Wilfrid Sellars attempts to deflect traditional objections to the straight rule of inductive acceptance by embedding it in a complicated system of levels. This system rests on a theory of probability in which the meaning of "probable" is reconstructed in the context of Sellars' general theory of practical reason. To say a statement is probable means, according to Sellars, that there is good reason for accepting the statement as true. In this paper I examine Sellars' attempt to resuscitate the (...) straight rule and conclude that not only does he fail, but his account of "probable" is circular. (shrink)

_John Dewey and Continental Philosophy_ provides a rich sampling of exchanges that could have taken place long ago between the traditions of American pragmatism and continental philosophy had the lines of communication been more open between Dewey and his European contemporaries. Since they were not, Paul Fairfield and thirteen of his colleagues seek to remedy the situation by bringing the philosophy of Dewey into conversation with several currents in continental philosophical thought, from post-Kantian idealism and the work of Friedrich Nietzsche (...) to twentieth-century phenomenology, hermeneutics, and poststructuralism. This unique volume includes discussions comparing and contrasting Dewey with the German philosophers G. W. F. Hegel, Friedrich Nietzsche, Martin Heidegger, and Hans-Georg Gadamer on such topics as phenomenology, naturalism, organicism, contextualism, and poetry. Others investigate a series of connections between Dewey and contemporary French philosophy, including the notions of subjectivity, education, and the critique of modernity in Michel Foucault; language and politics in Jacques Derrida; and the concept of experience in Gilles Deleuze. Also discussed is the question of whether we can identify traces of _Bildung_ in Dewey’s writings on education, and pragmatism’s complex relation to twentieth-century phenomenology and hermeneutics, including the problematic question of whether Heidegger was a pragmatist in any meaningful sense. Presented in intriguing pairings, these thirteen essays offer different approaches to the material that will leave readers with much to deliberate. _ John Dewey and Continental Philosophy_ demonstrates some of the many connections and opportunities for cross-traditional thinking that have long existed between Dewey and continental thought, but have been under-explored. The intersection presented here between Dewey’s pragmatism and the European traditions makes a significant contribution to continental and American philosophy and will spur new and important developments in the American philosophical debate. (shrink)

BackgroundAn analysis of the position statements of secular US medical and surgical professional societies on physician-assisted suicide (PAS) and euthanasia have not been published recently. Available statements were evaluated for position, content, and sentiment.MethodsIn order to create a comprehensive list of secular medical and surgical societies, the results of a systematic search using Google were cross-referenced with a list of societies that have a seat on the American Medical Association House of Delegates. Societies with position statements were identified. These statements (...) were divided into 5 categories: opposed to PAS and/or euthanasia, studied neutrality, supportive, acknowledgement without statement, and no statement. Linguistic analysis was performed using RapidMinder in order to determine word frequency and sentiment respective to individual statements. To ensure accuracy, only statements with word counts > 100 were analyzed. A 2-tailed independentttest was used to test for variance among sentiment scores of opposing and studied neutrality statements.ResultsOf 150 societies, only 12 (8%) have position statements on PAS and euthanasia: 11 for PAS (5 opposing and 4 studied neutrality) and 9 for euthanasia (6 opposing and 2 studied neutrality). Although the most popular words used in opposing and studied neutrality statements are similar, notable exceptions exist (suicide,medicine, andtreatmentappear frequently in opposing statements, but not in studied neutrality statements, whereaspsychologists,law, andindividualsappear frequently in studied neutrality statements, but not in opposing statements). Sentiment scores for opposing and studied neutrality statements do not differ (mean, 0.094 vs. 0.104;P = 0.90).ConclusionsFew US medical and surgical societies have position statements on PAS and euthanasia. Among them, opposing and studied neutrality statements share similar linguistic sentiment. Opposing and studied neutrality statements have clear differences, but share recommendations. Both opposing and studied neutrality statements cite potential risks of PAS legalization and suggest that good palliative care might diminish a patient’s desire for PAS. (shrink)

Purpose The purpose of this study is to examine the primary sources and methods of Web-based messaging during the early stages of the coronavirus pandemic. The authors use ethical lens to develop a conceptual framework to inform and reduce conflicts of Web-based messaging associated with COVID-19. Design/methodology/approach This paper provides a comprehensive review of three different ethical schools and identifies the cohesive theme of common good across them. Common good leading to a greater good serves as the (...) overarching ethical construct for Web-based messages that focus on society and not the singular individual, business or political ideology. Findings The findings suggest that the ethical construct of common good focuses on prioritizing the society over the individual and draws upon utilitarian principles focused on consequences, Kantian principles focused on intentions and Aristotelian principles focused on the definition of good. Web-based messaging on COVID-19 originates from diverse public and private sources and ethically can be governed by adherence to achieving the greatest good for society. Pervasive conflicts with COVID-19 messaging can be mitigated by pursuing a more ethical agenda with messages. Originality/value This manuscript provides a conceptual framework, based on ethical principles, to serve as a blueprint for Web-based messaging during a pandemic. This work offers an ethical perspective for communication during a pandemic and it is original in conceptualizing the components of Web-based messaging and decomposing them into the different levels where conflicts can occur. This article can serve as a template for Web-based communication pertaining to future pandemics and other events that benefit from prioritizing the impact on society over the impact on the individual. (shrink)

This paper applies models of the onset of adolescent sexual intercourse using national data from Denmark and the USA. The model gave excellent fits to data on Danish Whites and a good fit to American Whites, but the model-fits for American Blacks and Hispanics were not as good. The weakness of the latter model fits may reflect either real processes that the model does not capture or problems in the reliability of adolescent sexuality data.

Physical activity, and likely the motivation for it, varies throughout the day. The aim of this investigation was to create a short assessment (CRAVE: Cravings for Rest and Volitional Energy Expenditure) to measure motivation states (wants, desires, urges) for physical activity and sedentary behaviors. Five studies were conducted to develop and evaluate the construct validity and reliability of the scale, with 1,035 participants completing the scale a total of 1,697 times. In Study 1, 402 university students completed a questionnaire inquiring (...) about the want or desire to perform behaviors “at the present moment (right now).” Items related to physical activity (e.g., “move my body”) and sedentary behaviors (e.g., “do nothing active”). An exploratory structural equation model (ESEM) revealed that 10 items should be retained, loading onto two factors (5 each for Move and Rest). In Study 2, an independent sample (n= 444) confirmed these results and found that Move and Rest desires were associated with stage-of-change for exercise behavior. In Study 3, 127 community-residing participants completed the CRAVE at 6-month intervals over two years- two times each session. Across-session interclass correlations (ICC) for Move (ICC = 0.72–0.95) and Rest (ICC = 0.69–0.88) were higher than when they were measured across 24-months (Move: ICC = 0.53; Rest: ICC = 0.49), indicating wants/desires have state-like qualities. In Study 4, a maximal treadmill test was completed by 21 university students. The CRAVE was completed immediately pre and post. Move desires decreased 26% and Rest increased 74%. Changes in Move and Rest desires were moderately associated with changes in perceived physical fatigue and energy. In Study 5, 41 university students sat quietly during a 50-min lecture. They completed the CRAVE at 3 time points. Move increased 19.6% and Rest decreased 16.7%. Small correlations were detected between move and both perceived energy and tiredness, but not calmness or tension. In conclusion, the CRAVE scale has good psychometric properties. These data also support tenets of the WANT model of motivation states for movement and rest (Stults-Kolehmainen et al., 2020a). Future studies need to explore how desires to move/rest relate to dynamic changes in physical activity and sedentarism. (shrink)

This book critically assesses arguments for the existence of the God of classical theism, develops an innovative account of objects’ persistence, and defends new arguments against classical theism. The authors engage the following classical theistic proofs: Aquinas’s First Way, Aquinas’s De Ente argument, and Feser’s Aristotelian, Neo-Platonic, Augustinian, Thomistic, and Rationalist proofs. The authors also provide the first systematic treatment of the ‘existential inertia thesis’. By connecting the thesis to relativity theory and recent developments in the philosophy of physics, and (...) by developing a variety of novel existential-inertia-friendly explanations of persistence, they mount a formidable new case against classical theistic proofs. Finally, they defend new arguments against classical theism based on abstract objects and changing divine knowledge. The text appeals to students, researchers, and others interested in classical theistic proofs, the existence and nature of God, and the ultimate explanations of persistence, change, and contingency. (shrink)

The theory of epistemic vigilance posits that -- to quote the eponymous paper that introduced the theory -- “humans have a suite of cognitive mechanisms for epistemic vigilance, targeted at the risk of being misinformed by others." Despite the widespread acceptance of the theory of epistemic vigilance, however, I argue that the theory is a poor fit with the evidence: while there is good reason to accept that people ARE vigilant, there is also good reason to believe that (...) their vigilance is NOT epistemic. Rather, the evidence actually supports an alternative theory, one that I dub the theory of "Machiavellian vigilance": humans have a suite of cognitive mechanisms for Machiavellian vigilance, targeted at tracking others' relative social status and maintaining or enhancing one's own status. The evidence against epistemic vigilance stems from three sources: (a) data demonstrating that people are terrible at detecting honesty or competence, (b) data demonstrating that our vigilance is phylogenetically prior to the development of homo sapiens, and therefore was not designed to be sensitive to linguistic communication, and (c) data demonstrating that people's sources of information are distributed, and not detectable through individual vigilance. The evidence in favor of Machiavellian vigilance is the mirror image of the evidence against epistemic vigilance: (a) data demonstrating that people are very accurate at detecting status, (b) data demonstrating that social species, including bonobos and chimps, track the social status of their conspecifics, and (c) data demonstrating that people can quickly track status even in new social groups. (shrink)

Although sports and athletics provide a nearly universal social context for the learning of such cherished values as courage, honesty, discipline, communal efforts, and the pursuit of excellence, little attention has been devoted to the philosophy of this important element in human life. In a fascinating survey of the philosophic dimensions of sports and athletics, the author delves into a variety of topics, including game and play theory, play-forms and game principles in history, existentialism and sports, the popularity of sports, (...) its educational values, the function of ethics and moral values, and the role of competition, violence and aggression, self discovery, spirituality, and joy. He also considers recurrent problems such as corruption, the excessive emphasis on winning, and the exploitation of student athletes and suggests specific ways of preserving perspective and integrity. -- From publisher's description. (shrink)

Benardete paradoxes involve a beginningless set each member of which satisfies some predicate just in case no earlier member satisfies it. Such paradoxes have been wielded on behalf of arguments for the impossibility of an infinite past. These arguments often deploy patchwork principles in support of their key linking premise. Here I argue that patchwork principles fail to justify this key premise.

In this dissertation, I argue that all extant theories of prudential value are either a) enumeratively deficient, in that they are unable to accommodate everything that, intuitively, is a basic constituent of prudential value, b) explanatorily deficient, in that they are at least sometimes unable to offer a plausible story about what makes a given thing prudentially valuable, or c) both. In response to the unsatisfactory state of the literature, I present my own account, the Disjunctive Hybrid Theory or DHT. (...) DHT answers to and remedies each of the above inadequacies in a way that no other approach can. This account has the following general structure:Disjunctive Hybrid Theory (DHT): Thing x is basically good for person P if and only if x is either a) cared about (sufficiently and in the right way) by P, b) a bearer of (the right kind of) attitude-independent value, or c) both.Although it follows other recent accounts in combining elements from objective and subjective theories, DHT is a hybrid theory of a quite new kind. This is because it denies both subjective necessity (the constraint that, if thing x is to be basically good for person P, P must have some pro-attitude toward x) and objective necessity (the constraint that, if thing x is to be basically good for person P, x must have some attitude-independent value). I argue that the rejection of both necessity claims is called for if we are to move beyond the enumerative and explanatory limitations of existing accounts.I begin by outlining the general structure of DHT. I then argue, against various recent authors, that desire-satisfactionism remains the most appealing subjectivist approach to prudential value, in that it is best able to capture the central subjectivist insight. This insight is that a person can confer prudential value upon things by caring about them (sufficiently and in the right way). The subjectivist strand of DHT will thus be a version of desire-satisfactionism, which must be interpreted in line with what I call the object, as opposed to the combo, view. I move on to further motivate and develop the second, objectivist strand of DHT. This part of the theory involves a commitment to robustly attitude-independent prudential goods. I close by addressing some puzzles for the theory, and considering some of its more specific applications. (shrink)

In contemporary Anglo-American political philosophy, perfectionism is widely understood as the idea that the state may, or should, promote valuable conceptions of the good life and discourage conceptions that are worthless or bad. As such, debates over perfectionism occupy a central place in contemporary political philosophy because political philosophers are deeply concerned about whether or not a liberal state is permitted to promote any particular ethical or religious doctrine or impose it on its citizens. -/- In general, contemporary perfectionists (...) do not argue for the state’s pursuit of any religious doctrine. They only maintain that the state is permitted to make a wide range of public policies with the aim of promoting the good life. These policies, commonly found in liberal democratic societies, may include subsidizing museums and art galleries, preserving cultural heritage, setting up public libraries and providing free access to reading materials, encouraging athletic excellence, conserving nature and biodiversity, and educating citizens about the harm of recreational drugs. Nevertheless, perfectionism remains controversial among philosophers and political scientists. -/- It might be beneficial to take a sympathetic view of perfectionism and consider how perfectionists might defend their position against some of the common objections. These objections mainly include: (a) that the state does not possess legitimate authority to make decisions about the good life and seek to promote it; (b) that perfectionist policies are generally illiberal and paternalistic; and (c) that conceptions of the good life are objects of reasonable disagreement and hence cannot legitimately be promoted by the state. In addition, the nature and importance of perfectionist policies and politics will be discussed. (shrink)

I defend a new argument for causal finitism, the view that nothing can have an infinite causal history. I begin by defending a number of plausible metaphysical principles, after which I explore a host of novel variants of the Littlewood-Ross and Thomson’s Lamp paradoxes that violate such principles. I argue that causal finitism is the best solution to the paradoxes.

We draw out significant consequences of a relatively popular theory of metaphysical modality—branching actualism—for cosmological arguments for God’s existence. According to branching actualism, every possible world shares an initial history with the actual world and diverges only because causal powers (or dispositions, or some such) are differentially exercised. We argue that branching actualism undergirds successful responses to two recent cosmological arguments: the Grim Reaper Kalam argument and a modal argument from contingency. We also argue that branching actualism affords a response (...) to one popular defense of the classic contingency argument. What results are new difficulties for several cosmological arguments arising from the metaphysics of modality. (shrink)

Modal collapse arguments are all the rage in certain philosophical circles as of late. The arguments purport to show that classical theism entails the absurdly fatalistic conclusion that everything exists necessarily. My first aim in this paper is bold: to put an end to action-based modal collapse arguments against classical theism. To accomplish this, I first articulate the ‘Simple Modal Collapse Argument’ and then characterize and defend Tomaszewski’s criticism thereof. Second, I critically examine Mullins’ new modal collapse argument formulated in (...) response to the aforementioned criticism. I argue that Mullins’ new argument does not succeed. Third, I critically examine a powers-based modal collapse argument against classical theism that has received much less attention in the literature. Fourth, I show why God’s being purely actual, as well God’s being identical to each of God’s acts, simply cannot entail modal collapse given indeterministic causation. This, I take it, signals the death of modal collapse arguments. But not all hope is lost for proponents of modal collapse arguments—for the death is a fruitful one insofar as it paves the way for new inquiry into at least two new potential problems for classical theism. Showing this is my paper’s second aim. (shrink)

We examine two competing solutions to Benardete paradoxes: causal finitism, according to which nothing can have infinitely many causes, and the unsatisfiable pair diagnosis (UPD), according to which such paradoxes are logically impossible and no metaphysical thesis need be adopted to avoid them. We argue that the UPD enjoys notable theoretical advantages over causal finitism. Causal finitists, however, have levelled two main objections to the UPD. First, they urge that the UPD requires positing a ‘mysterious force’ that prevents paradoxes from (...) arising. Since such a force is implausible, the UPD is in trouble. Second, they employ recombination or patchwork principles to argue that paradoxical situations would be possible if causal finitism were false. Since such situations are not possible, causal finitism is true, and so a substantive metaphysical thesis is needed to avoid the paradoxes. We argue that the UPD proponent can successfully respond to these objections. (shrink)

The modal ontological argument (MOA) proceeds from God’s possible existence to God’s actual existence. A prominent objection to the MOA is that it suffers from a symmetry problem: an exactly parallel modal ontological argument can be given for God's non-existence. Several attempts have been made to break the symmetry between the arguments. This draft is a mostly comprehensive survey of those attempts. -/- The draft was initially written as a supplement to the 2024 Summer edition of the SEP entry on (...) Ontological Arguments. However, the draft is not included in the SEP entry. (shrink)

Edward Feser defends the ‘Aristotelian proof’ for the existence of God, which reasons that the only adequate explanation of the existence of change is in terms of an unchangeable, purely actual being. His argument, however, relies on the falsity of the Existential Inertia Thesis, according to which concrete objects tend to persist in existence without requiring an existential sustaining cause. In this article, I first characterize the dialectical context of Feser’s Aristotelian proof, paying special attention to EIT and its rival (...) thesis—the Existential Expiration Thesis. Next, I provide a more precise characterization of EIT, after which I outline two metaphysical accounts of existential inertia. I then develop new lines of reasoning in favor of EIT that appeal to the theoretical virtues of explanatory power and simplicity. Finally, I address the predominant criticisms of EIT in the literature. (shrink)

José Benardete developed a famous paradox involving a beginningless set of items each member of which satisfies some predicate just in case no earlier member satisfies it. The Grim Reaper version of this paradox has recently been employed in favor of various finitist metaphysical theses, ranging from temporal finitism to causal finitism to the discrete nature of time. Here, I examine a new challenge to these finitist arguments—namely, the challenge of implying that the future cannot be endless. In particular, I (...) develop future-oriented Benardete paradoxes and examine their epistemic symmetry with past-oriented paradoxes. (shrink)

We argue that there is a conflict among classical theism's commitments to divine simplicity, divine creative freedom, and omniscience. We start by defining key terms for the debate related to classical theism. Then we articulate a new argument, the Aloneness Argument, aiming to establish a conflict among these attributes. In broad outline, the argument proceeds as follows. Under classical theism, it's possible that God exists without anything apart from Him. Any knowledge God has in such a world would be wholly (...) intrinsic. But there are contingent truths in every world, including the world in which God exists alone. So, it's possible that God contingently has wholly intrinsic knowledge. But whatever is contingent and wholly intrinsic is an accident. So, God possibly has an accident. This is incompatible with classical theism. Finally, we consider and rebut several objections. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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James Henry Collin recently developed a new symmetry breaker favouring the ontological argument’s possibility premiss over that of the reverse ontological argument. The symmetry breaker amounts to an undercutting defeater for the reverse possibility premiss based on Kripkean cases of a posteriori necessity. I argue, however, that symmetry re-arises in two forms. First, I challenge the purported asymmetry in epistemic entitlements to the original and reverse possibility premisses. Second, relevantly similar Kripkean cases equally undercut the original possibility premiss.

The purpose of this article is to examine the relationship between philosophy (considered as an expression of fundamental values) and development, this here particularly understood in its economic sense. The author starts with an exploration of the meaning of development and then goes on to evaluate the views and perspectives that tend to argue against philosophy in its broadest sense (that is considered simply as a worldview or as a system of values) occupying a distinct and significant role in development. (...) In order to demonstrate this important point, the author explores what he considers to be the impact of the traditional African ethical outlook and values in relation to the economic activities and the process of development in contemporary Africa. O objectivo deste artigo é analisar a relação entre a filosofia (considerada como expressão de valores filosóficos fundamentais) e o desenvolvimento, sendo este especialmente entendido no sentido económico. O autor começa por explorar o significado de desenvolvimento e, em seguida, continua com a avaliação das visões e perspectivas que tendem a argumentar contra a filosofia no seu sentido mais alargado (isto é, a filosofia considerada simplesmente como visão do mundo ou como um sistema de valores) que ocupam um papel distinto e significativo no desenvolvimento, sendo esta exploração e avaliação efectuadas no sentido de argumentar que a filosofia tem, de facto, um papel muito distinto e significativo a desempenhar no processo de desenvolvimento, mesmo no sentido económico do termo. Para demonstrar este importante aspecto, o autor explora o que ele considera ser o impacto da perspectiva ética e dos valores tradicionais africanos em relação com as actividades económicas e o processo de desenvolvimento na África contemporânea. (shrink)

Surely God, as a perfectly rational being, created the universe for some _reason_. But is God’s creating the universe for a reason compatible with divine impassibility? That is the question I investigate in this article. The _prima facie_ tension between impassibility and God’s creating for a reason arises from impassibility’s commitment to God being uninfluenced by anything _ad extra_. If God is uninfluenced in this way, asks the detractor, how could he be moved to create anything at all? This _prima (...) facie_ tension has recently been formalized and dubbed the ‘Problem of Arbitrary Creation’. In this article, I defend a new extension of this problem. I begin by characterizing classical theism, divine simplicity, and divine impassibility. I then spell out the Problem of Arbitrary Creation as developed by R. T. Mullins. I next raise a worry for Mullins’ version of the argument. Finally, I extend the argument and show how my extension avoids the aforementioned worry. (shrink)

The modal collapse objection to classical theism has received significant attention among philosophers as of late. My aim in this paper is to advance this blossoming debate. First, I briefly survey the modal collapse literature and argue that classical theists avoid modal collapse if and only if they embrace an indeterministic link between God and his effects. Second, I argue that this indeterminism poses two challenges to classical theism. The first challenge is that it collapses God’s status as an intentional (...) agent who knows and intends what he is bringing about in advance. The second challenge is that it collapses God’s providential control over which creation obtains. (shrink)

Since the publication of Carl Hempel and Paul Oppenheim's ground-breaking work "Studies in the Logic of Explanation," the theory of explanation has remained a major topic in the philosophy of science. This valuable collection provides readers with the opportunity to study some of the classic essays on the theory of explanation along with the best examples of the most recent work being done on the topic. In addition to the original Hempel and Oppenheim paper, the volume includes Scriven's critical reaction (...) to it, Wilfrid Sellars's discussion of the problem of theoretical explanation, and pieces by Salmon, Railton, van Fraassen, Friedman, Kitcher, and Achinstein in which they demonstrate the vitality of the subject by extending the scope of the inquiry. (shrink)

Enric F. Gel has recently argued that classical theism enjoys a significant advantage over Graham Oppy's naturalism. According to Gel, classical theism – unlike Oppy's naturalism – satisfactorily answers two questions: first, how many first causes are there, and second, why is it that number rather than another? In this article, I reply to Gel's argument for classical theism's advantage over Oppy's naturalism. I also draw out wider implications of my investigation for the gap problem and Christian doctrine along the (...) way. (shrink)

What explains change? Edward Feser argues in his ‘Aristotelian proof’ that the only adequate answer to these questions is ultimately in terms of an unchangeable, purely actual being. In this paper, I target the cogency of Feser’s reasoning to such an answer. In particular, I present novel paths of criticism—both undercutting and rebutting—against one of Feser’s central premises. I then argue that Feser’s inference that the unactualized actualizer lacks any potentialities contains a number of non-sequiturs.

In this article, the author lists three problems that make any serious discussion about the ethics of leadership a very difficult undertaking. He then proposes a new, postindustrial paradigm of leadership. Using that understanding of leadership, two different sets of ethical analyses of leadership are possible: (I) those concerned with the process of leadership and (2) those concerned with the content of leadership (the changes proposed by the leaders and collaborators). In the end, the author suggests that the industrial paradigm (...) of ethics (the 18th century liberal philosophy) is inadequate to deal with the ethical decision making that leaders and collaborators must do in the 21 st century. Thus, a postindustrial paradigm of ethics must be developed to enable leaders and collaborators to make the tough ethical choices that will be demanded in the new millennium. (shrink)

This book aims to spell out the consequences of taking the technologies behind the doing of science seriously.

It is argued that the question “Can we trust technology?” is unanswerable because it is open-ended. Only questions about specific issues that can have specific answers should be entertained. It is further argued that the reason the question cannot be answered is that there is no such thing as Technology _simpliciter_. Fundamentally, the question comes down to trusting people and even then, the question has to be specific about trusting a person to do this or that.

What do appeals to case studies accomplish? Consider the dilemma: On the one hand, if the case is selected because it exemplifies the philosophical point, then it is not clear that the historical data hasn't been manipulated to fit the point. On the other hand, if one starts with a case study, it is not clear where to go from there—for it is unreasonable to generalize from one case or even two or three.