Spirituality is an important, but oft-overlooked, aspect of the self that may affect college students’ wellbeing and belonging. Few studies have systematically examined closeness to God and spiritual struggles as predictors of college student wellbeing during early college, which is a critical window for identity development. Moreover, research exploring interactions between spiritual struggles and closeness to God in predicting wellbeing outcomes is scarce. We address these gaps in the literature with an analytic sample comprised of 839 first-year college participants who (...) identify as religious. The results of correlational analyses and linear mixed effect models are presented. Closeness to God was associated with greater wellbeing and belonging, and spiritual struggles were associated with lower wellbeing and belonging. In exploratory analyses, a moderating effect of closeness to God on the relation between spiritual struggles and negative outcomes was observed. Implications for higher education and college student development are discussed. (shrink)

Psychologists have generated numerous measures designed to capture the “spiritual,” “religious,” and “transcendent” structures of human cognition, emotion, and behavior. Researchers often identify...

In bioethics, discussions of justice have tended to focus on questions of fairness in access to health care: is there a right to medical treatment, and how should priorities be set when medical resources are scarce. But health care is only one of many factors that determine the extent to which people live healthy lives, and fairness is not the only consideration in determining whether a health policy is just. In this pathbreaking book, senior bioethicists Powers and Faden confront foundational (...) issues about health and justice. How much inequality in health can a just society tolerate. The audience for the book is scholars and students of bioethics and moral and political philosophy, as well as anyone interested in public health and health policy. (shrink)

Political liberalism has increasingly come under fire from both the right and the left, in politics as well as in philosophy. In this new study, G.B. Madison offers a systematic rebuttal to these contemporary critics, attempting to demonstrate that the basic principles of classical liberal philosophy are not only internally valid and coherent but also directly relevant to the problems faced by society in the post-industrial age. Building on the theory of Frank H. Knight and other liberal tinkers, (...) class='Hi'>Madison outlines the postmodern theory of reason that is presupposed within classical liberal theory and makes the case that as a political philosophy liberalism can be justified entirely within its own terms, without reference to arbitrary or absolute values. (shrink)

I Deliberation, Practical Syllogisms , and Intuition. Introduction Aristotle's views on moral reasoning are a difficult and much disputed subject. ...

Despite advances in palliative care, some patients still suffer significantly at the end of life. Terminal Sedation (TS) refers to the use of sedatives in dying patients until the point of death. The following limits are commonly applied: (1) symptoms should be refractory, (2) sedatives should be administered proportionally to symptoms and (3) the patient should be imminently dying. The term ‘Expanded TS’ (ETS) can be used to describe the use of sedation at the end of life outside one or (...) more of these limits.In this paper, we explore and defend ETS, focusing on jurisdictions where assisted dying is lawful. We argue that ETS is morally permissible: (1) in cases of non-refractory suffering where earlier treatments are likely to fail, (2) where gradual sedation is likely to be ineffective or where unconsciousness is a clinically desirable outcome, (3) where the patient meets all criteria for assisted dying or (4) where the patient has greater than 2 weeks to live, is suffering intolerably, and sedation is considered to be the next best treatment option for their suffering.While remaining two distinct practices, there is scope for some convergence between the criteria for assisted dying and the criteria for ETS. Dying patients who are currently ineligible for TS, or even assisted dying, should not be left to suffer. ETS provides one means to bridge this gap. (shrink)

Structural Injustice advances a theory of what structural injustice is and how it works. Powers and Faden present both a philosophically powerful, integrated theory about human rights violations and structural unfairness, alongside practical insights into how to improve them.

We first show that the projection image of a discrete definable set is again discrete for an arbitrary definably complete locally o‐minimal structure. This fact together with the results in a previous paper implies a tame dimension theory and a decomposition theorem into good‐shaped definable subsets called quasi‐special submanifolds. Using this fact, we investigate definably complete locally o‐minimal expansions of ordered groups when the restriction of multiplication to an arbitrary bounded open box is definable. Similarly to o‐minimal expansions of ordered (...) fields, Łojasiewicz's inequality, Tietze's extension theorem and affiness of pseudo‐definable spaces hold true for such structures under the extra assumption that the domains of definition and the pseudo‐definable spaces are definably compact. Here, a pseudo‐definable space is a topological space having finite definable atlases. We also demonstrate Michael's selection theorem for definable set‐valued functions with definably compact domains of definition. (shrink)

Military metaphors are pervasive in biomedicine, including HIV research. Rooted in the mind set that regards pathogens as enemies to be defeated, terms such as “shock and kill” have become widely accepted idioms within HIV cure research. Such language and symbolism must be critically examined as they may be especially problematic when used to express scientific ideas within emerging health-related fields. In this article, philosophical analysis and an interdisciplinary literature review utilizing key texts from sociology, anthropology, history, and Chinese and (...) African studies were conducted to investigate the current proliferation of military metaphors. We found the use of these metaphors to be ironic, unfortunate, and unnecessary. To overcome military metaphors we propose to give them less aggressive meanings, and/or replace them with more peaceful metaphors. Building on previous authors' work, we argue for the increased use of “journey” metaphors as meaningful, cross-culturally app... (shrink)

This paper discusses an analogical argument for the compatibility of the evidential argument from evil and skeptical theism. The argument is based on an alleged parallel between the paradox of the preface and the case of apparently pointless evil. I argue that the analogical argument fails, and that the compatibility claim is undermined by the epistemic possibility of inaccessible reasons for permitting apparently pointless evils. The analogical argument fails, because there are two crucial differences between the case of apparently pointless (...) evil and the case of the preface. First, in the preface case, our non-cumulative evidence supports a claim of error, whereas the analogical argument is based on the idea that our non-cumulative evidence supports the success claim that there’s at least one instance of truly pointless evil. Second, our non-cumulative evidence of error in the case of the preface rests on a track record establishing author fallibility; in the case of apparently pointless evils, there is no relevant track record to support the claim that some apparently pointless evils are truly pointless. These differences, together with certain plausible assumptions about our fallibility and reliability with respect to propositions about evil, also indicate that inaccessible reasons for permitting apparently pointless evil are epistemically possible. Given the epistemic possibility of such reasons, we’re in no position to judge whether such reasons are present in every case no matter how large the set of such evils may be. (shrink)

The field of management has had difficulty embracing the concept of Machiavellianism despite the myriad of studies produced by other fields of social science. It appears that Machiavellianism as a unitary personality construct has limited efficacy in the complex world of organizations. The authors suggest a multidimensional approach to understanding the impact of an individual's threat to organizational functioning. Viewing the construct as discontinuous with two manifestations, predatory and benign, suggestions are made as to the location within organizations where such (...) individuals may be found. A research approach is also suggested. (shrink)

In this article, we address the relevance of J.S. Mill’s political philosophy for a framework of public health ethics. In contrast to some readings of Mill, we reject the view that in the formulation of public policies liberties of all kinds enjoy an equal presumption in their favor. We argue that Mill also rejects this view and discuss the distinction that Mill makes between three kinds of liberty interests: interests that are immune from state interference; interests that enjoy a presumption (...) in favor of liberty; and interests that enjoy no such presumption. We argue that what is of focal importance for Mill in protecting liberty is captured by the essential role that the value of self-determination plays in human well-being. Finally, we make the case for the plausibility of a more complex and nuanced Millian framework for public health ethics that would modify how the balancing of some liberty and public health interests should proceed by taking the thumb off the liberty end of the scale. Mill’s arguments and the legacy of liberalism support certain forms of state interference with marketplace liberties for the sake of public health objectives without any presumption in favor of liberty. (shrink)

A growing body of literature argues that achieving radical change in the agri-food system requires a radical renegotiation of our relationship with the environment alongside a change in our thinking and approach to transformational food politics. This paper argues that relational approaches such as a more-than-human ethic of care (MTH EoC) can offer a different and constructive perspective to analyse agri-food system transformation because it emphasises social structures and relationships as the basis of environmental change. A MTH EoC has not (...) yet been applied to regenerative agriculture, yet other literature on regenerative agriculture suggests that care may be present in these spaces and calls for the need for social science analysis of the regenerative movement. This paper uses a MTH EoC lens to reveal a diverse array of ways in which power is and can be deployed for change in the regenerative agriculture movement in Aotearoa, New Zealand. Globally, regenerative agriculture tends to be analysed through positivist, scientific approaches that focus on biophysical markers of ecological improvement. Yet, a relational approach reveals how engagement in regenerative agriculture is creating significant shifts in mindset towards more holistic and relational understandings of biological and social ecosystems. A regenerative mindset framework is suggested as a method of understanding the connection between a regenerative form of thinking, being and doing for farmers. Interviews suggested that this shift in farmers’ socio-ecological relations is crucial to the transformational potential of regenerative agriculture. This paper argues that relational analyses such as the MTH EoC approach used to analyse regenerative agriculture in this research, refresh the way we analyse agri-food system change. They also are critical to guiding and supporting on-the-ground socio-ecological shifts that are necessary to see agricultural transformation. (shrink)

This paper discusses the nature of competitiveness and argues that being competitive does not essentially involve a strong desire to win or to outperform others. The appeal of the ‘desire-to-win’ analysis of competitiveness can be explained away provided we distinguish between virtuous and vicious competitiveness. It is conceivable that a virtuously competitive athlete lack a strong desire to win or to outperform others. Moreover, there is empirical evidence that virtuous competitiveness and vicious competitiveness are distinct character traits. If being virtuously (...) competitive does not require a strong desire to win, then being competitive simpliciter does not require this. Other recent accounts, e.g. Kretchmar 2012 and Russell 2014, may appear to support the desire-to-win analysis, but careful reflection reveals that this is not the case. (shrink)

We argue that extreme endurance sport can be valuable for some nonhuman animals. To make the case, we focus specifically on dogsled racing. We argue that, given certain views about the nature of self-affirmation, perceptual agency, and affordances, sled dogs are capable of realizing significant value through extreme endurance running. Because our focus is on the axiological question of the nature of the value of the sport for its participants, we do not claim that extreme dogsledding is ethical; indeed, we (...) acknowledge the morally objectionable aspects of the practice in its current form. Still, we offer our argument as a critical step in providing an adequate moral justification for a reformed model of dogsled racing. If it is permissible, that is likely because it offers some significant benefits to sled dogs. Given some assumptions about sled dogs’ capacity to be guided by both internal and external affordances, those benefits include self-affirmation. (shrink)

BackgroundAlthough, moral distress presents a serious problem among critical care nurses in many countries, limited research has been conducted on it. A validated scale has been developed to evaluate moral distress and has enabled cross-cultural comparison for seeking its root causes.Research aimsThis study aimed to (1) clarify the current status of moral distress among nurses who worked in critical care areas in Japan, (2) compare the moral distress levels among nurses in Japan with previously reported results from the United States (...) (US), and (3) explore the factors associated with moral distress.Research designA nationwide cross-sectional study was conducted.Participants and research contextWe conducted a self-administered questionnaire survey using the Measure of Moral Distress–Healthcare Professionals (MMD-HP) among critical care nurses who were randomly selected from hospitals across Japan. The mean differences between the two countries were compared using a Student's t-test with summary statistics. The factors associated with higher levels of moral distress were examined using a multiple regression analysis.Ethical considerationsThe study was approved by the Ethics Committee of the Tokyo Medical and Dental University (approval nos. M2018-214 and M2019-045).ResultsWe obtained 955 valid responses from 94 facilities. In Japan, the items with the highest moral distress scores were those related to aggressive/inappropriate treatment. The total MMD-HP score was significantly higher in Japanese nurses compared to US nurses (122.8 ± 70.8 vs 112.3 ± 73.2). Some factors, such as leadership experience, were associated with higher moral distress.DiscussionThe top root causes of moral distress were similar to potentially inappropriate treatments in both countries.ConclusionThis study revealed the factors associated with higher moral distress and its characteristics in each country. These results can be used for reducing moral distress in the future. (shrink)

This paper investigates the adequacy of evidential relevance relations proposed by Glymour and others. These accounts incorporate, as a necessary condition, what I call the Positive Instance Condition (PIC): the evidence statement and auxiliary assumptions entail a "positive instance" of the hypothesis. I argue that any account which incorporates PIC as a necessary condition while allowing "bootstrap testing" is doomed to fail. A nonbootstrapping evidential relevance relation of similar form is proposed, and it is argued that, in addition to avoiding (...) published counter examples, this new relation meets two general requirements which, if not met, would undermine the ability of any account that incorporates PIC to accord with our intuitions of evidential relevance. (shrink)

Suppose that you have deeply personal information that you do not want to share. Further suppose that this information could help others, perhaps even saving their lives. Should you reveal the information or keep it secret? With the increasing prevalence of genetic testing, more and more people are finding themselves in this situation. Although a patient's genetic results are potentially relevant to all her biological family members, her first‐degree relatives—parents, children, and full siblings—are most likely to be affected. This is (...) especially true for genetic mutations—like those in the BRCA1 and BRCA2 genes—that are associated with a dramatically increased risk of disease. Fortunately, people are usually willing to share results with their at‐risk relatives. Occasionally, however, a patient refuses to disclose her findings to anyone outside her clinical team. Ethicists have written little on patients’ moral duties to their at‐risk relatives. Moreover, the few accounts that have been advanced are problematic. Some unnecessarily expose patients’ genetic information to relatives who are unlikely to benefit from it, and others fail to ensure that patients’ most vulnerable relatives are informed of their genetic risks. Patients’ duty to warn can be defended in a way that avoids these problems. I argue that the duty to share one's genetic results is grounded in the principle of rescue—the idea that one ought to prevent, reduce, or mitigate the risk of harm to another person when the expected harm is serious and the cost or risk to oneself is sufficiently moderate. When these two criteria are satisfied, a patient will most likely have a duty to warn. (shrink)

For more than a decade, the United States has been fighting wars so far from the public eye as to risk being forgotten, the struggles and sacrifices of its volunteer soldiers almost ignored. Photographer and writer Ashley Gilbertson has been working to prevent that. His dramatic photographs of the Iraq war for the New York Times and his book Whiskey Tango Foxtrot took readers into the mayhem of Baghdad, Ramadi, Samarra, and Fallujah. But with Bedrooms of the Fallen, (...) class='Hi'>Gilbertson reminds us that the wars in Afghanistan and Iraq have also reached deep into homes far from the noise of battle, down quiet streets and country roads—the homes of family and friends who bear their grief out of view. The book’s wide-format black-and-white images depict the bedrooms of forty fallen soldiers—the equivalent of a single platoon—from the United States, Canada, and several European nations. Left intact by families of the deceased, the bedrooms are a heartbreaking reminder of lives cut short: we see high school diplomas and pictures from prom, sports medals and souvenirs, and markers of the idealism that carried them to war, like images of the Twin Towers and Osama Bin Laden. A moving essay by Gilbertson describes his encounters with the families who preserve these private memorials to their loved ones, and shares what he has learned from them about war and loss. Bedrooms of the Fallen is a masterpiece of documentary photography, and an unforgettable reckoning with the human cost of war. (shrink)

Background:Moral distress has various adverse effects on nurses working in critical care. Differences in personal values, and between values and self-perception of behaviour are factors that may cause moral distress.Research aims:The aims of this study were (1) to identify ethical values and self-perception of behaviour of critical care nurses in Japan and (2) to determine the items with a large difference between value and behaviour and the items with a large difference in value from others.Research design:A nationwide, cross-sectional study was (...) conducted.Participants and research context:We developed a self-administered questionnaire with 28 items, which was completed by 1014 critical care nurses in Japan. The difference between value and self-perception of behaviour was calculated from the score of each value item minus the score of each self-perception of behaviour item. The size of the difference in value from the others was judged by the standard deviation of each item.Ethical considerations:The study was approved by the Ethics Committee of the Tokyo Medical and Dental University (approval nos. M2018-214, M2019-045).Results:The items with a large difference between value and behaviour sources were related to the working environment and decision-making support. The items with a large difference in value from others were related to hospital management and disclosure of information to patients.Discussion:Improving the working environment for nurses is important for reducing moral distress. Nurses are faced with a variety of choices, including advocating for patients and protecting the fair distribution of medical resources, and each nurse’s priorities might diverge from those of other team members, which can lead to conflict within the team.Conclusion:This study revealed items with particularly high risks of moral distress for nurses. The results provide foundational information that can guide the development of strategies to mitigate moral distress. (shrink)

It appears that there is an inconsistency in combining epistemic contextualism with a plausible closure principle for knowledge and the view that knowledge is factive. I discuss the proposal that in order to avoid inconsistency the contextualist should reject closure and retain factivity. The proposal offers an alternative to closure and an argument that warrant fails to transmit through inference in the relevant cases. I criticize both accounts. The proposed alternative to closure is not well motivated and leaves unresolved the (...) question of why standard closure should not hold. The argument that warrant does not transmit is based on an inaccurate model of warrant transmission. An important lesson that emerges is that known propositions themselves can serve as warrant for further propositions, which may be known provided they are competently deduced from the former. Indeed it is arguably the factivity of knowledge that accounts for the fact that known propositions themselves serve as warrant. Thus, the strategy of rejecting closure while retaining factivity is a bad one not merely because the proposed alternatives to standard closure are inadequate and transmission failure in relevant cases would not imply closure failure, but because factivity ensures that warrant transmission worries in the relevant cases are unfounded. (shrink)

This study utilized a multiple baseline design across two study skills to examine the impact of a self-monitoring checklist and follow-up performance feedback on the generalization of study skills for seven college students with disabilities. All training and follow-up support took place in a remedial college course. The accuracy of study skill use was analyzed to evaluate whether training gains occurred in a college level subject area different than the course in which the skills were taught in the absence of (...) teacher-guided stimuli and verbal prompts. Results provide evidence that relatively simple, classroom-based training and follow-up support markedly increased the accurate use of the notetaking and study guide skills immediately for three of the seven students. However, following a booster session, all but one student’s performance increased following intervention. Results were socially validated by students who indicated they were generally satisfied with the intervention and found it to be useful when studying for the college class. This type of training is critical because low retention rates in college programs are a likely outcome for students with disabilities when study skills are not used. (shrink)

An account of the author's experience in Iraq, presents photographs and commentary that convey the terror and exhilaration of photojournalism in an age of embedded reporting.

Technological advances in genetic testing have enabled prospective parents to learn about their risk of passing a genetic condition to their future children. One option for those who want to ensure that their biological children do not inherit a genetic condition is to create embryos through in vitro fertilisation and use a technique called preimplantation genetic testing to screen embryos for genetic abnormalities before implantation. Unfortunately, due to its high cost, IVF-with-PGT is out of reach for the vast majority of (...) Americans. This article addresses an issue that has been underexplored in the medical ethics literature: the lack of insurance coverage for IVF-with-PGT.Within the US system, a key concept in insurance is that of medically necessary care, which broadly consists of diagnostic services and treatment services. In this article, I argue that IVF-with-PGT could be classified as either a diagnostic service or as a treatment service. To make this case, I show that IVF-with-PGT is similar to other types of services that are often covered by US insurance providers. In light of these similarities, I argue that the current system is inconsistent with respect to what is—and is not—covered by insurance. To promote consistency and fairness in coverage, like cases should be treated alike—starting with greater coverage for IVF-with-PGT. (shrink)

This study analyzed the effects of aging on post-error behavioral adjustments from the perspective of cognitive control. A modified error awareness task was administered to young and older adults. In this task, two buttons were placed on the left and right sides in front of the participants, who were instructed to use the right button to perform a go/no-go task, and were notified if they made an error. There were three experimental conditions : participants had to push the right button (...) once in Condition A and twice in Condition B and C when a go-stimulus was presented. Conversely, participants were asked to withhold their response when a no-go stimulus was presented. Response inhibition differed depending on the experimental condition. The participants were asked to push the left button as quickly as possible when an error occurred. The results showed relatively longer reaction times to sudden errors among older adults compared with young adults. Furthermore, the difference in the error responses strongly influenced older adults’ response time after an error. These results suggest that the shift from proactive to reactive control may significantly influence post-error behavioral adjustments in older adults. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Have We Been Careless with Socrates' Last Words?:A Rereading of the PhaedoLaurel A. Madison (bio)In section 340 of The Gay Science, Nietzsche offers what he believes will be received as a scandalous interpretation of Socrates' last words. "Whether it was death or the poison or piety or malice—something loosened his tongue at that moment and he said: 'O Crito, I owe Asclepius a rooster.' This ridiculous and terrible (...) 'last word' means for those who have ears: 'O Crito, life is a disease.'"1 Nietzsche might be surprised, however, to discover just how many readers "have ears" to hear the pessimism and resentment in Socrates' voice as he bids farewell to his life. Indeed, this interpretation has become standard among both Plato scholars and non-scholars, taking on the air of orthodoxy.2Not only is this "Nietzschean" reading widespread, it also has a significant impact on how we understand Plato's project in general and, ultimately, whether or [End Page 421] not we believe that Plato still has something to teach us. This commonly accepted interpretation reinforces the view that Socrates and Plato were ascetics of the worst kind, hostile to life and the body in particular. As a consequence, significant portions of Plato's thought are treated as woefully unenlightened. Indeed, how can we take seriously the views of such a dualist who denigrates our earthly existence and urges us to deny and repress our passions, instincts, desires, and drives—i.e., to live for death?It is assumed correctly, I think, that Socrates' last words speak volumes about both his and Plato's view of the nature and task of human existence. However, the meaning of these words, I will argue, has been seriously misinterpreted and their intended significance fundamentally obscured. Thus it is time to take another, closer look at what is arguably Socrates' most important statement—a statement uttered with his last breath:Crito, we owe a cock to Asclepius; make this offering to him and do not forget.3How are we, as readers of this dialogue, to interpret Socrates' last words? What is the meaning of his final thought, his dying wish and command? According to the standard reading of this passage, Socrates awaits the termination of his life with gratitude and relief. As death closes in on him, he asks Crito to make an offering to Asclepius, the god of healing. By invoking this god, Socrates appears to be calling attention to the recovery from an illness. But what is the illness and what is the cure? At the moment these words are uttered, Socrates is on the brink of death and it is assumed that he views his death as the cure to the illness of life. This reading is substantiated by an earlier passage where Socrates argues that "the one aim of those who practice philosophy in the proper manner is to practice for dying and death" (64a3-4). The body, Socrates argues, obscures our pursuit of the truth and the sooner we can separate our soul from this hindrance (i.e., in death) the better off we will be, for "as long as we have a body and our soul is fused with such an evil we shall never adequately attain what we desire, which we affirm to be the truth" (66b3-5). From the philosopher's perspective, then, the body is something to "disdain" (, 65d1) and "despise" (, 68c11)—indeed, to "flee" from (, 65d1). Thus given the disparagement of our bodily existence in this earlier passage, how else can we interpret Socrates' final statement?4Because this "Nietzschean" reading of Socrates' last words appears to be based in large part upon the discussion of philosophy as preparation for death, any examination of it must include an analysis of the earlier passage as well.5 However, [End Page 422] to adequately interpret the discussion of philosophy as preparation for death (or any passage in the dialogues, for that matter), we must first place it in its context within the drama of the dialogue, the philosophical significance of which has been argued at length elsewhere.6 Let us then turn to the opening scene of the dialogue, for... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Have We Been Careless with Socrates' Last Words?:A Rereading of the PhaedoLaurel A. Madison (bio)In section 340 of The Gay Science, Nietzsche offers what he believes will be received as a scandalous interpretation of Socrates' last words. "Whether it was death or the poison or piety or malice—something loosened his tongue at that moment and he said: 'O Crito, I owe Asclepius a rooster.' This ridiculous and terrible (...) 'last word' means for those who have ears: 'O Crito, life is a disease.'"1 Nietzsche might be surprised, however, to discover just how many readers "have ears" to hear the pessimism and resentment in Socrates' voice as he bids farewell to his life. Indeed, this interpretation has become standard among both Plato scholars and non-scholars, taking on the air of orthodoxy.2Not only is this "Nietzschean" reading widespread, it also has a significant impact on how we understand Plato's project in general and, ultimately, whether or [End Page 421] not we believe that Plato still has something to teach us. This commonly accepted interpretation reinforces the view that Socrates and Plato were ascetics of the worst kind, hostile to life and the body in particular. As a consequence, significant portions of Plato's thought are treated as woefully unenlightened. Indeed, how can we take seriously the views of such a dualist who denigrates our earthly existence and urges us to deny and repress our passions, instincts, desires, and drives—i.e., to live for death?It is assumed correctly, I think, that Socrates' last words speak volumes about both his and Plato's view of the nature and task of human existence. However, the meaning of these words, I will argue, has been seriously misinterpreted and their intended significance fundamentally obscured. Thus it is time to take another, closer look at what is arguably Socrates' most important statement—a statement uttered with his last breath:Crito, we owe a cock to Asclepius; make this offering to him and do not forget.3How are we, as readers of this dialogue, to interpret Socrates' last words? What is the meaning of his final thought, his dying wish and command? According to the standard reading of this passage, Socrates awaits the termination of his life with gratitude and relief. As death closes in on him, he asks Crito to make an offering to Asclepius, the god of healing. By invoking this god, Socrates appears to be calling attention to the recovery from an illness. But what is the illness and what is the cure? At the moment these words are uttered, Socrates is on the brink of death and it is assumed that he views his death as the cure to the illness of life. This reading is substantiated by an earlier passage where Socrates argues that "the one aim of those who practice philosophy in the proper manner is to practice for dying and death" (64a3-4). The body, Socrates argues, obscures our pursuit of the truth and the sooner we can separate our soul from this hindrance (i.e., in death) the better off we will be, for "as long as we have a body and our soul is fused with such an evil we shall never adequately attain what we desire, which we affirm to be the truth" (66b3-5). From the philosopher's perspective, then, the body is something to "disdain" (, 65d1) and "despise" (, 68c11)—indeed, to "flee" from (, 65d1). Thus given the disparagement of our bodily existence in this earlier passage, how else can we interpret Socrates' final statement?4Because this "Nietzschean" reading of Socrates' last words appears to be based in large part upon the discussion of philosophy as preparation for death, any examination of it must include an analysis of the earlier passage as well.5 However, [End Page 422] to adequately interpret the discussion of philosophy as preparation for death (or any passage in the dialogues, for that matter), we must first place it in its context within the drama of the dialogue, the philosophical significance of which has been argued at length elsewhere.6 Let us then turn to the opening scene of the dialogue, for... (shrink)

In some cases where we are faced with a decision of whether to prioritize identified lives over statistical lives, we have no basis for assigning specific probabilities to possible outcomes. Is there any reason to prioritize either statistical or identified lives in such cases? The ‘uncertainty argument’ purports to show that, provided we embrace ex ante contractualism, we should prioritize saving identified lives in such cases. The argument faces two serious problems. First, it relies on the principle of indifference, and (...) as such it leads to inconsistent assignments of epistemic probability to possible outcomes. Moreover, even if the uncertainty argument can be reformulated in order to avoid reliance on the principle of indifference, the uncertainty in such cases still undermines any judgment of which course of action – saving a statistical, or rather an identified life – involves the greater burden. The indeterminacy involved in the statistical group might be thought to undermine the argument that application of the principle of indifference leads to inconsistency in this case, but the thought that it does rests on a misunderstanding of the relationship between indeterminacy and reference. (shrink)

In common with traditional forms of epistemic internalism, epistemological disjunctivism attempts to incorporate an awareness condition on justification. Unlike traditional forms of internalism, however, epistemological disjunctivism rejects the so-called New Evil Genius thesis. In so far as epistemological disjunctivism rejects the New Evil Genius thesis, it is revisionary. -/- After explaining what epistemological disjunctivism is, and how it relates to traditional forms of epistemic internalism / externalism, I shall argue that the epistemological disjunctivist’s account of the intuitions underlying the New (...) Evil Genius thought experiment is at best incomplete. As presented, therefore, epistemological disjunctivism is unable to accommodate the core guiding intuitions of epistemic internalism. Given the stated aim of not being revisionary on this score, the view is at a dialectical disadvantage over the traditional forms of epistemic internalism the position is meant to replace. Unfortunately, therefore, at present, the impasse between internalism and externalism remains. (shrink)

Recent calls have been made to move professional standards to a more principles-based perspective, supposing that emphasizing broad principles would eliminate the legalistic focus that rules may encourage, and accountants’ behavior would be more ethical and uniformly so. However, this supposition has yet to be empirically tested. The AICPA Code of Professional Conduct (Code) provides guidance in both forms: principles and rules. This experiment examines how the form of the Code affects independence judgments in a client acceptance context. We also (...) examine the potential for levels of moral development to influence the effectiveness of the Code.We find that subjects are more likely to consider their independence impaired, and are more likely to reject a questionable audit engagement, when rules-based (principles-based) reasoners are provided with Code rules (principles). Given the popularity of the view that rules-based standards are undesirable, these findings have significant implications for the profession as principles-based ethical standards are discussed. (shrink)

Recent calls have been made to move professional standards to a more principles-based perspective, supposing that emphasizing broad principles would eliminate the legalistic focus that rules may encourage, and accountants’ behavior would be more ethical and uniformly so. However, this supposition has yet to be empirically tested. The AICPA Code of Professional Conduct (Code) provides guidance in both forms: principles and rules. This experiment examines how the form of the Code affects independence judgments in a client acceptance context. We also (...) examine the potential for levels of moral development to influence the effectiveness of the Code.We find that subjects are more likely to consider their independence impaired, and are more likely to reject a questionable audit engagement, when rules-based (principles-based) reasoners are provided with Code rules (principles). Given the popularity of the view that rules-based standards are undesirable, these findings have significant implications for the profession as principles-based ethical standards are discussed. (shrink)

Articles by Lyn Horn and Alison Thompson highlight several points crucial to understanding how our theory figures in wider debates about social justice as well as the particular relevance of our theory for assessing the overall practice of public health (Horn, 2013; Thompson, 2013). We begin with these two articles, first to respond to and concur with many of their central points, and second to set the stage for dealing more efficiently with some points raised in the other articles.

When new drugs are approved by the Food and Drug Administration, the default assumption is that they will be available by prescription only, safe for use exclusively under clinical supervision. The paternalism underlying this default must be interrogated in order to ensure appropriate respect for patient autonomy. Upon closer inspection, prescription requirements are justified when nonprescription status would risk harm to third parties and when a large segment of the population would struggle to exercise their autonomy in using a drug (...) safely and effectively on their own. Although these justifications can support prescription status for many drugs, we propose that reversing the FDA's current default to instead begin with a presumption in favor of over‐the‐counter status is the best way to avoid interference with valid claims of patient autonomy. Under this approach, a range of drug products could be considered for an OTC switch, including oral contraceptives, statins, and HIV‐prevention drugs. (shrink)

: The increasing reliance upon, and perhaps the growing public and professional skepticism about, the special expertise of bioethicists suggests the need to consider the limits of moral expertise. For all the talk about method in bioethics, we, bioethicists, are still rather far off the mark in understanding what we are doing, even when we may be going about what we are doing fairly well. Quite often, what is most fundamentally at stake, but equally often insufficiently acknowledged, are inherently political, (...) essentially contested visions of the most compelling and attractive forms of life for individuals and social organization. The current situation in bioethics parallels similar debates in eighteenth-century jurisprudence, especially Jeremy Bentham's withering critique of the prevalent forms of judicial argument and his own, equally unsuccessful, attempt to develop a decision-making procedure in ethics that would operate on a plane above politics. The risk, both then and now, is that we will fail to appreciate the wide range of reasonable disagreement that will remain past the point of extended reflection and discussion. (shrink)

The New Evil Demon problem has been hotly debated since the case was introduced in the early 1980’s (e.g. Lehrer and Cohen 1983; Cohen 1984), and there seems to be recent increased interest in the topic. In a forthcoming collection of papers on the New Evil Demon problem (Dutant and Dorsch, forthcoming), at least two of the papers, both by prominent epistemologists, attempt to resist the problem by appealing to the distinction between justification and excuses. My primary aim here is (...) to critically evaluate this new excuse maneuver as a response to the New Evil Demon problem. -/- Their response attempts to give us reason to reject the idea that victims of the New Evil Demon have justification for believing as they do. I shall argue that this approach is ultimately unsuccessful, however much of value can be learned from these attempts. In particular, progress in the debate can be made by following those who advance the excuse maneuver and make explicit the connection between epistemic justification and epistemic norms. By doing so, the questions being debated are clarified, as is the methodology being used to attempt to answer them. (shrink)

This paper proposes deep and fundamental structures of communication among persons in a “coexistential” setting. The basic framework for this formalization of communication structures is Leibnizian notions of space and time together with the notion of the Existential Graph by C. S. Peirce and that of the Petri net, more precisely, the occurrence net. The fundamental structures of coexistential communication are then formalized as co-creation of Leibnizian space and time in such a manner that they are used to link the (...) communicated messages, thus establishing the “coexistential atmosphere and field” (“Ba” in Japanese) among the individuals. This framework is then applied to the analysis of theater play communication. Finally, the framework of information edaphology is also introduced to discuss the growth processes of individuals and communities through coexistential communication. (shrink)

Changing social norms has become the preferred approach in global efforts to prevent gender-based violence (GBV). In this article, we trace the rise of social norms within GBV-related policy and practice and their transformation from social processes that exist in the world to beliefs that exist in the minds of individuals. The analytic framework that underpins social norms approaches has been subject to ongoing critical revision but continues to have significant issues in its conceptualisation of power and its sidelining of (...) the political economy. These issues are particularly apparent in the use of individualised measures of social norms that cannot demonstrate causation, and conflation of social norms with culture. Recognising that the pressure to measure may be a key factor in reducing the complexity of the social norms approach, we call for the use of mixed methods in documenting the factors and processes that contribute to GBV and the effectiveness of interventions. As social norms approaches are increasingly prioritised over addressing the non-normative contributors to GBV (such as access to and control over productive resources), awareness of the limitations of social norms approaches is vital. (shrink)

Ongoing global efforts to circumcise adolescent and adult males to reduce their risk of acquiring HIV constitute the largest public health prevention initiative, using surgical means, in human history. Voluntary medical male circumcision (VMMC) programs in Africa have significantly altered social norms related to male circumcision among previously non-circumcising groups and groups that have practiced traditional (non-medical) circumcision. One consequence of this change is the stigmatization of males who, for whatever reason, remain uncircumcised. This paper discusses the ethics of stigma (...) with regard to uncircumcised adolescent males in global VMMC programs, particularly in certain recruitment, demand creation and social norm interventions. Grounded in our own experiences gained while conducting HIV-related ethics research with adolescents in Kenya, we argue that use of explicit or implicit stigma to increase the number of VMMC volunteers is unethical from a public health ethics perspective, particularly in campaigns that leverage social norms of masculinity. Ongoing global efforts to circumcise adolescent and adult males to reduce their risk of acquiring HIV constitute the largest public health prevention initiative, using surgical means, in human history. VMMC programs in Africa have significantly altered social norms related to male circumcision among previously non-circumcising groups and groups that have practiced traditional (non-medical) circumcision. One consequence of this change is the stigmatization of males who, for whatever reason, remain uncircumcised. This paper discusses the ethics of stigma with regard to uncircumcised adolescent males in global VMMC programs, particularly in certain recruitment, demand creation and social norm interventions. Grounded in our own experiences gained while conducting HIV-related ethics research with adolescents in Kenya, we argue that use of explicit or implicit stigma to increase the number of VMMC volunteers is unethical from a public health ethics perspective, particularly in campaigns that leverage social norms of masculinity. (shrink)

We are grateful to the commentators on our article1 for their thoughtful engagement with the ethical and clinical complexity of expanded terminal sedation (ETS) in end-of-life care. We will start by noting some points of common ground, before moving on to the more challenging ways in which TS might be permissibly expanded. First, several commentators pointed out, and we completely concur, that it is important to provide patients with full information about their end-of-life options, including the ‘outcomes, uncertainties and costs (...) of ETS’.2 Where possible, they should be given time to ‘process their feelings and to reflect on how they wish to live in their last few days, weeks or months’.3 Furthermore, where patients receive sedation, it will be critical that they receive appropriate medical and nursing care to prevent physical complications such as pressure ulcers.2 This would be no different from other patients who are in states of reduced consciousness from disease. We acknowledge that there are heightened risks with earlier and more rapid TS, including the potential loss of spiritual and social moments,4 as well as the meaning that can be derived from conscious existential distress.3 However, while these conscious experiences might be valuable to some, others might weigh them less highly against the foreseen …. (shrink)

In this article I argue that the value of epistemic justification cannot be adequately explained as being instrumental to truth. I intend to show that false belief, which is no means to truth, can nevertheless still be of epistemic value. This in turn will make a good prima facie case that justification is valuable for its own sake. If this is right, we will have also found reason to think that truth value monism is false: assuming that true belief does (...) have value, there is more of final epistemic value than mere true belief. (shrink)

Many of the contemporary disagreements regarding privacy are conceptual in nature. They concern the meaning or definition of privacy and the analytic basis of distinguishing privacy rights from other kinds of rights recognized within moral, political, or legal theories. The two main alternatives within this debate include reductionist views, which seek a narrow account of the kinds of invasions or intrusions distinctly involving privacy losses, and anti-reductionist theories, which treat a much broader array of interferences with a person as separate (...) and irreducible kinds of privacy invasions. Other theorists have expressed doubts about the prospects for achieving greater analytical precision even within a fairly expansive anti-reductionist approach. However, a reductionist privacy definition is defended in this article, and its primary theoretical virtues are its ability to unify and explain the insights of several competing definitions and its role in developing an account of privacy rights that is both internally coherent and consistent with a plausible understanding of the theoretical basis for a number of related rights. (shrink)

In "Pursuits of Wisdom," John Cooper brings this crucial question back to life. This marvelous book will shape the way we think about and engage with ancient philosophical traditions.