The rapid adoption and implementation of artificial intelligence in medicine creates an ontologically distinct situation from prior care models. There are both potential advantages and disadvantages with such technology in advancing the interests of patients, with resultant ontological and epistemic concerns for physicians and patients relating to the instatiation of AI as a dependent, semi- or fully-autonomous agent in the encounter. The concept of libertarian paternalism potentially exercised by AI (and those who control it) has created challenges to conventional assessments (...) of patient and physician autonomy. The unclear legal relationship between AI and its users cannot be settled presently, an progress in AI and its implementation in patient care will necessitate an iterative discourse to preserve humanitarian concerns in future models of care. This paper proposes that physicians should neither uncritically accept nor unreasonably resist developments in AI but must actively engage and contribute to the discourse, since AI will affect their roles and the nature of their work. One’s moral imaginative capacity must be engaged in the questions of beneficence, autonomy, and justice of AI and whether its integration in healthcare has the potential to augment or interfere with the ends of medical practice. (shrink)

Volume 20, Issue 3, March 2020, Page 81-83.

In the clinical setting, questions of medical ethics raise a host of perplexing problems, often complicated by conflicting perspectives and the need to make immediate decisions. In this volume, bioethicists and physicians provide a nuanced, in-depth approach to the difficult issues involved in bioethics consultation. Addressing the needs of researchers, clinicians, and other health professionals on the front lines of bioethics practice, the contributors focus primarily on practical concerns -- whether ethics consultation is best done by individuals, teams, or committees (...) how an ethics consult service should be structured the need for institutional support and techniques and programs for educating and training staff -- without neglecting more theoretical considerations, such as the importance of character or the viability of organizational ethics. (shrink)

In “Bioethics and the Whole: Pluralism, Consensus, and the Transmutation of Bioethical Methods into Gold,” Patricia Martin identifies themes common to three emerging approaches to clinical bioethics--clinical pragmatism, ethics facilitation, and mediation-in order to develop an “ethical consensus method” that can serve as a “practical, step-by-step guide” for decision making She is to be applauded both for her identification of themes common to these three approaches and for her contribution to what we hope will be a growing literature on practical (...) methods for problem solving in clinical bioethics that take seriously the ideal of consensus. After a few preliminary remarks concerning Martin's working model, we focus the majority of our commentary on the notion of “consensus,” which is at the heart of her “ethical consensus method,” and the three approaches from which it is drawn. (shrink)

In “Bioethics and the Whole: Pluralism, Consensus, and the Transmutation of Bioethical Methods into Gold,” Patricia Martin identifies themes common to three emerging approaches to clinical bioethics--clinical pragmatism, ethics facilitation, and mediation-in order to develop an “ethical consensus method” that can serve as a “practical, step-by-step guide” for decision making She is to be applauded both for her identification of themes common to these three approaches and for her contribution to what we hope will be a growing literature on practical (...) methods for problem solving in clinical bioethics that take seriously the ideal of consensus. After a few preliminary remarks concerning Martin's working model, we focus the majority of our commentary on the notion of “consensus,” which is at the heart of her “ethical consensus method,” and the three approaches from which it is drawn. (shrink)

In “Bioethics and the Whole: Pluralism, Consensus, and the Transmutation of Bioethical Methods into Gold,” Patricia Martin identifies themes common to three emerging approaches to clinical bioethics--clinical pragmatism, ethics facilitation, and mediation-in order to develop an “ethical consensus method” that can serve as a “practical, step-by-step guide” for decision making She is to be applauded both for her identification of themes common to these three approaches and for her contribution to what we hope will be a growing literature on practical (...) methods for problem solving in clinical bioethics that take seriously the ideal of consensus. After a few preliminary remarks concerning Martin's working model, we focus the majority of our commentary on the notion of “consensus,” which is at the heart of her “ethical consensus method,” and the three approaches from which it is drawn. (shrink)

The COVID-19 pandemic has, of necessity, demanded the rapid incorporation of virtual technologies which, suddenly, have superseded the physical medical encounter. These imperatives have been implemented in advance of evaluation, with unclear risks to patient care and the nature of medical practice that might be justifiable in the context of a pandemic but cannot be extrapolated as a new standard of care. Models of care fit for purpose in a pandemic should not be generalized to reconfigure medical care as virtual (...) by default, and personal by exception at the conclusion of the emergency. (shrink)

To mark the 30th anniversary of Richard Dawkins’s book, OUP is to issue a collection of essays about his work. Here, professor of psychology at Harvard University, wonders if Dawkins’s big idea has not gone far enough..

It is presently unclear whether a distinct “rural ethics” of navigating professional boundaries exists, and if so, what theoretical approaches may assist practitioners to manage overlapping relationships. To be effective clinicians while concurrently partaking in community life, practitioners must develop and maintain safe, ethical, and sustainable therapeutic relationships in rural and remote healthcare. A narrative review was conducted identifying a significant body of qualitative and theoretical literature which explores the pervasiveness of dual relationships for practitioners working in rural and remote (...) healthcare. Rather than viewing dual relationships as ethically unacceptable, much contemporary work focusses on the lived experiences of healthcare workers and explores what approaches may be available that both protect the therapeutic relationship while recognizing the unique nature of rural and remote healthcare practice. We conclude that practitioners must have a means of operating within a contextually informed ethics of professional boundaries. Drawing on pre-existing work, one schema is proposed that could form the basis for further engagement through interactive teaching sessions, professional development, mentoring, or guidelines. (shrink)

“Without good brain function, living to age 100 is not an attractive proposition,” said Nir Barzilai, director of the college’s Institute for Ageing Research. “We’ve shown that the same gene variant that helps people live to exceptional ages has the added benefit of helping them think clearly.

After characterizing the general outlines of Davidson's criticism of the idea of conceptual schemes, the specifics of his argument are examined and evaluated. It is argued that his argument against radically different conceptual schemes does mark out plausible limits to what might be thought of as differences against conceptual schemes, but it is doubtful that those he mentioned as proponents of the idea envisions such differences. It is argued that the stylized character of Davidson's arguments against the less radical (...) variants of the idea fail to foreclose the possibility of differences that many would find interesting. (shrink)

I. EXECUTIVE SUMMARY The MRCT Center Post-trial Responsibilities: Continued Access to an Investigational Medicine Framework outlines a case-based, principled, stakeholder approach to evaluate and guide ethical responsibilities to provide continued access to an investigational medicine at the conclusion of a patient’s participation in a clinical trial. The Post-trial Responsibilities (PTR) Framework includes this Guidance Document as well as the accompanying Toolkit. A 41-member international multi-stakeholder Workgroup convened by the Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard University (...) (MRCT Center) developed this Guidance and Toolkit. Project Motivation A number of international organizations have discussed the responsibilities stakeholders have to provide continued access to investigational medicines. The World Medical Association, for example, addressed post-trial access to medicines in Paragraph 34 of the Declaration of Helsinki (WMA, 2013): “In advance of a clinical trial, sponsors, researchers and host country governments should make provisions for post-trial access for all participants who still need an intervention identified as beneficial in the trial. This information must also be disclosed to participants during the informed consent process.” This paragraph and other international guidance documents converge on several consensus points: • Post-trial access (hereafter referred to as “continued access” in this Framework [for terminology clarification – see definitions]) is the responsibility of sponsors, researchers, and host country governments; • The plan for continued access should be determined before the trial begins, and before any individual gives their informed consent; • The protocol should delineate continued access plans; and • The plan should be transparent to potential participants and explained during the informed consent process. -/- However, there is no guidance on how to fulfill these responsibilities (i.e., linking specific responsibilities with specific stakeholders, conditions, and duration). To fill this gap, the MRCT Center convened a working group in September of 2014 to develop a framework to guide stakeholders with identified responsibilities. This resultant Framework sets forth applicable principles, approaches, recommendations and ethical rationales for PTR regarding continued access to investigational medicines for research participants. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Gehlen's core idea in Man is that humans have unique properties which distinguish them from all other species: 1. world-openness, a concept originally coined by Max Scheler, which describes the ability of humans to adapt to various environments (as contrasted with animals, which can only survive in environments which match their evolutionary specialisation). This gives us 2. the ability to shape our environment according to our intentions, and it comprises a view of language as a way of acting (Gehlen was (...) one of the first proponents of speech act theory), Human beings are also marked 3. by an excess of impulses and by 4. the ability of self-control. These properties allow us (again in contrast to all other animals) 5. to create our own (for example cultural) environments. Gehlen's philosophy has influenced many contemporary German thinkers in a range of disciplines, including Peter L. Berger, Thomas Luckmann and Niklas Luhmann in sociology, and Hans Blumenberg in philosophy. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

In this paper I argue against the view, defended by some philosophers, that it is part of the meaning of mental that being mental is incompatible with being physical. I call this outlook metalinguistic dualism, and I distinguish it from metaphysical theories of the mind-body relation such as Cartesian dualism. I argue that MLD is mistaken, but I don't try to defend the contrary view that mentalistic terms can be definitionally reduced to nonmental ones. After criticizing arguments by certain philosophers (...) which purport to establish MLD, I formulate a criterion for a phenomenon's being mental. I then show that this criterion is neutral between monistic and dualistic theories of the mind-body relation. Since if MLD were true it should be impossible to construct such a criterion, I conclude that it is false. The significance of my paper is that if I am right then I remove one important type of objection to aposteriori, noneliminative forms of the identity theory of mind, namely that such theories ought to be rejected merely on the basis of semantical considerations about the word mental. Beyond that, I believe that my criterion of mental phenomena correctly captures our intuitions about the nature of the distinction between mental and nonmental phenomena. (shrink)

This article examines Nowacki’s novel version of the kalam cosmological argument (N-KCA), and finds it seriously flawed. The N-KCA purportedly shows the factual impossibility of a denumerably infinite set of coexisting concrete entities; and that there would be such a set were an infinite temporal series of events to obtain because each existing substance bears its own necessarily permanent temporal marks and those of its ancestors. Nowacki, professing the A-theory of time, nevertheless maintains that truth-makers of past-event propositions are not (...) tensed facts, according to some correspondence theory of truth, but rather the temporal marks borne by existing substances. (shrink)

A key philosophical feature of Peter Jackson’s film interpretation of J.R.R. Tolkien’s _The Lord of the Rings_ is its use of fantasy to inspire a “recovery” of the actual or, in other words, a reawakening to the beauty of nature and the many possible ways of living in healthier ecological relation to the world. Though none of these ways is perfectly achieved, this pluralistic view is demonstrated in the various lifeways of Hobbits, Elves, Men, and Ents. All of the positive (...) relationships embodied in the films—to trees, mountains, horses, and vegetable gardens—involve loving care and attention, receiving nourishment and livelihood without instrumentalization, or reducing nature to mere resource. The films also vividly display a variety of ugly and destructive ways of using the land to accrue power and wealth. These noxious ways, specifically because they actively destroy the lands that they use, always need more. They will thus eventually annihilate the beautiful ways of being if they are not actively resisted. Some of those who would rather be tending their own trees, gardens, or horses or even wandering in the wild forests must therefore turn their attention to struggle and resistance instead. This is a struggle full of grief, and at times even verging on despair, but it is marked by the refusal to give up hope. Indeed, what Jackson and Tolkien have to say about hope is as important in responding to the ecological crisis as anything they have to say about nature, inasmuch as they help to remind us that even in our own times, “there is still hope.”. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

The ability to extract patterns from sensory input across time and space is thought to underlie the development and acquisition of language and literacy skills, particularly the subdomains marked by the learning of probabilistic knowledge. Thus, impairments in procedural learning are hypothesized to underlie neurodevelopmental disorders, such as dyslexia and developmental language disorder. In the present meta‐analysis, comprising 2396 participants from 39 independent studies, the continuous relationship between language, literacy, and procedural learning on the Serial Reaction Time task (SRTT) was (...) assessed across children and adults with typical development (TD), dyslexia, and Developmental Language Disorder (DLD). Despite a significant, but very small, relationship between procedural learning and overall language and literacy measures, this pattern was not observed at the group‐level when examining TD, dyslexic, and DLD groups separately. Based on the procedural/declarative model, a positive relationship was expected between procedural learning and language and literacy measures for the typically developing group; however, no such relationship was observed. This was also the case for the disordered groups (ps >.05). Also counter to expectations, the magnitude of the relationship between procedural learning and grammar and phonology did not differ between TD and DLD (ps >.05), nor between the TD and dyslexic group on reading, spelling, and phonology (ps >.05). While lending little support to the procedural/declarative model, we consider that these results may be the consequence of poor psychometric properties of the SRTT as a measure of procedural learning. (shrink)

The environment raises basic questions about many of the fundamental concepts and doctrines in aesthetics and the arts. Including new work by the leading international contributors to environmental aesthetics, this is the first book to deal with the relations between the arts and environment, directed towards a non-philosophical audience of practitioners and critics, as well as theorists. Introducing many for the basic ideas and issues in the theory of the arts, particularly as they bear on environment, this book addresses the (...) special concerns of an aesthetics of environment and explores the implications of environmental aesthetics for understanding both aesthetic theory and the aesthetic of individual arts. Environment and the Arts provides an introduction to some of the most intriguing and compelling questions about understanding and appreciating the arts and environment, setting a mark for the field and opening the topics to a wider audience. (shrink)

This paper focuses on examining the dynamic nature of community supported agriculture (CSA) and the real-world experiences which mark its contours, often making it distinct from the early idealized CSA “model.” Specifically, our study examines the narratives of the farmers of Devon Acres CSA over its duration, in tandem with a survey of recent shareholders in order to understand and explain its evolution. The framework we develop here shows that this CSA is largely characterized by instrumental and functional beliefs (...) and practices, with some elements in the collaborative mode. A key contribution of this research is the development of a framework which helps to highlight the relative fluidity and patchwork quality of CSA participant positions over time. At Devon Acres, the real-world factors and issues influencing CSA evolution are seen to be products of both the local and larger contexts, evident in such areas as shifts in farmer learning and adaptation, differences between beliefs and practices in member volunteer efforts, and changes in farm and resource conditions. With respect to CSA more broadly, we argue that the reality of dominant food system context and site-specific influences on CSA development compels us to rework our attachment to early idealized “model” traits. Expansion in CSA numbers, evidence of adaptation and situated learning, and retention of the local and organic as core traits, speak to the pragmatic yet transformative potential of CSA contribution to food system change. (shrink)

Here we are witness to the great cultural event of the West, the emergence of a Latin philosophical language translated from the Greek. Once again, it would be necessary to make a systematic study of the formation of this technical vocabulary that, thanks to Cicero, Seneca, Tertullian, Victorinus, Calcidius, Augustine, and Boethius, would leave its mark, by way of the Middle Ages, on the birth of modern thought. Can it be hoped that one day, with current technical means, it (...) will be possible to compile a complete lexicon of the correspondences of philosophical terminology in Greek and Latin? Furthermore, lengthy commentaries would be needed, for the most interesting task would be to analyze the shifts in meaning that take place in the movement from one language to another. In the case of the ontological vocabulary the translation of ousia by substantia, for example, is justly famous and has again recently inspired some remarkable studies. This brings us once more to a phenomenon we discretely alluded to earlier with the word philosophia, and which we will encounter throughout the present discussion: the misunderstandings, shifts or losses in meaning, the reinterpretations, sometimes even to the point of misreading, that arise once tradition, translation, and exegesis coexist. So our history of the Hellenistic and Roman thought will consist above all of recognizing and analyzing the evolution of meanings and significance. Pierre Hadot holds the chair of the History of Hellenistic and Roman Thought at the Collège de France. He is the author of many books and articles on the history of ancient philosophy and theology. Among his works are Plotin et la simplicité du regard, Porphyre et Vitctorinus, Marius Victorinus: Recherches sur sa vie et ses oeuvres, and Exercises spirituels et philosophie antique. Arnold I. Davidson, executive editor of Critical Inquiry, is associate professor of philosophy and a member of the Committees on the Conceptual Foundations of Science and General Studies in the Humanities at the University of Chicago. He introduced and edited the “Symposium on Heidegger and Nazism” . He is currently working on the history of horror as it relates to the epistemology of norms and deviations. Paula Wissing, a free-lance translator and editor, has recently translated Marcel Detienne and Jean-Pierre Vernant’s The Cuisine of Sacrifice among the Greeks . She also contributed translations of articles by Maurice Blanchot, Philippe Lacoue-Labarthe, and Emmanuel Levinas for the “Symposium on Heidegger and Nazism.”. (shrink)

My claim that probability ought to be defined as a purely subjective measure of human belief has been challenged in a recent and interesting article on these pages by Arnold Baise . Baise argues that probability ought to be defined, not as a purely subjective measure of human belief, as I have claimed, but rather in the following way: Probability P is a number between 0 and 1 that indicates how plausible it is that proposition A is true, based (...) on information I. In addition, one could add that a probability of 1 indicates certainty that the proposition is true, while a probability of 0 indicates certainty that the proposition is false. .The reasoning that leads Baise to advance this definition for probability, however, is seriously and apodictically flawed. As a consequence, his definition for probability must be rejected as a viable alternative to my purely subjective definition. (shrink)

Debates over how to conceptualize the nursing role were prominent in the nursing literature during the latter part of the twentieth century. There were, broadly, two schools of thought. Writers like Henderson and Orem used the idea of a self‐care deficit to understand the nurse as doing for the patient what he or she could not do alone. Later writers found this paternalistic and emphasized the importance of the patient's free will. This essay uses the ideas of positive and (...) negative freedom to explore the differing conceptions of autonomy which are implicit in this debate. The notion of positive freedom has often been criticized as paternalistic, and the criticisms of self‐care in the nursing literature echo criticisms from political philosophy. Recent work on relational autonomy and on the relationship between autonomy and identity are used to address these objections. This essay argues for a more nuanced conception of the obligation to support autonomy that includes both positive (freedom to) and negative (freedom from) dimensions. This conception of autonomy provides a moral foundation for conceptualizing nursing in something like Henderson's terms: as involving the duty to expand the patient's capacities. The essay concludes by generalizing the lesson. Respect for autonomy on the part of any health care provider requires both respect for the patient's choices and a commitment to expand the patient's ability to actualize their choices. (shrink)

Biologists, historians, lawyers, art historians, and literary critics all voice arguments in the critical dialogue about what constitutes evidence in research and scholarship. They examine not only the constitution and "blurring" of disciplinary boundaries, but also the configuration of the fact-evidence distinctions made in different disciplines and historical moments the relative function of such concepts as "self-evidence," "experience," "test," "testimony," and "textuality" in varied academic discourses and the way "rules of evidence" are themselves products of historical developments. The essays and (...) rejoinders are by Terry Castle, Lorraine Daston, Carlo Ginzburg, Ian Hacking, Mark Kelman, R. C. Lewontin, Pierre Vidal-Naquet, Mary Poovey, Donald Preziosi, Simon Schaffer, Joan W. Scott, Eve Kosofsky Sedgwick, and Barbara Herrnstein Smith. The critical responses are by Lauren Berlant, James Chandler, Jean Comaroff, Arnold I. Davidson, Harry D. harootunian, Elizabeth Helsinger, Thomas C. Holt, Francoise Meltzer, Robert J. Richards, Lawrence Rothfield, Joel Snyder, Cass R. Sunstein, and William Wimsatt. (shrink)

Mark Siderits’s contributions to the study of Indian philosophy have long included rational reconstruction of arguments and positions typical of the Madhyamaka school of Buddhist thought. A widely-known expression of this tradition’s core contention – “the ultimate truth is that there is no ultimate truth” – is widely attributed to Siderits, and my own studies of Madhyamaka have from the outset been influenced by his philosophically sophisticated work. Nonetheless, I have always resisted Siderits’s predilection for characterizing Madhyamaka as exemplifying (...) anti-realism, as well as the notion that this tradition’s concerns are best characterized as semantic. On my reading, the insight aptly expressed by Siderits’s signature formulation is better characterized as transcendental – as identifying, that is, something presupposed by the very fact that pursuit of the Buddhist path is in the first place intelligible. Siderits, then, would dispel his formulation’s air of paradox by taking it to mean, “it is ultimately true that no statement corresponds to the ultimate nature of reality.” I have taken the same statement as aptly expressing the contention, rather, that “it is ultimately true” – that is, practically incontrovertible once it has been clarified, by Madhyamaka critique, what it would mean for anything to be ‘ultimately real’ – “that there are no ultimately real existents.” While these make sense as philosophically distinct emphases, it is reasonable to wonder whether there is any practically significant difference between these ideas. By way of honoring Mark Siderits’s influence on my own understanding, this essay explores the extent and significance of our divergent emphases. (shrink)