OBJECTIVE: To describe the issues faced, and how they were addressed, by the University of Toronto Critical Care Medicine Program/Joint Centre for Bioethics Task Force on Appropriate Use of Life-Sustaining Treatment. The clinical problem addressed by the Task Force was dealing with requests by patients or substitute decision makers for life-sustaining treatment that their healthcare providers believe is inappropriate. DESIGN: Case study. SETTING: The University of Toronto Joint Centre for Bioethics/Critical Care Medicine Program Task Force on Appropriate Use of Life-Sustaining (...) Treatment. PARTICIPANTS: The 24-member Task Force included physician and nursing leaders from five critical care units, bioethicists, a legal scholar, a health administration expert, a social worker, and a hospital public relations professional. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Our specific lessons learned include a) a policy focus on process; b) use of a negotiation and mediation model, rather than a hospital ethics committee model, for this process; and c) the policy development process is itself a negotiation, so we recommend equal involvement of interested groups including patients, families, and the public. CONCLUSIONS: This article describes the key issues faced by the Task Force while developing its policy. It will provide a useful starting point for other groups developing policy on appropriate use of life-sustaining treatment. (shrink)

Popular culture can play a significant role in shaping the acceptance of evolving technologies, with nanotechnology likely to be a case in point. The most popular fiction work to date in this arena has been Michael Crichton's techno-thriller Prey, which fuses together nanotechnology science with science fiction. Within the context of Prey, this article examines the role that scientists and popular culture play in educating society, and one another, about emerging technologies. In di ferentiating fact from fiction, the article reflects (...) on how such distinctions may be important in proactive public dialogue projects. The article concludes that popular culture will be a key factor in informing citizen beliefs about the coming nano-age. Accordingly, governments, in conjunction with the scientific community, will need to be proactive in distinguishing science fact from science fiction for the benefit of their citizens. (shrink)

The conventionality of simultaneity at distant points is defended partly by reference to Einstein's 1905 paper founding special relativity. His famous light-signaling definition takes the transit time of light in one direction to be equal to that in the other. Conventionalists such as Reichenbach and Grunbaum argue that he could have made them unequal without denying any physical fact. However, Einstein's more detailed treatment in the 1910 Archives des sciences runs counter to this thesis. There he required that the two (...) signal-paths be physically equivalent and thus that whatever the signals travel through have no perturbing affect on their motions. (shrink)

In his original paper of 1905, "On the Electrodynamics of Moving Bodies", Einstein described a procedure for synchronizing distant clocks at rest in any inertial system K. Clocks thus synchronized may be said to be in standard signal synchrony in K. It has often been claimed that there are no logical or physical reasons for preferring standard signal synchronizations to any of a range of possible non-standard ones. In this paper, the range of consistent non-standard signal synchronizations, first for any (...) one inertial system, and second for any set of such systems, is investigated, and it is shown that the requirement of consistency leaves much less room for choice than is commonly supposed. Nevertheless consistent non-standard signal synchronizations appear to be possible. However, it is also shown that good physical reasons for preferring standard signal synchronizations exist, if the Special Theory of Relativity yields correct predictions. The thesis of the conventionality of distant simultaneity espoused particularly by Reichenbach and Grunbaum is thus either trivialized or refuted. (shrink)

Generative AI programs can produce high-quality written and visual content that may be used for good or ill. We argue that a credit–blame asymmetry arises for assigning responsibility for these outputs and discuss urgent ethical and policy implications focused on large-scale language models.

It is argued that causal understanding originates in experiences of acting on objects. Such experiences have consistent features that can be used as clues to causal identification and judgment. These are singular clues, meaning that they can be detected in single instances. A catalog of 14 singular clues is proposed. The clues function as heuristics for generating causal judgments under uncertainty and are a pervasive source of bias in causal judgment. More sophisticated clues such as mechanism clues and repeated interventions (...) are derived from the 14. Research on the use of empirical information and conditional probabilities to identify causes has used scenarios in which several of the clues are present, and the use of empirical association information for causal judgment depends on the presence of singular clues. It is the singular clues and their origin that are basic to causal understanding, not multiple instance clues such as empirical association, contingency, and conditional probabilities. (shrink)

In their paper Chris Gyngell, Hilary Bowman-Smart and Julian Savulescu offer a careful analysis of the Nuffield Council on Bioethics report, Genome Editing and Human Reproduction: social and ethical issues but they challenge us to go further still.i I want to suggest that, although their analysis is clear and accurate, its rather ‘molecular’ approach neglects the overall arc and orientation of the report. Furthermore, their conclusions about prospective parents’ reproductive obligations lack sensitivity to the proper evaluative context and offer (...) littlein the way of policy prescriptions. A neglected aspect of the report is the dialectical relation of the three sets of considerations through which it advances: those relating to the individuals directly involved, the wider society in which they live, and the future of human being in general. In particular, Gyngell et al.’s analysis does not attend to how the second principle advanced in the report interacts with the first. It also ignores an important implication of the refusal of a final synthesis, namely, to inaugurate a continual process of reflection between the first two sets of considerations. And it therefore inevitably glosses over practical questions of the mode and venue for this reflection. Something that has not been well understood in the reception …. (shrink)

Reichenbach, Grünbaum, and others have argued that special relativity is based on arbitrary conventions concerning clock synchronizations. Here we present a mathematical framework which shows that this conventionality is almost equivalent to the arbitrariness in the choice of coordinates in an inertial system. Since preferred systems of coordinates can uniquely be defined by means of the Lorentz invariance of physical laws irrespective of the properties of light signals, a special clock synchronization—Einstein's standard synchrony—is selected by this principle. No further restrictions (...) conerning light signal synchronization, as proposed, e.g., by Ellis and Bowman, are required in order to refute conventionalism in special relativity. (shrink)

This article examines nanotechnology within the context of the public interest. It notes that though nanotechnology research and development investment totalled US$9.6 billion in 2005, the public presently understands neither the implications nor how it might be best governed. The article maps a range of nanotechnology dialogue activities under way within the United Kingdom, the United States, Germany, and Australia. It explores the various approaches to articulating public interest matters and notes a shift in the way in which these governments, (...) on the whole, appear to be attempting to manage nanotechnology “risks.” It argues that open and transparent policy deliberations and extensive public discourse will be pivotal to protecting the public interest, gaining public trust and acceptance of nanotechnologies. The article concludes that though governing emerging technologies in the public interest is not a new concept, nanotechnology does present additional challenges that must be addressed by the guardians of the public interest. (shrink)

In this paper I sketch an account of moral blame and blameworthiness. I begin by clarifying what I take blame to be and explaining how blameworthiness is to be analyzed in terms of it. I then consider different accounts of the conditions of blameworthiness and, in the end, settle on one according to which a person is blameworthy for φ-ing just in case, in φ-ing, she violates one of a particular class of moral requirements governing the attitudes we bear, and (...) our mental orientation, toward people and other objects of significant moral worth. These requirements embody the moral stricture that we accord to these others a sufficient level of respect, one that their moral worth demands. This is a familiar theme which has its roots in P. F. Strawson’s pioneering views on moral responsibility. My development of it leads me to the conclusion that acting wrongly is not a condition of blameworthiness: violating a moral requirement to perform, or refrain from performing, an action is neither necessary nor sufficient for being blameworthy. All we are ever blameworthy for, I will argue, are certain aspects of our mental bearing toward others. We can be said to be blameworthy for our actions only derivatively, in the sense that those actions are the natural manifestations of the things for which we are strictly speaking blameworthy. (shrink)

Since the appearance of Plato’s Dialogues, philosophers have been preoccupied with the identity of Socrates and have maintained that successful interpretation of the work hinges upon a clear understanding of what thoughts and ideas can be attributed to him. In Descent of Socrates, Peter Warnek offers a new interpretation of Plato by considering the appearance of Socrates within Plato’s work as a philosophical question. Warnek reads the Dialogues as an inquiry into the nature of Socrates and in doing so (...) opens up the relationship between humankind and the natural world. Here, Socrates appears as a demonic and tragic figure whose obsession with the task of self-knowledge transforms the history of philosophy. In this uncompromising work, Warnek reveals the importance of the concept of nature in the Platonic Dialogues in light of Socratic practice and the Ancient ideas that inspire contemporary philosophy. (shrink)

There is a debate in normative ethics about whether or not our moral obligations depend solely on either our evidence concerning, or our beliefs about, the world. Subjectivists maintain that they do and objectivists maintain that they do not. I shall offer some arguments in support of objectivism and respond to the strongest argument for subjectivism. I shall also briefly consider the significance of my discussion to the debate over whether one’s future voluntary actions are relevant to one’s current moral (...) obligations. (shrink)

We study the proof-theoretic strength and effective content of the infinite form of Ramsey's theorem for pairs. Let RT n k denote Ramsey's theorem for k-colorings of n-element sets, and let RT $^n_{ denote (∀ k)RT n k . Our main result on computability is: For any n ≥ 2 and any computable (recursive) k-coloring of the n-element sets of natural numbers, there is an infinite homogeneous set X with X'' ≤ T 0 (n) . Let IΣ n and BΣ (...) n denote the Σ n induction and bounding schemes, respectively. Adapting the case n = 2 of the above result (where X is low 2 ) to models of arithmetic enables us to show that RCA 0 + IΣ 2 + RT 2 2 is conservative over RCA 0 + IΣ 2 for Π 1 1 statements and that $RCA_0 + I\Sigma_3 + RT^2_{ , is Π 1 1 -conservative over RCA 0 + IΣ 3 . It follows that RCA 0 + RT 2 2 does not imply BΣ 3 . In contrast, J. Hirst showed that $RCA_0 + RT^2_{ does imply BΣ 3 , and we include a proof of a slightly strengthened version of this result. It follows that $RT^2_{ is strictly stronger than RT 2 2 over RCA 0. (shrink)

David Lewis has offered a reply to the standard argument for the claim that the truth of determinism is incompatible with anyone’s being able to do otherwise than she in fact does. Helen Beebee has argued that Lewis’s compatibilist strategy is untenable. In this paper I show that one recent attempt to defend Lewis’s view against this argument fails and then go on to offer my own defense of Lewis’s view.

Normative ethical theories owe us an account of how to evaluate decisions under risk and uncertainty. Deontologists seem at a disadvantage here: our best decision theories seem tailor-made for consequentialism. For example, decision theory enjoins us to always perform our best option; deontology is more permissive. In this paper, we discuss and defend the idea that, when some pro-tanto wrongful act is all-things considered permissible, because it is a ‘lesser evil’, it is often merely permissible, by the lights of deontology. (...) We show that this raises new problems for deontological decision theory, and we show that to resolve them, we need to take a more innovative approach to morally evaluating decision-making under risk and uncertainty. (shrink)

Many health care decisions depend not only upon medical facts, but also on value judgments—patient goals and preferences. Until recent decades, patients relied on doctors to tell them what to do. Then ethicists and others convinced clinicians to adopt a paradigm shift in medical practice, to recognize patient autonomy, by orienting decision making toward the unique goals of individual patients. Unfortunately, current medical practice often falls short of empowering patients. In this article, we reflect on whether the current state of (...) medical decision making effectively promotes patients' health care goals. We base our reflections, in part, on research in which we observed physicians making earnest efforts to partner with patients in making treatment decisions, but still struggling to empower patients—failing to communicate clearly to patients about decision-relevant information, overwhelming patients with irrelevant information, overlooking when patients' emotions made it hard to engage in choices, and making recommendations before discussing patients' goals. (shrink)

Philosophy and Phenomenological Research, EarlyView.

Peter Schouls examines the role played by the concepts of freedom, mastery, and progress in Descartes' writings, arguing that these ideas express a vital and ...

In this lucid and penetrating book, Peter A. Schouls considers Locke's major writings in terms of the closely related ideas of freedom, progress, mastery, reason, and education.

This volume, an expanded edition of the philosophy of language issue of the journal Midwest Studies in Philosophy (1977), includes essays by some of the ...

The Mind Argument is an argument for the incompatibility of indeterminism and anyone's having a choice about anything that happens. Peter van Inwagen rejects the Mind Argument not because he is able to point out the flaw in it, but because he accepts both that determinism is incompatible with anyone's having a choice about anything that happens and that it is possible for someone to have a choice about something that happens. In this paper I first diagnose and clear (...) up a confusion in recent discussions of the Mind Argument and then go on to show why it is a bad argument. (shrink)

Despite its current popularity, “emergence” is a concept with a venerable history and an elusive, ambiguous standing in contemporary evolutionary theory. This paper briefly recounts the history of the term and details some of its current usages. Not only are there radically varying interpretations about how to define emergence but “reductionist” and “holistic” theorists hold very different views about the issue of causation. However, these two seemingly polar positions are not irreconcilable. Reductionism, or detailed analysis of the parts and their (...) interactions, is essential for answering the “how” question in evolution—how does a complex living system work? But holism is equally necessary for answering the “why” question—why did a particular arrangement of parts evolve? In order to answer the “why” question, a broader, multi-leveled paradigm is required. The reductionist approach to explaining emergent complexity has entailed a search for underlying “laws of emergence.” In contrast, the “Synergism Hypothesis” focuses on the “economics”—the functional effects produced by emergent wholes and their selective consequences in evolutionary change. This paper also argues that emergent phenomena represent, in effect, a subset of a larger universe of cooperative, synergistic effects in the natural world. (shrink)

In April 1999, Dr. Curt Freed of the University of Colorado in Denver and Dr. Stanley Fahn of Columbia Presbyterian Center in New York presented the results of a four-year, $5.7 million government-financed study using tissue from aborted fetuses to treat Parkinson’s disease at a conference of the American Academy of Neurology. The results of the first government-financed, placebo-controlled clinical study using fetal tissue showed that the symptoms of some Parkinson’s patients had been relieved. This research study involved forty subjects, (...) nineteen women and twenty-one men; all suffered from Parkinson’s disease for an average of 13.5 years. In the study, each subject underwent neurosurgery: “four tiny burr holes, drilled through the wrinkle lines above the eyebrows into the skull, to clear a pathway to the brain. But only half received injections of fetal cells into the putamen, the region of the brain that controls movement; the other half received nothing. One year later, three members of the placebo group said their symptoms had improved.” In two-thirds of the transplant recipients, the fetal tissue took hold and seemed to establish a new network to produce the missing neurochemical dopamine. (shrink)

Theorists have hypothesized that skill in critical thinking is positively correlated with the consistent internal motivation to think and that specific critical thinking skills are matched with specific critical thinking dispositions. If true, these assumptions suggest that a skill-focused curriculum would lead persons to be both willing and able to think. This essay presents a researchbased expert consensus definition of critical thinking, argues that human dispositions are neither hidden nor unknowable, describes a scientific process of developing conventional testing tools to (...) measure cognitive skills and human dispositions, and summarizes recent empirical research findings that explore the possible relationship of critical thinking skill and the consistent internal motivation, or disposition, to use that skill. Empirical studies indicate that for all practical purposes the hypothesized correlations are not evident. It would appear that effective teaching must include strategies for building intellectual character rather than relying exclusively on strengthening cognitive skills. (shrink)

This new book describes the intellectual structure of modern science as a body of knowledge produced by the Cartesian method.

ABSTRACTMother‐to‐child transmission of HIV represents a particularly dramatic aspect of the HIV epidemic with an estimated 600,000 newborns infected yearly, 90% of them living in sub‐Saharan Africa. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. MTCT is responsible for 90% of these infections. Two‐thirds of the MTCT are believed to occur during pregnancy and delivery, and about one‐third through breastfeeding. As the number of women of child bearing age infected with (...) HIV rises, so does the number of infected children. It is apparent that voluntary testing in Botswana has made some valuable inroads in decreasing perinatal HIV transmission, but the statistics showing the increased rate of HIV infection among women 15–24 years of age are not very promising. After reviewing all the pertinent scientific data it is clear that mandatory HIV testing of all pregnant women in conjunction with the implementation of a full package of interventions would save thousands of lives – mothers, newborns and others who could be infected as a result of these women not being aware of their HIV status. If the protection and preservation of human life is a priority in Botswana, then it is time to allow for mandatory HIV testing of all pregnant women, before it is too late for those who are the most vulnerable. To do less would be medically inappropriate and ethically irresponsible. (shrink)

Although knowledge of torture and physical and psychological abuse was widespread at both the Guantanamo Bay detention facility and Abu Ghraib prison in Iraq, and known to medical personnel, there was no official report before the January 2004 Army investigation of military health personnel reporting abuse, degradation, or signs of torture. Mounting information from many sources, including Pentagon documents, the International Committee of the Red Cross, Amnesty International, Human Rights Watch, etc., indicate that medical personnel failed to maintain medical records, (...) conduct routine medical examinations, provide proper care of disabled and injured detainees, accurately report illnesses and injuries, and falsified medical records and death certificates. Medical personnel and medical information was also used to design and implement psychologically and physically coercive interrogations. The United States military medical system failed to protect detainee's human rights, violated the basic principles of medical ethics and ignored the basic tenets of medical professionalism. (shrink)

In the last few years, the U.S. health care system has seemingly been gripped by “back to the nineties” fever. But there is a notable change in professional debates about how to better control health care costs. Discussion of health care rationing, which was hotly debated in the nineties, has become much more muted.Is health care rationing passé? I contend that debates about health care rationing have waned not because the need to ration has dwindled nor because ethical debates about (...) how or whether to ration have been resolved. They have declined because the word “rationing,” and unrelated concepts such as cost‐effectiveness analysis, have been replaced by terms—“parsimony,” “value,” and “CER”—that are not burdened by emotional and historical baggage.Sometimes the best way to promote healthy moral debate is to turn to new words that don't carry the burden of past debates. (shrink)

Background: Some members of the general public feel that patients who cause their own organ failure through smoking, alcohol use, or drug use should not receive equal priority for scarce transplantable organs. This may reflect a belief that these patients (1) cause their own illness, (2) have poor transplant prognoses or, (3) are simply unworthy. We explore the role that social acceptability, personal responsibility, and prognosis play in people's judgments about transplant allocation. Methods: By random allocation, we presented 283 prospective (...) jurors in Philadelphia county with one of five questionnaire versions. In all questionnaires, subjects were asked to distribute transplantable hearts between patients with and without a history of three controversial behaviors (eating high fat diets against doctors’ advice, cigarette smoking, or intravenous drug use). Across the five questionnaire versions, we varied the relative prognosis of the transplant candidates and whether their behavior caused their primary organ Results: Subjects were significantly less willing to distribute organs to intravenous drug users than to cigarette smokers or people eating high fat diets (p le; 0.0005), even when intravenous drug users had better transplant outcomes than other patients. Subjects’ allocation decisions were influenced by transplant prognosis, but not by whether the behavior in question was causally responsible for the patients’ organ failure. Conclusion: People's unwillingness to give scarce transplantable organs to patients with controversial behaviors cannot be explained totally on the basis of those behaviors either causing their primary organ failure or making them have worse transplant prognoses. Instead, many people believe that such patients are simply less worthy of scarce transplantable organs. (shrink)