Situations in which patients lack medical decision-making (MDM) capacity raise ethical challenges, especially when the patients decline care that their surrogate decision makers and/or clinicians agree is indicated. These patients are a vulnerable population and should receive treatment that is the standard of care, in line with their the values of their authentic self, just as any other patient would. But forcing treatment on patients who refuse it, even though they lack capacity, carries medical and psychological risks to the patients (...) and the hospital staff. It is also often impractical to force some treatments, especially in the long term. For example, independent of the ethical “should” question, how would one force hemodialysis for the rest of a patient’s life, or force a surgery that requires weeks of post-operative physical therapy? In this article we present a novel algorithm that can help clinicians with ethical and practical decision making, with the goals of achieving the best outcomes for patients and reducing moral distress for their caretakers and clinicians. (shrink)

Empirical adequacy matters directly - as it does for antirealists - if we aim to get all or most of the observable facts right, or indirectly - as it does for realists - as a symptom that the claims we make about the theoretical facts are right. But why should getting the facts - either theoretical or empirical - right be required of an acceptable theory? Here we endorse two other jobs that good theories are expected to do: helping us (...) with a) understanding and b) managing the world. Both are of equal, often greater, importance than getting a swathe of facts right, and empirical adequacy fares badly in both. It is not needed for doing these jobs and in many cases it gets in the way of doing them efficiently. (shrink)

Teaching false theories goes against the general pedagogical and philosophical belief that we must only teach and learn what is true. In general, the goal of pedagogy is taken to be epistemic: to gain knowledge and avoid ignorance. In this article, I argue that for realists and antirealists alike, epistemological and pedagogical goals have to come apart. I argue that the falsity of a theory does not automatically make it unfit for being taught. There are several good reasons for teaching (...) false theories in school science. These are false theories can bring about genuine understanding of the world; teaching some false theories from the history of science that line up with children’s ideas can provide students “intellectual empathy” and also aid in better grasp of concepts; teaching false theories from the history of science can sharpen students’ understanding of the nature of science; scientists routinely use false theories and models in their practice and it is good sense for science education to mirror scientific practice; and learning about patently non-scientific and antiscientific ideas will prepare students to face and respond to them. In making arguments for the foregoing five points, I draw upon the work of a variety of philosophers and historians of science, cognitive scientists, science education scholars, and scientists. My goal here is not only to justify theories considered false already being taught, but also to actively endorse the teaching of some theories considered false that are by and large not currently taught. (shrink)

Stump argued for a virtue epistemological reading of Duhem's good sense: according to him Duhem advanced good sense as a source of justified beliefs about theory choice and as a mark of the cognitive character of the physicist. Ivanova argues that Duhem proposed good sense as a post hoc explanation of theory choice rather than as a justification of it. I contend that Ivanova’s reading of Duhem is inaccurate and that good sense can indeed be accommodated within virtue epistemology. However (...) Stump’s account is incomplete: I propose that within virtue epistemology, agent reliabilism best accommodates Duhemian good sense. (shrink)

Bas van Fraassen’s stance voluntarism has raised the question of how to justify one’s own stance choice if one is to follow the voluntarist dictum that all rational stances, i.e. all those that don’t lead to ‘self-sabotage by one’s own lights’, are equally rational. van Fraassen’s response is that one justifies their stance choice based on one’s own values, but the problem is that those values only appeal to holders of the said stance and not others. In this paper I (...) propose a pragmatist approach to justifying stance choice. I argue that we can provide stance-transcendent justification for our choice of stance based on its stance-transcendent benefits. Consequently, multiple stances having stance-transcendent benefits should all be embraced as it is the epistemically virtuous thing to do. I advocate a move away from the standard voluntarist position of being a stance monist in practice—i.e. defending and holding only one stance—while acknowledging other rational stances only begrudgingly. I defend an active stance pluralism where we strive to actively hold different (apparently conflicting) stances depending on the context. Where that’s not possible, I propose that we should at least enthusiastically encourage multiple stances (taken by others). In Sect. 1 I introduce epistemic stances via a discussion of stance empiricism and stance scientific realism. In Sect. 2 I discuss the problem of stance justification and explore a few different existing teleological proposals for stance choice. Finally in Sect. 3 based on numerous examples from science and philosophy, I argue for a pragmatic, active, normative stance pluralism. I conclude with some clarifications on the rationale behind active stance pluralism. (shrink)

The integration of artificial intelligence into bioethics education represents a new pedagogical approach that addresses complex moral issues in healthcare. The use of AI-driven platforms like ChatGPT in bioethics education can enhance critical thinking and decision-making skills among students by providing a diverse range of perspectives and solutions. To assess the ability of ChatGPT-4 to understand and resolve ethical dilemmas using validated clinical case vignettes, thereby determining its suitability as a teaching aid in bioethics. Ten clinical scenarios, each with inherent (...) ethical issues, were presented to ChatGPT-4. These scenarios were expert-validated to ensure relevance and complexity. ChatGPT's responses were evaluated by two blinded external raters to eliminate bias. The assessment criteria included identification of bioethical principles, recognition of stakeholders and their outcomes, and comprehension of ethical and legal frameworks. Additionally, the quality of responses was scored on a scale of 1–10. ChatGPT showed proficiency in identifying the pertinent bioethical principles and stakeholders involved in the ethical dilemmas presented. It achieved an overall score of 84.5%, with high marks for its analytical capabilities in complex scenarios. However, the study identified areas for improvement, particularly in proposing comprehensive solutions and alternative actions. ChatGPT demonstrates potential as an effective tool for bioethics education, capable of guiding learners through the resolution of ethical issues in clinical practice. However, to fully integrate ChatGPT into bioethics education, it requires enhancements in delivering detailed, actionable guidance in ethical decision-making. Future development should focus on refining ChatGPT’s ability to offer nuanced solutions aligned with patient values and clinician needs. (shrink)