In this analysis we discuss the change in criteria for triage of patients during three different phases of a pandemic like COVID-19, seen from the critical care point of view. Availability of critical care beds has become a hot topic, and in many countries, we have seen a huge increase in the provision of temporary intensive care bed capacity. However, there is a limit where the hospitals may run out of resources to provide critical care, which is heavily dependent on (...) trained staff, just-in-time supply chains for clinical consumables and drugs and advanced equipment. In the first phase, we can still do clinical prioritisation and decision-making as usual, based on the need for intensive care and prognostication: what are the odds for a good result with regard to survival and quality of life. In the next, the resources are mostly available, but the system is stressed by many patients arriving over a short time period and auxiliary beds in different places in the hospital being used. We may have to abandon admittance of patients with doubtful prognosis. In the last phase, usual medical triage and priority setting may not be sufficient to decrease inflow and there may not be enough intensive care unit beds available. In this phase different criteria must be applied using a utilitarian approach for triage. We argue that this is an important transition where society, and not physicians, must provide guidance to support triage that is no longer based on medical priorities alone. (shrink)

We whole-heartedly support Andrew Garland, Stephanie Morain, and Jeremy Sugarman’s claim that clinicians have a duty to participate in pragmatic clinical trials (Garland, Morain, and Sugarman 2023)...

In their article, “The job of ‘ethics committees’”, Andrew Moore and Andrew Donnelly argue that current guidance documents provide that institutional research review committees ) perform two different and distinct functions, namely, a regulative review and an ethical review. They argue for separating those functions and for eliminating the ethics review role from IRBs. Instead, they want IRBs to focus exclusively on determining whether research proposals conform to governing regulations. In their argument, Moore and Donnelly correctly note that (...) regulatory requirements and ethical requirements can conflict. That point is correct, but hardly surprising. After all, regulations are general and the research proposals are specific, so an individual proposal may not conform to the general formulation of the rule and yet be consistent with ethics. Thus, a rule may generally be regarded as expressing a relevant moral consideration while providing a conclusion that does not appropriately reflect an ethical determination in the specific case. This inconsistency need not amount to what Moore and Donelly characterise as a ‘repellent’ or an ‘unconscionable’ review decision. Moore and Donnelly are also concerned that IRB decisions may differ from each other in their review of the same proposal. Again, they are correct in recognising that such inconsistent outcomes would be less likely if IRBs were to focus exclusively on whether proposals conformed to the regulations. That said, I reach the opposite conclusion. As I see it, IRBs present us with a good example of when the possibility of inconsistency is a relatively small consideration in comparison to the important values that are served by IRBs considering their protocol reviews in light of ethics and conforming to regulations. Allow me to explain. The authors and endorsers of research ethics …. (shrink)

The dossier of decrees concerning the Deceleans and the Demotionidae of Athens presents fascinating problems and has attracted plentiful discussion. For a long time there has been a division between the view of Wilamowitz and his followers, that the Demotionidae were a phratry and the Deceleans a privileged genos within it, and that of Wade–Gery refined by Andrewes, that the Deceleans were a phratry and the Demotionidae a privileged genos within it.3 Each of these interpretations gave rise to problems; and (...) since the work of Bourriot and Roussel on the gene there has been a reluctance to believe in gene as aristocratic clans able to control their phratries. Recently Hedrick has argued that the Demotionidae were the phratry and the Deceleans the members of the deme of Decelea; and Lambert has argued that the Demotionidae were the phratry and the Deceleans a genos–like body which formed a semi–independent group within the phratry and which in these decrees was extending its independence further. These interpretations also give rise to problems: in this paper I attempt to continue the debate and to show that an interpretation on Wade–Gery′s lines is after all the most likely to be right. (shrink)

What job should authorities give to review boards? We are grateful to Soren Holm, Rosamond Rhodes, Julian Savulescu and G Owen Schaefer for their thoughtful commentaries on our answer.1–4 Here we add to the discussion. Let us summarise the claims for which we argued.5 Relevant authorities can task boards with review for consistency with duly established code, thereby making code-consistent activities apt for approval and code-inconsistent activities apt for rejection. They can instead task boards with review for ethical acceptability, (...) making ethically acceptable activities apt for approval and ethically unacceptable activities apt for rejection. For every proposal a board might consider, these two different jobs establish different review bases, and their approvals and rejections also sometimes conflict. Some international and national statements require ECR, others instead require CCR, and others again seem either to require both or just to run the two together. Those responsible for these statements should make them clearer and better aligned here. For reasons of practicality, publicity and separation of powers, authorities do better to task boards with CCR and not ECR. These arguments also count against establishing any code with content that in effect collapses CCR into ECR. If our arguments withstand robust scrutiny, authorities should also remove ‘ethics’ and cognate terms from the names of these boards and their review activities and emphasise code expertise not ethics expertise in the required skill sets of boards. Our article noted that ‘ethical considerations informed the genesis of these boards and express their aspirations’. Rhodes similarly notes: ‘the authors and endorsers of research ethics codes, declarations and regulations … articulating the ethical standards for conducting human subject research’ and ‘This framework embeds the ethical parameters of human subject research into the moral missions of institutions’. Schaefer too …. (shrink)

Who carries the burden of proof in analytic philosophical debates, and how can this burden be satisfied? As it turns out, the answer to this joint question yields a fundamental challenge to the very conduct of metaphysics in analytic philosophy. Empirical research presented in this book indicates that the vastly predominant goal pursued in analytic philosophical dialogues lies not in discovering truths or generating knowledge, but merely in prevailing over one’s opponents. Given this goal, the book examines how most effectively (...) to allocate and discharge the burden of proof. It focuses on premises that must prudently be avoided because a burden of proof on them could never be satisfied, and in particular discusses unsupportable bridge premises across inference barriers, like Hume’s barrier between ‘is’ and ‘ought’, or the barrier between the content of our talk or thought, and the world beyond such content. Employing this content/world barrier for a critical assessment of mainstream analytic philosophical methods, this book argues that we must prudently avoid invoking intuitions or other content of thought or talk in support of claims about the world beyond content, that is, metaphysically significant claims. Yet as content-located evidence is practically indispensable to metaphysical debates throughout analytic philosophy, from ethics to the philosophy of mathematics, this book reaches the startling conclusion that all such metaphysical debates must, prudently, be terminated. (shrink)

Contemporary research ethics policies started with reflection on the atrocities perpetrated upon concentration camp inmates by Nazi doctors. Apparently, as a consequence of that experience, the policies that now guide human subject research focus on the protection of human subjects by making informed consent the centerpiece of regulatory attention. I take the choice of context for policy design, the initial prioritization of informed consent, and several associated conceptual missteps, to have set research ethics off in the wrong direction. The aim (...) of this paper is to sort out these confusions and their implications and to offer instead a straightforward framework for considering the ethical conduct of human subject research. In the course of this discussion I clarify different senses of autonomy that have been confounded and present more intelligible justifications for informed consent. I also take issue with several of the now accepted dogmas that govern research ethics. These include: the primacy of informed consent, the protection of the vulnerable, the substitution of beneficence for research's social purpose, and the introduction of an untenable distinction between innovation and research. (shrink)

Common morality has been the touchstone of medical ethics since the publication of Beauchamp and Childress's Principles of Biomedical Ethics in 1979. Rosamond Rhodes challenges this dominant view by presenting an original and novel account of the ethics of medicine, one deeply rooted in the actual experience of medical professionals. She argues that common morality accounts of medical ethics are unsuitable for the profession, and inadequate for responding to the particular issues that arise in medical practice. Instead, Rhodes (...) argues that medicine's distinctive ethics should be explained in terms of the trust that society allows to the profession. Trust is the core and starting point of Rhodes' moral framework, which states that the most basic duty of doctors0is to "seek trust and be trustworthy." 0Building from this foundation, Rhodes explicates the sixteen specific duties that doctors take on when they join the profession, and demonstrates how her view of these duties is largely consistent with the codes of medical ethics of medical societies around the world. She then explains why it is critical for physicians to develop the attitudes or "doctorly" virtues that comprise the character of trustworthy doctors and buttress physicians' efforts to fulfil their professional obligations. Her book's presentation of physicians' duties and the elements that comprise a doctorly character, together add up to a cohesive and comprehensive description of what medical professionalism really entails. Rhodes's analysis provides a clear understanding of medical professionalism as well as a guide for doctors navigating the ethically challenging situations that arise in clinical practice. (shrink)

In this chapter, the author argues against the commonly accepted reading, which was most fully articulated by Larry May in his article “Hobbes's Contract Theory ”. Contrary to that widely accepted interpretation, he shows that scholars overlook crucial distinctions that play a critical role in Hobbes's account. There Hobbes explained that reasonable men would appreciate the necessity of creating an artificial power to ensure that covenants would be “constant and lasting”. For Hobbes, the commonwealth is a distinct entity that men (...) “Cause” into existence by accepting “restraint” on their liberty in order to achieve “their own preservation, and a more contented life thereby”. The power fused in the People gives the congregation inordinate strength for security against the sovereign; the might of a Leviathan exceeds the power of any solitary sovereign. Adopting the complex account of the creation of civil society and the authorization of its sovereign has important implications for understanding Hobbes's political theory. (shrink)

This paper examines the idea of objective phenomenology, or a way of understanding the phenomenal character of conscious experiences that doesn’t require one to have had the kinds of experiences under consideration. My central thesis is that structural facts about experience—facts that characterize purely how conscious experiences are structured—are objective phenomenal facts. I begin by precisifying the idea of objective phenomenology and diagnosing what makes any given phenomenal fact subjective. Then I defend the view that structural facts about experience are (...) objective. I also argue that structural facts about experience, despite being objective, nevertheless still give rise to an explanatory gap. (shrink)

Cheating is deeply embedded in everyday life. The costs of the most common forms of cheating total close to a trillion dollars annually. Part of the problem is that many individuals fail to see such behavior as a serious problem. "Everyone does it" is a common rationalization, and one that comes uncomfortably close to the truth. That perception is also self-perpetuating. The more that individuals believe that cheating is widespread, the easier it becomes to justify. Yet what is most notable (...) about analysis of the problem is how little there is of it. Whether or not Americans are cheating more, they appear to be worrying about it less. In Cheating, eminent legal scholar Deborah L. Rhode offers the only recent comprehensive account of cheating in everyday life and the strategies necessary to address it. Because cheating is highly situational, Rhode drills down on its most common forms in sports, organizations, taxes, academia, copyright infringement, marriage, and insurance and mortgages. Cheating also reviews strategies necessary to address the pervasiveness and persistence of cheating in these contexts. We clearly need more cultural reinforcement of ethical conduct. Efforts need to begin early, with values education by parents, teachers, and other role models who can display and reinforce moral behaviors. Organizations need to create ethical cultures, in which informal norms, formal policies, and reward structures all promote integrity. People also need more moral triggers that remind them of their own values. Equally important are more effective enforcement structures, including additional resources and stiffer sanctions. Finally, all of us need to take more responsibility for combatting cheating. We need not only to subject our own conduct to more demanding standards, but also to assume a greater obligation to prevent and report misconduct. Sustaining a culture that actively discourages cheating is a collective responsibility, and one in which we all have a substantial stake. (shrink)

Interpretive Political Science is the second of two volumes featuring a selection of key writings by R.A.W. Rhodes. Volume II looks forward and explores the 'interpretive turn' and its implications for the craft of political science, especially public administration, and draws together articles from 2005 onwards on the theme of 'the interpretive turn' in political science. Part I provides a summary statement of the interpretive approach, and Part II develops the theme of blurring genres and discusses a variety of (...) research methods common in the humanities, including: ethnographic fieldwork, life history, and focus groups. Part III demonstrates how the genres of thought and presentation found in the humanities can be used in political science. It presents four examples of such blurring 'at work' with studies of: applied anthropology and civil service reform; women's studies and government departments; and storytelling and local knowledge. The book concludes with a summary of what is edifying about an interpretive approach, and why this approach matters, and revisits some of the more common criticisms before indulging in plausible conjectures about the future of interpretivism. The author seeks new and interesting ways to explore governance, high politics, public policies, and the study of public administration in general. (shrink)

Perception is riddled with cases of reliable misperception. These are cases in which a perceptual state is tokened inaccurately any time it is tokened under normal conditions. On the face of it, this fact causes trouble for theories that provide an analysis of perceptual content in non-semantic, non-intentional, and non-phenomenal terms, such as those found in Millikan (1984), Fodor (1990), Neander (2017), and Schellenberg (2018). I show how such theories can be extended so that they cover such cases without giving (...) up their core commitments. (shrink)

Some accounts of moral responsibility hold that an agent's responsibility is completely determined by some aspect of the agent's mental life at the time of action. For example, some hold that an agent is responsible if and only if there is an appropriate mesh among the agent's particular psychological elements. It is often objected that the particular features of the agent's mental life to which these theorists appeal (such as a particular structure or mesh) are not necessary for responsibility. This (...) is because there appear to be cases in which an agent acts at an earlier time which causes her to lack the appropriate psychological features at some later time and yet, intuitively, she is responsible at that later .. (shrink)

On reading Plato -- Socrates' story of death and life -- Theaetetus: boy-testing in Lotus land -- Sophist: casts of the net -- Sophist: another miss? -- Politician: another effort to snare Socrates-Odysseus -- Socrates is convicted by a jury of young children.

We are all familiar with the phenomenon of a proposition seeming true. Many think that these seeming states can yield justified beliefs. Very few have seriously explored what these seeming states are. I argue that seeming states are not plausibly analyzed in terms of beliefs, partial beliefs, attractions to believe, or inclinations to believe. Given that the main candidates for analyzing seeming states are unsatisfactory, I argue for a brute view of seemings that treats seeming states as irreducible propositional attitudes.

This is a discussion of the state of discussion on pragmatic reasons for belief.

This book brings together an international group of scholars to discuss the ramifications of Heidegger's Black Notebooks for philosophy and the humanities. In contrast to both those who seek to exonerate Heidegger and those who simply condemn him, they urge careful reading and rereading of his work to turn Heideggerian thought against itself.

Biblical scholar Michael Rhodes argues that the Bible offers a vision of justice-oriented discipleship that is critical for the formation of God's people. Grounded in biblical theology, virtue ethics, and his own experiences, he shows that justice is central to the Bible, central to Jesus, and central to authentic Christian discipleship.

For Kant, knowledge involves certainty. If “certainty” requires that the grounds for a given propositional attitude guarantee its truth, then this is an infallibilist view of epistemic justification. Such a view says you can’t have epistemic justification for an attitude unless the attitude is also true. Here I want to defend an alternative fallibilist interpretation. Even if a subject has grounds that would be sufficient for knowledge if the proposition were true, the proposition might not be true. And so there (...) is sometimes still rational room for doubt. The goal of this paper is to present four different models of what “certainty” amounts to, for Kant, each of which is compatible with fallibilism. (shrink)

In his 1978 paper “Mathematical Explanation”, Mark Steiner attempts to modernize the Aristotelian idea that to explain a mathematical statement is to deduce it from the essence of entities figuring in the statement, by replacing talk of essences with talk of “characterizing properties”. The language Steiner uses is reminiscent of language used for proofs deemed “pure”, such as Selberg and Erdős’ elementary proofs of the prime number theorem avoiding the complex analysis of earlier proofs. Hilbert characterized pure proofs as those (...) that use only “means that are suggested by the content of the theorem”, a characterization we have elsewhere called “topical purity”. In this paper we will examine the connection between Steiner’s account of mathematical explanation and topical purity. Are Steiner-explanatory proofs necessarily topically pure? Are topically pure proofs necessarily Steiner-explanatory? Answers to these questions will shed light on the general question of the relation between purity and explanatory power. (shrink)

While many aspects of cognition have been shown to be shared between humans and non-human animals, there remains controversy regarding whether the capacity to mentally time travel is a uniquely human one. In this paper, we argue that there are four ways of representing when some event happened: four kinds of temporal representation. Distinguishing these four kinds of temporal representation has five benefits. First, it puts us in a position to determine the particular benefits these distinct temporal representations afford an (...) organism. Second, it provides the conceptual resources to foster a discussion about which of these representations is necessary for an organism to count as having the capacity to mentally time travel. Third, it enables us to distinguish stricter from more liberal views of mental time travel that differ regarding which kind(s) of temporal representation is taken to be necessary for mental time travel. Fourth, it allows us to determine the benefits of taking a stricter or more liberal view of mental time travel. Finally, it ensures that disagreement about whether some species can mentally time travel is not merely the product of unrecognised disagreement about which temporal representation is necessary for mental time travel. We argue for a more liberal view, on the grounds that it allows us to view mental time travel as an evolutionarily continuous phenomenon, and to recognise that differences in the ways that organisms mentally time travel might reflect different temporal representations, or combinations thereof, that they employ. Our ultimate aim, however, is to create the conceptual framework for further discussion regarding what sorts of temporal representations are required for mental time travel. (shrink)

This three-part chapter explores a higher-order logic we call ‘Classicism’, which extends a minimal classical higher-order logic with further axioms which guarantee that provable coextensiveness is sufficient for identity. The first part presents several different ways of axiomatizing this theory and makes the case for its naturalness. The second part discusses two kinds of extensions of Classicism: some which take the view in the direction of coarseness of grain (whose endpoint is the maximally coarse-grained view that coextensiveness is sufficient for (...) identity), and some which take the view in the direction of fineness of grain (whose endpoint is the maximally fine-grained theory containing all distinctness claims compatible with Classicism). The third part introduces some techniques for constructing models of Classicism, and uses them to prove the consistency of many of the extensions of Classicism introduced in the second part. (shrink)

The achilles heel of the universal declaration of human rights -- The concept of human rights during the cold war -- Birth of the post cold war human rights dogma -- Toward a human rights without freedom -- The loss of America's human rights exceptionalism -- Human rights versus natural rights : a convergence against liberty -- Conclusion : toward reforming human rights.

Illusion and reality.--The knowing.--The fiction of a universe.--Reason and will.--Devolution.--A rational view of death.--Immediate implications of a rational view of death.--The love of truth.--Style and the philosophy.

The aim of the Analytic of Concepts is to derive and deduce a set of pure concepts of the understanding, the categories, which play a central role in Kant’s explanation of the possibility of synthetic a priori cognition and judgment. This chapter is structured around two questions. First, what is a pure concept of the understanding? Second, what is involved in a deduction of a pure concept of the understanding? In answering the first, we focus on how the categories differ (...) from the pure forms of sensibility and examine whether they are known only to be the pure forms of human thinking or rather the forms of discursive cognition as such. In answering the second, we draw a distinction between the application and the exemplification of the categories and use it to identify different ways of understanding Kant’s project in the Transcendental Deduction of the Categories. These questions connect because the answer to the first determines how we should understand the kind of entitlement which is to be established in the Deduction. (shrink)

Public reason in practice and theory -- False starts: unsuccessful justifications of public reason -- Respect for persons as a constraint on coercion -- Higher-order unanimity escape clause -- Civic friendship as a constraint on reasons for decision -- Public reason and (same-sex) marriage.

The fallacy fallacy is either the misdiagnosis of fallacy or the supposition that the conclusion of a fallacy must be a falsehood. This paper explores the relevance of these and related errors of reasoning for the appraisal of arguments, especially within virtue theories of argumentation. In particular, the fallacy fallacy exemplifies the Owl of Minerva problem, whereby tools devised to understand a norm make possible new ways of violating the norm. Fallacies are such tools and so are vices. Hence a (...) similar problem arises with argumentative vices. Fortunately, both instances of the problem have a common remedy. (shrink)

Some have it that wholes are, somehow, identical to their parts. This doctrine is as alluring as it is puzzling. But in this paper, I show that the doctrine is inconsistent with two widely accepted theses. Something has to go.

This chapter addresses an ambiguity in some of the literature on rational peer disagreement about the use of the term 'rational'. In the literature 'rational' is used to describe a variety of normative statuses related to reasons, justification, and reasoning. This chapter focuses most closely on the upshot of peer disagreement for what is rationally required of parties to a peer disagreement. This follows recent work in theoretical reason which treats rationality as a system of requirements among an agent's mental (...) states. It is argued that peer disagreement has either no, or a very limited, affect on what rationality requires of an agent in a given circumstance. This is in part because of difficulties generated by a novel example of evidence of evidence of p being evidence against p. This example calls into question the mechanisms whereby peer disagreement might affect what is rationally required of an agent. The chapter also reevaluates the importance of actual peer disagreement against the backdrop of prior expectations about whether disagreement is believed to be likely, arguing that peer disagreement is most likely to change what is rationally required of an agent when it is believed to be unlikely. (shrink)

Cognitive psychologists have recently identified alterations in perception and reasoning that contribute to the formation and maintenance of beliefs that happen to be delusional. Clinically significant delusions, however, are often deeply unusual. An account of their formation and maintenance must explain not merely how someone can come to hold false or uncommon beliefs, but also how someone can arrive at beliefs that seem profoundly improbable and even bizarre. This paper uses the philosophical concepts of the Bedrock and the Background to (...) provide an account of that foundational, nonrepresentational, non–rule-governed, dispositional structure of everyday understanding that underpins both our perception and our reasoning. The central claim is that the formation and maintenance of delusions becomes intelligible once they are seen to reflect disturbances to this foundational dispositional structure. Different dimensions of the Background are described along with the delusions that might follow from distortions to these dimensions. We challenge the assumption of much recent cognitive psychological theorizing that delusions can be understood as explanations of unusual experiences or as the product of hasty reasoning. Finally, the implications of the theory for the therapy of the delusional patient are briefly discussed. (shrink)

Higher-order logic augments first-order logic with devices that let us generalize into grammatical positions other than that of a singular term. Some recent metaphysicians have advocated for using these devices to raise and answer questions that bear on many traditional issues in philosophy. In contrast to these 'higher-order metaphysicians', traditional metaphysics has often focused on parallel, but importantly different, questions concerning special sorts of abstract objects: propositions, properties and relations. The answers to the higher-order and the property-theoretic questions may coincide (...) sometimes but will often come apart. I argue that when they do, the higher-order questions are closer to the metaphysical action and so it would be better for these debates to proceed in higher-order terms. (shrink)

Towards the unconditioned: Kant, Epicurus and Glückseligkeit -- Arendt and the time of the pardon -- Kant, evil, and the unconditioned -- Judgment after Derrida.

The norm of monogamy is pervasive, having remained widespread, in most Western cultures at least, in spite of increasing tolerance toward more diverse relationship types. It is also puzzling. People willingly, and often with gusto, adhere to it, yet it is also, prima facie at least, highly restrictive. Being in a monogamous relationship means agreeing to give up certain sorts of valuable interactions and relationships with other people and to severely restrict one’s opportunities for sex and love. It is this (...) restrictiveness which has led for calls among some philosophers for the justification of the norm, and some have argued that it cannot be justified. John McMurtry, for example, writing in 1972, compared monogamy to private property and argued that it serves the capitalist order (McMurtry 1972, 596–97). More recently, Harry Chalmers (2019) has argued that monogamy is morally impermissible. In this chapter we argue that rather than justify the norm, we ought to explain and understand its pervasiveness. Not everyone who follows the norm is doing so blindly, irrationally, or immorally. Indeed, many people are monogamous because being monogamous supports their needs and best enables them to flourish. We suggest that the human need for trust and attachment could underlie many people’s desires for monogamy and, therefore, explain monogamy’s pervasiveness. Focusing on the human need for trust and attachment security can also help us to understand why sexual infidelity can feel like such a betrayal. It can make sense to mutually agree to exclusivity in relationships, in spite of the apparent restrictions this brings. In a sense, not all restrictions are restrictive, because holding ourselves to limits on our behavior can in fact help us to invest in and experience the things we value most. (shrink)

Many say that ontological disputes are defective because they are unimportant or without substance. In this paper, we defend ontological disputes from the charge, with a special focus on disputes over the existence of composite objects. Disputes over the existence of composite objects, we argue, have a number of substantive implications across a variety of topics in metaphysics, science, philosophical theology, philosophy of mind, and ethics. Since the disputes over the existence of composite objects have these substantive implications, they are (...) themselves substantive. (shrink)

European Journal of Philosophy, EarlyView.

Matteo Ricci (1552-1610) was an Italian Jesuit and one of the first Christian missionaries to China in the modern era. He was a genuine polymath—a translator, cartographer, mathematician, astronomer, and musician. Above all, Ricci was a missionary for the gospel. As we briefly examine his 1603 seminal work, The True Meaning of the Lord of Heaven, our hope is that we, as evangelical educators, will perceive some of the deeper principles necessary for our own missionary work among unreached people.