We explore the possibilities for elementary embeddings $j : M \to N$, where M and N are models of ZFC with the same ordinals, $M \subseteq N$, and N has access to large pieces of j. We construct commuting systems of such maps between countable transitive models that are isomorphic to various canonical linear and partial orders, including the real line ${\mathbb R}$.

Research on the capacity to understand others' minds has tended to focus on representations ofbeliefs,which are widely taken to be among the most central and basic theory of mind representations. Representations ofknowledge, by contrast, have received comparatively little attention and have often been understood as depending on prior representations of belief. After all, how could one represent someone as knowing something if one does not even represent them as believing it? Drawing on a wide range of methods across cognitive science, (...) we ask whether belief or knowledge is the more basic kind of representation. The evidence indicates that nonhuman primates attribute knowledge but not belief, that knowledge representations arise earlier in human development than belief representations, that the capacity to represent knowledge may remain intact in patient populations even when belief representation is disrupted, that knowledge (but not belief) attributions are likely automatic, and that explicit knowledge attributions are made more quickly than equivalent belief attributions. Critically, the theory of mind representations uncovered by these various methods exhibits a set of signature features clearly indicative of knowledge: they are not modality-specific, they are factive, they are not just true belief, and they allow for representations of egocentric ignorance. We argue that these signature features elucidate the primary function of knowledge representation: facilitating learning from others about the external world. This suggests a new way of understanding theory of mind – one that is focused on understanding others' minds in relation to the actual world, rather than independent from it. (shrink)

BackgroundEthics consult services are well established, but often remain underutilized. Our aim was to identify the barriers and perceptions of the Ethics consult service for physicians, advance practice providers (APPs), and nurses at our urban academic medical center which might contribute to underutilization.MethodsThis was a cross-sectional single-health system, anonymous written online survey, which was developed by the UCSD Health Clinical Ethics Committee and distributed by Survey Monkey. We compare responses between physicians, APPs, and nurses using standard parametric and non-parametric statistical (...) methods. Satisfaction with ethics consult and likelihood of calling Ethics service again were assessed using a 0–100 scale using a 5-likert response structured (0 being “not helpful at all” to 100 being “extremely helpful”) and results presented using box plots and interquartile ranges (IQR).ResultsFrom January to July 2019, approximately 3800 surveys were sent to all physicians, APPs and nurses with a return rate of 5.5—10%. Although the majority of respondents had encountered an ethical dilemma (85–92.1%) only approximately half had ever requested an Ethics consult. The primary reason for physicians never having requested a consult was that they never felt the need for help (41%). For APPs the primary reasons were not knowing an Ethics consult service was available (33.3%) or not knowing how to contact Ethics (27.8%). For nurses, it was not knowing how to contact the Ethics consult service (30.8%) or not feeling the need for help (26.2%). The median satisfaction score (IQR) for Ethics consult services rated on a 0–100 scale, from physicians was 76 (29), for AAPs 89 (49), and nurses 70 (40) (p = 0.62). The median (IQR) of likelihood of consulting Ethics in the future also on a 0–100 scale was 71 (47) for physicians, 69 (45) for APPs, and 61 (45) for nurses (p = 0.79). APP’s and nurses were significantly more likely than physicians to believe that the team did not act on the Ethics consult’s recommendations.ConclusionsBased on the results presented, we were able to identify actionable steps to better engage healthcare providers—and in particular APPs and nurses—and scale up institutional educational efforts to increase awareness of the role of the Ethics consult service at our institution. Actionable steps included implementing a system of ongoing feedback that is critical for the sustainability of the Ethics service role. We hope this project can serve as a blueprint for other hospital-based Ethics consult services to improve the quality of their programs. (shrink)

This essay counteracts that trend [regarding the debate about whether partiality can be justified, those supporting impartiality have generally been on the offensive arguing that morality calls for impartiality] by taking a closer look at the moral complexity of our social practices of partiality. My adoption of this approach does not represent an endorsement of current notions of impartiality. The ideal of impartiality, in my view, should be substantially reformulated. However, that the concept of partiality is transparently defensible. In this (...) discussion, I focus on the aspects of partiality that complicate the philosophical defense of it. In the first part of the discussion, I argue that the moral value of partiality depends partly on the moral value of the relationships it helps to sustain. It matters to the philosophical issues at stake that personal relationships can be abusive and oppressive. In Section II, I refer to the vastly unequal social distribution of the means for favoring loved ones. Because many people have inadequate resources for caring for their loved ones, our conventional relationship practices of partiality-practices by which we care only for our ``own''-can be disasterous for many people. This seriously complicates the defense of partiality. The paper ends with a discussion, in Section III, of ``global moral concern'' and the resistance which most partialists show to it. (shrink)

Based on the relevant logic R, the system R# was proposed as a relevant Peano arithmetic. R# has many nice properties: the most conspicuous theorems of classical Peano arithmetic PA are readily provable therein; it is readily and effectively shown to be nontrivial; it incorporates both intuitionist and classical proof methods. But it is shown here that R# is properly weaker than PA, in the sense that there is a strictly positive theorem QRF of PA which is unprovable in R#. (...) The reason is interesting: if PA is slightly weakened to a subtheory P+, it admits the complex ring C as a model; thus QRF is chosen to be a theorem of PA but false in C. Inasmuch as all strictly positive theorems of R# are already theorems of P+, this nonconservativity result shows that QRF is also a nontheorem of R#. As a consequence, Ackermann's rule γ is inadmissible in R#. Accordingly, an extension of R# which retains its good features is desired. The system R##, got by adding an omega-rule, is such an extension. Central question: is there an effectively axiomatizable system intermediate between R# and R##, which does formalize arithmetic on relevant principles, but also admits γ in a natural way? (shrink)

Assuming that GCH holds and [Formula: see text] is [Formula: see text]-supercompact, we construct a generic extension [Formula: see text] of [Formula: see text] in which [Formula: see text] remains strongly inaccessible and [Formula: see text] for every infinite cardinal [Formula: see text]. In particular the rank-initial segment [Formula: see text] is a model of ZFC in which [Formula: see text] for every infinite cardinal [Formula: see text].

The term “exceptionalism” was introduced into health care in 1991 when Bayer described “HIV exceptionalism” as the policy of treating the human immunodeficiency virus different from other infectious diseases, particularly other sexually transmitted diseases. It was reflected in the following practices: pre- and post-HIV test counseling, the development of specific separate consent forms for HIV testing, and stringent requirements for confidentiality of HIV test results. The justification for these practices was the belief that testing was essential for prevention and that (...) patients might not seek HIV testing if confidentiality were not guaranteed. Confidentiality was believed to be particularly important given the degree of discrimination and stigmatization associated with the illness. Anonymous testing was a further step in ensuring strict confidentiality, even though such a practice prevented public officials from contacting partners and others who were at risk. (shrink)

In 1994, the Committee on Assessing Genetic Risks of the Institute of Medicine published their recommendations regarding the ethical issues raised by advances in genetics. One of the Committee's recommendation was to inform women when test results revealed misattributed paternity, but not to disclose this information to the women's partners. The Committee's reason for withholding such information was that “'genetic testing should not be used in ways that disrupt families”. In this paper, I argue that the Committee's conclusion in favour (...) of nondisclosure to the male partner is unethical. I argue that both parties ought to be informed. (shrink)

This article describes the process engaged by 17 expert scholars in the development of a set of six consensus recommendations about the normative foundations of pediatric decision-making. The process began with a robust pre-reading assignment, followed by three days of in-person symposium discussions that resulted in a publication in _Pediatrics_ entitled “Pediatric Decision-Making: Consensus Recommendations” (Salter et al. 2023). This article next compares the six recommendations to existing statements about pediatric decision-making (specifically those developed by the American Academy of Pediatrics), (...) highlighting similarities and differences. Finally, the article discusses the value of finding consensus in the field of pediatric bioethics. (shrink)

It is widely held that individuals who are unable to provide informed consent should be enrolled in clinical research only when the risks are low, or the research offers them the prospect of direct benefit. There is now a rich literature on when the risks of clinical research are low enough to enroll individuals who cannot consent. Much less attention has focused on which benefits of research participation count as ‘direct’, and the few existing accounts disagree over how this crucial (...) concept should be defined. This disagreement raises concern over whether those who cannot consent, including children and adults with severe dementia, are being adequately protected. The present paper attempts to address this concern by considering first what additional protections are needed for these vulnerable individuals. This analysis suggests that the extant definitions of direct benefits either provide insufficient protection for research subjects or pose excessive obstacles to appropriate research. This analysis also points to a modified definition of direct benefits with the potential to avoid these two extremes, protecting individuals who cannot consent without blocking appropriate research. (shrink)

In the biblical Book of Ruth, Boaz instructs his workers not to molest Ruth. We draw insights on the problem of workplace sexual harassment in the family-firm setting from the Book of Ruth. We then integrate these insights with several discrete findings in the literatures on workplace sexual harassment and family firms: First, family firms are relatively strong when it comes to a culture of fairness and respect. Second, family firms sometimes lack formal codes of ethics, which could hamper integrity. (...) Third, religious exemplars can reinforce the positive culture of family firms and even substitute for a formal code of ethics. Fourth, religious exemplars can also attenuate excessive risk-taking behavior in family firms. (shrink)

Release of the ATP hydrolysis product ortophosphate (Pi) from the active site of myosin is central in chemo‐mechanical energy transduction and closely associated with the main force‐generating structural change, the power‐stroke. Despite intense investigations, the relative timing between Pi‐release and the power‐stroke remains poorly understood. This hampers in depth understanding of force production by myosin in health and disease and our understanding of myosin‐active drugs. Since the 1990s and up to today, models that incorporate the Pi‐release either distinctly before or (...) after the power‐stroke, in unbranched kinetic schemes, have dominated the literature. However, in recent years, alternative models have emerged to explain apparently contradictory findings. Here, we first compare and critically analyze three influential alternative models proposed previously. These are either characterized by a branched kinetic scheme or by partial uncoupling of Pi‐release and the power‐stroke. Finally, we suggest critical tests of the models aiming for a unified picture. (shrink)

In February 1997, the Committee on Bioethics of the American Academy of Pediatrics updated its position on religious exemptions to medical care. In its earlier statement, the committee noted that forty-four states have religious exemptions to the child abuse and neglect statutes, and they argued for the repeal of these exemptions. The committee did not indude in its statement a position on religious exemptions to childhood immunization requirements that exist in forty-eight states, although this issue was discussed in committee meetings. (...) In its revised statement, the committee concluded that “The AAP does not support the stringent application of medical neglect laws when children do not receive recommended immunizations.” In this paper, we consider whether failure to immunize one's child is a form of medical neglect and, if so, whether states should repeal their religious exemptions to the immunization statutes. We argue that failure to vaccinate a child properly is medical neglect. (shrink)

In August 2000, Arthur Matas and his colleagues de scribed a protocol in which their institution began to accept as potential donors, individuals who came to the University of Minnesota hospital offering to donate a kidney to any patient on the waiting list. Matas and his colleagues refer to these donors as nondirected donors by which is meant that the donors are altruistic and that they give their organs to an unspecified pool of recipients with whom they have no emotional (...) relationship. This paper represents an ethical and policy critique of the nondirected donation protocol that was implemented at the University of Minnesota in August 1999. Specifically, I address the ethical questions: Whether altruistic living solid organ donations by strangers should be permitted? And if so, What are appropriate ethical guidelines for such donations? (shrink)

Controversies surrounding the determination of death by neurologic criteria (DNC), also known as brain death, have become increasingly common over the last decade, occasionally leading to parental refusal of all or part of an evaluation or declaration of DNC. We performed a prospective, crosssectional study of pediatric neurologists and intensivists who participate in professional listservs to ascertain perspectives and practices concerning the evaluation of DNC, specifically on obtaining permission for evaluations and managing refusals. Of the 334 respondents who had performed (...) an evaluation for DNC, 35 percent reported they had experienced at least one parental refusal, and 64.4 percent reported that they did not seek permission to perform an evaluation. Pediatric neurologists, careproviders who had less experience doing evaluations, and careproviders who had experienced parental refusal of an evaluation were more likely to obtain permission from parents. Most (80.8 percent) of respondents reported that their institution had a DNC policy. We found variability in many aspects of DNC evaluations and declarations, as well as the handling of refusals. Lack of consistency may make it more difficult for careproviders and families. Greater understanding of parental refusal of DNC evaluation is essential to inform efforts to increase consistency. (shrink)

We study regularity properties related to Cohen, random, Laver, Miller and Sacks forcing, for sets of real numbers on the Δ31\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\varvec{\Delta}^1_3}$$\end{document} level of the projective hieararchy. For Δ21\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\varvec{\Delta}^1_2}$$\end{document} and Σ21\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\varvec{\Sigma}^1_2}$$\end{document} sets, the relationships between these properties follows the pattern of the well-known Cichoń diagram for cardinal characteristics of the continuum. It is known that (...) assuming suitable large cardinals, the same relationships lift to higher projective levels, but the questions become more challenging without such assumptions. Consequently, all our results are proved on the basis of ZFC alone or ZFC with an inaccessible cardinal. We also prove partial results concerning Σ31\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\varvec{\Sigma}^1_3}$$\end{document} and Δ41\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\varvec{\Delta}^1_4}$$\end{document} sets. (shrink)

Economists tend to view ignorance as “rational,” neglecting the possibility that ignorance is unintentional. This oversight is reflected in economists’ model of “information search,” which can be fruitfully contrasted with “information browsing.” Information searches are designed to discover unknown knowns, whose value is calculable ex ante, such that this value justifies the cost of the search. In this model of human information acquisition, there is no primal or “radical” ignorance that might prevent people from knowing which information to look for, (...) lacking omniscience. Unlike ignorance that is rationally chosen on the basis of an accurate cost/benefit calculation, radical ignorance can explain human error. An account of error as grounded in radical ignorance bypasses the need to appeal to irrationality in order to explain economic (and other) mistakes. (shrink)

Both Morain and Largent (2023) and Garland, Morain, and Sugarman (2023) recognize the ethical challenges inherent in clinician participation in embedded research. Focusing on the question of integr...

We now fix A ⊆ Q. We study a fundamental class of digraphs associated with A, which we call the A-digraphs. An A,kdigraph is a digraph (Ak,E), where E is an order invariant subset of A2k in the following sense. For all x,y ∈ A2k, if x,y have the same order type then x ∈ E ↔ y ∈ E.

Most of my intellectual efforts have focused around a single general question in the foundations of mathematics (f.o.m.). I became keenly aware of this question as a student at MIT around 40 years ago, and readily adopted it as the principal driving force behind my research.

An unprovable theorem is a mathematical result that can-not be proved using the com-monly accepted axioms for mathematics (Zermelo-Frankel plus the axiom of choice), but can be proved by using the higher infinities known as large cardinals. Large car-dinal axioms have been the main proposal for new axioms originating with Gödel.

The sensible response to conflicts of interest is impaired by misconceptions and sloppy usage of terminology. Apparent and potential are widely misused modifiers for conflicts. Excessive legislative focus on financial interests limits understanding of the scope and significance of researchers' conflicts of interest. There is no moral or ethical failing in having a conflict of interest; the problem occurs when conflicts are not disclosed appropriately and when conflicts are allowed to bias research, teaching, or practice. Avoidance and prevention should be (...) applied to bias, not conflicts. (shrink)

In mathematics, we back up our discoveries with rigorous deductive proofs. Mathematicians develop a keen instinctive sense of what makes a proof rigorous. In logic, we strive for a *theory* of rigorous proofs.

Most of the research in foundations of mathematics that I do in some way or another involves the use of nonstandard models. I will give a few examples, and indicate what is involved.

A core value of Judaism is leading an ethical life. The Talmud, an authoritative source on Jewish law and tradition, has a number of discussions that deal with honesty in business and decision-making. One motive that can cause individuals to be unscrupulous is the presence of a conflict of interest. This paper will define, discuss, and review five Talmudic concepts relevant to conflict of interest. They are (1) Nogea B’Davar (being an interested party), (2) V’hiyitem N’keyim (behaving to ensure that (...) one is above suspicion) (3) Lifnei Iver (placing a stumbling block before the blind), (4) Shokhad (accepting a bribe), and (5) Geneivat Da’at (deception and undeserved goodwill). Case examples will be used to apply these Talmudic principles to contemporary business practice. This will include discussion of these Talmudic concepts as it applies to specific contemporary business examples relevant to the boardroom, accounting firms, investment banking, politics, and government. It may be impossible to eliminate all conflicts of interest. However, knowledge and awareness of these Talmudic principles can help individuals in business settings better address the ethical issues that they confront. (shrink)

Xenophilia, seen as a type of romanticism, is proposed as an explanation for the tendency within transpersonal psychology to privilege so-called exotic religious and spiritual traditions, as opposed to the xenophobic tendency within mainstream Western psychology of religion and spirituality to privilege the Judeo-Christian tradition. Claims made in a recent article published in a major psychology journal that Buddhism does not rest on supernatural faith and is the most psychological spiritual tradition are challenged as examples of this type of romanticism. (...) Demographic trends showing conversion rates to Buddhism in the US are contrasted with conversion rates to Christianity in South Korea, also evidencing this tendency to embrace religious and spiritual traditions in accord with xenophilia. (shrink)

Provide a formal system that is a conservative extension of PA for Π02 sentences, and even a conservative extension of HA, that supports the worry free smooth development of constructive analysis in the style of Errett Bishop.