Objectives—While clinical practice is complicated by many ethical dilemmas, clinicians do not often request ethics consultations. We therefore investigated what triggers clinicians' requests for ethics consultation. Design—Cross-sectional telephone survey.Setting—Internal medicine practices throughout the United States.Participants—Randomly selected physicians practising in internal medicine, oncology and critical care.Main measurements—Socio-demographic characteristics, training in medicine and ethics, and practice characteristics; types of ethical problems that prompt requests for consultation, and factors triggering consultation requests. Results—One hundred and ninety of 344 responding physicians (55%) reported requesting ethics (...) consultations. Physicians most commonly reported requesting ethics consultations for ethical dilemmas related to end-of-life decision making, patient autonomy issues, and conflict. The most common triggers that led to consultation requests were: 1) wanting help resolving a conflict; 2) wanting assistance interacting with a difficult family, patient, or surrogate; 3) wanting help making a decision or planning care, and 4) emotional triggers. Physicians who were ethnically in the minority, practised in communities under 500,000 population, or who were trained in the US were more likely to request consultations prompted by conflict. Conclusions—Conflicts and other emotionally charged concerns trigger consultation requests more commonly than other cognitively based concerns. Ethicists need to be prepared to mediate conflicts and handle sometimes difficult emotional situations when consulting. The data suggest that ethics consultants might serve clinicians well by consulting on a more proactive basis to avoid conflicts and by educating clinicians to develop mediation skills. (shrink)

Not all scientific explanations work by describing causal connections between events or the world's overall causal structure. In addition, mathematicians regard some proofs as explaining why the theorems being proved do in fact hold. This book proposes new philosophical accounts of many kinds of non-causal explanations in science and mathematics.

The practice of nonphysician ethicist-consultants giving ethics advice concerning the appropriate medical treatment of patients in hospitals is a relatively recent development. Although only a minority of hospitals make substantial use of any formal ethics consulting service, the number is growing and apparently will continue to do so. Indeed, at least among urban teaching hospitals, some sort of ethics consulting service is increasingly commonplace.

English summary: Marc Andre Wiegand analyzes the neo-Kantian premises of Gustav Radbruch's legal philosophy.

En dehors de Pascal en France, c'est surtout en Allemagne que tragique et tristesse ont été mis en rapport avant que leur distinction soit largement développée par Walter Benjamin dans son livre sur le drame baroque. L'opposition faite par Benjamin entre le Trauerspiel et la tragédie peut être interprétée comme l'aboutissement et l'achèvement d'une distinction courante dans la philosophie allemande depuis Hegel entre le " tragique " (antique) et le " triste " de la modernité (romantique). Si ces deux termes (...) ne sont pas ressentis en français comme formant un couple de concepts, il n'en va pas de même dans la philosophie et l'esthétique allemandes, où ils apparaissent régulièrement ensemble, exprimant soit une différence de degré (Hegel, Simmel), soit de nature (Nietzsche, Ziegler), soit enfin un rapport de polarité (Benjamin) et où se jouent des rapports différents avec le mythe et l'histoire. C'est un des grands mérites de Benjamin que d'avoir saisi cette polarité entre le tragique et le triste, qui n'avait jamais été formulée explicitement avant lui, et de l'avoir élevée au rang de théorie dans son opposition entre Trauerspiel et tragédie. Pour comprendre en profondeur les implications du concept de Trauerspiel introduit par Benjamin, et du concept de tristesse qui lui est lié, il est nécessaire de se replonger dans la tradition allemande, de connaître le milieu philosophique dans lequel Benjamin a fait ses études, en particulier les discussions autour de la philosophie de l'histoire et de la structure du temps au début du XXe siècle. Toute la pensée de Benjamin s'éclaire alors sous un jour nouveau qui permet de mieux saisir le lien entre ses écrits de jeunesse et sa pensée ultérieure. (shrink)

Despite the fact that there is considerable evidence against the causal efficacy of proximal (short-term) conscious intentions, many studies confirm our commonsensical belief in the efficacy of more distal (longer-term) conscious intentions. In this paper, I address two questions: (i) What, if any, is the difference between the role of consciousness in effective and in non-effective conscious intentions? (ii) How do effective conscious distal intentions interact with unconscious processes in producing actions, and how do non-effective proximal intentions fit into this (...) process? I argue that answers to these questions point to a picture of distal conscious intending as a form of self-programming. The metaphor of ?self-programming? will be elucidated by using a distinction between ?structuring? and ?triggering? causes. Though the self-programming metaphor does not amount to a full theory of conscious intending, I argue that it may be a useful heuristic in developing such a theory. I also argue that the metaphor is phenomenologically plausible. (shrink)

Conflicts of interest are rampant in the American medical community. Today it is not uncommon for doctors to refer patients to clinics or labs in which they have a financial interest (40% of physicians in Florida invest in medical centers); for hospitals to offer incentives to physicians who refer patients (a practice that can lead to unnecessary hospitalization); or for drug companies to provide lucrative give-aways to entice doctors to use their "brand name" drugs (which are much more expensive than (...) generic drugs). In Medicine, Money and Morals, Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change. (shrink)

Clinical Study Agreements can have profound effects both on the protection of human subjects and on the independence of investigators to conduct research with scientific integrity. Sponsors, institutions, and even investigators may fail to give adequate attention to these issues in the negotiation of CSAs. Despite the key role of CSAs in structuring ethically important aspects of research, they remain largely unregulated and unreviewed for adherence to ethical norms. Academic institutions routinely enter into research contracts that fail to meet adequate (...) ethical standards. This is a failing that can have serious consequences.Accordingly, it is necessary that some independent body have the authority both to review research contracts for compliance with norms of subject protection and ethical integrity, and to reject studies that fail to meet ethical standards. Such review should take place prior to the start of research, not later. Because of its expertise and authority, the institutional ethics review board is the appropriate body to undertake such review. Much recent commentary has focused on contractual restrictions on the investigator’s freedom to publish research findings. The Olivieri experience, and that of other investigators, has brought freedom of publication issues into sharp focus. Clinical study agreements also raise a number of other ethical issues relating to human subjects and research integrity, however, including disclosures relating to patient safety, data analysis and reporting, budget, confidentiality, and premature termination of the study. This paper describes the ethical issues at stake in structuring such agreements and suggests ethical standards to guide institutional ethics review. (shrink)

Les premiers travaux réalisés sur les effets du confinement du printemps 2020 sur les enfants ont établi que ceux qui étaient en résidence alternée l’avaient mieux vécu que les autres. L’objectif de cet article est de comprendre pourquoi. À partir de l’enquête Sapris et plus particulièrement du sous-échantillon des enfants âgés de 8-9 ans des cohortes Elfe et Epipage2, nous comparons les conséquences du confinement sur les enfants selon la structure familiale dans laquelle ils vivaient. Continu dans les familles nucléaires, (...) le temps familial est habituellement beaucoup plus fractionné entre les résidences des parents pour les enfants de familles séparées. Le confinement est venu transformer les expériences habituelles du temps familial pour les enfants, aussi bien dans son organisation que dans sa texture. Il a modifié leur cadre de vie ordinaire, en réorganisant leurs occupations au quotidien et en modifiant leurs relations avec leurs parents. En observant particulièrement les différences apparues entre les résidences alternées qui ont continué et celles qui ont été interrompues, nous montrons que si les mouvements réguliers des enfants ont pu constituer une respiration bienvenue pour les différents acteurs concernés, les alternances interrompues ont ouvert des espaces exceptionnels dans lesquels il a été possible de renouer avec des formes passées de continuité familiale. (shrink)

Bajo el título «Utopías, distopías y otras nostalgias», la cuarta edición del Congreso de Pensamiento Interdisciplinar, organizado por alumnos del grado de Filosofía, Política y Economía de la Alianza 4 Universidades, abordó el controvertido fenómeno woke, una supuesta mezcla de izquierda identitaria y progresismo políticamente correcto al que se acusa de promover la censura y la llamada «cultura de la cancelación». Sobre esta cuestión conversaron la escritora y filósofa Elizabeth Duval, la investigadora Ayme Román y el director académico y (...) profesor del Instituto Superior de Sociología, Economía y Política (ISSEP), Miguel Ángel Quintana Paz, en un debate moderado por dos de los alumnos organizadores del congreso, Guzmán Díez e Isabel Rodríguez. (shrink)

Several philosophers have argued that ‘constraints’ constrain (and thereby explain) by virtue of being modally stronger than ordinary laws of nature. In this way, a constraint applies to all possible systems, for a variety of possibility that is broader (that is, more inclusive) than the variety we employ when we say that the ordinary laws of nature apply to all physically possible systems. Explanations by constraint are thus more broadly unifying than ordinary causal explanations. Philosophical examples of good candidates for (...) constraints have heretofore been drawn almost exclusively from fundamental physics. This paper argues for the existence of such constraints (even multiple levels of them) in at least one human science (linguistics), not just in physics. (shrink)

Genocide is a matter of law. It is also a matter of history. Engaging some of the most disturbing responses to the Armenian genocide, Marc Nichanian strikingly reveals the complex role played by law and history in making this and other genocides endure as contentious events. Nichanian's book argues that both law and history fail to contend with the very nature of events for which there is no archive (no documents, no witnesses). Both history and law fail to address (...) the modern reality that events can be—and are now being—perpetrated that _depend_ upon the destruction of the archive, turning monstrous deeds into nonevents. Genocide, this book makes us see, is in one sense the _destruction_ of the archive. It relies on the historiographic perversion. (shrink)

Both individually and as a collection, these essays will promote understanding and provoke further debate amongst students and established scholars alike.

Alexander Pho and Benjamin A. White respond to Nicolas Dixon’s critique of mixed martial arts (MMA) through a ‘companions in innocence’ argument. Taking up a counterexample that Dixon is quick to dismiss, the authors argue that MMA techniques are on a par with the ‘pain-leveraging’ tactics used by cyclists and that pressing for a moral distinction between cycling and MMA leads to absurd conclusions about other practices. So, because cycling is morally permissible, MMA is morally permissible. This companions in innocence (...) argument fails. But cycling can be used to develop a better, though only partial, defense of MMA. (shrink)

Standardly, epistemic peers regarding a given matter are said to be people of equal competence who share all relevant evidence. Alternatively, one can define epistemic peers regarding a given matter as people who are equally likely to be right about that matter. I argue that a definition in terms of likelihood captures the essence of epistemic peerhood better than the standard definition or any variant of it. What is more, a likelihood definition implies the truth of the central thesis in (...) the debate on peer disagreement, the so-called Equal Weight View, according to which we should give the opinions of our peers the same weight we give our own. Adopting a likelihood definition, however, does not end the debate on peer disagreement, because the alleged theoretical alternatives to the Equal Weight View, reinterpreted in the light of a likelihood definition, can in fact be shown to be compatible with this view—though the reinterpreted versions may appear less plausible than the original ones. (shrink)

Inhaltsverzeichnis/Table of Contents: Introduction. Marc SLORS: Epiphenomenalism and Cross-Realization Induction. Michael PAUEN: Is Type Identity Incompatible with Multiple Realization? Sven WALTER: Need Multiple Realizability Deter the Identity-Theorist? Achim STEPHAN: Emergentism, Irreducibility, and Downward Causation. Carl GILLETT: The Varieties of Emergence: Their Purposes, Obligations and Importance. Wim DE MUIJNCK: Causation by Relational Properties. Albert NEWEN & Rimas ČUPLINSKAS: Mental Causation: A Real Phenomenon in a Physicalistic World without Epiphenomenalism or Overdetermination. Bernd LUDWIG: Warum kommen „mentale Ursachen“ physikalischen Erklärungen eigentlich nicht (...) in die Quere? Einige grundsätzliche Überlegungen zur Verwendung des Ausdrucks „A verursacht B“ im Umkreis moderner naturwissenschaftlicher Theorien. Besprechungen/Review Articles. Buchnotizen/Critical Notes. (shrink)

This article is an examination of killing in war in its moral and normative dimension – with attention given to how killing affects the acting agent. The author argues against the commonplace belief – often tacitly held if not consciously asserted – among academics, the general public, and even – if surprisingly – military professionals, that killing, including in a justified war, is always morally wrong – even when legally sanctioned and necessary to avert a greater moral wrong. This critique (...) of the “killing is wrong but in war it is necessary” trope is motivated in part by the large numbers of psychiatric battle casualties (specifically moral injury) suffered during operations in Iraq and Afghanistan, and which have attended military activity throughout history. The article approaches the issue through the field of Christian ethical reflection on just war. In building a moral framework for killing in combat, the article explores a typology of homicide, intention, double effect, love, and whether the attitudinal expectations of just warriors in the Christian tradition is realistic in combat. With this moral framework for killing in hand, this article concludes by drawing a critical distinction between moral injury and moral bruising. (shrink)

The evidence that we get from peer disagreement is especially problematic from a Bayesian point of view since the belief revision caused by a piece of such evidence cannot be modelled along the lines of Bayesian conditionalisation. This paper explains how exactly this problem arises, what features of peer disagreements are responsible for it, and what lessons should be drawn for both the analysis of peer disagreements and Bayesian conditionalisation as a model of evidence acquisition. In particular, it is pointed (...) out that the same characteristic of evidence from disagreement that explains the problems with Bayesian conditionalisation also suggests an interpretation of suspension of belief in terms of imprecise probabilities. (shrink)

Esquisses, plans, documents et photographies présentent l'exposition en cours de construction. Un texte explicatif donne les principales clés de lecture du poème de Rimbaud "Après le déluge", extrait des "Illuminations", et de la scénographie adoptée pour le mettre en scène.

Crise de l'art ou consensus culturel? Aujourd'hui, l'important n'est plus, semble-t-il, que la critique esthetique ait encore a dire sur Josef Beuys mais que le Centre Pompidou puisse faire croire qu'il dit tout de lui. Le culturel, dans son mecanisme institutionnel et mediatique bien huile, apparait comme l'ultime parade que l'ordre social ait su trouver pour conjurer sa peur - ou sa haine - de l'art. Cependant la critique n'a pas a se laisser abuser ni intimider par l'artifice du consensus (...) culturel qui regne actuellement. Il lui revient de continuer a evaluer les oeuvres, pour autant que le jugement sur l'art engage aussi la societe et l'epoque dans lesquelles cet art se deploie. La reflexion esthetique ne se reduit pas au jugement de gout, elle commence avec lui et se poursuit apres lui. (shrink)

A commonly neglected feature of the so-called Equal Weight View, according to which we should give our peers’ opinions the same weight we give our own, is its prima facie incompatibility with the common picture of philosophy as an armchair activity: an intellectual effort to seek a priori knowledge. This view seems to imply that our beliefs are more likely to be true if we leave our armchair in order to find out whether there actually are peers who, by disagreeing (...) with us, force us to revise our beliefs. This article argues that the Equal Weight View should be spelled out in such a way that not only actual peer disagreement requires us to revise our beliefs, but also merely possible peer disagreement. This result is not a reductio ad absurdum of the view. Quite the opposite: it shows that the view is, contrary to appearance, compatible with our common way of doing philosophy. (shrink)

Marc Hauser puts forth the theory that humans have evolved a universal moral instinct, unconsciously propelling us to deliver judgments of right and wrong independent of gender, education, and religion. Combining his cutting-edge research with the latest findings in cognitive psychology, linguistics, neuroscience, evolutionary biology, economics, and anthropology, Hauser explores the startling implications of his provocative theory vis-à-vis contemporary bioethics, religion, the law, and our everyday lives.

Unknown peers create a problem for those epistemologists who argue that we should be conciliatory in cases of peer disagreement. The standard interpretation of ‘being conciliatory’ has it that we should revise our opinions concerning a specific subject matter whenever we encounter someone who is as competent and well informed as we are concerning this subject matter (and thus is our peer) and holds a different opinion. As a consequence, peers whom we have never encountered and who are hence unknown (...) to us are not taken into account. This, however, appears odd; not only because it is an accidental matter which peers we happen to encounter and which not, but also because it would allow people to deliberately isolate themselves from any kind of intellectual exchange on the topic under consideration. The paper argues that we should take the problem of unknown peers seriously, and that disregarding the problem is an instance of the more general mistake of assuming that evidential quality and justified believability can be dealt with separately. Moreover, a solution to the problem of unknown peers is suggested. (shrink)

Modern sovereignty is anthropocentric, constituted and organized by reference to human beings alone. Although a metaphysical assumption, anthropocentrism is of immense practical import, enabling modern states to command loyalty and resources from their subjects in pursuit of political projects. It has limits, however, which are brought clearly into view by the authoritative taboo on taking UFOs seriously. UFOs have never been systematically investigated by science or the state, because it is assumed to be known that none are extraterrestrial. Yet in (...) fact this is not known, which makes the UFO taboo puzzling given the ET possibility. Drawing on the work of Giorgio Agamben, Michel Foucault, and Jacques Derrida, the puzzle is explained by the functional imperatives of anthropocentric sovereignty, which cannot decide a UFO exception to anthropocentrism while preserving the ability to make such a decision. The UFO can be "known" only by not asking what it is. (shrink)

Research shows that commitment-based interventions are among the most effective strategies to encourage pro-environmental behaviors, but methods to elicit commitments from a large number of individuals are often costly and unrealistic. Predictions requests—a commitment-type strategy—are an effective mass-communication strategy and have the potential to influence pro-environmental behavior among large audiences. This research is the first to demonstrate that prediction requests in a consumer behavior context influence preference for environmentally friendly products. In addition, this research examines the role of individual and (...) contextual factors in influencing the efficacy of prediction requests. Study 1 shows that exposure to an advertisement with a prediction request leads to increased preferences for environmentally sustainable household cleaning products, compared to a control advertisement, and that this effect is greater when the prediction request is paired with an audience cue . Study 2 indicates that the effect of prediction requests on preference for sustainable products is greater for individuals with interdependent self-construal. Substantive implications and directions for future research are discussed. (shrink)

Our ability to acknowledge and recognise our own identity - our 'self' - is a characteristic doubtless unique to humans. Where does this feeling come from? How does the combination of neurophysiological processes coupled with our interaction with the outside world construct this coherent identity? We know that our social interactions contribute via the eyes, ears etc. However, our self is not only influenced by our senses. It is also influenced by the actions we perform and those we see others (...) perform. Our brain anticipates the effects of our own actions and simulates the actions of others. In this way, we become able to understand ourselves and to understand the actions and emotions of others. -/- This book is the first to describe the new field of 'Motor Cognition' - one to which the author's contribution has been seminal. Though motor actions have long been studied by neuroscientists and physiologists, it is only recently that scientists have considered the role of actions in building the self. How consciousness of action is part of self-consciousness, how one's own actions determine the sense of being an agent, how actions performed by others impact on ourselves for understanding others, differentiating ourselves from them and learning from them: these questions are raised and discussed throughout the book, drawing on experimental, clinical, and theoretical bases. -/- The advent of new neuroscience techniques, like neuroimaging and direct electrical brain stimulation, together with a renewal of behavioral methods in cognitive psychology, provide new insights into this area. Mental imagery of action, self-recognition, consciousness of actions, imitation can be objectively studied using these new tools. The results of these investigations shed light on clinical disorders in neurology, psychiatry and in neuro-development. -/- This is a major new work that will lay down the foundations for the field of motor cognition. (shrink)