Dual-process models of cognition suggest that there are two types of thought: autonomous Type 1 processes and working memory dependent Type 2 processes that support hypothetical thinking. Models of creative thinking also distinguish between two sets of thinking processes: those involved in the generation of ideas and those involved with their refinement, evaluation, and/or selection. Here we review dual-process models in both these literatures and delineate the similarities and differences. Both generative creative processing and evaluative creative processing involve elements that (...) have been attributed to each of the dual processes of cognition. We explore the notion that creative thinking may rest upon the nature of a shifting process between Type 1 and Type 2 dual processes. We suggest that a synthesis of the evidence bases on dual-process models of cognition and of creative thinking, together with developing time-based approaches to explore the shifting process, could better inform the development of i.. (shrink)

Physician-assisted suicide laws in Oregon and Washington require the person's current competency and a prognosis of terminal illness. In The Netherlands voluntariness and unbearable suffering are required for euthanasia. Many people are more concerned about the loss of autonomy and independence in years of severe dementia than about pain and suffering in their last months. To address this concern, people could write advance directives for physician-assisted death in dementia. Should such directives be implemented even though, at the time, the person (...) is no longer competent and would not be either terminally ill or suffering unbearably? We argue that in many cases they should be, and that a sliding scale which considers both autonomy and the capacity for enjoyment provides the best justification for determining when: when written by a previously well-informed and competent person, such a directive gains in authority as the later person's capacities to generate new critical interests and to enjoy life decrease. Such an extension of legalized death assistance is grounded in the same central value of voluntariness that undergirds the current more limited legalization. (shrink)

Almost all jurisdictions where physician-assisted death is legal require that the requesting individual be competent to make medical decisions at time of assistance. The requirement of contemporary competence is intended to ensure that PAD is limited to people who really want to die and have the cognitive ability to make a final choice of such enormous import. Along with terminal illness, defined as prognosis of death within six months, contemporary competence is regarded as an important safeguard against mistake and abuse, (...) arguably the strongest objections to legalizing PAD.The insistence on contemporary competence is problematic. It means that someone who has dementia is ruled out as a candidate for PAD, even if she is terminally ill and suffering terrible and unrelievable pain. It also rules out individuals with strong and unwavering desires not to end their life in dementia. (shrink)

Competent patients have considerable legal authority to control life‐and‐death care. They may refuse medical life support, including medically delivered food and fluids. Even when they are not in need of any life‐saving care, they may expedite death by refusing food and water by mouth—voluntarily stopping eating and drinking, or VSED. Neither right is limited to terminal illness. In addition, in four U.S. states, competent patients, if terminally ill, may obtain lethal drugs for aid‐in‐dying.For people who have dementia and are no (...) longer competent, however, control over the end of life is much less extensive. They may have written a clear advance directive for refusing life‐saving care in specified circumstances yet subsequently find themselves living for years in severe dementia with no need for life‐saving care that could be refused. Chronic progressive dementia is not itself life threatening until its very final stage. Even in jurisdictions that permit active aid‐in‐dying, individuals with advanced dementia are not eligible; they lack the required current competence, and they are seldom deemed terminally ill. As for the right to VSED, its very name—voluntarily stopping eating and drinking—is seen as excluding noncompetent persons.One option for ensuring that one does not live years in severe dementia is to use advance directives to withhold food and water by mouth. The driving element behind VSED is that forcing people to ingest food is as objectionable an intrusion on bodily integrity, privacy, and liberty as imposing unwanted medical treatment. Thus, if incompetent people do not lose their rights to refuse life‐saving treatment, and if people when competent have just as strong a right to VSED as they do to refuse life‐saving treatment, then people do not lose their right to VSED when incompetent either. They only have to exercise it by AD. (shrink)

In the United States, amid the fractious politics of attempting to achieve something close to universal access to basic health care, two impressions are likely to feed skepticism about the status of a right to universal access: the moral principles that underlie any right to universal access may seem incredibly "ideal," not well rooted in the society's actual fabric, and the necessary practical and political attempts to limit the scope of universally accessible care to make its achievement realistic may seem (...) marked less by moral rhyme and reason than by the pull of conflicting interests. I try to directly dispel the first of these impressions and to obliquely question the second. The immense political barriers to .. (shrink)

The case of Mrs A is a provocative example of euthanasia by advance directive to avoid increasingly severe dementia. It is also a ‘perfect storm’ of a disturbing case, revealing both the challenges that can arise with advance euthanasia directives generally and particular issues in the Dutch procedures. Kim, Miller and Dresser have done a distinct service to bioethics in detailing the case, in explaining the basis of the regional euthanasia review committee reprimand of the administering geriatrician and in highlighting (...) some significant deficiencies in Dutch procedures.1 Many readers, after encountering the case, may find themselves sceptical that AEDs can be an ethically viable vehicle for avoiding living into severe dementia. I will argue that caution and care, not resistance to AEDs for dementia, is in order. Real dilemmas of implementation are inherent in advance directives, to be sure, dilemmas that can be aggravated by a patient’s dementia. Yet much can be done in writing an AED to make its implementation in dementia less problematic, and the Dutch emphasis on intolerable suffering as a necessary condition for euthanasia is not the appropriate legal framework. The difficulties in the case begin with the directive itself. Any advance directive, whether for refusing lifesaving treatment or for physician-assisted death, needs to be clear about what is and is not to happen and when. At first Mrs A’s directive seems to provide a trigger point: ‘I want to make use of the legal right to … euthanasia when I am still at all mentally competent and am no longer able to live at home with my husband. I absolutely do not want to be placed in an institution for elderly dementia patients’. In a revision added a year before her death, the time had become ‘whenever I think the time …. (shrink)

The Roman Catholic theological approach to euthanasia is radically prohibitive. The main theological argument for this prohibition is the so-called “stewardship argument”: Christians cannot escape accounting to God for stewardship of the bodies given them on earth. This contribution presents an alternative approach based on European existentialist and philosophical traditions. The suggestion is that exploring the fullness of our relational responsibility is more apt for a pluralist – and even secular – debate on the legitimacy of euthanasia.

In using quality of life as a guide to rationing health services, Oregon laid itself open to charges of bias against the disabled—charges that cannot be dismissed out of hand.

Durbin, history and philosophy of science scholar and writer, has created a volume that includes about 100 terms from the natural and social sciences. For each term there is an extended definition and discussion of related philosophic issues. Each entry, about three and one-half pages, also provides a bibliography of some six to a dozen sources. A thorough index includes all terms and people discussed in the entries. This is an excellent source for an entree to the scholarly literature on (...) basic topics such as chance, gender, history, indeterminism, instrumentalism, paradigm, scientific method, and vitalism. Choice This new reference, designed for both students and general readers, provides concise essays on more than one hundred basic core ideas or concepts in the natural and social sciences, supplemented by carefully selected bibliographic listings. Written with a minimum of technical jargon, the essays explore such issues as what it means to be scientific, how theories related to facts in science, and how science compares with other intellectual disciplines. After presenting a clear explanation of the concept, each entry discusses the historical and intellectual context that gave rise to theoretical controversy and assesses the significance of the idea for both the particular discipline and science as a whole. The individual bibliographies will guide the student in tracing the historical development of each subject and investigating its scientific and philosophical aspects in greater detail. Cross referencing and subject indexing are supplied. (shrink)

The case for U.S. health system reform aimed at achieving wider insurance coverage in the population and disciplining the growth of costs is fundamentally a moral case, grounded in two principles: a principle of social justice, the Just Sharing of the costs of illness, and a related principle of fairness, the Prevention of Free-Riding. These principles generate an argument for universal access to basic care when applied to two existing facts: the phenomenon of “market failure” in health insurance and, in (...) the U.S., the existing legal guarantee of access to emergency care. The principles are widely shared in U.S. moral culture by conservatives and liberals alike. Similarly, across the political spectrum, the fact of market failure is not contested , and the guarantee of access to emergency care is rarely challenged. The conclusion generated by the principles is not only that insurance for a basic minimum of care should be mandatory but that the scope of that care should be lean, efficient, and constrained in its cost. (shrink)

The case for U.S. health system reform aimed at achieving wider insurance coverage in the population and disciplining the growth of costs is fundamentally a moral case, grounded in two principles: (1) a principle of social justice, the Just Sharing of the costs of illness, and (2) a related principle of fairness, the Prevention of Free‐Riding. These principles generate an argument for universal access to basic care when applied to two existing facts: the phenomenon of “market failure” in health insurance (...) and, in the U.S., the existing legal guarantee of access to emergency care. The principles are widely shared in U.S. moral culture by conservatives and liberals alike. Similarly, across the political spectrum, the fact of market failure is not contested (though it is sometimes ignored), and the guarantee of access to emergency care is rarely challenged. The conclusion generated by the principles is not only that insurance for a basic minimum of care should be mandatory but that the scope of that care should be lean, efficient, and constrained in its cost. -/- . (shrink)

In using quality of life as a guide to rationing health services, Oregon laid itself open to charges of bias against the disabled—charges that cannot be dismissed out of hand.

As social creatures, human beings possess a number of identities. A young woman, for example, is a daughter and a member of a particular ethnic group. She is also likely to be a citizen, a friend,...

Refusal of lifesaving treatment, and such refusal by advance directive, are widely recognized as ethically and legally permissible. Voluntarily stopping eating and drinking is not. Ethically and legally, how does VSED compare with these two more established ways for patients to control the end of life? Is it more questionable because with VSED the patient intends to cause her death, or because those who assist it with palliative care could be assisting a suicide?In fact the ethical and legal basis for (...) VSED is virtually as strong as for refusing lifesaving treatment and less problematic than the basis for refusing treatment by advance directive. VSED should take its proper place among the accepted, permissible ways by which people can control the time and manner of death. (shrink)

In a recent paper in JME, Shelton and Geppert use an approach by Menzel and Chandler-Cramer to sort out ethical dilemmas about the oral feeding of patients in advanced dementia, ultimately arguing that the usefulness of advance directives about such feeding is highly limited. They misunderstand central aspects of Menzel’s and Chandler-Cramer’s approach, and in making their larger claim that such directives are much less useful than typically presumed, they fail to account for five important elements in writing good directives (...) for dementia and implementing them properly: (1) Directives should be paired with appointment of trusted agents. (2) Appointed agents’ authority can be greatly weakened without advance directives to guide them. (3) Directives’ implementation does not require clinically precise assessment of dementia’s stage. (4) Palliative support is typically required for withholding of oral feeding to be compassionate. (5) The central purpose of stopping feeding is often not the avoidance of suffering but not prolonging unwanted life. (shrink)

Paul T. Schotsmans; The Ethical Claim of a Dying Brother, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume 9, Issue 2-3, 1 January 2003.

Volume 20, Issue 8, August 2020, Page 80-82.

Low opportunity cost, weak influence of quality of life in the face of death, the social value of life extension to others, shifting psychological reference points, and hope have been proposed as factors to explain why people apparently perceive marginal life extension at the end of life to have disproportionately greater value than its length. Such value may help to explain why medical spending to extend life at the end of life is as high as it is, and the various (...) factors behind this value might provide normative rationale for that spending. Upon critical analysis, however, most of these factors turn out to be questionable or incompletely conceived; this includes hope, which is examined here in special detail. These factors help to explain complexity and nuance in the normative issues, but they do not provide adequate justification for spending as high as it often is. In any case, two additional factors must be added to the descriptive explanation of high spending, and they throw its normative justification into further doubt: the “insurance effect” and provider-created demand. Overall, the perception of especially high value of life at the end of life provides some normative justification for high spending, but seldom strong justification, and not for spending as high as it often is. (shrink)

“The thing about life is that one day you’ll be dead.” Indeed. But even total and honest acceptance of this brute fact about our relationship to death does not diminish the value we see in short remaining life at the end of life. Few just “give in” and no more fight for life because death is seen as an inherent part of life. They still invest small amounts of additional life with huge value. How high may that value plausibly be? (...) What is the value of a relatively short extension of life when death is inevitably near? (shrink)

The book, Against Fairness, by philosopher Stephen T. Asma is reviewed. Concepts of favoritism and justice are explored.

Since it may seem strange for a new series to begin with volume 3, a word of explanation is in order. The series, Philosophy and Technology, inaugurated in this form with this volume, is the official publication of the Society for Philosophy & Technology. Approximately one volume each year is tobe published, alternating between proceedings volumes - taken from contributions to biennial international conferences of the Society - and miscellaneous volumes, with roughly the character of a professional society journal. The (...) forerunners of the series in its present form were two proceedings volumes: Philosophy and Technology (1983), edited by Paul T. Durbin and Friedrich Rapp, and Philosophy and Technology //: Information Technology and Computers in Theory and Practice (1986), edited by Carl Mitcham and Alois Huning - both published (as volumes 80 and 90, respectively) in the series, Boston Studies in the Philosophy of Science. The Society for Philosophy & Technology, now more than ten years old, is devoted to the promotion of philosophical schalarship that deals in one way or another with technology and technological society. "Philosophical scholarship" is interpreted broadly as including contribu tions from any and all perspectives; the one requirement is that the schalarship be sound, and all contributions to the series are subject to rigorous blind refereeing. "Technology," the other half of the philos ophy-and-technology pairing, is also construed broadly. (shrink)

An assumed core of normative ethical principles may constitute a philosophically proper framework within which public policy should be formulated, but it seldom provides any substantive solutions. To generate public policy on bioethical issues, participants still need to confront underlying philosophical controversies. Professional philosophers' proper role in that process is to clarify major philosophical options, to press wider-ranging concistency questions, and to bring more parties into the philosophical debate itself by arguing for particular substantive claims. Though questions of fact that (...) mediate final policy conclusions frequently fall outside philosophical competence, one sort of fact, lack of political support, should seldom cause philosophers to stand aside; philosophers still have an important role as critics of culture, politics, and profession. They have no authority, however, on even the philosophical presuppositions of public policy. Keywords: bioethics, philosophy, public policy CiteULike Connotea Del.icio.us What's this? (shrink)

In this short paper—little more than a note, even a short “contrarian” sermon for this anniversary volume—what I do is argue that even the allegedly most “revolutionary” inventions of our computer-driven age are not revolutionary in the sense that their impacts are “driving” society. Some of them are genuinely revolutionary, I admit, but in the reverse direction. The inventions don’t “impact societies”; rather, particular communities within society use the technical languages that are at their core, invent them, embed them in (...) machines, and so on. It is not inventions but particular groups within modern—and so-called postmodern—societies that have invented and use technical languages which are embedded in gadgets that are said to “drive” modern or postmodern societies. And they do so only in one sense: they were invented and are used by various communities in our kinds of societies for a variety of ends. And if this is so, and if we feel those ends are undemocratic or positively anti-democratic, I conclude that we should resist them any way we can, even politically. (shrink)