In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...) distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

The diagnostic category of borderline personality disorder (BPD) has come under increasing criticism in recent years. In this paper, we analyze the role and impact of epistemic injustice, specifically testimonial injustice, in relation to the diagnosis of BPD. We first offer a critical sociological and historical account, detailing and expanding a range of arguments that BPD is problematic nosologically. We then turn to explore the epistemic injustices that can result from a BPD diagnosis, showing how they can lead to experiences (...) of testimonial injustice which impede patient engagement in meaning-making activities, thereby undermining standard therapeutic goals. We conclude by showing how our arguments bolster ongoing efforts to replace the diagnostic category of BPD with alternatives such as complex post-traumatic stress disorder. (shrink)

Theories of discourse bring to realism new ideas about how knowledge develops and how representations of reality are influenced. We gain an understanding of the conceptual aspect of social life and the processes by which meaning is produced. This collection reflects the growing interest realist critics have shown towards forms of discourse theory and deconstruction. The diverse range of contributions address such issues as the work of Derrida and deconstruction, discourse theory, Eurocentrism and poststructuralism. What unites all of the contributions (...) is a sense that it is essential to provide a realist alternative to the hitherto dominance of social constructionism, hermeneutics and postmodernism, over many of the issues discussed. By developing a realist perspective the different authors attempt to embed discourse within the structured nature of the reality of the world. Realism can situate language, discourse and ideology within context specific, or 'causally efficacious' circumstances. Realism can help to uncover issues of power, representation, and subjectivity and how discursive and other social practices produce real effects. This can help us understand the manner in which social structures are reproduced through various forms of ideology and discourse. And by knowing this, we can start to address questions concerning human emancipation and how the world is to be transformed. (shrink)

In this book we attempted to gather together a set of chapters that describe new ways of approaching questions about aesthetics and innovation. Rather than going over old ground, the chapters describe attempts to break out in new directions. The book begins with a description of von Ehrenfels development of a Gestalt theory of aesthetics so evocative of the Vienna of 1900 that readers will wish that they had been there to experience the intellectual excitement and ends with a survey (...) the very latest research on brain scan research on perception of art. In between, we encounter chapters as diverse as a description of cognitive effects on art perception and on the analogies between oscillations in art history and waves in the physical world. About half of the book contains chapters by well known western psychological aestheticians and half chapters by Russian scholars many of whom will be new to western readers. As well as describing new methods and results, the chapters by Russian scholars will be novel to most western readers, because the Russian perspective on aesthetics and innovation is rather different than the traditional western perspectives. Looking at phenomena from new viewpoints never hurts and very often helps in science. (shrink)

Topics covered in Discrete Mathematics have become essential tools in many areas of studies in recent years. This is primarily due to the revolution in technology, communications, and cyber security. The book treats major themes in a typical introductory modern Discrete Mathematics course: Propositional and predicate logic, proof techniques, set theory (including Boolean algebra, functions and relations), introduction to number theory, combinatorics and graph theory. An accessible, precise, and comprehensive approach is adopted in the treatment of each topic. The ability (...) of abstract thinking and the art of writing valid arguments are emphasized through detailed proof of (almost) every result. Developing the ability to think abstractly and roguishly is key in any areas of science, information technology and engineering. Every result presented in the book is followed by examples and applications to consolidate its comprehension. The hope is that the reader ends up developing both the abstract reasoning as well as acquiring practical skills. All efforts are made to write the book at a level accessible to first-year students and to present each topic in a way that facilitates self-directed learning. Each chapter starts with basic concepts of the subject at hand and progresses gradually to cover more ground on the subject. Chapters are divided into sections and subsections to facilitate readings. Each section ends with its own carefully chosen set of practice exercises to reenforce comprehension and to challenge and stimulate readers. As an introduction to Discrete Mathematics, the book is written with the smallest set of prerequisites possible. Familiarity with basic mathematical concepts (usually acquired in high school) is sufficient for most chapters. However, some mathematical maturity comes in handy to grasp some harder concepts presented in the book. (shrink)

8.3 The consistency proof -- 8.4 Applications of the consistency proof -- 8.5 Second-order arithmetic -- Problems -- Chapter 9: Set Theory -- 9.1 Axioms for sets -- 9.2 Development of set theory -- 9.3 Ordinals -- 9.4 Cardinals -- 9.5 Interpretations of set theory -- 9.6 Constructible sets -- 9.7 The axiom of constructibility -- 9.8 Forcing -- 9.9 The independence proofs -- 9.10 Large cardinals -- Problems -- Appendix The Word Problem -- Index.

Ranging over central issues of morals and politics and the nature of freedom and authority, this study examines the role of value-neutrality, rights, equality, ...

BackgroundDeep brain stimulation is approved for treating refractory obsessive-compulsive disorder in adults under the US Food and Drug Administration Humanitarian Device Exemption, and studies hav...

This lucidly written book examines the social and political significance of the natural sciences through a detailed and original account of science as an interpretive social practice.

The thesis of the present volume is critical and dual. (1) Present day philosophy of man and sciences of man suffer from the Greek mis taken polarization of everything human into nature and convention which is (allegedly) good and evil, which is (allegedly) truth and fal sity, which is (allegedly) rationality and irrationality, to wit, the polar ization of all fields of inquiry, the natural and social sciences, as well as ethics and all technology, whether natural or social, into the (...) totally positive and the totally negative. (2) Almost all philosophy and sci ences of man share the erroneous work ethic which is the myth of man's evil nature - the myth of the beast in man, the doctrine of original sin. To mediate or to compromise between the first view of human nature as good with the second view of it as evil, sociologists have devised a modified utilitarianism with deferred gratification so called, and the theory of the evil of artificial competition (capitalist and socialist alike) and of keeping up with the Joneses. Now, the mediation is not necessary. For, the polarization makes for abstract errors which are simplistic views of rationality, such as reductionism and positivism of all sorts, as well as for concrete errors, such as the disposition to condemn repeatedly those human weaknesses which are inevitable, namely man's inability to be perfectly rational, avoid all error, etc. , thus setting man against himself as all too wicked. (shrink)

Current models of autobiographical memory suggest that self-identity guides autobiographical memory retrieval. Further, the capacity to recall the past and imagine one’s self in the future can influence social problem solving. We examined whether manipulating self-identity, through an induction task in which students were led to believe they possessed high or low self-efficacy, impacted episodic specificity and content of retrieved and imagined events, as well as social problem solving. Compared to individuals in the low self efficacy group, individuals in the (...) high self efficacy group generated past and future events with greater specificity, positive words, and self-efficacious statements, and also performed better on social problem solving indices. A lack of episodic detail for future events predicted poorer performance on social problem solving tasks. Strategies that increase perceived self-efficacy may help individuals to selectively construct a past and future that aids in negotiating social problems. (shrink)

Jennifer Hornsby has defended the Reasons-Knowledge Thesis : the claim that \-ing because p requires knowing that p, where the ‘because’ at issue is a rationalising ‘because’. She defends by appeal to the thought that it provides the best explanation of why the subject in a certain sort of Gettier case fails to be in a position to \ because p. Dustin Locke and, separately, Nick Hughes, present some modified barn-façade cases which seem to constitute counterexamples to and undermine Hornsby’s (...) way of motivating it by rendering their alternative Reasons-Explanation Thesis a better explanation of Hornsby’s datum. This paper defends and Hornsby’s argument for it against those objections. First, I point out that their supposedly intuitive verdict about the relevant barn-façade cases is not as intuitive as they think. Second, I point out that even if we share the intuition: we have strong reason to doubt the verdict anyway. And finally, I point out that since is independently implausible, the two problems can be tackled anyway. (shrink)

According to standard comparativist views, death is bad insofar as it deprives someone of goods she would otherwise have had. In The Ethics of Killing, Jeff McMahan argues against such views and in favor of a gradualist account according to which how bad it is to die is a function of both the future goods of which the decedent is deprived and her cognitive development when she dies. Comparativists and gradualists therefore disagree about how bad it is to die at (...) different ages. In this paper I examine two prominent criticisms of gradualism and show that both misconstrue McMahan. I develop a related criticism that seems to show that a gradualist cannot coherently relate morbidity and mortality. This criticism also fails, but has an instructive implication for how policy-makers setting priorities for health care investments should regard choices between life-saving interventions and interventions against non-fatal diseases in the very young. (shrink)

Do we need a right to mental privacy? In an era of increasing sophistication in recording, interpreting, and directly intervening on our neural activity – not to mention efforts at combining neural...

Applications of artificial intelligence/machine learning in health care are dynamic and rapidly growing. One strategy for anticipating and addressing ethical challenges related to AI/ml for health care is patient and public involvement in the design of those technologies – often referred to as ‘co-design’. Co-design has a diverse intellectual and practical history, however, and has been conceptualized in many different ways. Moreover, AI/ml introduces challenges to co-design that are often underappreciated. Informed by perspectives from critical data studies and critical digital (...) health studies, we review the research literature on involvement in health care, and involvement in design, and examine the extent to which co-design as commonly conceptualized is capable of addressing the range of normative issues raised by AI/ml for health care. We suggest that AI/ml technologies have amplified and modified existing challenges related to patient and public involvement, and created entirely new challenges. We outline three pitfalls associated with co-design for ethical AI/ml for health care and conclude with suggestions for addressing these practical and conceptual challenges. (shrink)

Over the last few decades, multiple studies have examined the understanding of participants in clinical research. They show variable and often poor understanding of key elements of disclosure, such as expected risks and the experimental nature of treatments. Did the participants in these studies give valid consent? According to the standard view of informed consent they did not. The standard view holds that the recipient of consent has a duty to disclose certain information to the profferer of consent because valid (...) consent requires that information to be understood. The contents of the understanding and disclosure requirements are therefore conceptually linked. In this paper, we argue that the standard view is mistaken. The disclosure and understanding requirements have distinct grounds tied to two different ways in which a token of consent can be rendered invalid. Analysis of these grounds allows us to derive the contents of the two requirements. It also implies that it is sometimes permissible to enroll willing participants who have not understood everything that they ought to be told about their clinical trials. (shrink)

The ongoing debate within neuroethics concerning the degree to which neuromodulation such as deep brain stimulation (DBS) changes the personality, identity, and agency (PIA) of patients has paid relatively little attention to the perspectives of prospective patients. Even less attention has been given to pediatric populations. To understand patients’ views about identity changes due to DBS in obsessive-compulsive disorder (OCD), the authors conducted and analyzed semistructured interviews with adolescent patients with OCD and their parents/caregivers. Patients were asked about projected impacts (...) to PIA generally due to DBS. All patient respondents and half of caregivers reported that DBS would impact patient self-identity in significant ways. For example, many patients expressed how DBS could positively impact identity by allowing them to explore their identities free from OCD. Others voiced concerns that DBS-related resolution of OCD might negatively impact patient agency and authenticity. Half of patients expressed that DBS may positively facilitate social access through relieving symptoms, while half indicated that DBS could increase social stigma. These views give insights into how to approach decision-making and informed consent if DBS for OCD becomes available for adolescents. They also offer insights into adolescent experiences of disability identity and “normalcy” in the context of OCD. (shrink)

The debate about what constitutes the discipline of ethics and who qualifies as an ethics consultant is linked unavoidably to a debate that is potentiated by the reality of a rapidly changing and high-stakes health care consultation marketplace. Who we are and what we can offer to the moral gesture that is medicine is shaped by our fundamental understanding of the place of expert knowledge in the transformation of social reality. The struggle for self-definition is particularly freighted since clinical ethics (...) consultation aspires to be more than academic contemplation. Two recent books (Ethics Consultation by John La Puma and David Schiedermayer and The Health Care Ethics Consultant: A Practical Guide, edited by Francoise Baylis) exemplify the two most popular but most widely divergent positions on these issues. We argue that while useful, neither book addresses fully the particular and distinct role of the professional ethicist. (shrink)

To attribute confusion to someone is to take up a paternalistic stance in evaluating his reasoning.

The Practice of Value explores the nature of value and its relation to the social and historical conditions under which human agents live. At the core of the book are the Tanner Lectures delivered at Berkeley in 2001 by Joseph Raz, who has been one of the leading figures in moral and legal philosophy since the 1970's. Raz argues that values depend importantly on social practices, but that we can make sense of this dependence without falling back on cultural (...) relativism. In response, three eminent philosophers, Christine Korsgaard, Robert Pippin, and Bernard Williams, offer their own distinctive reflections on the connections between value and practice. The book begins with an introduction by Jay Wallace, setting the scene for what follows, and ends with a response from Raz to his commentators. The result is a fascinating debate, accessible to readers throughout and beyond philosophy, about the relations between human values and human life. (shrink)

ABSTRACTThis article develops a theory of just contractual relationships for a liberal society. As a liberal theory, our account is premised on liberalism's canonical commitments to self-determination and substantive equality. As a theory of contract law, it focuses on the parties’ interpersonal interactions rather than on the justice of the social order as a whole.Normatively, the article claims that the rules governing cases where one party experiences harsh circumstances or vulnerability during the bargaining process or operates under significant informational disadvantage (...) must be guided by the commitment to relational justice, that is, to reciprocal respect for self-determination and substantive equality. Jurisprudentially, the article studies the systemic difficulties hindering the translation of these normative prescriptions into legal language and analyzes how they affect the form assumed by the law of precontractual justice and its institutional pedigree. (shrink)

Introduction -- Instrumental rationality -- Social order -- Deontic constraint -- Intentional states -- Preference noncognitivism -- A naturalistic perspective -- Transcendental necessity -- Weakness of will -- Normative ethics.

We argue that there is a conflict among classical theism's commitments to divine simplicity, divine creative freedom, and omniscience. We start by defining key terms for the debate related to classical theism. Then we articulate a new argument, the Aloneness Argument, aiming to establish a conflict among these attributes. In broad outline, the argument proceeds as follows. Under classical theism, it's possible that God exists without anything apart from Him. Any knowledge God has in such a world would be wholly (...) intrinsic. But there are contingent truths in every world, including the world in which God exists alone. So, it's possible that God contingently has wholly intrinsic knowledge. But whatever is contingent and wholly intrinsic is an accident. So, God possibly has an accident. This is incompatible with classical theism. Finally, we consider and rebut several objections. (shrink)

In these pages we seek to integrate two claims. First, we argue that, taken to their logical conclusions, the considerations that support a strict form of protection for tangible property rights do not call for a similar form of protection when applied to the case of copyright. More dramatically, these considerations demand, on pain of glaring inconsistency, a substantially weaker protection for copyright. In pursuing this claim, we show that the form of protecting property rights is, to an important extent, (...) a feature of certain normal, though contingent, facts about the human world. Second, the normative question concerning the selection of a desirable protection for creative works is most naturally pursued from a tort law perspective, in part because the normative structure of copyright law simply is that of tort law. (shrink)

This is a new edition of Joseph Fletcher's 1966 work that ignited a firestorm of controversy at the time of its publication.

Back to the Rough Ground is a philosophical investigation of practical knowledge, with major import for professional practice and the ethical life in modern society. Its purpose is to clarify the kind of knowledge that informs good practice in a range of disciplines such as education, psychotherapy, medicine, management, and law. Through reflection on key modern thinkers who have revived cardinal insights of Aristotle, and a sustained engagement with the Philosopher himself, it presents a radical challenge to the scientistic assumptions (...) that have dominated how these professional domains have been conceived, practiced, and institutionalized. (shrink)

This research explores the impact of media engagement on the identity perceptions of the Aeta Ambala, an indigenous group in the Philippines, particularly after the 1991 Mt. Pinatubo eruption. This catastrophic event led to significant displacement and cultural shifts for the Aeta, who were forced to adapt to urban lifestyles. The study focuses on the differences in identity perceptions between the older and younger generations, with the former holding onto pre-eruption cultural norms and the latter aligning more with urban and (...) resettlement community cultures. Employing in-depth interviews and focus group discussions, the study finds that media representations often negatively portray the Aeta Ambala, leading to discrimination and altering self-perception. Despite this, the community maintains a strong sense of ethnic identity, viewing it as an immutable aspect of their heritage. Media engagement is seen as inevitable for staying informed, particularly in emergencies, but it also influences perceptions of the outside world and reshapes cultural and ethnic identity. Younger generations, more engaged with media, tend to adopt external beauty standards and lifestyles, leading to early marriages and cultural indifference. There is also a noted mistrust towards media organizations due to exploitation concerns. In conclusion, the study highlights the complex relationship between media interaction and self identification within the Aeta Ambala community, suggesting that while media engagement alters perceptions and behaviors, the core Aeta Ambala culture remains strong and resilient. (shrink)

Questions about when to limit unhelpful treatments are often raised in general medicine but are less commonly considered in psychiatry. Here we describe a survey of U.S. psychiatrists intended to characterize their attitudes about the management of suicidal ideation in patients with severely treatment-refractory illness. Respondents (n = 212) received one of two cases describing a patient with suicidal ideation due to either borderline personality disorder or major depressive disorder. Both patients were described as receiving all guideline-based and plausible emerging (...) treatments. Respondents rated the expected helpfulness and likelihood of recommending each of four types of intervention: hospitalization, additional medication changes, additional neurostimulation, and additional psychotherapy. Across both cases, most respondents said they were likely to provide each intervention, except for additional neurostimulation in borderline personality disorder, while fewer thought each intervention would be helpful. Substantial minorities of respondents indicated that they would provide an intervention they did not think was likely to be helpful. Our results suggest that while most psychiatrists recognize the possibility that some patients are unlikely to be helped by available treatments, many would continue to offer such treatments. (shrink)