Background Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians’ decisions to honor or forgo previously established advance directives (ADs). In addition, physician views regarding legal risk, patients’ ability to comprehend (...) complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Methods Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents’ perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Results Three hundred eighty-eight of 951 surveys were completed (41% response rate). Eighty percent reported they were likely to honor a patient’s AD despite its 5 year age. Fewer than half (41%) would honor the AD of a patient in ventricular fibrillation who had expressed a desire to “pass away in peace.” Few (17%) would forgo an AD following a family’s request for continued resuscitative treatment. A majority (52%) considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage (74%) disagreed that patients could not appreciate complexities surrounding their care while 69% agreed that costs should never impact a physician’s decision as to whether to comply with a patient’s AD. Conclusions Our findings highlight the impact, albeit small, external factors have on physician AD compliance. Most respondents based their decision on the clinical situation at hand and interpretation of the patient’s initial wishes and preferences expressed by the AD. (shrink)

The objective list theory of well-being holds that a plurality of basic objective goods directly benefit people. These can include goods such as loving relationships, meaningful knowledge, autonomy, achievement, and pleasure. The objective list theory is pluralistic (it does not identify an underlying feature shared by these goods) and objective (the basic goods benefit people independently of their reactive attitudes toward them). In this paper, I discuss the structure of this theory and show how it is supported by people's considered (...) judgments. I then respond to three objections. First, I argue that there is no conceptual reason to favor a monistic theory of well-being over a pluralistic one (such as the objective list theory). Second, I argue that states of affairs can benefit people even though they hold no positive reactive attitudes toward them. And, third, I argue that objective list theorists can identify a fairly-determinate list of basic goods. (shrink)

Considers four apparent problems of eternal life--is heaven a mystical or social reality, is it other-worldly or this-worldly, is it static or dynamic, is it boring?--and shows how the teachings of Thomas Aquinas support more satisfying solutions than many contemporary philosophical and theological approaches.

Issues of interest, identity and values intertwine in environmental conflicts, creating challenges that cannot generally be overcome using rationalities grounded in generalised argumentation and abstraction. To address the growing need to engage interests and identities along with plural values in the conservation of biodiversity and ecological systems, we introduce the concept of ‘appropriateness of actions’ and ground it in a relational understanding of environmental ethics. A determination of appropriateness for actions comes from combining outputs from value elicitation with those of (...) interest and identity negotiation in ways that are salient to specific people and their relationships to specific places. Drawing on the Blue Mountain Forest Partnership in the Pacific Northwest, we propose factors of success for supporting appropriate actions: 1) understanding context and identifying key stakeholders; 2) surfacing a diversity of interests and building system-level trust; 3) building empathy for different identities grounded in specific places; 4) eliciting diverse values and seeking to understand their links to worldviews and knowledge systems and; 5) seeking out appropriate actions. (shrink)

Ectogestation involves the gestation of a fetus in an ex utero environment. The possibility of this technology raises a significant question for the abortion debate: Does a woman’s right to end her pregnancy entail that she has a right to the death of the fetus when ectogestation is possible? Some have argued that it does not Mathison & Davis. Others claim that, while a woman alone does not possess an individual right to the death of the fetus, the genetic parents (...) have a collective right to its death Räsänen. In this paper, I argue that the possibility of ectogestation will radically transform the problem of abortion. The argument that I defend purports to show that, even if it is not a person, there is no right to the death of a fetus that could be safely removed from a human womb and gestated in an artificial womb, because there are competent people who are willing to care for and raise the fetus as it grows into a person. Thus, given the possibility of ectogestation, the moral status of the fetus plays no substantial role in determining whether there is a right to its death. (shrink)

What, if anything, directly detracts from well-being? Objective list theorists affirm basic goods such as knowledge, friendship, and achievement, but it is less clear what they should say about opposing bads. In this paper, I argue that false beliefs, unhealthy relationships, and failed projects are not basic bads and do not directly detract from well-being. They can have bad effects or elements, or block the realization of basic goods, but do not themselves carry negative weight with respect to well-being. This (...) is shown by comparing cases where these bads are present and absent, examining their relation to negative overall well-being, and considering the role of these bads in the pursuit of positive goods. (shrink)

Over the past 40 years, the sense of place concept has been well-established across a range of applications and settings; however, most theoretical developments have ‘privileged the slow’. Evidence suggests that place attachments and place meanings are slow to evolve, sometimes not matching material or social reality (lag effects), and also tending to inhibit change. Here we present some key blind spots in sense of place scholarship and then suggest how a reconsideration of sense of place as ‘fast’ and ‘slow’ (...) could fill them. By this, we mean how direct and immediate perception-action processes presented in affordance theory (resulting in immediately perceived place meanings) can complement slower forms of social construction presented in sense of place scholarship. Key blind spots are that sense of place scholarship: 1) rarely accounts for sensory or immediately perceived meanings; 2) pays little attention to how place meanings are the joint product of attributes of environmental features and the attributes of the individual; and; 3) assumes that the relationship between place attachment and behaviour is linear and not constituted in dynamic relations among mind, culture and environment.. We show how these blind spots can begin to be addressed by reviewing key insights from affordance theory, and through the presentation of applied examples. We discuss future empirical research directions in terms of: 1) how sense of place is both perceived and socially constructed; 2) whether perceived and socially constructed dimensions of place can relate to one another when perceived meanings become unsituated, and; 3) how place attachment may change over different stages of the life course based upon dynamic relationships between processes of perception-action and social construction. We conclude with insights into how processes of perception-action and social construction could be included in the design and management of urban landscapes. (shrink)

Research in the organizational sciences has tended to portray prosocial behavior as an unqualified positive outcome that should be encouraged in organizations. However, only recently, have researchers begun to acknowledge prosocial behaviors that help maintain an organization’s positive image in ways that violate ethical norms. Recent scandals, including Volkswagen’s emissions scandal and Penn State’s child sex abuse scandal, point to the need for research on the individual factors and situational conditions that shape the emergence of these unethical pro-organizational behaviors. Drawing (...) on trait activation theory, we argue that the “dark” trait of Machiavellianism should make individuals more willing to engage in UPB. Further, we argue that this willingness will be augmented when Machiavellians hold bottom-line-mentality climate perceptions, or the perception that ethical standards matter less than organizational performance. Using data from 170 U.S. employees, results suggested that Machiavellians are more willing to engage in UPB, but that BLMCPs may not affect their motivation to engage in UPB. We discuss the study’s theoretical and practical implications, as well as avenues for research. (shrink)

Phenomenological psychology is shown as a means to examine implications of mass-commodity culture, through the presentation of a phenomenological analysis of a TV commercial. This advertisement plays upon the vicissitudes of fathers' experiences of their relationships with their pre-pubescent daughters. The findings disclose an image of a father's ambivalently lived inability to tolerate his daughter's first sexual attraction to another male, and his attempt to continue to control the satisfaction of his daughter's bodily desire through commodities. The significance of and (...) alternatives to this variation are suggested. (shrink)

This article investigates the role of privacy and transparency in the 4th Space and outlines their implications for the development and dissemination of conspiracy theories. We argue that privacy can be exploited by individuals and organizations to spread conspiracy theories online, while organizational transparency, intended to increase accountability and ultimately trust, can have the adverse effect and nurture conspiracy beliefs. Through the lens of the 4th Space concept, we offer suggestions on how to approach those challenges which emerge as a (...) result of the complex entanglements of both actual and virtual world across time. (shrink)

This article investigates the role of privacy and transparency in the 4th Space and outlines their implications for the development and dissemination of conspiracy theories. We argue that privacy can be exploited by individuals and organizations to spread conspiracy theories online, while organizational transparency, intended to increase accountability and ultimately trust, can have the adverse effect and nurture conspiracy beliefs. Through the lens of the 4th Space concept, we offer suggestions on how to approach those challenges which emerge as a (...) result of the complex entanglements of both actual and virtual world across time. (shrink)

Thomas Aquinas St. Thomas Aquinas was a Dominican priest and Scriptural theologian. He took seriously the medieval maxim that “grace perfects and builds on nature; it does not set it aside or destroy it.” Therefore, insofar as Thomas thought about philosophy as the discipline that investigates what we can know naturally about God and … Continue reading Thomas Aquinas →.

Combining philosophical reflections with deep self-exploration to delve into the ancient mystery of death and rebirth, this book emphasizes collective rather than individual transformation. Drawing upon twenty years of experience working with nonordinary states, the author argues that when the deep psyche is hyper-simulated using Stanislaw Grof's powerful therapeutic methods, the healing that results sometimes extends beyond the individual to the collective unconscious of humanity itself.

This is a brief and accessible introduction to the thought of the great Franciscan theologian St. Bonaventure. Cullen focuses on the long-debated relation between philosophy and theology in the work of this important but neglected thinker, revelaing Bonaventure as a great synthesizer. Cullen's exposition also shows in a new and more nuanced way Bonaventure's debt to Augustine, while making clear how he was influenced by Aristotle. The book is organized according to the categories of Bonaventure's own classic text. De reductione (...) artium ad theologiam. Part I is devoted to the definition of Christian Wisdom. In Part II, "The Light of Philosophical Knowledge," individual chapters are devoted to Bonaventure's physics, metaphysics, and moral philosophy. Part III, "The Light of Theological Knowledge," includes chapters on the Trinity, Creation, Sin, the Incarnation, Grace, the Sacraments, and the Last Things. (shrink)

One important part of Aquinas’s theory of the nature of corruptible corporeal substances is his account of the individuation of such entities. In this paper, I examine an aspect of Aquinas’s account of individuation that has not received as much attention as some others, namely, how Aquinas applies his account of individuation specifically to cases involving non-living corporeal substances. I first offer an interpretation of a key passage in Aquinas’s corpus where he explains his theory of individuation. Second, I examine (...) a text where Aquinas applies his account of individuation to a case involving non-living substances. Finally, I raise a possible objection to what Aquinas says about the individuation of non-living substances and in answering the objection suggest that Aquinas holds the view that non-living substances enjoy a less perfect mode of individuality when compared to living substances. (shrink)

Thomas Aquinas St. Thomas Aquinas was a Dominican priest and Scriptural theologian. He took seriously the medieval maxim that “grace perfects and builds on nature; it does not set it aside or destroy it.” Therefore, insofar as Thomas thought about philosophy as the discipline that investigates what we can know naturally about God and … Continue reading Thomas Aquinas →.

Contributions to this volume examine three main areas relating to the metaphysics of Thomas Aquinas: the foundation of metaphysics within Thomism; the use of metaphysics in fundamental philosophical issues within Thomism; and the use of metaphysics in central theological issues.

_ Source: _Volume 26, Issue 1, pp 118 - 147 This paper challenges the widespread emphasis on the absence of God in post- Holocaust historiography, theology, and art by suggesting that Barnett Newman’s _Stations of the Cross_ may have been conceived under the theological category of the apophatic rather than the aesthetic category of the sublime. This paper focuses on the “anti-realist” position of Newman and other artists for whom the Holocaust necessitated a renewed aniconic tendency in Jewish aesthetics. His (...) work, I suggest, holds out a tension between absolute absence and redemptive presence that at once resists and affirms a negative aesthetic of God’s solidarity with suffering. (shrink)

Objective theories of human well-being typically focus on goods such as friendship, knowledge, autonomy, and achievement that are realized by everyone or almost everyone, are realized often in life, and are typically quite important to people. In this paper, I defend the possibility of minor objective goods—goods that still benefit people independently of their subjective attitudes toward them, but which are somewhat less prominent in life. Some examples are experiences of humor, care for young children, care for animals, engagement with (...) nature, and engagement with places or objects of cultural significance. I argue that these goods can be defended in the same way as more widely-recognized objective goods—by appealing to considered judgments about well-being. I further argue that there is no reason to rule out a long list of goods and that the minor goods I have mentioned cannot be subsumed under other recognized objective goods. Even thinkers who endorse a connection between human flourishing and human well-being should affirm the goods I have listed, since these goods can be defended as part of human flourishing. (shrink)

I do four things in responding to Patrick Toner’s incisive critique of my Aquinas and the Ship of Theseus (AST). First, I further motivate Aquinas’s position that Socrates exists in the post-mortem and ante-resurrection state by noting that Socrates’ situation is at least analogous to other states of affairs that would certainly count as atypical (although not impossible). Secondly, I offer a revised Thomistic account of artefact identity through time in light of Toner’s objections to Aquinas’srestrictive view. Unlike the restrictive (...) view, this revised account is compatible with common-sense intuitions. Thirdly, I show how my defense of Aquinas’s substance metaphysic in AST is useful for the purpose of constructing defeators for certain kinds of arguments for reductionism. Fourthly, I defend Aquinas’s views on the unity of substance against Toner’s suggestion that they are implausible on the grounds that they are in conflict with certain so-called “scientifically informed”common-sense beliefs. (shrink)

In the United States, food banks served an estimated 46 million people in 2015. A combination of government policy reforms and political economic trends contributed to the rising numbers of individuals relying on private food assistance in the US, the United Kingdom and other high-income countries. Although researchers frequently map urban food environments, this project is one of the first to map private food assistance and potential need at the census-tract scale. We utilize Geographic Information Systems, demographic data, and food (...) assistance locations to develop a rapid assessment tool that could support food banks, pantries, soup kitchens, and government agencies that seek to answer the question of whether people with the greatest need have food distribution sites in close proximity. We define access based on distance and then calculate potential food insecurity using either poverty rates or a food insecurity index. We apply these methods in a case study analysis of Santa Clara County, California. Our findings suggest that food assistance distribution locations match the areas of potential need in more than 80% of urban census tracts. However, there are several potentially underserved locations and populations that could benefit from new food assistance operations. The poverty and index-based approaches show significant spatial overlap in mapped areas of high food insecurity and low access. The poverty only approach produces a higher estimate of food insecurity rates, is easier to calculate, and draws attention to the need to address poverty as a root cause of hunger. (shrink)

Understanding risk factors for relationship dissolution and poor relationship adjustment among couples has been an active area of research in relationship science. One risk factor, non-marital cohabitation, has shown to predict higher rates of relationship dissolution and relationship instability in some samples, but the associations among German parents with children over time are less clear. In this study, we examined the links between non-marital cohabitation and 10-year outcomes in 220 German families with preschool-aged children at the initial assessment followed into (...) adolescence. Families were assessed 7 times over the 10 years and retention at the 10-year follow-up was over 92%. After accounting for multiple testing, only mother’s report of better initial interparental communication predicted whether parents were likely to stay together over the course of the 10 years. Adolescents of parents who cohabited were at higher risk for externalizing symptoms 10 years later compared to children of married parents. In addition, although there were no differences between cohabiting couples and married couples at the initial assessment in relationship adjustment, cohabiting mothers who stayed with their partner over the 10 years showed significantly greater declines in relationship adjustment over the 10 years compared to married mothers. Findings indicate the need for further research that explores family structure and dynamics over time to inform refinement of prevention programs targeting relationships and children’s mental health. (shrink)

I do four things in responding to Patrick Toner’s incisive critique of my Aquinas and the Ship of Theseus (AST). First, I further motivate Aquinas’s position that Socrates exists in the post-mortem and ante-resurrection state by noting that Socrates’ situation is at least analogous to other states of affairs that would certainly count as atypical (although not impossible). Secondly, I offer a revised Thomistic account of artefact identity through time in light of Toner’s objections to Aquinas’srestrictive view. Unlike the restrictive (...) view, this revised account is compatible with common-sense intuitions. Thirdly, I show how my defense of Aquinas’s substance metaphysic in AST is useful for the purpose of constructing defeators for certain kinds of arguments for reductionism. Fourthly, I defend Aquinas’s views on the unity of substance against Toner’s suggestion that they are implausible on the grounds that they are in conflict with certain so-called “scientifically informed”common-sense beliefs. (shrink)

This essay argues that Catholic bioethicists and moral theologians need an expanded theology of technological or technical domination. It describes five variants of the concept: (1) domination of persons over others, (2) prideful assertion of mastery over nature, (3) ambition to usurp the will of God, (4) over-emphasis on technical solutions to human problems, and (5) an ideology of utility, efficiency, and effectiveness. It is argued, however, that a sixth variant is needed in regard to twenty-first century technologies. Dietrich von (...) Hildebrand’s observations of “the useful” can be employed to show how the instrumental rationality of technologies often gains a false motivational force. This preference for utility is encouraged by the complex, opaque, and autonomous structures of contemporary technologies. (shrink)

Ad hominem arguments are generally dismissed on the grounds that they are not attempts to engage in rational discourse, but are rather aimed at undermining argument by diverting attention from claims made to assessments of character of persons making claims. The manner of this dismissal however is based upon an unlikely paradigm of rationality: it is based upon the presumption that our intellectual capacities are not as limited as in fact they are, and do not vary as much as they (...) do between rational people. When we understand rationality in terms of intellectual virtues, however, which recognize these limitations and provide for the complexity of our thinking, ad hominem considerations can sometimes be relevant to assessing arguments. (shrink)

I do four things in responding to Patrick Toner’s incisive critique of my Aquinas and the Ship of Theseus (AST). First, I further motivate Aquinas’s position that Socrates exists in the post-mortem and ante-resurrection state by noting that Socrates’ situation is at least analogous to other states of affairs that would certainly count as atypical (although not impossible). Secondly, I offer a revised Thomistic account of artefact identity through time in light of Toner’s objections to Aquinas’srestrictive view. Unlike the restrictive (...) view, this revised account is compatible with common-sense intuitions. Thirdly, I show how my defense of Aquinas’s substance metaphysic in AST is useful for the purpose of constructing defeators for certain kinds of arguments for reductionism. Fourthly, I defend Aquinas’s views on the unity of substance against Toner’s suggestion that they are implausible on the grounds that they are in conflict with certain so-called “scientifically informed”common-sense beliefs. (shrink)

The preferential option for the poor is a concept and set of ideas in Catholic social teaching that is highly relevant to bioethics scholarship and practice. The option for the poor is mentioned frequently in the bioethics literature but with little specification of its history and implications for ethical and theological analysis. This article examines the origins and implications of the preferential option; compares it to critical race theory, which dominates current debates about discrimination and oppression; and proposes a set (...) of principles for further application in bioethical scholarship and discussion. (shrink)

State-directed but market-oriented forms of regulation, especially environmental examples like cap-and-trade and ecological offsetting, have proliferated in the past two decades, but sociologists have been slow to theorize these broad institutional shifts. This article offers a framework for explaining these processes of regulatory marketization. First, I argue that institutions of this sort are examples of what I call command-and-commodify regulation, a mode of regulation that distinctively hybridizes economic and authoritative dimensions of power. Second, I explain how and why one example (...) of command-and-commodify regulation, species conservation banking, emerged and remained concentrated in California, but did not so easily develop in other American states. Finally, abstracting from the case, I argue that the concept of market reconstruction is useful for developing a more general theory of the ways that social conflicts and mobilization reconfigure regulatory power and thus give rise to new modes of regulation. Together, a theory of command-and-commodify regulation and market reconstruction may be useful for explaining the development of a wide variety of environmentally focused and other regulatory institutions. (shrink)