Institutional ethics committees (IECs) are part of a growing phenomenon in the American health care system. Although a major force driving hospitals to establish IECs is the desire to resolve difficult clinical dilemmas in a quick and systematic way, in this paper we argue that such a goal is naive and, to some extent, misguided. We assess the growing trend of these committees, analyse the theoretical assumptions underlying their establishment, and evaluate their strengths and shortcomings. We show how the 'medical (...) consultation' model is often inappropriately applied to IECs and suggest that IECs must operate under a different framework. Finally, we argue that IECs should be valued for the process they facilitate, and not for the product that they are, often unreasonably, expected to deliver. (shrink)

The papers collected in this volume are the results of a conference held at the Center for Continuing Education of the University of Chicago. Recognizing the convergence of interests among philosophers concerned with philosophical psychology and philosophically oriented psychologists, a number of philosophers and psychologists were brought together at the conference. The idea was a good one, but like so many interdisciplinary conferences, the results are disappointing. There is a fine historical introduction by Mischel in which he sketches the various (...) ways in which philosophy and psychology have been interconnected. The general theme is that conceptual and empirical investigations have developed in response to each other. The introduction nicely sets the scene for the possibility of contemporary cooperation. In the main, however, each of the contributors presents his thoughts on what he takes to be the key issues, but rarely speaks directly to issues raised by the other contributors. Toulmin, Peters, and Melden collectively present and further develop themes that are being currently explored in the philosophy of mind. Arnold, Atkinson, Campbell, and Madison represent a variety of approaches from the perspective of psychology. Ironically, some of the psychologists display more understanding of phenomenological trends in recent psychology than of those manifest in recent analytic philosophy.--R. J. B. (shrink)

The topic for this volume is a "natural" for the Minnesota Studies. Some of the most important issues concerning both the philosophy and history of science have been in the foreground of discussion for the past few years. Feigl's introductory paper "Beyond Peaceful Coexistence" sets the stage for a confrontation that never quite takes place here. Ernan McMullin's "The History and Philosophy of Science: A Taxonomy" is valuable in helping to sort out the issues by clarifying different types and uses (...) of the history and philosophy of science. Arnold Thackray raises a number of interesting meta-questions concerning the historiographic assumptions that have characterized recent history of science. There are several papers concerned with the issues of hermeticism [[sic]] that have been raised by F. A. Yates' work and a reassessment of philosophical and historical issues raised by the development of relativistic electrodynamics. Altogether this is a fine collection, even though so many different issues are explored that there is little sense of clear focus.--R. J. B. (shrink)

Few residency training programmes explicitly require substantive exposure to issues in medical ethics and fewer still have a formal curriculum in this area. Traditional undergraduate medical ethics courses teach preclinical students to identify ethical issues and analyse them at a theoretical level. Residency training, however, is the ideal time to establish the critical behavioural link which makes ethics truly useful in clinical medicine. The General Internal Medicine Residency Training Program at Rhode Island Hospital has developed an integrated, three-year curriculum with (...) the goals of helping residents to perceive ethical issues in clinical practice, to utilise basic philosophical principles in resolving ethical dilemmas and to communicate these issues clearly and sensitively to patients. The curriculum has been well received by residents and has had a hospital-wide impact. We believe that training residents in medical ethics and communication skills is an effective approach to developing physicians' humane qualities. (shrink)

Formal training in clinical ethics must become a central part of residency curricula to prepare practitioners to manage the ethical dimensions of patient care. Residency educators must ground their teaching in an understanding of the conceptual, biomedical, and psychosocial aspects of the important ethical issues that arise in that field of practice. Four aspects of professional competence in clinical ethics provide a useful framework for curricular planning. The physician should learn to: (1) recognize ethical issues as they arise in clinical (...) care and identify hidden values and unacknowledged conflicts; (2) think clearly and critically about these issues in ways that lead to ethically justifiable courses of action; (3) apply those practical skills needed to implement an ethically justifiably course of action; and (4) judge when the management of a clinical situation requires consultation with individuals or institutional bodies with additional expertise or authority. We argue that these practical goals can be accomplished with a relatively modest emphasis on the theoretical aspects of medical ethics. (shrink)

Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

In real-time, Twitter strongly imprints world events, popular culture, and the day-to-day; Twitter records an ever growing compendium of language use and change; and Twitter has been shown to enable certain kinds of prediction. Vitally, and absent from many standard corpora such as books and news archives, Twitter also encodes popularity and spreading through retweets. Here, we describe Storywrangler, an ongoing, day-scale curation of over 100 billion tweets containing around 1 trillion 1-grams from 2008 to 2020. For each day, we (...) break tweets into 1-, 2-, and 3-grams across 150+ languages, record usage frequencies, and generate Zipf distributions. We make the data set available through an interactive time series viewer, and as downloadable time series and daily distributions. We showcase a few examples of the many possible avenues of study we aim to enable including how social amplification can be visualized through ‘contagiograms’. (shrink)

We define and study a new restricted consistency notion RCon ∗ for bounded arithmetic theories T 2 j . It is the strongest ∀ Π 1 b -statement over S 2 1 provable in T 2 j , similar to Con in Krajíček and Pudlák, 29) or RCon in Krajı́ček and Takeuti 107). The advantage of our notion over the others is that RCon ∗ can directly be used to construct models of T 2 j . We apply this by (...) proving preservation theorems for theories of bounded arithmetic of the following well-known kind: The ∀ Π 1 b -separation of bounded arithmetic theories S 2 i from T 2 j is equivalent to the existence of a model of S 2 i which does not have a Δ 0 b -elementary extension to a model of T 2 j . More specific, let M ⊨ Ω 1 nst denote that there is a nonstandard element c in M such that the function n ↦ 2 log c is total in M . Let BLΣ 1 b be the bounded collection schema for Σ 1 b -formulas. We obtain the following preservation results: the ∀ Π 1 b -separation of S 2 i from T 2 j is equivalent to the existence of 1. a model of S 2 i +Ω 1 nst which is 1 b -closed w.r.t. T 2 j , 2. a countable model of S 2 i + BLΣ 1 b without weak end extensions to models of T 2 j. (shrink)

Anyone who aims to translate Hegel into readable English should bear in mind what he said in an early essay, viz. that before the living spirit which dwells in a philosophy can reveal itself it must be brought to birth by a kindred spirit. His approach to Hegel will therefore be sympathetic and in order to grasp the full import of what he is saying will try to think along with him, will try to become, as G.R.G. Mure said, an (...) actor in the dialectic. Then Hegel will be no more difficult to read in English than in German. The difficulties associated with his style and terminology are, in my opinion, exaggerated. Professor James Doull rightly says that just because Hegel’s terminology is thoroughly systematic, it is intelligible directly in a given passage to one who is at home in it. Differences in vocabulary and syntax are no barrier to the adequate expression of philosophic truth. In this connection it would be interesting and perhaps amusing if we could have Hegel’s comments on the biassed views of his Dutch disciple G.J.P.J. Bolland who founded a Hegelian school in Leiden at the beginning of this century. In a collection of his sayings occurs the following: “Honour to whom honour is due. Great is the spirit of Hegel - but in-the first decade of the twentieth century pure reason speaks the language of Holland and Bolland.” In a correspondence with Francis Sedlak in 1911 he stated that “even the language of Hegel is inferior to Dutch” and referred to English as a “semi-barbarous language in which the finest things cannot be said.”. (shrink)

Biologists, historians, lawyers, art historians, and literary critics all voice arguments in the critical dialogue about what constitutes evidence in research and scholarship. They examine not only the constitution and "blurring" of disciplinary boundaries, but also the configuration of the fact-evidence distinctions made in different disciplines and historical moments the relative function of such concepts as "self-evidence," "experience," "test," "testimony," and "textuality" in varied academic discourses and the way "rules of evidence" are themselves products of historical developments. The essays and (...) rejoinders are by Terry Castle, Lorraine Daston, Carlo Ginzburg, Ian Hacking, Mark Kelman, R. C. Lewontin, Pierre Vidal-Naquet, Mary Poovey, Donald Preziosi, Simon Schaffer, Joan W. Scott, Eve Kosofsky Sedgwick, and Barbara Herrnstein Smith. The critical responses are by Lauren Berlant, James Chandler, Jean Comaroff, Arnold I. Davidson, Harry D. harootunian, Elizabeth Helsinger, Thomas C. Holt, Francoise Meltzer, Robert J. Richards, Lawrence Rothfield, Joel Snyder, Cass R. Sunstein, and William Wimsatt. (shrink)

Since the Harvard Committees bold and highly successful attempt to redefine death in 1968 (Harvard Ad Hoc committee, 1968), multiple controversies have arisen. Stimulated by several factors, including the inherent conceptual weakness of the Harvard Committees proposal, accumulated clinical experience, and the incessant push to expand the pool of potential organ donors, the lively debate about the definition of death has, for the most part, been confined to a relatively small group of academics who have created a large body of (...) literature of which this issue of the Journal of Medicine and Philosophy is an example. Law and public policy, however, have remained essentially unaffected. This paper will briefly review the multiple controversies about defining death in an attempt to explain why they have and will remain unresolved in the academic community and have even less chance of being understood and resolved by politicians, legislators, and the general public. Considering this, we will end by suggesting the probable course of public policy and clinical practice in the decades ahead. (shrink)

We provide a justification for political liberalism’s Reciprocity Principle, which states that political decisions must be justified exclusively on the basis of considerations that all reasonable citizens can reasonably be expected to accept. The standard argument for the Reciprocity Principle grounds it in a requirement of respect for persons. We argue for a different, but compatible, justification: the Reciprocity Principle is justified because it makes possible a desirable kind of political community. The general endorsement of the Reciprocity Principle, we will (...) argue, helps realize joint political rule and relationships of civic friendship. The main obstacle to the realization of these values is the presence of reasonable disagreement about religious, moral, and philosophical issues characteristic of liberal societies. We show the Reciprocity Principle helps to overcome this obstacle. (shrink)

One way of increasing the supply of vital organs without violating the dead donor rule is to declare death on cardiopulmonary criteria after withdrawing life support. The question then is how quickly death may be declared.

Philosophy &Public Affairs, Volume 47, Issue 1, Page 72-103, Winter 2019.

One way of increasing the supply of vital organs without violating the dead donor rule is to declare death on cardiopulmonary criteria after withdrawing life support. The question then is how quickly death may be declared.

R. J. Hankinson traces the history of ancient Greek thinking about causation and explanation, from its earliest beginnings through more than a thousand years to the middle of the first millennium of the Christian era. He examines ways in which the Ancient Greeks dealt with questions about how and why things happen as and when they do, about the basic constitution and structure of things, about function and purpose, laws of nature, chance, coincidence, and responsibility.

Political liberals ask citizens not to appeal to certain considerations, including religious and philosophical convictions, in political deliberation. We argue that political liberals must include a demanding requirement of intellectual modesty in their ideal of citizenship in order to motivate this deliberative restraint. The requirement calls on each citizen to believe that the best reasoners disagree about the considerations that she is barred from appealing to. Along the way, we clarify how requirements of intellectual modesty relate to moral reasons for (...) deliberative restraint. And we argue against attempts to weaken our requirement of intellectual modesty by emphasizing those moral reasons. (shrink)

Psychopaths continue to be demonised by the media and estimates suggest that a disturbing percentage of the population has psychopathic tendencies. This timely and controversial new book summarises what we already know about psychopathy and antisocial behavior and puts forward a new case for its cause - with far-reaching implications. Presents the scientific facts of psychopathy and antisocial behavior. Addresses key questions, such as: What is psychopathy? Are there psychopaths amongst us? What is wrong with psychopaths? Is psychopathy due to (...) nature or nurture? And can we treat psychopaths? Reveals the authors' ground-breaking research into whether an underlying abnormality in brain development leaves psychopaths with an inability to feel emotion or fear. The resulting theory could lead to early diagnosis and revolutionize the way society, the media and the state both views and contends with the psychopaths in our midst. (shrink)