The aim of this essay is to show that phenomenal properties are contentless modes of appearances of representational properties. The essay initiates with examination of the first-person perspective of the conscious observer according to which a “reference to I” with respect to the observation of experience is determined. A distinction is then drawn between the conscious observer and experience as observed, according to which, three distinct modifications of experience are delineated. These modifications are then analyzed with respect to the content (...) of experience and from this the ground of the distinction between phenomenal and representational properties is identified. (shrink)

In his doctoral dissertation On the Principle of Sufficient Reason, Arthur Schopenhauer there outlines a critique of Euclidean geometry on the basis of the changing nature of mathematics, and hence of demonstration, as a result of Kantian idealism. According to Schopenhauer, Euclid treats geometry synthetically, proceeding from the simple to the complex, from the known to the unknown, “synthesizing” later proofs on the basis of earlier ones. Such a method, although proving the case logically, nevertheless fails to attain the raison (...) d’être of the entity. In order to obtain this, a separate method is required, which Schopenhauer refers to as “analysis,” thus echoing a method already in practice among the early Greek geometers, with however some significant differences. In this essay, I here discuss Schopenhauer’s criticism of synthesis in Euclid’s Elements, and the nature and relevance of his own method of analysis. (shrink)

The essay examines the ancient Greek origin of philosophy relative to the concept of wisdom. The nature of the sage is first considered. The sage is one who is deemed wise in his or her performances. But what is ‘wise’ about such performances? The Socratic denial of sage status is considered in reference to this. Socrates concludes that he is not wise as the gods are wise, but that he is wise insofar as he knows that he is not wise. (...) The apparent contradiction is resolved through the distinction between human (finite) and divine (infinite) wisdom. The latter notion is further examined in the works of Aristotle who articulates the “classical paradigm” of philosophy in pursuit of infinite wisdom. The attributes of infinite wisdom are identified, and the essay concludes with a discussion of the sagely performance of infinite wisdom, Aristotle himself serving as the representative example. (shrink)

A contentious feature in the thought of Arthur Schopenhauer is his account of the Platonic Ideas. This is no doubt evidenced by the scholarly literature where various difficulties have been identified in regards to this introduction, and often varying positions maintained. Within this essay, I offer a survey of the major debates surrounding this issue. Following this, I turn to a specific question related to Schopenhauer’s claim that his own account of the Platonic Ideas is authentic to the original views (...) of Plato himself. I show that, excepting minor points of similarity, Schopenhauer’s account is quite inauthentic to that of Plato. Still more, drawing upon his distinction between abstract and intuitive knowledge, I offer an interpretation of the relationship between Genius and contemplation employing the concept of a “circle of signification”. Finally, I identify some difficulties in relation to Schopenhauer’s views. (shrink)

In recent times, we have seen a resurgence of interest in the application of philosophy as a therapeutic for the purpose of alleviating the existential ills of human life. Within this paper, it is argued that not only can philosophy be applied as a therapeutic, but that the very act of doing philosophy is therapeutic. The paper begins with a discussion of human nature as bound to finitude and the suffering of existence. The necessity to labor along with the need (...) for relief from labor in the form of recreation and play is then discussed. Play is thereafter distinguished from leisure, and the concept of philosophical contemplation, following Aristotle, is introduced. It is argued that the activity of contemplation results in relief from the suffering of existence, and that its exercise may in consequence be considered a kind of therapeutic. (shrink)

Since Descartes, the nature of doubt has played a central role in the development of metaphysics both positively and negatively. Despite this fact, there has been very little discussion centering round the specific nature of doubt which led, for example, to the Cartesian discovery of the cogito. Certainly, the role of doubt has been well recognized: through doubt Descartes arrives at his indubitable first principle. But what can it mean to doubt the existence of the sensible world? This would seem (...) to rest upon the assumption that we have clear and distinct knowledge of the precise nature of what it means to exist and indeed of what it means to be. As it stands, Descartes’ initiates his Meditations upon certain definite assumptions that demand more thorough interrogation. In this paper and presentation, I examine the possible assumptions inherent in the Cartesian method of doubt within the first and second meditation and the manner in which this leads to the discovery of the cogito. I consider a number of essential questions in light of this: What presuppositions lie at bottom to Cartesian doubt? What is the precise nature of metaphysical doubt? What can it mean to doubt the existence of the sensible world? (shrink)

Following the Kantian critique of metaphysics, the conscious subject is discovered to be an insurmountable obstacle with respect to knowledge of things themselves. For this reason, Kant concludes that metaphysics as the science of being as being is impossible. In this essay, the possibilities of metaphysics in light of the problem of subjectivity are reexamined. The nature and relationship between the conscious subject and the embodiment of the subject is first examined. Following this, the subject’s “encounter with being” within consciousness (...) is analyzed yielding two fundamental structures that are determined to hold with respect to being in relation to the conscious subject. Further examination of the act of reflection coupled with judgment reveals that these structures may in fact be transcended, from which an encounter with being as such follows. On the basis of reflection and judgment, metaphysics is thereby determined to be possible. (shrink)

In this thesis, I examine the perceptibility of the Platonic Ideas in the thought of Arthur Schopenhauer. The work is divided into four chapters, each focusing and building upon a specific aspect related to this question. The first chapter (“"Plato and the Primacy of Intellect"”) deals with Schopenhauer’s interpretation specific to Platonic thought. I there address the question of why it is that Schopenhauer should consider Plato to have interpreted the Ideas as 'perceptible', particularly in view of evidence which seems (...) to testify to the contrary. Does Schopenhauer misinterpret Plato, or are there sufficient grounds for considering his interpretation consistent? This is important in light of Schopenhauer’s reinterpretation of the Platonic Idea on the basis of the primacy of the will in contradistinction to Plato’'s own emphasis upon the intelligible. In effect, for Schopenhauer, Plato confuses the nature of imperceptible concepts with the more perceptually grounded Ideas. In the second chapter (“"On the Direct Path to Knowledge"”), I explore Schopenhauer’'s methodological approach on the basis of the will. I there discuss the difference between Schopenhauer and Kant with respect to Transcendental Idealism, particularly in terms of their separate analysis and derivation of the thing-in-itself. From there, I turn to a consideration of Schopenhauer'’s discussion of the nature of formal and empirical intuitions, of abstraction and the nature of universal concepts, and finally of the intuitively grounded nature of mathematical demonstration which serves as an analogy for the manner in which Schopenhauer deals with knowledge of the Ideas. In the third chapter ("“The Perceptibility of the Ideas”"), I discuss the manner in which the Ideas become accessible as the manifestation of the Will, arising through the representation of perception. There a number of distinctions are made between Ideas and concepts, as well as the nature of contemplation through Genius. The Ideas are found to be perceptible as aesthetic intuitions which relate not only to the in-itself nature inherent to phenomena, but serve also as the essential basis and foundation for all genuine forms of art. In the fourth and final chapter (“"Critical Discussion of Schopenhauer’s Ideas"”), I consider and outline a number of potential problems with respect to Schopenhauer’s analysis. In particular, Schopenhauer encounters difficulties on the basis of the simultaneous immanence and transcendence of the Ideas; of the knowledge of the Ideas characterized as intuitive while yet having a strangely abstract basis; of the unity of the will in face of the plurality of Ideas and phenomena; and finally of the annihilation of the will which creates essential problems in terms of the desideratum of knowledge itself. I here also attempt to offer various solutions to these problems where relevant. The conclusion which I arrive at in this work is that any radical reorientation of ontology must bear an essential effect upon the character and methodology of knowledge itself. In other words, Schopenhauer’s interpretation of the perceptibility of the Ideas is a direct consequence of hi s analysis of the will as the metaphysical thing-in-itself. In fact, this essential change colors his entire epistemological approach, from science and mathematics, to logic and the Ideas—from the ground the up. (shrink)

In recent times, we have seen a resurgence of interest in the application of philosophy as a therapeutic for the purpose of alleviating the existential ills of human life. Within this paper, it is argued that not only can philosophy be applied as a therapeutic, but that the very act of doing philosophy is therapeutic. The paper begins with a discussion of human nature as bound to finitude and the suffering of existence. The necessity to labor along with the need (...) for relief from labor in the form of recreation and play is then discussed. Play is thereafter distinguished from leisure, and the concept of philosophical contemplation (theoria), following Aristotle, is introduced. It is argued that the activity of contemplation results in relief from the suffering of existence, and that its exercise may in consequence be considered a kind of therapeutic. (shrink)

This is the most comprehensive book ever published on philosophical methodology. A team of thirty-eight of the world's leading philosophers present original essays on various aspects of how philosophy should be and is done. The first part is devoted to broad traditions and approaches to philosophical methodology. The entries in the second part address topics in philosophical methodology, such as intuitions, conceptual analysis, and transcendental arguments. The third part of the book is devoted to essays about the interconnections between philosophy (...) and neighbouring fields, including those of mathematics, psychology, literature and film, and neuroscience. (shrink)

In this book Mark Bevir and Jason Blakely set out to make the most comprehensive case yet for an 'interpretive' or hermeneutic approach to the social sciences. Interpretive approaches are a major growth area in the social sciences today. This is because they offer a full-blown alternative to the behavioralism, institutionalism, rational choice, and other quasi-scientific approaches that dominate the study of human behavior. In addition to presenting a systematic case for interpretivism and a critique of scientism, Bevir (...) and Blakely also propose their own uniquely 'anti-naturalist 'notion of an interpretive approach. This anti-naturalist framework encompasses the insights of philosophers ranging from Michel Foucault and Hans-Georg Gadamer to Charles Taylor and Ludwig Wittgenstein, while also resolving dilemmas that have plagued rival philosophical defenses of interpretivism. In addition, working social scientists are given detailed discussions of a distinctly interpretive approach to methods and empirical research. The book draws on the latest social science to cover everything from concept formation and empirical inquiry to ethics, democratic theory, and public policy. An anti-naturalist approach to interpretive social science offers nothing short of a sweeping paradigm shift in the study of human beings and society. This book will be of interest to all who seek a humanistic alternative to the scientism that overwhelms the study of human beings today. (shrink)

When a patient lacks decision-making capacity, then according to standard clinical ethics practice in the United States, the health care team should seek guidance from a surrogate decision-maker, either previously selected by the patient or appointed by the courts. If there are no surrogates willing or able to exercise substituted judgment, then the team is to choose interventions that promote a patient’s best interests. We argue that, even when there is input from a surrogate, patient preferences should be an additional (...) source of guidance for decisions about patients who lack decision-making capacity. (shrink)

According to a standard account of patient decision-making capacity, patients can provide ethically valid consent or refusal only if they are able to understand and appreciate their medical c...

The capacity to designate a surrogate is not simply another kind of medical decision-making capacity. A patient with DMC can express a preference, understand information relevant to that choice, appreciate the significance of that information for their clinical condition, and reason about their choice in light of their goals and values. In contrast, a patient can possess the CDS even if they cannot appreciate their condition or reason about the relative risks and benefits of their options. Patients who lack DMC (...) for many or most kinds of medical choices may nonetheless possess the CDS, particularly since the complex means-ends reasoning required by DMC is one of the first capacities to be lost in progressive cognitive diseases. That is, patients with significant cognitive decline or mental illness may still understand what a surrogate does, express a preference about a potential surrogate, and be able to provide some kind of justification for that selection. Moreover, there are many legitimate and relevant rationales for surrogate selection that are inconsistent with the reasoning criterion of DMC. Unfortunately, many patients are prevented from designating a surrogate if they are judged to lack DMC. When such patients possess the CDS, this practice is ethically wrong, legally dubious and imposes avoidable burdens on healthcare institutions. (shrink)

Two new documents from the Committee on Bioethics of the American Academy of Pediatrics expand the terrain for parental decision making, suggesting that pediatricians may override only those parental requests that cross a harm threshold. These new documents introduce a broader set of considerations in favor of parental authority in pediatric care than previous AAP documents have embraced. While we find this to be a positive move, we argue that the 2016 AAP positions actually understate the importance of informed and (...) voluntary parental involvement in pediatric decision making. This article provides a more expansive account of the value of parental permission. In particular, we suggest that an expansive role for parental permission may reveal facts and values relevant to their child's treatment, encourage resistance to suboptimal default practices, improve adherence to treatment, nurture children's autonomy, and promote the interests of other family members. (shrink)

Children’s preferences about medical treatment—like the preferences of other patients—hold moral weight in decision-making that is independent of considerations of autonomy or best interests. In light of this understanding of the moral value of patient preferences, the American Academy of Pediatrics could strengthen the ethical foundation for its formal guidance on pediatric assent.

Background: Previous research shows that pediatricians inconsistently utilize the ethics consultation service (ECS). Methods: Pediatricians in two suburban, Midwestern academic hospitals were asked to reflect on their ethics training and utilization of ECS via an anonymous, electronic survey distributed in 2017 and 2018, and analyzed in 2018. Participants reported their clinical experience, exposure to formal and informal ethics training, use of formal and informal ethics consultations, and potential barriers to formal consultation. Results: Less experienced pediatricians were more likely to utilize (...) formal ethics consultation and more likely to have formal ethics training. The most commonly reported reasons not to pursue formal ECS consultation were inconvenience and self-reported expertise in pediatric ethics. Conclusions: These results inform ongoing discussions about ethics consultation among pediatricians and the role of formal ethics training in both undergraduate and graduate medical education. (shrink)

This article reports results of a survey about employment and compensation models for clinical ethics consultants working in the United States and discusses the relevance of these results for the professionalization of clinical ethics. This project uses self-reported data from healthcare ethics consultants to estimate compensation across different employment models. The average full-time annualized salary of respondents with a clinical doctorate is $188,310.08 (SD=$88,556.67), $146,134.85 (SD=$55,485.63) for those with a non-clinical doctorate, and $113,625.00 (SD=$35,872.96) for those with a masters as (...) their highest degree. Pay differences across degree level and type were statistically significant (F = 3.43; p. (shrink)

We agree with Emily Walsh (2020) that the current preferences of patients with dementia should sometimes supersede those patients’ advance directives. We also agree that consensus clinical ethics guidance does a poor job of explaining the moral value of such patients’ preferences. Furthermore, Walsh correctly notes that clinicians are often averse to treating patients with dementia over their objections, and that this aversion reflects clinical wisdom that can inform revisions to clinical ethics guidance. But Walsh’s account of the moral value (...) of the preferences of patients with dementia suffers from three major problems: (1) it does not engage the actual practices of clinical ethics; (2) it provides an inadequate account of why these patients’ preferences matter; and (3) it offers a poor explanation of clinicians’ intuitions in these cases. Her arguments engage a philosophical debate that is largely irrelevant to clinical practice and she therefore leaves pressing real-world clinical ethics questions unaddressed. After underscoring some of Walsh’s main points, we will discuss each of these shortcomings. (shrink)

Some physicians refuse to perform life-sustaining interventions, such as tracheostomy, on patients who are very likely to remain permanently unconscious. To explain their refusal, these clinicians often invoke the language of “futility”, but this can be inaccurate and can mask problematic forms of clinical power. This paper explores whether such refusals should instead be framed as conscientious objections. We contend that the refusal to provide interventions for patients very likely to remain permanently unconscious meets widely recognized ethical standards for the (...) exercise of conscience. We conclude that conscientious objection to tracheostomy and other life-sustaining interventions on such patients can be ethical because it does not necessarily constitute a form of invidious discrimination. Furthermore, when a physician frames their refusal as conscientious objection, it makes transparent the value-laden nature of their objection and can better facilitate patient access to the requested treatment. (shrink)

Analytic ethics in the central period – extending from the beginning of the twentieth century to post-World War II linguistic analysis – is too often construed by historians and philosophers alike in monolithic terms as the emotivism of A. J. Ayer. In contrast, we argue that a multiplicity of ethical doctrines were developed by analytic philosophers at this time of which Ayer's emotivism was just one. Moreover, we maintain that this multiplicity of ethical doctrines was itself the result of a (...) multiplicity of conceptions of analysis and that connecting these two sets of beliefs makes for the best understanding of analytic ethics. (shrink)

ABSTRACT The interpretive turn in the social sciences, although much discussed, has effectively stalled and even begun to backslide. With the publication of Interpretive Social Science: An Anti-Naturalist Approach, we provide a systematic defense of interpretive inquiry intended to help reinvigorate this mode of study across the human sciences. This defense, unfortunately, needs to be deployed not only against social scientists who unwittingly adopt naturalistic philosophical assumptions, but against interpretivist fellow travelers such as Michel Foucault, who occasionally do the same (...) thing; and even against interpretivists who assume that their philosophical position is secured by using only qualitative methods, and that quantitative methods are inherently unsuitable to interpretivist purposes. (shrink)

The concept of integrity appears in many arguments and theories in business ethics and organizational behavior where it plays multiple roles. It has been shown to have desirable organizational outcomes and is held as important by the academic and practitioner alike. Yet despite its prominence there are a variety of approaches to defining and conceptualizing it and little existent theory to explain its nature. We offer integrative social contracts theory (ISCT) as a framework that can anchor integrity in ethical theory (...) and also encompass aspects of integrity such as wholeness, consistency, and authenticity. In addition we show how ISCT can resolve some of the challenges to definitions of integrity that have been raised in the literature and hence we provide some suggestions for future academic research and suggestions for the practitioner. (shrink)

Vaccine refusal forces us to confront tensions between many values, including scientific expertise, parental rights, children’s best interests, social responsibility, public trust, and community health. Recent outbreaks of vaccine-preventable and emerging infectious diseases have amplified these issues. The prospect of a coronavirus disease 2019 vaccine signals even more friction on the horizon. In this contentious sociopolitical landscape, it is therefore more important than ever for clinicians to identify ethically justified responses to vaccine refusal.

We systematically examined the content of the websites of 46 agencies that buy and sell human eggs to understand how they market themselves to both donors and recipients. We found that these websites use marketing techniques that obscure the realities of egg donation, presenting egg donation as a mutually beneficial and fulfilling experience. Sites emphasize egg donors' emotional fulfillment and address recipients' anxieties by stressing the ability to find the perfect “fit” or “match”, suiting recipients’“preferences”/“desires”, and even designing/customizing a child. (...) Agencies attempt to create a sense of connection between the recipients and donors by reporting donors' personal characteristics — e.g., interests/hobbies, traits, mood/temperament, and self-reported childhood behavior/memories. Sites present donors as caring/generous and smart/successful/beautiful. These data, the first to examine several key aspects of egg donation agency websites, reveal critical aspects of how these companies communicate to prospective donors and recipients, raising several ethical concerns. Websites frame information in ways that may bias consumers, making emotional appeals that may distract from appropriate risk/benefit assessments and obscure the ethical challenges of egg donation. These data highlight needs for improved practices, adherence to guidelines, and consideration of enhanced guidelines or policy. (shrink)

The three of us work as academics and clinical ethicists. In our clinical ethics work, we often encounter patients who lack decision-making capacity, but who nonetheless have strong preferences abo...

More than 20 years ago, the pioneering pediatric ethicist William Bartholome wrote a fiery letter to the editor of this journal because he thought a recently published statement on pediatric assent, from the Committee on Bioethics of the American Academy of Pediatrics (AAP), showed insufficient respect for children. That AAP statement, like its 2016 update, asserts that pediatric assent should be solicited only when a child’s dissent will be honored. Bartholome objected that pediatricians should always solicit children’s assent and that (...) they should acknowledge and apologize when they treat children over their objections even when they must do so to promote children’s best interests. We think Bartholome was right. In this brief commentary, we elaborate on his perspective about the moral value of pediatric assent, and we suggest improvements to the corresponding clinical guidance. (shrink)

The field of clinical bioethics strongly advocates for the use of advance directives to promote patient autonomy, particularly at the end of life. This paper reports a study of clinical bioethicists’ perceptions of the professional consensus about advance directives, as well as their personal advance care planning practices. We find that clinical bioethicists are often sceptical about the value of advance directives, and their personal choices about advance directives often deviate from what clinical ethicists acknowledge to be their profession’s recommendations. (...) Moreover, our respondents identified a pluralistic set of justifications for completing treatment directives and designating surrogates, even while the consensus view focuses on patient autonomy. Our results suggest important revisions to academic discussion and public-facing advocacy about advance care planning. (shrink)

Two core questions in pediatric ethics concern when and how physicians are ethically permitted to intervene in parental treatment decisions (intervention principles), and the goals or values that should direct physicians’ and parents’ decisions about the care of children (guidance principles). Lainie Friedman Ross argues in this issue of The Journal of Clinical Ethics that constrained parental autonomy (CPA) simultaneously answers both questions: physicians should intervene when parental treatment preferences fail to protect a child’s basic needs or primary goods, and (...) both physicians and parents should be guided by a commitment to protect a child’s basic needs and primary goods. In contrast, we argue that no principle—neither Ross’s CPA, nor the best interest standard or the harm threshold—can serve as both an intervention principle and a guidance principle. First, there are as many correct intervention principles as there are different kinds of interventions, since different kinds of interventions can be justified under different conditions. Second, physicians and parents have different guidance principles, because the decisions physicians and parents make for a child should be informed by different values and balanced by different (potentially) conflicting commitments. (shrink)

Purpose: To determine the relative value that patients place on consent for procedures in the emergency department (ED) and to define a set of procedures that fall in the realm of implied consent. Methods: A questionnaire was administered to a convenience sample 134 of 174 patients who were seen in the ED of a Midwestern teaching hospital. The questionnaire asked how much time they believed was necessary to give consent for various procedures. Procedures ranged from simple (venipuncture) to complex (procedural (...) sedation). Results: Participants valued a simple blood draw at a low mean of 1.02 minutes of extra time and a lumbar puncture at a high mean of 7.78 minutes. Of all participants 52% and 48% noted a time-value of ?0? time on blood draw and intravenous line starts, respectively, indicating that they desire no additional consent for these procedures. Conclusion: Defining a set of ED procedures covered under implied consent will be difficult because many patients value formal consent for even the simplest procedure. (shrink)