Hospital ethics committees have become widespread over the last 25 years, stimulated by the Quinlan decision of the New Jersey Supreme Court, the report of a President's Commission, and most recently by the Joint Commission on Accreditation of Health Care Organizations , which now man dates that each hospital seeking accreditation have a functioning process for the consideration of ethical issues in patient care. Laws and regulations in several states require that hospitals establish ethics committees, and some states stipulate that (...) certain types of cases and disputes be taken to such committees. At least one state grants legal immunity to those who implement recommendations of an ethics committee. (shrink)

Hospital ethics committees have become widespread over the last 25 years, stimulated by the Quinlan decision of the New Jersey Supreme Court, the report of a President's Commission, and most recently by the Joint Commission on Accreditation of Health Care Organizations, which now man dates that each hospital seeking accreditation have a functioning process for the consideration of ethical issues in patient care. Laws and regulations in several states require that hospitals establish ethics committees, and some states stipulate that certain (...) types of cases and disputes be taken to such committees. At least one state grants legal immunity to those who implement recommendations of an ethics committee. (shrink)

The development of a `theory of mind' may not only be important for understanding the minds of others but also for using one's own mind. To investigate this supposition, forty children between the ages of three and four were given false-belief and creativity tasks. The numbers of appropriate and of original responses in the creativity test were found to correlate positively with performance on false-belief tasks. This association was robust, as it continued to be strong and significant even when age (...) and verbal intelligence were partialled out. The results support the hypothesis that the metarepresentational skills involved in theory of mind also affect the way children can access and scan their own mental repertoire beyond the areas of currently activated content (i.e. divergent thinking). With the advent of theory of mind a basic cognitive shift takes place in human development, and possibly took place in cognitive evolution. (shrink)

Principally under the influence of Saul Kripke (1972), philosophical semantics since the closing decades of 20th century has been dominated by thephenomenon Nathan Salmon (1986) aptly dubbed Direct Reference “mania.” Accordingly, it is now practically orthodox to hold that the meanings of proper names are entirely exhausted by their referents and devoid of any descriptive content. The return to a purely referential semantics of names has, nevertheless, coincided with a resurgence of some of the very puzzles that motivated description theories (...) of names in the first place, to wit: the informativeness of true identity statements of the form ‘a=b’ and the failure of substitutivity salve veritate for co-referential names in propositional attitude ascriptions. I argue that a Metalinguistic Description Theory of proper names, which treats the meaning of an arbitrary proper name as roughly equivalent to the definite description ‘the bearer of NN,’ offers a novel, semantically innocent solution to these puzzles when synthesized with Keith Donnellan’s (1966) insight that descriptions are semantically ambiguous between attributive and referential meanings. The ensuing account is then defended against two well-known Kripkean objections to metalinguisticsemantics: the Circularity Objection and the Paderewski Puzzle. (shrink)

Principally under the influence of Saul Kripke (1972), philosophical semantics since the closing decades of 20th century has been dominated by thephenomenon Nathan Salmon (1986) aptly dubbed Direct Reference “mania.” Accordingly, it is now practically orthodox to hold that the meanings of proper names are entirely exhausted by their referents and devoid of any descriptive content. The return to a purely referential semantics of names has, nevertheless, coincided with a resurgence of some of the very puzzles that motivated description theories (...) of names in the first place, to wit: the informativeness of true identity statements of the form ‘a=b’ and the failure of substitutivity salve veritate for co-referential names in propositional attitude ascriptions. I argue that a Metalinguistic Description Theory of proper names, which treats the meaning of an arbitrary proper name as roughly equivalent to the definite description ‘the bearer of NN,’ offers a novel, semantically innocent solution to these puzzles when synthesized with Keith Donnellan’s (1966) insight that descriptions are semantically ambiguous between attributive and referential meanings. The ensuing account is then defended against two well-known Kripkean objections to metalinguisticsemantics: the Circularity Objection and the Paderewski Puzzle. (shrink)

Since the BBS article in which Premack and Woodruff (1978) asked “Does the chimpanzee have a theory of mind?,” it has been repeatedly claimed that there is observational and experimental evidence that apes have mental state concepts, such as “want” and “know.” Unlike research on the development of theory of mind in childhood, however, no substantial progress has been made through this work with nonhuman primates. A survey of empirical studies of imitation, self-recognition, social relationships, deception, role-taking, and perspective-taking suggests (...) that in every case where nonhuman primate behavior has been interpreted as a sign of theory of mind, it could instead have occurred by chance or as a product of nonmentalistic processes such as associative learning or inferences based on nonmental categories. Arguments to the effect that, in spite of this, the theory of mind hypothesis should be accepted because it is more parsimonious than alternatives or because it is supported by convergent evidence are not compelling. Such arguments are based on unsupportable assumptions about the role of parsimony in science and either ignore the requirement that convergent evidence proceed from independent assumptions, or fail to show that it supports the theory of mind hypothesis over nonmentalist alternatives. Progress in research on theory of mind requires experimental procedures that can distinguish the theory of mind hypothesis from nonmentalist alternatives. A procedure that may have this potential is proposed. It uses conditional discrimination training and transfer tests to determine whether chimpanzees have the concept “see.” Commentators are invited to identify flaws in the procedure and to suggest alternatives. Key Words: apes; associative learning; concepts; convergence; deception; evolution of intelligence; folk psychology; imitation; mental state attribution; monkeys; parsimony; perspective-taking; primates; role-taking; self-recognition; social cognition; social intelligence; theory of mind. (shrink)

Features include a comprehensive review of existing material, combined with new perspectives to equip students for the challenges in the work environment; chapter overviews and student learning objectives offer a solid and useful framework in which to organise study; diagrams and charts present overviews and contexts for the subject to act as useful revision aids; effective pedagogy including a review of the arguments considered, a menu of seminar topics, and questions in every chapter, serving as an ideal basis for seminar (...) study; and additional open-ended simulations to allow students to work through unfolding scenarios. (shrink)

Background If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical - trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the (...) 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. (shrink)

Sleep onset is associated with marked changes in behavioral, physiological, and subjective phenomena. In daily life though subjective experience is the main criterion in terms of which we identify it. But very few studies have focused on these experiences. This study seeks to identify the subjective variables that reflect sleep onset. Twenty young subjects took an afternoon nap in the laboratory while polysomnographic recordings were made. They were awakened four times in order to assess subjective experiences that correlate with the (...) (1) appearance of slow eye movement, (2) initiation of stage 1 sleep, (3) initiation of stage 2 sleep, and (4) 5 min after the start of stage 2 sleep. A logistic regression identified control over and logic of thought as the two variables that predict the perception of having fallen asleep. For sleep perception, these two variables accurately classified 91.7% of the cases; for the waking state, 84.1%. (shrink)

Fractal time fluctuations of the spectral “1/f” form are universal in natural self-organizing systems. Neurobiology is uniquely infused with fractal fluctuations in the form of statistically self-similar clusters or bursts on all levels of description from molecular events such as protein chain fluctuations, ion channel currents and synaptic processes to the behaviors of neural ensembles or the collective behavior of Internet users. It is the thesis of this essay that the brain self-organizes via a vertical collation of these spontaneous events (...) in order to perceive the world and generate adaptive behaviors. REM sleep, which coalesces from self-similar clusters of burst-within-burst behavior during ontogeny, is essential to cognitive-emotional function, and has recurrent fractal organization. Empirical fMRI observations further support the association of fractal fluctuations in the temporal lobes, brainstem and cerebellum during the expression of emotional memory, spontaneous fluctuations of thought and meditative practice. Cognitive-emotional integration arises as amygdaloid-brainstem-cerebellar systems harmonize the vertical “1/f” symphony of coupled isochronous cortical oscillations in the pursuit of mindfulness. (shrink)

The dominant conventionalist view explains the wrong of breaking a promise as failing to do our fair share in supporting the practice of promise-keeping. Yet, this account fails to explain any unique moral standing that a promisee has to demand that the promisor keep the promise. In this paper, I provide a conventionalist response to this problem. In any cooperative practice, participants stand as both beneficiary and contributor. As a beneficiary, they are morally required to follow the rules of the (...) practice. As a contributor, they have claims on other participants to follow the rules. According to the rules of promise-keeping, a promisee has a unique claim on the promisor, and the personal wrong of breaking a promise should be understood as the violation of this unique and practice-dependent claim. (shrink)

This third edition offers increased coverage of sustainability and more chances for illustration and discussion of ethics in the messy day to day practicalities ...

Principles and the context, by J. C. Bennett.--Love monism, by J. M. Gustafson.--Responsibility in freedom, by E. C. Gardner.--The new morality, by G. Fackre.--When love becomes excarnate, by H. L. Smith.--Situational morality, by R. W. Gleason.--The nature of heresy, by G. Kennedy.--Situation ethics under fire, by J. Fletcher.

I argue that acknowledging Hume as a doxastic naturalist about belief in a deity allows an elegant, holistic reading of his Dialogues. It supports a reading in which Hume's spokesperson is Philo throughout, and enlightens many of the interpretive difficulties of the work. In arguing this, I perform a comprehensive survey of evidence for and against Philo as Hume's voice, bringing new evidence to bear against the interpretation of Hume as Cleanthes and against the amalgamation view while correcting several standard (...) mistakes. I ultimately isolate the interpretation of Philo's Reversal at the end of the Dialogues as of paramount importance, and show how my naturalistic interpretation makes this, and other notoriously difficult passages, unproblematic. (shrink)

Most liberals agree that governments should protect certain basic liberties, such as freedom of speech, freedom of religion and freedom of the person. Liberals disagree, however, about whether free market rights should also be protected. By “free market rights,” we mean those rights typically associated with laissez-faire economic systems such as freedom of contract, a right to market returns, and claims to privately own the means of production.We do not use the phrase “economic liberties,” as Tomasi does, because it does (...) not distinguish between the “economic rights” defended by classical liberal and those defended by socialists. Those on the right often see such freedoms as core liberal commitments, while those on the left argue that an economic system should be organized to protect the interests of the less advantaged members of society. If free market rights should be protected, then most existing societies are unjust. These societies fail the liberal standard in the same ways as th .. (shrink)

To be a conventionalist about a specific obligation or right is to believe that the obligation or right is dependent on the existence of a social practice. A conventionalist about property, for example, believes that a moral right to property is generated by conventional norms rather than by any natural right. One problem with dominant conventionalist theories is that they do not adequately justify conventional moral claims. They can justify why it is wrong to steal, for example, but they do (...) not justify the claim that you have on me to not steal from you. As a remedy, this article develops and defends the Principle of Legitimate Expectations. Suggested by John Rawls, this principle grants individuals a moral claim to what the rules of morally justified practices entitle them. This article addresses common objections to the principle to show how it can ground a wide range of conventional moral claims. (shrink)

Theories of truth and vagueness are closely connected; in this article, I draw another connection between these areas of research. Gupta and Belnap’s Revision Theory of Truth is converted into an approach to vagueness. I show how revision sequences from a general theory of definitions can be used to understand the nature of vague predicates. The revision sequences show how the meaning of vague predicates are interconnected with each other. The approach is contrasted with the similar supervaluationist approach.

Most criticism and exposition of John Rawls’s political theory has focused on his account of distributive justice rather than on his support for liberalism. Because of this, much of his argument for protecting the basic liberties remains under explained. Specifically, Rawls claims that representative citizens would agree to guarantee those social conditions necessary for the exercise and development of the two moral powers, but he does not adequately explain why protecting the basic liberties would guarantee these social conditions. This gap (...) in his argument leads to two problems. First, the Rawlsian argument for the priority of liberty would fail if the gap could not be filled. His argument would still support the protection of individual freedoms, but these freedoms would be treated like other primary goods and regulated by the difference principle. Second, without a full argument, there is not sufficient reason to favor Rawls’s left-liberal conception of the basic liberties over a more right-leaning conception that would prioritize the protection of free-market rights. To address these two problems, this paper fills in the gap in order to better explain Rawls’s full argument for egalitarian liberalism. (shrink)

Recent evaluation of the practice of euthanasia and related medical decisions at the end of life in the Netherlands has shown a slight decrease in the frequency of physician-assisted death since the enactment of the Euthanasia Law in 2002. This paper focuses on the absence of euthanasia cases concerning patients with dementia and a written advance euthanasia directive, despite the fact that the only real innovation of the Euthanasia Law consisted precisely in allowing physicians to act upon such directives. The (...) author discusses two principal reasons for this absence. One relates to the uncertainty about whether patients with advanced dementia truly experience the suffering they formerly feared. There is reason to assume that they don’t, as a consequence of psychological adaptation and progressive unawareness (anosognosia). The second, more fundamental reason touches upon the ethical relevance of shared understanding and reciprocity. The author argues that, next to autonomy and mercifulness, “reciprocity” is a condition sine qua non for euthanasia. The absence thereof in advanced dementia renders euthanasia morally inconceivable, even if there are signs of suffering and notwithstanding the presence of an advance euthanasia directive. This does not mean, however, that advance euthanasia directives of patients with dementia are worthless. They might very well have a role in the earlier stages of certain subtypes of the disease. To illustrate this point the author presents a case in which the advance directive helped to create a window of opportunity for reciprocity and shared decision-making. (shrink)

In his own writings, Rawls purposively used only a loose characterization of the basic structure, but two prominent misinterpretations highlight the current need for a more detailed account. First, G.A. Cohen argues that the Rawlsian focus on the basic structure is arbitrary due to the Rawlsian appeal to profound effects. Second, some theorists conflate the justification of coercion with the assessment of a basic structure by defining the basic structure as the coercive structure. Both misinterpretations can be corrected by carefully (...) specifying what social institutions are and explaining which social institutions come together to form the basic structure of society. (shrink)

In The Tyranny of the Ideal, Gerald Gaus gives an extended argument on behalf of the “Open Society.” Instead of claiming that it is uniquely best from some privileged moral perspective, he argues for the Open Society by showing why it is acceptable to many perspectives. In this way, Gaus argues for a liberal market-based society in a way that treats deep diversity as a fundamental feature of social life. However, the argument falters at four important points. When taken together, (...) these four problems significantly limit the significance of Gaus’s conclusions. (shrink)