Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient’s interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians (...) have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. (shrink)

Since 1995, students, researchers, and professionals have turned to The Craft of Research for clear and helpful guidance on how to conduct research and report it effectively. Now, master teachers Wayne C. Booth, Gregory G. Colomb, and Joseph M. Williams have completely revised and updated their classic handbook. The new edition will continue to help thousands of students and writers plan, carry out, and report on research to produce effective term papers, dissertations, articles, or books -- in any field, (...) at any level. (shrink)

This exploratory study of ethical decision making by individuals in organizations found moral intensity, as defined by Jones (1991), to significantly influence ethical decision making intentions of managers. Moral intensity explained 37% and 53% of the variance in ethical decision making in two decision-making scenarios. In part, the results of this research support our theoretical understanding of ethical/unethical decision-making and serve as a foundation for future research.

In this book, Joseph G. Morgan examines the career of Wesley Fishel, a political scientist who vigorously supported American intervention in the Vietnam War, which he deemed a "great, and tragic, American experiment." Morgan demonstrates how Fishel continued to champion the prospect of an independent South Vietnam, even when Vietnamese resistance and infighting among American and Vietnamese leaders undermined this effort. Morgan also analyzes how opponents of the war questioned Fishel's scholarly integrity and his academic collaboration with the US (...) government in implementing Cold War policies. (shrink)

Conscientious objection in the health care field—that is, refusal on the part of a medical professional to perform or cooperate in a procedure when it violates his or her conscience—is a growing concern for international legislators and a source of contentious debates among ethicists and the general public. Recognizing a general right to conscientious objection based on individual liberty, and thus a subjective right, could have negative consequences. Conscientious objection in health care settings should be fully protected, however, when the (...) objection is based on principles that are fundamental to the medical profession and the legal system. Examples from Italy and other nations show how protections there safeguard conscientious objection when a health professional objects to taking a human life. National Catholic Bioethics Quarterly 12.4 (Winter 2012): 611–620. (shrink)

Since the passage of Title VII of the Civil Rights Act of 1964 and more recent Federal legislation, managers, regulators, and attorneys have been busy in sorting out the legal meaning of fairness in employment. While ethical managers must follow the law in their hiring practices, they cannot be satisfied with legal compliance. In this article, we first briefly summarize what the law requires in terms of fair hiring practices. We subsequently rely on multiple perspectives to explore the ethical meaning (...) of fairness in hiring. Ethical fairness underlies the law and regulations in this area, but goes beyond them as well. We conclude by demonstrating that ethical hiring practices enable managers to make better hiring decisions. (shrink)

Specialists and primary care physicians play an integral role in treating the twin epidemics of pain and addiction. But inadequate access to specialists causes much of the treatment burden to fall on primary physicians. This article chronicles the differences between treatment contexts for both pain and addiction — in the specialty and primary care contexts — and derives a series of reforms that would empower primary care physicians and better leverage specialists.

Joseph G. Ramsey argues that Richard Wright’s 1940 novella “Bright and Morning Star” has been consistently misunderstood. What has been almost universally read as a narrative of communist heroism stages instead a heroic mistake. “Bright and Morning Star” is not a story primarily about heroic individual sacrifice, but about the ways collective struggle can fail.

“Perfect Day” by Lou Reed and “Village Ghetto Land” by Stevie Wonder are prime examples of “melic” irony in song—cases in which expressive irony is achieved through the interplay and tension between a song’s lyrics and its musical accompaniment. But how exactly can a song achieve this ironic effect, especially if, as formalists maintain, music on its own is incapable of meaning, much less communicative irony? In this paper, I illuminate this type of irony by applying a Gricean account of (...) verbal irony to song. I explore the complexities of this application, and suggest that, through ironic interplay with lyrics, the music of a song can acquire semantic capacities of its own. (shrink)

Le canon 812 du Code de droit canon de 1983 exige que ceux qui enseignent une discipline théologique dans une université catholique aient un mandatum de la part de l’autorité ecclésiastique compétente. Entre insistances et rappels à l’ordre romains, s’en suivirent aux Etats-Unis neuf ans de consultations, discussions et conflits qui impliquèrent évêques, présidents d’universités et théologiens. Il y a là un fait théologique et ecclésial dont les Eglises d’autres pays n’ont pas fait la même expérience. L’examen des enjeux ecclésiologiques (...) de ces péripéties constitue l’objet de ces réflexions qui représentent ainsi une sorte de lettre théologique des Etats-Unis. Pourquoi l’acuité de la question dans ce pays ? Comment comprendre le mandatum avec l’emploi du concept de communion ? Qu’est-ce que ce mandatum comme fait historique et comme institution ecclésiale ? Telles sont les questions auxquelles tente de répondre J.G. Mueller dans cet article.Canon 812 of the Code of Canon Law of 1983 requires that those who teach a theological discipline in a Catholic university have a mandatum from the competent church authority. In between Rome’s insistence and calls to order, there followed nine years of consultations, discussions, and conflicts in the United States involving bishops, university presidents, and theologians. This is a theological and ecclesial fact of which Churches in other countries have not had the same experience. An examination of the ecclesiological stakes of these vicissitudes constitutes the subject of these reflections, which represents a sort of theological letter from the United States. Why the acuity of the question in this country? How can we understand the mandatum by using the concept of communion? What is this mandatum as a historical fact and as an ecclesiastical institution? Such are the questions that J.G. Mueller attempts to answer in this article. (shrink)

: This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in (...) moral problem solving are discussed. (shrink)

Main Response Topics ? Introduction ? Open display and public evaluation ? Publicity versus patient privacy ? Facial tissue donation ? Validity of Louisville Instrument for Risk Acceptance ? Patients' understanding of risk ? Face versus hand transplantation ? Rejection rates/risks ? Patient compliance ? Exit strategy ? Functional recovery ? Societietal implications ? Psychological implications ? Conclusion: Uncertainty likely to persist.

One way to work toward intercultural understanding is through interreligious dialogue, given the centrality that religion often has in a culture. David Burrell has suggested that Maimonides and Aquinas can offer us principles for interreligious dialogue. In particular, he argues that their negative theology shows us the impossibility of one tradition claiming a better understanding of God than those advanced by other traditions. This should lead religious traditions away fromcompetition and toward dialogue. In my paper, I propose a critique of (...) Burrell’s thesis, arguing for a different interpretation of Maimonides and Aquinas and adifferent understanding of interreligious dialogue. While it is true that Maimonides and Aquinas have a well-developed sense of the limits of our theological knowledge, they do not draw the conclusion that these limitations necessarily make all understandings of God equal. I think Maimonides and Aquinas show us instead that the firmest basis for interreligious dialogue is the recognition that some genuine knowledge of the divine is available to all, regardless of religious tradition. (shrink)

There has been much discussion of whether there could be objects A and B that are “individuatively vague” in the following way: object A and object B neither determinately stand in the relation of identity to one another, nor do they determinately fail to stand in this relation. If there are objects of this type, then we would have a genuine case of metaphysical vagueness, or “vagueness-in-the-world.” The possibility of vague objects in this sense strikes many as incoherent. The possibility’s (...) very description not only seems to talk of two objects but, much worse, it seems to point to a feature that distinguishes them: unlike object A, object B is not determinately identical to object A. This suspicion of incoherence is voiced in the famous arguments given against the possibility by Gareth Evans and Nathan Salmon. But the status of those arguments and others is uncertain. Here I present a new argument against vague objects — or more precisely, against the possibility of individuatively vague objects that satisfy an important and common additional condition that I will call “Democracy.” Since my argument turns on a connection between what is indeterminate and what is possible, I call it “the modal argument.”. (shrink)

This article identifies and compares meanings of wildfire risk mitigation for stakeholders in the Front Range of Colorado, USA. We examine the case of a collaborative partnership sponsored by government agencies and directed to decrease hazardous fuels in interface areas. Data were collected by way of key informant interviews and focus groups. The analysis is guided by the Circuit of Culture model in communication research. We found both shared and differing meanings between members of this partnership (the ‘‘producers’’) and other (...) stakeholders not formally in the partnership (the ‘‘consumers’’). We conclude that those promoting the partnership’s project to mitigate risk are primarily aligned with a discourse of scientific management. Stakeholders outside the partnership follow a discourse of community. We argue that failure to recognize and account for differences in the way risk mitigation is framed and related power dynamics could hamper the communicational efforts of the collaborative partnership and impact goals for fuels reduction. We recommend ways that both groups can capitalize on shared meanings and how agency managers and decision makers can build better working relationships with interface communities and other external stakeholders. (shrink)

In this conceptual article, the authors explore the possibilities of another approach to examining the human dimensions of wildland fire. They argue that our understanding of this issue could be enhanced by considering a cultural studies construct known as the ‘‘circuit of culture.’’ This cross-disciplinary perspective provides increased analytic power by accounting for the meaningful role of 5 cultural processes in terms of their location and interrelation within social experience. The authors compare the circuit of culture approach with a body (...) of recent literature focused on wildland fire. The authors make the case that this research has moved in a positive direction since wildland fire first ignited social scientific interest in the 1980s, but it is still missing key cultural processes. Ultimately, following the circuit allows us to make more nuanced statements about meaning, something much needed in the face of the wicked problem of wildland fire. (shrink)

ABSTRACTAs sports fans, we often experience what seem to be strong garden-variety emotions—everything from joy and euphoria to anger, dread and despair. In self-description, in physiology and even in phenomenology, these reactions to sporting events present themselves as genuine emotions. But we don’t act on these ‘sporting emotions’ in the ways one might expect. This is because these reactions are not genuine emotions. Or so I argue. Johan Huizinga suggested that play has a pretend ‘set aside’ ‘extra-ordinary’ character. And Kendall (...) Walton has argued that make-believe is involved in our emotional responses to fiction, as well as to sport. Here I articulate and extend the idea that sporting emotions centrally involve pretense and make-believe in ways that can meet some forceful objections. These extensions draw on a ‘double-consciousness’ I claim to find in the pretense of play. I end by saying why the proper characterization of our sporting emotions is important. (shrink)

The paper is a critical discussion of the rich and insightful final chapter of Mitchell Green’s Self-Expression . There, Green seeks to elucidate the compelling, but inchoate intuition that when we’re fully and most expertly expressing ourselves, we can ‘push out’ from within not just our inner representations, but also the ways that we feel. I question, first, whether this type of ‘qualitative expression’ is really distinct from the other expressive forms that Green explores, and also whether it’s genuinely ‘expressive’. (...) I then scrutinize the nature of the ‘qualitative congruences’ that lie at the heart of Green’s theory; and I wonder whether they can play the role Green claims they can in providing a novel account of artistic expression. (shrink)

: This response to Lynn Jansen's critique of clinical pragmatism concentrates on two themes: (1) contrasting approaches to moral epistemology and (2) the connection between theory and practice in clinical ethics. Particular attention is paid to the status of principles and the role of consensus, with some closing speculations on how Dewey might view the current state of bioethics.

First Philosophy and the Kinds of Substance JOSEPH G. DEFILIPPO ON A CERTAIN INTERPRETATION Aristotle's Metaphysics contains two incompati- ble conceptions of metaphysics or, as he calls it, first philosophy. At two points in the treatise he identifies first philosophy with theology . Along with this identification comes a certain view about the nature and number of theoretical sciences. We are told in E. 1 that there are three: natural philosophy, mathematics, and theology. Natural philosophy deals with nonseparate,' mutable (...) substance, whereas the objects of mathematics are nonseparate but immutable. It is left to theology to study substance that is both separate and immutable . Hence it is prior to the other two theoretical sciences and more worthy of honor. But for Aristotle first philosophy is not merely a compartmentalized science concerned with a single genus or kind of substance; he means it to be a universal science of "being qua being." Indeed, it is the status of first philosophy as the primary theoretical science that is supposed to provide for its universal scope. As he says in E. 1, it is universal "in this way, because it is first" 0o26a3o-31). Large and well- known difficulties loom in the way of this tantalizing idea. First, it is not clear how theology's position of primacy is the cause of its universal scope; if anything, divine substance seems to be a special item within a more.. (shrink)

Das Wesen der menschlichen Kopfarbeit. -- Briefe an Karl Marx. -- Die Religion der Sozialdemokratie, 2. Kanzelrede. -- Die Grenzen der Erkenntnis. -- Verkappte Theologie. -- Philosophie. -- Schriften von und über Joseph Dietzgen (p. 175-176).

Those inclined to believe in the existence of propositions as traditionally conceived might seek to reduce them to some other type of entity. However, parsimonious propositionalists of this type are confronted with a choice of competing candidates – for example, sets of possible worlds, and various neo-Russellian and neo-Fregean constructions. It is argued that this choice is an arbitrary one, and that it closely resembles the type of problematic choice that, as Benacerraf pointed out, bedevils the attempt to reduce numbers (...) to sets – should the number 2 be identified with the set Ø or with the set Ø, Ø? An “argument from arbitrary identification” is formulated with the conclusion that propositions (and perhaps numbers) cannot be reduced away. Various responses to this argument are considered, but ultimately rejected. The paper concludes that the argument is sound: propositions, at least, are sui generis entities. (shrink)

In 1960, E. P. Wigner, a joint winner of the 1963 Nobel Prize for Physics, published a paper titled On the Unreasonable Effectiveness of Mathematics in the Natural Sciences [61]. This paper can be construed as an examination and affirmation of Galileo's tenet that “The book of nature is written in the language of mathematics”. To this effect, Wigner presented a large number of examples that demonstrate the effectiveness of mathematics in accurately describing physical phenomena. Wigner viewed these examples as (...) illustrations of what he called the empirical law of epistemology, which asserts that the mathematical formulation of the laws of nature is both appropriate and accurate, and that mathematics is actually the correct language for formulating the laws of nature. At the same time, Wigner pointed out that the reasons for the success of mathematics in the natural sciences are not completely understood; in fact, he went as far as asserting that “… the enormous usefulness of mathematics in the natural sciences is something bordering on the mysterious and there is no rational explanation for it.”. (shrink)

In a seemingly offhand, often overlooked comment, Karl Marx deemed 'human corporeal organisation' the 'first fact of human history'. Following Marx's corporeal turn and pursuing the radical implications of his corporeal insight, this book undertakes a reconstruction of the corporeal foundations of historical materialism. Part I exposes the corporeal roots of Marx's materialist conception of history and historical-materialist Wissenschaft. Part II attempts a historical-materialist mapping of human corporeal organisation. Suggesting how to approach human histories up from their corporeal foundations, Part (...) III elaborates historical-materialism as 'corporeal semiotics'. Part IV, a case study of Marx's critique of capitalist socio-economic and cultural forms, reveals the corporeal foundations of that critique and the corporeal depth of his vision of human freedom and dignity. (shrink)

The shortage of organs for transplantation by its nature prompts ethical dilemmas. For example, although there is an imperative to save human life and reduce suffering by maximising the supply of vital organs, there is an equally important obligation to ensure that the process by which we increase the supply respects the rights of all stakeholders. In a relatively unexamined practice in the USA, organs are procured from unrepresented decedents without their express consent. Unrepresented decedents have no known healthcare wishes (...) or advance care planning document; they also lack a surrogate. The Revised Uniform Anatomical Gift Act of 2006 sends a mixed message about the procurement of organs from this patient population and there are hospitals that authorise donation. In addition, in adopting the RUAGA, some states included provisions that clearly allow organ procurement from unrepresented decedents. An important unanswered question is whether this practice meets the canons of ethical permissibility. The current Brief Report presents two principled approaches to the topic as a way of highlighting some of the complexities involved. Concluding remarks offer suggestions for future research and discussion. (shrink)

In 'A Puzzle about Belief' Saul Kripke appeals to a principle of disquotation that allows us to infer a person's beliefs from the sentences to which she assents (in certain conditions). Kripke relies on this principle in constructing some famous puzzle cases, which he uses to defend the Millian view that the sole semantic function of a proper name is to refer to its bearer. The examples are meant to undermine the anti-Millian objection, grounded in traditional Frege-cases, that truth-value is (...) not always maintained when co-referential names are intersubstituted in belief reports. I argue here that our disquotational practice is sensitive to certain shifts in conversational context, and it is only if we overlook these shifts - if we 'misdisquote' - that we can draw the conclusions Kripke wants to draw from his examples. In the wake of this conclusion, I provide a 'contextualist' treatment of Kripke's puzzle cases. I show how this treatment is motivated by certain norms of rationality, and I defend these norms against an intriguing 'anti-Cartesian' theory of mind. Throughout the paper, I develop the larger implications that my treatment of Kripke's argument has for the semantic theory of names and belief reports, and, more generally, for our picture of the relation between linguistic behaviour and our states of mind. (shrink)

Psychobiography has been a topical area and an applied research specialty in psychology since Freud’s influential psychoanalytic psychobiography of Leonardo da Vinci. Throughout the last century, psychobiographers have emphasized the importance of anchoring interpretations of life histories in established psychological theories and rigorous historiographic research methods. One topical area receiving less attention in psychobiography is the critical relationship between the psychobiographer and her or his subject as it relates to the process of psychobiographical writing. The present article explores the phenomenology (...) and challenges of this relationship in order to ultimately propose practical strategies for navigating countertransference issues throughout the subject selection, research and publication phases of psychobiography. Freud’s psychobiography of Leonardo da Vinci is used as a model of the stages of psychobiography, the evolution of the psychobiographer-subject relationship, and the challenges of countertransference. (shrink)