10) from nondemocratic perpetrators of torture. Yet, the implementation of a torture program in a democratic state is remarkably similar to the implementation of a torture program in a nondemocratic state. In both cases, torture is an institutionalized practice given moral and political meaning through broad social and political narratives. This chapter uses the post-9/11 US torture program as a case study of a democratic perpetrator in order to explore the interaction between democratic narratives of torture, state implementation of torture, and the moral psychology of individual torturers. This permits a way of thinking about torture perpetration that goes beyond a myopic focus on torture as individual act to understand the interaction and mutual reinforcement of different forms of torture perpetration. This analysis also offers a starting point from which to consider how to resist and oppose torture narratives that sustain democratic tortue, a question I explore in the conclusion of this chapter. (shrink)

Imagination: Cross-Cultural Philosophical Analyses is a rare intercultural inquiry into the conceptions and functions of the imagination in contemporary philosophy. Divided into East Asian, comparative, and post-comparative approaches, it brings together a leading team of philosophers to explore the concepts of the illusory and illusions, the development of fantastic narratives and metaphors, and the use of images and allegories across a broad range of traditions. Chapters discuss how imagination has been interpreted by thinkers such as Zhuangzi, Plato, Confucius, Heidegger, and (...) Nietzsche. By drawing on sources including Buddhist aesthetics, Daoism, and analytic philosophy of mind, this cross-cultural collection shows how the imagination can be an indispensable tool for the comparative philosopher, opening up new possibilities for intercultural dialogue and critical engagement. (shrink)

The debate about the ethical implications of Artificial Intelligence dates from the 1960s :741–742, 1960; Wiener in Cybernetics: or control and communication in the animal and the machine, MIT Press, New York, 1961). However, in recent years symbolic AI has been complemented and sometimes replaced by Neural Networks and Machine Learning techniques. This has vastly increased its potential utility and impact on society, with the consequence that the ethical debate has gone mainstream. Such a debate has primarily focused on principles—the (...) ‘what’ of AI ethics —rather than on practices, the ‘how.’ Awareness of the potential issues is increasing at a fast rate, but the AI community’s ability to take action to mitigate the associated risks is still at its infancy. Our intention in presenting this research is to contribute to closing the gap between principles and practices by constructing a typology that may help practically-minded developers apply ethics at each stage of the Machine Learning development pipeline, and to signal to researchers where further work is needed. The focus is exclusively on Machine Learning, but it is hoped that the results of this research may be easily applicable to other branches of AI. The article outlines the research method for creating this typology, the initial findings, and provides a summary of future research needs. (shrink)

Increased technological and pharmacological interventions in patient care when patient outcomes are uncertain have been linked to the escalation in moral and ethical dilemmas experienced by health care providers in acute care settings. Health care research has shown that facilities that are able to attract and retain nursing staff in a competitive environment and provide high quality care have the capacity for nurses to process and resolve moral and ethical dilemmas. This article reports on the findings of a systematic review (...) of the empirical literature (1980 — February 2007) on the effects of unresolved moral distress and poor ethical climate on nurse turnover. Articles were sought to answer the review question: Does unresolved moral distress and a poor organizational ethical climate increase nurse turnover? Nine articles met the criteria of the review process. Although the prevailing sentiment was that poor ethical climate and moral distress caused staff turnover, definitive answers to the review question remain elusive because there are limited data that confidently support this statement. (shrink)

Fallibilists claim that one can know a proposition on the basis of evidence that supports it even if the evidence doesn't guarantee its truth. Jessica Brown offers a compelling defence of this view against infallibilists, who claim that it is contradictory to claim to know and yet to admit the possibility of error.

Technologies to rapidly alert people when they have been in contact with someone carrying the coronavirus SARS-CoV-2 are part of a strategy to bring the pandemic under control. Currently, at least 47 contact-tracing apps are available globally. They are already in use in Australia, South Korea and Singapore, for instance. And many other governments are testing or considering them. Here we set out 16 questions to assess whether — and to what extent — a contact-tracing app is ethically justifiable.

Pt. I. The apparent good. Evaluative cognition -- Perceiving the good -- Phantasia and the apparent good -- pt. II. The apparent good and non-rational motivation. Passions and the apparent good -- Akrasia and the apparent good -- pt. III. The apparent good and rational motivation. Phantasia and deliberation -- Happiness, virtue, and the apparent good -- Practical induction -- Conclusion : Aristotle's practical empiricism.

Debates about terrorism and technology often focus on the potential uses of technology by non-state terrorist actors and by states as forms of counterterrorism. Yet, little has been written about how technology shapes how we think about terrorism. In this chapter I argue that technology, and the language we use to talk about technology, constrains and shapes our understanding of the nature, scope, and impact of terrorism, particularly in relation to state terrorism. After exploring the ways in which technology shapes (...) moral thinking, I use two case studies to demonstrate how technology simultaneously hides and enables terroristic forms of state violence: police control technologies and Unmanned Aerial Vehicles (UAVs), or drones. In both these cases, I argue that features of these technologies, combined with a narrative of precision and efficiency, serves to mask the terroristic nature of the violence that these practices inflict and reinforces the moral exclusion of those against whom these technologies are deployed. In conclusion, I propose that identifying acts of terrorism requires a focus on the impact of technologies of violence (whether they are “high tech” or not) on those most affected, regardless of whether users of these technologies conceive of their actions as terroristic. (shrink)

As the range of potential uses for Artificial Intelligence, in particular machine learning, has increased, so has awareness of the associated ethical issues. This increased awareness has led to the realisation that existing legislation and regulation provides insufficient protection to individuals, groups, society, and the environment from AI harms. In response to this realisation, there has been a proliferation of principle-based ethics codes, guidelines and frameworks. However, it has become increasingly clear that a significant gap exists between the theory of (...) AI ethics principles and the practical design of AI systems. In previous work, we analysed whether it is possible to close this gap between the ‘what’ and the ‘how’ of AI ethics through the use of tools and methods designed to help AI developers, engineers, and designers translate principles into practice. We concluded that this method of closure is currently ineffective as almost all existing translational tools and methods are either too flexible or too strict. This raised the question: if, even with technical guidance, AI ethics is challenging to embed in the process of algorithmic design, is the entire pro-ethical design endeavour rendered futile? And, if no, then how can AI ethics be made useful for AI practitioners? This is the question we seek to address here by exploring why principles and technical translational tools are still needed even if they are limited, and how these limitations can be potentially overcome by providing theoretical grounding of a concept that has been termed ‘Ethics as a Service.’. (shrink)

The term "fake news" ascended rapidly to prominence in 2016 and has become a fixture in academic and public discussions, as well as in political mud-slinging. In the flurry of discussion, the term has been applied so broadly as to threaten to render it meaningless. In an effort to rescue our ability to discuss—and combat—the underlying phenomenon that triggered the present use of the term, some philosophers have tried to characterize it more precisely. A common theme in this nascent philosophical (...) discussion is that contemporary fake news is not a new kind of phenomenon, but just the latest iteration of a broader kind of phenomenon that has played out in different ways across the history of human information-dissemination technologies. While we agree with this, we argue that newer sorts of fake news reveal substantial flaws in earlier understandings of this notion. In particular, we argue that no deceptive intentions are necessary for fake news to arise; rather, fake news arises when stories which were not produced via standard journalistic practice are treated as though they had been. Importantly, this revisionary understanding of fake news allows us to accommodate and understand the way that fake news is plausibly generated and spread in a contemporary setting, as much by non-human actors as by ordinary human beings. (shrink)

ABSTRACTWith over 560 citations reported on Google Scholar by April 2018, a publication by Juslin and Gabrielsson presented evidence supporting performers’ abilities to communicate, with hig...

did plato and aristotle have anything to say about belief? The answer to this question might seem blindingly obvious: of course they did. Plato distinguishes belief from knowledge in the Meno, Republic, and Theaetetus, and Aristotle does so in the Posterior Analytics. Plato distinguishes belief from perception in the Theaetetus, and Aristotle does so in the De anima. They talk about the distinction between true and false beliefs, and the ways in which belief can mislead and the ways in which (...) it can steer us aright. Indeed, they make belief a central component of their epistemologies.The view underlying these claims—one so widespread these days as to remain largely unquestioned—is that when Plato and Aristotle talk... (shrink)

This book argues that the major traditions in the philosophy of language have mistakenly focused on highly idealized linguistic contexts. Instead, it presents a non-ideal foundational theory of language that contends that the essential function of language is to direct attention for the purpose of achieving diverse social and political goals. Philosophers of language have focused primarily on highly idealized linguistic contexts in which cooperative agents are working toward the shared goal of gaining information about the world. This approach abstracts (...) away from important issues like power, ideology, social position, and diversity of goals which are crucial to explaining linguistic phenomena both at the semantic and pragmatic levels. This book begins by examining the work of some of the pioneers of this tradition--primarily David Lewis, Paul Grice, and Robert Stalnaker. The author shows that various problems have their source in idealizations made at the foundational level of linguistic theory and proposes to rebuild from the ground-up. She presents a non-ideal foundational theory of language which retains the major insights of traditional frameworks while rejecting the social idealizations that guide them. Then, she explores the social and political applications of her account to issues such as dog whistling, propaganda, slurs and racist speech, silencing, and manipulation. Non-Ideal Foundations of Language will appeal to researchers and advanced students in philosophy of language who are interested in the social and political applications of language, as well as traditional metasemantic theory. (shrink)

According to the naïve, pre-theoretic conception, lying seems to be characterized by the intent to deceive. However, certain kinds of bald-faced lies appear to be counterexamples to this view, and many philosophers have abandoned it as a result. I argue that this criticism of the naïve view is misplaced; bald-faced lies are not genuine instances of lying because they are not genuine instances of assertion. I present an additional consideration in favor of the naïve view, which is that abandoning it (...) comes at an extremely high price; alternative accounts which eschew the intent-to-deceive condition on lying have difficulty distinguishing lies from non-literal speech. (shrink)

We present a unified empirical and philosophical account of moral consistency reasoning, a distinctive form of moral reasoning that exposes inconsistencies among moral judgments about concrete cases. Judgments opposed in belief or in emotion and motivation are inconsistent when the cases are similar in morally relevant respects. Moral consistency reasoning, we argue, regularly shapes moral thought and feeling by coordinating two systems described in dual process models of moral cognition. Our empirical explanation of moral change fills a gap in the (...) empirical literature, making psychologically plausible a defensible new model of justified moral change and a hybrid theory of moral judgment. (shrink)

A number of examples of studies from the field ‘The Philosophy of Mathematical Practice’ (PMP) are given. To characterise this new field, three different strands are identified: an agent-based, a historical, and an epistemological PMP. These differ in how they understand ‘practice’ and which assumptions lie at the core of their investigations. In the last part a general framework, capturing some overall structure of the field, is proposed.

Research groups around the world are currently busy trying to invent new life in the laboratory, looking for extraterrestrial life, or making machines increasingly more life-like. In the case of astrobiology, any newly discovered life would likely be very old, but when discovered it would be new to us. In the case of synthetic organic life or life-like machines, humans will have invented life that did not exist before. Together, these endeavors amount to what we call the emerging plurality of (...) lives because we see a future where we are surrounded by, and interact with, life of many different origins, as well as entities that we have not traditionally seen as being alive. In the future these entities will likely possess properties that we so far have only associated with living beings, thereby transcending and perhaps blurring the borders between life and non-life. (shrink)

In response to Habgood-Coote (2019) and a growing number of scholars who argue that academics and journalists should stop talking about fake news and abandon the term, we argue that the reasons which have been offered for eschewing the term 'fake news' are not sufficient to justify such abandonment. Prima facie, then, we take ourselves and others to be justified in continuing to talk about fake news.

Perception of temporal patterns is fundamental to normal hearing, speech, motor control, and music. Certain types of pattern understanding are unique to humans, such as musical rhythm. Although human responses to musical rhythm are universal, there is much we do not understand about how rhythm is processed in the brain. Here, I consider findings from research into basic timing mechanisms and models through to the neuroscience of rhythm and meter. A network of neural areas, including motor regions, is regularly implicated (...) in basic timing as well as processing of musical rhythm. However, fractionating the specific roles of individual areas in this network has remained a challenge. Distinctions in activity patterns appear between "automatic" and "cognitively controlled" timing processes, but the perception of musical rhythm requires features of both automatic and controlled processes. In addition, many experimental manipulations rely on participants directing their attention toward or away from certain stimulus features, and measuring corresponding differences in neural activity. Many temporal features, however, are implicitly processed whether attended to or not, making it difficult to create controlled baseline conditions for experimental comparisons. The variety of stimuli, paradigms, and definitions can further complicate comparisons across domains or methodologies. Despite these challenges, the high level of interest and multitude of methodological approaches from different cognitive domains (including music, language, and motor learning) have yielded new insights and hold promise for future progress. (shrink)

Hypocrites invite moral opprobrium, and charges of hypocrisy are a significant and widespread feature of our moral lives. Yet it remains unclear what hypocrites have in common, or what is distinctively bad about them. We propose that hypocrites are persons who have undermined their claim to moral authority. Since this self-undermining can occur in a number of ways, our account construes hypocrisy as multiply realizable. As we explain, a person’s moral authority refers to a kind of standing that they occupy (...) within a particular moral community. This status is both socially important and normatively precarious. Hence, moral agents are right to be vigilant when it comes to hypocrisy, and are often justified in their outrage when they detect it. We further argue that our view can preserve what is attractive in rival accounts, while avoiding their associated problems. (shrink)