Clinicians at quaternary centers see part of their mission as providing hope when others cannot. They tend to see sicker patients with more complex disease processes. Part of this mission is offering longshot treatment modalities that are unlikely to achieve their stated goal, but conceivably could. When patients embark on such a treatment plan, it may fail. Often treatment toward an initial goal continues beyond the point at which such a goal is feasible. We explore the progression of care from (...) longshot to fantasy using two pediatric cases. This progression may be differentiated into four distinct stages of care related to the potential of achieving the initial goals of care. Physicians are often ill prepared for the progression of treatments from a longshot hope to an unfeasible and, therefore, typically unjustified intervention. We present a structured approach to guide clinicians at referral institutions where these situations may be common. The transition of care from “longshot” to “fantasy” is an inherent part of quaternary care for the sickest of patients that has been underexplored. Physicians are often poorly equipped to approach that transition. We advocate this approach to the shift from longshot to fantasy with the belief that such a structured method will have multiple benefits, including: reduced suffering for the patient; decreased emotional burden on patient and family; decreased provider moral distress; increased likelihood of seeking high quality palliative care earlier; and provision of honest and straightforward information to patients and their families. (shrink)

One of very few monographs devoted to Plato's Meno, this study emphasizes the interplay between its protagonists, Socrates and Meno. It interprets the Meno as Socrates' attempt to persuade his interlocutor, by every device at his disposal, of the value of moral inquiry—even though it fails to yield full-blown knowledge—and to encourage him to engage in such inquiry, insofar as it alone makes human life worth living.

Conditional logics were originally developed for the purpose of modeling intuitively correct modes of reasoning involving conditional—especially counterfactual—expressions in natural language. While the debate over the logic of conditionals is as old as propositional logic, it was the development of worlds semantics for modal logic in the past century that catalyzed the rapid maturation of the field. Moreover, like modal logic, conditional logic has subsequently found a wide array of uses, from the traditional (e.g. counterfactuals) to the exotic (e.g. conditional (...) obligation). Despite the close connections between conditional and modal logic, both the technical development and philosophical exploitation of the latter has outstripped that of the former, with the result that noticeable lacunae exist in the literature on conditional logic. My dissertation addresses a number of these underdeveloped frontiers, producing new technical insights and philosophical applications. -/- I contribute to the solution of a problem posed by Priest of finding sound and complete labeled tableaux for systems of conditional logic from Lewis' V-family. To develop these tableaux, I draw on previous work on labeled tableaux for modal and conditional logic; errors and shortcomings in recent work on this problem are identified and corrected. While modal logic has by now been thoroughly studied in non-classical contexts, e.g. intuitionistic and relevant logic, the literature on conditional logic is still overwhelmingly classical. Another contribution of my dissertation is a thorough analysis of intuitionistic conditional logic, in which I utilize both algebraic and worlds semantics, and investigate how several novel embedding results might shed light on the philosophical interpretation of both intuitionistic logic and conditional logic extensions thereof. -/- My dissertation examines deontic and connexive conditional logic as well as the underappreciated history of connexive notions in the analysis of conditional obligation. The possibility of interpreting deontic modal logics in such systems (via embedding results) serves as an important theoretical guide. A philosophically motivated proscription on impossible obligations is shown to correspond to, and justify, certain (weak) connexive theses. Finally, I contribute to the intensifying debate over counterpossibles, counterfactuals with impossible antecedents, and take—in contrast to Lewis and Williamson—a non-vacuous line. Thus, in my view, a counterpossible like "If there had been a counterexample to the law of the excluded middle, Brouwer would not have been vindicated" is false, not (vacuously) true, although it has an impossible antecedent. I exploit impossible (non-normal) worlds—originally developed to model non-normal modal logics—to provide non-vacuous semantics for counterpossibles. I buttress the case for non-vacuous semantics by making recourse to both novel technical results and theoretical considerations. (shrink)

"A collection of essays on the early modern English writer, proto-feminist, and rhetorician Mary Astell. Includes discussions on human nature, equality, rationality, power, freedom, friendship, marriage, and education"--Provided by publisher.

The paper is interested in likely routes for the evolution of normative practice, which, it is here assumed, is a necessary precursor to the development of language. It argues that each normative practice requires a policing practice, consisting of, at least, moves of commendation, condemnation, and retraction, and it contrasts policing with mere monitoring practice. So the evolution of norms can be seen to be the development of policing from mere monitoring practice. It conjectures that a likely site for such (...) a development to take place is in the active transmission of technology, notably, toolmaking technology. Using data and observations drawn from the archaeological record and the psychology of mimicry, it attempts to illustrate the likely emergence of policing practices. (shrink)

Matter as such produces nothing, changes nothing, does nothing; and however convenient it may afterwards be to abbreviate our nomenclature and our descriptions, we must most carefully realize in the outset that the spermatozoon, the nucleus, the chromosomes or the germ-plasma can never act as matter alone, but only as seats of energy and as centres of force.Science is a human endeavor that is rarely if ever just about science: it is also a social, political, and economic enterprise. As such (...) it is structured around an ethos: a belief system, or theory, that accounts for the nature of relevant aspects of existence. Much like other belief systems in the broader culture in which they occur, we build stories in defense... (shrink)

Our task in this study, then, is to see what Hegel makes of Aristotle in unifying and interpreting his doctrine, to see how far ... some of the questions that are continually being raised about Hegel's purpose and meaning in the philosophy of mind.

What we experience is somewhat of a melange, something at once perceptual, mediated by the sense organs; scientific, reflecting our use of mathematical and other formal devices to make clear and systematic the causes of what is now taking place, and pointing us towards what might be expected; eventful, stretches of vital movement in which beginning and ending are, though separate, inescapably interlocked; and important, reflecting both our sense of value and the presence of an objective standard outside us and (...) unaffected by our interests. Initially these strands are inchoately together, constituting commonsense objects, artifactual or natural, the occupants of the world of which we unreflectively take account. On some occasions one of these facets may be to the fore, on other occasions it may be so recessive that its presence is overlooked. (shrink)

We look on Fernán Pérez de Guzmán as an exile not only because he lived out the last thirty years of his life in the relative seclusion of his estate in Batres; he is an exile, too, because as a poet he has long been banished from critical acclaim. For an enthusiastic view, one has to go back to the 1860s and the eulogy of the literary historian José Amador de los Ríos, according to whom Fernán Pérez's graceful didacticism deserved (...) “[el] aprecio de la verdadera crítica.” Since then, “the appreciation of true critics” has been reserved for what is now considered a canonical work of prose history, the Generaciones y semblanzas, whereas most of his poetry has been condemned for stylistic inelegance — ironically, as we shall see, one of the very qualities he seems deliberately to have cultivated. (shrink)

1. In this paper have done what Niklas Luhmann always recommended us to do: I have drawn a distinction – or to be more precise, I have some distinctions. I have done so because I think, and you all know, that in the ongoing debates on so-called “globalization” there is not enough of distinction, and no distinction at all very often. And that is particularly unsatisfactory if the critique, or even the rejection, of globalization is at stake. 2. The first (...) of my distinctions is between Europeanization (in Heidegger’s sense) and Americanization, as this term is meant usually today. These two concepts, and the processes they refer to, seem to be quite similar in so far as what is meant that a particular part of mankind at a given period of history has succeeded in becoming a hegemonic power on a global scale – economically, politically (and militarily) and/or culturally. One could think, and Heidegger himself really does, that those two processes have also in common that they are historically contingent: Nothing of this sort could have happened as well; other powers could have, and have indeed, played a similar role at other times; it could have come out completely different etc. etc. In my view, though, there should be made a distinction here because the world-wide success-story of modern science and technology has to be accounted for by causes and dynamics which are not only gradually, but qualitatively different from what we need to explain the globalization of, let’s say, American blue jeans, or T‐Shirts etc. 3. This brings me to the distinction between globalization and Americanization, which are identified nowadays very often, and that particularly so in order to attack and reject globalization as being nothing but Americanization. At this point, then, it seems to me necessary to draw distinction between (a) globalization as such – regarded to be a factual, complex and heterogeneous process that has to be analyzed in all its aspects by econonomists, sociologists etc and (b) universalization. (shrink)

Are such evils necessary? If they are, what necessitates them? If they are not, why do they occur? Could there be a universe in which there was no evil of any kind? If so, why is evil in ours? Must any universe whatsoever contain something evil? Does a universe therefore presuppose the existence of a superior being?

This paper aims to show that in Republic ii Glaucon and Adeimantus contend that being just is not a good of any kind; it is the good consequences of seeming just that place it in Glaucon’s third and lowest class of goods. The brothers challenge Socrates to prove that being just has good consequences. They do not ask him to prove that being just is good for itself apart from its consequences, nor is this something he attempts to prove.

A God would have the wisdom, power and concern to do all that must be done to supplement man's activities in such a way that only good is done, and this everywhere. If we could count on his existence, concern and aid, we could be sure of getting the right help and to the right degree. Only a God is both powerful and wise enough to provide all the help that would be needed, and only a God is good and (...) wise enough to give it always at the right time and in the right way. He alone can guarantee the perfect production of whatever was distorted and left undone because of man's impotence, ignorance and folly. It is tempting therefore to claim that men always do, or that they always should look to a God for the aid they need if good is to be fully realized. (shrink)

These various paradoxes can be viewed as variants of a ninth to the effect that men ought to do what is absolutely right, although none has sufficient power or knowledge for the purpose. It is to this last paradox that I shall devote the major part of my discourse. I will try to show that the paradox is inescapable, that a number of commonly accepted answers to it are unsatisfactory, and that an adequate answer to it will require a consideration (...) of activities and categories which are outside the province of ethics. Only after these steps are covered will we be in a position to justify our basic contention that ethics and religion are independent and even sometimes incompatible enterprises. (shrink)

Global Governance Futures addresses the crucial importance of thinking through the future of global governance arrangements. It considers the prospects for the governance of world order approaching the middle of the twenty-first century by exploring today's most pressing and enduring health, social, ecological, economic, and political challenges. Each of the expert contributors considers the drivers of continuity and change within systems of governance and how actors, agents, mechanisms, and resources are and could be mobilized. The aim is not merely to (...) understand state, intergovernmental, and non-state actors. It is also to draw attention to those underappreciated aspects of global governance that push understanding beyond strictures of traditional conceptualizations, and that offer better insights into the future of world order. Three sections enable readers to appreciate better the sum of forces likely to shape world order in the near and not-so-near future: "Planetary," changes wrought by continuing human domination of the Earth and by war; current and future geopolitical, civilizational, and regional contestations; and life in and between urban and non-urban environments. "Divides," including threats to human rights gains; the plight of migrants; those who have and those who do not; persistent racial, gender, religious, and sexual-orientation-based discrimination; and those who govern and those who are governed. "Challenges," of food and health insecurities; ongoing environmental degradation and species loss; the current and future politics of international assistance and data; and the wrong turns taken in the control of illicit drugs and crime. Designed to engage advanced undergraduate and graduate students in international relations, organization, law, and political economy as well as the general reader, this book invites readers to adopt both a backward- and forward-looking view of global governance. It will spark discussion and debate as to how dystopic futures might be avoided and change agents mobilized. (shrink)

1. Mr. Grünbaum says, "it is clearly meaningless to say that one object is larger than another unless there is a...common metrical framework to which...these bodies can be referred." But he also says, as one ought, that "sodium atoms separated by...light years...share the characteristics of sodium." Apparently he and I agree that sodium atoms, x and y, can share the characteristics of sodium without the need of an intermediary third term. Substitute "sodium similarity" for "share the characteristics of sodium" and (...) we get "x and y have sodium similarity." Substitute "magnitude" for "sodium" and it then becomes evident that equal magnitudes can be members of two-termed relations. And since a larger body is a body, part of which has the same magnitude as the whole of another, unequal magnitudes can also, despite his denial, be related by two-termed relations. It would be foolish, of course, to deny that a metric introduces a third term. But must there not be something for the metric to measure? It was with this something my paper was concerned. I take it to be presupposed by the theory of relativity, and the theories which will follow it in the course of the history of science. Mr. Grünbaum, if I understand him, gets to his conclusion because he arbitrarily identifies "being" with "being known," "magnitude" with "measured size.". (shrink)

This essay examines Don Ihde’s postphenomological philosophy of technology through the lens of philosophical anthropology, that sub-discipline of philosophy concerned with the nature and place of the human being. While Ihde’s philosophical corpus and its reception in Postphenomenology: A Critical Companion to Ihde indicate rich resources for thinking about human nature, several themes receive too little attention in both, including the nature of the human being, the emergence of the posthuman, and the place of the human being in our contemporary (...) pluriculture. (shrink)

Star Trek becomes an ideal vehicle for modern narratives exploring the nature of being human in a technological age. In its fifty years of robots, androids, cyborgs, and alien others on the small and big screens, Star Trek has played a function not unlike that of Greek myth. Whether dealing with Greek gods such as Apollo, salt‐craving beasts and Hortas, or hive minds and androids, Star Trek fashions moderns’ myths that provoke reflection on what it means to be human and (...) transformations that either preserve or destroy one's humanity. It is seen that the feminist model in the long processes of development of the android Data, liberated Borg drone Seven of Nine, and Voyager's holographic Doctor, and their struggle to understand, if not finally attain, humanity. As children who were insufficiently socialized into their own families, these three characters face the difficult task of reconstituting families aboard Enterprise or Voyager. (shrink)