In most U.S. jurisdictions, clinicians providing informal “curbside” consults are protected from medical malpractice liability due to the absence of a doctor-patient relationship. A recent Minnesota Supreme Court case, Warren v. Dinter, offers the opportunity to reassess whether the majority rule is truly serving the best interests of patients.

Medical research is widely thought to have a fundamentally therapeutic orientation, in spite of the fact that clinical research is thought to be ethically distinct from medical care. We need an entirely new conception of clinical research ethics—one that looks to science instead of the doctor‐patient relationship.

A recent commentary defends 1) the concept of 'brain arrest' to explain what brain death is, and 2) the concept that death occurs at 2–5 minutes after absent circulation. I suggest that both these claims are flawed. Brain arrest is said to threaten life, and lead to death by causing a secondary respiratory then cardiac arrest. It is further claimed that ventilation only interrupts this way that brain arrest leads to death. These statements imply that brain arrest is not death (...) itself. Brain death is a devastating state that leads to death when intensive care, which replaces some of the brain's vital functions such as breathing, is withdrawn and circulation stops resulting in irreversible loss of integration of the organism. Circulatory death is said to occur at 2–5 minutes after absent circulation because, in the context of DCD, the intent is to not attempt reversal of the absent circulation. No defense of this weak construal of irreversible loss of circulation is given. This means that paents in identical physiologic states are dead (in the DCD context) or alive (in the resuscitation context); the current state of death (at 2–5 minutes) is contingent on a future event (whether there will be resuscitation) suggesting backward causation; and the commonly used meaning of irreversible as 'not capable of being reversed' is abandoned. The literature supporting the claim that autoresuscitation does not occur in the context of no cardiopulmonary resuscitation is shown to be very limited. Several cases of autoresuscitation are summarized, suggesting that the claim that these cases are not applicable to the current debate may be premature. I suggest that brain dead and DCD donors are not dead; whether organs can be harvested before death from these patients whose prognosis is death should be debated urgently. (shrink)

Objective: Contemporary ethical accounts of the patient-provider relationship emphasise respect for patient autonomy and shared decision making. We sought to examine the relative influence of involvement in decisions, confidence and trust in providers, and treatment with respect and dignity on patients’ evaluations of their hospital care.Design: Cross-sectional survey.Setting: Fifty one hospitals in Massachusetts.Participants: Stratified random sample of adults discharged from a medical, surgical, or maternity hospitalisation between January and March, 1998. Twelve thousand six hundred and eighty survey recipients responded.Main outcome (...) measure: Respondent would definitely be willing to recommend the hospital to family and friends.Results: In a logistic regression analysis, treatment with respect and dignity 3.4, 99% confidence interval 2.8 to 4.2) and confidence and trust in providers were more strongly associated with willingness to recommend than having enough involvement in decisions . Courtesy and availability of staff , continuity and transition , attention to physical comfort , and coordination of care were also significantly associated with willingness to recommend.Conclusions: Confidence and trust in providers and treatment with respect and dignity are more closely associated with patients’ overall evaluations of their hospitals than adequate involvement in decisions. These findings challenge a narrow emphasis on patient autonomy and shared decision making, while arguing for increased attention to trust and respect in ethical models of health care. (shrink)

Among Aristotle’s criticisms of the Form of the Good is his claim that the knowledge of such a Good could be of no practical relevance to everyday rational agency, e.g. on the part of craftspeople. This critique turns out to hinge ultimately on the deeply different assumptions made by Plato and Aristotle about the relation of ‘good’ and ‘good for’. Plato insists on the conceptual priority of the former; and Plato wins the argument.

French philosopher Bernard Stiegler’s teacher, the great Jacques Derrida, when speaking of the nature of the life of Aristotle, questioned the need for biography and anecdote. Philosophy excludes b...

In thinking the passage from the “all-human cerebrum” to what one might call the contemporary “all-too-human” cerebrum in neo-liberal societies and beyond to the “all-too-transhuman” cerebrum in the cybernetic society, in contrasting Wells’s idea of a new world order with the dystopia of the disordering un-world, in considering the prospects of a “world brain” faced with the realities of the “global mnemotechnical system”, in highlighting the differences between the global and authoritarian instrument of “control” in Wells and the descriptions of (...) the control society by Deleuze, and finally, in critiquing the “unifying of the general intelligence services of the world” in Wells and the capturing of the “general intellect”, this paper maps the contemporary prospects of the “world brain” against the backdrop of the worldweariness of the present. (shrink)

A joke is amusing if and only if it’s fitting to be amused by it; an act is regrettable if and only if it’s fitting to regret it. Many philosophers accept these biconditionals and hold that analogous ones obtain between a wide range of additional evaluative properties and the fittingness of corresponding responses. Call these the _fit–value biconditionals_. The biconditionals give us a systematic way of recognizing the role of fit in our ethical practices; they also serve as the bedrock (...) of various metaethical projects, such as fitting-attitude analysis of value and the ‘fittingness first’ approach. Yet despite the importance of the biconditionals, there is very little discussion of their proper interpretation. This paper argues that any plausible interpretation of the fit_–_value biconditionals must disarm several kinds of apparent counterexample. For instance, that an achievement is pride-worthy doesn’t imply it is fitting for me to take pride in it because the achievement might not be mine or that of anyone close to me; that a joke is amusing doesn’t imply it is fitting for me to be amused by it for six straight months; and that a person is loveable doesn’t imply it is fitting for me to love him romantically because that person might be my sibling. We consider possible responses to such counterexamples and develop what we consider the most promising interpretation of the biconditionals. The upshot is that certain widespread assumptions about fit and its relation to value and reasons should be reconsidered. (shrink)

Anthology of readings in moral philosophy.

By tracing the genealogy of Lawrence Ferlinghetti's outlandish notion of the fourth person singular and its appropriation in The Logic of Sense, several keys concepts in Deleuze's thought such as the nonpersonal and pre-individual subjectivity can be rendered clearer to the understanding. While there is poetic licence in the use of the term by Ferlinghetti, the fourth person singular is heuristic for exploring the notion of free indirect speech and, more speculatively, the ideas of impersonal death and suicide. The fourth (...) person singular is thus a trope that sheds light on the ideas of humour, irony, lightness and becoming ‘without a verb’ in Deleuze's thought. Under close scrutiny is what Ferlinghetti designates as the ‘cool’ eyes of the fourth person singular. We shall work to differentiate these from so-called mad, Dada-esque ‘unblinking’ eyes. We shall ask how the poet in ‘obscenely seeing’ the impossible possibility of life can envision – perspicaciously – the immanent sense of death-in-life. From what standpoint does the poet gain access to the real? To consider this fully it is necessary to follow the Deleuzian interpretation of singularities as true transcendental events so as to clarify what gives life a ‘non-personal power, above individuals’. (shrink)

What words we use, and what meanings they have, is important. We shouldn't use slurs; we should use 'rape' to include spousal rape (for centuries we didn’t); we should have a word which picks out the sexual harassment suffered by people in the workplace and elsewhere (for centuries we didn’t). Sometimes we need to change the word-meaning pairs in circulation, either by getting rid of the pair completely (slurs), changing the meaning (as we did with 'rape'), or adding brand new (...) word-meaning pairs (as with 'sexual harassment'). A problem, though, is how to do this. One might worry that any attempt to change language in this way will lead to widespread miscommunication and confusion. I argue that this is indeed so, but that's a feature, not a bug of attempting to change word-meaning pairs. The miscommunications and confusion such changes cause can lead us, via a process I call transformative communicative disruption, to reflect on our language and its use, and this can be further, rather than hinder, our goal of improving language. (shrink)

Some patients who have been diagnosed as “dead by neurologic criteria” continue to exhibit certain brain functions, most commonly, neuroendocrine functions. This preservation of neurologic function after the diagnosis of “brain death” or “brainstem death” is an ongoing source of controversy and concern in the medical, bioethics, and legal literatures. Most obviously, if some brain function persists, then it is not the case that all functions of the entire brain have ceased and hence, declaring such a patient to be “dead” (...) would be a false positive, in any nation with so-called “whole brain death” laws. Furthermore, and perhaps more concerning, the preservation of any brain function necessarily entails the preservation of some amount of brain perfusion, thereby raising the concern as to whether additional areas of neural tissue may remain viable, including areas in the brainstem. These and other considerations cast significant doubt on the reliability of diagnosing either “brain death” or “brainstem death.”. (shrink)

Kant's Critique of Judgment has often been interpreted by scholars as comprising separate treatments of three uneasily connected topics: beauty, biology, and empirical knowledge. Rachel Zuckert's book interprets the Critique as a unified argument concerning all three domains. She argues that on Kant's view, human beings demonstrate a distinctive cognitive ability in appreciating beauty and understanding organic life: an ability to anticipate a whole that we do not completely understand according to preconceived categories. This ability is necessary, moreover, for (...) human beings to gain knowledge of nature in its empirical character as it is, not as we might assume it to be. Her wide-ranging and original study will be valuable for readers in all areas of Kant's philosophy. (shrink)

Lucidly and persuasively written, this book will be an invaluable resource for students and scholars seeking to understand Irigaray's original contribution to philosophical and feminist thought.

This Element presents a philosophical exploration of the concept of the 'model organism' in contemporary biology. Thinking about model organisms enables us to examine how living organisms have been brought into the laboratory and used to gain a better understanding of biology, and to explore the research practices, commitments, and norms underlying this understanding. We contend that model organisms are key components of a distinctive way of doing research. We focus on what makes model organisms an important type of model, (...) and how the use of these models has shaped biological knowledge, including how model organisms represent, how they are used as tools for intervention, and how the representational commitments linked to their use as models affect the research practices associated with them. This title is available as Open Access on Cambridge Core. (shrink)

In Talking about, Unnsteinsson defends an intentionalist theory of reference by arguing that confused referential intentions degrade reference. Central to this project is a “belief model” of both identity confusion and unconfused thought. By appealing to a well‐known argument from Campbell, I argue that this belief model falls short, because it fails to explain the inferential behavior it promises to explain. Campbell's argument has been central in the contemporary literature on Frege's puzzle, but Unnsteinsson's account of confusion provides an opportunity (...) for more clarity about how the argument is best interpreted, and what it shows. (shrink)

This article employs Foucauldian and feminist analytics to advance a critical approach to wearable digital health- and activity-tracking devices. Following Foucault’s insight that the growth of individual capabilities coincides with the intensification of power relations, I argue that digital self-tracking devices (DSTDs) expand individuals’ capacity for self-knowledge and self-care at the same time that they facilitate unprecedented levels of biometric surveillance, extend the regulatory mechanisms of both public health and fashion/beauty authorities, and enable increasingly rigorous body projects devoted to the (...) attainment of normative femininity. These technologies of surveillance, normalization, and discipline thus function to augment, and facilitate the cooperation of, neoliberal-era biopower and post-feminist patriarchal power. My analysis of digital self-tracking devices’ instrumentality to biopower and patriarchy contributes to the emergent field of critical digital health studies and builds new connections between political, social, and feminist theories of embodiment; biopower studies; fat studies; and trans-disciplinary body studies. (shrink)

This is the first book to undertake an applied postmedia and philosophical approach to the work of Felix Guattari. It provides a way to understand philosophically issues in contemporary technology, social life and consumer culture in Asia.

Current axiomatizations for extensive measurement postulate the existence of infinitely small objects. This assumption is neither necessary nor reasonable. This paper develops this theme and presents a more acceptable axiom system. A representation theorem is stated and proved in detail. This work improves some previous results of the author.

This paper offers three objections to Leslie’s recent and already influential theory of generics :375–403, 2007a, Philos Rev 117:1–47, 2008): her proposed metaphysical truth-conditions are subject to systematic counter-examples, the proposed disquotational semantics fails, and there is evidence that generics do not express cognitively primitive generalisations.

In this volume, Rachel Giora explores how the salient meanings of words - the meanings that stand out as most prominent and accessible in our minds - shape how we think and how we speak. For Giora, salient meanings display interesting effects in both figurative and literal language. In both domains, speakers and writers creatively exploit the possibilities inherent in the fact that, while words have multiple meanings, some meanings are more accessible than others. Of the various meanings weencode (...) in our mental lexicon for a given word or expression, we ascribe greater cognitive priority to some over others. Interestingly, the most salient meaning is not always the literal meaning. Giora argues that it is cognitively prominent salient meanings, rather than literal meanings, that play the most important role in the comprehension and production of language. She shows that even though context begins to affect comprehension immediately, it does so without obstructing the early accessing of salient meanings. Thus, the meaning we first attend to is the salient word meaning, regardless of contextual bias. Knowledge of salient meanings turns out to play a major role, perhaps the most important role, in the process of using and understanding of language. Going beyond the familiar effects of literal meaning and context, the Graded Salience Hypothesis presents the most comprehensive explanation for how we use language for meaning. In this volume, Giora presents her new model for the first time in a book-length treatment, with original and illuminating perspectives that will be of interest to linguists, philosophers, psychologists, and all who want to know more about just how we understand what we mean. (shrink)

It is tempting to hold that guilt‐tripping is morally wrong, either because it is objectionably manipulative, or because it involves gratuitously aiming to make another person suffer, or both. In this article, I develop a picture of guilt according to which guilt is a type of pain that incorporates a commitment to its own justification on the basis of the subject's wrongdoing. This picture supports the hypothesis that feeling guilty is an especially efficient means for a wrongdoer to come to (...) more deeply understand why her behavior was wrong; it is precisely because guilt is painful and involves a self‐reflexive justificatory element that it is able to play this role. Such a picture, moreover, preserves the possibility that deliberately making others feel guilty needn't involve aiming gratuitously to harm them and needn't be objectionably manipulative. It follows that we should be surprisingly sanguine about the practice of inducing guilt in wrongdoers as a means of facilitating their moral edification. (shrink)

This book is about the norms of the speech act of assertion. This is a topic of lively contemporary debate primarily carried out in epistemology and philosophy of language. Suppose that you ask me what time an upcoming meeting starts, and I say, “4 p.m.” I’ve just asserted that the meeting starts at 4 p.m. Whenever we make claims like this, we’re asserting. The central question here is whether we need to know what we say, and, relatedly, whether what we (...) assert must be true. If the meeting is really at 3:30 p.m., you’ll be late, and probably rather upset that I told you the wrong time. In some sense, it seems like I’m on the hook for having said something false. This sense that I’ve done something wrong suggests that there are certain standards of evaluating assertions: a way of distinguishing between good and bad, appropriate and inappropriate. We call these standards norms. And so the debate about what, if any, norms govern the linguistic practice of assertion is known as the norms of assertion debate. When one’s assertion satisfies the norm, we say that the assertion is warranted. -/- Various philosophers have typically focused their views of the norms of assertion on articulating the level of epistemic support required for properly asserting. Some argue, for example, that one must know what one asserts. Others argue that one merely needs to justifiably believe what one asserts–an epistemic standing weaker than knowledge. The purpose of this book is to defend what I propose as the central norm governing our practice of assertion, which I call the Supportive Reasons Norm. Here’s what it looks like: -/- One may assert that p only if: One has supportive reasons for p, The relevant conventional and pragmatic elements of the context are present, and One asserts that p at least in part because the assertion that p satisfies and. -/- In rough outline, the standards for warrantedly asserting shift with changes in context, although knowledge is never required for warrantedly asserting. In fact, in some special contexts, speakers may warrantedly lie. This latter feature particularly sets apart my view from others in the debate. This also means that truth, knowledge, and even belief aren’t necessary conditions for warrantedly asserting. (shrink)

We offer an interpretation of the mental files framework that eliminates the metaphor of files, information being contained in files, etc. The guiding question is whether, once we move beyond the metaphors, there is any theoretical role for files. We claim not. We replace the file-metaphor with two theses: the semantic thesis that there are irreducibly relational representational facts (viz. facts about the coordination of representations); and the metasemantic thesis that processes tied to information-relations ground those facts. In its canonical (...) statement, the ‘file’-theory makes reference to a certain kind of relational representational feature, and a certain kind of mental activity. Mental files need not come into it. In short, we posit mental filing without mental files. Our interpretation avoids awkward problems that arise on the standard interpretation and clarifies the explanatory commitments of the theory. (shrink)

Rachel Cohon offers an original interpretation of the moral philosophy of David Hume, focusing on two areas.

Classifying Madness (Springer, 2005) concerns philosophical problems with the Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the D.S.M. The D.S.M. is published by the American Psychiatric Association and aims to list and describe all mental disorders. The first half of Classifying Madness asks whether the project of constructing a classification of mental disorders that reflects natural distinctions makes sense. Chapters examine the nature of mental illness, and also consider whether mental disorders fall into natural kinds. The (...) second half of the book addresses epistemic worries. Even supposing a natural classification system to be possible in principle, there may be reasons to be suspicious of the categories included in the D.S.M. I examine the extent to which the D.S.M. depends on psychiatric theory, and look at how it has been shaped by social and financial factors. I aim to be critical of the D.S.M. without being antagonistic towards it. Ultimately, however, I am forced to conclude that although the D.S.M. is of immense practical importance, it is unlikely to come to reflect the natural structure of mental disorders. (shrink)

Medical ethics assumes a clear boundary between clinical research and clinical medicine: one produces knowledge for the benefit of future patients, while the other provides optimal care to individuals right now. It also assumes that the two cannot be integrated without sacrificing the needs of the current patient to those of future patients. But integration could allow us to provide better care to everyone, now and in the future.

In this book, Rachel Zuckert provides the first overarching account of Johann Gottfried Herder's complex aesthetic theory. She guides the reader through Herder's texts, showing how they relate to eighteenth- and nineteenth-century European philosophy of art, and focusing on two main concepts: aesthetic naturalism, the view that art is natural to and naturally valuable for human beings as organic, embodied beings, and - unusually for Herder's time - aesthetic pluralism, the view that aesthetic value takes many diverse and culturally (...) varying forms. Zuckert argues that Herder's theory plays a pivotal role in the history of philosophical aesthetics, marking the transition from the eighteenth-century focus on aesthetic value as grounded in human nature to the nineteenth-century focus on art as socially significant and historically variable. Her study illuminates Herder's significance as an innovative thinker in aesthetics, and will interest a range of readers in philosophy of art and European thought. (shrink)

The imaginative context in which artificial intelligence is embedded remains a crucial touchstone from which to understand and critique both the histories and prospective futures of an AI-driven world. A recent article from Cave and Dihal sets out a narrative schema of four hopes and four corresponding fears associated with intelligent machines and AI. This article seeks to respond to the work of Cave and Dihal by presenting a gendered reading of this schema of hopes and fears. I offer a (...) brief genealogy of narratives which feature female automata, before turning to examine how gendered technology today—particularly AI assistants like Siri and Alexa—reproduces the historical narratives associated with intelligent machines in new ways. Through a gendered reading of the hopes and fears associated with AI, two key responses arise. First, that the affective reactions to intelligent machines cannot be readily separated where such machines are gendered female. And second, that the gendering of AI technologies today can be understood as an attempt to reconcile the opposing hopes and fears AI produces, and that this reconciliation is based on the association of such technologies with traditional notions of femininity. Critically, a gendered reading enables us to problematize the narratives associated with AI and expose the power asymmetries that lie within, and the technologies which arise out of, such narratives. (shrink)

What happens when we consider transformative experiences from the perspective of gender transitions? In this paper I suggest that at least two insights emerge. First, trans* persons’ experiences of gender transitions show some limitations to L.A. Paul’s (forthcoming) decision theoretic account of transformative decisions. This will involve exploring some of the phenomenology of coming to know that one is trans, and in coming to decide to transition. Second, what epistemological effects are there to undergoing a transformative experience? By connecting some (...) experiences of gender transitions to feminist standpoint epistemology, I argue that radical changes in one’s identity and social location also radically affects one’s access to knowledge in ways not widely appreciated in contemporary epistemology. (shrink)

Classic statements of research ethics advise against permitting physician-investigators to obtain consent for research participation from patients with whom they have preexisting treatment relationships. Reluctance about “dual-role” consent reflects the view that distinct normative commitments govern physician–patient and investigator–participant relationships, and that blurring the research–care boundary could lead to ethical transgressions. However, several features of contemporary research demand reconsideration of the ethics of dual-role consent. Here, we examine three arguments advanced against dual-role consent: that it creates role conflict for the (...) physician-investigator; that it can compromise the voluntariness of the patient-participant’s consent; and that it promotes therapeutic misconceptions. Although these concerns have merit in some circumstances, they are not dispositive in all cases. Rather, their force—and the ethical acceptability of dual-role consent—varies with features of the particular study. As research participation more closely approximates usual care, it becomes increasingly acceptable, or even preferable, for physicians to seek consent for research from their own patients. It is time for a more nuanced approach to dual-role consent. (shrink)

There's been a great deal of interest in epistemology regarding what it takes for a hearer to come to know on the basis of a speaker's say-so. That is, there's been much work on the epistemology of testimony. However, what about when hearers don't believe speakers when they should? In other words, what are we to make of when testimony goes wrong? A recent topic of interest in epistemology and feminist philosophy is how we sometimes fail to believe speakers due (...) to inappropriate prejudices – implicit or explicit. This is known as epistemic injustice. In this article, I discuss Miranda Fricker's groundbreaking work on epistemic injustice, as well as more recent developments that both offer critique and expansion on the nature and extent of epistemic injustice. (shrink)

In this paper I present my proposal for the central norm governing the practice of assertion, which I call the Supportive Reasons Norm of Assertion (SRNA). The critical features of this norm are that it's highly sensitive to the context of assertion, such that the requirements for warrantedly asserting a proposition shift with changes in context, and that truth is not a necessary condition for warrantedly asserting. In fact, I argue that there are some cases where a speaker may warrantedly (...) assert something she knows to be false. Only SRNA seems able to account for such cases. (shrink)

Stephen Jay Gould argued that the shape of animal life as we know it is a radically contingent accident of history determined more by fortune than comparative functional merit. Acknowledging the formative role of contingency in macroevolution is crucial, Gould believed, to vanquishing the lingering vestiges of progressivism that continue to buttress anthropocentric views of life. Gould’s contingency thesis has come under fire in recent years by proponents of convergent evolution who argue that not only is replication ubiquitous in evolution, (...) but also that it indicates an evolutionary process charging inexorably toward ever more complex and human-like outcomes. We argue here that although convergentist approaches are widely seen as inimical to the Gouldian view of life, in fact the two are indispensable allies in the anti-progressivist crusade, particularly in relation to the evolution of mind. We illustrate this by examining the progressivist foundations of comparative cognition science and the ongoing resistance to attributions of convergent minds. (shrink)