Members of the Clinical Ethics Consultation Affairs Standing Committee of the American Society for Bioethics and Humanities present a collection of insights and recommendations developed from their collective experience, intended for those engaged in the work of healthcare ethics consultation.

Treating patients and their family members with respect and dignity is a broadly accepted goal of health care. The work presented in this article is part of a larger project aimed at better understanding what constitutes treatment with respect and dignity in the ICU to improve the care that patients and family members receive in this regard. Direct observation was selected as one of the methods to facilitate this understanding because it provides the opportunity to see and document what actually (...) occurs during encounters among patients, their families, and clinicians. This article reports seven major thematic domains and many subthemes that together create a detailed account of the interpersonal and environmental components of treatment with respect and dignity. Attention to these components might enhance the experience and treatment of patients and family members. (shrink)

A caregiver from the dominant U.S. culture and a patient from a very different culture can resolve cross‐cultural disputes about treatment, not by compromising important values, but by focusing on the patient's goals.

Respect and dignity are central to moral life, and have a particular importance in health care settings such as the intensive care unit (ICU). We conducted 15 semistructured interviews with 21 participants during an ICU admission to explore the definition of, and specific behaviors that demonstrate, respect and dignity during treatment in the ICU. We transcribed interviews and conducted thematic qualitative analysis. Seven themes emerged that focused on what it means to be treated with respect and/or dignity: treated as a (...) person; Golden Rule; acknowledgement; treated as family/friend; treated as an individual; treated as important/valuable; and treated as equal. Participants described particular behaviors or actions that were considered related to demonstrating treatment with respect and dignity: listening; honesty/giving information; attention to body/modesty/appearance; caring/bedside manner; patient and family as an information source; attention to pain; and responsiveness. These behaviors provide a framework for improving experiences with care in the ICU. (shrink)

A limiting factor in ethics education in medical training has been difficulty in assessing competence in ethics. This study was conducted to test the concept that content analysis of pediatric residents’ personal reflections about ethics experiences can identify changes in ethical sensitivity and reasoning over time. Analysis of written narratives focused on two of our ethics curriculum’s goals: 1) To raise sensitivity to ethical issues in everyday clinical practice and 2) to enhance critical reflection on personal and professional values as (...) they affect patient care. Content analysis of written reflections was guided by a tool developed to identify and assess the level of ethical reasoning in eight domains determined to be important aspects of ethical competence. Based on the assessment of narratives written at two times (12 to 16 months/apart) during their training, residents showed significant progress in two specific domains: use of professional values, and use of personal values. Residents did not show decline in ethical reasoning in any domain. This study demonstrates that content analysis of personal narratives may provide a useful method for assessment of developing ethical sensitivity and reasoning. (shrink)

Despite wide recognition of the importance of treating patients with respect and dignity, little is known about what constitutes treatment in this regard. The intensive care unit (ICU) is a unique setting that can pose specific threats to treatment with respect and dignity owing to the critical state of patients, stress and anxiety amongst patients and their family members, and the highly technical nature of the environment. In attempt to understand various stakeholders’ perspectives of treatment with respect and dignity, patients (...) and family members were interviewed, a wide range of health care professionals participated in focus groups, and third party observers took field notes of interactions in the ICU. This paper compares and contrasts the data that were generated using these different methods. Triangulating the data in this way contributes to a more complete and nuanced understanding of treatment with respect and dignity in the ICU. (shrink)

Little is known about health care professionals’ perceptions regarding what it means to treat patients and families with respect and dignity in the intensive care unit (ICU) setting. To address this gap, we conducted nine focus groups with different types of health care professionals (attending physicians, residents/fellows, nurses, social workers, pastoral care, etc.) working in either a medical or surgical ICU within the same academic health system. We identified three major thematic domains, namely, intrapersonal (attitudes and beliefs), interpersonal (behaviors), and (...) system (contextual) factors that influence treatment with respect and dignity. Participants suggested strategies for improving treatment of patients and families in the ICU with respect and dignity, as well as the related need for enhancing respect among the multidisciplinary team of clinicians. Implementing these strategies will require innovative educational interventions and leadership. Future research should focus on the design and evaluation of such interventions on the quality of care. (shrink)

Behavioral scientists routinely publish broad claims about human psychology and behavior in the world's top journals based on samples drawn entirely from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies. Researchers – often implicitly – assume that either there is little variation across human populations, or that these “standard subjects” are as representative of the species as any other population. Are these assumptions justified? Here, our review of the comparative database from across the behavioral sciences suggests both that there is (...) substantial variability in experimental results across populations and that WEIRD subjects are particularly unusual compared with the rest of the species – frequent outliers. The domains reviewed include visual perception, fairness, cooperation, spatial reasoning, categorization and inferential induction, moral reasoning, reasoning styles, self-concepts and related motivations, and the heritability of IQ. The findings suggest that members of WEIRD societies, including young children, are among the least representative populations one could find for generalizing about humans. Many of these findings involve domains that are associated with fundamental aspects of psychology, motivation, and behavior – hence, there are no obviousa priorigrounds for claiming that a particular behavioral phenomenon is universal based on sampling from a single subpopulation. Overall, these empirical patterns suggests that we need to be less cavalier in addressing questions ofhumannature on the basis of data drawn from this particularly thin, and rather unusual, slice of humanity. We close by proposing ways to structurally re-organize the behavioral sciences to best tackle these challenges. (shrink)

"First published by Oxford University Press, 1916."--Title page verso.

Does all conscious experience essentially involve self-consciousness? In his Subjectivity and Selfhood: Investigating the First-Person, Dan Zahavi answers “yes”. I criticize three core arguments offered in support of this answer—a well-known regress argument, what I call the “interview argument,” and a phenomenological argument. Drawing on Sartre, I introduce a phenomenological contrast between plain experience and self-conscious experience. The contrast challenges the thesis that conscious experience entails self-consciousness.

Since the very beginning, Confucianism has been troubled by a serious gap between its political ideals and the reality of societal circumstances. Contemporary Confucians must develop a viable method of governance that can retain the spirit of the Confucian ideal while tackling problems arising from nonideal modern situations. The best way to meet this challenge, Joseph Chan argues, is to adopt liberal democratic institutions that are shaped by the Confucian conception of the good rather than the liberal conception of (...) the right.Confucian Perfectionism examines and reconstructs both Confucian political thought and liberal democratic institutions, blending them to form a new Confucian political philosophy. Chan decouples liberal democratic institutions from their popular liberal philosophical foundations in fundamental moral rights, such as popular sovereignty, political equality, and individual sovereignty. Instead, he grounds them on Confucian principles and redefines their roles and functions, thus mixing Confucianism with liberal democratic institutions in a way that strengthens both. Then he explores the implications of this new yet traditional political philosophy for fundamental issues in modern politics, including authority, democracy, human rights, civil liberties, and social justice.Confucian Perfectionism critically reconfigures the Confucian political philosophy of the classical period for the contemporary era. (shrink)

Joseph J. Fins calls for a reconsideration of severe brain injury treatment, including discussion of public policy and physician advocacy.

José Benardete developed a famous paradox involving a beginningless set of items each member of which satisfies some predicate just in case no earlier member satisfies it. The Grim Reaper version of this paradox has recently been employed in favor of various finitist metaphysical theses, ranging from temporal finitism to causal finitism to the discrete nature of time. Here, I examine a new challenge to these finitist arguments—namely, the challenge of implying that the future cannot be endless. In particular, I (...) develop future-oriented Benardete paradoxes and examine their epistemic symmetry with past-oriented paradoxes. (shrink)

Rigid designators for concrete objects and for properties -- On the coherence of the distinction -- On whether the distinction assigns to rigidity the right role -- A uniform treatment of property designators as singular terms -- Rigid appliers -- Rigidity - associated arguments in support of theoretical identity statements: on their significance and the cost of its philosophical resources -- The skeptical argument impugning psychophysical identity statements: on its significance and the cost of its philosophical resources -- The skeptical (...) argument further examined: on resources, allegedly overlooked, for confirming psychological identities. (shrink)

A caregiver from the dominant U.S. culture and a patient from a very different culture can resolve cross‐cultural disputes about treatment, not by compromising important values, but by focusing on the patient's goals.

Benardete paradoxes involve a beginningless set each member of which satisfies some predicate just in case no earlier member satisfies it. Such paradoxes have been wielded on behalf of arguments for the impossibility of an infinite past. These arguments often deploy patchwork principles in support of their key linking premise. Here I argue that patchwork principles fail to justify this key premise.

The paper argues that normative reasons are of two fundamental kinds, practical which are value related, and adaptive, which are not related to any value, but indicate how our beliefs and emotions should adjust to fit how things are in the world. The distinction is applied and defended, in part through an additional distinction between standard and non-standard reasons (for actions, intentions, emotions or belief).

Democracy in Moderation views constitutional liberal democracy as grounded in a principle of avoiding extremes and striking the right balance among its defining principles of liberty, equality, religion, and sustainable order, thus tempering tendencies toward sectarian excess. Such moderation originally informed liberal democracy, but now is neglected. Moderation can guide us intellectually and practically about domestic and foreign policy debates, but also serve the sustainability of the constitutional, liberal republic as a whole. Our recent theory thus doesn't help our practice, (...) given our concerns about polarization and sectarianism in ideas, policy, and politics. A rediscovery of Montesquieu and his legacy in shaping America's complex political order, including influence on Washington's practical moderation and Tocqueville's philosophical moderation, addresses these enduring theoretical and practical problems. Moderation also offers a deeper theory of leadership or statesmanship, particularly regarding religion and politics, and of foreign policy and strategy rooted in liberal democracy's first principles. (shrink)

Alan Gibson has invited me to discuss publicly some of the issues I raised in my referee's report for History of Political Thought on his article ‘Ancients, Moderns and Americans: The Republicanism- Liberalism Debate Revisited’. I gladly accepted, not least because a dialogue on views of the American Founding is fitting both for the subject and Gibson's instructive characterization of it. The Federalist opens by identifying candid debate as a fundamental achievement for young America, giving hope that reflection and choice, (...) not just accident and force, can govern humans. Similarly, Gibson's argument that America's formative political thought comprises ‘multiple traditions’ — including Lockean liberalism, the republicanism of English opposition writings, and other influences — seems to define the Founding as not a monologue but a lively dialogue. I agree that complexity and not a single, pure strain of thought defines America's Founding, but this is not to say there are no fundamental principles for which the Founding stands. In the spirit of candid exchange, I will not discuss the many points in Dr Gibson's article with which I agree but those where one might interpret the American Founding differently or find an important dimension overlooked. (shrink)

Behavioral scientists routinely publish broad claims about human psychology and behavior in the world's top journals based on samples drawn entirely from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies. Researchers – often implicitly – assume that either there is little variation across human populations, or that these “standard subjects” are as representative of the species as any other population. Are these assumptions justified? Here, our review of the comparative database from across the behavioral sciences suggests both that there is (...) substantial variability in experimental results across populations and that WEIRD subjects are particularly unusual compared with the rest of the species – frequent outliers. The domains reviewed include visual perception, fairness, cooperation, spatial reasoning, categorization and inferential induction, moral reasoning, reasoning styles, self-concepts and related motivations, and the heritability of IQ. The findings suggest that members of WEIRD societies, including young children, are among the least representative populations one could find for generalizing about humans. Many of these findings involve domains that are associated with fundamental aspects of psychology, motivation, and behavior – hence, there are no obviousa priorigrounds for claiming that a particular behavioral phenomenon is universal based on sampling from a single subpopulation. Overall, these empirical patterns suggests that we need to be less cavalier in addressing questions ofhumannature on the basis of data drawn from this particularly thin, and rather unusual, slice of humanity. We close by proposing ways to structurally re-organize the behavioral sciences to best tackle these challenges. (shrink)

Belief storage is often modeled as having the structure of a single, unified web. This model of belief storage is attractive and widely assumed because it appears to provide an explanation of the flexibility of cognition and the complicated dynamics of belief revision. However, when one scrutinizes human cognition, one finds strong evidence against a unified web of belief and for a fragmented model of belief storage. Using the best available evidence from cognitive science, we develop this fragmented model into (...) a nascent theory of the cognitive architecture of belief storage. (shrink)

I defend a new argument for causal finitism, the view that nothing can have an infinite causal history. I begin by defending a number of plausible metaphysical principles, after which I explore a host of novel variants of the Littlewood-Ross and Thomson’s Lamp paradoxes that violate such principles. I argue that causal finitism is the best solution to the paradoxes.

The thesis of self-elusiveness says, roughly, that the self fails to be phenomenally manifest from the first-person perspective. This thesis has a long history. Yet many who endorse it do so only in a very specific sense. They say that the self fails to be phenomenally manifest as an object from the first-person perspective; they say that self-experience is not a species of ‘object-consciousness’. Yet if consciousness outstrips object-consciousness, then we are left with the possibility that there is another sense (...) in which the self is phenomenally manifest. Alas, efforts to articulate just what this form of self-experience comes to—often a holy grail of sorts for those in, and influenced by, the phenomenological tradition—have remained stubbornly obscure. This essay attempts a partial remedy. Taking a cue from Bernard Lonergan, I suggest that self-experience, while not a species of object-consciousness, is nonetheless partially grounded in it. The result is a view that is compatible with self-experience being representational and relational, contra tradition. (shrink)

Longlisted for the PEN/E.O. Wilson Literary Science Writing Award A leading neuroscientist offers a history of the evolution of the brain from unicellular organisms to the complexity of animals and human beings today Renowned neuroscientist Joseph LeDoux digs into the natural history of life on earth to provide a new perspective on the similarities between us and our ancestors in deep time. This page-turning survey of the whole of terrestrial evolution sheds new light on how nervous systems evolved in (...) animals, how the brain developed, and what it means to be human. In The Deep History of Ourselves, LeDoux argues that the key to understanding human behavior lies in viewing evolution through the prism of the first living organisms. By tracking the chain of the evolutionary timeline he shows how even the earliest single-cell organisms had to solve the same problems we and our cells have to solve each day. Along the way, LeDoux explores our place in nature, how the evolution of nervous systems enhanced the ability of organisms to survive and thrive, and how the emergence of what we humans understand as consciousness made our greatest and most horrendous achievements as a species possible. (shrink)

Joseph Sauveur (1653-1716) fut mathématicien, physicien et théoricien de la musique. Souvent considéré comme le fondateur de l' acoustique moderne, on lui doit les premières mesures de la fréquence absolue d'un son, une théorie mathématique du tempérament, les premières explications convaincantes des phénomènes d'harmoniques et de battements, ainsi que l'application de ses recherches aux jeux d'orgue et à d'autres instruments de musique. Ce volume réunit l'ensemble des travaux de Sauveur sur le son et la musique, ainsi qu'un manuscrit de (...) cet auteur datant de 1697, publié ici pour la première fois. Les travaux de Sauveur sont accompagnés de textes d'introduction et de notes explicatives"--Page 4 of cover. (shrink)

Analytic debates about truth are wide-ranging, but certain key themes tend to crop up time and again. The three themes that we will examine in this paper are (i) the nature and behaviour of the ordinary concept of truth, (ii) the meaning of discourse about truth, and (iii) the nature of the property truth. We will start by offering a brief overview of the debates centring on these themes. We will then argue that cross-linguistic experimental philosophy has an indispensable yet (...) underappreciated role to play in all of these debates. Recognising the indispensability of cross-linguistic experimental philosophy should compel philosophers to significantly revise the ways in which they inquire about truth. It should also prompt analytic philosophers more generally to consider whether similar revisions might be necessary elsewhere in the field. (shrink)

The seventh edition of this pragmatic guide to determining right and wrong in the workplace is updated with new case studies and ancillary materials to combine stakeholder perspectives with a deep dive on workplace ethics issues. Using a unique stakeholder-based approach, this book takes business ethics out of the theory realm and provides practical ways to analyze any business decision. Including dozens of cases, Joseph Weiss looks beyond the impacts of ethical lapses on share price and profit to focus (...) on relationships between stakeholders, including individuals, groups, corporations, and governments. The new seventh edition includes seven new cases and ten new Point/Counterpoint exercises, which challenge students to argue both sides of a contemporary issue. It incorporates the latest research as well as updated cases dealing with recent scandals at organizations such as Boeing, Facebook, and Uber. Professors will have access to online support, including teaching notes, PowerPoint slides, and sample tests. The book is equipped with a step-by-step guide to implementing stakeholder analysis, tips to help students apply ethical principles in their personal and professional lives, and comprehensive coverage of employee workplace issues. Addressing relevant topics such as risk management, preferential hiring, and sexual harassment in conjunction with the digital divide, bribery, the environment, and more, Business Ethics, seventh edition explores ethical implications in today's increasingly interconnected global business environment. (shrink)

Renaissance Posthumanism brings together two historical periods--"Renaissance" signifying a rebirth of the ancient and "Posthumanism" a death of the modern--to ponder each through the possibilities of the other. This collection rethinks the humanities under the auspices of the posthumanities of the posthumanities under the auspices of Renaissance humanism.

This collection of chapters, from an international group of theologians and scripture scholars, engages the hermeneutical insights of Bernard Lonergan and those influenced by him to both advance theoretical discussions concerning the interpretation of Christian Scripture and to demonstrate the usefulness of such hermeneutical insights through applied readings of specific biblical texts.

The point of Hegel's dissatisfaction with Kant -- Rethinking Peirce's fallibilism -- Pragmatism's future : a touch of prophecy.

In “Brain Data in Context: Are New Rights the Way to Mental and Brain Privacy?” Daniel Susser and Laura Cabrera (2024) make a compelling case as to why the greater availability of neural data itsel...

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Consciousness, subjectivity, and the history of the organism -- Subjectivity considered as the first-person perspective -- Subjectivity and reference -- Unconscious subjectivity -- What subjectivity is not -- Subjectivity in the neurobiological image -- Subjectivity in the neurobiological image -- The science of subjectivity -- Putting the neuro in neurophenomenology -- Neural correlates of consciousness reconsidered -- Neurophilosophy, Darwinian naturalism, and subjectivity.

Management Ethics: Integrity at Work redefines what it means for a manager to function with integrity in the private and public sectorsùdomestically and globally. It integrates the latest theoretical work in both descriptive and normative ethics, and incorporates legal, communication, quality, and organizational theories into a conceptual framework that improves managerial judgment in the handling of moral complexity at work. The authors use their organizational ethics consulting and academic research experience to provide practical assessment and decision-making tools that convert ethics (...) theories into sound action steps. The book examines three key dimensions of management integrityùjudgment, process, and developmental dimensionsùand applies them to individual chapters devoted to the subprocesses of ethical planning, organizing, leading, and controlling. The authors focus their theories and tools on 28 ethics minicases related to each management function in seven allied management application clusters: accounting, auditing management; finance, investment management; marketing, advertising management; business management, business law, human resource management; technology, quality operations, organizational behavior management; public, nonprofit, health care management; and international, environmental, public policy management. Management Ethics: Integrity at Work builds management integrity by linking and enhancing both ethics and management competence in responsible planning, organizing, leading, and controlling for use by professionals and students in the private and public sectorsùdomestically and globally. (shrink)