Planned home birth has been considered by some to be consistent with professional responsibility in patient care. This article critically assesses the ethical and scientific justification for this view and shows it to be unjustified. We critically assess recent statements by professional associations of obstetricians, one that sanctions and one that endorses planned home birth. We base our critical appraisal on the professional responsibility model of obstetric ethics, which is based on the ethical concept of medicine from the Scottish and (...) English Enlightenments of the 18th century. Our critical assessment supports the following conclusions. Because of its significantly increased, preventable perinatal risks, planned home birth in the United States is not clinically or ethically benign. Attending planned home birth, no matter one’s training or experience, is not acting in a professional capacity, because this role preventably results in clinically unnecessary and therefore clinically unacceptable perinatal risk. It is therefore not consistent with the ethical concept of medicine as a profession for any attendant to planned home birth to represent himself or herself as a “professional.” Obstetric healthcare associations should neither sanction nor endorse planned home birth. Instead, these associations should recommend against planned home birth. Obstetric healthcare professionals should respond to expressions of interest in planned home birth by pregnant women by informing them that it incurs significantly increased, preventable perinatal risks, by recommending strongly against planned home birth, and by recommending strongly for planned hospital birth. Obstetric healthcare professionals should routinely provide excellent obstetric care to all women transferred to the hospital from a planned home birth. The professional responsibility model of obstetric ethics requires obstetricians to address and remedy legitimate dissatisfaction with some hospital settings and address patients’ concerns about excessive interventions. Creating a sustained culture of comprehensive safety, which cannot be achieved in planned home birth, informed by compassionate and respectful treatment of pregnant women, should be a primary focus of professional obstetric responsibility. (shrink)

Objective To determine the attitudes of Egyptian patients regarding their participation in research and with the collection, storage and future use of blood samples for research purposes. Design Cross-sectional survey. Study population Adult Egyptian patients (n=600) at rural and urban hospitals and clinics. Results Less than half of the study population (44.3%) felt that informed consent forms should provide research participants the option to have their blood samples stored for future research. Of these participants, 39.9% thought that consent forms should (...) include the option that future research be restricted to the illness being studied. A slight majority (66.2%) would donate their samples for future genetic research. Respondents were more favourable towards having their blood samples exported to other Arab countries (62.0%) compared with countries in Europe (41.8%, p<0.001) and to the USA (37.2%, p<0.001). Conclusions This study shows that many individuals do not favour the donation of a blood sample for future research. Of those who do approve of such future research, many favour a consent model that includes an option restricting the future research to the illness being studied. Also, many Egyptians were hesitant to have their blood samples donated for genetic research or exported out of the Arab region to the USA and European countries. Further qualitative research should be performed to determine the underlying reasons for many of our results. (shrink)

ABSTRACT Closed time is possible in several senses of ‘possible’. One might like to know, therefore, whether closed time is possible in the sense that it is compatible with standard metaphysical theories of time. In this paper I am concerned with whether closed time is compatible with A and/or B theories of time. A common enough view amongst philosophers is that B theories do but A theories do not allow closed time. However, I show that prima-facie neither approach allows closed (...) time, but that with a little work standard versions of both approaches do. This shows that there’s no special problem with the notion of eternal return. (shrink)

Tradition and authority in theologyThe problem of authority in theology is as old as the Bible itself. Authority comes into question especially when a new trend in theology diverges from the approved. One can claim authority for a 'new' theology by reinterpretation of an authoritative tradition; by miracle stories; by association of one's theological point of view with an authoritative person from the past; and by an appeal to the oldest stratum in the authoritative text or tradition. This article concentrates (...) mainly on the Biblical era. (shrink)

While the question of free will does not figure as prominently in Buddhist writings as it does in western theology, philosophy, and psychology, it is a topic that was addressed in the earliest Buddhist writings. According to these accounts, for pragmatic and ethical reasons, the Buddha rejected both determinism and indeterminism as understood at that time. Rather than asking the metaphysical question of whether already humans have free will, Buddhist tradition takes a more pragmatic approach, exploring ways in which we (...) can acquire greater freedom to make wise choices that are truly conducive to our own and others' genuine well-being. One key to achieving such freedom is the cultivation of attentional skills so that one can deliberately focus one's attention with continuity and clarity on one's chosen object. A second theme is the cultivation of insight into the manner in which our own attitudes shape experience, allowing for the possibility of altering not only the way we experience events in the present, but also how we are influenced by our memories of the past. Finally, the Great Perfection school of Tibetan Buddhism emphasizes the realization of the deepest dimension of consciousness -- pristine awareness -- which transcends the nexus of causality. This is regarded as the ultimate source of freedom and the ultimate nature of human identity. (shrink)

Objectives: to assess physicians’ and patients’ views in Saudi Arabia towards involving the patient versus the family in the process of diagnosis disclosure and decision-making, and to compare them with views from the USA and Japan.Design: A self-completion questionnaire was translated to Arabic and validated.Participants: Physicians from different specialties and ranks and patients in a hospital or attending outpatient clinics from 6 different regions in KSA.Results: In the case of a patient with incurable cancer, 67% of doctors and (...) 51% of patients indicated that they would inform the patient in preference to the family of the diagnosis . Assuming the family already knew, 56% of doctors and 49% of patients would tell the patient even if family objected . However, in the case of HIV infection, 59% of physicians and 81% of patients would inform the family about HIV status without the patient’s consent . With regards to withholding ventilatory support, about 50% of doctors and over 60% of patients supported the use of mechanical ventilation in a patient with advanced cancer, regardless of the wishes of the patient or the family. Finally, the majority of doctors and patients were against assisted suicide.Conclusions: Although there was more recognition for a patient’s autonomy amongst physicians, most patients preferred a family centred model of care. Views towards information disclosure were midway between those of the USA and Japan. Distinctively, however, decisions regarding life prolonging therapy and assisted suicide were not influenced to a great extent by wishes of the patient or family, but more likely by religious beliefs. (shrink)

Calling is a very important concept in Christianity. In the medieval era, calling was restricted to ecclesiastical work alone, a devotion to the life of contemplation. Ordinary work or physical labour was not considered qualified to be a calling. Martin Luther was the one who taught that the ordinary work of the ordinary people was also God’s calling and equally spiritual as the ecclesiastical work. However, Miroslav Volf, a Croatian theologian, criticised Luther that his view of calling was too static (...) and irrelevant to the modern context where people often choose to quit a job because of its negative effects and some people have to do multiple jobs in order to make ends meet. While recognising the validity of Volf’s critique, this article seeks to demonstrate that even in the modern context, calling is still a very important theological concept to reflect upon work. Luther’s vocational view of work could be retrieved in discussing the theology of work by putting it in dialogue with Calvin, Kuyper, and other theologians.Contribution: This article seeks to show that the concept of calling is indispensable in constructing a sound theology of work for the modern context. By understanding work as calling, Christian workers are enabled to see how they are participating in God’s redemptive work through their jobs. (shrink)

Pregnant women and their interests have been underrepresented in health research. Little is known about issues relevant to women considering research participation during pregnancy. We performed in-depth interviews with 22 women enrolled in either one of two trials sponsored by the National Institutes of Health to assess the safety and immunogenicity of the H1N1 vaccine during pregnancy. Three themes characterized women’s decisions to participate in research: they valued early access to the vaccine, they perceived a safety advantage when participating in (...) research, and they wanted to help advance scientific knowledge. However, there were also some considerations that would disincline them to participate in research—for instance, a significant risk of maternal or fetal harm, the presence of a placebo arm in a study, or a requirement to significantly change planned therapy or behavior. Pregnant women who participated in the H1N1 vaccine trials viewed research favorably, citing its advantages over standard clinical care. These findings emphasize that access to benefit should guide policy for including pregnant women in research. (shrink)

Reading is not only “cold” information processing, but involves affective and aesthetic processes that go far beyond what current models of word recognition, sentence processing, or text comprehension can explain. To investigate such “hot” reading processes, standardized instruments that quantify both psycholinguistic and emotional variables at the sublexical, lexical, inter-, and supralexical levels (e.g., phonological iconicity, word valence, arousal-span, or passage suspense) are necessary. One such instrument, the Berlin Affective Word List (BAWL) has been used in over 50 published studies (...) demonstrating effects of lexical emotional variables on all relevant processing levels (experiential, behavioral, neuronal). In this paper, we first present new data from several BAWL studies. Together, these studies examine various views on affective effects in reading arising from dimensional (e.g., valence ) and discrete emotion features (e.g., happiness ), or embodied cognition features like smelling. Second, we extend our investigation of the complex issue of affective word processing to words characterized by a mixture of affects. These words entail positive and negative valence, and/or features making them beautiful or ugly. Finally, we discuss tentative neurocognitive models of affective word processing in the light of the present results, raising new issues for future studies. (shrink)

Without a doubt, one of the main reasons Platonsim remains such a strong contender in the Foundations of Mathematics debate is because of the prima facie plausibility of the claim that objectivity needs objects. It seems like nothing else but the existence of external referents for the terms of our mathematical theories and calculations can guarantee the objectivity of our mathematical knowledge. The reason why Frege – and most Platonists ever since – could not adhere to the idea that mathematical (...) objects were mental, conventional or in any other way dependent on our faculties, will or other historical contingencies was that objects whose properties of existence depended on such contingencies could not warrant the objectivity required for scientific knowledge. This idea gained currency in the second half of the 19th Century and remains current for the most part today. However, it was not always like that. Objectivity, after all, has a history, and according to its historians (Daston 2001), the view that scientific knowledge need be objective is a fairly recent one. Up until mid-19th Century, science was not so much concerned with objectivity, as it was concerned with truth. Before the rise of the modern university and the professional scientist, science had the discovery of truths as its ultimate goal. In contrast, modern science now aims at the production and acquisition of objective knowledge. The difference might seem.. (shrink)

What is it to be a woman? What is it to be a man? We start by laying out desiderata for an analysis of 'woman' and 'man': descriptively, it should link these gender categories to sex biology without reducing them to sex biology, and politically, it should help us explain and combat traditional sexism while also allowing us to make sense of the activist view that gendering should be consensual. Using a Putnam-style 'Twin Earth' example, we argue that none of (...) the existing analyses in the feminist literature succeeds in meeting all of our desiderata. Finally, we propose a positive account that we believe can satisfy all the desiderata outlined. According to our theory, the genders 'woman' and 'man' are individuated not by their contemporary connections to sex biology, but by their historical continuity with classes that were originally closely connected to sex biology. (shrink)

Susan Schneider (2019) has proposed two new tests for consciousness in AI (artificial intelligence) systems, the AI Consciousness Test and the Chip Test. On their face, the two tests seem to have the virtue of proving satisfactory to a wide range of consciousness theorists holding divergent theoretical positions, rather than narrowly relying on the truth of any particular theory of consciousness. Unfortunately, both tests are undermined in having an ‘audience problem’: Those theorists with the kind of architectural worries that motivate (...) the need for such tests should, on similar grounds, doubt that the tests establish the existence of genuine consciousness in the AI in question. Nonetheless, the proposed tests constitute progress, as they could find use by some theorists holding fitting views about consciousness and perhaps in conjunction with other tests for AI consciousness. (shrink)

The present work posits that social motives, particularly status seeking in the form of moral grandstanding, are likely at least partially to blame for elevated levels of affective polarization and ideological extremism in the U.S. In Study 1, results from both undergraduates (N = 981; Mean age = 19.4; SD = 2.1; 69.7% women) and a cross-section of U.S. adults matched to 2010 census norms (N = 1,063; Mean age = 48.20, SD = 16.38; 49.8% women) indicated that prestige-motived grandstanding (...) was consistently and robustly related to more extreme ideological views on a variety of issues. In Study 2, results from a weighted, nationally-representative cross-section of U.S. adults (N = 2,519; Mean age = 47.5, SD = 17.8; 51.4% women) found that prestige motivated grandstanding was reliably related to both ideological extremism and affective polarization. (shrink)

This book offers an introduction to the Sophists of fifth-century Athens and a new overall interpretation of their thought. Since Plato first animadverted on their activities, the Sophists have commonly been presented as little better than intellectual mountebanks - a picture which Professor Kerferd forcefully challenges here. Interpreting the evidence with care, he shows them to have been part of an exciting and historically crucial intellectual movement. At the centre of their teaching was a form of relativism, most famously expressed (...) by Protagoras as 'Man is the measure of all things', and which they developed in a wide range of views - on knowledge and argument, virtue, government, society, and the gods. On all these subjects the Sophists did far more than simply provoke Plato to thought. Their contributions were substantial and serious; they inaugurated the debate on many central philosophical questions and decisively shifted the focus of philosophical attention from the cosmos to man. (shrink)

This provocative but persuasive book is essentially a radical attack upon the Humean conception of causality and the presentation and defense of a counter-theory, closer to everyday experience and pre-Humean traditional views. As formulated by empiricist philosophers, the Humean approach depends on two basic postulates. The philosophical analysis of any non-empirical concept must be a formal explication; any residue elements have to be accounted for in terms of their psychological origins. The world as experienced can be conceived adequately as (...) a logically independent system of things or flux of events, without the unwarranted assumption that individuals persist diachronically. As the grounds for undermining these assumptions, the authors develop a conception of causes as "powerful particulars," i.e., things which have both a nature and powers. So long as the nature remains unchanged the agent in question will continue to behave in this fashion with a natural necessity, stemming from the individual’s nature and specific powers. The opening chapter discusses the problem of conceptual and natural necessity—as distinct from logical necessity which alone is allowed by the Humean empiricists. Natural necessity is the mark of the relationship between real causes and their respective effects, whereas conceptual necessity characterizes the way our statements about such are themselves related. Later the irreducibility of natural necessity is emphasized and its differences from logical entailment spelled out. Chapter two takes up the subject of the "regularity theory and its allies." Characteristic of such are two claims: the empirical content of a causal-relationship statement is exhausted by the actual or hypothetical regularity between independent entities, and the necessity ordinarily attributed to causal production is an illusion, to be accounted for in various ways. Subsequent chapters are devoted to assaulting the pillars of the Humean notion either directly or indirectly through an illuminating and attractive account of their own theory of nature, causal powers, and natural necessity. The final chapter, entitled "Fields of Potential," indulges in speculation about the nature of ultimate entities on the basis of an extended generalization of the notion of the powerful individual, and concludes with a brief account of the historical antecedents of Faraday’s modern field theory and the metaphysical implications of a generalized field theory.—A.B.W. (shrink)

"Procedural Justice" offers a theory of procedural fairness for civil dispute resolution. The core idea behind the theory is the procedural legitimacy thesis: participation rights are essential for the legitimacy of adjudicatory procedures. The theory yields two principles of procedural justice: the accuracy principle and the participation principle. The two principles require a system of procedure to aim at accuracy and to afford reasonable rights of participation qualified by a practicability constraint. The Article begins in Part I, Introduction, with two (...) observations. First, the function of procedure is to particularize general substantive norms so that they can guide action. Second, the hard problem of procedural justice corresponds to the following question: How can we regard ourselves as obligated by legitimate authority to comply with a judgment that we believe (or even know) to be in error with respect to the substantive merits? The theory of procedural justice is developed in several stages, beginning with some preliminary questions and problems. The first question - what is procedure? - is the most difficult and requires an extensive answer: Part II, Substance and Procedure, defines the subject of the inquiry by offering a new theory of the distinction between substance and procedure that acknowledges the entanglement of the action-guiding roles of substantive and procedural rules while preserving the distinction between two ideal types of rules. The key to the development of this account of the nature of procedure is a thought experiment, in which we imagine a world with the maximum possible acoustic separation between substance and procedure. Part III, The Foundations of Procedural Justice, lays out the premises of general jurisprudence that ground the theory and answers a series of objections to the notion that the search for a theory of procedural justice is a worthwhile enterprise. Sections II and III set the stage for the more difficult work of constructing a theory of procedural legitimacy. Part IV, Views of Procedural Justice, investigates the theories of procedural fairness found explicitly or implicitly in case law and commentary. After a preliminary inquiry that distinguishes procedural justice from other forms of justice, Part IV focuses on three models or theories. The first, the accuracy model, assumes that the aim of civil dispute resolution is correct application of the law to the facts. The second, the balancing model, assumes that the aim of civil procedure is to strike a fair balance between the costs and benefits of adjudication. The third, the participation model, assumes that the very idea of a correct outcome must be understood as a function of process that guarantees fair and equal participation. Part IV demonstrates that none of these models provides the basis for a fully adequate theory of procedural justice. In Part V, The Value of Participation, the lessons learned from analysis and critique of the three models are then applied to the question whether a right of participation can be justified for reasons that are not reducible to either its effect on the accuracy or its effect on the cost of adjudication. The most important result of Part V is the Participatory Legitimacy Thesis: it is (usually) a condition for the fairness of a procedure that those who are to be finally bound shall have a reasonable opportunity to participate in the proceedings. The central normative thrust of Procedural Justice is developed in Part VI, Principles of Procedural Justice. The first principle, the Participation Principle, stipulates a minimum (and minimal) right of participation, in the form of notice and an opportunity to be heard, that must be satisfied (if feasible) in order for a procedure to be considered fair. The second principle, the Accuracy Principle, specifies the achievement of legally correct outcomes as the criterion for measuring procedural fairness, subject to four provisos, each of which sets out circumstances under which a departure from the goal of accuracy is justified by procedural fairness itself. In Part VII, The Problem of Aggregation, the Participation Principle and the Accuracy Principle are applied to the central problem of contemporary civil procedure - the aggregation of claims in mass litigation. Part VIII offers some concluding observations about the point and significance of Procedural Justice. (shrink)

The International Classification of Functioning, Disability and Health (ICF), designed by the WHO, attempts to provide a holistic model of functioning and disability by integrating a medical model with a social one. The aim of this article is to analyze the ICF’s claim to holism. The following components of the ICF’s complexity are analyzed: (1) health condition, (2) body functions and structures, (3) activity, (4) participation, (5) environmental factors, (6) personal factors, and (7) health. Although the ICF claims to be (...) holistic, it presupposes a monistic materialistic ontology. We indicate some limitations of this ontology, proposing instead: (a) a pluralistic–holistic ontology (PHO) and (b) a multidimensional view of the human being, with individual and environmental aspects, in relation to three levels of reality implied by the PHO. For the ICF to attain its holistic claim, the interactions between its components should be based on (a) and (b). (shrink)

Could an artificial intelligence become a legal person? As of today, this question is only theoretical. No existing computer program currently possesses the sort of capacities that would justify serious judicial inquiry into the question of legal personhood. The question is nonetheless of some interest. Cognitive science begins with the assumption that the nature of human intelligence is computational, and therefore, that the human mind can, in principle, be modelled as a program that runs on a computer. Artificial intelligence (AI) (...) research attempts to develop such models. But even as cognitive science has displaced behavioralism as the dominant paradigm for investigating the human mind, fundamental questions about the very possibility of artificial intelligence continue to be debated. This Essay explores those questions through a series of thought experiments that transform the theoretical question whether artificial intelligence is possible into legal questions such as, "Could an artificial intelligence serve as a trustee?" What is the relevance of these legal thought experiments for the debate over the possibility of artificial intelligence? A preliminary answer to this question has two parts. First, putting the AI debate in a concrete legal context acts as a pragmatic Occam's razor. By reexamining positions taken in cognitive science or the philosophy of artificial intelligence as legal arguments, we are forced to see them anew in a relentlessly pragmatic context. Philosophical claims that no program running on a digital computer could really be intelligent are put into a context that requires us to take a hard look at just what practical importance the missing reality could have for the way we speak and conduct our affairs. In other words, the legal context provides a way to ask for the "cash value" of the arguments. The hypothesis developed in this Essay is that only some of the claims made in the debate over the possibility of AI do make a pragmatic difference, and it is pragmatic differences that ought to be decisive. Second, and more controversially, we can view the legal system as a repository of knowledge-a formal accumulation of practical judgments. The law embodies core insights about the way the world works and how we evaluate it. Moreover, in common-law systems judges strive to decide particular cases in a way that best fits the legal landscape-the prior cases, the statutory law, and the constitution. Hence, transforming the abstract debate over the possibility of AI into an imagined hard case forces us to check our intuitions and arguments against the assumptions that underlie social decisions made in many other contexts. By using a thought experiment that explicitly focuses on wide coherence, we increase the chance that the positions we eventually adopt will be in reflective equilibrium with our views about related matters. In addition, the law embodies practical knowledge in a form that is subject to public examination and discussion. Legal materials are published and subject to widespread public scrutiny and discussion. Some of the insights gleaned in the law may clarify our approach to the artificial intelligence debate. (shrink)

There is currently a debate over whether cognitive architecture is classical or connectionist in nature. One finds the following three comparisons between classical architecture and connectionist architecture made in the pro-connectionist literature in this debate: (1) connectionist architecture is neurally plausible and classical architecture is not; (2) connectionist architecture is far better suited to model pattern recognition capacities than is classical architecture; and (3) connectionist architecture is far better suited to model the acquisition of pattern recognition capacities by learning than (...) is classical architecture. If true, (1)-(3) would yield a compelling case against the view that cognitive architecture is classical, and would offer some reason to think that cognitive architecture may be connectionist. We first present the case for (1)-(3) in the very words of connectionist enthusiasts. We then argue that the currently available evidence fails to support any of (1)-(3). (shrink)

The use of biotechnology in food productiongives rise to consumer concerns. The term ``consumerconcern'' is often used as a container notion. Itincludes concerns about food safety, environmental andanimal welfare consequences of food productionsystems, and intrinsic moral objections againstgenetic modification. In order to create clarity adistinction between three different kinds of consumerconcern is proposed. Consumer concerns can be seen assigns of loss of trust. Maintaining consumer trustasks for governmental action. Towards consumerconcerns, governments seem to have limitedpossibilities for public policy. Under current (...) WTOregulations designed to prevent trade disputes,governments can only limit their policies to 1) safetyregulation based upon sound scientific evidence and 2)the stimulation of a system of product labeling. Ananalysis of trust, however, can show that ifgovernments limit their efforts in this way, they willnot do enough to avoid the types of consumer concernsthat diminish trust. The establishment of a technicalbody for food safety – although perhaps necessary –is in itself not enough, because concerns that relatedirectly to food safety cannot be solved by ``pure''science alone. And labeling can only be a good way totake consumer concerns seriously if these concerns arerelated to consumer autonomy. For consumer concernsthat are linked to ideas about a good society,labeling can only provide a solution if it is seen asan addition to political action rather than as itssubstitution. Labeling can help consumers take uptheir political responsibility. As citizens, consumershave certain reasonable concerns that can justifiableinfluence the market. In a free-market society, theyare, as buyers, co-creators of the market, andsocietal steering is partly done by the market.Therefore, they need the information to co-create thatmarket. The basis of labeling in these cases, however,is not the good life of the individual but thepolitical responsibility people have in their role asparticipants in a free-market. Then, public concernsare taken seriously. Labeling in that case does nottake away the possibilities of reaching politicalgoals, but it adds a possibility. (shrink)

Objectives: To analyse and compare the surveys on German doctors and judges on end of life decision making regarding their attitudes on the advance directive and on the dying process.Design: The respondents were to indicate their agreement or disagreement to eight statements on the advance directive and to specify their personal view on the beginning of the dying process.Participants: 727 doctors in three federal states and 469 judges dealing with guardianship matters all over Germany.Main measurements: Comparisons of means, analyses of (...) variance, pivot tables and factor analyses .Results: Three attitude groups on advance directive were disclosed by the analysis: the decision model, which emphasises the binding character of a situational advance directive; the deliberation model, which puts more emphasis on the communicative aspect; and the delegation model, which regards the advance directive as a legal instrument. The answers regarding the beginning of the dying process were broadly distributed, but no marked difference was observed between the responding professions. The dying process was assumed by most participants to begin with a life expectancy of only a few days.Conclusions: A high degree of valuation for advance directive was seen in both German doctors and judges; most agreed to the binding character of the situational directive. Regarding the different individual concepts of the dying process, a cross-professional discourse on the contents of this term seems to be overdue. (shrink)

According to transhumanists who urge the radical enhancement of human beings, humanity’s top priority should be engineering “posthumans,” whose features would include agelessness. Increasingly, transhumanism is critiqued on foundational grounds rather than based largely on anticipated results of its implementation, such as rising social inequality. This expansion is crucial but insufficient because, despite its radical aim, transhumanism reflects beliefs and attitudes that are evident in the broader culture. With a focus on the yearning to eliminate aging, I consider four of (...) these: a disproportionate reliance on science and technology to address major human challenges; the conceptualization of human beings in terms of binaries like “young-old”; a repudiation of vulnerability; and intensifying perfectionism. Illuminating these interlocked commitments both deepens an existing critique of transhumanism and draws our attention to deleterious cultural views that must be vigorously contested if our commitment to human flourishing is to be deep and unwavering. (shrink)

Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

This work represents an attempt to assess the nature and extent of Moore's influence on twentieth century philosophy. The essays it contains were all written in or after 1958, the year of Moore's death, by philosophers whom he knew and respected. As such the writers were often able to highlight certain neglected aspects of his thought as well as ideas he never put in print. Though 10 of the 19 essays have appeared in print before, there are original papers by (...) Ryle, Ewing, William and Martha Kneale, Ayer, Lazerowitz and Urmson as well as somewhat longer studies by Kennick, Greig and Redpath. Together they deal with practically every aspect of Moore's metaphysical and ethical views, his often misunderstood philosophy of common sense, and the special methodology he thought particularly appropriate for investigating philosophical problems. In addition to special treatises on his views on utilitarianism, the naturalistic fallacy, free will, and propositions, the book is introduced with the delightful biographical study Braithwaite did for the Proceedings of the British Academy. The editors see Moore's writings not only as a model of the standard of exactness and refinement of thought one has come to expect of a careful philosopher, but as altering the direction of philosophical investigation. His method of analysis, and especially his ability to translate abstract formulations into concrete meanings, opened the eyes of philosophers to the fuzzy aspects and latent confusions in their own views and arguments. As his former pupils, the editors may be excused for feeling that philosophy after Moore will never be the same as before, but by bringing together this fine selection of essays they have done much to insure his contribution will not be forgotten.--A. B. W. (shrink)

In current dairy farming it is possible to run a profitable farm without having to adapt the system to the needs of dairy cows. In such systems the interests of the farmer and animals often diverge. Consequently, specific animal welfare problems occur. Foot disorders in dairy cattle are an illustrative example resulting from the specific methods of housing and management in current dairy farming. Foot disorders and the resulting lameness are considered the most important welfare problem in dairy farming. However, (...) these foot disorders not only typify welfare problems related to certain housing systems, but they also lead to the premature culling of cows. The assessment of the impact of foot disorders on the welfare of dairy cows raised the question of whether premature culling affects animal welfare since it affects the longevity of a cow. We argue that this aspect of longevity is morally relevant as an animal welfare issue. In this paper we aim to explore whether longevity is both (a) a morally relevant aspect in the discussion on killing animals and (b) a constitutive element of animal welfare. In other words, we aim to explore whether longevity is an independent moral argument in an animal welfare discussion. We claim that longevity is not merely important as an indicator of animal welfare, but is also a constitutive element of animal welfare. We argue that we need a more integrated approach to animal welfare and that an assessment that includes the aspect of time is necessary. This view involves a shift from views on animal welfare in terms of functioning or feeling well to a view on animal welfare that includes the aspect of natural living in which species-specific development is important. To show the impact of these points of view, we look at the practical implications for choices concerning the management of foot disorders in dairy cattle. (shrink)

In communities of user-generated content, systems for the management of content and/or their contributors are usually accepted without much protest. Not so, however, in the case of Wikipedia, in which the proposal to introduce a system of review for new edits (in order to counter vandalism) led to heated discussions. This debate is analysed, and arguments of both supporters and opponents (of English, German and French tongue) are extracted from Wikipedian archives. In order to better understand this division of the (...) minds, an analogy is drawn with theories of bureaucracy as developed for real-life organizations. From these it transpires that bureaucratic rules may be perceived as springing from either a control logic or an enabling logic. In Wikipedia, then, both perceptions were at work, depending on the underlying views of participants. Wikipedians either rejected the proposed scheme (because it is antithetical to their conception of Wikipedia as a community) or endorsed it (because it is consonant with their conception of Wikipedia as an organization with clearly defined boundaries). Are other open-content communities susceptible to the same kind of ‘essential contestation’? (shrink)

Tom Regan has made a very important contribution to the debate on environmental ethics in his “On the Nature and Possibility of an Environmental Ethic.” The debate can be brought out yet more clearly by contrasting Regan’s views with those of an eminent critic of environmental ethics in Regan’s sense, William K. Frankena. I argue that Regan’s position has much to recommend it, but has a fatal flaw whichwould render environmental ethics unjustifiable. I suggest this flaw can be remedied (...) by divorcing an environmental ethic from a dubious ontological commitment. Reflection on metaethics, ontological commitments, and the nature of ethical justification leads to a conclusion favorable to an environmental ethic. (shrink)

This collection provides a thorough grounding in the philosophy of American pragmatism by examining the views of four principal thinkers - Charles S. Peirce, William James, John Dewey, and George Herbert Mead - on issues of central and enduring importance to life in human society. Pragmatism emerged as a characteristically American response to an inheritance of British empiricism. Presenting a radical reconception of the nature of experience, pragmatism represents a belief that ideas are not merely to be contemplated but (...) must be put into action, tested and refined through experience. At the same time, the American pragmatists argued for an emphasis on human community that would offset the deep-seated American bias in favor of individualism. Far from being a relic of the past, pragmatism offers a dynamic and substantive approach to questions of human conduct, social values, scientific inquiry, religious belief, and aesthetic experience that lie at the center of contemporary life. This volume is an invaluable introduction to a school of thought that remains vital, instructive, and provocative. (shrink)

This study investigates the differences in the way bribery and extortion is perceived by two different cultures — American and Nigerian. Two hundred and forty American business students and one hundred and eighty Nigerian business students were presented with three scenarios describing a businessman offering a bribe to a government official and three scenarios describing a businessman being forced to pay a bribe to an official in order to do business. The Reidenbach-Robin instrument was used to measure the ethical reactions (...) of the two samples to these scenarios. Results indicate that ethical reactions to bribery and extortion vary by (a) the nationality of the person offering the bribe, and (b) the country where the bribe is offered. In addition, Nigerians perceived some of the scenarios as being less unethical than did Americans. (shrink)

Public health advocates, government agencies, and commercial organizations increasingly use nutritional science to guide food choice and diet as a way of promoting health, preventing disease, or marketing products. We argue that in many instances such references to nutritional science can be characterized as nutritional scientism. We examine three manifestations of nutritional scientism: the simplification of complex science to increase the persuasiveness of dietary guidance, superficial and honorific references to science in order to justify cultural or ideological views about (...) food and health, and the presumption that nutrition is the primary value of food. This paper examines these forms of nutritional scientism in the context of biopolitics to address bioethical concerns related to the misuse of scientific evidence to make claims regarding the effect of diet on health. We argue that nutritional scientism has ethical implications for individual responsibility and freedom, concerning iatrogenic harm, and for well-being. (shrink)

The first book to be devoted to the logic behind the application of ethical theories, this collection of essays explores the question of how many different moral traditions (utilitarianism, natural rights theory, Marxism, Christian moral theology, and Kantianism among others) view the relation between theory and concrete judgments. By considering many applications of moral theory in medical ethics the authors illustrate their point.

I argue that views of human rationality are strongly affected by the adoption of a two minds theory in which humans have an old mind which evolved early and shares many features of animal cognition, as well as new mind which evolved later and is distinctively developed in humans. Both minds have a form of instrumental rationality—striving for the attainment of goals—but by very different mechanisms. The old mind relies on a combination of evolution and experiential learning, and is (...) therefore driven entirely by repeating behaviours which succeeded in the past. The new mind, however, permits the solution of novel problems by reasoning about the future, enabling consequential decision making. I suggest that the concept of epistemic rationality—striving for true knowledge—can only usefully be applied to the new mind with its access to explicit knowledge and beliefs. I also suggest that we commonly interpret behaviour as irrational when the old mind conflicts with the new and frustrates the goals of the conscious person. (shrink)

Aims and background: Little is known about how participants perceive prevention trials, particularly trials designed to prevent mental illness. This study examined participants’ motives for participating in a trial and their views of randomisation and the ability to withdraw from a randomised controlled trial for prevention of depression. Methods: Participants were older adults reporting elevated depression symptoms living in urban and regional locations in Australia who had consented to participate in an RCT of interventions to prevent depression. Participants rated (...) their agreement with various statements describing motivations for enrolment in the trial and opinions regarding randomisation and withdrawal. Results: The majority of participants expressed a triad of altruistic motivation for participation, relative lack of concern about randomisation and commitment to the trial. Certain subgroups of participants, such as women and those with higher depression scores, reported higher levels of concern about specific issues. Conclusions: The findings suggest that participants enrolled in prevention trials for mental illness are likely to hold positive attitudes towards research trials. The identification of relationships between key person factors and trial-related attitudes enabled profiling of participant groups, which can inform recruitment strategies and interactions of participants and research projects in future prevention trials. (shrink)

This volume contains four versions of the lecture notes taken by Kant's students of his university courses in ethics given regularly over a period of some thirty years. The notes are very complete and expound not only Kant's views on ethics but many of his opinions on life and human nature. Much of this material has never before been translated into English. As with other volumes in the series, there are copious linguistic and explanatory notes and a glossary of (...) key terms. (shrink)

The purpose of this research is to extend prior research testing the premise that small deviations from ethical behavior lead to even larger deviations from ethical behavior. This study examines the association between a person’s willingness to bribe a police officer to avoid being issued a speeding ticket with their views on inappropriate behavior of corporate executives. Our sample of 528 participants comes from Colombia (90), Ecuador (70), South Africa (131) and the United States (237). As part of our (...) data gathering, we controlled for social desirability response bias in the responses of the students who participated in our study. Our data indicate significant differences between the views of the students from Colombia, Ecuador, and South Africa when compared to the views of the students from the United States. The analysis indicates that, for all four dilemmas, the most significant variable was the belief about how ethical it was to pay a bribe to avoid a traffic ticket. In addition, in three of our four dilemmas, Paulhus’ Impression Management Subscale, which measures social desirability response bias, was the second most significant variable. Finally, in three of the four dilemmas, the students from Colombia, Ecuador and South Africa thought the actions described in the dilemmas were less ethical than the students from the United States. (shrink)

In this book, Michael Arbib, a researcher in artificial intelligence and brain theory, joins forces with Mary Hesse, a philosopher of science, to present an integrated account of how humans 'construct' reality through interaction with the social and physical world around them. The book is a major expansion of the Gifford Lectures delivered by the authors at the University of Edinburgh in the autumn of 1983. The authors reconcile a theory of the individual's construction of reality as a network of (...) schemas 'in the head' with an account of the social construction of language, science, ideology and religion to provide an integrated schema-theoretic view of human knowledge. The authors still find scope for lively debate, particularly in their discussion of free will and of the reality of God. The book integrates an accessible exposition of background information with a cumulative marshalling of evidence to address fundamental questions concerning human action in the world and the nature of ultimate reality. (shrink)

White Fire challenges the critical tradition that for nearly half a century has celebrated the power of blackness in American literature. This tradition presents Herman Melville as investigating, then rejecting the optimistic vision of Ralph Waldo Emerson because he lacked a viable sense of evil. Williams digs beneath the obvious contrasts between these two great contemporaries, asking three questions about their relationship: What was Emerson actually saying at the time Melville was serving his literary apprenticeship? How much did Melville know (...) of Emerson's provocative thought? What use did Melville make of ideas and images that Emerson, more than any other contemporary, espoused? In his findings, Williams views Melville as far less the independent critic of Emerson that modern critics have described and far more the responsive artist and opportunist, absorbing images and ideas from the most readily available sources and transforming them into art. (shrink)

This essay investigates the indeterminacy thesis - roughly the claim that the content of authoritative legal materials (such as the texts of constitutions, statutes, cases, rules, and regulations) does not determine the outcome of particular legal disputes. The indeterminacy thesis can be formulated as either "strong" or weak." The strong version of the indeterminacy thesis is demonstrably false, but several weak versions of the thesis are true but lack the radical implications of strong indeterminacy.The strong indeterminacy thesis is the claim (...) that all cases are "hard" cases - or that in any case any conceivable result can be derived from existing legal doctrine. Strong indeterminacy does not hold if there are easy cases - cases in which some outcomes cannot be legally correct. For example, if it were the case that the first paragraph of this abstract did not slander Gore Vidal, then there would be at least one easy case, and strong indeterminacy would be false.Weak versions of the indeterminacy thesis include the claim that important cases are indeterminate, that the law does not necessarily determine outcomes, or that every case could become indeterminate if political conditions supported indeterminacy. These weaker claims may be true, but they lack the critical bite associated with strong indeterminacy.The essay also distinguishes between "determinacy," "indeterminacy," and "underdeterminacy." The law is "determinate" with respect ot a given case if and only if the set of results that can be squared with the legal materials contains only one member. The law is "indeterminate" with respect to a given case if and only if the set of results that can be squared with the legal materials is identical with the set of all imaginable results. The law is "underdeterminate" with respect to a given case if and only if the set of results that can be squared with the legal materials is a nonidentical subset of the set of all imaginable results.This article was first published in 1987, and some of the author's views have been revised in interim. (shrink)

The ancient critics are well known—some might say notorious—for their readiness to read literature, and particularly Homer, through moral spectacles. Their interpretations of Homeric epic are philosophical, not only in the more limited sense that they identified specific doctrines in the speeches of Homer's characters, making the poet or his heroes spokesmen for the views of Plato or Epicurus, but also in a wider sense: the critics demand from Homer not merely entertainment but enlightenment on moral and religious questions, (...) on good and evil, on this life and the after-life. When they fail to find what they seek, they follow Plato and find him wanting. (shrink)

This book derives from a 1993 National Endowment for the Humanities Summer Institute on Knowledge, Teaching, and Wisdom. The Institute took place at the University of California, Berkeley, and was co-directed by Keith Lehrer and Nicholas D. Smith. The aims of the Institute were several: we sought to reintroduce wisdom as a topic of discussion among contemporary philosophers, to undertake an historical investigation of how and when and why it was that wisdom faded from philosophical view, and to ask how (...) contemporary epistemological theories might apply to the obviously related subjects of teaching and wisdom. In recruiting participants, Lehrer and Smith put the greatest emphasis on those with professional interests in epistemology and the history of philosophy, of the ancient Greeks especially ancient Greek philosophy (because in the writings all three subjects of the Institute were explicitly related and discussed). But in addition to these two groups, some effort was made also to include others, with academic specializations in a variety of fields other than epistemology and the history of philosophy, to ensure that a broad perspective could be achieved in our discussions. To an obvious extent, the papers in this book reflect the recruitment emphases and variety. They also testify to the extent that the Institute managed to bring life to our subjects, and to raise very old questions in a contemporary context. (shrink)

In a recent article, Thomas Nagel argues against the court’s decision to strike down the Dover school district’s requirement that biology teachers in Dover public schools inform their students about Intelligent Design. Nagel contends that this ruling relies on questionable demarcation between science and nonscience and consequently misapplies the Establishment Clause of the constitution. Instead, he argues in favor of making room for an open discussion of these issues rather than an outright prohibition against Intelligent Design. We contend that Nagel’s (...) arguments do not succeed. First, we argue that Nagel’s case trades on an ambiguity regarding the content of non-theological views and fails to engage adequately some of the problems of ID. Then we raise concerns about Nagel’s conclusion; specifically, we will point to three incongruities between Nagel’s argument and his conclusion, and then we will raise a more general worry about the likely impact of Nagel’s view. (shrink)

In a recent article, Thomas Nagel argues against the court’s decision to strike down the Dover school district’s requirement that biology teachers in Dover public schools inform their students about Intelligent Design. Nagel contends that this ruling relies on questionable demarcation between science and nonscience and consequently misapplies the Establishment Clause of the constitution. Instead, he argues in favor of making room for an open discussion of these issues rather than an outright prohibition against Intelligent Design. We contend that Nagel’s (...) arguments do not succeed. First, we argue that Nagel’s case trades on an ambiguity regarding the content of non-theological views and fails to engage adequately some of the problems of ID. Then we raise concerns about Nagel’s conclusion; specifically, we will point to three incongruities between Nagel’s argument and his conclusion, and then we will raise a more general worry about the likely impact of Nagel’s view. (shrink)

The thesis of "Freedom of Communicative Action" is that Jurgen Habermas's theory of communicative action illuminated the deep structure of the First Amendment freedom of speech. Haberams's theory takes speech act theory as its point of departure. Communicative action coordinates indivudal behavior through rational understanding. Communicative action is distinguished from strategic action--the use of communication to manipulate, deceive, or coerce. Part I offers an introduction. Part II outlines a hermeneutic approach to interpretation of the First Amendent. Part III explores and (...) criticizes existing theories of the freedom of speech. Part IV explicates Habermas's theory of communicative action. Part V developes a theory of the freedom of expression based on Habermas's theory of communication. Part VI applies that theory to particular problems in free speech doctrine. Part VII draws some conclusions about the implications of this exercise for the development of doctrine and the theory of communicative action. "Freedom of Communicative Action" was published in 1989, and some of the views expressed in the article are no longer affirmed by the author. (shrink)

If one were to find a date for the games put on by Pompey to celebrate the opening of his theatre in 55 B.C., it would be possible to assign a more precise date to the delivery of Cicero's speech in Pisonem than seems to have been done so far. Asconius states quite firmly that the in Pisonem was delivered in the second consulship of Pompey and Crassus, a few days before the lavish games celebrating the opening of Pompey's theatre. (...) Asconius rejects a counter-view that the speech was delivered late in the following year. (shrink)

Johnson and Stricker published an opinion piece in the Journal of Medical Ethics presenting their perspective on the 2008 agreement between the Infectious Diseases Society of America (IDSA) and the Connecticut Attorney General with regard to the 2006 IDSA treatment guideline for Lyme disease. Their writings indicate that these authors hold unconventional views of a relatively common tick-transmitted bacterial infection caused by the spirochete Borrelia burgdorferi. Therefore, it should come as no surprise that their opinions would clash with the (...) IDSA's evidence-based guidelines for the diagnosis and treatment of Lyme disease. Their allegations of conflict of interest against the IDSA resemble those made against the National Institutes of Health, the Food and Drug Administration and the Centers for Disease Control and Prevention in 2000, which were found to be baseless. It is the responsibility of all physicians and medical scientists to stand up to antiscientific, baseless and unethical attacks on those who support an evidence-based approach to caring for patients. (shrink)

Movies have a striking aesthetic power: they can draw us in and induce a peculiar mode of involvement in their images – they absorb us. While absorbed in a movie, we lose track both of the passage of time and of the fact that we are sitting in a dark room with other people watching the play of light upon a screen. What is the source of the power of movies? Noël Carroll, who cites Maurice Merleau-Ponty as an influence on (...) his account of the power of movies, agrees with Merleau-Ponty that our perceptual experience of movies draws on many of the capacities at work in our perceptual experience of everyday situations. Yet Merleau-Ponty’s account of perception shows that Carroll’s emphasis on intellectual inference and the entertaining of unasserted thoughts is a distortion of the phenomenology of cinematic absorption. According to Merleau-Ponty, such intellectual operations come into play in cases of breakdown but should not be read back into the primary absorbed experience as being implicitly operative all along. After presenting and criticizing Carroll’s view, I interpret and expand upon Merleau-Ponty’s position, showing that his version of the analogy between cinematic perception and everyday perception is more convincing than Carroll’s. (shrink)

. Atomic individualism is embedded in most definitions of stakeholder theory, and as a result, stakeholders are not integral to the basic identity of the corporation which is considered to be independent of, and separate from, its stakeholders. Feminist theory has been suggested as a way of developing a more relational view of the corporation and its stakeholders, but it lacks a systematically developed conceptual framework for undergirding its own insights. Pragmatic philosophy is offered as a way of providing this (...) theoretical undergirding for . a relational understanding of the firm and its stakeholders. (shrink)

Advocates of cognitive enhancement maintain that technological advances would augment autonomy indirectly by expanding the range of options available to individuals, while, in a recent article in this journal, Schaefer, Kahane, and Savulescu propose that cognitive enhancement would improve it more directly. Here, autonomy, construed in broad procedural terms, is at the fore. In contrast, when lauding the goodness of enhancement expressly, supporters’ line of argument is utilitarian, of an ideal variety. An inherent conflict results, for, within their utilitarian frame, (...) the content of rational, hence autonomous, choices is quite restricted. Further, advocates do not clearly indicate their relative emphasis between the often conflicting goals of maximizing benefit and avoiding harm. In practice, their construction of harms is highly expansive, for disabilities include any constraints that “rational” people would decline if it were technically possible to do so. For advocates, this means that where enhancement measures are available, those constraints become avoidable limitations, and not to remove them is to harm. The centrality of harm-avoidance and their ideal utilitarian frame entail sociopolitical requirements that enhancement defenders disallow when trumpeting autonomy in the vein of individual choice. Advocates have thus not done enough to support the claim that their views are wholly separate from earlier eugenics. (shrink)