Christian physicians are in danger of losing the right of conscientious objection in situations they deem immoral. The erosion of this right is bolstered by the doctrine of "physician value neutrality" (PVN) which may be an impetus for the push to require physicians to refer for procedures they find immoral. It is only a small step from referral to compelling performance of these same procedures. If no one particular value is more morally correct than any other (a foundational PVN premise) (...) and a physician ought to be value neutral, than conscientious objection to morally objectionable actions becomes a thing of the past. However, the argument for PVN fails. Therefore, Christian physicians should state their values openly, which would allow patients the ability to choose like-minded physicians. Some possible responses to this erosion of conscientious objection include, disengagement from non-Christian institutions, the formation of distinctly Christian medical institutions and political action. However, for the Christian the initial focus should be on a life of holiness which requires each of us to avoid evil. (shrink)

Physician conflict of interest has been of concern since Hippocrates and rarely is this concern more evident than in the relationship between pharmaceutical sales representatives (PSR) and physicians. Given the acrimonious public debates concerning this issue a careful exploration of the concerns at sake and the conceptual arguments which support such concerns is called for. In this piece I will take as heuristic the conceptual philosophical framework argued for by H. Tristram Engelhardt. This framework would sanction interactions between PSRs and (...) physicians given that such relationships are free and without coercion. Further, patients must be informed, uncoerced and free in choosing such relationships with physicians who engage in interactions with PSRs. I consider four major criticisms which claim that PSR-physician interactions are morally impermissible: 1) influence, 2) “patients do not choose, but they pay,” 3) violation of ethical principles, and 4) erosion of the patient-physician relationship. Each is shown to be unpersuasive under Engelhardtian philosophy. As long as the principle of permission and informed consent obtain without coercion than the interaction between PSRs and physicians would be construed to be morally permissible. (shrink)

Managed care poses a challenge to the traditional conceptualization of medicine and of the physician-patient relationship. People have evaluated the merits of managed care by focusing upon the way its incentives alter the relationship between physician and patient. However, this misses the key to rightly evaluating MCOs. To address the ethics of MCOs one should focus on the institution-patient relationship, and this has not been sufficiently addressed in the literature. I will address this relationship here and show how the institution-patient (...) relationship has evolved, why it has become increasingly prominent, and why we must move beyond business ethics for rightly understanding it. (shrink)

Although the notion of physician value neutrality in medicine may be traced back to the writings of Sir William Osler, it is relatively new to medicine and medical ethics. We argue in this paper that how physician value neutrality has been cashed out is often obscure and its defense not persuasive. In addition, we argue that the social/political implementation of neutrality, Political Liberalism, fails, and thus, PVN's case is weakened, for PVN's justification relies largely on the reasoning undergirding PL. For (...) these reasons, we conclude that PVN has no philosophical or ethical warrant and thus should be abandoned. We suggest that the physician present to her patients some type of statement or creed that would give them an idea of where she stands on important axiological issues and how these stands are cashed out clinically. (shrink)

Regional Perspectives in Bioethics" illustrates the ways in which the national and international political landscape encompasses persons from diverse and often fragmented moral communities with widely varying moral intuitions, premises, evaluations and commitments.

Regional Perspectives in Bioethics" illustrates the ways in which the national and international political landscape encompasses persons from diverse and often fragmented moral communities with widely varying moral intuitions, premises, evaluations and commitments.

Schelling's 1806 polemic against Fichte, and his last major work on the philosophy of nature. The heat of anger can concentrate the mind. Convinced that he had been betrayed by his former collaborator and colleague, Schelling attempts in this polemic to reach a final reckoning with Fichte. Employing the format of a book review, Schelling directs withering scorn at three of Fichte’s recent publications, at one point likening them to the hell, purgatory, and would-be paradise of Fichtean philosophy. The central (...) bone of contention is the understanding of nature: Fichte sees it as lifeless matter in motion, sheer opposition to be overcome, while Schelling waxes poetic in his defense of a living, organic nature of which humanity is a vital part. Indeed, we do not know ourselves without understanding our connection to nature, argues Schelling, anticipating many thinkers in contemporary environmental ethics. Dale E. Snow’s introduction sets the stage and explains the larger context of the conflict, which was already visible in the correspondence of the two philosophers, which broke off by 1802. Notes are included throughout the text, providing background information and identifying the many references to Fichte. Dale E. Snow is Associate Professor of Philosophy at Loyola University of Maryland and the author of Schelling and the End of Idealism, also published by SUNY Press. (shrink)

Orthodox bioethics is distinctive in how it reflects on issues in bioethics. This distinctiveness is found in the relationship of spirituality and liturgy to ethics. Eber's essay, however, treats the distinctiveness as absolute uniqueness. In so focusing on the incommensurability of Orthodox bioethics Eber fails to tell his reader what Orthodox bioethics is about. Furthermore, his description of Western Christian ethics is seriously inaccurate.

In prevention and health promotion interventions, screening methods and risk profile assessments are often used as tools for establishing the interventions’ effectiveness, for the selection and determination of the health status of participants. The role these instruments fulfil in the creation of effectiveness and the effects these instruments have themselves remain unexplored. In this paper, we have analysed the role screening methods and risk profile assessments fulfil as part of prevention and health promotion programmes in the selection, enrolment and participation (...) of participants. Our analysis showed, that screening methods and health risk assessments create effects as they objectify health risks and/or the health status of individuals, i.e., they select the individuals ‘at risk’ and indicate the lifestyle modifications these people are required to make in order to improve their health. Yet, these instruments also reduce the group of participants thereby decreasing the possible effect of interventions, as they provide the legitimisation for people to make choices to whether they enrol or not and what lifestyle changes they incorporate into their lives. In other words, they present a space of interaction, in which agency is distributed across the practice nurses, the participants and the instruments. Decisions were not just made upon the projection of the outcomes of these instruments; decisions that were made by both the patients and practice nurses were the resultant of their opinions on these outcomes that were formed in interaction with the instruments. (shrink)

Here we prove that if T and T′ are strongly minimal theories, where T′ satisfies a certain property related to triviality and T does not, and T′ is model complete, then there is no computable embedding of Mod(T) into Mod(T′). Using this, we answer a question from [4], showing that there is no computable embedding of VS into ZS, where VS is the class of infinite vector spaces over Q, and ZS is the class of models of Th(Z, S). Similarly, (...) we show that there is no computable embedding of ACF into ZS, where ACF is the class of algebraically closed fields of characteristic 0. (shrink)

Christology seems to fall fairly clearly into two divisions. The first is concerned with the truth of the two propositions: ‘Christ is God’ and ‘Christ is a man’. The second is concerned with the mutual compatibility of these propositions. The first part of Christology tends to confine itself to what is sometimes called ‘positive theology’: that is to say, it is largely given over to examining the Jons revelationis —let us not prejudge currently burning issues by asking what this is—to (...) see what evidence can be found for the truth of these propositions. Clearly, the methods used will be above all those of New Testament exegesis. The second part of Christology will necessarily consist entirely of that speculative theology which is contrasted with positive theology. Even if the earliest speculation on this topic is to be found in the New Testament itself and thus becomes fair game for the exegetes, any attempt to relate the primary truths, ‘Christ is God’ and ‘Christ is a man’, to eachother is a work of reflection, and in the terminology I am using speculative. (shrink)

The posterior parietal cortex (PPC) is the most likely site where egocentric spatial relationships are represented in the brain. PPC cells receive visual, auditory, somaesthetic, and vestibular sensory inputs; oculomotor, head, limb, and body motor signals; and strong motivational projections from the limbic system. Their discharge increases not only when an animal moves towards a sensory target, but also when it directs its attention to it. PPC lesions have the opposite effect: sensory inattention and neglect. The PPC does not seem (...) to contain a “map” of the location of objects in space but a distributed neural network for transforming one set of sensory vectors into other sensory reference frames or into various motor coordinate systems. Which set of transformation rules is used probably depends on attention, which selectively enhances the synapses needed for making a particular sensory comparison or aiming a particular movement. (shrink)

Is it possible to interfere with individual decision-making while preserving freedom of choice? The purpose of this article is to assess whether ‘libertarian paternalism’, a set of political and ethical principles derived from the observations of behavioural sciences, can form the basis of a viable framework for the ethical analysis of public health interventions. First, the article situates libertarian libertarianism within the broader context of the law and economics movement. The main tenets of the approach are then presented and particular (...) attention is given to its operationalization through the notion of a ‘nudge’. Essentially, a ‘nudge’ consists in an intervention, which aims to suggest one choice over another by gently steering individual choices in welfare-enhancing directions yet without imposing any significant limit on available choices. Finally, the article concludes that, while it fails as an overreaching framework of ethical analysis, libertarian paternalism nonetheless constitutes a valuable addition to the conceptual toolbox of public health ethics. (shrink)

This collection of essays, addresses, and one interview come from the years 1966-73 and cover a wide spectrum of interest, dealing with such general topics as 'The Absence of God in Modern Culture' and 'The Future of Christianity.'.

For countable structure, "Scott rank" provides a measure of internal, model-theoretic complexity. For a computable structure, the Scott rank is at most [Formula: see text]. There are familiar examples of computable structures of various computable ranks, and there is an old example of rank [Formula: see text]. In the present paper, we show that there is a computable structure of Scott rank [Formula: see text]. We give two different constructions. The first starts with an arithmetical example due to Makkai, and (...) codes it into a computable structure. The second re-works Makkai's construction, incorporating an idea of Sacks. (shrink)

For countable structure, "Scott rank" provides a measure of internal, model-theoretic complexity. For a computable structure, the Scott rank is at most [Formula: see text]. There are familiar examples of computable structures of various computable ranks, and there is an old example of rank [Formula: see text]. In the present paper, we show that there is a computable structure of Scott rank [Formula: see text]. We give two different constructions. The first starts with an arithmetical example due to Makkai, and (...) codes it into a computable structure. The second re-works Makkai's construction, incorporating an idea of Sacks. (shrink)

In a discussion-note in Mind, Father P. M. Farrell, O.P., gave an account, in what he admitted to be an embarrassingly brief compass, of the Thomist doctrine concerning evil. There is one sentence in this discussion which at first glance appears paradoxical. Father Farrell has been arguing that a universe containing ‘corruptible good’ as well as incorruptible is better than one containing ‘incorruptible good’ only. He continues: ‘If, however, they are to manifest this corruptible good, they must be corruptible and (...) they must sometimes corrupt.’ The final words, despite Father Farrell's italics, strike one as expressing, not a self-evident truth, but a non sequitur. The fact that I am capable of committing murder does not entail that I will at some time commit it. It is not immediately obvious that a similar entailment holds in the case of corruption and corruptibility. (shrink)

Why is there a 'hard problem' of consciousness? Why do we seem unable to grasp intuitively that physical brain processes can be identical to experiences? Here I comment on the 'meta-problem' (Chalmers, 2018), based on previous ideas (Storm, 2014; 2018). In short: humans may be 'inborn dualists' ('neuroscepticism'), because evolution gave us two (types of) brain systems (or functional modes): one (Sp) for understanding relatively simple physical phenomena, and another (Sm) specialized for mental phenomena. Because Sp cannot deal with the (...) immense complexity of the brain processes underlying consciousness, it represents them as fundamentally different from nonmental physical phenomena (dualist intuition), using 'simulations' to produce 'Sm-type understanding'/predictions that seems radically different from 'Sp-type understanding'. (By analogy, different sensory modalities, handled by distinct brain systems, evoke qualitatively different experiences.) Brain systems for Sp representations of our brain processes never evolved, because they would be useless. When lacking a single 'template' matching different aspects of reality (objective vs. subjective = simulated), complementary 'models' are needed ('neuro-complementarity'), like the wave–particle duality in quantum mechanics. Thus, it seems plausible that Sp and Sm evolved because they were needed to cope with different challenges, and that 'problem intuitions' are side effects of these useful but different brain systems. (shrink)

For a computable structure A\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathcal{A}}$$\end{document}, there may not be a computable infinitary Scott sentence. When there is a computable infinitary Scott sentence φ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\varphi}$$\end{document}, then the complexity of the index set I\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${I}$$\end{document} is bounded by that of φ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\varphi}$$\end{document}. There are results giving “optimal” Scott sentences for (...) structures of various familiar kinds. These results have been driven by the thesis that the complexity of the index set should match that of an optimal Scott sentence. In this note, it is shown that the thesis does not always hold. For a certain subgroup of Q\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathbb{Q}}$$\end{document}, there is no computable d-Σ2\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\Sigma_2}$$\end{document} Scott sentence, even though the index set is d-Σ20\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\Sigma^0_2}$$\end{document}. (shrink)