Drawing on the performance appraisal and medical literatures, we examine representative ethical issues involved in current appraisal practices of individual physicians: the use of invalid and unreliable measures; organizational goals conflicting with patient health goals; using individual measures for what are group performance results; making individual attributions for what are systemic causes ; and using clinical feedback for organizational purposes. Suggestions for developing more ethical performance appraisals include reflecting upon the multiple purposes and means of appraisals, and the limitations of (...) current practices. Greater understanding of the effects of current appraisal practices on physicians can help minimize its potentially adverse consequences on the delivery of quality healthcare. (shrink)

Late 1980s economic theory failed to account for Japanese-style economies. Leading thinkers ignored the success and achievements of these systems by passing them off as exceptions due to “cultural uniqueness,” or by altering the facts to fit their theories. Chalmers Johnson argues that the success of the Japanese economy is neither random nor a function of culture but due to policy, particularly to Japanese industrial policy.

Japan is the world's second most productive economy, but its economic system is intensely controversial. It differs from both the plan-rational systems of the communist world and the market-rational systems of the capitalist world in that it combines elements of both. This configuration directly challenges orthodox capitalist theory as advanced by the United States and the United Kingdom. During the 1990s, when Japan's economy slowed greatly and some other economies of East Asia were besieged by international capital flows, Japan's economy (...) was singled out for a withering ideological critique. Nonetheless, what is wrong in Japan is not its economy but its status as a military satellite of the United States, which causes its political system to be ineffective in serving the country's economic interests. (shrink)

In June 2001, the American Medical Association (AMA) issued a revised and expanded version of the Principles of Medical Ethics (last published in 1980). In light of the new and more comprehensive document, the present essay is geared to consideration of a longstanding tension between physician's autonomy rights and societal obligations in the AMA Code. In particular, it will be argued that a duty to treat overrides AMA autonomy rights in social emergencies, even in cases that involve personal risk to (...) physicians (e.g., bioterrorist attack, HIV infection, SARS). The argument will be made by way of the logic and language of the AMA Code through its history, commentaries, and precedents. It also will be shown that there are substantial reasons to believe that the logic of the Code is sound in morally relevant ways. The essay will conclude with some philosophical proposals suggesting a framework for the duty to render aid and the extension of those duties to physicians facing personal risks. (shrink)

Trust relations in medicine are argued to be a requisite response to the special vulnerability of persons as patients. Even so, the problem of motivating trust remains a vital concern. On this score, it is argued that a strong motivation can be found in recognizing that professional self-interest actually entails cultivation of patient trust as a means to maintain professional self-governance. And while the initial move to restore trust must be provoked from such narrow concerns, the process of sustaining trust (...) will require educational initiatives aimed at restoring attitudes and skills suggestive of Percival's concept of empathic care. By including such initiatives, future waves of medical professionals are apt to sustain trust with deepened commitments to character, care, and trust as constitutive properties of their professional mission. (shrink)

Drawing on the performance appraisal and medical literatures, we examine representative ethical issues involved in current appraisal practices of individual physicians: the use of invalid and unreliable measures; organizational goals conflicting with patient health goals; using individual measures for what are group performance results; making individual attributions for what are systemic causes (and results); and using clinical feedback for organizational purposes. Suggestions for developing more ethical performance appraisals include reflecting upon the multiple purposes and means of appraisals, and the limitations (...) of current practices. Greater understanding of the effects of current appraisal practices on physicians can help minimize its potentially adverse consequences on the delivery of quality healthcare. (shrink)

As the issue of assisted dying continues toward more expanded legal standing, we shift our primary focus from questions of patients' rights to the largely overlooked challenges that face physicians who elect to assist patients in ending their lives. Dr. Howard Grossman, a Manhattan internist and plaintiff in the unsuccessful New York lawsuit to the Supreme Court, came forward to say, “Anybody who has done it knows that it is a tremendous decision that you carry with you forever.”1 We focus (...) our attention on the psychological experience and philosophical conflicts faced by physicians engaged in physician-assisted dying. Based on those potential conflicts, we argue for a new model of the physician and patient relationship in assisted dying: a medical friendship. a. (shrink)

In this paper I will argue that in emergency cases, physician autonomy is soci-etally constrained under Principle VI of the American Medical Association's “Principles of Medical Ethics”1 The issue will be seen to turn on whether the contextual use of “emergency” should be construed narrowly or broadly; I argue for a broadened rendering. Although a societal emergency is not defined here, I recommend that the condition of inner city healthcare presents a paradigm “patient” for such emergency care. I further urge (...) that because societal constraints on physician autonomy are ambiguous and only derived indirectly in the AMA document, further AMA comment on physician autonomy and societal responsibility would advance clarity on the profession's commitment to the public trust. (shrink)

San John Henry Newman es ampliamente entendido como un hombre de conciencia, tanto en su vida como en sus escritos. El objetivo de este artículo es explorar más profundamente los escritos de Newman sobre la conciencia, en orden a mostrar tanto la importancia que la categoría de conciencia aporta nuestro sentido moral como la percepción religiosa y existencial de lo que estamos llamados a hacer, así como vínculo de todas las criaturas humanas a su Creador. Una lectura cuidadosa de unos (...) textos nos ayudará a evitar la mala interpretación común del brindis de Newman por la conciencia que distorsiona su punto de vista como si colocase la conciencia y el Magisterio en oposición, o que si concediese mucho más respeto a la conciencia que a la enseñanza con autoridad de la Iglesia. (shrink)

As the issue of assisted dying continues toward more expanded legal standing, we shift our primary focus from questions of patients' rights to the largely overlooked challenges that face physicians who elect to assist patients in ending their lives. Dr. Howard Grossman, a Manhattan internist and plaintiff in the unsuccessful New York lawsuit to the Supreme Court, came forward to say, “Anybody who has done it knows that it is a tremendous decision that you carry with you forever.”1 We focus (...) our attention on the psychological experience and philosophical conflicts faced by physicians engaged in physician-assisted dying. Based on those potential conflicts, we argue for a new model of the physician and patient relationship in assisted dying: a medical friendship. a. (shrink)

This new edition includes a substantial new preface by the author, in which he discusses repression, determinism, transference, and "practical rationality," and ...

In this essay it is shown that the imaginative art of scientific theorizing – at its technical best – animates Quine's philosophy as importantly as the more Spartan norms honored in his present pantheon of virtues. By drawing a contrast between the standing of theories in philosophy and theories in science, it will be shown that the speculative reaches of philosophy, along with developments in semantic theory, now oblige an internal revision of Quine's stance against meaning as it was announced (...) in “Two Dogmas of Empiricism.” So, corollary to this proposed revision, I argue that in natural philosophy, the muse of the “art of science” deserves an address along with the more Spartan norms in Quine's present philosophical pantheon. As semantic theory and analyticity thus gain a measure of philosophical tenability, Quine's holism emerges as the more central doctrine of his mature vision. (shrink)

In this essay it is shown that the imaginative art of scientific theorizing – at its technical best – animates Quine's philosophy as importantly as the more Spartan norms honored in his present pantheon of virtues. By drawing a contrast between the standing of theories in philosophy and theories in science, it will be shown that the speculative reaches of philosophy, along with developments in semantic theory, now oblige an internal revision of Quine's stance against meaning as it was announced (...) in “Two Dogmas of Empiricism.” So, corollary to this proposed revision, I argue that in natural philosophy, the muse of the “art of science” deserves an address along with the more Spartan norms in Quine's present philosophical pantheon. As semantic theory and analyticity thus gain a measure of philosophical tenability, Quine's holism emerges as the more central doctrine of his mature vision. (shrink)

Inspired by the person and writings of C.S. Lewis, this book examines pertinent and pressing issues in living the Christian faith today. Experts in their fields share their insights and conclusions.

Re-Vision addresses four issues that lie at the crux of the relationship between science and religion—the origin of the cosmos and creation in Genesis; evolutionary theory and God’s action in the world; genes and human freedom; and whether intelligent design is good science and/or good theology.

Using interpretative case study methods, the researchers examined the beliefs and practices of 10 preservice social studies teachers with self-described preferences to teach for justice. While all...

A critical notice of David J. Chalmers, Constructing the World (Oxford University Press,2012).

David Chalmers’ two-dimensionalism is an ambitious philosophical program that aims to “ground” or “construct” Fregean meanings and restore “the golden triangle” of apriority, necessity, and meaning that Kripke seemingly broke. This paper aims to examine critically what Chalmers’ theory can in reality achieve. It is argued that the theory faces severe challenges. There are some gaps in the overall arguments, and the reasoning is in some places somewhat circular. Chalmers’ theory is effectively founded on certain strong philosophical (...) assumptions. It is concluded that it is unclear whether the theory can deliver all it promises. (shrink)

Chalmers (Mind 120(479): 587–636, 2011a) presents an argument against “referentialism” (and for his own view) that employs Bayesianism. He aims to make progress in a debate over the objects of belief, which seems to be at a standstill between referentialists and non-referentialists. Chalmers’ argument, in sketch, is that Bayesianism is incompatible with referentialism, and natural attempts to salvage the theory, Chalmers contends, requires giving up referentialism. Given the power and success of Bayesianism, the incompatibility is prima facie (...) evidence against referentialism. In this paper, I review Chalmers’ arguments and give some responses on behalf of the referentialist. (shrink)

This paper brings out an inconsistency between David Chalmers's dualism, which is the main element of his philosophy of mind, and his structuralism, which is the main element of his epistemology. The point is ad hominem , but the inconsistency if it can be established is of considerable independent interest. For the best response to the inconsistency, I argue, is to adopt what Chalmers calls ‘type‐C Materialism’, a version of materialism that has been much discussed in recent times (...) because of its promise to move us beyond the stand‐off between standard versions of materialism and dualism. In turn, if that version of materialism is true, both dualism and structuralism should be rejected. (shrink)

In The Conscious Mind, D. Chalmers appeals to his semantic framework in order to show that conceivability, as employed in his "zombie" argument for dualism , is sufficient for genuine possibility. I criticize this attempt.

In _The Conscious Mind: In Search of a Fundamental Theory_, David Chalmers poses an interesting and powerful challenge to materialism or physicalism. Further, he goes a long way towards providing a proof by example that the rejection of materialism need not commit one to scientifically suspicious “ghost in the machine” doctrines, but can be wedded to a generally naturalistic perspective. As an (as yet) unpersuaded physicalist and functionalist, his case against physicalism seems an appropriate target for criticism. However, it (...) would be beyond the scope of the present paper—or anything of similar length—to attempt a full-scale reply. A full-scale reply could be executed in brief compass only if Chalmers were guilty of (and rested his case entirely upon) some relatively simple mistake. But he does not. If he is mistaken, the mistakes are more subtle and difficult to bring to light. Instead, I shall outline the essentials of his case against materialism, attempt to point to one problem that appears to infect his views and argue that, if his position is to be acceptable, he needs to deal with it more adequately than he has so far. (shrink)