Patient autonomy, as exercised in the informed consent process, is a central concern in bioethics. The typical bioethicist's analysis of autonomy centers on decisional capacity—finding the line between autonomy and its absence. This approach leaves unexplored the structure of reasoning behind patient treatment decisions. To counter that approach, we present a microeconomic theory of patient decision-making regarding the acceptable level of medical treatment from the patient's perspective. We show that a rational patient's desired treatment level typically departs from the level (...) yielding an absence of symptoms, the level we call ideal. This microeconomic theory demonstrates why patients have good reason not to pursue treatment to the point of absence of physical symptoms. We defend our view against possible objections that it is unrealistic and that it fails to adequately consider harm a patient may suffer by curtailing treatment. Our analysis is fruitful in various ways. It shows why decisions often considered unreasonable might be fully reasonable. It offers a theoretical account of how physician misinformation may adversely affect a patient's decision. It shows how billing costs influence patient decision-making. It indicates that health care professionals' beliefs about the ‘unreasonable’ attitudes of patients might often be wrong. It provides a better understanding of patient rationality that should help to ensure fuller information as well as increased respect for patient decision-making. (shrink)

Volume 19, Issue 11, November 2019, Page 78-80.

Patient noncompliance with physician prescriptions, especially in nonsymptomatic chronic diseases, is frequently characterized in the literature as harmful and economically costly (Miller 1997).1 Nancy Houston Miller views patient noncompliance as harmful because noncompliance can result in continued or new health problems leading to hospital admissions. Further, she places the annual monetary cost of noncompliance at $100 billion.Patient noncompliance with prescribed treatment is considered the least understood form of health behavior (Coons 2001). Despite the plethora of attention in journal articles, the (...) issue of noncompliance remains unresolved even in terms of understanding the main correlates to .. (shrink)

Sallust used Fortuna to. give his story specialized political meaning and to incorporate materials and judgments that extend the purview of his narrative to all of Roman history. Fortuna is a configuration of events that appears at certain moments in a state's existence and presents demands for careful application of intelligence, virtus, animus or ingenium, if things are to proceed well and a new era is to begin . If virtus is not present, fortuna rages and destroys . Admirable men (...) seek gloria through virtus, but also require an historian to reconstruct actions. Fortuna offers men of leisure the opportunity to apply intelligence to a course of events and to write and therefore to create history in a secondary but more lasting sense. (shrink)

The case of Twin B involves the decision to send a newborn to a less intensive Level 2 special care nursery (SCN) than to the Level 3 neonatal intensive care unit (NICU) that is considered optimal by the physician. The physician’s acceptance of the transfer is against the child’s best interest and is due to parental convenience. In analyzing the case, we reject the best interest standard. Our rejection is partly supported by the views of Douglas Diekema, John Hardwig, (...) and Lannie Ross. Instead of the best interest standard, we offer and defend an approach we base on a microeconomic analysis of externalities, such as those involved with automobile emissions. This extends our previously presented general microeconomic approach to patient decision-making. It provides a clearer way to evaluate situations, like those of Twin B, in which burdens faced by family members may be used to determine the appropriate level of treatment for a decisionally incapable patient. (shrink)

Each contributor to this book has used personal experience as the basis from which to frame his individual sociological perspectives. Because they have personalized their work, their accounts are real, and recognizable as having come from 'real' persons, about 'real' experiences. There are no objectively-distanced disembodied third person entities in these accounts. These writers are actual people whose stories will make you laugh, cry, think, and want to know more.

Researchers designing a clinical trial may be aware of disputed evidence of serious risks from previous studies. These researchers must decide whether and how to describe these risks in their model informed consent document. They have an ethical obligation to provide fully informed consent, but does this obligation include notice of controversial evidence? With ACCORD as an example, we describe a framework and criteria that make clear the conditions requiring inclusion of important controversial risks. The ACCORD model consent document did (...) not include notice of prior trials with excess death. We develop and explain a new standard labeled risk in equipoise. We argue that our approach provides an optimal level of integrity to protect the informational needs of the reasonable volunteers who agree to participate in clinical trials. We suggest language to be used in a model consent document and the informed consent discussion when such controversial evidence exists. (shrink)

This article is about the history of logic in Australia. Douglas Gasking (1911?1994) undertook to translate the logical terminology of John Anderson (1893?1962) into that of Ludwig Wittgenstein's (1921) Tractatus. At the time Gilbert Ryle (1900?1976), and more recently David Armstrong, recommended the result to students; but it is reasonable to have misgivings about Gasking as a guide to either Anderson or Wittgenstein. The historical interest of the debate Gasking initiated is that it yielded surprisingly little information about Anderson's (...) traditional (syllogistic or Aristotelian) logic and its relation to classical (first-order predicate or Russellian) logic, the ostensible topic; but the materials now exist to interpret Anderson's logic in classical logic, possibly as an algebra of classes. This would be of little interest to contemporary logicians, but it might shed some light on Anderson's philosophy. (shrink)

Douglas McDermid presents a study of the remarkable flourishing of Scottish philosophy from the 18th to the mid-19th century. He examines how Kames, Reid, Stewart, Hamilton, and Ferrier gave illuminating treatments of the central philosophical problem of the existence of a material world independently of perception and thought.

Stewart and Korol (“De-Signing Fat,” International Journal of Applied Philosophy 23.2 [2009]) contend that obesity is benign. In support of their position they have focussed on selected papers that do not take into consideration key realities. Their attempt to minimise the impact of obesity appears to centre on how difficult it can be to lose weight by diet alone (and its risks) and problems with measurements of obesity, while failing to acknowledge the specific and well-documented impact of deleterious biochemical (...) alterations arising from central obesity. Stewart and Korol also do not point out the considerable controversy with the fat but fit (metabolically healthy obesity [MHO]) concept. Whether looping from above or below, nothing changes the biochemical realities of central obesity. Above all, Stewart and Korol never once mention the benefits of obesity prevention, rather focussing on the difficulties of losing weight. Thus, respectfully, a word of caution is put forward on the views of Stewart and Korol regarding obesity. (shrink)

Stewart and Korol contend that obesity is benign. In support of their position they have focussed on selected papers that do not take into consideration key realities. Their attempt to minimise the impact of obesity appears to centre on how difficult it can be to lose weight by diet alone and problems with measurements of obesity, while failing to acknowledge the specific and well-documented impact of deleterious biochemical alterations arising from central obesity. Stewart and Korol also do not (...) point out the considerable controversy with the fat but fit concept. Whether looping from above or below, nothing changes the biochemical realities of central obesity. Above all, Stewart and Korol never once mention the benefits of obesity prevention, rather focussing on the difficulties of losing weight. Thus, respectfully, a word of caution is put forward on the views of Stewart and Korol regarding obesity. (shrink)

Johnstone, H. W., Jr. Rhetoric and communication in philosophy.--Smith, C. R. and Douglas, D. G. Philosophical principles in the traditional and emerging views of rhetoric.--Wallace, K. R. Bacon's conception of rhetoric.--Thonssen, L. W. Thomas Hobbes's philosophy of speech.--Walter, O. M., Jr. Descartes on reasoning.--Douglas, D. G. Spinoza and the methodology of reflective knowledge in persuasion.--Howell, W. S. John Locke and the new rhetoric.--Doering, J. F. David Hume on oratory.--Douglas, D. G. A neo-Kantian approach to the epistomology of (...) judgment in criticism.--Bevilacqua, V. M. Lord Kames's theory of rhetoric.--Brockriede, W. E. Bentham's philosophy of rhetoric.--Anderson, R. E. Kierkegaard's theory of communication.--Macksoud, S. J. Ludwig Wittgenstein, radical operationism and rhetorical stance.--Stewart, J. J. L. Austin's speech act analysis.--Torrence, D. L. A philosophy of rhetoric from Bertrand Russell.--Clark, A. Martin Buber, dialogue, and the philosophy of rhetoric.--Bennett, W. Kenneth Burke--a philosophy in defense of un-reason.--Dearin, R. D. The philosophical basis of Chaim Perelman's theory of rhetoric. (shrink)

Blame is multifarious. It can be passionate or dispassionate. It can be expressed or kept private. We blame both the living and the dead. And we blame ourselves as well as others. What’s more, we blame ourselves, not only for our moral failings, but also for our non-moral failings: for our aesthetic bad taste, gustatory self-indulgence, or poor athletic performance. And we blame ourselves both for things over which we exerted agential control (e.g., our voluntary acts) and for things over (...) which we lacked such control (e.g., our desires, beliefs, and intentions). I argue that, despite this manifest diversity in our blaming practices, it’s possible to provide comprehensive account of blame. Indeed, I propose a set of necessary and sufficient conditions that aims to specify blame’s extension in terms of its constitution as opposed to its function. And I argue that this proposal has a number of advantages beyond accounting for blame in all its disparate forms. For one, it can account for the fact that one’s having had control over whether one was to φ is a necessary condition for one’s being fittingly blamed for having φ-ed. For another, it can account for why, unlike fitting shame, fitting blame is always deserved, which in turn explains why there is something morally problematic about ridding oneself of one’s fitting self-blame (e.g., one’s fitting guilt). (shrink)

Moving beyond both realist and anti-realist accounts of mathematics, Shapiro articulates a "structuralist" approach, arguing that the subject matter of a mathematical theory is not a fixed domain of numbers that exist independent of each other, but rather is the natural structure, the pattern common to any system of objects that has an initial object and successor relation satisfying the induction principle.

The idea of basic action is a fixed point in the contemporary investigation of the nature of action. And while there are arguments aimed at putting the idea in place, it is meant to be closer to a gift of common sense than to a hard-won achievement of philosophical reflection. It first appears at the stage of innocuous description and before the announcement of philosophical positions. And yet, as any decent magician knows, the real work so often gets done in (...) the set-up. I argue that the seemingly innocent idea of basic action is, in fact, bound up with a wide-spread conception of the nature of bodily or physical action (section 3). Its legitimacy is vital to the intelligibility of the causal theory of action, according to which physical action consists of a mere event and a condition of mind joined (in the right way) by the bond of causality. Left unchecked, means-end reason threatens to permeate physical action, and thus threatens the sovereignty of the sphere of material events at the center of the causal theory: such events, including the movements of one’s body when one intentionally moves it, are thought to be constitutively independent of the subject’s rational capacities. Basic action is a necessary countermeasure, a sort of metaphysical containment wall needed to preserve the separate jurisdictions of the mind of the acting subject and what merely happens. I argue that so long as action theory proceeds under the assumption that there must be basic action, it must regard our relation to the progress of our own deeds as not different in principle from Marx’s understanding of the relation of the non-worker (Nichtarbeiter) to the material processes that realize his own ideas, namely the work done on the factory floor. Each is alienated from the progress, or getting done, of his deeds. In each the process of doing something intentionally turns out to be a case of delegating tasks to another power. How the process comes to completion is not willed, and at best watched: the causal work is not the agent’s work, his knowledge not self-knowledge (section 5). We should find this unacceptable. And if this is right, it should be a pressing question whether there must be basic action. I argue that we have no good reason to think so: basic action is not forced on us by argument (sections 2 and 4). It is open to us to consider an alternative, one on which action is not, in the fundamental case, barren of means- end structure, but instead permeated by it: we register as a force in nature not at the limit of the means-end order but precisely in its constitution. [from article introduction]. (shrink)

This chapter examines the views of seventeenth-century British philosophers on the notion of logic and demonstrative knowledge, particularly Francis Bacon, Thomas Hobbes, and John Locke, offering an overview of traditional Aristotelianism in relation to logic and describing Bacon's approach to demonstration and logic. It also analyzes the contribution of the Cambridge Platonists and evaluates the influence of Cartesianism. The chapter concludes that theorizing about logic and demonstrative knowledge followed an arc familiar from other branches of philosophy such as metaphysics or (...) the philosophy of science. (shrink)

This reader-friendly book examines philosophies and philosophers using an engaging, non-condescending approach that speaks to you at your level.

Argumentation, which can be abstractly defined as the interaction of different arguments for and against some conclusion, is an important skill to learn for everyday life, law, science, politics and business. The best way to learn it is to try it out on real instances of arguments found in everyday conversational exchanges and legal argumentation. The introductory chapter of this book gives a clear general idea of what the methods of argumentation are and how they work as tools that can (...) be used to analyze arguments. Each subsequent chapter then applies these methods to a leading problem of argumentation. Today the field of computing has embraced argumentation as a paradigm for research in artificial intelligence and multi-agent systems. Another purpose of this book is to present and refine tools and techniques from computing as components of the methods that can be handily used by scholars in other fields. (shrink)

This monograph poses a series of key problems of evidential reasoning and argumentation. It then offers solutions achieved by applying recently developed computational models of argumentation made available in artificial intelligence. Each problem is posed in such a way that the solution is easily understood. The book progresses from confronting these problems and offering solutions to them, building a useful general method for evaluating arguments along the way. It provides a hands-on survey explaining to the reader how to use current (...) argumentation methods and concepts that are increasingly being implemented in more precise ways for the application of software tools in computational argumentation systems. It shows how the use of these tools and methods requires a new approach to the concepts of knowledge and explanation suitable for diverse settings, such as issues of public safety and health, debate, legal argumentation, forensic evidence, science education, and the use of expert opinion evidence in personal and public deliberations. (shrink)

It describes and explains the patient-centered model examining and evaluating qualitative and quantitative research. It comprehensively covers the evolution and the six interactive components of the patient-centered clinical method, taking the reader through the relationships between the patient and doctor and the patient and clinician. All the editors are professors in the Department of Family Medicine at the University of Western Ontario, London, Canada.

There are, broadly speaking, two ways to think about rationality, as defined in the following passage: ‘Reason’ for a long time meant the activity of understanding and assimilating the eternal ideas which were to function as goals for men. Today, on the contrary, it is not only the business but the essential work of reason to find means for the goals one adopts at any given time. To use what Horkheimer called objective reason, and what others have called expressive or (...) non–instrumental reason, is to reflect on one's goals, to attempt to determine what preferences one ought to hold. On the other hand, to use what Horkheimer called subjective reason is to ‘be concerned with means and ends, with the adequacy of procedures for purposes more or less taken for granted’, that is, to be instrumentally rational. This contrast between non-instrumental and instrumental reason is at the heart of many contemporary social and philosophical disputes. 1. (shrink)

A brief exploration of the nature of, and motivations for, contemporary forms of metaethical quietism. Also outlines some of the prominent objections to such positions and discusses some of the limitations of these objections from the quietist's perspective.

ABSTRACT Michael Rescorla has argued that it makes sense to compute directly with numbers, and he faulted Turing for not giving an analysis of number-theoretic computability. However, in line with a later paper of his, it only makes sense to compute directly with syntactic entities, such as strings on a given alphabet. Computing with numbers goes via notation. This raises broader issues involving de re propositional attitudes towards numbers and other non-syntactic abstract entities.