The application of neurostimulation techniques such as deep brain stimulation —often called a brain pacemaker for neurological conditions like Parkinson's disease —has generated “currents of hope.” Building on this hope, there is significant interest in applying neurostimulation to psychiatric disorders such as major depression and obsessive-compulsive disorder. These emerging neurosurgical practices raise a number of important ethical and social questions in matters of resource allocation, informed consent for vulnerable populations, and commercialization of research.

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 41.1 (2003) 136-137 [Access article in PDF] John Watkins. Human Freedom after Darwin: A Critical Rationalist View. Chicago: Open Court Publishing, 1999. Pp. xi + 348. Cloth, $49.95. Paper, $24.95. John Watkins examines man's place in nature since Darwin. As a critical rationalist, using the methods of science, Watkins hopes to construct a world-view which challenges competing hypotheses and supports his own. He (...) recognizes that his view is, also, a candidate for critical rejection. All scientific views are, in principle, fallible. He divides his book into two parts: Naturalism and Freedom. [End Page 137]In evolutionary development, he accepts, as critically established, the sequence: matter before life, life before mind, and, no mind without a brain. Thus, naturalism is preferred beforesupernaturalism or divine intervention. These guides may support a continuous, steady evolutionaryprocess or discontinuity, mutations, and various stages of change. Darwin acceptedthe former and held physical changes were unaffected by consciousness. All change is, in principle,present from the beginning and unfolds over time. Darwin's view, then, is deterministic.Watkins challenges this position and argues for consciousness affecting physical change in new and unpredictable ways. It is herein that the possibility of animal and human freedom lies. Watkins gives examples of the actions of the hunter and hunted among animals, and of strategies developed by humans during crises, to support the view that there are novel and unpredictable actions by conscious beings. These actions can hardly be called predetermined in the nature of things. There is a huge difference between a general genetic structure for kinds of behavior and specific actions during crises (not that these are the only instances of freedom). At any rate, there is a reciprocal action between an individual and its environment and not merely a unilinear one.In Part II, Freedom, Watkins examines some classical, philosophical views of human freedom. He gives brief, but penetrating, analyses of Hobbes, Descartes, Hume, Kant, Schopenhauer, and Spinoza. Either they account for human action in strictly physical terms that are causally deterministic or they turn to non-empirical sources that are not verifiable. Since the latter make no difference in our account of behavior, they are entities multiplied beyond necessity. Those who give a completely deterministic view—Hobbes, Hume, and Schopenhauer—offer no continuum between cause and chance. Chance turns out to depend upon our ignorance of causes; further examination would show it causally determined.Watkins seems most sympathetic to Spinoza's treatment. In his hard-headed naturalism, Spinoza rejects any non-natural or supernatural accounts of human behavior. He is a strict determinist where man's confrontation with nature is concerned. Human emotions are passive and react to our environment; they do not affect it. Human reason makes no difference, but in its capacity to contemplate eternal truths it offers a way out. Instead of reacting to nature, man may transcend it. This transcendence is the key to Spinoza's view of the intellectual love of God, and human freedom. Watkins criticizes this flight from man's place in nature and the limited use of reason. In this vein, Spinoza seems to abandon the confrontation of nature for a flight to eternal truths. For Watkins, however, reasons must be used in confronting nature. As we saw, he claims that reason may have an effect upon the environment that is novel and unpredictable. Human agency is a part of the evolutionary story. Human agency is not an either/or proposition. There are degrees of effectiveness in human response to nature.In his analysis of human freedom, Watkins turns to the works of Newton, Faraday, Einstein, and others. In studying the problems posed by the consideration of natural phenomena during their time, they showed intellectual perspicacity of the highest order. Faraday's unified field theory brought electrical and magnetic phenomena, previously thought to be disparate, together. Newton's laws of motion brought celestial and terrestrial mechanics under one theory. Einstein changed the way in which space, time, mass, energy, and light were conceived. In a real sense, they were... (shrink)

In this analysis I apply a Foucauldian approach to ethics to examine the politically prescribed moral and ethical character required of carers of aged persons at home in Australia and the role of nurses in shaping these behaviours. The work that spousal carers provide, although often founded on love and/or obligation, has been formalized through a variety of policy initiatives and technologies that serve to construct the moral approach they must adopt. This shaping of conduct at the most personal level (...) takes place through the application of codes of behaviour policed largely by nurses. These codes redefine the mode of coexistence between an aged husband and wife and propose a new form of relationship that is derived from and supports policies of the deinstitutionalization of care services for elderly persons. In this way modern carer policy has drawn on knowledge and governance of the self to produce a morality of caring that is both authoritative and scientific. (shrink)

The Ethics of Need: Agency, Dignity, and Obligation argues for the philosophical importance of the notion of need and for an ethical framework through which we can determine which needs have moral significance. In the volume, Sarah Clark Miller synthesizes insights from Kantian and feminist care ethics to establish that our mutual and inevitable interdependence gives rise to a duty to care for the needs of others. Further, she argues that we are obligated not merely to meet others’ needs (...) but to do so in a manner that expresses "dignifying care," a concept that captures how human interactions can grant or deny equal moral standing and inclusion in a moral community. She illuminates these theoretical developments by examining two cases where urgent needs require a caring and dignifying response: the needs of the elderly and the needs of global strangers. Those working in the areas of feminist theory, women’s studies, aging studies, bioethics, and global studies should find this volume of interest. (shrink)

This paper considers the justifications for adhering to a principle of confidentiality within medical practice. These are found to derive chiefly from respect for individual autonomy, the doctor/patient contract, and social utility. It is suggested that these will benefit more certainly if secrecy is rejected and the principle of confidentiality is removed from the area of health care.

An assessment of America's preference for "extra-large" shares examples ranging from mega churches and breast augmentation to landfills and mega-malls, in a cautionary report that reveals some of the consequences of these choices.

Specialists and primary care physicians play an integral role in treating the twin epidemics of pain and addiction. But inadequate access to specialists causes much of the treatment burden to fall on primary physicians. This article chronicles the differences between treatment contexts for both pain and addiction — in the specialty and primary care contexts — and derives a series of reforms that would empower primary care physicians and better leverage specialists.

In this chapter, we critique a concept of resilience that has emerged from contemporary positive psychology and its application to health education. We argue that the present popularity of “resilience” as a strategy for managing mental health discourages educational institutions from providing students with the mental health services they need. Using the tools of American pragmatism, especially the work of John Dewey, we criticize the paradigm of resilience and identify several concrete reformulations of disability studies which would make concrete differences (...) in the lives of those with mental disability. (shrink)

Traditional philosophical discussions of knowledge have focused on the epistemic status of full beliefs. In this book, Moss argues that in addition to full beliefs, credences can constitute knowledge. For instance, your .4 credence that it is raining outside can constitute knowledge, in just the same way that your full beliefs can. In addition, you can know that it might be raining, and that if it is raining then it is probably cloudy, where this knowledge is not knowledge of propositions, (...) but of probabilistic contents. -/- The notion of probabilistic content introduced in this book plays a central role not only in epistemology, but in the philosophy of mind and language as well. Just as tradition holds that you believe and assert propositions, you can believe and assert probabilistic contents. Accepting that we can believe, assert, and know probabilistic contents has significant consequences for many philosophical debates, including debates about the relationship between full belief and credence, the semantics of epistemic modals and conditionals, the contents of perceptual experience, peer disagreement, pragmatic encroachment, perceptual dogmatism, and transformative experience. In addition, accepting probabilistic knowledge can help us discredit negative evaluations of female speech, explain why merely statistical evidence is insufficient for legal proof, and identify epistemic norms violated by acts of racial profiling. Hence the central theses of this book not only help us better understand the nature of our own mental states, but also help us better understand the nature of our responsibilities to each other. (shrink)

Firms use algorithms to make important business decisions. To date, the algorithmic accountability literature has elided a fundamentally empirical question important to business ethics and management: Under what circumstances, if any, are algorithmic decision-making systems considered legitimate? The present study begins to answer this question. Using factorial vignette survey methodology, we explore the impact of decision importance, governance, outcomes, and data inputs on perceptions of the legitimacy of algorithmic decisions made by firms. We find that many of the procedural governance (...) mechanisms in practice today, such as notices and impact statements, do not lead to algorithmic decisions being perceived as more legitimate in general, and, consistent with legitimacy theory, that algorithmic decisions with good outcomes are perceived as more legitimate than bad outcomes. Yet, robust governance, such as offering an appeal process, can create a legitimacy dividend for decisions with bad outcomes. However, when arbitrary or morally dubious factors are used to make decisions, most legitimacy dividends are erased. In other words, companies cannot overcome the legitimacy penalty of using arbitrary or morally dubious factors, such as race or the day of the week, with a good outcome or an appeal process for individuals. These findings add new perspectives to both the literature on legitimacy and policy discussions on algorithmic decision-making in firms. (shrink)

This paper develops a precise understanding of the thesis of moral encroachment, which states that the epistemic status of an opinion can depend on its moral features. In addition, I raise objections to existing accounts of moral encroachment. For instance, many accounts fail to give sufficient attention to moral encroachment on credences. Also, many accounts focus on moral features that fail to support standard analogies between pragmatic and moral encroachment. Throughout the paper, I discuss racial profiling as a case study, (...) arguing that moral encroachment can help us identify one respect in which racial profiling is epistemically problematic. (shrink)

Introduction: The humanities enrich and transform the practice of medicine. What remains to be seen, however, is how best to integrate humanities into the medical curriculum to optimize both educational and patient-related outcomes. The present study considers the structure of an innovative student-driven humanities curriculum and seeks to understand its strengths and limitations, as well as make recommendations for improvement. Methods: The Penn State College of Medicine, University Park Regional Campus uses an inquiry-based approach to education, whereby students are responsible (...) for creating learning objectives in four core pillars of exploration: Foundational Science, Clinical Science, Health Systems Science, and Health Humanities. This study explores student-derived humanities learning objectives (HLO) across four years of the curriculum. Results: 420 HLOs met criteria for analysis and were coded as instrumental (developing direct clinical skill), non-instrumental (non-skill based), or both. Of these, 125 (30%) were instrumental, 239 (57%) were non-instrumental, and 56 (13%) were coded as both. Most instrumental HLO centered around communication skills. Non-instrumental HLO most commonly focused on bearing witness and critiquing a particular experience within a social and/or political context. Conclusions: Findings from this study contribute to the development of a humanities curriculum in a student-directed learning program. Non-instrumental HLO lacked a theoretical framework to guide student’s investigations to a deeper level of analysis. Student-directed learning offers many strengths, but can be enhanced through external direction from humanities trained faculty, particularly given that many medical students have a limited humanities background. (shrink)

Generic generalizations such as ‘mosquitoes carry the West Nile virus’ or ‘sharks attack bathers’ are often accepted by speakers despite the fact that very few members of the kinds in question have the predicated property. Previous work suggests that such low-prevalence generalizations may be accepted when the properties in question are dangerous, harmful, or appalling. This paper argues that the study of such generic generalizations sheds light on a particular class of prejudiced social beliefs, and points to new ways in (...) which those beliefs might be undermined and combatted. (shrink)

Existing discussions of legal proof address a host of apparently disparate questions: What does it take to prove a fact beyond a reasonable doubt? Why is the reasonable doubt standard notoriously elusive, sometimes considered by courts to be impossible to define? Can the standard of proof by a preponderance of the evidence be defined in terms of probability thresholds? Why is statistical evidence often insufficient to meet the burden of proof? -/- This paper defends an account of proof that addresses (...) each of these questions. Where existing theories take a piecemeal approach to these puzzles, my theory develops an insight that unifies them—namely, the thesis that legal proof requires knowledge. Although this thesis may seem radical at first, I answer several common objections to it, and I argue that it does better than several competing accounts when it comes to making sense of our intuitions about what legal proof requires. (shrink)

Contemporary discourses surrounding adoption have a normative tone and are critical of the ways in which international adoption is power based and exploitative. These discourses have a significant influence on adoptive parents, structuring their actions and opening the door for scrutiny of individual adopters' motives and ethics. As an internationally adoptive parent, I reflect, in this article, on my experience and use it as a vantage point from which to consider alternative perspectives on the ethical debates in the extant adoption (...) literature. The insights gained from my experience can inform adoption practices and the development of more nuanced, less polarized perspectives on the ethics of international adoption and inspire new avenues of research that explore the ways in which adoptive parents navigate their socio-political contexts in ways that are ethically sensitive and workable for them. (shrink)

This paper motivates and develops a novel semantics for several epistemic expressions, including possibility modals and indicative conditionals. The semantics I defend constitutes an alternative to standard truth conditional theories, as it assigns sets of probability spaces as sentential semantic values. I argue that what my theory lacks in conservatism is made up for by its strength. In particular, my semantics accounts for the distinctive behavior of nested epistemic modals, indicative conditionals embedded under probability operators, and instances of constructive dilemma (...) containing epistemic vocabulary. (shrink)

This chapter defines and defends time-slice epistemology, according to which there are no essentially diachronic norms of rationality. The chapter begins by distinguishing two notions of time-slice epistemology, and ends by defending time-slice theories of action under indeterminacy, i.e. theories about how you should act when the outcome of your decision depends on some indeterminate claim. In a recent chapter, J. Robert G. Williams defends a theory of action under indeterminacy which is subject to several objections. An alternative theory is (...) proposed in its place. The resulting discussion highlights a more general moral about action under indeterminacy, namely that time-slice theories are supported by strong analogies with ethical theories. In particular, our understanding of agents torn between interpretations of a decision situation should be guided by our theories of agents torn between incommensurable values. (shrink)

This paper argues that just as full beliefs can constitute knowledge, so can properties of your credence distribution. The resulting notion of probabilistic knowledge helps us give a natural account of knowledge ascriptions embedding language of subjective uncertainty, and a simple diagnosis of probabilistic analogs of Gettier cases. Just like propositional knowledge, probabilistic knowledge is factive, safe, and sensitive. And it helps us build knowledge-based norms of action without accepting implausible semantic assumptions or endorsing the claim that knowledge is interest-relative.

"One of the most careful and intensive among the introductory texts that can be used with a wide range of students. It builds remarkably sophisticated technical skills, a good sense of the nature of a formal system, and a solid and extensive background for more advanced work in logic.... The emphasis throughout is on natural deduction derivations, and the text's deductive systems are its greatest strength. Lemmon's unusual procedure of presenting derivations before truth tables is very effective." --Sarah Stebbins, (...) The Journal of Symbolic Logic. (shrink)

Aristotle connects modality and time in ways strange and perplexing to modern readers. In this book the author proposes a new solution to this exegetical problem. Although primarily expository, this work explores topics of central concern for current investigations into causality, time, and change.

This paper defends an account of full belief, including an account of its relationship to credence. Along the way, I address several familiar and difficult questions about belief. Does fully believing a proposition require having maximal confidence in it? Are rational beliefs closed under entailment, or does the preface paradox show that rational agents can believe inconsistent propositions? Does whether you believe a proposition depend partly on your practical interests? My account of belief resolves the tension between conflicting answers to (...) these questions that have been defended in the literature. In addition, my account complements fruitful probabilistic theories of assertion and knowledge. (shrink)

Ducks lay eggs' is a true sentence, and `ducks are female' is a false one. Similarly, `mosquitoes carry the West Nile virus' is obviously true, whereas `mosquitoes don't carry the West Nile virus' is patently false. This is so despite the egg-laying ducks' being a subset of the female ones and despite the number of mosquitoes that don't carry the virus being ninety-nine times the number that do. Puzzling facts such as these have made generic sentences defy adequate semantic treatment. (...) However complex the truth conditions of generics appear to be, though, young children grasp generics more quickly and readily than seemingly simpler quantifiers such as `all' and `some'. I present an account of generics that not only illuminates the strange truth conditions of generics, but also explains how young children find them so comparatively easy to acquire. I then argue that generics give voice to our most cognitively primitive generalizations and that this hypothesis accounts for a variety of facts ranging from acquisition patterns to cross-linguistic data concerning the phonological articulation of operators. I go on to develop an account of the nature of these cognitively fundamental generalizations and argue that this account explains the strange truth-conditional behavior of generics. (shrink)

Atrial natriuretic peptides appear to elicit their actions in some target tissues by binding to a novel cell‐surface transmembrane protein which possesses both peptide binding and guanylate cyclase activities. Ligand binding stimulates enzyme activity to produce increased intracellular concentrations of cyclic GMP which, in turn, mediates the cell's physiological response.

This review emphasizes the worldwide and U.S. evolving population demographics and the need for the dental profession to exercise its professional and ethical duty to expand its traditional patient base to provide needed services.

An investigation into Aristotle's metaphysics of nature as expounded in the Physics. It focuses in particular his conception of change, a concept which is shown to possess a unique metaphysical structure, with implications that should engage the attention of contemporary analysis. First published in hardback in 1982, the book is now available for the first time in paperback. 'A powerful and appealing explanatory scheme which succeeds on the whole in drawing together a great many seemingly disparate elements in the Physics (...) into a neat unitary stucture.' Canadian Philosophical Review. (shrink)

This article reports the findings of a qualitative study that explored the organizational influences on moral distress for health professionals working in pediatric intensive care units across Canada. Participants were recruited to the study from PICUs across Canada. The PICU is a high-tech, fast-paced, high-pressure environment where caregivers frequently face conflict and ethical tension in the care of critically ill children. A number of themes including relationships with management, organizational structure and processes, workload and resources, and team dynamics were identified. (...) This study provides a rare and important multi-disciplinary perspective on this topic and the findings have implications for administrators and leaders who seek to improve the moral climate of healthcare delivery. (shrink)

One of the main themes that has emerged from behavioral decision research during the past three decades is the view that people's preferences are often constructed in the process of elicitation. This idea is derived from studies demonstrating that normatively equivalent methods of elicitation (e.g., choice and pricing) give rise to systematically different responses. These preference reversals violate the principle of procedure invariance that is fundamental to all theories of rational choice. If different elicitation procedures produce different orderings of options, (...) how can preferences be defined and in what sense do they exist? This book shows not only the historical roots of preference construction but also the blossoming of the concept within psychology, law, marketing, philosophy, environmental policy, and economics. Decision making is now understood to be a highly contingent form of information processing, sensitive to task complexity, time pressure, response mode, framing, reference points, and other contextual factors. (shrink)

Recently, von Fintel (2001) and Gillies (2007) have argued that certain sequences of counterfactuals, namely reverse Sobel sequences, should motivate us to abandon standard truth conditional theories of counterfactuals for dynamic semantic theories. I argue that we can give a pragmatic account of our judgments about counterfactuals without giving up the standard semantics. In particular, I introduce a pragmatic principle governing assertability, and I use this principle to explain a variety of subtle data concerning reverse Sobel sequences.

Recently many have argued that agents must sometimes have credences that are imprecise, represented by a set of probability measures. But opponents claim that fans of imprecise credences cannot provide a decision theory that protects agents who follow it from foregoing sure money. In particular, agents with imprecise credences appear doomed to act irrationally in diachronic cases, where they are called to make decisions at earlier and later times. I respond to this claim on behalf of imprecise credence fans. Once (...) we appreciate the complexity of our intuitions about rational decision making, we can see that diachronic cases are in fact evidence for the essential claims motivating imprecise credence models. I argue that our decision theory for imprecise agents should mirror our decision theory for agents in moral dilemmas, and I develop permissive norms that explain our intuitions about both sorts of agents. (shrink)

This paper discusses three potential varieties of update: updates to the common ground, structuring updates, and updates that introduce discourse referents. These different types of update are used to model different aspects of natural language phenomena. Not-at-issue information directly updates the common ground. The illocutionary mood of a sentence structures the context. Other updates introduce discourse referents of various types, including propositional discourse referents for at-issue information. Distinguishing these types of update allows a unified treatment of a broad range of (...) phenomena, including the grammatical evidentials found in Cheyenne (Algonquian) as well as English evidential parentheticals, appositives, and mood marking. An update semantics that can formalize all of these varieties of update is given, integrating the different kinds of semantic contributions into a single representation of meaning. (shrink)

Many languages grammatically mark evidentiality, i.e., the source of information. In assertions, evidentials indicate the source of information of the speaker while in questions they indicate the expected source of information of the addressee. This dissertation examines the semantics and pragmatics of evidentiality and illocutionary mood, set within formal theories of meaning and discourse. The empirical focus is the evidential system of Cheyenne (Algonquian: Montana), which is analyzed based on several years of fieldwork by the author.

Traditionally, discussions of moral participation – and in particular moral agency – have focused on fully formed human actors. There has been some interest in the development of morality in humans, as well as interest in cultural differences when it comes to moral practices, commitments, and actions. However, until relatively recently, there has been little focus on the possibility that nonhuman animals have any role to play in morality, save being the objects of moral concern. Moreover, when nonhuman cases are (...) considered as evidence of moral agency or subjecthood, there has been an anthropocentric tendency to focus on those behaviors that inform our attributions of moral agency to humans. For example, some argue that the ability to evaluate the principles upon which a moral norm is grounded is required for full moral agency. Certainly, if a moral agent must understand what makes an action right or wrong, then most nonhuman animals would not qualify (and perhaps some humans too). However, if we are to understand the evolution of moral psychology and moral practice, we need to turn our attention to the foundations of full moral agency. We must first pay attention to the more broadly normative practices of other animals. Here, we begin that project by considering evidence that great apes and cetaceans participate in normative practices. (shrink)