Background: This study attempts to understand if medical providers beliefs about the moral permissibility of honoring patient-directed refusals of life-sustaining treatment (LST) are tied to their beliefs about the patient’s decision-making capacity. The study aims to answer: 1) does concern about a patient’s treatment decision-making capacity relate to beliefs about whether it is morally acceptable to honor a refusal of LST, 2) are there differences between provider types in assessments of decision-making capacity and the moral permissibility to refuse LST, and (...) 3) do provider demographics impact beliefs about decision-making capacity and the moral permissibility to refuse LST. Methods: A mixed-methods survey using Likert assessment and vignette-based questions was administered to medical providers within a single health system in the upper Midwest (N = 714) to assess their perspectives on the moral acceptance and decision-making capacity in cases of withholding and withdrawing treatment and suicide. Results: Behavioral health providers report accepting of the moral permissibility of suicide (91.2%) more than either medical providers (77.2%) or surgeons (74.4%) (n = 283). Decision-making capacity was questioned more in the vignettes of the patients refusing life-saving surgery (36%) and voluntarily starvation (40.8%) than in the vignette of the patient requesting to deactivate a pacemaker (13%) (n = 283). Behavioral health providers were more concerned about the capacity to refuse life-saving surgery (55.9%) than medical providers (33.8%) or surgeons (23.1%) (n = 283). Conclusions: Respondents endorse the moral permissibility of persons to withhold or withdraw from treatment regardless of motive. Clinical concerns about a patient’s treatment decision-making capacity do not strongly correlate to views about the moral permissibility of honoring refusals of LST. Different provider types appear to have different thresholds for when to question treatment decision-making capacity. Behavioral health providers tend to question treatment decision-making capacity to refuse LST more than non-behavioral health providers. (shrink)

Most arguments about conscientious objections in medicine fail to capture the full scope and complexity of the concept before drawing conclusions about their permissibility in practice. Arguments favoring and disfavoring the accommodation of conscientious objections in practice tend to focus too narrowly on prima facie morally contentious treatments and religious claims of conscience, while further failing to address the possibility of moral perspectives changing over time. In this paper, I argue that standard reasons against permitting conscientious objections in practice—that their (...) permission may result in harm to patients, the idea that medical providers willingly enter into the medical field, and that conscientious objections stand contrary to medical professionalism—do not apply in all cases and that the medical field and health systems in which many physicians now practice should continue to tolerate conscientious objections in practice. (shrink)

Volume 20, Issue 7, July 2020, Page 139-141.

This paper aims to demonstrate how public disclosure can be used to balance physicians9 conscientious objections with their professional obligations to patients – specifically respect for patient autonomy and informed consent. It is argued here that physicians should be permitted to exercise conscientious objections, but that they have a professional obligation to provide advance notification to patients about those objections. It is further argued here that public disclosure is an appropriate and ethically justifiable limit to the principle of advance notification. (...) The argument for publicly disclosing physicians9 conscientious objections is made in this paper by discussing three practical benefits of public disclosure in medicine, and then addressing how publicly disclosing physicians9 conscientious objections is not an undue invasion of privacy. Three additional concerns with public disclosure of physicians9 conscientious objections are briefly addressed – potential harassment of physicians, workplace discrimination, and mischaracterising physicians9 professional aptitude – concluding that each of these concerns requires further deliberation in the realm of business ethics. (shrink)

People are typically grateful for medical technologies used in the treatment of illness or injury. This chapter explores how Lucas has led Star Wars audiences astray into accepting false beliefs and fallacies about the value of technology, particularly in a medical context. Via the naturalistic fallacy, Lucas conveys the false belief that most technology is “unnatural” and so is bad, harmful, or associated with the dark side. Lucas is not wrong that technology can be fearful, but its value depends in (...) part on how it's intended to be used. Even the use of some medical technologies that can extend life raise questions about whether they should be used in all cases. Many bioethical conflicts center around whether a seriously ill or injured person would want certain medical interventions used to extend their life, given potential trade‐offs. Lucas's portrayal of technology in Star Wars is biased against its true value in societies. (shrink)

The American Journal of Bioethics, Volume 11, Issue 9, Page 12-13, September 2011.

Volume 20, Issue 7, July 2020, Page 95-97.

This narrative symposium examines the relationship of bioethics practice to personal experiences of illness. A call for stories was developed by Tod Chambers, the symposium editor, and editorial staff and was sent to several commonly used bioethics listservs and posted on the Narrative Inquiry in Bioethics website. The call asked authors to relate a personal story of being ill or caring for a person who is ill, and to describe how this affected how they think about bioethical questions and the (...) practice of medicine. Eighteen individuals were invited to submit full stories based on review of their proposals. Twelve stories are published in this symposium, and six supplemental stories are published online only through Project MUSE. Authors explore themes of vulnerability, suffering, communication, voluntariness, cultural barriers, and flaws in local healthcare systems through stories about their own illnesses or about caring for children, partners, parents and grandparents. Commentary articles by Arthur Frank, Bradley Lewis, and Carol Taylor follow the collection of personal narratives. (shrink)

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing p...

The focus on translational research in clinical trials has the potential to generate clinically relevant genetic data that could have importance to patients. This raises challenging questions about communicating relevant genetic research results to individual patients. An exploratory pharmacogenetic analysis was conducted in the international ovarian cancer phase III trial, AGO-OVAR 16, which found that patients with clinically important germ-line BRCA1/2 mutations had improved progression-free survival prognosis. Mechanisms to communicate BRCA results were evaluated, because these findings may be beneficial to (...) patients and their families. Communicating individual BRCA results was not anticipated during clinical trial design. Consequently, options were not available for patients to indicate their preference for receiving their individual results when they signed pharmacogenetic informed consent. Differences in local requirements, clinical practice, and opinion regarding the ethical aspects of how to convey genetic results to patients are all potential barriers to returning individual BRCA results to patients. Communicating the aggregate BRCA result from this study provided clinical investigators with a mechanism to disseminate the overall study finding to patients while taking individual circumstances, local guidelines and clinical practice into account. This study illustrates the importance of increasing the clarity and scope of informed consent and the need for patient engagement to ensure clinical trial participants can indicate their preference regarding receipt of potentially important individual pharmacogenetic results. This study was registered in the NCT Clinical Trial Registry under NCT00866697 on March 19, 2009, following approval from participating ethics committees. (shrink)

v. 1. Editorial introduction -- v. 2. The English and Latin texts (i) -- v. 3. The English and Latin texts (ii).

When making decisions, humans can observe many kinds of information about others' activities, but their effects on performance are not well understood. We investigated social learning strategies using a simple problem-solving task in which participants search a complex space, and each can view and imitate others' solutions. Results showed that participants combined multiple sources of information to guide learning, including payoffs of peers' solutions, popularity of solution elements among peers, similarity of peers' solutions to their own, and relative payoffs from (...) individual exploration. Furthermore, performance was positively associated with imitation rates at both the individual and group levels. When peers' payoffs were hidden, popularity and similarity biases reversed, participants searched more broadly and randomly, and both quality and equity of exploration suffered. We conclude that when peers' solutions can be effectively compared, imitation does not simply permit scrounging, but it can also facilitate propagation of good solutions for further cumulative exploration. (shrink)

Near-death experiences are a big challenge to the fields of science and philosophy; termed as hallucinatory by neurologists and “stuff of which fantasies are made off” by sceptics, there are some unique near-death experiences which defy these claims. Memories generated during these experiences are of specific interest as they are created without a body and can be recalled post the experience. Call it the mind, soul, psyche or consciousness, if deliberated as a form of quantum generated energy, a strong correlation (...) under a reductionist based perspective can be obtained. Life at a macroscopic level may not be similar to life at a quantum level, and has been proved in quantum physics through its spooky properties like quantum entanglement. Self-sustaining quantum generated energy through entanglement is the answer to all mystical realties and the answer lies in believing in its existence in and around us. It is this energy that brings in the awareness of one’s existence and which performs tasks beyond the imagination of the current self; an energy created at the creation of all that exists; a true supernatural force. This paper reviews a unique void near-death experience and hypothesizes quantum entanglement to be involved in the conception and storage of these energy-based memories in a quantum subatomic cloud which can be restated if returned back to the body or lost to the environment upon death. (shrink)

Events have beginnings, ends, and often overlap in time. A major question is how perceivers come to parse a stream of multimodal information into meaningful units and how different event boundaries may vary event processing. This work investigates the roles of these three types of event boundaries in constructing event temporal relations. Predictions were made based on how people would err according to the beginning state, end state, and overlap heuristic hypotheses. Participants viewed animated events that include all the logical (...) possibilities of event temporal relations, and then made temporal relation judgments. The results showed that people make use of the overlap between events and take into account the ends and beginnings, but they weight ends more than beginnings. Neural network simulations showed a self‐organized distinction when learning temporal relations between events with overlap versus those without. (shrink)

INTRODUCTION Although the writings of Thomas Reid are very fertile and interesting, his life is biographically barren in comparison to such seventeenth - and ...

Top-down dynamical models of cognitive processes, such as the one presented by Thelen et al., are important pieces in understanding the development of cognitive abilities in humans and biological organisms. Unlike standard symbolic computational approaches to cognition, such dynamical models offer the hope that they can be connected with more bottom-up, neurologically inspired dynamical models to provide a complete view of cognition at all levels. We raise some questions about the details of their simulation and about potential limitations of top-down (...) dynamical models. (shrink)

There is an ongoing concern about workplace ethics. Many voices say that our educational system ought to do something about it, but they do not agree about how to do this. By the time students reach post‐secondary education, they will have already developed a general moral sense. The concern is whether their moral sense is sufficient for ethical situations in the workplace. If not, post‐secondary education is expected to close the gap. In order to do this, educators need information about (...) what is missing. Educators can set clear, work‐related objectives and use classroom activities to reach those objectives based on an identification of these gaps. (shrink)

We expand on the article “Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force” to consider the ways in which rural...

Part of the Renaissance genius was to look at familiar things in unfamiliar ways.1 Although a variety of approaches to the study of leadership are becoming familiar, it still helps to consider new ones. Of use in such moments are the works of unfamiliar writers who have spent considerable energy thinking from an alien perspective. One does not have to accept their assertions uncritically in order to profit from reading them, yet it does take courage sometimes to start down a (...) strange path. In the spirit of applying new ideas to familiar themes, this article interprets volume one of Georges Bataille’s The Accursed Share2 in the light of the phenomenon we refer to as leadership. Bataille, who was born in 1897 and died in 1962, certainly qualifies as a writer with an alien perspective. He has the potential to offend. At times, he becomes positively cryptic, as in asserting ‘that the sexual act is in time what the tiger is in space’. Nonetheless, the book itself develops a plausible line of reasoning. Society, it argues, is determined by how it disposes of energy. And since energy that cannot be used will be squandered, it matters how a society chooses to do this. Bataille argues further that moments of true ‘sovereignty’ occur when we squander what would otherwise have been useful. This paper summarizes the argument of The Accursed Share and applies it to the outpourings that followers make to leaders. Rather than regard these uneven relationships as examples of utilitarian reciprocity, perhaps we can tap into the idea that attentiveness to leadership is more in the form of an offering or sacrifice to something that expresses us, as an excuse to display exuberance. This approach promises insight into issues of charisma, followership as self-denial, and mass psychology. It also pertains to the tendency of followers to turn against leaders in ritual sacrifice as meaningful superfluity.3. (shrink)

THE NATURE OF ART is a collection of 29 seminal, historically-organized readings that are focused on a basic philosophical question: What is Art? Including writings from the Western tradition'both Continental and Analytic traditions'as well as non-Western, minority, and feminist writings, this volume provides students with a rich set of resources to explore this matter both broadly and deeply. Introductions to each reading situate the selection amidst each respective thinker's body of work and the greater philosophical context in which the remarks (...) arose. Reading questions accompany each selection, drawing students' attention to key points to be encountered. Hailed by reviewers and adopters for its clarity and rigor, Wartenberg's THE NATURE OF ART offers a lively and engaging introduction to the philosophy of art. (shrink)

The newly updated Right and Wrong 2nd Edition is an accessible introduction to the major traditions in western philosophical ethics, written in a lively and engaging style. It is designed for entry-level ethics courses and includes real-life ethical scenarios chosen to appeal directly to students. Greatly expanded and improved, this successful text introduces students to the major ethical traditions, and provides a simple methodology for resolving ethical dilemmas Treats teleological and deontological approaches to ethics as the two most important traditions, (...) but now includes chapters on virtue ethics and the ethics of care The very accessible writing style speaks directly to students’ own experience Draws examples from three types of real-life ethical scenarios submitted by students: academic dishonesty, partying, and personal relationships Provides a concise treatment of this notoriously complex subject, perfect for entry-level ethics and applied ethics courses. (shrink)

This chapter contains section titled: Personhood: A Start Are Dolphins Persons? Language and the Hand Personhood Redefined Conclusion: What Kind of Beings Are Dolphins?

Michel Foucault, one of the most cited scholars in the social sciences, devoted his last three lectures to a study of leader development. Going back to pagan sources, Foucault found a persistent theme in Hellenistic antiquity that, in order to qualify for leadership, a person must undergo processes of subjectivation, which is simply the way that a person becomes a Subject. From this perspective, an aspiring leader first becomes a Subject who happens to lead. These processes depend on a condition (...) of _parresia_, which is truth-telling at great risk that is for the edification of the other person. A leader requires a mentor and advisors in order to lead successfully, while also developing the capacity in one’s own mind to heed the truth. In other words, a leader must learn how to guide oneself. A valuable contribution to the field of leadership studies, this book summarizes these last lectures as they pertain to the study and practice of leadership, emphasizing the role of ethics and truth-telling as a check on power. It then presents several other contexts where these same lessons can be seen in practice, including in the life of Alexander Solzhenitsyn, whose career as a writer epitomized speaking truth to power, and somewhat surprisingly in the United States military, in response to its twenty-first century mission of counterinsurgency. (shrink)

David Ekdahl (2023), in a constructive and thoughtful commentary, outlines both points of agreement with and suggestions for further research arising from our paper ‘Crossing the Fictional Line: Moral Graveness, the Gamer’s Dilemma, and the Paradox of Fictionally Going Too Far’ (Montefiore & Formosa, 2023).

According to a widely held view, a Kantian intuition functions like a singular term. I argue that this view is false. Its apparent plausibility, both textual and philosophical, rests on attributing to Kant a Fregean conception of judgment. I show that Kant does not hold a Fregean conception of judgment and argue that, as a consequence, intuition cannot be understood on analogy with singular terms.

In this book Thomas Wren uncovers and assesses the largely hidden philosophical assumptions about human motivation that have shaped contemporary psychological ...

This interdisciplinary volume questions one of the most fundamental tenets of social theory by focusing on detachment, an important but neglected aspect of social life. Going against the grain of recent theoretical celebrations of engagement, this book challenges us to re-think the relational basis of social theory. In so, doing it brings to light the productive aspects of disconnection, distance and detachment. Rather than treating detachment simply as the moral inversion of compassion and engagement, the volume brings together empirical studies (...) and theoretical comments by leading anthropologists, sociologists and science studies scholars. Taken together, these illustrate the range of contexts within which distance and disconnection can offer meaningful frameworks for action. Positioned at the cutting edge of social theory, this landmark volume will be of great interest to students and academics across the social sciences and humanities. (shrink)

The debate of nativisim versus empiricism is over the relative importance of evolutionary versus ontogenetic mechanisms. This is mostly seen today as a false dichotomy. The synthesis of these positions provides a modern viewpoint of grounded category formation. This combined view places equal importance on feedback between these levels in guiding development, and is more appropriately compared to culturalist positions.

Revision of author's thesis (doctoral)--University of Chicago, 2008 under title: The word made flesh and the mazy page: symbol and allegory in Coleridge's philosophy of faith.