In a recent issue of the Journal of Medicine and Philosophy, several scholars wrote on the topic of ethics expertise in clinical ethics consultation. The articles in this issue exemplified what we consider to be two troubling trends in the quest to articulate a unique expertise for clinical ethicists. The first trend, exemplified in the work of Lisa Rasmussen, is an attempt to define a role for clinical ethicists that denies they have ethics expertise. Rasmussen cites the dependence of ethical (...) expertise on irresolvable meta-ethical debates as the reason for this move. We argue against this deflationary strategy because it ends up smuggling in meta-ethical assumptions it claims to avoid. Specifically, we critique Rasmussen’s distinction between the ethical and normative features of clinical ethics cases. The second trend, exemplified in the work of Dien Ho, also attempts to avoid meta-ethics. However, unlike Rasmussen, Ho tries to articulate a notion of ethics expertise that does not rely upon meta-ethics. Specifically, we critique Ho’s attempts to explain how clinical ethicists can resolve moral disputes using what he calls the “Default Principle” and “arguments by parity.” We show that these strategies do not work unless those with the moral disagreement already share certain meta-ethical assumptions. Ultimately, we argue that the two trends of attempting to avoid meta-ethics by denying that clinical ethicists have ethics expertise, and attempting to articulate how ethics expertise can be used to resolve disputes without meta-ethics both fail because they do not, in fact, avoid doing meta-ethics. We conclude that these trends detract from what clinical ethics consultation was founded to do and ought to still be doing—provide moral guidance, which requires ethics expertise, and engagement with meta-ethics. To speak of ethicists without ethics expertise leaves their role in the clinic dangerously unclear and unjustified. (shrink)

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

Four experiments demonstrate category congruency priming by subliminal prime words that were never seen as targets in a valence-classification task and a gender-classification task . In Experiment 1, overlap in terms of word fragments of one or more letters between primes and targets of different valences was larger than between primes and targets of the same valence. In Experiments 2 and 3, the sets of prime words and target words were completely disjoint in terms of used letters. In Experiment 4, (...) pictures served as targets. The observed subliminal priming effects for novel primes cannot be driven by partial analysis of primes at the word-fragment level; they suggest instead that primes were processed semantically as whole words contingent upon prime duration. (shrink)

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

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

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

Responding to volatile criticisms frequently leveled at Leo Strauss and those he influenced, the prominent contributors to this volume demonstrate the profound influence that Strauss and his students have exerted on American liberal democracy and contemporary political thought. By stressing the enduring vitality of classic books and by articulating the theoretical and practical flaws of relativism and historicism, the contributors argue that Strauss and the Straussians have identified fundamental crises of modernity and liberal democracy.

In lieu of an abstract, here is a brief excerpt of the content:Epistemology and Environmental Philosophy:The Epistemic Significance of PlaceChristopher J. Preston (bio)IntroductionEnvironmental philosophy began its life as a series of investigations into the question of whether an ethic of the environment was necessary and possible. A good deal of interesting ink was spilled in this quest. But over time a vigorous community of inquirers has created a territory much more broad. Questions of politics and metaphysics, meta-ethics and aesthetics are (...) now staples of the discipline. The philosophies of science and technology, of biology and ecology, each now contain questions that belong to environmental philosophy. Continental thought in general and phenomenology in particular have both come to include major thinkers happy to call themselves environmental philosophers.Despite the significant current breadth of the field, there still remain a few philosophers that dismiss environmental philosophy. They do this because they think that the real business of philosophy resides far away from environmental concerns in Platonic and Cartesian questions about [End Page 1] knowledge, truth, and mind. This collection is an attempt to draw the attention of those few remaining skeptics by bringing the concerns of environmental philosophers into direct contact with epistemology and its cognates. Each of the following articles addresses relationships between knowledge, truth, and mind and the physical environments from which those central features of human life emerge. The physical environments that are the concerns of these authors include the flesh and blood physiologies, the rock and earth geographies, and the life and death ecologies out of which all knowledge claims ultimately emerge. These authors endeavor to contextualize epistemology relative to the material environments from which it issues. This task of environmentally contextualizing the life of the mind is one I have termed elsewhere the grounding of knowledge (Preston 2003).The articles that follow draw together threads that the careful observer might have already noticed in several areas of philosophy. This observer might have seen feminist epistemologists grounding knowledge not only in social contexts that include gender, race, and class, but also in physical contexts that include bodies and geographies (Haraway 1988, Harding 1998). She might have noticed laboratory theorists grounding scientific theories among the physical realities of the lab (Latour and Woolgar 1979, Knorr-Cetina 1992). She might also have read the work of philosophers of mind and cognitive scientists exploring how the mind seems often to rely upon embodied experience in external environments in the work it does (Johnson 1987, Clark 1997). She might have been captured by the texts of phenomenologists reporting how people perceive and experience from enfleshed and embedded locations (Casey 1993, Abram 1996). She would also, no doubt, be familiar with environmental philosophers admiring how Native American epistemologies take geography seriously, a process Sioux Indian Vine Deloria has called "thinking from a spatial point of view" (Deloria 1994). She might even have had her attention drawn to an area of perceptual studies known as ecological psychology promoting the radical idea that inner processes of perception are in fact more fruitfully studied by focusing on outer considerations such as animacy and environmental structure (Gibson 1979, Reed 1996). These quite radical departures from the traditional picture together suggest that what was previously thought to be located exclusively in the deep recesses of the human mind is in reality intricately woven into a number of external and environmental factors. [End Page 2] Environments can no longer be looked at as just incidentally relevant to epistemology. They are not just the scenes in which the making of a knowledge claim happens to take place. Physical environments can be in subtle but important ways partly constitutive of those claims.The grounding of knowledge that this collection proposes holds forth a number of promises. It promises, for example, to make epistemology more earth-bound and attentive to the ecologies in which it takes place. It promises to illuminate how the human mind and its activities do not so much distance us from the rest of nonhuman nature as demonstrate our connection with it through its very workings. Grounding knowledge also suggests a corrective to the disembodied epistemologies of Platonists and their heirs while simultaneously supplying another way for environmental philosophy to broaden its scope beyond ethics... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Epistemology and Environmental Philosophy:The Epistemic Significance of PlaceChristopher J. Preston (bio)IntroductionEnvironmental philosophy began its life as a series of investigations into the question of whether an ethic of the environment was necessary and possible. A good deal of interesting ink was spilled in this quest. But over time a vigorous community of inquirers has created a territory much more broad. Questions of politics and metaphysics, meta-ethics and aesthetics are (...) now staples of the discipline. The philosophies of science and technology, of biology and ecology, each now contain questions that belong to environmental philosophy. Continental thought in general and phenomenology in particular have both come to include major thinkers happy to call themselves environmental philosophers.Despite the significant current breadth of the field, there still remain a few philosophers that dismiss environmental philosophy. They do this because they think that the real business of philosophy resides far away from environmental concerns in Platonic and Cartesian questions about [End Page 1] knowledge, truth, and mind. This collection is an attempt to draw the attention of those few remaining skeptics by bringing the concerns of environmental philosophers into direct contact with epistemology and its cognates. Each of the following articles addresses relationships between knowledge, truth, and mind and the physical environments from which those central features of human life emerge. The physical environments that are the concerns of these authors include the flesh and blood physiologies, the rock and earth geographies, and the life and death ecologies out of which all knowledge claims ultimately emerge. These authors endeavor to contextualize epistemology relative to the material environments from which it issues. This task of environmentally contextualizing the life of the mind is one I have termed elsewhere the grounding of knowledge (Preston 2003).The articles that follow draw together threads that the careful observer might have already noticed in several areas of philosophy. This observer might have seen feminist epistemologists grounding knowledge not only in social contexts that include gender, race, and class, but also in physical contexts that include bodies and geographies (Haraway 1988, Harding 1998). She might have noticed laboratory theorists grounding scientific theories among the physical realities of the lab (Latour and Woolgar 1979, Knorr-Cetina 1992). She might also have read the work of philosophers of mind and cognitive scientists exploring how the mind seems often to rely upon embodied experience in external environments in the work it does (Johnson 1987, Clark 1997). She might have been captured by the texts of phenomenologists reporting how people perceive and experience from enfleshed and embedded locations (Casey 1993, Abram 1996). She would also, no doubt, be familiar with environmental philosophers admiring how Native American epistemologies take geography seriously, a process Sioux Indian Vine Deloria has called "thinking from a spatial point of view" (Deloria 1994). She might even have had her attention drawn to an area of perceptual studies known as ecological psychology promoting the radical idea that inner processes of perception are in fact more fruitfully studied by focusing on outer considerations such as animacy and environmental structure (Gibson 1979, Reed 1996). These quite radical departures from the traditional picture together suggest that what was previously thought to be located exclusively in the deep recesses of the human mind is in reality intricately woven into a number of external and environmental factors. [End Page 2] Environments can no longer be looked at as just incidentally relevant to epistemology. They are not just the scenes in which the making of a knowledge claim happens to take place. Physical environments can be in subtle but important ways partly constitutive of those claims.The grounding of knowledge that this collection proposes holds forth a number of promises. It promises, for example, to make epistemology more earth-bound and attentive to the ecologies in which it takes place. It promises to illuminate how the human mind and its activities do not so much distance us from the rest of nonhuman nature as demonstrate our connection with it through its very workings. Grounding knowledge also suggests a corrective to the disembodied epistemologies of Platonists and their heirs while simultaneously supplying another way for environmental philosophy to broaden its scope beyond ethics... (shrink)

In Abram Brummett and Erica K. Salter's excellent paper, “Mapping the Moral Terrain of Clinical Deception,” they rightly note that it is sometimes ethically appropriate for health care professionals to deceive patients and families. However, they also note that because doing so violates a prima facie duty of honesty, the ethical burden of proof falls upon the deceiver. Hence, they also provide a sophisticated framework for determining whether any given case is warranted. I applaud their overall approach but also (...) critique some of their claims, in particular, their conclusion that lies of commission require greater justification than those of omission and their conflation of the principles of beneficence and nonmaleficence. I also urge them to give greater attention to how power asymmetries should be accounted for and to the impact such deceptive choices might have on the clinician's character. (shrink)

In Minimal Rationality, Christopher Cherniak boldly challenges the myth of Man the the Rational Animal and the central role that the "perfectly rational...

Lucid, non-intimidating presentation of propositional logic, propositional calculus and predicate logic by Russian scholar. Topics of concern in a variety of fields, including computer science, systems analysis, linguistics, etc. Accessible to high school students; valuable review of fundamentals for professionals. Exercises (no solutions). Preface. Three appendices. Indices. Bibliogaphy. 14 figures.

In a recent paper in Psychological Science, Kouider and Dupoux reported obtaining unconscious Stroop priming only when subjects had partial awareness of the masked distractor words . Kouider and Dupoux conjectured that semantic priming occurs only when such partial awareness is present. The present experiments tested this conjecture in an affective categorization priming task that differed from Kouider and Dupoux’s in using masked distractors that subjects had practiced earlier as visible words. Experiment 1 showed priming from practiced words when subjects (...) had no partial awareness of those words. Experiment 2 showed that, in the absence of partial awareness, practiced words yielded priming but not-practiced words did not. Experiment 3 corroborated Experiment 1 and 2s results using a different test of partial awareness. These results suggest that unconscious processing of subword elements drives masked semantic priming by practiced words. (shrink)

Citizens have two mutually exclusive options: they can exile, or even execute, a god among men, or they can submit to superhuman monarchy. Aristotle thinks any state would choose the former, but finds the latter option superior and argues the citizenry should submit to the superhuman monarch because that is precisely what ideal citizens would do if such a being appeared in their society. This problem appears in great cinema and nowhere more powerfully than in J. J. Abrams's Star Trek (...) and Star Trek Into Darkness with the character of James T. Kirk. In his Nicomachean Ethics, Aristotle describes a man he calls the megalopsychos, the great‐souled man or proud man. Aristotle defines the two solutions to the problem of greatness, exile or monarchic rule, as mutually exclusive, but Kirk is able to progress from exile on Delta Vega to the captain's chair, the former seeming necessary for the latter. (shrink)

Au Centre Pompidou-Metz, faisant écho à l'exposition inaugurale, un colloque international a étudié de manière pluridisciplinaire et transversale la question du chef-d'œuvre. Loin de se focaliser sur le débat esthétique, les diverses approches ont assigné le droit, l'histoire, la sociologie, l'économie et les sciences exactes, pour mieux soumettre cet "objet" à un véritable examen clinique. Cette question ne serait-elle plus d'actualité? Loin s'en faut! Entre cœur et raison, la sacralisation des œuvres d'art produit toujours autant de savoirs, de savoir-faire et (...) de savoirs sur le faire. Mettant en avant le patrimoine, restaurant les objets de l'art, les reconstituant, favorisant le tourisme culturel, exhumant le vrai, condamnant le faux : à sa mesure, le "chef-œuvre" dynamise encore et toujours les divers moments de l'art. (shrink)

This chapter contains section titled: “A Holdover from the Cylon Wars” The Resurrection Ship The Limit on Cylon Intelligence “The Cylons Send No One” “The Shape of Things to Come” Notes.

Our aim in this article is to bring some clarity to the clinical ethics expertise debate by critiquing and replacing the taxonomy offered by the Core Competencies report. The orienting question for our taxonomy is: Can clinical ethicists offer justified, normative recommendations for active patient cases? Views that answer “no” are characterized as a “negative” view of clinical ethics expertise and are further differentiated based on (a) why they think ethicists cannot give justified normative recommendations and (b) what they think (...) ethicists can offer, if they cannot offer recommendations. Views that answer “yes” to the orienting question are characterized as a “positive” view of clinical ethics expertise. Positive views are distinguished according to four additional questions. First (P1), how are those recommendations generated? Second (P2), what is the nature of the recommendations? Third (P3), we ask, how are the recommendations justified? And finally (P4), how are the recommendations communicated? (shrink)

The coherence objection to the doctrine of the Incarnation maintains that it is impossible for one individual to have both the attributes of God and the attributes of a human being. This article examines Thomas Aquinas’s answer to this objection. I challenge the dominant, mereological interpretation of Aquinas’s position and, in light of this challenge, develop and defend a new alternative interpretation of Aquinas’s response to this important objection to Christian doctrine.

Assertion is the central vehicle for the sharing of knowledge. Whether knowledge is shared successfully often depends on the quality of assertions: good assertions lead to successful knowledge sharing, while bad ones don't. In Sharing Knowledge, Christoph Kelp and Mona Simion investigate the relation between knowledge sharing and assertion, and develop an account of what it is to assert well. More specifically, they argue that the function of assertion is to share knowledge with others. It is this function that supports (...) a central norm of assertion according to which a good assertion is one that has the disposition to generate knowledge in others. The book uses this functionalist approach to motivate further norms of assertion on both the speaker and the hearer side and investigates ramifications of this view for other questions about assertion. (shrink)

Moral pluralism poses a foundational problem for secular clinical ethics: How can ethical dilemmas be resolved in a context where there is disagreement not only on particular cases, but further, on...

The ethics of autonomous cars and automated driving have been a subject of discussion in research for a number of years :28–58, 2016). As levels of automation progress, with partially automated driving already becoming standard in new cars from a number of manufacturers, the question of ethical and legal standards becomes virulent. For exam-ple, while automated and autonomous cars, being equipped with appropriate detection sensors, processors, and intelligent mapping material, have a chance of being much safer than human-driven cars in (...) many regards, situations will arise in which accidents cannot be completely avoided. Such situations will have to be dealt with when programming the software of these vehicles. In several instances, internationally, regulations have been passed, based on legal considerations of road safety, mostly. However, to date, there have been few, if any, cases of a broader ethics code for autonomous or automated driving preceding actual regulation and being based on a broadly composed ethics committee of independent experts. In July 2016, the German Federal Minister of Transport and Digital Infrastructure, Alexander Dobrindt, appointed a national ethics committee for automated and connected driving, which began its work in September 2016. In June 2017, this committee presented a code of ethics which was published in German and in English. It consists of 20 ethical guidelines. Having been a member of this committee, I will present the main ethical topics of these guidelines and the discussions that lay behind them. (shrink)

In this essay, I argue that a proper understanding of the historicity of love requires an appreciation of the irreplaceability of the beloved. I do this through a consideration of ideas that were first put forward by Robert Kraut in “Love De Re” (1986). I also evaluate Amelie Rorty's criticisms of Kraut's thesis in “The Historicity of Psychological Attitudes: Love is Not Love Which Alters Not When It Alteration Finds” (1986). I argue that Rorty fundamentally misunderstands Kraut's Kripkean analogy, and (...) I go on to criticize her claim that concern over the proper object of love should be best understood as a concern over constancy. This leads me to an elaboration of the distinct senses in which love can be seen as historical. I end with a further defense of the irreplaceability of the beloved and a discussion of the relevance of recent debates over the importance of personal identity for an adequate account of the historical dimension of love. (shrink)

This handbook article gives a critical overview of recent discussions of epistemic authority. It favors an account that brings into balance the dictates of rational deference with the ideals of intellectual self-governance. A plausible starting point is the conjecture that neither should rational deference to authorities collapse into total epistemic submission, nor the ideal of mature intellectual self-governance be conflated with (illusions of) epistemic autarky.

What is the proper role of a clinical ethics consultant’s religious beliefs in forming recommendations for clinical ethics consultation? Where Janet Malek has argued that religious belief should have no influence on the formation of a CEC’s recommendations, Clint Parker has argued a CEC should freely appeal to all their background beliefs, including religious beliefs, in formulating their recommendations. In this paper, I critique both their views by arguing the position envisioned by Malek puts the CEC too far from religion (...) and the position envisioned by Parker puts the CEC too close. For a CEC to give recommendations about what is morally prohibited, permissible, or obligatory in the clinic, I propose a view of the CEC that is neither religious nor non-religious but quasi-religious. I argue that a quasi-religious approach avoids the problems of both religious and non-religious views while preserving their benefits. Additionally, a quasi-religious view resists the marginalization of “religious” traditions that occurs when secular ethicists come to think of their approach as somehow distinctly non-religious. (shrink)

This paper is divided into three sections. The first presents some examples of the killing/letting die distinction. The second draws a further distinction between what I call negative and positive cases of acting or refraining. Here I argue that the moral significance of the acting/refraining distinction is different for positive and for negative cases. In the third section I apply the above distinction to euthanasia, and argue that mercy killing should be regarded as analogous to positive rather than negative cases. (...) On the basis of this, I then support active rather than passive euthanasia. (shrink)

Descartes’s arguments about the certainty of mathematics in the Rules for the Direction of the Mind cannot be understood independently of his attack on the authority of ancient authors. The author maintains this view by reading Descartes’s claims about mathematics through the lens of status theory, a framework for disputation revived by Renaissance dialecticians. Within status theory, “certainty” was closely associated with consensus. The essay shows how Descartes used status to attack the authority of the ancient authors and elevate mathematics (...) as an alternative. Descartes’s arguments about the certainty of mathematics are colored by his effort to make mathematics satisfy the demands of status-based disputation. Specifically, in order to elevate the status of mathematics, Descartes portrayed it as more common—prone to consensus—than he really believed it was. (shrink)