The United States health care industry is the second largest in the world, expending an estimated 479 million metric tons (MMT) of carbon dioxide per year, nearly 8 percent of the country's total emissions. The importance of carbon reduction in health care is slowly being accepted. However, efforts to “green” health care are incomplete since they generally focus on buildings and structures. Yet hospital care and clinical service sectors contribute the most carbon dioxide within the U.S. health care industry, with (...) structures/equipment and pharmaceuticals ranking as the third and fourth highest emitters in the industry. Given the magnitude of health care carbon emissions—and the paucity of attention to the carbon of hospital care and clinical services—this essay identifies overuse of health care as a health threat with serious ethical implications, offers a data‐driven action plan for carbon reduction in health care, and provides practical suggestions for more sustainable health care delivery in the United States. (shrink)

Higher order cognitive processes, including ethical decision making (EDM), are influenced by the experiencing of discrete emotions. Recent research highlights the negative influence one such emotion, anger, has on EDM and its underlying processes. The mechanism, however, by which anger disrupts the EDM has not been investigated. The current study sought to discover whether cognitive appraisals of an emotion-evoking event are the driving mechanisms behind the influence of anger on EDM. One primary (goal obstacle) and one secondary (certainty) appraisal of (...) anger were examined. Study results suggest that appraisals of certainty are the driving mechanism behind the negative relationship between anger and EDM. Certainty appraisals led to less application of EDM-promoting strategies and more unethical social motives. Findings further highlight the value of investigating appraisals of emotional events, given their cognitive nature, for their potential effects on cognitive operations, such as EDM. Future directions and implications are discussed. (shrink)

In 1783 John Michell published a note entitled ‘On the Means of Discovering the Distance, Magnitude etc. of the Fixed Stars, in Consequence of the Diminution of the Velocity of their Light’, but it was Christian Doppler who in 1842 for the first time formulated the principle : If a source of sound or light is in motion relative to an observer, or an observer in motion relative to a source, the period of the waves received by the observer will (...) be different from the period of the waves emitted by the source. The acoustical Doppler principle was verified in 1845 by Buys-Ballot's experiments and by Ernst Mach ). H. Fizeau proposed to verify the optical Doppler principle by measuring the shift of lines in the spectra of stars . This was carried out by William Huggins , and H. C. Vogel and led to exact results in 1892. The Doppler effect with canal rays was shown by Johannes Stark in 1905. (shrink)

People who work and live in a certain moral practice usually possess a specific form of moral wisdom. If we manage to incorporate their moral intuitions in ethical reasoning, we can arrive at judgements and theories that grasp a moral experience that generally cannot be found outside the said practice. To achieve this goal, we need a legitimate way to balance moral intuitions, ethical principles and general theories. In the present contribution, we describe a version of the model of Reflective (...) Equilibrium, which we call the Normative-Empirical Reflective Equilibrium . RE provides a framework for ethical thinking that includes both moral experience and normative theory.After an outline of the model, we focus on the role of empirical research and illustrate how empirical data on moral intuitions can add to the comprehensiveness of the set of moral beliefs in NE-RE. Subsequently, we describe how coherence among the elements of an NE-RE can be understood and measured. Finally, we address an important question for any method of moral reasoning: what is the status of the outcome of the reasoning process? This is a matter of justification. We argue for a so-called good reasoning-justified outcome strategy in NE-RE. This strategy is built on a reasoning process in which the reason-giving force of each element is tested and weighed. The thinker has to work towards a coherent view in which only the elements with sufficient justificatory power are retained. If the thinker decides that the elements fit together into a coherent view, a reflective equilibrium is reached. NE-RE is an attempt to describe a model for moral reasoning that can profit from the moral wisdom present among experienced agents through the use of empirical research. (shrink)

A recurrent issue in the vast amount of literature on reasoning models in ethics is the role and nature of moral intuitions. In this paper, we start from the view that people who work and live in a certain moral practice usually possess specific moral wisdom. If we manage to incorporate their moral intuitions in ethical reasoning, we can arrive at judgements and (modest) theories that grasp a moral experience that generally cannot be found outside the practice. Reflective equilibrium (RE) (...) provides a framework for balancing moral intuitions, ethical principles and general theories. Nevertheless, persisting problems associated with the use of intuitions need to be addressed. One is the objection that moral intuitions lack the credibility necessary to guide moral reasoning. Ethicists have tried to solve this problem by formulating criteria to separate the “bad” intuitions from the “good” ones at the beginning of the reasoning process. We call this the credible input-justified outcome strategy. An example is the appeal to the common morality by Beauchamp and Childress. We think this approach is unsuccessful. As an alternative, we outline the good reasoning-justified outcome strategy. It connects to a variant of RE in which intuitions from different sources are incorporated. We argue that the elements of RE have different levels of justificatory power at the start of reasoning. In our strategy, each element can gain or lose justificatory power when it is tested in a reasoning process that meets several criteria. (shrink)

This chapter explores Gottlob Frege's contribution to logic. Frege has been called the greatest logician since Aristotle, but he failed to gain influence on the mathematical community of his time and the depth and pioneering character of his work was acknowledged only after the collapse of his logicist program due to the Zermelo–Russell antinomy in 1902. Frege, by proving his theorem χ without recourse to Wertverläufe, exhibited an inconsistency (or at least an incoherence) in the traditional notion of the extension (...) of a concept. He prompted our awareness of a situation the future analyses of which will hopefully not only deepen our systematic control of the interplay of concepts and their extensions but also improve our understanding of the historical development of the notion of “extension of a concept” and its historiographical assessment. (shrink)

Respect for autonomy is well known as a core element of normative views on good care. Most often it is interpreted in a liberal way, with a focus on independence and self-determination. In this article we argue that this interpretation is too narrow in the context of care in nursing homes. With the aim of developing an alternative view on respect for autonomy in this setting we described four interpretations and investigated the moral intuitions (i.e. moral judgements) of caregivers regarding (...) these approaches. We found that these caregivers seemed to value different notions relating to respect for autonomy under different circumstances. There was no significant difference in moral judgements between men and women or between doctors and nurses. We conclude that a multidimensional understanding of this principle would best fit this context. We end this article with a description of a modest theory of respect for autonomy in nursing homes. (shrink)

People who work and live in a certain moral practice usually possess a specific form of moral wisdom. If we manage to incorporate their moral intuitions in ethical reasoning, we can arrive at judgements and theories that grasp a moral experience that generally cannot be found outside the said practice. To achieve this goal, we need a legitimate way to balance moral intuitions, ethical principles and general theories. In the present contribution, we describe a version of the model of Reflective (...) Equilibrium, which we call the Normative-Empirical Reflective Equilibrium . RE provides a framework for ethical thinking that includes both moral experience and normative theory.After an outline of the model, we focus on the role of empirical research and illustrate how empirical data on moral intuitions can add to the comprehensiveness of the set of moral beliefs in NE-RE. Subsequently, we describe how coherence among the elements of an NE-RE can be understood and measured. Finally, we address an important question for any method of moral reasoning: what is the status of the outcome of the reasoning process? This is a matter of justification. We argue for a so-called good reasoning-justified outcome strategy in NE-RE. This strategy is built on a reasoning process in which the reason-giving force of each element is tested and weighed. The thinker has to work towards a coherent view in which only the elements with sufficient justificatory power are retained. If the thinker decides that the elements fit together into a coherent view, a reflective equilibrium is reached. NE-RE is an attempt to describe a model for moral reasoning that can profit from the moral wisdom present among experienced agents through the use of empirical research. (shrink)

On 5 May 1957, Leopold Löwenheim passed away in a Berlin hospital following a short but severe illness, unnoticed by the community of mathematical logicians who believed that he had perished in a Nazi concentration camp in or shortly after 1940 (the year of publication in the Journal of Symbolic Logic of his last paper before the end of World War II). The 50th anniversary of his death seems an appropriate date for the posthumous publication of a paper that was (...) supposed to appear in Fundamenta Mathematicae in 1939, the galley proofs of which Löwenheim had already seen and corrected when German troops invaded Poland on 1 September 1939. Löwenheim managed to save the proofs through the War, despite the loss of most of his possessions during the bombing of Berlin in 1943 and 1944. By another lucky chance, a copy of the proofs survived in the present author's possession, when the originals were lost during a flat clearing in Berlin as part of the estate of Johannes Teichert (1904?1994), Löwenheim's step-son, when his widow moved into a nursing-home in May 1999. Later, I will expand these short remarks slightly but seize the present opportunity to resume (and in some places add to) the extant data on Löwenheim's life and writings. (shrink)

Worries about safety of approved drugs have pushed post registration research to become the fastest growing drug research phase. Until recently, phase IV studies were mainly conducted for marketing purposes and run much like a phase III trial—at institutions with experienced investigators and a list of inclusion and exclusion criteria. Innovative phase IV studies involve ordinary physicians in research naïve communities. This brings ethical issues familiar to medical research into clinical practice. As a consequence, individual physicians are challenged to protect (...) scientific integrity and to secure the ethical conduct of research. Several ethical issues need to be addressed in the process of developing a scientifically sound and ethically high principled practice of phase IV research.PHASE IVEssential to phase IV research is the focus on how drugs work in the real world. The research goal may be to explore a specific pharmacological effect, to establish the incidence of adverse reactions, or to determine the effects of long-term administration of a drug. They may also be designed to establish a new clinical indication for a drug.1 Subjects may or may not be randomised, and the studies typically involve large numbers of patient-subjects and physicians.Doubts concerning the scientific rigor and clinical value have put postmarketing research in a poor light. However, high quality phase IV research is badly needed to further pharmaceutical science. First, because it can provide reliable data on the effectiveness, safety and optimal use of a drug in treated populations.2 3 In pre-registration clinical trials , a pharmaceutical product is studied under unrealistic circumstances. Under-representation of women and elderly are common and the concomitant use of medicines is usually extremely restrictive in these trials.4 Second, phase IV can provide much needed data for evidence-based …. (shrink)

In the Netherlands, the legalization of assisted suicide for persons with a death wish without severe illness, often referred to as persons with “completed life” or “tiredness of life,” is intensel...

Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include (...) a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sensemaking processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed. (shrink)

A nonfoundationalist reading of Fides et Ratio, both in its negative regard for Enlightenment reasoning and its implicit understanding of the philosophical task of justifying belief, enables an appreciation of the encyclical as a particular kind of post-Enlightenment Roman Catholic stance. A nonfoundationalist perspective, understood as a philosophical position on the justification of belief, can be instructive in the encyclical’s articulation of Credo ut intelligam. Fides et Ratio offers a contextualized understanding of justification in its treatment of universality that can (...) only be recognized, affirmed and confessed within the particularity of faith. (shrink)

Zusammenfassung Sportvereine reagieren auf einen Veränderungsdruck ihrer Umwelt selten einheitlich und keinesfalls immer so, wie es die damit verbundenen Forderungen nahe legen. Was steckt hinter diesem Phänomen? Weshalb ist es anscheinend so irrelevant für die Entwicklung der Sportvereine, wenn externe Experten die Notwendigkeit von Strukturveränderungen einfordern? Bedeutet dies, dass Sportvereine ausschließlich nach dem Gutdünken ihrer Funktionäre operieren, oder dass sie gar unfähig sind, sich von Ereignissen in ihrer Umwelt zu Lernprozessen anregen zu lassen? Der vorliegende Beitrag beschäftigt sich mit der (...) Lernfähigkeit von Sportorganisationen. Dabei zeigt sich der Sportverein als besonders lernfähig im Hinblick auf eine Abwehr von Irritationen. Die Notwendigkeit dieser Abwehr ergibt sich aus den sportvereinsspezifischen Organisationsstrukturen. (shrink)

Although case-based training is popular for ethics education, little is known about how specific case content influences training effectiveness. Therefore, the effects of (a) codes of ethical conduct and (b) forecasting content were investigated. Results revealed richer cases, including both codes and forecasting content, led to increased knowledge acquisition, greater sensemaking strategy use, and better decision ethicality. With richer cases, a specific pattern emerged. Specifically, content describing codes alone was more effective when combined with short-term forecasts, whereas content embedding codes (...) within context was more effective when combined with long-term forecasts, leading to greater knowledge acquisition and sensemaking strategy use. (shrink)

This article explores the question of how to understand social media following the Habermasian theory of the structural transformation of the public sphere. We argue for a return to political-economic fundamentals as the basis for analysing the public sphere and seek to establish a characteristic connection between digital-behavioural control and singularised audiences in the context of proprietary markets. In the digital constellation, it is less a matter of immobilising the citizen as a consumer but rather of their political activation – (...) albeit in conditions under which commercial interests have primacy: privatisation without privatism. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 39.1 (2001) 145-146 [Access article in PDF] Nicholas Jolley. Locke. His Philosophical Thought. Oxford: Oxford University Press, 1999. Pp. 233. $55.00, cloth; $19.95, paper. One of the main aims of this lean and clearly set out book is "to argue for the fundamental unity of Locke's thought" in the Essay concerning Human Understanding. Thus while it deals with many of the usual 'central (...) themes' (ideas, knowledge, freedom, personal identity, etc.), this Locke is more ambitious than are other general surveys of the Essay. Another, related aim of the book is to defend Locke against charges of inconsistency. Here, it is successful in many instances. But even as sympathetic a reader as Jolley has to admit several times that there are in Locke's text "elements of inconsistency," positions that are "hard to reconcile" with each other, and "tensions" if not contradictions.For the most part Jolley's exposition follows the structure of the Essay, beginning with "the origin and nature of ideas," going through the various topics from Book II, then moving to themes in Book III ("Classification and Language") and ending with an account of Book IV ("Knowledge and Faith"). He proceeds by giving brief expositions of Locke's arguments on the issues at hand, sometimes reflecting on alternative readings, and considering objections to, and defences of Locke. There is some discussion of other major seventeenth-century philosophers, and there are—fairly general—references to the corpuscular philosophy and to Aristotelianism. But on the whole, Jolley does not burden his account with much historical context, focusing instead on individual "issues" and arguments concerning Locke's own text.Yet, sometimes Jolley's discussion of Locke's arguments leaves the reader with statements that require considerable elaboration. For example, in his treatment of Reid's critique of Locke's account of personal identity (according to which Locke's theory is inconsistent with the transitivity of identity), he ends his discussion by simply stating that "it is not obviously foolish to question whether the transitivity relation holds for identity over time" (121). Foolish or not, what is obvious is that more needs to be said to make this suggestion plausible, both in itself and as part of a reading of Locke.At other times Jolley's expositions are not as clear as they might be and remain unconvincing. Thus, in defending Michael Ayers's much debated view that all Lockean ideas are of the nature of mental images, he concedes that it is difficult to accommodate Locke's ideas of reflection (i.e., ideas of mental operations) to this reading. Yet he defends it, saying that Locke interprets the imagist programme "with some latitude." But if ideas of reflection are excluded, it would seem rather difficult to persist with the claim that Locke "is indeed an imagist." This relates to another issue that is much discussed in Locke scholarship: the notion of what Locke calls "substratum" or "pure substance in general." As Jolley reports, Michael Ayers has argued that 'substratum' does not stand for a bare particular but must be understood in the light of Locke's doctrine of real essence: real essence and substance are not to be equated but they pick out the same thing. Thus, according to Ayers, when Locke draws attention to our ignorance of both substance and real essence, he is not preaching agnosticism at two distinct metaphysical levels. Jolley rejects this reading. But while he points out, rightly in my view, that substratum concerns our thinking about objects, in places he appears to accept that the notion is a metaphysical one, for he holds (against Ayers) [End Page 145] that the distinction between substratum and real essence does concern different metaphysical levels (73). Locke himself is clear enough about the status of the "notion of pure substance in general." When he introduces it (II.xxiii.2), he does so as part of his account of how complex ideas of substances are formed: the notion is part of our ideas of particular kinds of substances. Now this notion cannot be derived... (shrink)

A philosophical system that aims to explain the structure of nature from the perspective of the framework of human consciousness, and thus the foundations of mathematics and physics.