Most arguments about conscientious objections in medicine fail to capture the full scope and complexity of the concept before drawing conclusions about their permissibility in practice. Arguments favoring and disfavoring the accommodation of conscientious objections in practice tend to focus too narrowly on prima facie morally contentious treatments and religious claims of conscience, while further failing to address the possibility of moral perspectives changing over time. In this paper, I argue that standard reasons against permitting conscientious objections in practice—that their (...) permission may result in harm to patients, the idea that medical providers willingly enter into the medical field, and that conscientious objections stand contrary to medical professionalism—do not apply in all cases and that the medical field and health systems in which many physicians now practice should continue to tolerate conscientious objections in practice. (shrink)

Volume 20, Issue 7, July 2020, Page 139-141.

People are typically grateful for medical technologies used in the treatment of illness or injury. This chapter explores how Lucas has led Star Wars audiences astray into accepting false beliefs and fallacies about the value of technology, particularly in a medical context. Via the naturalistic fallacy, Lucas conveys the false belief that most technology is “unnatural” and so is bad, harmful, or associated with the dark side. Lucas is not wrong that technology can be fearful, but its value depends in (...) part on how it's intended to be used. Even the use of some medical technologies that can extend life raise questions about whether they should be used in all cases. Many bioethical conflicts center around whether a seriously ill or injured person would want certain medical interventions used to extend their life, given potential trade‐offs. Lucas's portrayal of technology in Star Wars is biased against its true value in societies. (shrink)

The American Journal of Bioethics, Volume 11, Issue 9, Page 12-13, September 2011.

Volume 20, Issue 7, July 2020, Page 95-97.

Background: This study attempts to understand if medical providers beliefs about the moral permissibility of honoring patient-directed refusals of life-sustaining treatment (LST) are tied to their beliefs about the patient’s decision-making capacity. The study aims to answer: 1) does concern about a patient’s treatment decision-making capacity relate to beliefs about whether it is morally acceptable to honor a refusal of LST, 2) are there differences between provider types in assessments of decision-making capacity and the moral permissibility to refuse LST, and (...) 3) do provider demographics impact beliefs about decision-making capacity and the moral permissibility to refuse LST. Methods: A mixed-methods survey using Likert assessment and vignette-based questions was administered to medical providers within a single health system in the upper Midwest (N = 714) to assess their perspectives on the moral acceptance and decision-making capacity in cases of withholding and withdrawing treatment and suicide. Results: Behavioral health providers report accepting of the moral permissibility of suicide (91.2%) more than either medical providers (77.2%) or surgeons (74.4%) (n = 283). Decision-making capacity was questioned more in the vignettes of the patients refusing life-saving surgery (36%) and voluntarily starvation (40.8%) than in the vignette of the patient requesting to deactivate a pacemaker (13%) (n = 283). Behavioral health providers were more concerned about the capacity to refuse life-saving surgery (55.9%) than medical providers (33.8%) or surgeons (23.1%) (n = 283). Conclusions: Respondents endorse the moral permissibility of persons to withhold or withdraw from treatment regardless of motive. Clinical concerns about a patient’s treatment decision-making capacity do not strongly correlate to views about the moral permissibility of honoring refusals of LST. Different provider types appear to have different thresholds for when to question treatment decision-making capacity. Behavioral health providers tend to question treatment decision-making capacity to refuse LST more than non-behavioral health providers. (shrink)

This narrative symposium examines the relationship of bioethics practice to personal experiences of illness. A call for stories was developed by Tod Chambers, the symposium editor, and editorial staff and was sent to several commonly used bioethics listservs and posted on the Narrative Inquiry in Bioethics website. The call asked authors to relate a personal story of being ill or caring for a person who is ill, and to describe how this affected how they think about bioethical questions and the (...) practice of medicine. Eighteen individuals were invited to submit full stories based on review of their proposals. Twelve stories are published in this symposium, and six supplemental stories are published online only through Project MUSE. Authors explore themes of vulnerability, suffering, communication, voluntariness, cultural barriers, and flaws in local healthcare systems through stories about their own illnesses or about caring for children, partners, parents and grandparents. Commentary articles by Arthur Frank, Bradley Lewis, and Carol Taylor follow the collection of personal narratives. (shrink)

The focus on translational research in clinical trials has the potential to generate clinically relevant genetic data that could have importance to patients. This raises challenging questions about communicating relevant genetic research results to individual patients. An exploratory pharmacogenetic analysis was conducted in the international ovarian cancer phase III trial, AGO-OVAR 16, which found that patients with clinically important germ-line BRCA1/2 mutations had improved progression-free survival prognosis. Mechanisms to communicate BRCA results were evaluated, because these findings may be beneficial to (...) patients and their families. Communicating individual BRCA results was not anticipated during clinical trial design. Consequently, options were not available for patients to indicate their preference for receiving their individual results when they signed pharmacogenetic informed consent. Differences in local requirements, clinical practice, and opinion regarding the ethical aspects of how to convey genetic results to patients are all potential barriers to returning individual BRCA results to patients. Communicating the aggregate BRCA result from this study provided clinical investigators with a mechanism to disseminate the overall study finding to patients while taking individual circumstances, local guidelines and clinical practice into account. This study illustrates the importance of increasing the clarity and scope of informed consent and the need for patient engagement to ensure clinical trial participants can indicate their preference regarding receipt of potentially important individual pharmacogenetic results. This study was registered in the NCT Clinical Trial Registry under NCT00866697 on March 19, 2009, following approval from participating ethics committees. (shrink)

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing p...

Issues of reliability are claiming center-stage in the epistemology of machine learning. This paper unifies different branches in the literature and points to promising research directions, whilst also providing an accessible introduction to key concepts in statistics and machine learning – as far as they are concerned with reliability.

Big Ideas for Little Kids includes everything a teacher, a parent, or a college student needs to teach philosophy to elementary school children from picture books. Written in a clear and accessible style, the book explains why it is important to allow young children access to philosophy during primary-school education. Wartenberg also gives advice on how to construct a "learner-centered" classroom, in which children discuss philosophical issues with one another as they respond to open-ended questions by saying whether they agree (...) or disagree with what others have said. (shrink)

Cette étude essaye d’établir qu’il y a deux notions très différentes de « fondation » à l’œuvre dans les Recherches logiques de Husserl. Dans la IIIème Recherche, où le terme est formellement introduit, lorsqu’il se demande quels sont les contenus qui peuvent exister d’une manière autonome (indépendants) et lesquels peuvent exister uniquement en tant que moments d’autre chose (dépendants), Husserl suit ce que j’appelle un « modèle ontologique ». Selon ce modèle, le concret possède une priorité sur à l’abstrait qui (...) est fondé en lui. Dans la VIème Recherche, en revanche, Husserl s’oriente principalement sur un « modèle gnoséologique » qui voit le complexe comme fondé sur ce qui est relativement simple, étant donné que les expériences d’ordre supérieur (telles les perceptions de types d’objets plus complexes) sont « fondées sur » des expériences plus simples, bien qu’elles ne puissent pas y être réduites. L’exemple principal ici est celui des intuitions catégoriales : fondées sur les intuitions sensibles, elles n’y sont pas réductibles. Mais cette distinction entre deux sens différents du terme de « fondation » peut également nous aider à mieux comprendre de nombreuses thèses husserliennes plutôt controversées. Par exemple, elle peut nous permettre de mieux comprendre dans quelle mesure faire l’expérience d’un être humain comme un tout se fonde sur l’expérience d’un corps physique, et cela même si l’étant que nous rencontrons inclut à la fois des aspects corporels et des aspects spirituels – les deux étant vus, d’une manière essentielle, comme des moments de cette unique personne qui fait l’objet de notre expérience. (shrink)

v. 1. Editorial introduction -- v. 2. The English and Latin texts (i) -- v. 3. The English and Latin texts (ii).

Events have beginnings, ends, and often overlap in time. A major question is how perceivers come to parse a stream of multimodal information into meaningful units and how different event boundaries may vary event processing. This work investigates the roles of these three types of event boundaries in constructing event temporal relations. Predictions were made based on how people would err according to the beginning state, end state, and overlap heuristic hypotheses. Participants viewed animated events that include all the logical (...) possibilities of event temporal relations, and then made temporal relation judgments. The results showed that people make use of the overlap between events and take into account the ends and beginnings, but they weight ends more than beginnings. Neural network simulations showed a self‐organized distinction when learning temporal relations between events with overlap versus those without. (shrink)

In this book, T. M. Scanlon offers new answers to these questions, as they apply to the central part of morality that concerns what we owe to each other.

We expand on the article “Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force” to consider the ways in which rural...

This paper is an exposition and evaluation of the Agustín Rayo's views about the epistemology and metaphysics of mathematics, as they are presented in his book The Construction of Logical Space.

Near-death experiences are a big challenge to the fields of science and philosophy; termed as hallucinatory by neurologists and “stuff of which fantasies are made off” by sceptics, there are some unique near-death experiences which defy these claims. Memories generated during these experiences are of specific interest as they are created without a body and can be recalled post the experience. Call it the mind, soul, psyche or consciousness, if deliberated as a form of quantum generated energy, a strong correlation (...) under a reductionist based perspective can be obtained. Life at a macroscopic level may not be similar to life at a quantum level, and has been proved in quantum physics through its spooky properties like quantum entanglement. Self-sustaining quantum generated energy through entanglement is the answer to all mystical realties and the answer lies in believing in its existence in and around us. It is this energy that brings in the awareness of one’s existence and which performs tasks beyond the imagination of the current self; an energy created at the creation of all that exists; a true supernatural force. This paper reviews a unique void near-death experience and hypothesizes quantum entanglement to be involved in the conception and storage of these energy-based memories in a quantum subatomic cloud which can be restated if returned back to the body or lost to the environment upon death. (shrink)

In recent years an increasing number of psychologists have begun to explore the prevalence, causes and effects of ordinary people’s intuitions about moral realism. Many of these studies have lacked in construct validity, i.e., they have failed to measure moral realism. My aim in this paper accordingly is to motivate and guide methodological improvements. In analysis of prominent existing measures, I develop general recommendations for overcoming ten prima facie serious worries about research on folk moral realism. G1 and G2 require (...) studies’ answer choices to be as metaethically comprehensive as methodologically feasible. G3 and G4 prevent fallacious inferences from intuitions about related debates. G5 and G6 limit first-order moral and epistemic influences. G7 address studies’ instructions. And G8 and G9 suggest tests of important psychological presuppositions. (shrink)

This volume is a study of the influence of Timaeus on the development of Western cosmology in three axial periods of European culture: Late Antiquity, Middle Ages and Renaissance.

In recent years, a plethora of high-profile scientific publications has been reporting about machine learning algorithms outperforming clinicians in medical diagnosis or treatment recommendations. This has spiked interest in deploying relevant algorithms with the aim of enhancing decision-making in healthcare. In this paper, we argue that instead of straightforwardly enhancing the decision-making capabilities of clinicians and healthcare institutions, deploying machines learning algorithms entails trade-offs at the epistemic and the normative level. Whereas involving machine learning might improve the accuracy of medical (...) diagnosis, it comes at the expense of opacity when trying to assess the reliability of given diagnosis. Drawing on literature in social epistemology and moral responsibility, we argue that the uncertainty in question potentially undermines the epistemic authority of clinicians. Furthermore, we elucidate potential pitfalls of involving machine learning in healthcare with respect to paternalism, moral responsibility and fairness. At last, we discuss how the deployment of machine learning algorithms might shift the evidentiary norms of medical diagnosis. In this regard, we hope to lay the grounds for further ethical reflection of the opportunities and pitfalls of machine learning for enhancing decision-making in healthcare. (shrink)

Thomas Reid is now recognized as one of the towering figures of the Enlightenment. Best known for his published writings on epistemology and moral theory, he was also an accomplished mathematician and natural philosopher, as an earlier volume of his manuscripts edited by Paul Wood for the Edinburgh Reid Edition, Thomas Reid on the Animate Creation, has shown. The Correspondence of Thomas Reid collects all of the known letters to and from Reid in a fully annotated form. (...) Letters already published by Sir William Hamilton and others have been reedited, and roughly half of the letters included appear in print for the first time. Writing in 1802, Reid's disciple and biographer Dugald Stewart doubted that Reid's correspondence &"would be generally interesting.&" This collection proves otherwise, for the letters illuminate virtually every aspect of Reid's life and career and, in some instances, provide us with invaluable evidence about activities otherwise undocumented in his manuscripts or published works. Through his correspondence we can trace Reid's relations with contemporaries such as David Hume and his colleagues at both King's College, Aberdeen, and the University of Glasgow, as well as his engagement with the most controversial philosophical, scientific, and political issues of his day. If anything, the letters assembled here serve as the starting point for understanding Reid and his place in the Enlightenment. (shrink)

There is an ongoing concern about workplace ethics. Many voices say that our educational system ought to do something about it, but they do not agree about how to do this. By the time students reach post‐secondary education, they will have already developed a general moral sense. The concern is whether their moral sense is sufficient for ethical situations in the workplace. If not, post‐secondary education is expected to close the gap. In order to do this, educators need information about (...) what is missing. Educators can set clear, work‐related objectives and use classroom activities to reach those objectives based on an identification of these gaps. (shrink)

Feeling good: four ways -- Finding that feeling -- The place of pleasure -- Knowing what's what -- Making things happen -- Being good -- Love and friendship -- Putting it together.

Conciliatory theories of disagreement require that one lower one’s confidence in a belief in the face of disagreement from an epistemic peer. One question about which people might disagree is who should qualify as an epistemic peer and who should not. But when putative epistemic peers disagree about epistemic peerhood itself, then Conciliationism makes contradictory demands and paradoxes arise.

Existing research suggests that people's judgments of actual causation can be influenced by the degree to which they regard certain events as normal. We develop an explanation for this phenomenon that draws on standard tools from the literature on graphical causal models and, in particular, on the idea of probabilistic sampling. Using these tools, we propose a new measure of actual causal strength. This measure accurately captures three effects of normality on causal judgment that have been observed in existing studies. (...) More importantly, the measure predicts a new effect ("abnormal deflation"). Two studies show that people's judgments do, in fact, show this new effect. Taken together, the patterns of people's causal judgments thereby provide support for the proposed explanation. (shrink)

A growing number of decision theorists have, in recent years, defended the view that rationality is permissive under risk: Different rational agents may be more or less risk-averse or risk-inclined. This can result in them making different choices under risk even if they value outcomes in exactly the same way. One pressing question that arises once we grant such permissiveness is what attitude to risk we should implement when choosing on behalf of other people. Are we permitted to implement any (...) of the rationally permissible risk attitudes, is there some specific risk attitude that is required when choosing for others, or are we required to defer to the risk attitudes of the people on whose behalf we are choosing? This article elaborates on this question, explains its wider practical and theoretical significance, provides an overview of existing answers, and explores how to go about providing a more systematic account of how to choose on behalf of others in risky contexts. (shrink)

Michel Foucault, one of the most cited scholars in the social sciences, devoted his last three lectures to a study of leader development. Going back to pagan sources, Foucault found a persistent theme in Hellenistic antiquity that, in order to qualify for leadership, a person must undergo processes of subjectivation, which is simply the way that a person becomes a Subject. From this perspective, an aspiring leader first becomes a Subject who happens to lead. These processes depend on a condition (...) of _parresia_, which is truth-telling at great risk that is for the edification of the other person. A leader requires a mentor and advisors in order to lead successfully, while also developing the capacity in one’s own mind to heed the truth. In other words, a leader must learn how to guide oneself. A valuable contribution to the field of leadership studies, this book summarizes these last lectures as they pertain to the study and practice of leadership, emphasizing the role of ethics and truth-telling as a check on power. It then presents several other contexts where these same lessons can be seen in practice, including in the life of Alexander Solzhenitsyn, whose career as a writer epitomized speaking truth to power, and somewhat surprisingly in the United States military, in response to its twenty-first century mission of counterinsurgency. (shrink)

Cet essai présente une description de plusieurs travaux inédits de Jacques Derrida au sujet de Marx et d'Althusser datant des années 1960 et 1970. Au-delà du travail philologique, il s'agit aussi d'une étude théorique de notions telles que 'idéologie', 'fétichisme', 'reproduction', 'division du travail', 'différence sexuelle', 'domination', 'économie politique', 'matérialisme dialectique', ou 'production culturelle' — tout autant à travers les textes marxistes que dans les lectures déconstructives qu'en propose alors Derrida. Durant les années 1970, dans le cadre de son séminaire, (...) Derrida s'efforce de penser une autre économie politique, au-delà de l'économie du propre qu'il identifie aussi bien chez les économistes classiques que chez leurs critiques marxistes. Ces lectures détaillées et combattives de textes marxistes restent aujourd'hui inédites. Leur prise en compte contribue à redéfinir l'image de Derrida et de la déconstruction, en témoignant de ses discussions très avancées de Marx, d'Althusser, et de la pensée marxiste — et ce dès la fin des années 1960 et le début des années 1970, plus de 20 ans avant la publication de Spectres de Marx (1993). -/- Une version plus courte de cet article fut traduite en espagnol par Ramiro Parodi, et publiée en 2019 dans le numéro 7 de la revue Demarcaciones — numéro consacré au 25ème anniversaire de la publication de Spectres de Marx. (shrink)