For decades questionnaires have been used to measure the cognitive and psychological effects of prenatal genetic testing, but little is known about why some women undergo testing and others decline. Research indicates that many factors influence decision making, including values and beliefs. What is often denied rather than recognized is that the professional and personal values and beliefs held by the health care provider influence the patient’s decision. It is assumed that, if genetic services are delivered in a nondirective manner, (...) patients will not be affected by the provider’s personal and professional standpoint. The qualitative research data reported here challenge this assumption. Getting to know patients’ moral understanding and patterns of ethical reasoning by listening to their personal stories is recommended as a better way for nurses to help patients to make informed and autonomous decisions about prenatal genetic screening or diagnostic tests. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 39.1 (2001) 149-151 [Access article in PDF] Reinhard Brandt. Kritischer Kommentar zu Kants Anthropologie in pragmatischer Hinsicht (1798). Kant-Forschungen, Band 10. Hamburg: Felix Meiner Verlag, 1999. Pp. 543. Cloth, DM. The appearance of a commentary on Kant's Anthropology is very timely, indeed indispensable, given the advent of a new phase in Kant scholarship, attentive to the writings surrounding the main critical texts as (...) a way of gaining a more comprehensive understanding of his thought. This new approach has been partly precipitated by the 1997 release of Volume 25 of the Academy edition containing the student transcriptions of Kant's anthropology lectures spanning a period of twenty-four years. The Anthropology is especially important for understanding Kant's moral philosophy. From 1773 forward, Kant himself never taught morality without concurrently offering his course in anthropology. His own students were thus cognizant of Kant's conception of human nature. Yet during the last 200 years few have paid attention to what sort of being, in Kant's view, was called upon to fulfill the moral vocation. As Brandt points out, the Anthropology has previously provoked no notable study, no discussion among either advocates or detractors.The precise nature of the relation between the Anthropology and Kant's critical philosophy remains an open question. Brandt himself is skeptical about the importance of the Anthropology for moral philosophy. He argues against seeing an integrated relation between the Anthropology and the critical system. For Brandt, the two stand alongside each other. The pragmatic anthropology serves merely as an "encyclopedia of the Kantian philosophy on an empirical level," providing an empirical discussion of its problems (8). He also argues that the pragmatic anthropology is neither identical with the anthropology required as a discipline supplementary to pure moral philosophy (14) [End Page 149] nor with the transcendental anthropology providing the self-knowledge of understanding reason (17). The seeming hallmarks of Kant's thought, such as the triadic structure of cognition, feeling, and desire, are simply an omnipresent "psychological division of European cultural history" (99-100) and so unpersuasive as evidence for a systematic connection of the texts. Anthropology has no "idea of reason" as its "basis." It begins in empirical psychology (especially Baumgarten's) and in Kant's effort to separate it from this discipline as a distinct, "pragmatic discipline" with the goal of "facilitating the prudent action of future world citizens" (9, 11). Brandt's interpretation probably influences his selection of passages from the critical philosophy referenced in his Kommentar.The commentary sets Kant's Anthropology in the historical context of Western thought, identifying related passages in texts which Kant is known to have read, as well as materials unfamiliar to him, but still pertinent for a given theme. Over 400 primary sources (from Homer and the philosophers of antiquity, to such recent writers as Richard Rorty) are referenced, as well as over 300 authors in the secondary literature. The commentary is critical, including in its textual analysis differences between the 1798 and 1800 published editions of the Anthropology, and comparisons with the manuscript in Kant's own hand (now located in Rostock). Marginalia are noted, and in some cases passages struck from Kant's manuscript are reproduced in the Kommentar; one such particularly long passage pertains to Kant's discussion of sensibility as contrasted with the understanding (175-181). Parallel passages are identified in Kant's other writings, including his published works, Reflexionen, correspondence, and other lecture notes. These include references to the anthropology lecture notes compiled in Volume 25, thus making the commentary helpful for someone investigating shifts and developments in Kant's treatment of a given topic. The historical context is also quite helpful for understanding the very concepts of "anthropology" (49-63), "pragmatic" (53), and "application" (57). Brandt concludes that with regard to its sources, Kant's anthropology is a "literary anthropology" (85) and that its central thematic is "the human being as an acting being" (89).Brandt offers very interesting and helpful discussions of various topics, with helpful citations, which... (shrink)

Lichtenbergs Schriften können wir uns als der wunderbarsten Wünschelrute be‐dienen; wo er einen Spass macht, liegt ein Problem verborgen.

Accepted medical practice already violates the dead donor rule. Explicitly jettisoning the rule—allowing vital organs to be extracted, under certain conditions, from living patients—is a radical change only at the conceptual level. But it would expand the pools of eligible organ donors.

The use of brain imaging technology as a common tool of research has spawned concern and debate over how investigators should respond to incidental fndings discovered in the course of research. In this article, we argue that investigators have an obligation to respond to incidental fndings in view of their entering into a professional relationship with research participants in which they are granted privileged access to private information with potential relevance to participants' health. We discuss the scope and limits of (...) this professional obligation to respond to incidental fndings, bearing in mind that the relationship between investigators and research participants differs fundamentally from the doctor-patient relationship. (shrink)

There are advantages to thrift over honest toil. If we can make do without numbers we avoid challenging questions over the metaphysics and epistemology of such entities; and we have a good idea, I think, of what a nominalistic metaphysics should look like. But minimizing ontology brings its own problems; for it seems to lead to error theory— saying that large swathes of common-sense and best science are false. Should recherche philosophical arguments really convince us to give all this up? (...) Such Moorean considerations are explicitly part of the motivation for the recent resurgence of structured metaphysics, which allow a minimal (perhaps nominalistic) fundamental ontology, while avoiding error-theory by adopting a permissive stance towards ontology that can be argued to be grounded in the fundamental. This paper evaluates the Moorean arguments, identifying key epistemological assumptions. On the assumption that Moorean arguments can be used to rule out error-theory, I examine deflationary ‘representationalist’ rivals to the structured metaphysics reaction. Quinean paraphrase, fictionalist claims about syntax and semantics are considered and criticized. In the final section, a ‘direct’ deflationary strategy is outlined and the theoretical obligations that it faces are articulated. The position advocated may have us talking a lot like a friend of structured metaphysics—but with a very different conception of what we’re up to. (shrink)

The structuring and transformation of myth is presented as a function of a number of brain “operators.” Each operator is understood to represent specifically evolved neural tissue primarily of the neocortex of the brain. Mythmaking as well as other cognitive processes is seen as a behavior arising from the evolution and integration of certain parts of the brain. Human ceremonial ritual is likewise understood as the culmination of a long phylogenetic evolutionary process, and a neural model is presented to explain (...) its properties. Finally, the mechanism by which ritual is used to resolve the antinomies of myth structure is explored. (shrink)

Response to commentaries on keynote article.

Recently, Brukner and Zeilinger 3354) have claimed that the Shannon information is not well defined as a measure of information in quantum mechanics, adducing arguments that seek to show that it is inextricably tied to classical notions of measurement. It is shown here that these arguments do not succeed: the Shannon information does not have problematic ties to classical concepts. In a further argument, Brukner and Zeilinger compare the Shannon information unfavourably to their preferred information measure, I , with regard (...) to the definition of a notion of “total information content.” This argument is found unconvincing and the relationship between individual measures of information and notions of “total information content” investigated. We close by considering the prospects of Zeilinger's Foundational Principle as a foundational principle for quantum mechanics. (shrink)

This essay outlines one aspect of a larger collaboration with John Beatty and Alan Love.2 The project’s focus is philosophical, but for reasons that will become clear momentarily, the method of approach is historical. All three of us share the conviction that philosophical issues concerning the foundations of the sciences are often illuminated by investigating their history. It is my hope that this paper both provides support for that thesis, and illustrates it. The focal philosophical issue can be stated in (...) the form of a puzzle about contemporary discussions of the conceptual foundations of evolutionary theory. The role of the concepts of “chance” and “randomness” in that theory is a significant part of .. (shrink)

The term therapeutic misconception was coined by Paul Appelbaum and his colleagues to describe the tendency of patients enrolled in clinical trials to confuse research participation with the personal clinical attention characteristic of medical care. It has not been recognized that an analogous therapeutic misconception pervades ethical thinking about clinical research with patient-subjects. Investigators and bioethicists often judge the ethics of clinical research based on ethical standards appropriate to the physician-patient relationship in therapeutic medicine. This ethical approach to clinical research (...) constitutes a misconception because it fails to appreciate the ethically significant differences between clinical research and clinical care.In this article I argue that the assumption that the ethical principles governing the practice of therapeutic medicine should also apply to clinical research with patient- subjects produces incoherence in research ethics and erroneous guidance concerning certain controversial research designs. (shrink)

Classic deductive logic entails that once a conclusion is sustained by a valid argument, the argument can never be invalidated, no matter how many new premises are added. This derived property of deductive reasoning is known as monotonicity. Monotonicity is thought to conflict with the defeasibility of reasoning in natural language, where the discovery of new information often leads us to reject conclusions that we once accepted. This perceived failure of monotonic reasoning to observe the defeasibility of natural-language arguments has (...) led some philosophers to abandon deduction itself (!), often in favor of new, non-monotonic systems of inference known as `default logics'. But these radical logics (e.g., Ray Reiter's default logic) introduce their desired defeasibility at the expense of other, equally important intuitions about natural-language reasoning. And, as a matter of fact, if we recognize that monotonicity is a property of the form of a deductive argument and not its content (i.e., the claims in the premise(s) and conclusion), we can see how the common-sense notion of defeasibility can actually be captured by a purely deductive system. (shrink)

. The phenomenology of certain mystical states is contrasted with the sense of “baseline” reality in an exploration of primary senses of reality. Nine theoretical and eight actual primary senses of reality are described. A neurophysiological model is presented to account for these states, and their possible adaptive significance is considered from an evolutionary perspective. Finally the state of absolute unitary being is contrasted with baseline reality, and their competing claims for primacy are evaluated in an epistemological context.

An analysis of the underlying neurophysiology of aesthetics and religiousexperience allows for the development of an Aesthetic‐Religious Continuum. This continuumpertains to the variety of creative and spiritual experiences available to human beings. This mayalso lead to an understanding of the neurophysiological mechanism underlying both“positive” and “negative” aesthetics. An analysis of this continuumallows for the ability to understand the neurophenomenological aspects of a variety of humanexperiences ranging from relatively simple aesthetic experiences to profound spiritual and unitarystates such as those obtained during (...) meditation. However, it may be possible through aneuropsychological analysis to determine the similarities that exist across such experiences.Thus, certain parts of the brain may be functioning in similar ways during different experiences.It may be the case that the specific neuropsychological components of a given experience maydepend on the strength of the affectual response of the person and the ability to mark suchexperiences as significant. Further, even though similar structures may be functioning duringdifferent experiences, their inhibitory and excitatory interactions may be different. Finally, byconsidering the Aesthetic‐Religious Continuum, we may eventually arrive at a betterunderstanding of how we experience and define reality. (shrink)

With breathtalung speed, traditional criminal prohibitions against assisted suicide have been declared unconstitutional in twelve states, including California and New York. This poses great promise and great peril. The promise is that competent terminally ill patients, as a compassionate measure of last resort, will have the option of putting an end to their suffering by physician-assisted suicide. More sigmficant, legally permitting this controversial option may be a catalyst for doctors, health care institutions, and society to improve the care of the (...) dying. PAS should be limited only to those relatively few competent patients who continue to suffer intolerably despite unrestrained efforts to palliate and who face a continued existence that they regard as worse than death. When dying patients know they will not be abandoned to miserable and pointless suffering if palliative care fails, they will be fortified to cope better with the process of dying.The immediate peril is that PAS will become a quick fix, available on demand to any patient diagnosed as terminally ill, thus bypassing palliative care and producing premature deaths. (shrink)

It is always possible to construct a real function f, given random quantities X and Y with continuous distribution functions F and G, respectively, in such a way that f(X) and f(Y), also random quantities, have both the same distribution function, say H. This result of De Finetti introduces an alternative way to somehow describe the `opinion' of a group of experts about a continuous random quantity by the construction of Fields of coincidence of opinions (FCO). A Field of coincidence (...) of opinions is a finite union of intervals where the opinions of the experts coincide with respect to that quantity of interest. We speculate on (dis)advantages of Fields of Opinion compared to usual `probability' measures of a group and on their relation with a continuous version of the well-known Allais' paradox. (shrink)

Whether treatment decision-making capacity can be meaningfully applied to patients with a diagnosis of “personality disorder” is examined. Patients presenting to a psychiatric emergency clinic with threats of self-harm are considered, two having been assessed and reviewed in detail. It was found that capacity can be meaningfully assessed in such patients, although the process is more complex than in patients with diagnoses of a more conventional kind. The process of assessing capacity in such patients is very time-consuming and may become, (...) in itself, a therapeutic intervention. (shrink)

In debate with John Caiazza, we clarify the meaning of the terms technology and secular, arguing that technology is not really secular. Only when combined with antireligious secularism do we get the modern techno‐secular worldview. Science is not secular in the strong sense, nor does its practice automatically lead to the techno‐secular. As a complete worldview, techno‐secularism is antireligious, but it also is dehumanizing and destructive of our environment. Religion may provide a transcendent source for a humanizing morality that might (...) move technology in a more ecofriendly, humane direction. The alternative is not a happy one for our posthuman technological future. (shrink)

Among the many components of legal preparedness for public health emergencies is the assurance that the public health workforce and its private sector partners are competent to use the law to facilitate the performance of essential public health services and functions. This is a significant challenge. Multiple categories of emergencies, stemming from natural disasters to emerging infectious diseases, confront public health practitioners. Interpreting, assessing, and applying legal principles during emergencies are complicated by the changing legal environment and differences in governmental (...) organization of emergency management functions. While law and legal competencies are essential to routine public health practices, once government declares a state of public health emergency or disaster, the legal landscape changes. Typical legal responses to protect the public's health may no longer be the norm. Public health practitioners, legal counsel, health care partners, and others need to be able to assess changing laws and policies and apply them in real-time. (shrink)

Forensic science error rates are needlessly high. Applying the perspective of veritistic social epistemology to forensic science could produce new institutional designs that would lower forensic error rates. We make such an application through experiments in the laboratory with human subjects. Redundancy is the key to error prevention, discovery, and elimination. In the “monopoly epistemics” characterizing forensics today, one privileged actor is asked to identify the truth. In “democratic epistemics,” several independent parties are asked. In an experiment contrasting them, democratic (...) epistemics reduced the rate at which biased observers obscured the truth by two-thirds. These results highlight, first, the potential of “epistemic systems design,” which employs the techniques of economic systems design to address issues of veracity rather than efficiency, and second, the value of “experimental epistemology,” which employs experimental techniques in the study of science. (shrink)

Critics of Hannah Arendt's Lectures on Kant's Political Philosophy argue that Arendt fails to address the most important problem of political judgment, namely, validity. This essay shows that Arendt does indeed have an answer to the problem that preoccupies her critics, with one important caveat: she does not think that validity is the all-important problem of political judgment--the affirmation of human freedom is.

This essay examines the significantly different approaches of John Rawls and Hannah Arendt to the problem of judgment in democratic theory and practice.