The 2006 term of the United States Supreme Court is now well underway, and the results of the congressional mid-term elections are in. No doubt, decisions will be handed down and national legislation proposed – perhaps even enacted – that will directly or indirectly affect the physician-patient relationship as well as the profession of medicine itself. Of major concern to physicians, patients, and the lay public is the ongoing, rather contentious debate surrounding both patient access to adequate pain control and (...) what constitutes proper physician conduct in treating patients who are experiencing either chronic or end stage disease pain. Those knowledgeable in palliative medicine maintain that an “epidemic of undertreated pain” now exists, and probably has existed for more than a decade. A significant number of patients experience unnecessary pain and suffering, and this disturbing phenomenon is both an individual patient care problem and a public health concern. (shrink)

The U.S.Supreme Court's 6-decision in Gonzales v. Oregon is the latest defeat for the Bush administration in its sustained attack on Oregon's physician-assisted suicide law. Both the majority opinion and the major dissent in Oregon provide an opportunity to assess the dangers inherent in allowing a political agenda that emphasizes the sanctity of life and minimizes professional ethical obligations to overshadow quality patient care at the end of life.

Over the past decade or so, no issue in medical ethics or bioethics law has raised more concerns about federal intervention in the practice of medicine, about judicial attempts to craft health policy, or about the wisdom of public mandates directing specific health care initiatives than the issue of physician-assisted suicide. State voter referenda, lower and federal court cases, proposed legislation in both houses of Congress, and orders and determinations from agencies within the executive branch of two administrations are representative (...) of the kinds of actions taken in the last ten years implicating medical care at the end of life. Whether the intent was to codify into law physician-assisted suicide, to deny a constitutional right of assisted suicide, or to make “easier” physicians' efforts to alleviate intractable suffering at the risk of hastening death, or to prohibit physician aid in dying altogether, the impact on the patient-doctor relationship and on our understanding of what constitutes dignified and humane care at the end of life is undeniable. (shrink)

Over the past decade or so, no issue in medical ethics or bioethics law has raised more concerns about federal intervention in the practice of medicine, about judicial attempts to craft health policy, or about the wisdom of public mandates directing specific health care initiatives than the issue of physician-assisted suicide. State voter referenda, lower and federal court cases, proposed legislation in both houses of Congress, and orders and determinations from agencies within the executive branch of two administrations are representative (...) of the kinds of actions taken in the last ten years implicating medical care at the end of life. Whether the intent was to codify into law physician-assisted suicide, to deny a constitutional right of assisted suicide, or to make “easier” physicians' efforts to alleviate intractable suffering at the risk of hastening death, or to prohibit physician aid in dying altogether, the impact on the patient-doctor relationship and on our understanding of what constitutes dignified and humane care at the end of life is undeniable. (shrink)

Philosophy professor Bryan Hilliard begins this unusual medical ethics textbook, composed of selections from U.S. Supreme Court cases, commentaries, and discussion questions, by addressing a questi...

Philosophy professor Bryan Hilliard begins this unusual medical ethics textbook, composed of selections from U.S. Supreme Court cases, commentaries, and discussion questions, by addressing a questi...

La fenomenología describe las estructuras trascendentales de la experiencia humana. Momentos tales como la afectividad, la temporalidad, la corporalidad, la espacialidad y la intersubjetividad constituyen elementos clave al interior de esta aproximación. Situada en este contexto, la siguiente contribución tiene como objetivo elaborar una descripción acerca de la experiencia de la disociación (Spaltung). Para lograr este cometido nuestro artículo dispondrá de tres momentos. Primero, presentaremos una descripción fenomenológica acerca del cuerpo propio (Leib). Segundo, y situados al interior de la propuesta (...) filosófica de Marc Richir, esbozaremos una fenomenología genética que deje de manifiesto la primera constitución del esquema corporal durante la infancia mediante la labor de la Phantasia. Para finalizar, presentaremos una fenomenología genética del cuerpo propio que arroje luces acerca del origen trascendental de la experiencia disociativa. (shrink)

In the April, 1985 issue of Bio Essays, F. Vella presented an evaluation of the recent GPEP report, concerning medical school education in the United States. Here, Hilliard Jason and Jane Westberg present an additional discussion of the issues.

The following pages sketch the outlines of “a Canaanite reading” of the health system. Beginning with the Black person—African, Afro-diasporic, Aboriginal, and Torres Strait Islander—who is seen by a health professional, the functions and effects of the racializing gaze are examined. I wrestle with Al Saji’s understanding of “colonial disregard,” Whittaker’s insights into the extractive disposition of settler institutions vis-à-vis Indigenous peoples, and Saidiya Hartman and Fred Moten’s struggle with the spectacular. This leads me to conclude that the situation of (...) the Black within the health system is a tragic one. The prescription for the path out of this tragedy that I settle on, responding to Okiji’s opening call, is found in Vernon Ah Kee’s “Unwritten” series. (shrink)

Aristotle thinks that happiness is an activity---it consists in doing something---rather than a feeling. It is the best activity of which humans are capable and is spread out over the course of a life. But what kind of activity is it? Some of his remarks indicate that it is a single best kind of activity, intellectual contemplation. Other evidence suggests that it is an overarching activity that has various virtuous activities, ethical and intellectual, as parts. At stake are questions about (...) how we should live and the correct balance of theoretical and practical activity. Numerous interpreters have sharply disagreed about Aristotle's answers to such questions. This book offers a fundamentally new approach to determining what kind of activity Aristotle thinks happiness is, one that challenges widespread assumptions that have until now prevented a dialectically satisfactory interpretation. This approach displays the boldness and systematicity of Aristotle's practical philosophy. (shrink)

The distinction between germline and somatic gene editing is fundamental to the ethics of human gene editing. Multiple conferences of scientists, ethicists, and policymakers, and multiple professional bodies, have called for moratoria on germline gene editing, and editing of human germline cells is considered to be an ethical “red line” that either never should be crossed, or should only be crossed with great caution and care. However, as research on germline gene editing has progressed, it has become clear that not (...) all germline interventions are alike, and that these differences make a significant moral difference, when it comes to ethical questions about research, regulation, clinical application, and medical justification. In this paper, I argue that, rather than lumping all germline interventions together, we should distinguish between revising, correcting, and transferring genes, and I assess the consequences of this move for the ethics of gene editing. (shrink)

Aristotle’s typical procedure is to identify something's four causes. Intentional action has typically been treated as an exception: most think that Aristotle has the standard causalist account, according to which an intentional action is a bodily movement efficiently caused by an attitude of the appropriate sort. I show that action is not an exception to Aristotle’s typical procedure: he has the resources to specify four causes of action, and thus to articulate a powerful theory of action unlike any other on (...) offer. (shrink)

Although primarily known as a portrait painter, Charles Willson Peale also possessed a profound interest in natural history. Indeed, Peale eventually founded the first natural history museum in the United States, and, during the end of the eighteenth century, he began to overlap his two great interests: art and nature. The event Peale chronicled in his 1804 painting The Exhumation of the Mastodon caused an extreme stir within the intellectual and religious circles of its time, and brought about, at the (...) very least, a serious questioning in the deeply held notion of the Great Chain of Being. Although now largely discredited, this religious conviction postulated two concepts that Peale’s Exhumation of the Mastodon seemingly contradicts. The first was the belief that no animals since creation had suffered the fate of extinction. The second was a lack of belief in geological time. Indeed, one Irish clergyman calculated the actual date of creation to 4004 BCE. In this paper, I explore Peale’s monumental painting, a work that is many things, a self-portrait and history painting among others. Indeed, in this painting, Peale was responding to science, religion, and their shifting positions within early-nineteenth-century America. When viewed together, Peale’s The Exhumation of the Mastodon is not merely a record of an event that occurred in New York during the early nineteenth century, and instead is a document of Peale and the interaction of science and religion in early-Federal America. (shrink)

Rationality contains a selection of the best contemporary writing on one of the central issues in the philosophy of social science. The contributors address themselves to questions which have increasingly become the subject of a many-sided debate between philosophers, sociologists and anthropologists: How are we to understand the beliefs and actions of other men in other cultures? Can we translate the meanings and the reason of one culture into the language of another. This volume is essential reading for courses on (...) the methodology and philosophy of social science and is so arranged that the student is introduced step by step to the cut and thrust of scholarly debate. (shrink)

Aristotle’s theory of human happiness in the Nicomachean Ethics explicitly depends on the claim that contemplation (theôria) is peculiar to human beings, whether it is our function or only part of it. But there is a notorious problem: Aristotle says that divine beings also contemplate. Various solutions have been proposed, but each has difficulties. Drawing on an analysis of what divine contemplation involves according to Aristotle, I identify an assumption common to all of these proposals and argue for rejecting it. (...) This allows a straightforward solution to the problem and there is evidence that Aristotle would have adopted it. (shrink)

In a brilliant and explosively controversial work, the author attacks modern science for destroying our spiritual sense of self. What is the role of science in present-day society? Should we be as dazzled as we are by the innovations, the insights, and the miraculous improvements in material life that science has wrought? Or is there a darker, more pernicious side to our scientific success? Renowned British science columnist Bryan Appleyard thoroughly explores each of these provocative topics in a book (...) that has incited the ire of the scientific community. He points out that while scientists have shaped our lives and our beliefs, they have consistently failed to explain human consciousness, the soul, or the meaning of life. From Galileo to Darwin, from Copernicus to Oppenheimer, countless scientists have proclaimed a universe in which human beings are only an accidental presence. The unwitting result is that science has cast humankind adrift, paralyzing us with fear and cutting us off from personal or religious truth. In Appleyard's view, science has done us "appalling spiritual damage." These startling conclusions have prompted strong counterattacks from the scientific establishment. Yet regardless of where one falls in the debate, Understanding the Present forces readers to re-examine society's blind faith in the benevolence of modern science. "An exposition that is dazzling for its concrete illustrations and examples."--The New York Times "A withering indictment of modern science . . . This should crack a few test tubes."--Kirkus Reviews. (shrink)

After a period of inactivity, interest in explanationism as a thesis about the nature of epistemic justification has been renewed. Poston and McCain have both recently offered versions of explanationist evidentialism. In this paper, we pose two objections to explanationist evidentialism. First, explanationist evidentialism fails to state a sufficient condition for justification. Second, explanationist evidentialism implies a vicious regress.

In his 1923 play R.U.R.: Rossum s Universal Robots, Karel Capek coined In 1993, we began a humanoid robotics project aimed at constructing a robot for use in exploring theories of human intelligence. In this article, we describe three aspects of our research methodology that distinguish our work from other humanoid projects. First, our humanoid robots are designed to act autonomously and safely in natural workspaces with people. Second, our robots are designed to interact socially with people by exploiting natural (...) human social cues. Third, we believe that robotics offers a unique tool for testing models of human intelligence drawn from developmental psychology and cognitive science. (shrink)

This article proposes an approach to educational distribution that attempts to minimise enduring tensions among conflicting values. At the foundation of this approach is a threshold of educational adequacy based on what is needed for citizens to participate in a democratic society. This threshold is justified because it minimises conflict with parental rights and because it better manages ‘the bottomless pit’ problem of educational distribution. This threshold is then modified to stipulate that, after the threshold has been reached, public resources (...) should be distributed equally across students from all backgrounds. While this modification is essential to sending messages of equal citizenship, it also leaves a ‘moral residue’ because it allows wealthy parents to invest greater private resources in their children, thus preserving their children's competitive advantage. Minimising this harm requires policy mechanisms outside of schools that more aggressively break the link between educational outcomes, success in market competition, and social goods. Something ‘external’ to educational institutions is necessary, then, for the achievement of educational justice. (shrink)

Drawing on 10 sets of data gathered in the General Social Survey between 2000 and 2018, this study examined whether confidence in the press mediated political party affiliation as a determinant of attitudes toward the scientific community. The study observed full mediation effects in three of five instances in which Republicans occupied the White House, with partial or no mediation observed at other points. Overall findings showed that males, White respondents, and those who had completed more years of school, as (...) well as Democrats and those who indicated higher levels of confidence in the press, tended to report greater levels of confidence in the scientific community. The study discusses quantitative results in light of increased partisanship and derisive attacks on news media. (shrink)

There are two dominant approaches to quantification: the Fregean and the Tarskian. While the Tarskian approach is standard and familiar, deep conceptual objections have been pressed against its employment of variables as genuine syntactic and semantic units. Because they do not explicitly rely on variables, Fregean approaches are held to avoid these worries. The apparent result is that the Fregean can deliver something that the Tarskian is unable to, namely a compositional semantic treatment of quantification centered on truth and reference. (...) We argue that the Fregean approach faces the same choice: abandon compositionality or abandon the centrality of truth and reference to semantic theory. Indeed, we argue that developing a fully compositional semantics in the tradition of Frege leads to a typographic variant of the most radical of Tarskian views: variabilism, the view that names should be modeled as Tarskian variables. We conclude with the consequences of this result for Frege's distinction between sense and reference. (shrink)

A controversy rages over the question of how should controversial topics be taught. Recent work has advanced the “epistemic criterion” as the resolution to this controversy. According to the epistemic criterion, a matter should be taught as controversial when contrary views can be entertained on the matter without the views being contrary to reason. When an issue is noncontroversial, according to the epistemic criterion, the correct position can be taught “directively,” with the teacher endorsing that position. When there is a (...) legitimate controversy, the view should be taught “nondirectively,” with the teacher remaining neutral. In response, Bryan Warnick and Spencer Smith argue that the proponents of the epistemic criterion fail to recognize the multidimensional nature of what it means to learn to be rational. Recognizing this complexity undermines the link between the epistemic status of the controversy and directiveness of one's teaching, suggesting more flexibility in how teachers approach controversial issues. It also implies the need for a new category of teaching, which Warnick and Smith call “soft-directive” teaching. (shrink)

This article deals with the question of what time reversal means. It begins with a presentation of the standard account of time reversal, with plenty of examples, followed by a popular non-standard account. I argue that, in spite of recent commentary to the contrary, the standard approach to the meaning of time reversal is the only one that is philosophically and physically viable. The article concludes with a few open research problems about time reversal.

A survey of the medical, ethical and legal issues that surround this controversial topic.

Design of clinical trials for germline gene editing stretches current accepted standards for human subjects research. Among the challenges involved is a set of issues concerningintergenerational monitoring—long-term follow-up study of subjects and their descendants. Because changes made at the germline would be heritable, germline gene editing could have adverse effects on individuals’ health that can be passed on to future generations. Determining whether germline gene editing is safe and effective for clinical use thus may require intergenerational monitoring. The aim of (...) this paper is to identify and argue for the significance of a set of ethical issues raised by intergenerational monitoring in future clinical trials of germline gene editing. Though long-term, multigenerational follow-up study of this kind is not without precedent, intergenerational monitoring in this context raises unique ethical challenges, challenges that go beyond existing protocols and standards for human subjects research. These challenges will need to be addressed if clinical trials of germline gene editing are ever pursued. (shrink)

Aristotle appears to claim at Nicomachean Ethics 10.8, 1178a9 that there are two kinds of happy life: one theoretical, one practical. This claim is notoriously problematic and does not follow from anything that Aristotle has said to that point. However, the apparent claim depends on supplying 'happy' or 'happiest' from the previous sentence, as is standard among translators and interpreters. I argue for an alternative supplement that commits Aristotle to a much less problematic and unexpected position and permits a wider (...) variety of interpretations of Aristotle’s overall theory of happiness. (shrink)

Autism spectrum disorder is characterised by differences in unimodal and multimodal sensory and proprioceptive processing, with complex biases towards local over global processing. Many of these elements are implicated in versions of the rubber hand illusion, which were therefore studied in high-functioning individuals with ASD and a typically developing control group. Both groups experienced the illusion. A number of differences were found, related to proprioception and sensorimotor processes. The ASD group showed reduced sensitivity to visuotactile-proprioceptive discrepancy but more accurate proprioception. (...) This group also differed on acceleration in subsequent reach trials. Results are discussed in terms of weak top-down integration and precision-accuracy trade-offs. The RHI appears to be a useful tool for investigating multisensory processing in ASD. (shrink)

Clark acknowledges but resists the indirect mind–world relation inherent in prediction error minimization (PEM). But directness should also be resisted. This creates a puzzle, which calls for reconceptualization of the relation. We suggest that a causal conception captures both aspects. With this conception, aspects of situated cognition, social interaction and culture can be understood as emerging through precision optimization.

According to a widely credited model in the business ethics literature, ethical decisions are a function of two kinds of factors, personal(individual) and situational, and these factors interact with each other. According to a contrary view of decision making that is widely held in some areas of business research, individuals’ decisions about ethical issues (and subsequent actions) are purely a function of their self-interest.The laboratory experiment reported in this paper provides a test of the person-situation interactionist model, using the general (...) theoretical and experimental framework used in the experimental economics literature. One individual and two situational factors relating to moral intensity were examined which may influence decisions to misrepresent information in the course of business activities.The individual and one situational variable were significantly related to participants’ actions. The interactions among individual andsituation variables were not individually significant, although the model including interactions had a much higher level of statistical significance. Gender was significant, both directly and in interaction with moral development, suggesting that it may be worthy of further examination. (shrink)

ABSTRACT Tetlock's Expert Political Judgment is a creative, careful, and mostly convincing study of the predictive accuracy of political experts. My only major complaints are that Tetlock (1) understates the predictive accuracy of experts, and (2) does too little to discourage demagogues from misinterpreting his work as a vindication of the wisdom of the average citizen. Experts have much to learn from Tetlock's epistemological audit, but there is still ample evidence that, compared to laymen, experts are very good.

Semantics in the Montagovian tradition combines two basic tenets. One tenet is that the semantic value of a sentence is an intension, a function from points of evaluations into truth-values. The other tenet is that the semantic value of a composite expression is the result of applying the function denoted by one component to arguments denoted by the other components. Many philosophers object to intensional semantics on the grounds that intensionally equivalent sentences do not substitute salva veritate into attitude ascriptions. (...) They propose instead that the semantic values of sentences must be structured propositions. In rejecting intensional semantics, philosophers who endorse structured propositions also usually reject functional compositionality, undermining both tenets of the Montagovian programme. I defend a semantic theory that incorporates both structured propositions and functional compositionality. I argue that this semantic theory can preserve many explanatory benefits of Montague semantics. Finally, I show how treating composition functional application can resolve core problems internal to a theory of structured propositions. (shrink)

In the language of second-order logic, first- and second-order variables are distinguished syntactically and cannot be grammatically substituted. According to a prominent argument for the deployment of these languages, these substitution failures are necessary to block the derivation of paradoxes that result from attempts to generalize over predicate interpretations. I first examine previous approaches which interpret second-order sentences using expressions of natural language and argue that these approaches undermine these syntactic restrictions. I then examine Williamson’s primitivist approach according to which (...) second-order sentences are not offered readings in a previously understood language. I argue that the syntactic restrictions alone do not block the derivation of the paradox, unless they are backed by a principled reason that the language cannot be expanded to allow the grammatical substitution of first- and second- order variables. I argue that there is neither a syntactic nor a semantic principle that prohibits such an expansion. (shrink)

In this paper, we explore the impact of individualism and collectivism on three basic aspects of ethical decision making - the perception of moral problems, moral reasoning, and behavior. We argue that the inclusion of business practices within the moral domain by the individual depends partly upon individualism and collectivism. We also propose a pluralistic approach to post-conventional moral judgment that includes developmental paths appropriate for individualist and collectivist cultures. Finally, we argue that the link between moral judgment and behavior (...) is related to individualism and collectivism. (shrink)

According to a widely credited model in the business ethics literature, ethical decisions are a function of two kinds of factors, personal(individual) and situational, and these factors interact with each other. According to a contrary view of decision making that is widely held in some areas of business research, individuals’ decisions about ethical issues (and subsequent actions) are purely a function of their self-interest.The laboratory experiment reported in this paper provides a test of the person-situation interactionist model, using the general (...) theoretical and experimental framework used in the experimental economics literature. One individual and two situational factors relating to moral intensity were examined which may influence decisions to misrepresent information in the course of business activities.The individual and one situational variable were significantly related to participants’ actions. The interactions among individual andsituation variables were not individually significant, although the model including interactions had a much higher level of statistical significance. Gender was significant, both directly and in interaction with moral development, suggesting that it may be worthy of further examination. (shrink)

The principle of compositionality requires that the meaning of a complex expression remains the same after substitution of synonymous expressions. Alleged counterexamples to compositionality seem to force a theoretical choice: either apparent synonyms are not synonyms or synonyms do not syntactically occur where they appear to occur. Some theorists have instead looked to Frege’s doctrine of “reference shift” according to which the meaning of an expression is sensitive to its linguistic context. This doctrine is alleged to retain the relevant claims (...) about synonymy and substitution while respecting the compositionality principle. Thus, Salmon (Philos Rev 115(4):415, 2006) and Glanzberg and King (Philosophers’ Imprint 20(2):1–29, 2020) offer occurrence-based accounts of variable binding, and Pagin and Westerståhl (Linguist Philos 33(5):381–415, 2010c) argue that an occurrence-based semantics delivers a compositional account of quotation. Our thesis is this: the occurrence-based strategies resolve the apparent failures of substitutivity in the same general way as the standard expression-based semantics do. So it is a myth that a Frege-inspired occurrence-based semantics affords a genuine alternative strategy. (shrink)

We present a precise form of structural realism, called group structural realism , which identifies ‘structure’ in quantum theory with symmetry groups. However, working out the details of this view actually illuminates a major problem for structural realism; namely, a structure can itself have structure. This article argues that, once a precise characterization of structure is given, the ‘metaphysical hierarchy’ on which group structural realism rests is overly extravagant and ultimately unmotivated.

This paper examines the impact of the level of economic development, income inequality, and five cultural variables on the rate of software piracy at the country level. The study finds that software piracy is significantly correlated to GNP per capita, income inequality, and individualism. Implications for anti-piracy programs and suggestions for future research are developed.

:Since the advent of recombinant DNA technology, expectations about the potential for altering genes and controlling our biology at the fundamental level have been sky high. These expectations have gone largely unfulfilled. But though the dream of being able to control our biology is still far off, gene editing research has made enormous strides toward potential clinical use. This paper argues that when it comes to determining permissible uses of gene editing in one important medical context—germline intervention in reproductive medicine—issues (...) about enhancement and eugenics are, for the foreseeable future, a red herring. Current translational goals for gene editing research involve a different kind of editing than would be required to achieve manipulation of complex traits such as intelligence, and there are more pressing questions that need attention if clinical use of gene editing in reproductive medicine ever becomes a possibility. (shrink)