The Ethics of Parenthood argues for original views about the right to raise one's biological children, about paternalism, about reacting differently to bad behavior because the wrongdoer is "only a child," about what raising a child requires, and about the obligations that parents and children have after the children are grown.

Parents whose children will become adults are expected to help them do so, as opposed to only keeping them alive while they manage it on their own. The parental help must respect the child's standing as a separate individual: our children aren't ours to shape to our design, even if our aim is to help them flourish. But then how are we to raise our children with respect for their individuality? According to Matthew Clayton, doing so requires refraining from attempting (...) to provide our child with any values that reasonable persons would dispute. According to Harry Brighouse and Adam Swift, it doesn't require that: parents have a right to try to instil values, including disputable ones, because they must have this right if families are to enjoy ‘family relationship goods’. I argue against Clayton's position, and against Brighouse and Swift's. I introduce a different approach, and flesh it out in light of a difficulty it faces. I then return to the initial problem, identifying some ways in which the approach I've offered explains how to raise one's child with respect. (shrink)

This book is the most comprehensive, integrated explanatory account yet published of the properties of question formations and their variation across languages. It makes an important contribution to the current debate over whether syntax should be understood derivationally, arguing that the best model of language is one in which sentences are constructed in a series of operations that precede or follow each other in time. The central problem it addresses is the nature of the difference between languages in which all (...) wh-words move overtly to a clause-initial position ; languages in which one wh-phrase moves per clause but all others remain in situ ; and languages in which there is no overt movement at all. Professor Richards focuses on the nature of syntactic movement in order to see what this reveals about the syntactic derivation. He considers the nature of interactions between movement operations and investigates the behaviour of multiple overt wh-movement, scrambling, cliticization, and object shift. His general conclusions about the relationship between movement and multiple specifiers follow straightforwardly from basic principles of Shortest Move and Shortest Attract. He develops a PF-imposed well-formedness condition on movement chains, which allows for the development of theories of anti-agreement, the that-trace effect, and the conditions on participial agreement in Romance, among other phenomena. He defends the claim that well-formed dependencies can improve the status of ill-formed dependencies created later in the derivation, illustrating the explanatory power, under certain structural conditions, of his Principle of Minimal Compliance. He uses data on the locality of wh-movement to argue that the Principle of Minimal Compliance is responsible for a number of the apparent distinctions between overt and covert movement. This book will interest syntacticians at graduate level and above as well as linguistic theorists concerned with the syntax-semantics interface. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

This paper offers a way to construe personality as the relatively stable hierarchy of one's desires: the fact that one prefers solitude to competition , finds dishonesty more aversive than arrogance , and so on. Several measures of the intensity of a desire are discussed: the alacrity with which one seeks to satisfy it, the persistence in one's efforts to do so, and other displays of one's willingness to sacrifice for its satisfaction. A method is offered for distinguishing preferences which (...) are features of personality from others which are insufficiently stable or otherwise to be explained. Finally the usefulness of this conception for moral theory is explored. Specifically, I argue that those attracted to utilitarianism have here an unusually congenial way of thinking about moral character, and a way to meet certain leading objections to their view. (shrink)

Context Opioid treatment agreements (OTAs) are documents that clinicians present to patients when prescribing opioids that describe the risks of opioids and specify requirements that patients must meet to receive their medication. Notwithstanding a lack of evidence that OTAs effectively mitigate opioids’ risks, professional organizations recommend that they be implemented, and jurisdictions increasingly require them. We sought to identify the jurisdictions that require OTAs, how OTAs might affect the outcomes of lawsuits that arise when things go wrong, and instances in (...) which the law permits flexibility for clinicians and health care institutions to adopt best practices. -/- Methods We surveyed the laws and regulations of all 50 states and the District of Columbia to identify which jurisdictions require the use of OTAs, the circumstances in which OTA use is mandatory, and the terms OTAs must include (if any). We also surveyed criminal and civil judicial decisions in which OTAs were discussed as evidence on which a court relied to make its decision to determine how OTA use influences litigation outcomes. -/- Findings Results show that a slight majority (27) of jurisdictions now require OTAs. With one exception, the jurisdictions’ requirements for OTA use are triggered at least in part by long-term prescribing. There is otherwise substantial variation and flexibility within OTA requirements. Results also show that even in jurisdictions where OTA use is not required by statute or regulation, OTA use can inform courts’ reasoning in lawsuits involving patients or clinicians. Sometimes, but not always, OTA use legally protects clinicians from liability. -/- Conclusions -/- Our results show that OTA use is entwined with legal obligations in various ways. Clinicians and health care institutions should identify ways for OTAs to enhance clinician–patient relationships and patient care within the bounds of relevant legal requirements and risks. (shrink)

What would make it the right time for you to die, or the wrong one? In particular, could it be the right time for you to die even if your loved ones want to make the sacrifices needed to prolong your life, because that would cost them too dearly? The worry is that it would be selfish to permit these sacrifies, and wrong for that reason. I think it matters that the sacrifies would occur within a relationship of mutual devotion, (...) and I try to say how it matters. In particular, I argue against some fairly simple views of what constitutes impermissible selfishness in this context, and in favor of approaching such decisions in a different way. (shrink)

Prospective parents centainly ought to avoid creating a child whose life would be so terrible that no one should have to live it. However, those who sought to avoid it would risk making a serious moral error, if their reasoning did follow a certain pattern.The error would be failure to respect autonomy, which includes a claim to judge for oneself whether one's life is worth living. I explain how this applies to a decision about whether someone is to exist at (...) all, and what difference it would make if prospective parents paid autonomy the respect it merits. (shrink)

While working with police in the U.K. and in many countries in Europe, I encountered instances of police officers in the grip of dilemmas about misplaced, misguided, divided, and conflicting loyalt...

Inference to the best explanation (IBE) is the principle of inference according to which, when faced with a set of competing hypotheses, where each hypothesis is empirically adequate for explaining the phenomena, we should infer the truth of the hypothesis that best explains the phenomena. When our theories correctly display this principle, we call them our ‘best’. In this paper, I examine the explanatory role of mathematics in our best scientific theories. In particular, I will elucidate the enormous utility of (...) mathematical structures. I argue from a reformed indispensability argument that mathematical structures are explanatorily indispensable to our best scientific theories. Therefore, IBE scientific realism entails mathematical realism. I develop a naturalistic, neo-Quinean ontology, which grounds physical and mathematical entities in structures. Mathematical structures are the truthmakers for the entities of our quantificational discourse. I also develop an ‘ontic conception’ of explanation, according to which explanations exist in the world, whether or not we discover and model them. I apply the ontic account to mathematical structures, arguing that these structures are the explanations for particles, forces, and even the conservation laws of physics. As such, mathematical structures provide the fundamental grounding for ontological commitment. I conclude by reviewing the evidence from modern physics for the existence of mathematical structures. (shrink)