This article reflects on the intersection of the New Testament’s witness with current questions of illness, medication, risk, luck, death, and hope. Drawing principally on the Gospel of Matthew and the letters of Paul, I argue that, for Christians, hope in the resurrection—not the ability to avoid suffering and death—provides the best context for prudential judgment in light of the inscrutability of the future and the concomitant opacity that attends medical decision-making. We do not and will not know what we (...) would need to know in order to make decisions we can count on with surety, and we thus read Scripture in order to become the people who can make wise judgments in the meantime called hope. (shrink)

BackgroundPatient autonomy is a fundamental, yet challenging, principle of professional medical ethics. The idea that individual patients should have the freedom to make choices about their lives, including medical matters, has become increasingly prominent in current literature. However, this has not always been the case, especially in communist countries where paternalistic attitudes have been interwoven into all relationships including medical ones. Patients’ expectations and the role of the doctor in the patient-physician relationship are changing. Croatia, as a transitional country, is (...) currently undergoing this particular process.MethodsQualitative research was conducted by means of six focus group discussions held in the years 2012 and 2013 in Croatia. Focus groups were held separately with each of the following: first year and final year medical students, physicians engaged in medical ethics education, physicians practicing in a clinical hospital, family medicine residents and individuals representing patients with chronic disease. This research specifically addresses issues related to patient autonomy, in particular, the principles of truth telling, confidentiality, and informed consent. All focus group discussions were audio taped and then transcribed verbatim and systematized according to acknowledged qualitative analysis methods.Results and discussionPatient autonomy is much more than a simple notion defined as the patient’s right to make treatment decisions independently. It has to be understood in context of the broader socio-cultural setting. At present, both patients and medical doctors in Croatia are increasingly appreciating the importance of promoting the principle of autonomy in medical decision-making. However, the current views of medical students, physicians and patients reveal inconsistencies.Conclusions Knowing how to respect the various facets of patients’ autonomy should be part of physician’s professional duties, and also be reflected in his or her core clinical competencies. For this reason greater importance should be dedicated to patient autonomy issues in medical education in Croatia. (shrink)

Este artigo científico procurou investigar o processo de adaptação da Universidade Brasileira aos novos paradigmas impostos pelas políticas neoliberais. A análise se faz a partir de breve histórico do liberalismo e de suas imbricações no ensino. Apontando também a relativização da suposta democratização e modernização do ensino pelas novas perspectivas impostas pelo mercado. São levantadas também questões como autonomia universitária e legitimação da instituição de ensino superior.

ABSTRACTThis essay argues that retrieving insights from the ancient Stoic philosophers for Christian ethics is much more difficult than is often assumed and, further, that the “ethics of retrieval” is itself something worth prolonged reflection. The central problem is that in their ancient sense both Christianity and Stoicism are practically dense patterns of reasoning and mutually incompatible forms of life. Coming to see this clearly requires the realization that the encounter between Stoicism and Christianity is a conflict of lived traditions. (...) Precisely because we cannot simply extract Stoic insights from the lives in which they belong, the task of determining how Stoicism is useful for Christianity is exceptionally challenging. Indeed, doing justice to the Stoics has more to do with facing an alternative to Christianity than it does with appropriating insights for our own use. These points are developed in conversation with Elizabeth Agnew Cochran's recent article on the Stoic influence upon Jonathan Edwards. (shrink)

O objetivo deste texto é discutir a tarefa filosófica de elucidação do conceito de conseqüência lógica. Primeiramente, serão eleitos dois critérios de adequação para uma elucidação desse conceito: (1) preservação da verdade nas instâncias, ou adequação material e (2) garantia da verdade da conclusão na inferência válida, ou adequação epistêmica. Em seguida serão apresentadas a proposta de Tarski (1956) e as correspondentes críticas de Etchemendy (2008). Conclui-se com comentários a respeito da natureza das investigações lógicas.

Rare diseases, defined as having a prevalence inferior to 1/2000, are poorly understood scientifically and medically. Appropriate diagnoses and treatments are scarce, adding to the burden of living with chronic medical conditions. The moral significance of rare disease experiences is often overlooked in qualitative studies conducted with adults living with rare diseases. The concept of morally problematic situations arising from pragmatist ethics shows promise in understanding these experiences. The objectives of this study were to (1) acquire an in-depth understanding of (...) morally problematic situations experienced by adults living with rare diseases in the province of Québec and (2) to develop an integrative model of the concept of morally problematic situations. To this end, an online survey targeting this population was developed through a participatory action research project. Respondents provided 90 long testimonies on the most important morally problematic situations they faced, often in healthcare settings. An integrative model was developed based on various qualitative analyses of these testimonies and relevant literature. The integrative model showcases that morally problematic situations have causes (i.e., contextual and relational factors, personal factors, jeopardized valuations), have affective repercussions (i.e., emotions and feelings, internal tensions), prompt action (i.e., through empowerment strategies leading to the evolution of situations), and elicit outcomes (i.e., factual consequences, residual emotions and feelings, positive or negative resolutions). In sum, this study advances understanding of the moral experiences of adults living with rare diseases while proposing a comprehensive conceptual tool to guide future empirical bioethics research on moral experiences. (shrink)

CB1 receptors are functionally present within brain mitochondria, although they are usually considered specifically targeted to plasma membrane. Acute activation of mtCB1 alters mitochondrial ATP generation, synaptic transmission, and memory performance. However, the detailed mechanism linking disrupted mitochondrial metabolism and synaptic transmission is still uncharacterized. CB1 receptors are among the most abundant G protein-coupled receptors in the brain and impact on several processes, including fear coping, anxiety, stress, learning, and memory. Mitochondria perform several key physiological processes for neuronal homeostasis, including (...) production of ATP and reactive oxygen species, calcium buffering, metabolism of neurotransmitters, and apoptosis. It is therefore possible that acute activation of mtCB1 impacts on these different mitochondrial functions to modulate synaptic transmission. In reviewing and integrating across the literature in this area, we describe the possible mechanisms involved in the regulation of brain physiology by mtCB1 receptors. Activation of mitochondrial CB1 but not of plasma membrane CB1 decreases brain mitochondrial activity, glutamatergic synaptic transmission, and memory performance. Several processes can be involved in this alteration of brain physiology, including mitochondrial ATP and ROS production, axonal mitochondrial transport, Ca2+ homeostasis, and/or metabolism of the neurotransmitter glutamate. (shrink)

The problem of luck is advanced and defended against libertarian theories of responsibility-enabling ability. An outline of an account of ability is articulated to explore some features of the sort of ability moral responsibility requires. The account vindicates the luck objection and suggests a novel puzzle: Libertarianism is structurally barred from answering the problem of luck because responsibility requires, but inherently lacks, an explanation from reason states to actions that preserves reliability of connection between responsibility-grounding reasons-sensitivity and action.

Frankfurt examples invite controversy over whether the pertinent agent in these examples lacks the specific ability to do otherwise, and whether what she does can be obligatory or permissible. We develop an account of ability that implies that this agent does not have the specific ability to refrain from performing the germane action. The account also undergirds a view of obligation that entails that it is morally required or prohibited for an agent to perform an action only if she has (...) the specific ability to do, and to do otherwise than, perform it. Therefore, in Frankfurt examples, it is neither obligatory nor impermissible for the relevant agent to do what she does. (shrink)

As a preliminary step to beginning to assess the usefulness of clinical vignettes to measure ethical sensitivity in undergraduate medical students, five clinical vignettes with seven to nine ethical issues each were created. The ethical issues in the vignettes were discussed and outlined by an expert panel. One randomly selected vignette was presented to first, second and third year students at the University of Toronto as part of another examination. The students were asked to list the issues presented by the (...) patient problem. Responses from 281 students were obtained. These students identified an average of 2.72 ethical issues per vignette. Each response was classified under the domains of autonomy, beneficence and justice. Comparisons were made between classes and between vignettes. There was considerable variation between classes and the responses to different vignettes seem to indicate that different vignettes measure the various domains in different ways. It does appear that the use of vignettes is one way to measure aspects of ethical sensitivity in medical students but more study is required to clarify exactly what is being measured. (shrink)

In 1835, Alexis de Tocqueville famously called for 'a new political science' that could address the problems and possibilities of a 'world itself quite new.' For Tocqueville, the democratic world needed not just a new political science, but also new arts of statesmanship and leadership. In this volume, editors Brian Danoff and L. Joseph Hebert, Jr. have brought together a diverse set of essays which reveal that Tocqueville's understanding of democratic statesmanship remains highly relevant today.

An instrument to assess 'ethical sensitivity' has been developed. The instrument presents four clinical vignettes and the respondent is asked to list the ethical issues related to each vignette. The responses are classified, post hoc, into the domains of autonomy, beneficence and justice. This instrument was used in 1990 to assess the ethical sensitivity of students in all four medical classes at the University of Toronto. Ethical sensitivity, as measured by this instrument, is not related to age or grade-point average. (...) Sensitivity increases between the 1st and 2nd year and then decreases throughout the rest of undergraduate medical training, such that the 4th-year students identify fewer issues than those entering medical school. Students expressing a career choice of family medicine identify more issues than their peers. Several problems with the use of the instrument and the interpretation of the data were found. Nonetheless, these findings, if reproducible, are important and their meaning needs further discussion. (shrink)

RésuméLa sémiotique a inventé ou utilisé plusieurs modèles logiques pour représenter la structure élémentaire de la signification. Le carré sémiotique est sans doute l’un des plus célèbres de ces modèles. Il faut se demander, devant l’importance des phénomènes triadiques, si les modèles dyadiques sont (toujours) adaptés à leur description ou s’il ne faudrait pas se tourner (aussi) vers des modèles triadiques. Or, les modèles triadiques de la structure élémentaire de la signification nous apparaissent bien moins nombreux. À notre connaissance, seule (...) la sémiotique de Peirce et le templum de Boudon occupent cet espace autrement laissé vacant. Nous voulons ici à la fois présenter et exemplifier le templum et le compléter, en nous inspirant du carré sémiotique, pour le faire évoluer vers un « prisme sémiotique ». Nous proposerons également d’autres modèles logiques, comme le pentalemme et le cube sémiotiques. Au passage, nous étudierons plusieurs questions et problèmes – dont la décidabilité – entourant les modèles logiques. Nous ferons quelques applications sommaires de certains modèles, sur le temps, l’espace et la transcendance principalement. (shrink)

In this groundbreaking, cross-disciplinary work of philosophy and biblical studies, New Testament scholar C. Kavin Rowe explores the promise and problems inherent in engaging rival philosophical claims to what is true. Juxtaposing the Roman Stoics Seneca, Epictetus, and Marcus Aurelius with the Christian saints Paul, Luke, and Justin Martyr, and incorporating the contemporary views of Jeffrey Stout, Alasdair McIntyre, Charles Taylor, Martha Nussbaum, Pierre Hadot, and others, the author suggests that in a world of religious pluralism there is negligible (...) gain in sampling from separate belief systems. This thought-provoking volume reconceives the relationship between ancient philosophy and emergent Christianity as a rivalry between strong traditions of life and offers powerful arguments for the exclusive commitment to a community of belief and a particular form of philosophical life as the path to existential truth. (shrink)

Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians is a concise and practical guide to ethical decision-making in medicine. The text is aimed at second- and third-year one-semester ethics courses offered in medical schools, health sciences departments, and nursing programs. By taking an applied approach rather than a theoretical approach, this text serves the needs of medical and nursing students, residents, and practicing physicians by sorting through questions of moral principles relevant to the diverse and growing (...) number of healthcare professionals. The many topics covered include truth telling, refusal of treatment, assisted suicide, managing error, and reproductive choice. (shrink)

This article presents the results of a research that aimed to examine the phenomenon of student cheating on exams in faculties of education in Quebec universities. A total of 573 preservice teachers completed an online survey in 2018. The questionnaire consisted of 28 questions with a Likert scale related to individual and contextual factors associated with the propensity to cheat on exams as well as two yes/no items on the arguments for cheating. Descriptive and hierarchical linear regression analyses highlighted the (...) existence of cheating but also how three factors influenced the students’ propensity to cheat: influence of peers, methods of cheating, and institutional context. (shrink)

This article seeks to define what is semiotic and what is Semiotics. Provided first is a brief presentation of various perspectives of Semiotics. Pursuant to this, we will seek to uncover Semiotics’ particulars by evaluating various approaches. We will commence by framing the definitions of the word “Semiotic” to consider then Semiotics via eight particular anthropic – human-related – levels. This partition, derived by the author from a Rastier typology, defines the following levels: noumenophysical, phenophysical, semiotic, representational (“mental images” and (...) concepts), sens (physical), felt (affects), cognitive other and transcendental. From here, we will consider the place of Semiotics among disciplines. Finally, the text presents a typology of relationship between disciplines, including semiotics: anadisciplinarity, disciplinarity, valodisciplinarity, intradisciplinary (such as intertheoricity), multidisciplinary, interdisciplinary, transdisciplinary, metadisciplinarity). (shrink)

Jean Greisch a soixante ans. A l'occasion de cet anniversaire, trente de ses collègues et amis de divers continents ont souhaité unir leurs réflexions à ce que son œuvre, désormais considérable, inspire sur les différentes scènes de la pensée. La thématique générale, qui constitue l'intitulé du présent volume, est emblématique d'une production singulière : passage entre les deux langues de son Luxembourg natal, entre la phénoménologie et la philosophie de la religion, entre la métaphysique et la théologie, entre les sciences (...) humaines et l'herméneutique, entre la poésie et l'éthique. Enseignant, traducteur, conférencier international et auteur, il continue de frayer différents types de passages : dresser des ponts, ouvrir des brèches, risquer des percées, souffrir des traversées, ménager des transitions, inventer des tracés. (shrink)

Saint Augustin écrit : " Qu'est-ce donc que le temps ? Si personne ne me le demande, je le sais ; mais, si on me le demande et que je veuille l'expliquer, je ne le sais plus.

This essay argues that retrieving insights from the ancient Stoic philosophers for Christian ethics is much more difficult than is often assumed and, further, that the "ethics of retrieval" is itself something worth prolonged reflection. The central problem is that in their ancient sense both Christianity and Stoicism are practically dense patterns of reasoning and mutually incompatible forms of life. Coming to see this clearly requires the realization that the encounter between Stoicism and Christianity is a conflict of lived traditions. (...) Precisely because we cannot simply extract Stoic insights from the lives in which they belong, the task of determining how Stoicism is useful for Christianity is exceptionally challenging. Indeed, doing justice to the Stoics has more to do with facing an alternative to Christianity than it does with appropriating insights for our own use. These points are developed in conversation with Elizabeth Agnew Cochran's recent article on the Stoic influence upon Jonathan Edwards. This essay is a response to C. Kavin Rowe's critique of my 2011 argument that certain dimensions of Roman Stoic ethics are at work in Jonathan Edwards's moral thought. Rowe raises questions about the act of selectively retrieving ideas from a philosophical tradition to support constructive work in another tradition. I argue for the importance of acknowledging how Christian thought has been shaped by what Jeffrey Stout describes as moral bricolage, the selective retrieval of ideas from various traditions, and I contend that this bricolage can continue to be a fruitful means through which Christian ethics engages external traditions. Moreover, the importance of Stoicism's retrieval in early modern philosophy makes the work of eighteenth-century theologians such as Edwards a particularly valuable resource for exploring the plausibility of Christian engagement with the Stoics. (shrink)

Deontic modals are the topic of my dissertation. All deontic modals, yes, but justification in particular, and epistemic justification even more specifically. Deontic modals operate upon performances—they appraise performances. Positively appraised, a performance is appropriate, decent, justifiable, right, permissible, or proper; negatively appraised, inappropriate, indecent, unjustifiable, wrong, impermissible, or improper. Belief and knowledge and performances in exactly the same sense that action and intention are performances: all are products of powers that are in some sense responsive to reasons. The principal (...) difference is the direction of fit between mind and world. Knowledge and belief the product of cognitive powers aimed at adapting mind to world, action and intention the product of conative powers aimed at adapting world to mind. All are normatively evaluable and the characteristic normative appraisal of each is deontic. Epistemology, ethics, and rational choice all investigate the nature of deontic modals, differing only insofar as the central aims are epistemic, moral, or prudential in nature. In this sense, the general theory of deontic modals is the parent to epistemology, ethics, and rational choice. My project is to develop and defend a schematic theory of justification. I achieve this end by developing and defending a general theory of deontic modalities. Riffing on two pithy turns of phrase, the deontic theory may be tersely sloganized: value first and one must do the best one can. It is a teleological theory that defines all deontic concepts from the theoretically foundational notions of ability and value. Roughly, a belief is epistemically justifiable if, and only if, it is part of an epistemically optimific belief set the agent is able to have. Roughly, an act is morally justifiably if, and only if, it is part of a morally optimific action set the agent is able to perform. My pet interest is in the former. The resultant framework is enormously fruitful, especially in epistemology. (shrink)

The present study extends the study of individuals' ethical ideology withinthe context of marketing ethics issues. A national sample of marketing professionals participated. Respondents' ethical ideologies were classified as absolutists, situationists, exceptionists, or subjectivists using the Ethical Position Questionnaire (Forsyth, 1980). Respondents then answered questions about three ethically ambiguous situations common to marketing and sales. The results indicated that marketers' ethical judgments about the situations differed based on their ethical ideology, with absolutists rating the actions as most unethical. The findings (...) are consistent with those of two earlier studies that utilized samples of business students (Barnett et al., 1994, 1995). The results suggest that personal moral philosophy is an important influence on ethical decision making that should be considered in empirical studies of business ethics. The results also support the utility of the Ethical Position Questionnaire (Forsyth, 1980) as a means for researchers and practitioners to assess individuals' ethical ideology. (shrink)