ABSTRACT It is becoming increasingly common (at least in the United States) for doctors to appeal to futility judgments as the basis for certain types of clinical decisions, such as the decision to withhold CPR. The clinical use of futility judgments raises two basic questions regarding futility. First, how is the concept of futility to be understood? Secondly, once we have a clearer understanding of futility, what role should determinations of futility play in clinical decision‐making? Much of the discussion about (...) the concept of futility has centered on the value‐ladenness of futility judgments. I argue that futility determinations need to be distinguished from two other types of value‐based judgments, namely, identification of the goals of treatment and treatment decisions based on an assessment of the benefits and burdens of treatment. If this distinction is sound, it suggests a very limited role for futility determinations in clinical decisionmaking, a role which should serve to promote communication between doctor and patient. (shrink)

What are species? One popular answer is that species are individuals. Here I develop another approach to thinking about species, an approach based on the notion of a lineage. A lineage is a sequence of reproducing entities, individuated in terms of its components. I argue that one can conceive of species as groups of lineages, either organism lineages or population lineages. Conceiving of species as groups of lineages resolves the problems that the individual conception of species is supposed to resolve. (...) It has added the virtue of focusing attention on the characteristic of species that is most relevant to understanding their role in evolutionary processes, namely, the lineage structure of species. (shrink)

ABSTRACTIt is becoming increasingly common for doctors to appeal to futility judgments as the basis for certain types of clinical decisions, such as the decision to withhold CPR. The clinical use of futility judgments raises two basic questions regarding futility. First, how is the concept of futility to be understood? Secondly, once we have a clearer understanding of futility, what role should determinations of futility play in clinical decision‐making? Much of the discussion about the concept of futility has centered on (...) the value‐ladenness of futility judgments. I argue that futility determinations need to be distinguished from two other types of value‐based judgments, namely, identification of the goals of treatment and treatment decisions based on an assessment of the benefits and burdens of treatment. If this distinction is sound, it suggests a very limited role for futility determinations in clinical decisionmaking, a role which should serve to promote communication between doctor and patient. (shrink)

Species are thought by many to be important units of evolution. In this paper, I argue against that view. My argument is based on an examination of the role of species in the synthetic theory of evolution. I argue that if one adopts a gradualist view of evolution, one cannot make sense of the claim that species are units in the minimal sense needed to claim that they are units of evolution, namely, that they exist as discrete entities over time. (...) My second argument is directed against an appeal to Eldredge and Gould's theory of punctuated equilibria to support the claim that species are units of evolution. If one adopts their view, it may be possible to identify discrete temporal entities that can plausibly be termed species, but there is no reason to claim that those entities are units of evolution. Thus, on two plausible interpretations of the role of natural selection in the process of evolution, species are of no special importance. I then consider some of the reasons why species have been thought to be important evolutionary units by many contemporary evolutionary biologists. Finally, I discuss briefly the implications of this conclusion for evolutionary biology. (shrink)

I construe the question Are species sets? as a question about whether species can be conceived of as sets, as the term set is understood by contemporary logicians. The question is distinct from the question Are species classes?: The conception of classes invoked by Hull and others differs from the logician's conception of a set. I argue that species can be conceived of as sets, insofar as one could identify a set with any given species and that identification would satisfy (...) three desiderata: the set would be a set of organisms, the identification would be apposite, and the identification would permit the formulation of statements about species in set-theoretic terms. One cannot, however, identify a species with any given set. Understanding the claim that species are sets in this way enables one to understand better the dispute between some who accept the claim (e.g., Kitcher 1984, 1987) and some who apparently reject it (e.g., Mayr 1987). (shrink)

Crimes such as the mass murder recently committed in Norway provoke the strongest calls for the death penalty. Among ethicists, the morality of capital punishment typically is discussed in terms of whether or not capital punishment can be morally justified, i.e., the question is whether or not capital punishment is ever permissible. However, neither the morality nor immorality of capital punishment has been decisively demonstrated. My argument assumes that capital punishment is permissible in at least some circumstances. I argue that, (...) even if we think that capital punishment is (sometimes) morally permissible, if we take into account the moral value of mercy, we can see that rejecting capital punishment as a form of punishment is preferable to using it. My argument takes the following form:1. Capital punishment is not morally required in any case.2. Mercy is a morally valuable trait; actions that demonstrate mercy have more moral worth than those that do not, ceteris paribus. Thus, a moral viewpoint that incorporates mercy is preferable to one that does not.3. Not executing those who have committed capital crimes (under some conditions) demonstrates mercy.4. Just punishment of capital crimes is compatible with showing mercy.5. Thus, not executing those who have committed capital crimes (under some conditions) is morally preferable to executing them. I conclude with a brief discussion of the implications of my argument. (shrink)

Crimes such as the mass murder recently committed in Norway provoke the strongest calls for the death penalty. Among ethicists, the morality of capital punishment typically is discussed in terms of whether or not capital punishment can be morally justified, i.e., the question is whether or not capital punishment is ever permissible. However, neither the morality nor immorality of capital punishment has been decisively demonstrated. My argument assumes that capital punishment is permissible in at least some circumstances. I argue that, (...) even if we think that capital punishment is (sometimes) morally permissible, if we take into account the moral value of mercy, we can see that rejecting capital punishment as a form of punishment is preferable to using it. My argument takes the following form:1. Capital punishment is not morally required in any case.2. Mercy is a morally valuable trait; actions that demonstrate mercy have more moral worth than those that do not, ceteris paribus. Thus, a moral viewpoint that incorporates mercy is preferable to one that does not.3. Not executing those who have committed capital crimes (under some conditions) demonstrates mercy.4. Just punishment of capital crimes is compatible with showing mercy.5. Thus, not executing those who have committed capital crimes (under some conditions) is morally preferable to executing them. I conclude with a brief discussion of the implications of my argument. (shrink)

Reviews evidence which suggests that there may be little or no direct introspective access to higher order cognitive processes. Ss are sometimes unaware of the existence of a stimulus that importantly influenced a response, unaware of the existence of the response, and unaware that the stimulus has affected the response. It is proposed that when people attempt to report on their cognitive processes, that is, on the processes mediating the effects of a stimulus on a response, they do not do (...) so on the basis of any true introspection. Instead, their reports are based on a priori, implicit causal theories, or judgments about the extent to which a particular stimulus is a plausible cause of a given response. This suggests that though people may not be able to observe directly their cognitive processes, they will sometimes be able to report accurately about them. Accurate reports will occur when influential stimuli are salient and are plausible causes of the responses they produce, and will not occur when stimuli are not salient or are not plausible causes. (shrink)

Narrative medicine is one of medicine’s most important internal reforms, and it should be a critical dimension of healthcare debate. Healthcare reform must eventually ask not only how do we pay for healthcare and how do we distribute it, but more fundamentally, what kind of healthcare do we want? It must ask, in short, what are the goals of medicine? Yet, even though narrative medicine is crucial to answering these pivotal and inescapable questions, it is not easy to describe. Many (...) of its core claims go against the grain of common sense thinking about medicine. This article argues that the best way to understand narrative medicine is to tell a story that puts its emergence in historical context. (shrink)

This article introduces cultural studies of medicine to medical humanities readers. Rather than offer extended definitions of cultural studies of medicine or provide a detailed history of the domain, I have organized this introduction around a close reading and review of three recently published texts in the field. These three texts, dealing respectively with cyborg technology, AIDS, and the medical management of sexual identity problems, represent excellent examples of the opportunities and possibilities of applying cultural studies approaches to medical topics. (...) After working through these texts (and the semiotic theories which animate them), I devote my conclusion to a broader consideration of the role of cultural studies of medicine for both medical practice and medical humanities scholarship. (shrink)

Working through the lens of Donna Haraway's cyborg theory and directed at the example of Prozac, I address the dramatic rise of new technoscience in medicine and psychiatry. Haraway's cyborg theory insists on a conceptualization and a politics of technoscience that does not rely on universal “Truths” or universal “Goods” and does not attempt to return to the “pure” or the “natural.” Instead, Haraway helps us mix politics, ethics, and aesthetics with science and scientific recommendations, and she helps us understand (...) that (without recourse to universal truth or universal good) questions of legitimacy in science come down to local questions of effect and inclusion. What, in the case of my example, are the effects of Prozac? And for whom? Who is included and empowered to create legitimate psychiatric knowledge? Who is excluded and why? And, what political strategies will increase the democratic health of psychiatric science and practice? (shrink)

Staged 2 different videotaped interviews with the same individual—a college instructor who spoke English with a European accent. In one of the interviews the instructor was warm and friendly, in the other, cold and distant. 118 undergraduates were asked to evaluate the instructor. Ss who saw the warm instructor rated his appearance, mannerisms, and accent as appealing, whereas those who saw the cold instructor rated these attributes as irritating. Results indicate that global evaluations of a person can induce altered evaluations (...) of the person's attributes, even when there is sufficient information to allow for independent assessments of them. Furthermore, Ss were unaware of this influence of global evaluations on ratings of attributes. In fact, Ss who saw the cold instructor actually believed that the direction of influence was opposite to the true direction. They reported that their dislike of the instructor had no effect on their rating of his attributes but that their dislike of his attributes had lowered their global evaluations of him. (shrink)

Discusses three concepts crucial to an understanding of the nature of religion: anxiety, guilt, and freedom. The various essays examine these from the viewpoint of several different religious traditions, movements and thinkers. Contents: Editor's Preface. Donald Gard: A Personal Perspective. Part I. Guiltless Morality; The Family of Changing Woman: Nature and Women in Navaho Thought; The Sacraments as "Fear-provoking" and "Awe-inspiring" Rites in the Greek Fathers; The Doctrine of Karma; Two Concepts of Predestination in Current Islamic Thought. Part II. The (...) Spirit of Medieval Penitents; The Evolution of Freedom as Catholicity in Catholic Ethics; Agape and the Liberation Movements. Part III. Calvin's Idea of Freedom in the Ethics of Schleiermacher and Barth; Creativity and Freedom in the Thought of Martin Buber; The Liberating Visions of C. G. Jung; 'The World's Most Perverse Habit'; Appendix: Study Questions. (shrink)

Discusses three concepts crucial to an understanding of the nature of religion: anxiety, guilt, and freedom. The various essays examine these from the viewpoint of several different religious traditions, movements and thinkers. Contents: Editor's Preface. Donald Gard: A Personal Perspective. Part I. Guiltless Morality; The Family of Changing Woman: Nature and Women in Navaho Thought; The Sacraments as 'Fear-provoking' and 'Awe-inspiring' Rites in the Greek Fathers; The Doctrine of Karma; Two Concepts of Predestination in Current Islamic Thought. Part II. The (...) Spirit of Medieval Penitents; The Evolution of Freedom as Catholicity in Catholic Ethics; Agape and the Liberation Movements. Part III. Calvin's Idea of Freedom in the Ethics of Schleiermacher and Barth; Creativity and Freedom in the Thought of Martin Buber; The Liberating Visions of C. G. Jung; 'The World's Most Perverse Habit'; Appendix: Study Questions. (shrink)

The use of complementary and alternative medicine (CAM) by US consumers has grown in recent years. CAM therapies often utilize medicinal herbs as part of the treatment process; however, research on US practitioner preferences for medicinal herbs is limited, despite growing concern surrounding the sustainability of wild-harvested medicinal herbs. In order better to understand consumer preferences for this emerging market, a mail survey of US practitioners (licensed acupuncturists) was conducted to examine the importance of five herb attributes in practitioners’ herb (...) selection decisions: (1) country of origin, (2) freshness, (3) production method (organic versus conventional), (4) price, and (5) traceability. The significance of these five traits is investigated using discrete choice analysis, and the implications for US medicinal herb growers are discussed. (shrink)

We address the following issues raised by the commentators of our target article and book: the problem of multiple perspectives; how to define group selection; distinguishing between the concepts of altruism and organism; genetic versus cultural group selection; the dark side of group selection; the relationship between psychological and evolutionary altruism; the question of whether the psychological questions can be answered; psychological experiments. We thank the contributors for their commentaries, which provide a diverse agenda for future study of evolution and (...) morality. Our response will follow the organization of our book, distinguishing between evolutionary issues that concern fitness effects and psychological issues that concern motives. (shrink)

The hypothesis of group selection fell victim to a seemingly devastating critique in 1960s evolutionary biology. In Unto Others, we argue to the contrary, that group selection is a conceptually coherent and empirically well documented cause of evolution. We suggest, in addition, that it has been especially important in human evolution. In the second part of Unto Others, we consider the issue of psychological egoism and altruism -- do human beings have ultimate motives concerning the well-being of others? We argue (...) that previous psychological and philosophical work on this question has been inconclusive. We propose an evolutionary argument for the claim that human beings have altruistic ultimate motives. (shrink)