There is a wind of change about to affect the training of all house officers in the United States. The Accreditation Council of Graduate Medical Education has promulgated a set of general competencies for all U.S.-trained residents, with a major thrust focused on bioethics and professionalism that will likely catch residency directors unaware. The ACGME's General Competencies document globally addresses many relationship-based ethical roles and responsibilities of house officers in healthcare. Of note, this document contains a specific section on professionalism. (...) However, the entire document is woven with a sustained thread of medical ethics throughout its other sections. The intent is to imbue each physician with those skills, rules, and aspects of character that will be a foundation for humane, ethical, professional conduct. Professionalism does indeed go beyond ethical principles, accounting for competency and commitment to excellence and, most of all, implying a virtue ethics account of medical practice. The need to address the central place of virtue ethics in house-staff education is apparent, and we now have the right tool for the job—the ACGME General Competencies. (shrink)

The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit (...) for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received. (shrink)

The emergence of the ethics consultation as a means to resolve moral crises in clinical medicine has revealed the need for a worksheet that would facilitate intake and analysis. The author developed the Bioethics Consultation Form as an attempt to remedy this need. The form is arranged in an outline format and is a useful asset to ethics committee discussions and record keeping. The first section covers basic intake data concerning the patient's medical and personal information, advance directives, and values, (...) as well as the values of the physician and family. After the intake section is completed with the above data, the ethics consultant then turns to the analysis section. This second section allows for (1) the discussion of conflicting values, (2) the identification of priorities, and (3) the elucidation of ethical norms relevant to the case.The Bioethics Consultation Form was adopted by the Patient Care Advisory committee of the Franklin Square Hospital Center in Baltimore, Maryland in 1986. The methodology in the use of the form will be discussed. Further, the potential spectrum of consultative cases that can be analyzed using the form will be highlighted. (shrink)

Physicians and families need to interact more meaningfully to clarify the values and preferences at stake in advance care planning. The current use of advance directives fails to respect patient autonomy. This paper proposes using the family covenant as a preventive ethics process designed to improve end-of-life planning by incorporating other family members—as agreed to by the patient and those family members—into the medical care dialogue. The family covenant formulates advance directives in conversation with family members and with the assistance (...) of a physician, thereby making advance directives more acceptable to the family, and more intelligible to other physicians. It adds the moral force of a promise to the obligation of respecting a patient’s preferences about end-of-life care. These negotiations between patient, family, and physician, from early planning phases through implementation, should greatly reduce the incidence of family disagreements on what the patient would have wanted. The family covenant ensures advance directive discussions within the family, promotes and respects the autonomy of other family members, and might even spur others in the family to complete advance directives through additional covenants. The family covenant holds the potential to transform moral quagmires into meaningful moral conversation. J Am Geriatr Soc 51:1155–1158, 2003. (shrink)

Abstract:Respect for persons protects patients regarding their own healthcare decisions. Patient informed choice for altruism (PICA) is a proposed means for a fully autonomous patient with decisionmaking capacity to limit his or her own treatment for altruistic reasons. An altruistic decision could bond the patient with others at the end of life. We contend that PICA can also be an advance directive option. The proxy, family, and physicians must be reminded that a patient’s altruistic treatment refusal should be respected.

The development of the Values History instrument for use in advance directive decision making has raised the question of the importance of values in eliciting advance directives. This pilot study examines the relationship between the domains of values and advance directives drawn from the Values History in three generation intrafamily triads. Significant correlations between values and advance directives were found primarily within the youngest generation. Results reveal a relatively high familiarity by the participants of the various established forms of advance (...) directives. Also, a significant percentage of parents and grand- parents was found to have signed some form of advance directive. (shrink)

While I concur that the conclusions reached in the target article by Burger and Kass (2009) in this issue are essentially on target, the authors glossed over an important consideration in ethics an...

Medical school curricula, although traditionally and historically dominated by science, have generally accepted, appreciated, and welcomed the inclusion of literature over the past several decades. Recent concerns about medical professional formation have led to discussions about the specific role and contribution of literature and stories. In this article, we demonstrate how professionalism and the study of literature can be brought into relationship through critical and interrogative interactions based in the literary skill of close reading. Literature in medicine can question the (...) meaning of “professionalism” itself, thereby resisting standardization in favor of diversity method and of outcome. Literature can also actively engage learners with questions about the human condition, providing a larger context within which to consider professional identity formation. Our fundamental contention is that, within a medical education framework, literature is highly suited to assist learners in questioning conventional thinking and assumptions about various dimensions of professionalism. (shrink)

A collection of personal narratives and essays, Living Professionalism is designed to help medical students and residents understand and internalize various aspects of professionalism. These essays are meant for personal reflection and above all, for thoughtful discussion with mentors, with peers, with others throughout the health care provider community who care about acting professionally.

One of the enduring concerns of moral philosophy is deciding who or what is deserving of ethical consideration. Much recent attention has been devoted to the "animal question" -- consideration of the moral status of nonhuman animals. In this book, David Gunkel takes up the "machine question": whether and to what extent intelligent and autonomous machines of our own making can be considered to have legitimate moral responsibilities and any legitimate claim to moral consideration. The machine question poses a (...) fundamental challenge to moral thinking, questioning the traditional philosophical conceptualization of technology as a tool or instrument to be used by human agents. Gunkel begins by addressing the question of machine moral agency: whether a machine might be considered a legitimate moral agent that could be held responsible for decisions and actions. He then approaches the machine question from the other side, considering whether a machine might be a moral patient due legitimate moral consideration. Finally, Gunkel considers some recent innovations in moral philosophy and critical theory that complicate the machine question, deconstructing the binary agent--patient opposition itself. Technological advances may prompt us to wonder if the science fiction of computers and robots whose actions affect their human companions could become science fact. Gunkel's argument promises to influence future considerations of ethics, ourselves, and the other entities who inhabit this world. (shrink)

A familiar interpretation of quantum mechanics (one of a number of views sometimes labeled the "Copenhagen interpretation'"), takes its empirical apparatus at face value, holding that the quantum wave function evolves by the Schrödinger equation except on certain occasions of measurement, when it collapses into a new state according to the Born rule. This interpretation is widely rejected, primarily because it faces the measurement problem: "measurement" is too imprecise for use in a fundamental physical theory. We argue that this is (...) a weak objection, as there may be many ways of making "measurement" precise. However, measurement-collapse interpretations face a more serious objection: a dilemma tied to the quantum Zeno effect. Is measurement itself an observable that can enter superpositions? If yes, then the standard measurement-collapse dynamics is ill-defined. If no, then (at least if measurement is an observable), measurements can never start or finish. The best way out is to deny that measurement is an observable, but this leads to strong and revisionary consequences. This reinforces the view that there is no nonrevisionary interpretation of quantum mechanics. (shrink)

This chapter describes three relatively specific forms such as destructive uploading, gradual uploading, and nondestructive uploading. Neuroscience is gradually discovering various neural correlates of consciousness, but this research program largely takes the existence of consciousness for granted. It presents an argument for the pessimistic view and an argument for the optimistic view, both of which run parallel to related arguments that can be given concerning teletransportation. Cryonic technology offers the possibility of preserving our brains in a low‐temperature state shortly after (...) death, until such time as the technology is available to reactivate the brain or perhaps to upload the information in it. Reconstructive uploading from brain scans is closely akin to ordinary (nongradual) uploading from brain scans, with the main difference being the time delay, and perhaps the continued existence in the meantime of the original person. (shrink)

A new theory of moral and aesthetic value for the age of remix, going beyond the usual debates over originality and appropriation. Remix—or the practice of recombining preexisting content—has proliferated across media both digital and analog. Fans celebrate it as a revolutionary new creative practice; critics characterize it as a lazy and cheap (and often illegal) recycling of other people's work. In Of Remixology, David Gunkel argues that to understand remix, we need to change the terms of the debate. (...) The two sides of the remix controversy, Gunkel contends, share certain underlying values—originality, innovation, artistic integrity. And each side seeks to protect these values from the threat that is represented by the other. In reevaluating these shared philosophical assumptions, Gunkel not only provides a new way to understand remix, he also offers an innovative theory of moral and aesthetic value for the twenty-first century. In a section called “Premix,” Gunkel examines the terminology of remix (including “collage,” “sample,” “bootleg,” and “mashup”) and its material preconditions, the technology of recording. In “Remix,” he takes on the distinction between original and copy; makes a case for repetition; and considers the question of authorship in a world of seemingly endless recompiled and repurposed content. Finally, in “Postmix,” Gunkel outlines a new theory of moral and aesthetic value that can accommodate remix and its cultural significance, remixing—or reconfiguring and recombining—traditional philosophical approaches in the process. (shrink)

Addressing a challenge and opportunity that is definitive of life in the 21st century, this book provides a range of possible solutions that serve to motivate and structure future research and debate around the concept of 'the other' in communication.

Zizek Studies: The Greatest Hits (So Far) assembles and presents the best work published in the field of Zizek Studies over the last ten years, providing teachers, students, and researchers with a carefully curated volume of leading-edge scholarship addressing the unique and sometimes eclectic work of Slovenian philosopher and cultural critic Slavoj Zizek. The chapters included in this collection have been rigorously tested in and culled from the (virtual) pages of the International Journal of Zizek Studies, a leading open access (...) journal that began publication in 2007. The book is organized into three sections or subject areas where Zizek and his seemingly indefatigable efforts have had significant impact: philosophy, politics, and popular culture. As a "greatest hits," the book offers the long-time fan and uninitiated newcomer alike a comprehensive overview of the wide range of opportunity in the field of Zizek studies and a remarkable collection of truly interdisciplinary "hits" from a diverse set of innovative and accomplished writers. (shrink)

What are the philosophical views of professional philosophers, and how do these views change over time? The 2020 PhilPapers Survey surveyed around 2000 philosophers on 100 philosophical questions. The results provide a snapshot of the state of some central debates in philosophy, reveal correlations and demographic effects involving philosophers' views, and reveal some changes in philosophers' views over the last decade.

Introduction -- Repression, ignorance, and undone science -- The epistemic dimension of the political opportunity structure -- The politics of meaning: from frames to design conflicts -- The organizational forms of counterpublic knowledge -- Institutional change, industrial transitions, and regime resistance politics -- Contemporary change: liberalization and epistemic modernization -- Conclusion.

The book is an extended study of the problem of consciousness. After setting up the problem, I argue that reductive explanation of consciousness is impossible , and that if one takes consciousness seriously, one has to go beyond a strict materialist framework. In the second half of the book, I move toward a positive theory of consciousness with fundamental laws linking the physical and the experiential in a systematic way. Finally, I use the ideas and arguments developed earlier to defend (...) a form of strong artificial intelligence and to analyze some problems in the foundations of quantum mechanics. (shrink)

In a response to my recent article in this journal, Shahram Shahryari argues that I fail to present a third position between absolutism and relativism. He makes two points: first, that fallibilism is insufficient as an alternative, because it is compatible with both relativism and absolutism. The second point is that my argument that experience can lead to objective judgment without being a new absolute fails. I discuss these in turn, showing that both critiques fail and that pragmatism is a (...) genuine alternative between absolutism and relativism. (shrink)

A collection of essays focusing on the relationship between concepts of the holy and the unholy in western European medieval culture. Demonstrates how religion, magic, and science were all modes of engagement with a natural world that was understood to be divinely created and infused with mysterious power"--Provided by publisher.

This book describes various Western musical ecologies of the cosmos developed from the ancient world to the present, ecologies that seek to define the creation and preservation of the universe through musical principles. The author explores centuries of musical treatises, hymns, and Western fiction.

I will present two examples of influential (and incorrect) interpretations of Poincaré, pinpointing their errors and documenting some of their diffusion. The first example, which appears to have been initiated by Moritz Schlick, is the widespread misinterpretation of Poincaré’s argument for geometric conventionalism by basing it on the underdetermination of theories in science. The second example, having to do with Poincaré’s claim that Euclidean and non-Euclidean geometries are inter-translatable, stems from Louis Rougier and was spread in the English language literature (...) by Max Black. I will then reflect on whether it is possible to avoid fragmentation in the interpretation of Poincaré, using Jeremy Gray’s admirable attempt at completeness in his intellectual biography of Poincaré as an example. Finally, I will propose one possible new direction for study of Poincaré that might enrich our view of him substantially by achieving a level of detail that has so far been lacking. (shrink)

[This is an edited version of a keynote talk at the conference on Neural Information Processing Systems (NeurIPS) on November 28, 2022, with some minor additions and subtractions.] -/- There has recently been widespread discussion of whether large language models might be sentient or conscious. Should we take this idea seriously? I will break down the strongest reasons for and against. Given mainstream assumptions in the science of consciousness, there are significant obstacles to consciousness in current models: for example, their (...) lack of recurrent processing, a global workspace, and unified agency. At the same time, it is quite possible that these obstacles will be overcome in the next decade or so. I conclude that while it is somewhat unlikely that current large language models are conscious, we should take seriously the possibility that successors to large language models may be conscious in the not-too-distant future. (shrink)

Through a philosophical lens, this book explores the powerful educational capabilities of classic psychedelics.

A short, reader-friendly introduction to a complex philosophical topic. One that encompasses not just philosophical and literary topics but technological ones as well.

Terra nova 2.0 -- The real problem -- Social contract 2.0 -- In the face of others -- Open-ended conclusions.

This book argues against the common view that there are no essential differences between Plato and the Neoplatonist philosopher, Plotinus, on the issues of mysticism, epistemology, and ethics. Beginning by examining the ways in which Plato and Plotinus claim that it is possible to have an ultimate experience that answers the most significant philosophical questions, David J. Yount provides an extended analysis of why we should interpret both philosophers as mystics. The book then moves on to demonstrate that both (...) philosophers share a belief in non-discursive knowledge and the methods to attain it, including dialectic and recollection, and shows that they do not essentially differ on any significant views on ethics. Making extensive use of primary and secondary sources, Plato and Plotinus on Mysticism, Epistemology and Ethics shows the similarities between the thought of these two philosophers on a variety of philosophical questions, such as meditation, divination, wisdom, knowledge, truth, happiness and love. (shrink)

Standing on the Shoulders of Darwin and Mendel: Early Views of Inheritance explores early theories about the mechanisms of inheritance. Beginning with Charles Darwin's now rejected Gemmule hypothesis, the book documents the reception of Gregor Mendel's work on peas and follows the work of early 20th century scholars. The research of Francis Galton, a cousin of Darwin, and the friction it caused between these two are a part of longer story of the development of genetics and an understanding of how (...) offspring inherit the characteristics of their parents. Bateson, Garrod, de Vries, Tschermak and others are all characters in a scientific story of discovery, acrimony, cooperation and revelation. (shrink)

For many years, researchers and practitioners have sought out meaningful indicators of sales performance. Yet, as the concept of performance has broadened, the understanding of what makes up a successful seller, has become far more complicated. The complexity of buyer-seller relationships has changed therefore as the definition of sales performance has expanded, cultivating a growing interest in ethical/unethical actions since they could potentially have impacts on sales performance. Given this environment, the purpose of this study is to explore the impact (...) of moral judgment on sales performance and sellers engaging in a customer-oriented selling approach. Specifically, by utilizing a sample of 345 business-to-business salespeople, this study examines the relationships between moral judgment, customer-oriented selling, and outcome and behavior based performance. Results, managerial implications, and opportunities for future research are provided. (shrink)

There is a long tradition in philosophy of using a priori methods to draw conclusions about what is possible and what is necessary, and often in turn to draw conclusions about matters of substantive metaphysics. Arguments like this typically have three steps: first an epistemic claim , from there to a modal claim , and from there to a metaphysical claim.

The philosophical interest of verbal disputes is twofold. First, they play a key role in philosophical method. Many philosophical disagreements are at least partly verbal, and almost every philosophical dispute has been diagnosed as verbal at some point. Here we can see the diagnosis of verbal disputes as a tool for philosophical progress. Second, they are interesting as a subject matter for first-order philosophy. Reflection on the existence and nature of verbal disputes can reveal something about the nature of concepts, (...) language, and meaning. In this article I first characterize verbal disputes, spell out a method for isolating and resolving them, and draw out conclusions for philosophical methodology. I then use the framework to draw out consequences in first-order philosophy. In particular, I argue that the analysis of verbal disputes can be used to support the existence of a distinctive sort of primitive concept and that it can be used to reconstruct a version of an analytic/synthetic distinction, where both are characterized in dialectical terms alone. (shrink)

Is conceptual analysis required for reductive explanation? If there is no a priori entailment from microphysical truths to phenomenal truths, does reductive explanation of the phenomenal fail? We say yes . Ned Block and Robert Stalnaker say no.

This chapter analyzes aspects of the relationship between consciousness and intentionality. It focuses on the phenomenal character and the intentional content of perceptual states, canvassing various possible relations among them. It argues that there is a good case for a sort of representationalism, although this may not take the form that its advocates often suggest. By mapping out some of the landscape, the chapter tries to open up territory for different and promising forms of representationalism to be explored in the (...) future. In particular, it argues for a nonreductive, narrow, and Fregean variety of representationalism, which contrasts strongly with more widely explored varieties. It concludes with some words about the fundamental relationship between consciousness and intentionality. (shrink)