In focusing their view on Kuhn, Robert Veatch and William Stempsey ignore alternative sources of insight from other voices that could help move us beyond incommensurability. Richard Rorty and Helen Longino, for example, offer another view of science and objectivity with constructive insight for the practice of science and medicine. Keywords: positivism, relativism, scientific knowledge, incommensurability, Kuhn, Rorty, Longino CiteULike Connotea Del.icio.us What's this?

Two articles in this issue of the Hastings Center Report explore two sides of the same problematic coin. In “The Limits of Surrogates’ Moral Authority and Physician Professionalism,” Jeffrey Berger discusses the moral problem of a surrogate refusing a treatment, palliative sedation, on behalf of a patient whose suffering is refractory to intensive palliative efforts provided by a multidisciplinary team. In “After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation,” Ellen Robinson and her colleagues analyze data from a study (...) of cases in which physicians wished not to perform cardiopulmonary resuscitation on patients whom they thought it would harm. Both articles begin from the idea of a professional determination about a physician's duty to a patient that conflicted with a surrogate's determination about what should or should not be done for that patient. Berger's argument stops just short of a solution, however, because a physician's professional obligation to help patients, even within guidelines set by other professionals, is insufficient protection for patients. But if Berger's theory is right—that sometimes surrogates lack moral authority to make decisions on behalf of patients—then the Robinson team has developed a careful and public process for attending to that conflict. (shrink)

The Quality Attestation Presidential Task Force has made a thoughtful and thorough contribution to the establishment of clinical ethics consultation as a professional field. As Eric Kodish, Joseph J. Fins, and colleagues indicate, quality attestation is another step in bringing greater accountability and transparency to CEC. To complete this process, however, the work of the QAPTF must be situated within a larger project. As the field further develops, there will be a move toward restricting CEC to those who have demonstrated, (...) by means of this version of the quality attestation or an eventual iteration of it, that they are capable of conducting an ethics consultation with the skill, knowledge, and rigor necessary. This raises the question of how potential consultants will gain the experience required to produce a portfolio of cases when only those who are qualified are permitted to perform CECs, either by their institution or by some external evaluator, such as The Joint Commission. Now may be the time to begin thinking about further developments in the field that will complement both current academic training programs and the quality attestation process. For this, we might look to the Association for Clinical Pastoral Education for its model for certifying educators of chaplains who wish to become professionals. (shrink)

Homeopathy is a form of complementary medicine which relies heavily on observation and experience. The three distinguishing characteristics of homeopathy are that remedies are prescribed on the totality of a person's symptoms, that the remedy likely to cure a person is a dilution of that substance which would cause the same symptoms in a healthy person, and that remedies are prepared using microdoses of substances which are diluted and then vigorously shaken. Mainstream medicine criticizes homeopathy by saying that its gentleness (...) has outlived its usefulness and treatment successes are probably no more than placebo action. In addition, its critics charge that homeopathy is unscientific, runs counter to the "laws of nature" and will not stand up to scientific scrutiny. Homeopaths reply that mainstream medicine is dangerous, that homeopathy works in children and animals (usually thought resistant to placebo), and that several good controlled clinical trials have shown positive results. There is a difference between showing that homeopathy works and adequately accounting for its mechanism of action. Clinical trials have concentrated on the former and remain unexplained in the latter. Keywords: complementary medicine, empirical homeopathy CiteULike Connotea Del.icio.us What's this? (shrink)

A woman admitted to the emergency room of a hospital died because no surgeon could be found to stop the bleeding from injuries she sustained in a farming accident. The case points to ethical shortcomings both institutionally and professionally. The call system is inadequate, and physician fears of being sued or insufficiently compensated contribute to the overall problem. Potential responses include the institutional equivalent of a root cause analysis and an understanding of the pressures brought to bear on physicians to (...) treat emergencies. (shrink)

Clinicians, operating within complex systems, make mistakes, as people do in every human endeavor, and when they do, patients are sometimes harmed. One important question is how we as clinicians can find resolution in the wake of an error. The published literature has divided errors into those caused by “systems” and by “individuals.” But whereas both “systems” and “individual” approaches are important in understanding the cause of an error, neither alone can fully lead to resolution once an error has occurred. (...) Instead, both are necessary to understand, resolve, and prevent errors. (shrink)

John Bayley’s Elegy for Iris, his memoir about living with Iris Murdoch after the onset of dementia, unsettles models of mind and agency that ignore human relationship, dependency, and the vulnerabilities of the cared for and the carer. Experiencing Iris as ambiguously absent and present while he attentively cares for her, Bayley frames his memoir as an elegy, a reflection on love and loss that conventionally represents two subjects—the author and the one he lost. Bayley’s acts of (...) care and his stories about his wife, both as she was and as she has become, sustain her moral worth as a person. Writing as an elegist, a survivor entitled to be heard, Bayley moves his experience of caring and loss from personal to social realms, from speaker to listener, opening ethical space for consolation and for social responsibility for the vulnerable. (shrink)

What is ugly? One of the leading cultural commentators of our times, Stephen Bayley, takes us on a journey of discovery by skillfully weaving centuries of art and design history into a discourse on the nature of beauty and its polar opposite, ugly.

Since the industrial revolution, when everything ran by clockwork, people have understood how important it is to live in the moment. But over time our world has grown increasingly busy, and we've lost our ability to truly savour each unique experience and the simple pleasures the world has to offer. Cultural commentator and critic Stephen Bayley seeks to explain what real value is: it's about taking the time and making the effort to appreciate things, of understanding the permanent charm (...) of modest daily rituals performed with care and feeling. Of caring about appearances and meaning. Of being bold in matters of taste. Of fully understanding the source of lasting pleasure. Of making every encounter with an object or person meaningful. Value is an elegiac account of what's recently been lost in the digital apocalypse. But also an enthusiastic anticipation of what we can regain in a post-viral, more analogue and more thoughtful world. (shrink)

López-Escobar, E. G. K. Introduction.--Kueker, D. W. Back-and-forth arguments and infinitary logics.--Green, J. Consistency properties for finite quantifier languages.--Cunningham, E. Chain models.--Gregory, J. On a finiteness condition for infinitary languages.

Since 1981 AIDS has illuminated, like a roving searchlight, a series of ethical questions, which extend far beyond the apparently narrow limits of one disease. It has revealed, one by one, human attitudes and behaviours that were previously unquestioned, or unobserved - based on unidentified but shaky pre-suppositions.This commentary offers two contrasting perspectives on the problems facing developing countries. In the first part, I comment on the preceding article, from the perspective of a clinician who has worked for many years (...) in Africa, and who witnessed the emergence of AIDS in the early 1980s and its medical, social, political and economic consequences.1 In the second, I comment on a conference in Lusaka in September 1999 that addressed many of the issues.Narrowing the gap?“Narrowing the gap” raises questions about truth or transparency in the activities of multinational companies, the ethics and economics of health care in global society and the distribution of responsibility for unwanted side effects of new treatments. The scale of HIV infection in developing countries draws attention to weaknesses or instability in theoretical and practical structures, which serve - or should serve - human wellbeing, whenever it is disturbed by disease.Truth and transparencyDuring the last 60 years, combined with improved standards of living, the products of pharmaceutical effort and ingenuity have resulted in large gains in life expectancy. These were most marked in rich northern societies, but even poor southern countries had seen it extended by 15 to 20 years, until recently.However, “the costs of drug development are not small”.2 A detailed study of costs of clinical trials found that the total cost of new drug development can be as high as $500 million per drug.3 Patent laws allow a temporary monopoly for the production and sale for a number of years. During this “protected” …. (shrink)

The Carol J. Adams Reader gathers together Adams's foundational and recent articles in the fields of critical studies, animal studies, media studies, vegan studies, ecofeminism and feminism, as well as relevant interviews and conversations in which Adams identifies key concepts and new developments in her decades-long work. This volume, a companion to The Sexual Politics of Meat (Bloomsbury Revelations), offers insight into a variety of urgent issues for our contemporary world: Why do batterers harm animals? What is the relationship between (...) genocide and attitudes toward other animals? How do activism and theory feed each other? How do race, gender, and species categories interact in strengthening oppressive attitudes? In clear language, Adams identifies the often hidden aspects of cultural presumptions. The essays and conversations found here capture the decades-long energy and vision that continue to shape new ways of thinking about and responding to oppression. (shrink)

When should we listen to our guts and when should we ignore them? What makes disgust and other related emotions morally relevant in some situations but not others? In this paper, I argue that emotions are morally relevant only when they are backed up by reasons and arguments.

On the surface, developing a social psychology of science seems compelling as a way to understand how individual social cognition – in aggregate – contributes towards individual and group behavior within scientific communities (Kitcher, 2002). However, in cases where the functional input-output profile of psychological processes cannot be mapped directly onto the observed behavior of working scientists, it becomes clear that the relationship between psychological claims and normative philosophy of science should be refined. For example, a robust body of social (...) psychological research demonstrates implicit gender bias in the evaluation of others (e.g., Steinpreis, Anders, & Ritzke, 1999). Many expected implicit bias to be a major cause of women’s underrepresentation in math intensive fields of science; however, quantitative sociological research of hiring and manuscript and grant evaluation has discovered no gender disparity in outcomes (Ceci & Williams, 2011). Why might this be so? This paper will discuss methodological challenges that go beyond classic problems of external validity in extrapolating psychological effects and explanations to scientific communities. These problems include more complex external validity issues raised by the introduction of multi-process models of cognition (e.g., implicit versus explicit social cognition) as well as the reflexive role that folk and experimental theories of social psychology play in guiding the behavior of scientists at the individual and community level. (shrink)

New Tenth Anniversary edition of this classic text with a new preface by the author, compares myths about meat-eating with myths about manliness, and seeks to ...

Introduction : first things : two black and blue thoughts -- Author's note I. a sewing needle inside a plastic and rubber suction cup sitting on a watch spring, or, an object for seeing nothing -- Elegy of milk, in black and blue : the bruising of La Chambre claire -- "A" is for Alice, for amnesia, for anamnesis: a fairy tale (almost blue) called La Jetée -- Happiness with a long piece of black leader : Chris Marker's sans soleil (...) -- Author's note II. She wrote me -- "Summer was inside the marble": Alain Resnais and Magurite Duras's Hiroshima mon amour. (shrink)

This book is designed for the sophomore/junior level Introduction to Advanced Mathematics course. Written in a modified R.L. Moore fashion, it offers a unique approach in which readers construct their own understanding. However, while readers are called upon to write their own proofs, they are also encouraged to work in groups. There are few finished proofs contained in the text, but the author offers “proof sketches” and helpful technique tips to help readers as they develop their proof writing skills. This (...) book is most successful in a small, seminar style class. Logic, Sets, Induction, Relations, Functions, Elementary Number Theory, Cardinality, The Real Numbers For all readers interested in abstract mathematics. (shrink)

Pateman challenges the way contemporary society functions by questioning the standard interpretation of an idea that is deeply embedded in American and British political thought: that our rights and freedoms derive from the social contract explicated by Locke, Hobbes, and Rousseau and interpreted in the United States by the Founding Fathers. The author shows how we are told only half the story of the original contract that establishes modern patriarchy. The sexual contract is ignored and thus men's patriarchal right over (...) women is also glossed over. No attention is paid to the problems that arise when women are excluded from the original contract but incorporated into the new contractual order. One of the main targets of the book is those who try to turn contractarian theory to progressive use, and a major thesis of the book is that this is not possible. Thus those feminists who have looked to a more "proper" contract- one between genuinely equal partners, or one entered into without any coercion- are misleading themselves. In the author's words, "In contract theory universal freedom is always a hypothesis, a story, a political fiction. Contract always generates political right in the forms of domination and subordination." Thus the book is also aimed at mainstream political theorists, and socialist and other critics of contract theory. The author offers a sweeping challenge to conventional understandings- of both left and right- of actual contracts in everyday life: the marriage contract, the employment contract, the prostitution contract, and the new surrogate mother contract. By bringing a feminist perspective to bear on the contradictions and paradoxes surrounding women and contract, and the relation between the sexes, she is able to shed new light on fundamental political problems of freedom and subordination. (shrink)

Pt. I. The road to mechanism : ancient Greece to the scientific revolution. Body and soul at war : Plato -- Body and nature : Aristotle and the Stoics -- The resurrection of the body : Christianity -- From astrology to the cult of dissection : the Renaissance -- The body-machine : Descartes -- The road not followed : Spinoza -- pt. II. The limits of mechanism : contemporary problems and solutions. The legacy of mechanism : the fragmenting and disappearing (...) body -- Recovering the body : yoga -- Recovering the body : alternative medicine. (shrink)

A new translation by Martin Hammond of Xenophon's Memorabilia and Apology of Socrates, with introduction and notes by Carol Atack, in the Oxford World's Classics series. -/- ISBN: 9780198856092 -/- 'Who would you say knows himself?' -/- In 399 BCE Socrates was tried in Athens on charges of irreligion and corruption of the young, convicted, and sentenced to death. Like Plato, an almost exact contemporary, in his youth Xenophon (c. 430-c. 354 BCE) was one of the circle of mainly upper-class (...) young Athenians attracted to Socrates' teaching. His Memorabilia is both a passionate defence of Socrates against those charges, and a kaleidoscopic picture of the man he knew, painted in a series of mini-dialogues and shorter vignettes, with a varied and deftly characterized cast—entitled and ambitious young men, atheists and hedonists, artists and artisans, Socrates' own stroppy teenage son Lamprocles, the glamorous courtesan Theodote. Topics given Socrates' characteristic questioning treatment include education, law, justice, government, political and military leadership, democracy and tyranny, friendship, care of the body and the soul, and concepts of the divine. Xenophon sees Socrates as above all a supreme moral educator, coaxing and challenging his associates to make themselves better people, not least by the example of how he lived his own life. Self-knowledge, leading to a reasoned self-control, was for Socrates the essential first step on the path to virtue, and some found it uncomfortable. The Apology is a moving account of Socrates' behaviour and bearing in his last days, immediately before, during, and after his trial. (shrink)

Impermanence is one of the most fundamental truths of our lives and one of the most uncomfortable realities for kids. This sweet story of changing seasons, ripping your favorite piece of clothing, and even growing up helps kids understand that even though we eventually have to say goodbye to everything, because everything changes there is a world of possibilities for the future.

This book elaborates on the distinction between societal innovation and social innovation. It provides eight case studies to illustrate the scope, process, outcome, and impact of societal innovation and social innovation. In addition, the book proposes a model for interested parties to maximize their contribution for the common social good in a systematic and effective way. Case studies are used to illustrate concepts for readers to grasp the real essence of the relatively abstract notions of societal innovation and social innovation. (...) In doing so, the book shows how small efforts can bring big benefits for the under privileged and to society as a whole. This book serves as a helpful resource for government officials, social innovation practitioners, social entrepreneurs, Non Profit Organizations, as well as students who would like to contribute to the common social good. (shrink)

We find three related holisms in Davidson's work: the holism that Quine brought to bear against the analytic–synthetic distinction, which arises due to the interdependence of meaning and belief; a holism of belief itself that Quine dubbed the “web of belief,” and a parallel holism of meaning. These holisms are plausible in spite of recent arguments against them. They are also important. As Davidson showed, they supply a much needed justification for Quine's Principle of Charity; and because this is so, (...) holism played a crucial, though little noticed, role in his charity‐based argument against relativism in “On the Very Idea of a Conceptual Scheme.” However, he did not adequately render the relativist's idea of an alternative, and this led him to conflate two quite distinct theses as a single, third dogma of empiricism: the relativist's thesis that languages may be true but not translatable, and the skepticism‐generating thesis that we have only mediated epistemic access to reality. (shrink)

Deeply rooted structures of racism, ableism, misogyny, ageism, and transphobia hurt great numbers of people, exposing them to intolerance, economic exclusion, and physical harm around the globe. Billions of land animals suffer and die annually in concentrated feeding operations and slaughterhouses. Our planet and all who live here are in perilous straights as the climate changes. In the face of such grievous problems, people who want to find positive ways to respond often grapple with difficult questions about how to make (...) a difference. Effective Altruism has arisen as an attempt to help answer these questions, encouraging people to give as much money as they can in the most effective ways to address human and animal suffering. But the Effective Altruists’ answers support some of the very social structures that cause suffering, undermining its efforts to “do the most good.” The Good It Promises, The Harm It Does is the first book-length critique of Effective Altruism. It brings together a diverse group of activists and scholars to explore Effective Altruism’s failure to meaningfully address forms of human and animal suffering. (shrink)