Surgical ethics is a well-recognized field in clinical ethics, distinct from medical ethics. It includes at least a dozen important issues common to surgery that do not exist in internal medicine simply because of the differences in their practices. But until now there has been a tendency to include ethical issues of anesthesiology as a part of surgical ethics. This may mask the importance of ethical issues in anesthesiology, and even help perpetuate an unfortunate view that surgeons are “captain of (...) the ship” in the operating theater (leaving anesthesiologists in a subservient role. We will have a better ethical understanding if we see surgery and anesthesia as two equal partners, ethically as well as in terms of patient care. Informed consent is one such issue, but it is not limited to that. Even on the topic of what type of anesthesia to use, anesthesiologists have often felt subsumed to the surgeon’s preferences. This commentary takes the case study and uses it as a exemplar for this very claim: it is time to give due recognition for a new field in clinical ethics, ethics in anesthesia. (shrink)

According to the colored-brain thesis, sense data or qualia are real physical-chemical qualities, located inside the brain, possibly at a specific locus. Our hypothesis is that the seats of phenomenal consciousness have a structure and a materiality. According to the proposed view, a chromatic quale emerges when a certain pixel of the visual sensorium is fed with a certain pattern Σ of spikes; a change in this pattern quickly changes the color that is subjectively generated. How could one manage to (...) measure chromatic qualia? In principle, with nanoscopical techniques, one could capture all the patterns that fall on the sensorium, and transmit the information to other media. But this does not capture the qualia. However, if the patterns are made to fall on a tissue of the same kind, typically inside another person’s brain, this other person will have roughly the same subjective experience as the first person. The model is used to explore two different situations involving qualia inversion. The paper also explores Cartesian materialism, and the claim that phenomenal time and space are identical to a region of physical time and space. (shrink)

Experimental work has revealed causal links between physical cleansing and various psychological variables. Empirically, how robust are they? Theoretically, how do they operate? Major prevailing accounts focus on morality or disgust, capturing a subset of cleansing effects, but cannot easily handle cleansing effects in non-moral, non-disgusting contexts. Building on grounded views on cognitive processes and known properties of mental procedures, we proposegrounded proceduresof separation as a proximate mechanism underlying cleansing effects. This account differs from prevailing accounts in terms of explanatory (...) kind, interpretive parsimony, and predictive scope. Its unique and falsifiable predictions have received empirical support: Cleansing attenuates or eliminates otherwise observed influences of prior events (1) across domains and (2) across valences. (3) Cleansing manipulations produce stronger effects the more strongly they engage sensorimotor capacities. (4) Reversing the causal arrow, motivation for cleansing is triggered more readily by negative than positive entities. (5) Conceptually similar effects extend to other physical actions of separation. On the flipside, grounded procedures ofconnectionare also observed. Together, separation and connection organize prior findings relevant to multiple perspectives (e.g., conceptual metaphor, sympathetic magic) and open up new questions. Their predictions are more generalizable than the specific mappings in conceptual metaphors, but more fine-grained than the broad assumptions of grounded cognition. This intermediate level of analysis sheds light on the interplay between mental and physical processes. (shrink)

Expressions of the form 'S is aware of the fact that p' are commonplace. This book provides a systematic exploration of the relation between knowledge and factual awareness, arguing that knowledge is but one species of factual awareness and that we can understand the possession of objective reasons, the normativity of knowledge, and the nature of knowledge in terms of factual awareness. In this way, the state of factual awareness is, structurally and substantively, a more basic type of state than (...) knowledge. If correct, this undermines a number of ways in which knowledge has been regarded as ‘first’ in recent epistemology. (shrink)

Our commentators explore the operation of grounded procedures across all levels of analysis in the behavioral sciences, from mental to social, developmental, and evolutionary/functional. Building on them, we offer two integrative principles for systematic effects of grounded procedures to occur. We discuss theoretical topics at each level of analysis, address methodological recommendations, and highlight further extensions of grounded procedures.

_Contributes a black Atlantic perspective to postmodernism, theology, and metaphysics._.

The emergence of signaling systems has been observed in numerous experimental and real-world contexts, but there is no consensus on which shared mechanisms underlie such phenomena. A number of explanatory mechanisms have been proposed within several disciplines, all of which have been instantiated as credible working models. However, they are usually framed as being mutually incompatible. Using an exemplar-based framework, we replicate these models in a minimal configuration which allows us to directly compare them. This reveals that the development of (...) optimal signaling is driven by similar mechanisms in each model, which leads us to propose three requirements for the emergence of conventional signaling. These are the creation and transmission of referential information, a systemic bias against ambiguity, and finally some form of information loss. Considering this, we then discuss some implications for theoretical and experimental approaches to the emergence of learned communication. (shrink)

The study of metaphor is now firmly established as a central topic within cognitive science and the humanities. We marvel at the creative dexterity of gifted speakers and writers for their special talents in both thinking about certain ideas in new ways, and communicating these thoughts in vivid, poetic forms. Yet metaphors may not only be special communicative devices, but a fundamental part of everyday cognition in the form of 'conceptual metaphors'. An enormous body of empirical evidence from cognitive linguistics (...) and related disciplines has emerged detailing how conceptual metaphors underlie significant aspects of language, thought, cultural and expressive action. Despite its influence and popularity, there have been major criticisms of conceptual metaphor. This book offers an evaluation of the arguments and empirical evidence for and against conceptual metaphors, much of which scholars on both sides of the wars fail to properly acknowledge. (shrink)

The year 2013 may someday be seen as the year a new profession was born. Clinical ethics consultation has been practiced in different ways for roughly 30 years, originally initiated by a group of h...

Charles Griswold has written a comprehensive philosophical study of Smith's moral and political thought. Griswold sets Smith's work in the context of the Enlightenment and relates it to current discussions in moral and political philosophy. Smith's appropriation as well as criticism of ancient philosophy, and his carefully balanced defence of a liberal and humane moral and political outlook, are also explored. This 1999 book is a major philosophical and historical reassessment of a key figure in the Enlightenment that will be (...) of particular interest to philosophers and political and legal theorists, as well as historians of ideas, rhetoric, and political economy. (shrink)

When a belief is self-fulfilling, having it guarantees its truth. When a belief is self-defeating, having it guarantees its falsity. These are the cases of “self-impacting” beliefs to be examined below. Scenarios of self-defeating beliefs can yield apparently dilemmatic situations in which we seem to lack sufficient reason to have any belief whatsoever. Scenarios of self-fulfilling beliefs can yield apparently dilemmatic situations in which we seem to lack reason to have any one belief over another. Both scenarios have been used (...) independently to challenge Evidentialism, on which what we may rationally believe is all and only what fits our current evidence. Here we tie the two scenarios together and explore what a knowledge-sensitive evidentialist approach to one implies for the other. (shrink)

A fourteen year old is diagnosed with aplastic anemia. The teen and his parents are Jehovah’s Witnesses. An ethics consult is called on the day of admission by an ethically sophisticated social worker and attending. The patient and his parents see this diagnosis as “a test of their faith.” The ethical analysis focuses on the mature minor doctrine, i.e. whether the teen has the capacity to make this decision. The hospital chooses to take the case to court, with a result (...) that is at odds with the ethics consultation recommendations. Ethics was never deposed or otherwise invited to be involved with the hearing. Thus the larger question of the relation of ethics and law was brought into stark relief. (shrink)

The emergence of signaling systems has been observed in numerous experimental and real‐world contexts, but there is no consensus on which (if any) shared mechanisms underlie such phenomena. A number of explanatory mechanisms have been proposed within several disciplines, all of which have been instantiated as credible working models. However, they are usually framed as being mutually incompatible. Using an exemplar‐based framework, we replicate these models in a minimal configuration which allows us to directly compare them. This reveals that the (...) development of optimal signaling is driven by similar mechanisms in each model, which leads us to propose three requirements for the emergence of conventional signaling. These are the creation and transmission of referential information, a systemic bias against ambiguity, and finally some form of information loss. Considering this, we then discuss some implications for theoretical and experimental approaches to the emergence of learned communication. (shrink)

Informed consent is the single most important concept for understanding decision-making capacity. There is a steady pull in the clinical world to transform capacity into a technical concept that can be tested objectively, usually by calling for a psychiatric consult. This is a classic example of medicalization. In this article I argue that is a mistake, not just unnecessary but wrong, and explain how to normalize capacity assessment.Returning the locus of capacity assessment to the attending, the primary care doctor, and (...) even to ethics consultation in today's environment will require a substantial effort to undo a strong but illusory impression of capacity assessment. Hospital attorneys as well as clinical ethicists with a sophisticated understanding of health law can be in the vanguard of this reorientation. (shrink)

The American Journal of Bioethics, Volume 12, Issue 8, Page 13-15, August 2012.

The philosophy of medicine cum bioethics has become the socially recognized source for moral and epistemic direction in health-care decision-making. Over the last three decades, this field has been accepted politically as an authorized source of guidance for policy and law. The field's political actors have included the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, the Department of Health, Education, and Welfare, the President's Commission for the Study of Ethical Problems in Medicine and Biomedical (...) and Behavioral Research, the National Bioethics Advisory Commission, and the new Council on Bioethics; these groups and agencies have set forth rules on issues ranging from the role of humans in biomedical research to the production of human embryos for research, the definition of death, and the permissibility of human cloning. The members of the field are not just scholars and teachers in an academic realm directed to both theoretical and applied issues. They are, in addition, practitioners of a conceptual and moral trade that possesses a legal and political standing. This essay critically addresses the sudden emergence of bioethics as a societally recognized source of moral guidance, a source replete with authorized moral experts. Attention is directed to moral and conceptual assumptions that have led the philosophy of medicine, and especially bioethics, to acquire a quasi-juridical/political role in guiding clinical choices, framing health-care policy, and directing court holdings. (shrink)

This papers deals with examples offered by Adams, Austin and others which seem to show that `if' does not conform to all of the laws of the conditional. These a reconciled by treating them as conjunctions with embedded modalities.

Interpreting Figurative Meaning critically evaluates the recent empirical work from psycholinguistics and neuroscience examining the successes and difficulties associated with interpreting figurative language. There is now a huge, often contradictory literature on how people understand figures of speech. Gibbs and Colston argue that there may not be a single theory or model that adequately explains both the processes and products of figurative meaning experience. Experimental research may ultimately be unable to simply adjudicate between current models in psychology, linguistics and philosophy (...) of how figurative meaning is interpreted. Alternatively, the authors advance a broad theoretical framework, motivated by ideas from 'dynamical systems theory', that describes the multiple, interacting influences which shape people's experiences of figurative meaning in discourse. This book details past research and theory, offers a critical assessment of this work and sets the stage for a new vision of figurative experience in human life. (shrink)

[This is a paper that was originally written in 2017 and doesn't represent Silva's current thinking about the relation between belief and degrees of confidence. See On Believing and Being Convinced for more.] Can there be knowledge and rational belief in the absence of a rational degree of confidence? Yes, and cases of "mistuned knowledge" demonstrate this. In this paper we leverage this normative possibility in support of advancing our understanding of the metaphysical relation between belief and credence. It is (...) generally assumed that a Lockean metaphysics of belief that reduces outright belief to degrees of confidence would immediately effect a unification of coarse-grained epistemology of belief with fine-grained epistemology of confidence. Scott Sturgeon has suggested that the unification is effected by understanding the relation between outright belief and confidence as an instance of the determinable-determinate relation. But determination of belief by confidence would not by itself yield the result that norms for confidence carry over to norms for outright belief unless belief and high confidence are token identical. We argue that this token-identity thesis is incompatible with the neglected phenomenon of “mistuned knowledge”—knowledge and rational belief in the absence of rational confidence. We contend that there are genuine cases of mistuned knowledge and that, therefore, epistemological unification must forego token identity of belief and high confidence. We show how partial epistemological unification can be secured given determination of outright belief by degrees of confidence even without token-identity. Finally, we suggest a direction for the pursuit of thoroughgoing epistemological unification. (shrink)

How can one be trained to enter the evolving field of clinical ethics consultation? The classroom is not the proper place to teach clinical ethics consultation; it is best done in a clinical setting. The author maps the elements that might be included in an apprenticeship, and sets out propositions for debate regarding the training needed for clinical ethics consultants and directors of clinical ethics consultation services.

Contemporary theories of consciousness are based on widely different concepts of its nature, most or all of which probably embody aspects of the truth about it. Starting with a concept of consciousness indicated by the phrase “the feeling of what happens” (the title of a book by Antonio Damásio), we attempt to build a framework capable of supporting and resolving divergent views. We picture consciousness in terms of Reality experiencing itself from the perspective of cognitive agents. Each conscious experience is (...) regarded as composed of momentary feeling events that are combined by recognition and evaluation into extended conscious episodes that bind cognitive contents with a wide range of apparent durations (0.1 secs to 2 or more secs, for us humans, depending on circumstances and context). Three necessary conditions for the existence of consciousness are identified: a) a ground of Reality, envisaged as an universal field of potentiality encompassing all possible manifestations, whether material or 'mental'; b) a transitional zone, leading to; c) a manifest world with its fundamental divisions into material, 'informational' and quale-endowed aspects. We explore ideas about the nature of these necessary conditions, how they may relate to one another and whether our suggestions have empirical implications. (shrink)