© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

This book draws on fields as diverse as biochemistry, physiology, pharmacology, psychology, psychiatry, and ethology, to form a fascinating synthesis of information on the nature of fear and of panic and anxiety disorders. Dr. Marks offers both a detailed discussion of the clinical aspects of fear-related syndromes and a broad exploration of the sources and mechanisms of fear and defensive behavior. Dealing first with normal fear, he establishes a firm, scientific basis for understanding it. He then presents a thorough analysis (...) of the development, symptoms and treatment of fear-related syndromes. Phobic and obsessive-compulsive disorders are examined in detail. The book is illustrated with examples of fear and defensive behavior in other living organisms. By drawing provocative analogies between animal and human behavior, it sheds new light on the origins of fears, phobias, and obsessive-compulsive problems, as well as on their treatment by drugs and psychological means. Clinical psychologists, ethologists, and anyone interested in the mechanisms of behavior will be fascinated by this authoritative study. The text is intriguing and informative, and the bibliography of over 2,100 entries makes it an invaluable reference. (shrink)

This paper explores the idea that a name should be associated with a reference condition, rather than with a referent, just as a sentence should be associated with a truth condition, rather than with a truth value. The suggestion, to be coherent, needs to be set in a freelogical framework (following Burge). A prominent advantage of the proposal is that it gives a straight-forward semantics for empty names. A problem discussed in this paper is that of reconciling the rigidity of (...) names with seeming truths of the form “there might have been such a planet as Vulcan.”. (shrink)

How successful are Fregean theories compared with guise-theoretic Millian theories in dealing with a range of problematic propositional attitude ascriptions? The range considered is roughly that of Paderewski puzzles and their relatives. I argue that these fall into two categories: in one category, the Fregean theory looks to be under pressure from guise-theoretic rivals, though I argue that Fregeans can, to advantage, borrow some guise-theoretic machinery. Concerning the other category, which includes Kripke's two Paderewski puzzles, I argue that these puzzles (...) are neutral between Fregean and Millian approaches; more generally, they have no direct bearing on semantics. Their solution requires correct views about rationality, self-knowledge and transparency. (shrink)

The paper explores the severity of the problem of soil erosion and a variety of approaches to the problem. The typology of approaches includes doing nothing, individual party litigation, the state's invocation of public trust doctrine, and the state's exercise of its police power. The Reinvest in Minnesota Program reflects the state's exercise of its police power and addresses the problem of soil erosion by retiring marginal land from crop production through conservation easements. Programs such as Reinvest in Minnesota also (...) reflect a certain ethic about the land. (shrink)

Drawing on early work on ethical leadership, we argue that when leaders engage in leader moral hypocrisy (i.e., ethical promotion without ethical demonstration), followers can experience psychological reactance—a negative response to a perceived restriction of freedom—which can have negative downstream consequences. In a survey of employee–manager dyads (study 1), we demonstrate that leader moral hypocrisy is positively associated with follower psychological reactance, which increases follower deviance. In two subsequent laboratory experiments, we find similar patterns of results (study 2) and explore (...) potential alternative mechanisms (study 3). We demonstrate in a final experiment with working adults that the relationship between leader moral hypocrisy and psychological reactance is partly explained by increased perceptions of a leader’s use of power (study 4). We discuss the implications of our findings and advocate for further understanding of the risks associated with psychological reactance in response to leaders and other workplace situations. (shrink)

Though scholarly consensus has long associated Beowulf with the Bear's Son folk tradition , many have felt that the Grendel episode comes closer to an Irish folktale called “the Hand and the Child.” Wilhelm Grimm first noticed the similarities between the episode and Irish narratives in which a hero defends a hall against a monstrous attacker, and variants of the folktale were adduced as analogues a century ago by Ludwig Laistner, Stopford Brooke, and Albert Stanborough Cook. In 1903 George Lyman (...) Kittredge collected variants, gave the story a name, and briefly discussed its structure and similarity to the poem. This study remains important for both sides in the subsequent debate because, while showing that the variants represented a widespread and consistent pattern, Kittredge expressed skepticism over its relationship to Beowulf. Raymond W. Chambers endorsed that verdict in the second edition of his Beowulf: An Introduction. (shrink)

Recent studies on colonial discourse have demonstrated that the speeches of freedom activists in colonial Africa served as sites of resistance. One key text type that has, however, been neglected in the critical literature on the discourse of emancipation is the national anthem of colonised states. To fill this gap, the present study examines the discursive enactment of resistance in the anthems of former British colonies in Africa, focusing on the transitivity framework in systemic functional linguistics. Semantic and structural parallelisms (...) across the anthems are identified as evidence of a collective memory, a cultural trauma reconfigured and reconstituted to reclaim a positive identity and project a desirable postcolonial future. They also foreground the motif of freedom and legitimise the African as the owner of the reclaimed territory. These procedures articulate an anti-imperialist and anti-establishment stance that provides hope, strength and encouragement to an oppressed group. This paper extends the scholarship on the discursive enactment of resistance by focusing attention on a context underexplored in the literature. It also illustrates the (re)construction of relevant ideologies in national anthems to stimulate desirable, progressive attitudes among citizenry in African states. The paper is furthermore significant to decolonial research and highlights the role of language in political decolonisation processes. (shrink)

This state-of-the-science volume brings together an array of leading authorities to comprehensively review theory and research in this burgeoning area.

Historically associated with military service, conscientious objection has become a significant phenomenon in health care. Mark Wicclair offers a comprehensive ethical analysis of conscientious objection in three representative health care professions: medicine, nursing and pharmacy. He critically examines two extreme positions: the 'incompatibility thesis', that it is contrary to the professional obligations of practitioners to refuse provision of any service within the scope of their professional competence; and 'conscience absolutism', that they should be exempted from performing any action contrary (...) to their conscience. He argues for a compromise approach that accommodates conscience-based refusals within the limits of specified ethical constraints. He also explores conscientious objection by students in each of the three professions, discusses conscience protection legislation and conscience-based refusals by pharmacies and hospitals, and analyzes several cases. His book is a valuable resource for scholars, professionals, trainees, students, and anyone interested in this increasingly important aspect of health care. (shrink)

Spiritual Traditions and the Virtues provides a philosophical appreciation of the spiritual life, showing how a certain conception of spiritual well-being, rooted in Thomas Aquinas's account of the virtues, can generate a distinctive vision of human life, and the possibilities for spiritual fulfilment.

There are many different kinds of libertarianism. The first is right libertarianism, which received its most powerful expression in Robert Nozick’s Anarchy, State and Utopia (1974), a book that still sets the baseline for discussions of libertarianism today. The second, I will call faux libertarianism. For reasons I will explain in this paper, most ‘man-on-the-street’ libertarians and most politicians who claim to be libertarians are actually this kind of libertarian. And third, there is left libertarianism, which is what I shall (...) spend most of this paper explicating. But I will not simply be surveying the views of those who identify as left libertarians and put this forth as if I were engaged in an exegetical exercise. Instead, what I shall set forth is a kind of manifesto, a statement of why I consider myself a left libertarian, one that takes this approach to political morality well beyond where it was left around the end of the last century by the previous generation of left libertarians. My hope is to provide those who find certain left libertarian ideas attractive a guide by which they can explain and harmonise their own views, recognise left libertarianism as a distinct comprehensive political doctrine, and feel more open to identify themselves as left libertarian too. (shrink)

Recognition of conscientious objection seems reasonable in relation to controversial and contentious issues, such as physician assisted suicide and abortion. However, physicians also advance conscience‐based objections to actions and practices that are sanctioned by established norms of medical ethics, and an account of their moral force can be more elusive in such contexts. Several possible ethical justifications for recognizing appeals to conscience in medicine are examined, and it is argued that the most promising one is respect for moral integrity. It (...) is also argued that an appeal to conscience has significant moral weight only if the core ethical values on which it is based correspond to one or more core values in medicine. Finally, several guidelines pertaining to appeals to conscience and their ethical evaluation are presented. (shrink)

In industries populated by small and medium enterprises, managers' good intentions frequently incur barriers to superior environmental performance (Tilley, Bus Strategy Environ 8:238-248, 1999). During the period when the U.S. wine industry was beginning to promote voluntary adoption of sound environmental practices, we examined managers' attitudes, norms, and perceptions of stakeholder pressures to assess their intentions to implement environmental management programs (EMP). We found that managers within the simple structures of these small and medium firms are responsive to attitudes, norms, (...) and pressures from internal stakeholders and that voluntarily established EMP increased the success of firms' implementation of energy conservation and recycling practices. Applications of our findings to future research on small and medium enterprises as well as direct practical applications of our results are discussed. (shrink)

For years now, unionization has been under vigorous attack. Membership has been steadily declining, and with it union bargaining power. As a result, unions may soon lose their ability to protect workers from economic and personal abuse, as well as their significance as a political force. In the Name of Liberty responds to this worrying state of affairs by presenting a new argument for unionization, one that derives an argument for universal unionization in both the private and public sector from (...) concepts of liberty that we already accept. In short, In the Name of Liberty reclaims the argument for liberty from the political right, and shows how liberty not only requires the unionization of every workplace as a matter of background justice, but also supports a wide variety of other progressive policies. (shrink)

The persistent failure of public schooling in low-income communities constitutes one of our nation's most pressing civil rights and social justice issues. Many school reformers recognize that poverty, racism, and a lack of power held by these communities undermine children's education and development, but few know what to do about it. A Match on Dry Grass argues that community organizing represents a fresh and promising approach to school reform as part of a broader agenda to build power for low-income communities (...) and address the profound social inequalities that affect the education of children. Based on a comprehensive national study, the book presents rich and compelling case studies of prominent organizing efforts in Chicago, New York City, Los Angeles, Denver, San Jose, and the Mississippi Delta. The authors show how organizing groups build the participation and leadership of parents and students so they can become powerful actors in school improvement efforts. They also identify promising ways to overcome divisions and create the collaborations between educators and community residents required for deep and sustainable school reform. Identifying the key processes that create strong connections between schools and communities, Warren, Mapp, and their collaborators show how community organizing builds powerful relationships that lead to the transformational change necessary to advance educational equity and a robust democracy. (shrink)

Exploitation and Economic Justice in the Liberal Capitalist State offers the first new, liberal theory of economic justice to appear in more than 30 years. The theory presented is designed to offer an alternative to the most popular liberal egalitarian theories of today and aims to be acceptable to both right and left libertarians too.

What is conscientious objection? -- Should conscientious objectors be accommodated? -- Assessing objectors' beliefs and reasons -- Accommodation and conscientious provision.

Recent work in experimental philosophy has shown that people are more likely to attribute intentionality, knowledge, and other psychological properties to someone who causes a bad side effect than to someone who causes a good one. We argue that all of these asymmetries can be explained in terms of a single underlying asymmetry involving belief attribution because the belief that one’s action would result in a certain side effect is a necessary component of each of the psychological attitudes in question. (...) We argue further that this belief-attribution asymmetry is rational because it mirrors a belief-formation asymmetry, and that thebelief-formation asymmetry is also rational because it is more useful to form some beliefs than others. (shrink)

A US Department of Health and Human Services Final Rule, Protecting Statutory Conscience Rights in Health Care, and a proposed bill in the British House of Lords, the Conscientious Objection Bill, may well warrant a concern that—to borrow a phrase Daniel Callahan applied to self-determination—conscientious objection in health care has “run amok.” Insofar as there are no significant constraints or limitations on accommodation, both rules endorse an approach that is aptly designated “conscience absolutism.” There are two common strategies to counter (...) conscience absolutism and prevent conscientious objection in medicine from running amok. One, non-toleration, is to decline to accommodate physicians who refuse to provide legal, professionally accepted, clinically appropriate medical services within the scope of their clinical competence. The other, compromise or reasonable accommodation, is to impose constraints on accommodation. Several arguments for non-toleration are critically analyzed, and I argue that none warrants its acceptance. I maintain that non-toleration is an excessively blunt instrument to prevent conscientious objection in medicine from running amok. Instead, I defend a more nuanced contextual approach that includes constraints on accommodation. (shrink)

We show that the fundamental legal structure of a well-written financial contract follows a state-transition logic that can be formalized mathematically as a finite-state machine (specifically, a deterministic finite automaton or DFA). The automaton defines the states that a financial relationship can be in, such as “default,” “delinquency,” “performing,” etc., and it defines an “alphabet” of events that can trigger state transitions, such as “payment arrives,” “due date passes,” etc. The core of a contract describes the rules by which different (...) sequences of events trigger particular sequences of state transitions in the relationship between the counterparties. By conceptualizing and representing the legal structure of a contract in this way, we expose it to a range of powerful tools and results from the theory of computation. These allow, for example, automated reasoning to determine whether a contract is internally coherent and whether it is complete relative to a particular event alphabet. We illustrate the process by representing a simple loan agreement as an automaton. (shrink)

For a long time, economic growth has been seen as the most promising source of funds to use toward reducing economic inequality, as well as a necessity if we are aiming at achieving full employment. But one of the most troubling aspects of the recent exponential rise in economic inequality is that this rise has occurred despite continued economic growth. Increases in national income have gone almost exclusively to the super-rich, while real wages for almost everybody else have stagnated or (...) even declined. And while the unemployment rate dropped significantly before the coronavirus pandemic hit, good, permanent, high-wage jobs with benefits had by then often been replaced by temporary, part-time, low-wage jobs without benefits, leaving even the employed feeling economically insecure. And now, of course, unemployment is again skyrocketing, and it is unclear how long it might take to come down. As a result, we have now arrived at a point of reckoning: can we continue to believe that liberal capitalism is the most promising combination of economic and political ideologies for securing a prosperous and just future? If not, what might replace it? Is the problem capitalism, or is it liberalism? Are we up against economic forces that we cannot influence or control, or is it our political will and the liberal values we endorse that are being tested? This paper looks at all these questions, and suggests how we might think about the prospects for a liberal future. (shrink)

Evidence-based medicine (EBM) has thus far failed to adequately account for the appropriate incorporation of other potential warrants for medical decision making into clinical practice. In particular, EBM has struggled with the value and integration of other kinds of medical knowledge, such as those derived from clinical experience or based on pathophysiologic rationale. The general priority given to empirical evidence derived from clinical research in all EBM approaches is not epistemically tenable. A casuistic alternative to EBM approaches recognizes that five (...) distinct topics, 1) empirical evidence, 2) experiential evidence, 3) pathophysiologic rationale, 4) patient goals and values, and 5) system features are potentially relevant to any clinical decision. No single topic has a general priority over any other and the relative importance of a topic will depend upon the circumstances of the particular case. The skilled clinician must weigh these potentially conflicting evidentiary and non-evidentiary warrants for action, employing both practical and theoretical reasoning, in order to arrive at the best choice for an individual patient. (shrink)

Previous discussions of the evolution of the self have diverged greatly in their estimates of the date at which the capacity for self-thought emerged, the factors that led self-reflection to evolve, and the nature of the evidence offered to support these disparate conclusions. Beginning with the assumption that human self-awareness involves a set of distinct cognitive abilities that evolved at different times to solve different adaptive problems, we trace the evolution of self-awareness from the common ancestor of humans and apes (...) to the beginnings of culture, drawing upon paleontological, anthropological, biological, and psychological evidence. These data converge to suggest that that modern self-thought appeared just prior to the Middle-Upper Paleolithic transition, approximately 60,000 years ago.Recto running head: Evolution of the Self. (shrink)

Background: Previous research shows that pediatricians inconsistently utilize the ethics consultation service (ECS). Methods: Pediatricians in two suburban, Midwestern academic hospitals were asked to reflect on their ethics training and utilization of ECS via an anonymous, electronic survey distributed in 2017 and 2018, and analyzed in 2018. Participants reported their clinical experience, exposure to formal and informal ethics training, use of formal and informal ethics consultations, and potential barriers to formal consultation. Results: Less experienced pediatricians were more likely to utilize (...) formal ethics consultation and more likely to have formal ethics training. The most commonly reported reasons not to pursue formal ECS consultation were inconvenience and self-reported expertise in pediatric ethics. Conclusions: These results inform ongoing discussions about ethics consultation among pediatricians and the role of formal ethics training in both undergraduate and graduate medical education. (shrink)

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

In Liberalism with Excellence, Matthew Kramer makes an argument for how excellence may enter in into liberalism, despite liberalism’s strong commitment to neutrality. Kramer seeks to challenge not only the uncompromising rejection of this position by liberals such a Jonathan Quong, but also the so-called “blended” approach of “soft-perfectionist” scholars such as Joseph Raz and George Sher. In this essay, I do not so much challenge Kramer’s approach as offer an alternative for accomplishing the same thing. Under my proposal, certain (...) forms of excellence and neutrality can both be accommodated as long as state support for the form of excellence at issue is proportional to the support for such a form of excellence within the relevant polity, competing forms of excellence are non-rivalrous, and no one is forced to embrace a form of excellence with which they disagree. My proposal is therefore not what Ronald Dworkin derogatively characterized as “a checkerboard solution.” Rather than allowing the state to support contrary moral positions at one and the same time, it is a solution that takes morally compatible but nevertheless competing conceptions of excellence seriously, and exhibits neutrality by giving them proportional rather than full support. This neither forces anyone to pursue the particular forms of excellence the state supports nor prevents them from pursuing some other form of excellence entirely or, if they wish, no form of excellence at all. (shrink)

Discussions of appeals to conscience by healthcare professionals typically focus on situations in which they object to providing a legal and professionally permitted service, such as abortion, sterilization, prescribing or dispensing emergency contraception, and organ retrieval pursuant to donation after cardiac death. “Negative claims of conscience” will designate such appeals to conscience. When healthcare professionals advance a negative claim of conscience, they do so to secure an exemption from ethical, professional, institutional, and/or legal obligations or requirements to provide a healthcare (...) service. (shrink)

This book is the first comprehensive study of the meaning and measure of enforceability. While we have long debated what restraints should govern the conduct of our social life, we have paid relatively little attention to the question of what it means to make a restraint enforceable. Focusing on the enforceability of legal rights but also addressing the enforceability of moral rights and social conventions, Mark Reiff explains how we use punishment and compensation to make restraints operative in the (...) world. After describing the various means by which restraints may be enforced, Reiff explains how the sufficiency of enforcement can be measured, and he presents a unified theory of deterrence, retribution, and compensation that shows how these aspects of enforceability are interconnected. Reiff then applies his theory of enforceability to illuminate a variety of real-world problem situations. (shrink)

In response to physicians who refuse to provide medical services that are contrary to their ethical and/or religious beliefs, it is sometimes asserted that anyone who is not willing to provide legally and professionally permitted medical services should choose another profession. This article critically examines the underlying assumption that conscientious objection is incompatible with a physician’s professional obligations (the “incompatibility thesis”). Several accounts of the professional obligations of physicians are explored: general ethical theories (consequentialism, contractarianism, and rights-based theories), internal morality (...) (essentialist and non-essentialist conceptions), reciprocal justice, social contract, and promising. It is argued that none of these accounts of a physician’s professional obligations unequivocally supports the incompatibility thesis. (shrink)

Corporate social responsibility (CSR) has emerged as an effective way for firms to create favorable attitudes among consumers. Although prior research has addressed the direct influence of proactive and reactive CSR on consumer responses, this research hypothesized that consumers’ perceived organizational motives (i.e., attributions) will mediate this relationship. It was also hypothesized that the source of information and location of CSR initiative will affect the motives consumers assign to a firms’ engagement in the initiative. Two experiments were conducted to test (...) these hypotheses. The results of Study 1 indicate that the nature of a CSR initiative influences consumer attribution effects and that these attributions act as mediators in helping to explain consumers’ responses to CSR. Study 2 suggests that the source of the CSR message moderates the effect of CSR on consumer attributions. The mediating influence of the attributions as well as the importance of information source suggests that proper communication of CSR can be a viable way to inculcate positive corporate associations and purchase intentions. (shrink)