Many patients believe that cardiopulmonary resuscitation is more likely to be successful than it really is in clinical practice. Even when working with accurate information, some nevertheless remain resolute in demanding maximal treatment. They maintain that even if survival after cardiac arrest with CPR is extremely low, the fact remains that it is still greater than the probability of survival after cardiac arrest without CPR. Without realising it, this line of reasoning is strikingly similar to Pascal’s Wager, a Renaissance-era argument (...) for accepting the proposition for God’s existence. But while the original argument is quite logical—if not universally compelling—the modern variant makes several erroneous assumptions. The authors here present a case of a patient who unwittingly appeals to Pascal’s Wager to explain his request for maximal treatment, in order to highlight the crucial divergences from the original Wager. In understanding the faulty assumptions inherent in the application of Pascal’s Wager to code status decisions—and identifying the underlying motivations which the Wager serves to confirm—providers can better ensure that the true values and preferences of patients are upheld. (shrink)

_Explores the ancient and perennial notion of the four elements as environmental ideas._.

Clinical simulation using standardized patients has become standard in medical education—and is now being incorporated into some graduate programs in bioethics—for both formative and summative evaluation. In most hospitals, though, clinical ethics consultation is done by the ethics committee (or a subset of it). This study is the first, to our knowledge, to examine the effectiveness of standardized patient simulation in training hospital ethics committees to deal with ethically complex and emotionally fraught clinical situations. Following a substantial revision of the (...) institution’s nonbeneficial treatment policy, ethics committee members underwent a simulation to determine whether a specific requested treatment should be withheld on the basis of futility. Pre- and postintervention surveys showed improvement in all domains, although the small sample size limited the power of the study, with only one measure showing a statistically significant difference. An interesting incidental finding was that one-quarter of committee members voted against a determination of futility, even though the case clearly met the definition set forth in the policy. This highlights the emotional challenges in implementing an ethically rigorous, unanimously accepted policy that ultimately determines the timing and manner of a patient’s death. (shrink)

Philosophers, Henri Bergson once observed, "seem to philosophize as if they were sealed in the privacy of their study and did not live on a planet surrounded by the vast organic world of animals, plants, insects, and protozoa." Providing a solid overview of ecological philosophy and original insights into this developing field, Minding Nature focuses on some of the most influential thinkers who, in fact, have emphasized our natural relations to the earth, our social creations, and each other. Combining philosophy, (...) ecology, and political theory, chapters thoroughly examine, critique, and build upon the ideas of such luminaries as Thomas Hobbes, Martin Heidegger, Ernst Bloch, Hannah Arendt, Herbert Marcuse, Barry Commoner, Rachel Carson, and Jurgen Habermas, among others. Each thinker considered has contributed significantly to both contemporary discussion and historical understanding of political, epistemological, or social aspects related to nature and, with several exceptions, stimulated constructive dialogue within progressive, democratic, and radical left circles. By challenging the notion that conservation is inherently politically conservative or that our oikos (home) must be rendered uniformly economic where ecology is concerned, they enable us to rethink the possibility of creating a more democratic and ecological society. (shrink)

This paper examines some of the key ways in which water is mediated by technology and human artifacts. I show how the modes in which we conceive and experience this vital fluid are affected deeply by the techniques and instruments we use to interact with it. I argue that a notion of the domestication of water enables us to better grasp our relations with the environment given that vast volumes of water are now neither completely natural nor artificial in the (...) conventional senses of the terms. Instead, water is often filtered through an expansive technological network that not merely changes its flows and phenomenal forms but greatly alters or multiplies its meanings. As examples of this process, I investigate the practical engagement with water by the first Western philosopher; the construction of several large hydrological projects; efforts at river management in the aesthetic landscape; and the emergence of bottled water. (shrink)

The sky proclaimed Emerson is “the daily bread of the eyes.” Despite the apparent truth of this observation, we often fail to appreciate the complex canopy of air above and around us in considerations of environmental aesthetics and ecological awareness. I examine the sky and aerial phenomena that are bound to, closely allied with, or materially emergent from, this ocean of blue. In the process, I develop a perspective for thinking about some of the aesthetic characteristics and dimensions of this (...) realm. I show that understanding and appreciating the sky must attend to features related to ephemerality, protean colors, the lack of aclear and definite frame, and other non-anthropogenic qualities. I pay particular attention to explorations of horizontally-mobile clouds and, for the sake of contrast, vertically-originating snow by painters, poets, and philosophers who are able to express imaginative components of these phenomena and to reveal or vivify aspects that complement or complete the more realistic descriptions provided by natural scientists. The always-accessible and ever-fluctuating beauty of the sky offers the potential for deepening our daily experiences of and encounters with the elemental world in which we are sensually immersed and physicallyembedded. It also helps to offer an indirect rationale for respecting and protecting this vital other-than-human sphere. (shrink)

The sky proclaimed Emerson is “the daily bread of the eyes.” Despite the apparent truth of this observation, we often fail to appreciate the complex canopy of air above and around us in considerations of environmental aesthetics and ecological awareness. I examine the sky and aerial phenomena that are bound to, closely allied with, or materially emergent from, this ocean of blue. In the process, I develop a perspective for thinking about some of the aesthetic characteristics and dimensions of this (...) realm. I show that understanding and appreciating the sky must attend to features related to ephemerality, protean colors, the lack of aclear and definite frame, and other non-anthropogenic qualities. I pay particular attention to explorations of horizontally-mobile clouds and, for the sake of contrast, vertically-originating snow by painters, poets, and philosophers who are able to express imaginative components of these phenomena and to reveal or vivify aspects that complement or complete the more realistic descriptions provided by natural scientists. The always-accessible and ever-fluctuating beauty of the sky offers the potential for deepening our daily experiences of and encounters with the elemental world in which we are sensually immersed and physicallyembedded. It also helps to offer an indirect rationale for respecting and protecting this vital other-than-human sphere. (shrink)

I examine the kindred phenomena of shadows and night in order to reveal their significance for better understanding our lifeworld and the elemental environment. I first describe how light is primary to ecological perception and how it conditions our conceptions of space, truth, and beauty. Light and darkness are involved in a dialectical relationship rather than conceived as polar opposites. Borne of the interplay of both realms, shadows have been disparaged historically and deserve to be reconsidered for their aesthetic appearance (...) and their relevance to an ecology and anthropology of perception. Night, in turn, is often marked by a negative ontology that points toward the possibility of a kind of elemental a priori, but it is important to characterize darkness in terms of its subtle shades and filtering by way of the creative matrix of the human imagination. Seeing the night in novel and unexpected ways, especially via the insights and descriptions of phenomenologists, poets, and artists, enables us to grasp the depth and atmosphere of the surrounding world and to light up our geographical perspectives, our philosophical visions, and our environmental awareness. (shrink)

I examine the ancient and perennial notion of the elements (stoicheia) and its relation to an idea of place proper (topos) and natural place (topos oikeios) in Aristotle's work. Through an exploration of his accounts, I argue that Aristotle develops a robust theory of place that is relevant to current environmental and geographical thought. In the process, he provides a domestic household and home for earth, air, fire and water that offers a supplement or an alternative to more abstract and (...) controversial uses of a conception of 'nature' (physis). I identify and elaborate upon environmental aspects of place-based and elemental philosophy. (shrink)

The study of landscape and place has become an increasingly fertile realm of inquiry in the humanities and social sciences. In this new book of essays, selected from presentations at the first annual meeting of the Society for Philosophy and Geography, scholars investigate the experiences and meanings that inscribe urban and suburban landscapes. Gary Backhaus and John Murungi bring philosophy and geography into a dialogue with a host of other disciplines to explore a fundamental dialectic: while our collective and personal (...) activity modifies the landscape, in turn, the landscape modifies human identities, and social and environmental relations. Whether proposing a peripatetic politics, conducting a sociological analysis of building security systems, or critically examining the formation of New York City's municipal parks, each essay sheds distinctive light on this fascinating and engaging aspect of contemporary environmental studies. (shrink)

A comprehensive analysis of ethical topics in palliative care, combining clinical experience and philosophical rigor. A broad array of topics are explored from historical, legal, clinical, and ethical perspectives, offering both the seasoned clinician and interested lay reader a thorough examination of the complex ethical issues facing patients suffering from life-threatening illness.

The semantic paradoxes are often associated with self-reference or referential circularity. Yablo (Analysis 53(4):251–252, 1993), however, has shown that there are infinitary versions of the paradoxes that do not involve this form of circularity. It remains an open question what relations of reference between collections of sentences afford the structure necessary for paradoxicality. In this essay, we lay the groundwork for a general investigation into the nature of reference structures that support the semantic paradoxes and the semantic hypodoxes. We develop (...) a functionally complete infinitary propositional language endowed with a denotation assignment and extract the reference structural information in terms of graph-theoretic properties. We introduce the new concepts of dangerous and precarious reference graphs, which allows us to rigorously define the task: classify the dangerous and precarious directed graphs purely in terms of their graph-theoretic properties. Ungroundedness will be shown to fully characterize the precarious reference graphs and fully characterize the dangerous finite graphs. We prove that an undirected graph has a dangerous orientation if and only if it contains a cycle, providing some support for the traditional idea that cyclic structure is required for paradoxicality. This leaves the task of classifying danger for infinite acyclic reference graphs. We provide some compactness results, which give further necessary conditions on danger in infinite graphs, which in conjunction with a notion of self-containment allows us to prove that dangerous acyclic graphs must have infinitely many vertices with infinite out-degree. But a full characterization of danger remains an open question. In the appendices we relate our results to the results given in Cook (J Symb Log 69(3):767–774, 2004) and Yablo (2006) with respect to more restricted sentences systems, which we call $\mathcal{F}$ -systems. (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.

As the population in the United States gets older, more people suffer from dementia, which often causes neuropsychiatric symptoms such as agitation and paranoia. This can lead patients to refuse medications, prompting consideration of covert administration (that is, concealing medication in food or drink). While many condemn this practice as paternalistic, deceptive, and potentially harmful, the end result of assuming the “moral high ground” can be increased suffering for patients and families. This article addresses common criticisms of covert medication and (...) presents a detailed algorithm by which to determine whether the practice is ethically permissible in specific cases. It also explores why so little attention has been paid in the U.S. to this presumably common practice, and reviews professional statements from Europe that endorse the practice. Finally, it presents a compelling argument for the role of Ulysses clauses in advance care planning, not only for patients with psychiatric illness but also for those who may suffer from dementia, which is far more common. (shrink)

A leading political theorist’s groundbreaking defense of ideal conceptions of justice in political philosophy Throughout the history of political philosophy and politics, there has been continual debate about the roles of idealism versus realism. For contemporary political philosophy, this debate manifests in notions of ideal theory versus nonideal theory. Nonideal thinkers shift their focus from theorizing about full social justice, asking instead which feasible institutional and political changes would make a society more just. Ideal thinkers, on the other hand, question (...) whether full justice is a standard that any society is likely ever to satisfy. And, if social justice is unrealistic, are attempts to understand it without value or importance, and merely utopian? Utopophobia argues against thinking that justice must be realistic, or that understanding justice is only valuable if it can be realized. David Estlund does not offer a particular theory of justice, nor does he assert that justice is indeed unrealizable—only that it could be, and this possibility upsets common ways of proceeding in political thought. Estlund engages critically with important strands in traditional and contemporary political philosophy that assume a sound theory of justice has the overriding, defining task of contributing practical guidance toward greater social justice. Along the way, he counters several tempting perspectives, including the view that inquiry in political philosophy could have significant value only as a guide to practical political action, and that understanding true justice would necessarily have practical value, at least as an ideal arrangement to be approximated. Demonstrating that unrealistic standards of justice can be both sound and valuable to understand, Utopophobia stands as a trenchant defense of ideal theory in political philosophy. (shrink)

David Hume's Enquiry concerning Human Understanding is the definitive statement of the greatest philosopher in the English language. His arguments in support of reasoning from experience, and against the "sophistry and illusion"of religiously inspired philosophical fantasies, caused controversy in the eighteenth century and are strikingly relevant today, when faith and science continue to clash. The Enquiry considers the origin and processes of human thought, reaching the stark conclusion that we can have no ultimate understanding of the physical world, or (...) indeed our own minds. In either sphere we must depend on instinctive learning from experience, recognizing our animal nature and the limits of reason. Hume's calm and open-minded skepticism thus aims to provide a new basis for science, liberating us from the "superstition" of false metaphysics and religion. His Enquiry remains one of the best introductions to the study of philosophy, and his edition places it in its historical and philosophical context. (shrink)

The zetetic turn in epistemology raises three questions about epistemic and zetetic norms. First, there is the relationship question: what is the relationship between epistemic and zetetic norms? Are some epistemic norms zetetic norms, or are epistemic and zetetic norms distinct? Second, there is the tension question: are traditional epistemic norms in tension with plausible zetetic norms? Third, there is the reaction question: how should theorists react to a tension between epistemic and zetetic norms? Drawing on an analogy to practical (...) philosophy, I develop a focal point view to resolve these motivating questions. On the focal point view, traditional epistemic norms and zetetic norms answer different types of normative questions. There is nevertheless a familiar type of evaluative tension between traditional epistemic norms and zetetic norms, but this tension is an unavoidable feature of the normative landscape and not a sign that traditional epistemic norms need revision. But if traditional epistemic norms are not zetetic norms, then in what sense is zetetic epistemology a project for epistemologists? I conclude by articulating a sense in which some nontraditional epistemic norms are zetetic norms, and in which zetetic epistemology is an important part of the study of theoretical rationality. (shrink)

By means of an example, shows the possibility of beliefs that are separately rational whilst together inconsistent.

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)

This book is an attempt to get to the bottom of an acute and perennial tension between our best scientific pictures of the fundamental physical structure of the world and our everyday empirical experience of it. The trouble is about the direction of time. The situation (very briefly) is that it is a consequence of almost every one of those fundamental scientific pictures--and that it is at the same time radically at odds with our common sense--that whatever can happen can (...) just as naturally happen backwards. Albert provides an unprecedentedly clear, lively, and systematic new account--in the context of a Newtonian-Mechanical picture of the world--of the ultimate origins of the statistical regularities we see around us, of the temporal irreversibility of the Second Law of Thermodynamics, of the asymmetries in our epistemic access to the past and the future, and of our conviction that by acting now we can affect the future but not the past. Then, in the final section of the book, he generalizes the Newtonian picture to the quantum-mechanical case and (most interestingly) suggests a very deep potential connection between the problem of the direction of time and the quantum-mechanical measurement problem. The book aims to be both an original contribution to the present scientific and philosophical understanding of these matters at the most advanced level, and something in the nature of an elementary textbook on the subject accessible to interested high-school students. Table of Contents: Preface 1. Time-Reversal Invariance 2. Thermodynamics 3. Statistical Mechanics 4. The Reversibility Objections and the Past-Hypothesis 5. The Scope of Thermodynamics 6. The Asymmetries of Knowledge and Intervention 7. Quantum Mechanics Appendix: Gedankenexperiments with Heat Engines Index Reviews of this book: The foundations of statistical mechanisms are often presented in physics textbooks in a rather obscure and confused way. By challenging common ways of thinking about this subject, Time and Chance can do quite a lot to improve this situation. --Jean Bricmont, Science Albert is perfecting a style of foundational analysis that is uniquely his own...It has a surgical precision...and it is ruthless with pretensions. The foundations of thermodynamics is a topic that has accumulated a good deal of dead wood; this is a fire that will burn and burn. --Simon W. Saunders, Oxford University As usual with Albert's work, the exposition is brisk and to the point, and exceptionally clear...The book will be an extremely valuable contribution to the literature on the subject of philosophical issues in thermodynamics and statistical mechanics, a literature which has been thin on the ground but is now growing as it deserves to. --Lawrence Sklar, University of Michigan. (shrink)

How should one react when one has a belief, but knows that other people—who have roughly the same evidence as one has, and seem roughly as likely to react to it correctly—disagree? This paper argues that the disagreement of other competent inquirers often requires one to be much less confident in one’s opinions than one would otherwise be.

For all of the emphasis on quality improvement—as well as the acknowledged overlap between assessment of the quality of healthcare services and clinical ethics—the quality of clinical ethics consultation has received scant attention, especially in terms of empirical measurement. Recognizing this need, the second edition of Core Competencies for Health Care Ethics Consultation identified four domains of ethics quality: (1) ethicality, (2) stakeholders’ satisfaction, (3) resolution of the presenting conflict/dilemma, and (4) education that translates into knowledge. This study is the (...) first, to our knowledge, to directly measure all of these domains. Here we describe the quality improvement process undertaken at a tertiary care academic medical center, as well as the tools developed to measure the quality of ethics consultation, which include post-consultation satisfaction surveys and weekly case conferences. The information gained through these tools helps to improve not only the process of ethics consultation, but also the measurement and assurance of quality. (shrink)

I attempt to get as clear as possible on the chain of reasoning by which irreversible macrodynamics is derivable from time-reversible microphysics, and in particular to clarify just what kinds of assumptions about the initial state of the universe, and about the nature of the microdynamics, are needed in these derivations. I conclude that while a “Past Hypothesis” about the early Universe does seem necessary to carry out such derivations, that Hypothesis is not correctly understood as a constraint on the (...) early Universe’s entropy. (shrink)

We start by presenting three different views that jointly imply that every person has many conscious beings in their immediate vicinity, and that the number greatly varies from person to person. We then present and assess an argument to the conclusion that how confident someone should be in these views should sensitively depend on how massive they happen to be. According to the argument, sometimes irreducibly de se observations can be powerful evidence for or against believing in metaphysical theories.

Worries about mental causation are prominent in contemporary discussions of the mind and human agency. Originally, the problem of mental causation was that of understanding how a mental substance (thought to be immaterial) could interact with a material substance, a body. Most philosophers nowadays repudiate immaterial minds, but the problem of mental causation has not gone away. Instead, focus has shifted to mental properties. How could mental properties be causally relevant to bodily behavior? How could something mental qua mental cause (...) what it does? After looking at the traditional Problem of Interaction, we survey various versions of the property-based problem and look at proposed solutions to them. (shrink)

Unprecedented advances in medicine, genetic engineering, and demographic forecasting raise new questions that strain the categories and assumptions of traditional ethical theories. Heyd's approach resolves many paradoxes in intergenerational justice, while offering a major test case for the profound problems of the limits of ethics and the nature of value. This title is part of UC Press's Voices Revived program, which commemorates University of California Press’s mission to seek out and cultivate the brightest minds and give them voice, reach, and (...) impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1992. (shrink)

Our aim in this entry is to articulate the state of the art in the moral psychology of personal identity. We begin by discussing the major philosophical theories of personal identity, including their shortcomings. We then turn to recent psychological work on personal identity and the self, investigations that often illuminate our person-related normative concerns. We conclude by discussing the implications of this psychological work for some contemporary philosophical theories and suggesting fruitful areas for future work on personal identity.