This chapter contains sections titled: Side‐Effects of Wykstra's Noseeum Defense Verdict on Noseeum Defenses Evaluating van Inwagen's Second Skeptical Defense Overall Verdict on Skeptical Defenses On to Substantive Defenses Suggested Reading.

This essay discusses unlimited insurance subrogation (UIS) as a means of improving the deterrence and compensation results of medical malpractice law. Under UIS, health care insureds could assign their entire potential medical malpractice claims to their first-party commercial and government insurers. UIS should improve deterrence by establishing first-party insurers as plaintiffs to confront liability insurers on the defense side, leading to more effective prosecution of meritorious claims and reducing meritless and unnecessary litigation. UIS should improve compensation outcomes by converting (...) litigation cost- and risk- laden “tort insurance” into cheaper and enhanced first-party insurance. UIS also promises dynamic benefits through further reforms by contract between the first-party and liability insurers that would take charge of system. No UIS-related costs are apparent that would outweigh these benefits. (shrink)

In global business, business organizations and their representatives frequently encounter corruption and may be the perpetrators, victims, or simply participants in such acts. While international corruption has existed in multiple forms for several years, many individuals, companies, nations, and international organizations are currently attempting to reduce or eliminate corrupt acts because of their harmful effects on local economies and the quality of life of citizens. Several of these corruption curtailment efforts have been directed toward the supply-side of corruption, i.e., those (...) who make corrupt payments. In developing an understanding of corruption, however, and formulating strategies for its reduction, consideration must also be given to the demand-side of corruption, i.e., those who demand and accept corrupt payments. Accordingly, this study examined the demand-side of corruption and several related factors in the categories of government, economy and poverty, education, geography, and culture. Analysis of these factors employed the Corruption Perceptions Index (CPI), formulated annually by Transparency International (TI), and other sources. Several factors in each of the five categories were found to correlate significantly with perceived corruption, and strategies for addressing these issues were developed and discussed. (shrink)

A person drives her well‐maintained car cautiously and alertly to the movies. Freak circumstances send the car out of control. It veers in the direction of a pedestrian whom it will kill unless she, or a third party, blows it up with a grenade. Whether the driver is liable to be thusly killed polarizes debates about the ethics of self‐defense. But debaters frequently conflate the questions of whether and by what means the driver is liable to be killed. The (...) paper separates these questions: it argues the driver's liability to lethal harm need not entail her liability to the grenade. (shrink)

Competition among scientists for funding, positions and prestige, among other things, is often seen as a salutary driving force in U.S. science. Its effects on scientists, their work and their relationships are seldom considered. Focus-group discussions with 51 mid- and early-career scientists, on which this study is based, reveal a dark side of competition in science. According to these scientists, competition contributes to strategic game-playing in science, a decline in free and open sharing of information and methods, sabotage of others’ (...) ability to use one’s work, interference with peer-review processes, deformation of relationships, and careless or questionable research conduct. When competition is pervasive, such effects may jeopardize the progress, efficiency and integrity of science. (shrink)

Determinist thought with its sui generis view on life, nature and being as a whole is a point of view that could be observed in many different cultures and beliefs. It was thanks to Greek thought that it ceased to be a cultural element and transformed into a systematic cosmology. Schools such as Leucippos, then Democritos and Stoa attempted to integrate the determinist philosophy into ontology and cosmology. In the course of time, physics and metaphysics-based determinism approaches were introduced, and (...) a wide spectrum has emerged from genetics to behaviorism, from culture to psychology, from atomism to divinity. Determinism, whether physical or metaphysical origin, ignores freedom of will and deny agency competence over human behavior. Due to this feature, it is opposed by ethical theories, legal philosophies and religions. When the arguments for determinism are possible to disprove logically and philosophically, this is not so easy when the claims base themselves on scientific base. As the logical consequence of this novel fact, it is important to question the epistemological value of scientific knowledge and critically analyze the data of experiments and clinical studies in terms of methodology when answering any hypothesis such as neuro-biological, neuro-psychological, or neuro-theological argumentations. On the other hand, it is necessary to reach alternative experiments on the same subject or to show that it is possible to interpret them in different ways, as in the example of the Libet experiment. The neurobiological determinism based on biological reductionism, emerged as the result of ignoring the ontological difference of the mind, equating the mind with the brain, or defining mentality as an epiphenomenon of the brain. The main divergence stems from the acceptance of materialist philosophy. Paradigms that reduce existence only to matter do not take the metaphysical possibilities into account. In this case, although the problems called qualia or subjective experience stand there unresolved, the claim is preserved. Although many new developments such as the discovery of the entropy law, the big bang theory, and quantum physics have shaken the materialist philosophy, modern science resists an epistemological revision. However, with the current epistemology, it does not seem possible to grasp both the universe and the being as a whole. This is the most important reason why every attempt to understand the nature and spiritual side of human beings fails despite numerous experiments on the brain. However, the human brain is an organ that seems sophisticated and its secrets cannot be easily solved. Since there is not enough information about the brain, there is not enough evidence to claim that the brain, and therefore the mind, are part of the deterministic universe. Increasing brain researches since the last quarter of the twentieth century has revealed that genes, neurons and particularly brain chemistry claim much greater role than expected in human behavior. These results have been instrumentalized by some researchers for a radical claim that free will is an illusion, while by others it has led to the acceptance of will as less important over actions than was thought. Both ideas adopted a model of biological determinism in which freedom of will was ignored. Hypotheses based on controversial interpretations of various experiments raised concerns about religious, moral, and legal responsibility. Although man cannot be thought of as a non-free being from the point of view of common sense, the smog screen over the truth would not be lifted unless the scientific data in question had a correct interpretation. At first glance, it seems unreasonable to discuss universal determinism in the quantum universe. Nevertheless, the claim that strong causality prevails in the material world, including consciousness, remains in place. Therefore, firstly criticizing determinism and then examining biological determinism will help to fix the conceptual framework. This article aims to explain why genetics and neurobiology, while acknowledging their importance in the realization of behavior, can’t completely abolish moral agency. Some hypotheses attribute consciousness and free will to the physico-shimic structure of the brain, the random activity of neurons, or the ability to automatically transform inputs into outputs with the advantage of genetic information. This is the most sensitive and important point of being human; it attacks free will. Paradoxically, while global civilization of our time promises infinite freedom to human beings the science of the same age tries to prove that it is not free. (shrink)

A recent study published in the American Journal of Organ Transplantation proposes that an organ donor application in Facebook can increase the rates at which individuals donate organs. While I offer support for the use of social media mechanisms in the service of the promotion of organ donation public health initiatives, there are several ethical concerns surrounding informed consent.While Facebook has made a noble effort to aid public health initiatives focused on organ donation, the current application does not promote decisions (...) that are based on individuals’ personal values and goals. Without an intervention that promotes an understanding and appreciation of a decision for or against donation, the application does not obtain informed consent. Without first ensuring that a Facebook member has registered with her or his own state donor registry, this social media mechanism may create more confusion than clarity about an individual’s organ donor status.If Facebook desires to have a positive impact on the rates of organ donation, it must do so in a manner that obtains proper consent and promotes ethically informed decisions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Not Only Sub Specie Aeternitatis, but Equally Sub Specie DurationisA Defense of Hegel's Criticisms of Spinoza's PhilosophyJ. M. Fritzman and Brianne RileyIn what seem like halcyon days, when William Jefferson Clinton was America's President, James Carville wrote We're Right, They're Wrong: A Handbook for Spirited Progressives, arguing against the Republican Party's "Contract with America" (derided by the Left as a "Contract on America") and for progressivism. In the (...) present philosophical conjuncture, what is required is a precisely analogous intervention—"Hegel's Right, Spinoza's Wrong: An Article for Spirited Hegelians." Hegel criticizes Spinoza's philosophy at various places in his writings.1 Spinozists have made several major challenges to Hegel's criticisms.2 Although there have been explications of Hegel's criticisms, there has been no effective response to the Spinozists' challenges.3 Until now. This article defends Hegel's criticisms of Spinoza's philosophy and shows that the challenges to his criticisms fail.This article presents a précis of Spinoza's system and shows the senses in which Hegel is not wholly enamored with it. It defends Hegel's criticism of Spinoza's system as an acosmism from Parkinson's challenges to it. It considers both Myers's view that Hegel's system begins where Spinoza's system ends and McMinn's charge that the systems of Spinoza and Hegel are fundamentally identical. Myers and McMinn misunderstand Hegel's dialectical method, and so they incorrectly believe that the methods of Spinoza and Hegel are complementary. Hegel's dialectics can sublate the systematic pluralism that Myers and Armour propose as its alternative. The penultimate section discusses the modifications that must be made to Spinoza's system to advance from his substance to Hegel's subject.Clinton successfully appropriated what was worthwhile in the "Contract with America," but he also effectively argued that the "Contract" would be a disaster for America. Similarly, Hegel assimilates the truth in his predecessors' philosophies while demonstrating how those philosophies remain [End Page 76] one-sided and partial. This article concludes by showing how this happens to Spinoza's philosophy.Everybody Loves SpinozaSpinoza's philosophy is a metaphysical monism. That is, he thinks that there is only one basic substance. Although there is only one substance, it necessarily expresses itself through an infinite number of attributes, and an attribute is the essence of substance as experienced by the intellect.4 Humans are capable of knowing only two of these attributes: thought and extension. Objects, ideas, and relations—Spinoza refers to all of these as "modes"—are presented through some attribute or other. Spinoza denies that a thing presented through one attribute can cause or be affected by anything presented through another attribute. Rather, each thing which is presented through an attribute has an infinite number of counterparts presented through the infinite number of attributes. Indeed, those infinite counterparts are that thing, presented through the other attributes. Substance necessarily expresses itself through the attributes and modes, according to Spinoza, and everything that is possible is also actual.5Spinoza's substance expresses itself through its attributes and modes, but what occurs at the level of the attributes and modes has no reciprocal effect on substance. Like unrequited love, expression is a one-way street. Not e pluribus unum (out of many, one), but e unibus plurum (out of one, many). Unlike the relation of the states to the federal government, the attributes and modes do not possess a relative or circumscribed autonomy vis-à-vis substance.6 Substance expressing itself through its attributes and modes is nature, according to Spinoza, and nature in turn is God. Hence, Spinoza's God is wholly immanent within the world—for him, God is the world—and so he rejects that traditional God of theism, who transcends and is wholly independent from the world. Spinoza rejects as illusory all notions of purpose and intention.7 Although individuals generally believe that their actions are performed in order to fulfill some goal, Spinoza instead maintains that human actions are entirely determined and necessary and that the belief that actions are done to accomplish something is entirely mistaken. He believes that all happenings—physical... (shrink)

In this paper we (1) define and describe the practice of narrative medicine, (2) reveal the need for narrative medicine by exposing the presuppositions that give rise to its discounting, including a reductive empiricism and a strict dichotomy between scientific fact and narrative value, (3) show evidence of the effects of education in narrative competence in the medical clinic, and (4) present Peircean realism as the proper conceptual model for our argument that the medical school curriculum committees should give space (...) to the employment of the scientific and literary knowledge in medical practice. On account of our argument, we contend that the medical community should tend to latitude and openness with regard to the tools we use to resolve medical problems. These tools include both biomedical and narrative knowledge. (shrink)

An account and development of Arthur Murphy's Theory of Practical Reason and its application to contemporary moral problems. Chapter II gives a schematic account of Murphy's theory of normative discourse. Chapter III contrasts this theory with other theories and approaches. The author justly remarks that "Murphy's intent has been primarily to restore proper balance among considerations that play a role in practical discourse and to steer clear of the pitfalls which would impair or diminish the effectiveness of reason in human (...) actions." Chapter IV deals with "the contemporary erosion of practical reason and critique of existentialistic [[sic]] ethics." Chapter V contains an interesting discussion of Murphy's conception of developing and dynamic self as responsible agent. It gives recognition to the moral self as basic condition that underlies the activity of practical justification. The final chapter undertakes practical applications of the theory expounded. The monograph is a good exposition and defense of Murphy's important contribution to contemporary moral philosophy.--A. S. C. (shrink)

The relevance of the study has two sides — individual and general. In its essential aspect, it is the development of achievements of predecessors by consistently taking into account the latest data on trends and changes in the interconnected spheres of education, economics and culture. In the individual aspect, it is about improving the professional means of improving the efficiency of teaching foreign languages in order to form students with a high level of linguistic-professional competence. Public relevance is the goal (...) of educating young people in a new patriotic direction, because today, due to various global influences, the classical principles of life in the agrarian system, created in recent centuries, or in the industrial society, are devalued due to various global influences. The purpose of the study in a broad sense was to highlight the causes and consequences of the European religious Reformation as the main factor in accelerating the movement of the whole of Western Europe to the position of the world leader that previously belonged to China. We see precis e tasks in the integrated analysis on the basis of the latest discoveries of many humanities and exact sciences in the educational, economic and cultural systems of Germany and other successful European states. On this basis, we hope to fulfill the public task which is to make significant proposals in the plans and practice of higher education reform in Ukraine. The methodology of the study relies on the best classical means, on the principle of historicism and the continuity of the connection between the material and the ideal, a modern multidisciplinary approach. For the highest effectiveness of the research, we will use the latest scientific data and recommendations of the innovators who collect and use these data. The results of the study mostly follow from the mentioned new discoveries. They testify that in ancientt history, in the role of locomotives of civilizational progress in the western part of Eurasia, direct descendants of the inventors of agriculture acted, among which the especially great contribution belongs to the ancestors of Ukrainians from the territories of Trypillya and the Great Trypillya. It is indicated that during the existence of the Great Trypillya, future German farmers acquainted themselves with the technologies of the Great Trypillya, so the German language, through borrowed words, became part of the Indo-European family. It is noted that after the collapse of the Great Trypillya, the Germans and Slavs became neighbors along the meridian Elbe. In the age of steppe invasions, future Ukrainians and Germanic tribes did not get in contact, and the influence of the Roman Empire was mostly experienced by western lands. Emphasis was placed on the evolution of ideological, religious and other paradigms in the territory of Germany after the collapse of the Holy Roman Empire, which determined the development of the nation for the next hundreds of years. The religious and philosophical paradigmatic origins of those unique features of culture and education that during the nineteenth century were emphasized. brought Germany to the position of the scientific and technological leader of the world. The high role of German neo-humanism and the Berlin Research University were noted. In the final section, special attention is paid to religious issues and to the destructive impact on social and other processes in the German immigration flows of Islamists. The conclusions focus on the competition of several important paradigms in the education of modern Germany and the proposals made to incorporate German experience in legislation and the use of the Bologna process. An important caution is made regarding the choice of Germany's strategy for the development of the scientific and educational complex 'within the framework of the Lisbon project. This country has become a world leader not only in alternative energy, but also in the implementation of the fourth industrial revolution. We consider an example of this leadership like the regular world conferences in Davos, which involve the majority of influential politicians and economists. (shrink)

John Harris is one of the prominent philosophers and bioethicists of our time. He has published tens of books and hundreds of papers throughout his professional life. This paper aims to take a ‘deep-look’ at Harris' works to argue that it is possible to find some principles of Islamic ethics in Harrisian philosophy, namely in his major works, as well as in his personal life. This may be surprising, or thought of as a ‘big’ and ‘groundless’ claim, since John Harris (...) has nothing to do with any religion in his intellectual works. The major features of Harrisian philosophy could be defined as consequentialism or utilitarianism with liberal overtones. Despite some significant and fundamental differences in the application of principles (ie, abortion, euthanasia), the similarities between the major principles in Harrisian philosophy and Islamic ethics are greater at some points than the similarities between Islamic ethics and some other religious ethics (ie, Christian, Judaism). In this study I compare Harrisian teachings with major Islamic principles on ‘Responsibility’, ‘Side-effects and Double-effects’, ‘Equality’, ‘Vicious choice, guilt and innocence’, ‘Organ transplantation and property rights’ and ‘Advance directives’. (shrink)

During the past few years considerable debate has arisen within academic journals with respect to the use of smart drugs or cognitive enhancement pharmaceuticals. The following paper seeks to examine the foundations of this cognitive enhancement debate using the example of methylphenidate use among college students. The argument taken is that much of the enhancement debate rests upon inflated assumptions about the ability of such drugs to enhance and over-estimations of either the size of the current market for such drugs (...) or the rise in popularity as drugs for enhancing cognitive abilities. This article provides an overview of the empirical evidence that methylphenidate has the ability to significantly improve cognitive abilities in healthy individuals, and examines whether the presumed uptake of the drug is either as socially significant as implied or growing to the extent that it requires urgent regulatory attention. In addition, it reviews the evidence of side-effects for the use of methylphenidate which may be an influential factor in whether an individual decides to use such drugs. The primary conclusions are that neither drug efficacy, nor the benefit-to-risk balance, nor indicators of current or growing demand provide sufficient evidence that methylphenidate is a suitable example of a cognitive enhancer with mass appeal. In light of these empirically based conclusions, the article discusses why methylphenidate might have become seen as a smart drug or cognitive enhancer. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Intention and Wrongdoing: A Defense of the Principle of Double Effect by Joshua StuchlikMichael J. DegnanSTUCHLIK, Joshua. Intention and Wrongdoing: A Defense of the Principle of Double Effect. Cambridge: Cambridge University Press, 2021. xvi + 220 pp. Cloth, $99.99In this book Joshua Stuchlik vigorously defends the principle of double effect (PDE), which states, "There is a strict moral constraint against bringing about serious evil (harm) to (...) an innocent person intentionally, but it is permissible in a wider range of circumstances to act in a way that brings about serious evil incidentally, as a foreseen but non-intended side effect." After defining the terms of the principle and considering an intuitive case-based defense, he supports its truth based on a standard of solidarity. Since the PDE requires the distinction between intended consequences and nonintended side effects, he explains Elizabeth Anscombe's theory of intention, which supports the distinction's moral significance. He uses her theory to treat the closeness problem, the irrelevance of intention critique, and a challenge from Joshua Greene's empirical moral psychology that purports to undermine deontological constraints on causing harm.I present Stuchlik's grounding for the PDE followed by an uncontroversial example of its application. After this I consider two important objections to the PDE that Stuchlik critiques: the closeness problem and James Rachels's argument that intentions are irrelevant to judging the moral permissibility of actions. I conclude by examining Stuchlik's treatment of these challenges.Stuchlik interprets the PDE's very strict constraint against intentional killing or seriously harming the innocent as a near absolute prohibition, for he believes innocent persons are not suitable recipients of intentional harm. He grounds this constraint on the principle of solidarity. Being in solidarity with another is possessing concern for that other's sake. The ground for this concern is a shared human nature that enables members to think of themselves as making a "we." Human nature consists in the structured potentialities for knowing and freely choosing. Evidence of these rational potentialities is the human orientation toward the transcendent values of truth and goodness. Such embodied potentialities have inviolable worth.The scenarios of the precision bomber and the terror bomber illustrate the moral significance of the intended harm versus the nonintended but foreseen harm that Stuchlik adopts from Elizabeth Anscombe's action theory. Each bombers' goal is to help his country win a just war. The precision bomber pursues that goal by targeting a munitions factory. Though he foresees that many noncombatants will be killed or seriously [End Page 367] injured from the bomb, he does not necessarily intend these harms. By contrast, the terror bomber targets a civilian center necessarily intending harm for noncombatants. The PDE rules out his conduct.Anscombe's account of intention can lead to the problem of closeness in which the content of an intention is sufficiently fine-grained that an agent need not intend harm in almost any situation. Stuchlik illustrates the problem with Alexander Pruss's zookeeper scenario.An eccentric literalistic but always truthful magnate tells Sam he will donate to famine relief saving a hundred lives if and only if Sam follows his directions to the iota. Sam is to purchase a gun, sneak at night into a zoo owned by the magnate and kill the first mammal he sees. Sam sneaks into the zoo, sees a mammal in the distance, and forms the intention to shoot it. Then he notices that the mammal is human but shoots nonetheless on utilitarian grounds.In this case applying the PDE shows that Sam is simply intending that a mammal be killed. The fact that the mammal is a human is irrelevant, according to Anscombe's action theory.Stuchlik's response clarifies the scope of intention in the PDE. As stated above, the intention's content includes seriously harming an innocent human. However, if the intention ranges only over an intention to bring about an effect, E, and it turns out that E is a serious harm for an innocent human being, then applying the principle shows that Sam's action is wrong. The intended effect of killing the mammal is, as a matter of fact, an... (shrink)

This paper considers the argument that if the ban on doping in sports was abolished it would be possible to have doping under medical control, i.e. open doping, prescribed by doctors with collection of reliable information about effects and side-effects. A game-theoretic argument is developed showing that this positive scenario is very unlikely to be instantiated given reasonable assumptions about the motivation of sportspersons and sports doctors. It is furthermore shown that the standard arguments against the current ban on doping (...) also entail that if doping was made legal any requirements that it should be open doping could not be justified. (shrink)

This target article argues that the Turing test implicitly rests on a "naive psychology," a naturally evolved psychological faculty which is used to predict and understand the behaviour of others in complex societies. This natural faculty is an important and implicit bias in the observer's tendency to ascribe mentality to the system in the test. The paper analyses the effects of this naive psychology on the Turing test, both from the side of the system and the side of the observer, (...) and then proposes and justifies an inverted version of the test which allows the processes of ascription to be analysed more directly than in the standard version. (shrink)

We describe the informed consent procedures in a research clinic in Santiago, Chile, and a qualitative study that evaluated these procedures. The recruitment process involves information, counseling and screening of volunteers, and three or four visits to the clinic. The study explored the decision‐making process of women participating in contraceptive trials through 36 interviews. Women understood the research as experimentation or progress. The decision to participate was facilitated by the information provided; time to consider it and to discuss it with (...) partners or relatives; and perceived benefits such as quality of care, non‐cost provision of methods and medical care. For some women, participation was an opportunity to express altruism. The main obstacles for participation were perceived side effects or risks. The final risk‐benefit balance was strongly influenced by women’s needs. Women perceived that the consent form benefited the clinic, proving that participants had made a free decision, and benefited the volunteers by warranting their right to free medical care. The most important problem detected was occasional misunderstanding of the information given on the form. We concluded that a full decision‐making process enhances women’s ability to exercise their right to choose, and assures research institutions that trials are conducted without coercion and that the participants are committed to the study. Researchers have the responsibility of conducting this process. (shrink)

A distinction is commonly drawn between continuous sedation until death and physician-assisted suicide/euthanasia. Only the latter is found to involve killing, whereas the former eludes such characterization. I argue that continuous sedation until death is equivalent to physician-assisted suicide/euthanasia in that both involve killing. This is established by first defining and clarifying palliative sedation therapies in general and continuous sedation until death in particular. A case study analysis and a look at current practices are provided. This is followed by a (...) defense of arguments in favor of definitions of death centering on higher brain (neocortical) functioning rather than on whole brain or cardiopulmonary functioning. It is then shown that continuous sedation until death simulates higher brain definitions of death by eliminating consciousness. Appeals to reversibility and double effect fail to establish any distinguishing characteristics between the simulation of death that occurs in continuous sedation until death and the death that occurs as a result of physician-assisted suicide/euthanasia. Concluding remarks clarify the moral ramifications of these findings. (shrink)

Careerism refers to an individual’s propensity to achieve their personal and career goals through nonperformance-based activities. We investigated the role of several dispositional predictors of careerism, including Five-factor model personality traits, primary psychopathy, and exchange ideology. Based on data from 131 respondents, as expected, we observed that emotional stability was negatively correlated with careerism. Primary psychopathy and exchange ideology explained additional variance in careerism after accounting for FFM traits. Relative importance analyses indicated that psychopathy and exchange ideology were equally important (...) in predicting careerism. We highlight the need for future research efforts investigating the combined effects of contextual factors—particularly, human resource practices—and individual differences to understand careerism in the workplace. (shrink)

Deep brain stimulation is a well-established therapy for the motor symptoms of Parkinson’s disease, but there remains an opportunity to improve symptom relief. The temporal pattern of stimulation is a new parameter to consider in DBS therapy, and we compared the effectiveness of Temporally Optimized Patterned Stimulation to standard DBS at reducing the motor symptoms of PD. Twenty-six subjects with DBS for PD received three different patterns of stimulation while on medication and using stimulation parameters optimized for standard DBS. Side (...) effects and motor symptoms were assessed after 30 min of stimulation with each pattern. Subjects experienced similar types of side effects with TOPS and standard DBS, and TOPS were well-tolerated by a majority of the subjects. On average, the most effective TOPS was as effective as standard DBS at reducing the motor symptoms of PD. In some subjects a TOPS pattern was the most effective pattern. Finally, the TOPS pattern with low average frequency was found to be as effective or more effective in about half the subjects while substantially reducing estimated stimulation energy use. TOPS DBS may provide a new programing option to improve DBS therapy for PD by improving symptom reduction and/or increasing energy efficiency. Optimizing stimulation parameters specifically for TOPS DBS may demonstrate further clinical benefit of TOPS DBS in treating the motor symptoms of Parkinson’s disease. (shrink)

Patients with right parietal lesions often deny their paralysis , but do they have "tacit" knowledge of their paralysis? I devised three novel tests to explore this. First, the patients were given a choice between a bimanual task vs a unimanual one . They chose the former on 17 of 18 trials and, surprisingly, showed no frustration or learning despite repeated failed attempts. I conclude that they have no tacit knowledge of paralysis . Second, I used a "virtual reality box" (...) to convey the optical illusion to the patient that she was moving her paralyzed left hand up and down to the rhythm of a metronome, and yet she showed no sign of surprise. Third, I irrigated patient BM′s left ear canal with cold water, a procedure that is known to shift that patient′s spatial frame of reference by stimulating the vestibular system. Surprisingly, this allowed her "repressed" memory of paralysis to come to the surface; she said she had been paralyzed continuously for several days. I suggest that the vestibular stimulation produces these remarkable effects by mimicking REM sleep. These patients also emply a whole arsenal of grossly exaggerated Freudian "defense mechanisms" to account for their paralysis. To explain this, I propose that in normal individuals the left hemisphere ordinarily deals with small, local anomalies by trying to impose consistency but, when the anomaly exceeds threshold, an interaction with the right hemisphere forces a "paradigm shift". A failure of this process, in patients with right hemisphere damage, might partially account for anosognosia. Finally, I present a new conceptual framework that may help link several psychological and neurological phenomena such as Freudian defense mechanisms, vestibular stimulation, anosognosia, memory repression, visual illusions, anterograde amnesia, REM sleep, dreaming, and humor. (shrink)

Background: Mental fatigue can impact physical demands and tactical behavior in sport-related contexts. Small-sided games are often used to develop a specific sport-related context. However, the effects of mental fatigue on physical demands and tactical behaviors during soccer SSGs have not been aggregated for systematical assessment.Objective: This systematic review was conducted to compare the effects of mental fatigue vs. control conditions in terms of the total running distance and tactical behavior of soccer players during SSGs.Methods: The data sources utilized were (...) PubMed, PsycINFO, Scielo, Scopus, SPORTDiscus, and Web of Science. The study eligibility criteria were established based on PICOS: Population: healthy youth and young adult men soccer players with regular training practice and belonging to teams with regular competitions; Intervention: exposed to mental fatigue-induced protocols only before SSGs; Comparator: control conditions before SSGs; Outcomes: physical demands and tactical behavior ; Study design: counterbalanced cross-over design; and only full-text and original articles written in English.Results: The database search initially identified 111 titles. From those, six articles were eligible for the systematic review and meta-analysis. Results showed no significant effect of fatigue on total running distance and tactical behavior.Conclusions: A non-significant effect of mental fatigue on total running distance and tactical behaviors performed by soccer players during SSGs was found in this systematic review. (shrink)

In this paper we show how recent concepts from Dynamic Logic, and in particular from Dynamic Epistemic logic, can be used to model and interpret quantum behavior. Our main thesis is that all the non-classical properties of quantum systems are explainable in terms of the non-classical flow of quantum information. We give a logical analysis of quantum measurements (formalized using modal operators) as triggers for quantum information flow, and we compare them with other logical operators previously used to model various (...) forms of classical information flow: the “test” operator from Dynamic Logic, the “announcement” operator from Dynamic Epistemic Logic and the “revision” operator from Belief Revision theory. The main points stressed in our investigation are the following: (1) The perspective and the techniques of “logical dynamics” are useful for understanding quantum information flow. (2) Quantum mechanics does not require any modification of the classical laws of “static” propositional logic, but only a non-classical dynamics of information. (3) The main such non-classical feature is that, in a quantum world, all information-gathering actions have some ontic side-effects. (4) This ontic impact can affect in its turn the flow of information, leading to non-classical epistemic side-effects (e.g. a type of non-monotonicity) and to states of “objectively imperfect information”. (5) Moreover, the ontic impact is non-local: an information-gathering action on one part of a quantum system can have ontic side-effects on other, far-away parts of the system. (shrink)

Most of us have two strong intuitions (or sets of intuitions) in relation to fairness in health care systems that are funded by public money, whether through taxation or compulsory insurance. The first intuition is that such a system has to treat patients (and other users) fairly, equitably, impartially, justly and without discrimination. The second intuition is that doctors, nurses and other health care professionals are allowed to, and may even in some cases be obligated to give preference to the (...) interests of their particular patients or clients over the interests of other patients or clients of the system. These two intuitions are in potential conflict. One of the most obvious ways in which to ensure impartiality in a health care system is to require impartiality of all actors in the system, i.e. to give health care professionals a duty to treat everyone impartially and to deny them the ‘right’ to give their patients preferential treatment. And one of the possible side-effects of allowing individual health care professionals to give preference to ‘their clients’ is to create inequality in health care. This paper explores the conflict and proposes that it can be right to give preference to ‘your’ patients in certain circumstances. (shrink)

When a physician acts as both doctor and researcher conflicts can develop. When a doctor does not know whether a patient is taking active drug or placebo, any new medical problems can result in a dilemma. Is the patient's suffering a side effect of the medication or is this a new medical problem? Mrs W's case demonstrates the problem that can occur when the physician is blinded in the name of research.

Ecotage, or the destruction of property for the sake of promoting environmental ends, is beginning to (re)establish itself both as a topic of public discussion and as a radical activist tactic. In response to these developments, a small but growing academic literature questions whether, and if so under what conditions, ecotage can be morally justified. This paper contributes to the literature by arguing that instances of ecotage are pro tanto justified insofar as they are instances of effective and proportionate self- (...) and/or other-defense. Having elucidated and defended its central claim, this paper concludes by briefly considering some other morally relevant features of ecotage that might tell for or against its overall justification in particular cases. (shrink)

Whereas indirect euthanasia is a common clinical practice, active euthanasia remains forbidden in most countries. The reason for this differentiation is usually seen in the principle of double-effect (PDE). PDE states that there is a morally relevant difference between the intended consequences of an action and merely foreseen, unintended side-effects. This article discloses the fundamental assumptions presenting the basis for this application of the PDE and examines whether these assumptions are compatible with the PDE. It is shown that neither a (...) liberal nor a utilitarian point of view makes the utilization of the PDE possible. In accordance with philosophical tradition, only within the doctrine of the sanctity of life does the PDE seem to be applicable. By analysing the premises of this doctrine, and comparing them with those of the PDE, the inconsistency of this idea is demonstrated. It is suggested that the role of the PDE in the current discussion on euthanasia is largely exaggerated. (shrink)

In a recent article, Gross argues that physicians in decent societies have a civic duty to aid in the torturing of suspected terrorists during emergency conditions. The argument presupposes a communitarian society in which considerations of common good override questions of individual rights, but it is also utilitarian. In the event that there is a ticking bomb and no other alternative available for defusing it, torture must be used, and physicians must play their part. In an earlier article, Jones also (...) argues in favour of physician participation in torture, going so far as to enthusiastically endorse the allocation of research resources as well to ensure that the ability to meet emergency situations is as efficient as scientifically possible. I argue against both these views and defend the absolute prohibition against torture generally, and against any participation by physicians in particular. I show that these arguments are incompatible with liberal or decent societies, and that the institutional requirements for making torture effective would constitute an unacceptable degradation both of medical ethics and practice, as well as of political institutions in general. (shrink)

In Roman Catholic Moral Theology, a direct abortion is never permitted. An indirect abortion, in which a life threatening pathology is treated, and the treatment inadvertently leads to the death of the fetus, may be permissible in proportionately grave situations. In situations in which a mother’s life is endangered by the pregnancy before the fetus is viable, there is some debate about whether the termination of the pregnancy is a direct or indirect abortion. In this essay a recent case from (...) a Roman Catholic sponsored hospital in Phoenix is reviewed along with the justifications for and arguments against viewing the pregnancy termination as an indirect abortion. After review of several arguments on both sides of the debate, it is concluded that termination of the pregnancy itself as the means of saving the mother cannot be considered an indirect abortion and that the principle of “double effect” does not justify the termination. In addition, the importance of a breakdown in communication between the local bishop and the administration of the hospital is shown to have contributed to the ultimate loss of Catholic sponsorship of the hospital. (shrink)

The number of people who survive critical illness is increasing. In parallel, a growing body of literature reveals a broad range of side-effects following intensive care treatment. Today, more attention is needed to improve the quality of survival. Based on nine individual stories of illness experiences given by participants in two focus groups and one individual interview, this paper elaborates how former critically ill patients craft and recraft their personal stories throughout their illness trajectory. The analysis was conducted from a (...) phenomenological perspective and led to the meaning structure; a quest to find oneself after critical illness. In this structure, illness represented a breakdown of the participants’ lives, forcing them to develop a new understanding of themselves. Despite acute illness, they felt safe in hospital. Coming home, however, meant a constant balancing between health and illness, and being either in or out of control. To gain a deeper understanding of the participants’ narratives of survival, the meaning structure was developed from a phenomenological life world perspective, Heidegger’s concept of homelikeness and Arthur Frank’s typologies of illness narratives. In conclusion listening to and acknowledging the patients’ lived experiences of critical illness may support the patient efforts to establish the newly defined self and hence be vital for recovery. Phenomenology is one approach facilitating care tailored to the patients’ lived experience of critical illness and its aftermaths. (shrink)

The problem of non-compliance with treatment and its repercussions on the clinical evolution of different conditions has been widely investigated.1–4 Non-compliance has also been shown to have significant economic implications, not only as a result of product loss but also indirectly through the complication of disease management and its subsequent healthcare and social costs.5–7Non-compliance as a health problemThe term “non-compliance” might be taken to refer both to the failure to follow a drug regimen and to the failure to adopt other (...) measures that contribute to improvement in health—for example, changes in lifestyle or diet. This letter focuses on the former.Non-compliance with a drug regimen can be the result of a number of different factors9–11 and a variety of techniques have been developed in an attempt to control it.12,13 Of these, the few techniques that have been shown to be effective have only managed to solve the problem in specific situations over short periods of time. The use of such techniques to control non-compliance, particularly where these are effective, raises interesting ethical questions about the extent to which their application constitutes an infringement of the patient’s right to decide on how to manage their own health.8 Here we suggest that in some cases one factor that leads to non-compliance is the tendency to provide extensive and exhaustive information on side effects in …. (shrink)

In this article, tragedy and utopia are juxtaposed, and it is proposed that the problem of “medicalisation” is better understood in a framework of tragedy than in a utopian one. In utopia, it is presupposed that there is an error behind every setback and every side effect, whereas tragedy brings to light how side effects can be the result of irreconcilable conflicts. Medicalisation is to some extent the result of such a tragic conflict. We are given power by medical progress, (...) but are also confronted with our fallibility, thus provoking insecurity. This situation is illustrated by the sudden infant death syndrome . Recent epidemiological investigations have shown that infants sleeping in a prone position have a 15–20 times higher risk of dying from SIDS than infants sleeping in a supine position. A simple means of preventing infant death is suggested by this discovery, but insecurity is also created. What else has been overlooked? Perhaps a draught, or wet diapers, or clothes of wool are just as dangerous as sleeping prone? Further investigations and precautions will be needed, but medicalisation prevails. (shrink)

The issues of the ethics of germ line modification in general and of enhancement by germ line modification in particular have been the subject of hundreds of articles in the bioethical literature. Both because the techniques are far from perfected and because the potential long term side effects are unkown, there is a widespread consensus that germ line modification for enhancement is absolutely unethical and beyond the pale at the present time. The author considers a thought expperiment projecting into the (...) future in which perhaps the safety and reversibility of germ line modification have been clearly demonstrated. Under such circumstances it is contended that the dividing line between treatment and enhancement is difficult and indeed perhaps impossible to maintain. The Jewish tradition is examined and from the various sources cited it would seem that the benefits of certain kinds of genetic enhancements might well outweigh the objections to such manipulations. (shrink)

Treatment-resistant symptoms complicate the clinical course of schizophrenia, and a large proportion of patients do not reach functional recovery. In consequence, polypharmacy is frequently used in treatment-refractory cases, addressing psychotic positive, negative and cognitive symptoms, treatment-emergent side effects caused by antipsychotics and comorbid depressive or obsessive-compulsive symptoms. To a large extent, such strategies are not covered by pharmacological guidelines which strongly suggest antipsychotic monotherapy. Add-on strategies comprise combinations of several antipsychotic agents and augmentations with mood stabilizers; moreover, antidepressants and experimental (...) substances are applied. Based on the accumulated evidence of clinical trials and meta-analyses, combinations of clozapine with certain second-generation antipsychotic agents and the augmentation of antipsychotics with antidepressants seem recommendable, while the augmentation with mood stabilizers cannot be considered superior to placebo. Forthcoming investigations will have to focus on innovative pharmacological agents, the clinical spectrum of cognitive deficits and the implementation of cognitive behavioral therapy. (shrink)

In _The American Way of Peace, _Jan S. Prybyla traces the implementation of an idea derived from bedrock American values that has shaped the American character from the nation’s beginning. The idea—simple, generous, optimistic, and effective—was and remains to give people realizable hope, an attainable dream, by creating a peaceful, secure, and materially comfortable world, a Pax Americana, the American Way of Peace. In the period surveyed, beginning with the end of World War II, this objective was achieved through American (...) initiative and with American leadership, despite resistance from Nazi barbarism, Soviet serfdom, and, more recently, Islamic extremist inhumanity. There has also been opposition from some of those in the western confines of Europe whom Pax Americana helped raise from the ashes to which they had been reduced. _The American Way of Peace _examines the work of reconstruction, the enemy bombardment, as well as the hurtful sniping along the way by the beneficiaries of American support. Prybyla recommends a reevaluation of American relations with those to whom friendship is but a utilitarian device, in light of the present eruption of terrorism worldwide. The need for America to act wisely and resolutely in defense of civilized values, to stem the third tidal wave of terrorist savagery, and to venture where others fear to tread is more compelling now than it has been in the six decades past, for today America’s very survival as a force for immense good in the world is being put to the test. (shrink)

Germany has just started a public debate on priority-setting, rationing and cost-effectiveness due to the cost explosion within the German health care system. To date, the costs for German health care run at 11,6 % of its Gross Domestic Product (GDP, 278,3 billion €) that represents a significant increase from the 5,9 % levels present in 1970. In response, the German Parliament has enacted several major and minor legal reforms over the last three decades for the sake of cost containment (...) and maintaining stability of the health care system. The Statutory Health Insurance—SHI (Gesetzliche Krankenversicherung—GKV) is based on the fundamental principle of solidarity and provides an ethical and legal framework for implementing equity, comprehensiveness and setting the principles and rules for financing and providing health care services and benefits. Within the SHI system, several major actors can be identified: the Federal Ministry of Health, the 16 state ministries of health, the Federal Joint Committee (G-BA), the physicians (with their associations) and the hospitals (with their organizations) on the provider side, and the sickness funds with their associations on the purchasers’ side. This article reviews the structure and complexities of the German health care system with its major players and participants. The focus will be put on relevant ethical, legal and economic aspects for prioritization, rationalization, rationing and cost-effectiveness of medical benefits and services. In conclusion, this article pleads for open discussion on the challenging subject of priority-setting instead of accepting the implicit and non-transparent rationing of medical services that currently occurs at many different levels within the health care system, as it stands today. (shrink)

Chapter one is an introduction. In chapter two, I argue that, due to a lack of knowledge of Newton, Hume is unable to use the "Science of Man" to provide a foundation for the other sciences. Hume's account of causality and the missing shade of blue receive special attention. Hume tries, without paying attention to scientific practice, to constrain what science can be about. ;In chapter three, I reconstruct Adam Smith's epistemology. The major theoretical concept of Smith's moral psychology, the (...) "Impartial Spectator," illuminates his views on the articulation and reception of scientific theories; it brings out the open-ended, social and norm-governed nature of science. Sentiments motivate inquiry, but adopting its results can still be reasonable. After Newton, Smith is not a skeptic, but a realist. ;In chapter four, I explain Smith's methodology in Wealth of Nations . Smith employs a model to enable observed deviations from expected regularities to uncover genuine social causes and aid in improving theory in a potentially open-ended process of successive approximation. I draw on The History of Astronomy where Smith attacks Descartes for trying to explain away deviations from general rules. ;In Chapter five, I explain the political aims of Smith's WN. Smith is an Incremental Redistributionist . Smith's reform proposals and the values that guide his theorizing are in aid of the working poor. I attack a possible political counter-argument against this by attending to Smith's historical understanding of property; Smith's defense of property rights, following Hume's critique of Locke, is by no means absolute. Yet, Smith's appeals to "humanity" appear without justification in WN. ;In chapter six, I investigate the purpose of philosophy in commercial society. In the debate between Rousseau and Hume on philosophic self-understanding, between self-sufficiency and independence, Smith sides with the latter. Smith emphasizes, however, that once basic needs are met, friendship among equals is a more valuable than wealth; it provides happiness and is within every one's reach. Philosophers can enjoy immortality after death if they attempt to be benefactors to humanity, but Smith believes that philosophic friendship is its own and highest reward. (shrink)

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and (...) anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

Efforts for better services are achieved by small steps such as analyzing data of the customer. What is significant for the customer should as well significant for the banking institution. Transparency and a better understand- ding of the pattern behavior of customers can be used for the good of both partners such as good relationships in the fu- ture eventually be beneficial for the customer as well as a banking institution. The responsibility of both sides is crucial to understand the (...) accountability of customers and banking institutions. The method of identification of user messages of the banking application proposed in the article involves the use of user data for information processing, taking into account the peculiarities of the use of mobile devices and the user's dialogue with bank messages. Also, the proposed method allows you to rank messages to identify the most important messages and get the desired result by providing ef- fective recommendations in favor of each of the participants in customer interaction with the bank. The introduction of modern educational programs "Information Control Systems and Technologies", "Artificial Intelligence Systems" and "Systems Analysis" in the field of information technology, allows users and managers to interact with the bank's custo- mers sufficient information to make informed recommendations for effective management decisions. The article consi- ders the conceptual model of interaction of users and managers on interaction with users of the bank, use of technolo- gies and algorithms of artificial intelligence, machine learning processes to formalize the process of dialogue, systema- tization and ranking of messages and notifications between customers and managers. The Conceptual model of inter- action of the user of banking services with messages is presented. The article also describes the features of the dialogue between the user of banking services and the manager for the implementation of algorithms for interaction with custo- mers. The example of the city block of bank users considers and takes into account the difference in the amount of in- formation received by the bank, which must be sent during different periods of the week and take into account the amount of information to be sent, which will be significantly less and, consequently, the number of necessary services. will also be smaller. In this example, taking into account the amount of information that can be consumed during differ- rent periods of the week, the number of services that can be provided to the user will also be much smaller. The reflec- tion of such interactions in the model is an important aspect, as noted in the article. (shrink)

Rosenfield says rhetorical critics agree that the purpose of criticism is to "study the effects of rhetorical discourse". But he claims such a study, like all theoretical analysis, must work through the medium of a set of theoretical concepts. They intervene between us and what we analyze, and contribute to what we are able to say about what exists on the other side of the theoretical grid. In this case, concepts of cause and effect are most important, since rhetorical effects (...) are to be studied. The author then examines two theories of rhetoric, that of Aristotle and that of "information theorists," to see how concepts of cause-effect influence each. He says he need not examine Aristotle’s concept of cause as it works in describing the heavens, nor in theology, nor in "reference to a logical ‘Unmoved Mover'," because such uses do not apply directly to human behavior moreover we cannot interpret Aristotle consistently, "for he contradicts himself" ; moreover we need not depend on Aristotle’s own "explicit statements". The author aims not at providing "an interpretation of Aristotle as revealed in his words," but his attitude of mind, treating his "corpus" in a "flexible" way, allowing "his mind to range away from the printed page". He then proposes to imagine what sort of ideas a sophisticated man like Aristotle, living in a "primitive" society, might have about force, change, etc. This will provide the "foundation" for the author’s interpretation of Aristotle. He goes on to speak about perfective impulses, active and acquiescent powers, dynamic re-alignment, dynamic equilibrium, tendency to order, and referential grids. There are no fewer than 138 references to Aristotle in 36 pages, many long citations, taken from many different works of the Philosopher. Occasionally a remark will point out the difference between Aristotle’s world-view and ours; for instance after quoting Aristotle to the effect that living things need food and perish without it, the author says, "If Aristotle had possessed our vocabulary, he might have said that stable contexts and processes exhibit homeostatic characteristics. However, without the benefit of our experience or terminology, he had to approach such concepts obliquely". (shrink)

Proponents of numerous recent theories of a person's good hold that a plausible account of the good for a person must satisfy existence internalism. Yet little direct defense has been given for this position. I argue that the principal intuition behind internalism supports a stronger version of the thesis than it might appear--one that effects a "double link" to motivation. I then identify and develop the main arguments that have been or might be given in support of internalism about (...) a person's good, showing how these arguments support this stronger version of internalism. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 22 (2002) 133-135 [Access article in PDF] Response to Harry L. Wells Frances S. Adeney Louisville Presbyterian Theological Seminary Current understandings of how religions may reflect divine truth often use a model developed in England by Alan Race that designates attitudes toward other religions as exclusive, inclusive, or pluralist. John Hick's use of this seemingly simple paradigm, in conversation with scholars in the United States, presupposes the (...) reality of the divine, along with the unknowability of that reality through any human effort or religious tradition. Hick mediates that tension by calling on practitioners of all religions to recognize the relativity of their beliefs and, on that basis, tolerate the religions of others. Both use of and critiques of that model have generated lively discussion among scholars and practitioners of religions.Consider, for example, two possible ways to move beyond this model. The first is theological. Attempts to describe the divine by speaking of transcendence, immanence, or emptiness stretch human ability to conceptualize and communicate. Enlarging the understanding of God from within a tradition itself to a view that understands God's presence to be active in all traditions, moves us beyond the pluralist category. A second way of going beyond the current model does not attempt to elucidate pan-religious conceptions of the divine but strives to analyze particular traditions themselves. The history of particular traditions and their encounters with one another influence the theologies of the religions themselves and shape theories of religious otherness purported by those traditions. Finding a particular historical set of conditions and beliefs conducive to a positive pluralism that maintains the integrity of each tradition without relativizing all positions would move us beyond Hick's current relativizing pluralist position. These two approaches each struggle with a different side of the tension resulting from presuppositions in the theory of religions put forward in the exclusivist, inclusivist, pluralist model. The first grapples with the ontological issues and the second addresses the epistemological issues of that tension.Harry Wells chooses to work with the first—the ontological assumption of divine reality. He outlines a Christian Trinitarian relational view of God that not only encompasses but goes beyond the pluralist category as outlined by John Hick. At the same time, he finds the source for that view in a particular historical tradition of Christianity—the early church fathers. [End Page 133]Wells begins by wondering how he can move beyond Raimon Panikkar's pluralism, which, he claims, already moves beyond Hick's understanding of the pluralist category. Wells then outlines his own pluralist understanding by describing a dynamic and relational understanding of the divine. In so doing, he entertains the notion of knowing something of noumenal reality, no matter how indirectly, through the eyes of a particular tradition. By drawing the circle of divine presence very widely, Wells attempts to express from within the Christian tradition a view of God that allows for a distinctive divine work through other traditions. The practitioner, through experience, encounters a reality that changes perceptions both of the divine and of the religious other.Here Wells moves beyond the necessity of deconstructing all absolute claims to truth by different religions in order to maintain a pluralist position. Rather than relativize all particular religious traditions, as Hick suggests, Wells utilizes a perspectival approach and projects from it a view of the divine that allows for truth in other traditions. In this way he removes the debilitating necessity of embracing agnosticism by all religious traditions and shows, rather, how pluralist claims may be formed from within a single deeply held tradition.This broader understanding of the divine, rooted in early Christian mysticism according to Wells, does not rule out tolerance of other religions but embraces tolerance for reasons of faith, rather than through agnosticism. In effect, Wells argues that a theological orientation growing from an encounter with divine mystery influences the articulation of a specific tradition and its stance toward other religions.While avoiding the dualism inherent in studying religions only phenomenonologically and, at the same time, postulating a noumenal reality, this approach is not without its dangers. One... (shrink)

Social evolution theory conventionally takes an externalist explanatory stance, treating observed cooperation as explanandum and the positive assortment of cooperative behaviour as explanans. We ask how the circumstances bringing about this positive assortment arose in the first place. Rather than merely push the explanatory problem back a step, we move from an externalist to an interactionist explanatory stance, in the spirit of Lewontin and the Niche Construction theorists. We develop a theory of ‘social niche construction’ in which we consider biological (...) entities to be both the subject and object of their own social evolution. Some important cases of the evolution of cooperation have the side-effect of causing changes in the hierarchical level at which the evolutionary process acts. This is because the traits that act to align the fitness interests of particles in a collective can also act to diminish the extent to which those particles are bearers of heritable fitness variance, while augmenting the extent to which collectives of such particles are bearers of heritable fitness variance. In this way, we can explain upward transitions in the hierarchical level at which the Darwinian machine operates in terms of particle-level selection, even though the outcome of the process is a collective-level selection regime. Our theory avoids the logical and metaphysical paradoxes faced by other attempts to explain evolutionary transitions. (shrink)

The dystopian elements of the Alien films display the dark side of social mechanisms. Modern philosophy is not exempt from the temptations of this “authoritarian synthesis”. It also responds to the themes of impurity, whether through religious heresy, mental illness, or bodily invasion or corruption. In the shooting script for Alien, it is clear that Ripley has been “infected” by the Xenomorph Facehugger in the pod; on screen, that fact is held from us until much later in the film for (...) dramatic effect. Ripley's fears about contagion actually fit together well with the thinking of the German Idealist philosophers of the late eighteenth and early nineteenth centuries, who were among the first philosophers of biology. Ripley does not seem much interested in sex throughout the first two Alien films, but she is interested in having a family, especially after Newt's death. (shrink)

Lady Mary Shepherd holds that the relation of cause and effect consists of the combination of two objects to create a third object. She also holds that this account implies that causes are synchronous with their effects. There is a single instant in which the objects that are causes combine to create the object which is their effect. Hume argues that cause and effect cannot be synchronous because if they were then the entire chain of successive causes and effects would (...) all collapse into a single moment, and succession would not be possible. I argue that Shepherd has a ready, although implicit response, to Hume’s argument. Since causation is combination on Shepherd’s view, she is free to hold that there are times in between those instants in which combinations occur, during which times other, non-combinatory changes occur, which changes account for succession. (shrink)

Happ presents this volume as essentially a philological study of the concept of matter in Aristotle. He is well aware of the philosophical issues and explicitly states his position on them, but the dominant concern is with a close and exhaustive analysis of relevant texts. The work is meant to be a contribution to the history of ideas, and Happ intends to continue the study in other periods of Greek thought. He does not cover all the aspects of the problem (...) of matter; he admits, for instance, that the problem of the substantiality of matter has been left aside. Philosophically, he tries to avoid the extremes of idealism and realism, and sees Aristotle's theory of knowledge as involving both subject and object; phenomena need the help of mind to become actual. He also considers Aristotle to be more similar to Plato than many authors do, and thinks there is little chronological development in the basic issues of Aristotle's thought. He admits aporetic aspects in Aristotle, but combined with an approach to philosophical problems which is both systematic and dynamic. There are eight major sections in the book: An exhaustive review of the literature and a statement of the philosophical viewpoint of the author; Matter in Plato and the Academy, and Aristotle's introduction of the term hylë. ; Matter as substrate for opposites; Metaphysics IV, VI, XI; Matter in the celestial world; Meteorology IV and the biological works; Matter and knowledge; abstraction; matter and mathematics; matter and the science of metaphysics. ; Matter as a principle of being. There as 130 pages of indices and numerous cross-references in the footnotes. Happ stresses that matter is a principle of being in Aristotle, not anything "stuffy," as it was taken by the Stoics. He claims the "idealist" side of Aristotle's doctrine on matter had little philosophical effect in later thought; but isn't the medieval notion of prime matter precisely that of a principle? And is the Plotinian notion of matter as close to Aristotle as Happ claims? One may wonder if he is reading neo-platonic spiritualized matter back into Aristotle. Some of the best pages deal with mathematics and the need for mind to actualize mathematical entities, and with analysis of matter in the heavens and in aether. Happ admits to conjecture when he says that in Metaphysics VII 3 Aristotle, through his via negativa, reaches matter as a general principle of being, beyond the physical substratum of material things. In its comprehension, depth and subtlety of analysis, this work is clearly one of the major studies on Aristotle; it is also superbly printed and bound, and exorbitantly priced.--R. S. (shrink)

One of the key problems facing bioethics concerns those cases where, due to the limited human and technical resources of medicine, patients are in fact doomed to die. The reason for withdrawing treatment may be the futility of using the available means, as well as the burden of certain procedures. In the contemporary world, euthanasia is offered as an alternative to withdrawing treatment, that is, direct causing the death of a patient, killing. They distinguish these two types of practice by (...) analyzing the duties of the physician, the intentions of all subjects, the differences between action and inaction. The obligation to save the patient at all costs should be rejected because of the non-humanity of this principle. That is why, however, the doctor faces a dilemma: to leave the patient to natural processes, or to kill him or her directly. The intention in both cases is to solve a problem in which the treatment of the patient becomes futile, and the withdrawing sooner or later leads to death. Euthanasia in its passive form may procedurally coincide with the withdrawing treatment. Withdrawing treatment is the decision, and therefore, it is more an action than inaction. It seems that the choice between euthanasia and withdrawing treatment is purely technical. The author of the article suggests comparing the mechanisms of decision making in the application of euthanasia and withdrawing treatment, looking at the purpose of these decisions and the means of its reaching. In the case of euthanasia, the purpose of action or inaction is to relieve suffering, and the means is to cause death. In the case of withdrawing treatment, instead, the goal is also the good of the patient, but death is not a means but a side effect. Therefore, the author recognizes that withdrawing treatment is a more moral practice than euthanasia, which is a direct killing and is justified by the low value of one’s life. (shrink)

The doctrine (or principle) of double effect is often invoked to explain the permissibility of an action that causes a serious harm, such as the death of a human being, as a side effect of promoting some good end. According to the principle of double effect, sometimes it is permissible to cause a harm as a side effect (or “double effect”) of bringing about a good result even though it would not be permissible to cause such a harm as a (...) means to bringing about the same good end. Does the principle of double effect play the important explanatory role that has been claimed for it? To consider this question, one must be careful to clarify just what the principle is supposed to explain. Three misinterpretations of the principle’s force or range of application are common. 1. To ensure that Double Effect is not misunderstood as principle issuing a blanket permission on causing any unintended harm that yields a benefit, applications must require that the agent seek to minimize the harm involved. 2. Since it is widely accepted that it is wrong to aim to produce harm to someone as an end, to rule this out is not part of double effect’s distinctive content. 3. Harms that were produced regretfully and only for the sake of producing a good end may be prohibited by double effect because they were brought about as part of the agent’s means to realizing the good end. (shrink)