Abstract:This paper, presented as the 2019 Cambridge Quarterly Neuroethics NetworkCharcot Lecture, traces the nosology of disorders of consciousness in light of 2018 practice guidelines promulgated by the American Academy of Neurology, the American College of Rehabilitation Medicine and the National Institute on Disability, Independent Living and Rehabilitation Research. By exploring the ancient origins of Jennett and Plum’s persistent vegetative state and subsequent refinements in the classification of disorders of consciousness—epitomized by the minimally conscious state, cognitive motor dissociation, and the (...) recently described chronic vegetative state—the author argues that there is a counter-narrative to the one linking these conditions to the right to die. Instead, there is a more nuanced schema distinguishing futility from utility, informed by technical advances now able to identify covert consciousness contemplated by Jennett and Plum. Their prescience foreshadows recent developments in the disorders of consciousness literature yielding a layered legacy with implications for society’s normative and legal obligations to these patients. (shrink)

While neuroethics is generally thought to be a modern addition to the broader field of bioethics, this subdiscipline has existed in clinical practice throughout the course of the 20th century. In this essay, Fins describes an older tradition of clinical neuroethics that featured such physician-humanists as Sir William Osler, Wilder Penfield, and Fred Plum, whose work and legacy exploring disorders of consciousness is highlighted. Their normative work was clinically grounded and focused on the needs of patients, in contrast (...) to modern neuroethics, which is more speculative and distant from the lived reality of the clinic. Using recent developments in the diagnosis and treatment of disorders of consciousness, and the history of the vegetative and minimally conscious states, Fins asks why modern neuroethics has taken this turn and what can be done to restore clinical neuroethics to a more proportionate place in the field. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Minding Brain Injury, Consciousness, and Ethics: Discourse and DeliberationsJoseph J. Fins (bio) and James Giordano (bio)The annual John Collins Harvey Lecture at the Georgetown University’s Pellegrino Center for Clinical Bioethics is a forum for addressing contemporary topics at the intersection of medicine and bioethics. This year, in marking the decadal anniversary of the launch of the Brain Research through Advancing Innovative Neurotechnology (BRAIN) Initiative, the Harvey Lecture provided an (...) interactive discussion with renowned clinician, researcher, scholar, and author, Joseph J. Fins, MD—who is the E. William Davis, Jr., MD Professor of Medical Ethics, Chief of the Division of Medical Ethics, and a Professor of Medicine at Weill Cornell Medical College—conducted by James Giordano, PhD, MPhil—who is a Professor of Neurology and Biochemistry, and Chief of the Pellegrino Center’s Neuroethics Studies Program at the Georgetown University Medical Center. The discourse focused upon the topic of covert consciousness, and the ways in which current and developing brain science technologies, together with revised practices of medicine, in general, may afford new opportunities in patient care, but may also give rise to issues, questions, challenges, and opportunities for neuroethics.Prof. James GIORDANO:Prof. Fins, your most recent book, Rights Come to Mind: Brain Injury, Ethics, and the Struggle for Consciousness (Fins 2015), addresses your ongoing work to employ current and emerging neurological approaches to reveal conscious functions in patients with profound brain injury and disease. To be sure, the destination—if you will—is to talk about covert consciousness. But in commencing this discussion, I’d like to propose a route, which traces your professional journey to this point in your career, and how it led you on your search to reveal consciousness in those patients who lack expressive capability. You went into palliative care first, and that brought you to where you are today. [End Page 227]Prof. Joseph J. FINS:First, let me thank you and the Pellegrino Center for the honor of giving the John Harvey Collins Lecture in such an interactive manner. The forefront of neurological care—and the neuroethical issues and methods focal to such practice—wasn’t what I initially intended to do professionally, but I think that therein is a good lesson for young people’s career aspirations. Simply put, one doesn’t always know where they’ll end up at the beginning of the journey, and as Kierkegaard said, life is lived forward, but is understood backwards (Kierkegaard 1843).In the nineties and the early 2000s, I was trying to help improve the quality of care of people at the end of life, and I wrote a book, entitled The Palliative Ethic of Care: Clinical Wisdom at Life’s End (Fins 2006), in which I addressed notions of phronesis—practical wisdom—in integrating theory and practice toward improving how people die. I became interested in the Quinlan case (Quinlan 1976), and the right to die, and around the same time, I ran into a colleague of mine at Cornell: Dr. Nicholas D. Schiff. Dr. Schiff is a neurologist, who was a protégé of Fred Plum, who was the originator of the concept of the vegetative state with Bryan Jennett, back in 1972. Fred was both of our teachers here at Cornell. Niko (Dr. Schiff) was interested in patients with disorders of consciousness, and was beginning to envision doing work—that ultimately, we did—using deep brain stimulation (DBS) to try to treat patients in the minimally conscious state, a category that was subsequently codified in 2002.I realized that a whole population of people—with these disorders of consciousness—had been somewhat marginalized, and their neglect essentially devolves back to the considerations of the right to die. The right to die was established in the Quinlan case because Judge Hughes—the presiding chief judge of the New Jersey Supreme Court—talked about Ms. Quinlan’s loss of a cognitive, sapient state as being the moral warrant for her right to die, given the fact that it was viewed as a futile situation. I recognized, over the ensuing years—from my background in palliative and end-of-life care—[1] that we had over-generalized notions of futility... (shrink)

Ford, Norman In 1972 Brian Jennett and Fred Plum recommended the term 'persistent vegetative state' to describe a state of continuing 'wakefulness without awareness', which can follow a variety of severe insults to the brain. Their description of the syndrome has stood the test of time, but PVS continues to be a source of medical, legal, and ethical debate.

Fred Feldman's fascinating new book sets out to defend hedonism as a theory about the Good Life. He tries to show that, when carefully and charitably interpreted, certain forms of hedonism yield plausible evaluations of human lives. Feldman begins by explaining the question about the Good Life. As he understands it, the question is not about the morally good life or about the beneficial life. Rather, the question concerns the general features of the life that is good in itself (...) for the one who lives it. Hedonism says (roughly) that the Good Life is the pleasant life. After showing that received formulations of hedonism are often confused or incoherent, Feldman presents a simple, clear, coherent form of sensory hedonism that provides a starting point for discussion. He then presents a catalogue of classic objections to hedonism, coming from sources as diverse as Plato, Aristotle, Brentano, Ross, Moore, Rawls, Kagan, Nozick, Brandt, and others. One of Feldman's central themes is that there is an important distinction between the forms of hedonism that emphasize sensory pleasure and those that emphasize attitudinal pleasure. Feldman formulates several kinds of hedonism based on the idea that attitudinal pleasure is the Good. He claims that attitudinal forms of hedonism - which have often been ignored in the literature -- are worthy of more careful attention. Another main theme of the book is the plasticity of hedonism. Hedonism comes in many forms. Attitudinal hedonism is especially receptive to variations and modifications. Feldman illustrates this plasticity by formulating several variants of attitudinal hedonism and showing how they evade some of the objections. He also shows how it is possible to develop forms of hedonism that are equivalent to the allegedly anti-hedonistic theory of G. E. Moore and the Aristotelian theory according to which the Good Life is the life of virtue, or flourishing. He also formulates hedonisms relevantly like the ones defended by Aristippus and Mill. Feldman argues that a carefully developed form of attitudinal hedonism is not refuted by objections concerning 'the shape of a life'. He also defends the claim that all of the alleged forms of hedonism discussed in the book genuinely deserve to be called 'hedonism'. Finally, after dealing with the last of the objections, he gives a sketch of his hedonistic vision of the Good Life. (shrink)

Everyone agrees that justice is a profoundly important value. People march and protest to demand it; more than a few have died in its pursuit. Yet when we stop to reflect on what makes for justice, or try to state in a clear way what we mean when we speak of justice, we may be perplexed. But if you are going to die in defense of some value, it is important for you to have a fairly clear conception of what (...) that value is. This book is an attempt to explain and defend, in clear and precise terms, a novel and controversial view about what makes for distributive justice in a country. The theory is a form of desertism, according to which justice reigns in a country when the government ensures that citizens receive the benefits and burdens they deserve. (shrink)

This book provides an introduction to measurement theory for non-specialists and puts measurement in the social and behavioural sciences on a firm mathematical foundation. Results are applied to such topics as measurement of utility, psychophysical scaling and decision-making about pollution, energy, transportation and health. The results and questions presented should be of interest to both students and practising mathematicians since the author sets forth an area of mathematics unfamiliar to most mathematicians, but which has many potentially significant applications.

1. Philosophers tend to talk of belief as a ‘propositional attitude.’ As Fodor says:" The standard story about believing is that it's a two place relation, viz., a relation between a person and a proposition. My story is that believing is never an unmediated relation between a person and a proposition. In particular nobody grasps a proposition except insofar as he is appropriately related to some vehicle that expresses the proposition. " Fodor's story – that belief is a three-place relation (...) between a person, a proposition and a vehicle – is hardly non-standard; by assigning to propositions an essential place in acts of belief, he too is a ‘propositionalist’. My own view is that believing is primarily a relation between a believer and the world . While a great many human beliefs are propositional, many, perhaps most, are mondial and propositionless. As for animals who lack language, it may be that all their beliefs are mondial. In the present article, I show that distinguishing these two very different kinds of belief – de mundo as well as de dicto – enables one to explain phenomena of doxastic dissonance that standard propositionalist accounts cannot adequately explain .The next two sections, §1.1 and §1.2, are about ‘the world’ that is the doxastic object in the primary belief relation, providing needed background for the thesis that mondial belief is more primitive and basic than propositional belief.1.1. The world does not contain itself. Things in the world are …. (shrink)

Drawing on insights from social learning and social cognitive perspectives and research on the multilevel reality of leadership influences, we developed and tested a multilevel model that examines mechanisms and conditions through which ethical leadership deters work unit- and individual-level ostracism. Based on two field studies using multiple measurement points, we found that at the work unit level of analysis, relational climate partially mediates the negative relationship between ethical leadership and work unit-level ostracism whereas state mindfulness partially mediates the cross-level (...) influence of ethical leadership on individual-level ostracism. Contrary to our hypothesis, we found that the relationship between ethical leadership and relational climate was stronger when work units had a more mechanistic structure, and not when it had an organic work unit structure. Finally, we found that relational climate not only moderates the relationship between state mindfulness and individual-level ostracism, but also moderates the indirect influence of ethical leadership on individual-level ostracism through state mindfulness such that the indirect effect is stronger when relational climate is high as opposed to low. These findings highlight the individual- and work unit-level conditions and mechanisms through which ethical leadership relates to decreased ostracism at work, and thus extends theory and research on ethical leadership and ostracism. (shrink)

In a recent paper, Tristan Haze offers two examples that, he claims, are counterexamples to Nozick's Theory of Knowledge. Haze claims his examples work against Nozick's theory understood as relativized to belief forming methods M. We believe that they fail to be counterexamples to Nozick's theory. Since he aims the examples at tracking theories generally, we will also explain why they are not counterexamples to Dretske's Conclusive Reasons Theory of Knowledge.

Critical Theory constitutes one of the major intellectual traditions of the twentieth century, and is centrally important for philosophy, political theory, aesthetics and theory of art, the study of modern European literatures and music, the history of ideas, sociology, psychology, and cultural studies. In this volume an international team of distinguished contributors examines the major figures in Critical Theory, including Horkheimer, Adorno, Marcuse, Benjamin, and Habermas, as well as lesser known but important thinkers such as Pollock and Neumann. The volume (...) surveys the shared philosophical concerns that have given impetus to Critical Theory throughout its history, while at the same time showing the diversity among its proponents that contributes so much to its richness as a philosophical school. The result is an illuminating overview of the entire history of Critical Theory in the twentieth century, an examination of its central conceptual concerns, and an in-depth discussion of its future prospects. (shrink)

The primary task confronting an examination of the claimed connection between Kant's general theory of cognition and his account of aesthetic judgment requires clarifying perhaps the most obscure component of that account, the doctrine of the harmony of the faculties. Kant's presentation of this doctrine makes it notoriously difficult to penetrate. Much of what Kant says about the harmony of the faculties – perhaps the very phrase “the harmony of the faculties” – is rather imprecise and metaphorical. Yet, the importance (...) of a correct understanding of the harmony of the faculties to assessing both the merits of Kant's aesthetic theory and his claims for the epistemological significance of reflection is difficult to overstate, for it is precisely this state of harmony that ultimately grounds the validity of judgments of taste and does so in virtue of being a state in which the most general prerequisites to conceptual judgment are present. (shrink)

By contributing a few hundred dollars to a charity like UNICEF, a prosperous person can ensure that fewer poor children die, and that more will live reasonably long, worthwhile lives. Even when knowing this, however, most people send nothing, and almost all of the rest send little. What is the moral status of this behavior? To such common cases of letting die, our untutored response is that, while it is not very good, neither is the conduct wrong. What is the (...) source of this lenient assessment? In this contentious new book, one of our leading philosophers argues that our intuitions about ethical cases are generated not by basic moral values, but by certain distracting psychological dispositions that all too often prevent us from reacting in accord with our commitments. Through a detailed look at how these tendencies operate, Unger shows that, on the good morality that we already accept, the fatally unhelpful behavior is monstrously wrong. By uncovering the eminently sensible ethics that we've already embraced fully, and by confronting us with empirical facts and with easily followed instructions for lessening serious suffering appropriately and effectively, Unger's book points the way to a compassionate new moral philosophy. (shrink)

The purpose Tarski speaks of is "to do justice to our intuitions which adhere to the classical Aristotelian conception of truth." Tarski takes this to be some form of correspondence theory. He has earlier considered and rejected an even less satisfactory formula of this sort: 'a sentence is true if it corresponds to reality'. His own semantic conception of truth is meant to be a more precise variant doing justice to the correspondence standpoint. In this spirit I shall presently suggest (...) a revised version of. (shrink)

In the 17th century, Hobbes stated that we reason by addition and subtraction. Historians of logic note that Hobbes thought of reasoning as “a ‘species of computation’” but point out that “his writing contains in fact no attempt to work out such a project.” Though Leibniz mentions the plus/minus character of the positive and negative copulas, neither he nor Hobbes say anything about a plus/minus character of other common logical words that drive our deductive judgments, words like ‘some’, ‘all’, ‘if’, (...) and ‘and’, each of which actually turns out to have an oppositive, character that allows us, “in our silent reasoning,” to ignore its literal meaning and to reckon with it as one reckons with a plus or a minus operator in elementary algebra or arithmetic. These ‘logical constants’ of natural language figure crucially in our everyday reasoning. Because Hobbes and Leibniz did not identify them as the plus and minus words we reason with, their insight into what goes on in ‘ratiocination’ did not provide a guide for a research program that could develop a +/- logic that actually describes how we reason deductively. I will argue that such a +/- logic provides a way back from modern predicate logic—the logic of quantifiers and bound variables that is now ‘standard logic’—to an Aristotelian term logic of natural language that had been the millennial standard logic. (shrink)

The first-ever multivolume treatment of the issues in legal philosophy and general jurisprudence, from both a theoretical and a historical perspective. The work is aimed at jurists as well as legal and practical philosophers. Edited by the renowned theorist Enrico Pattaro and his team, this book is a classical reference work that would be of great interest to legal and practical philosophers as well as to jurists and legal scholar at all levels. The work is divided in two parts. The (...) theoretical part, consisting of five volumes, covers the main topics of the contemporary debate; the historical part, consisting of six volumes, accounts for the development of legal thought from ancient Greek times through the twentieth century. The entire set will be completed with an index. Volume 6: A History of the Philosophy of Law from the Ancient Greeks to the Scholastics 2nd revised edition, edited by Fred D. Miller, Jr. and Carrie-Ann Biondi Volume 6 is the first of the Treatise’s historical volumes and is dedicated to the philosophers’ philosophy of law from ancient Greece to the 16th century. The volume thus begins with the dawning of legal philosophy in Greek and Roman philosophical thought and then covers the birth and development of European medieval legal philosophy, the influence of Judaism and the Islamic philosophers, the revival of Roman and Christian canon law, and the rise of scholastic philosophy in the late Middle Ages, which paved the way for early-modern Western legal philosophy. This second, revised edition comes with an entirely new chapter devoted to the later Scholastics and an epilogue on the legacy of ancient and medieval thought for modern legal philosophy, as well as with updated references and indexes. (shrink)

The modern theory of computability is based on the works of Church, Markov and Turing who, starting from quite different models of computation, arrived at the same class of computable functions. The purpose of this paper is the show how the main results of the Church-Markov-Turing theory of computable functions may quickly be derived and understood without recourse to the largely irrelevant theories of recursive functions, Markov algorithms, or Turing machines. We do this by ignoring the problem of what constitutes (...) a computable function and concentrating on the central feature of the Church-Markov-Turing theory: that the set of computable partial functions can be effectively enumerated. In this manner we are led directly to the heart of the theory of computability without having to fuss about what a computable function is.The spirit of this approach is similar to that of [RGRS]. A major difference is that we operate in the context of constructive mathematics in the sense of Bishop [BSH1], so all functions are computable by definition, and the phrase “you can find” implies “by a finite calculation.” In particular ifPis some property, then the statement “for eachmthere isnsuch thatP” means that we can construct a functionθsuch thatP)for allm. Church's thesis has a different flavor in an environment like this where the notion of a computable function is primitive.One point of such a treatment of Church's thesis is to make available to Bishopstyle constructivists the Markovian counterexamples of Russian constructivism and recursive function theory. The lack of serious candidates for computable functions other than recursive functions makes it quite implausible that a Bishopstyle constructivist could refute Church's thesis, or any consequence of Church's thesis. Hence counterexamples such as Specker's bounded increasing sequence of rational numbers that is eventually bounded away from any given real number [SPEC] may be used, as Brouwerian counterexamples are, as evidence of the unprovability of certain assertions. (shrink)

Gleason's theorem for ������³ says that if f is a nonnegative function on the unit sphere with the property that f(x) + f(y) + f(z) is a fixed constant for each triple x, y, z of mutually orthogonal unit vectors, then f is a quadratic form. We examine the issues raised by discussions in this journal regarding the possibility of a constructive proof of Gleason's theorem in light of the recent publication of such a proof.

We consider notions of boundedness of subsets of the natural numbers ℕ that occur when doing mathematics in the context of intuitionistic logic. We obtain a new characterization of the notion of a pseudobounded subset and we formulate the closely related notion of a detachably finite subset. We establish metric equivalents for a subset of ℕ to be detachably finite and to satisfy the ascending chain condition. Following Ishihara, we spell out the relationship between detachable finiteness and sequential continuity. Most (...) of the results do not require countable choice. (shrink)

I spent last year teaching in Paris and when I came home for visits, Emil and I would play the analogy game between Western European and American political tendencies. Besides the obvious matches between Reagan, Thatcher and Chirac, we talked of the similarities between George Will and Ian Gilmore, the intellectual spokesman for the Tory Wets, both of whom drew on the same stock of quotes from Bolingbroke, Hume and Burke. But what of the American neo-liberals? Who were their counterparts? (...) Despite some obvious similarities between the British Social Democrats and some of the French high-tech socialists, it was difficult to compare the neo-liberals to any other European formation. (shrink)

Until the mid 1970s, pragmatism reigned as the “almost… official philosophy of America.” European critics charged that James’ and Dewey's pragmatism was less a philosophy than a “method of doing without one.” But pragmatism's loose and democratic emphasis on problem-solving suited the unbounded American personality with its optimistic faith in persistent progress. Dewey's pragmatism was at once so democratic and informal in its emphasis on shared methods of rational inquiry that Bertrand Russell once accused him of “being unable to distinguish (...) between the work of a scientist and that of a bricklayer.” Pragmatism was so central to America's sense of itself, noted a widely-read 1950 Amherst College pamphlet on “Pragmatism and American Culture,” that to question its merits was to place “American civilization itself on trial.”. (shrink)

Le Monde's financial analyst Paul Fabra captured the essence of the Western “Alliances'” difficulties in an article describing European reactions to Carter and Reagan economic policies. Under Carter he noted, the U.S. initially followed an expansionary policy of low interest rates and increased public spending driving the dollar downward. The cheaper dollar increased both American exports to Europe and European complaints about American competition. Reagan reversed course and the Europeans had a different, though equally intense set of grievances. “The fact (...) is,” concluded Fabra, “Europe is uncomfortable with a strong or weak dollar.” He might have said a strong or weak America. (shrink)