The dominant model for bioethical inquiry taught in medical schools is that of principlism. The heritage of this methodology can be traced to the Enlightenment project of generating a universalizable justification for normative morality arising from within the individual, rational agent. This project has been criticized by Alasdair MacIntyre who suggests that its failure has resulted in a fragmented and incoherent contemporary ethical framework characterized by fundamental intractability in moral debate. This incoherence implicates principlist conceptions of bioethics. Medical ethics as (...) practiced, though, is partially in keeping with teleological alternatives to principlism. Nonetheless, the hegemony of principlism threatens to harm the practice of good medicine whenever it is used to provide justification for the sanction or prohibition of practices, despite not being equipped to grant moral authority to such justifications. An example of this failure and its resulting harm is expressed in the growing obsolescence of living donor liver transplantation. (shrink)

In order to promote social distancing during the recent COVID-19 pandemic, physicians and healthcare systems have made efforts to replace in-person with virtual clinic visits when feasible. While these efforts have been well received and seem compatible with sound clinical practice, they do not perfectly replicate the experience of a face-to-face exchange between doctor and patient. This essay attempts to describe features of the virtual visit that distinguish it from its face-to-face analog and considers the phenomenological work of Emmanuel Levinas (...) in arguing that these differences may limit the force of the ethical summons a provider would otherwise experience before the face of a patient. The diminishment of this signal therapeutic experience may engender vocational as well as clinical consequences, which should be weighed against the practical benefits of the virtual visit as we consider whether our enthusiasm for this mode of practice should continue. (shrink)

A contemporary debate concerning the epistemology of testimony is portrayed by its protagonists as having its origins in the eighteenth century and the respective views of David Hume and Thomas Reid. Hume is characterized as a reductionist and Reid as an anti-reductionist. This terminology has been widely adopted and the reductive approach has become synonymous with Hume. In Sect. 1 I spell out the reductionist interpretation of Hume in which the justification possessed by testimonially-acquired beliefs is reducible to the epistemic (...) properties of perception, memory and inductive inference. This account of testimony is taken to be found in the section ‘On Miracles’ of Hume’s Enquiry concerning Human Understanding. In Sect. 2 I introduce the distinction between global and local reductionism, and Coady’s interpretation of Hume as a global reductionist. He takes Hume’s position to be untenable. The rest of the paper explores alternative interpretations of Hume. Section 3 develops a local reductionist interpretation of Hume on testimony. It is argued, though, that such an approach is unstable and, in response, Sect. 4 turns to anti-reductionism in its contemporary forms and in Reid’s teleological account. In Sect. 5 I argue for an anti-reductionist account of Hume, one drawn from his discussion of the testimony of history in the Treatise of Human Nature, thus moving away from the usually exclusive focus upon the discussion of miracles in the first Enquiry, upon which the reductionist interpretation is based. Given the standard meaning of ‘Humeanism’ in the current debate, my interpretation amounts to the claim that Hume is not a Humean with respect to testimony. (shrink)

This is one of four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and nineteen multi-disciplinary partner organizations. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policymakers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.This paper focuses on the fourth core element: information that can be used in shaping and applying law as a public health tool, specifically in the context of public health emergencies. (shrink)

This is one of four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and nineteen multi-disciplinary partner organizations. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policymakers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.This paper focuses on the fourth core element: information that can be used in shaping and applying law as a public health tool, specifically in the context of public health emergencies. (shrink)

Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian tube. Some medical organizations and clinical articles have suggested opportunistic salpingectomy to reduce the risk of ovarian cancer in patients at average risk of developing it. This entails removing the fallopian tubes at the same time as another procedure that would occur anyway. The authors argue that the principles of totality and double effect can justify such salpingectomies, even though there is a low incidence of ovarian (...) cancer. Since screening tools for ovarian cancer are ineffective and treatment options are poor, the good effect of reducing the risk of death from this type of ovarian cancer can be proportionate to the bad effects of the minor increase in surgical risk over the other procedure, the unintended side effect of infertility, and the removal of normally functioning tissue. The authors conclude that it is within the purview of a patient and physician to determine whether the benefits are proportionate to the risks in a particular case. (shrink)

The Department of Health and Human Services, Office for Civil Rights enforces Section 504 of the 1973 Rehabilitation Act and Title II of the Americans with Disabilities Act. OCR works through complaint investigations and compliance reviews, as well as outreach, technical assistance, and public education to promote voluntary compliance. In the Olmstead decision of June 1999, the Supreme Court held that the ADA’s “integration regulation” requires state and local government to administer services, programs, and activities in the most integrated setting (...) appropriate to the needs of qualified individuals with disabilities. The decision changed the focus from whether a right to more integrated services exists, to under what circumstances and how services will be provided. The New Freedom Initiative announced by President Bush in February 2001 is a broadbased initiative to remove barriers to community living for people with disabilities and promote swift implementation of the Olmstead decision. (shrink)

Religious art can reconfigure our conception of God’s omniscience. This should be seen in terms of divine understanding, with empathy and love required for God’s understanding of human beings. §I surveys reasons to think that God can empathize with us. §II and §III consider different ways that religious art has attempted to represent such empathetic relations. There are images of Christ’s suffering that elicit empathy in the viewer, and there are depictions of God’s empathetic understanding of humanity. §IV and §V (...) consider the epistemic roles of art and how religious art can reconfigure how we think of God’s omniscience. (shrink)

In this paper I argue that the development of cubism by Picasso and Braque at the beginning of the twentieth century can be illuminated by consideration of long-running philosophical debates concerning perceptual realism, in particular by Locke’s distinction between primary and secondary properties, and Kant’s empirical realism. Daniel-Henry Kahnweiler, Picasso’s dealer and early authority on cubism, interpreted Picasso and Braque as Kantian in their approach. I reject his influential interpretation, but propose a more plausible, Kantian reading of cubism.

There is a clean image of knowledge transmission between thinkers that involves sincere and reliable speakers, and hearers who carefully assess the epistemic credentials of the testimony that they hear. There is, however, a murkier side to testimonial exchange where deception and lies hold sway. Such mendacity leads to sceptical worries and to discussion of epistemic vice. Here, though, I explore cases where deceit and lies are involved in knowledge transmission. This may sound surprising or even incoherent since lying usually (...) involves saying something that is false. Even if a liar unwittingly tells the truth, those believing their testimony would not acquire knowledge. In §1, however, I suggest a range of examples where lies can be used to transmit knowledge. The kinds of cases upon which I focus are those involving ‘engineered knowledge’, where a speaker skilfully manipulates another into having a true belief. Such cases are epistemologically significant for several reasons. First, they are counter-examples to a range of widely held assumptions about knowledge. We have, for example, cases where sincerity is not necessary for knowledge transmission, where there is knowledge from falsehood, and, as we shall discuss in §2, knowledge that is fragile or not safe. Second, in §3 and §4 I suggest that engineered knowledge is best captured by a virtue theoretic approach to testimonial transmission. (shrink)

All communities have common resources that are vulnerable to selfish motives. The current paper explores this challenge in the specific case of the urban commons, defined as the public spaces and scenery of city neighborhoods. A theoretical model differentiates between individual incentives and social incentives for caring for the commons. The quality of a commons is defined as the level of physical (e.g., loose garbage) and social (e.g., public disturbances) disorder. A first study compared levels of disorder across the census (...) block groups of a single city; the second compared the disorder generated by individual addresses in two neighborhoods. Each study found that homeownership, an individual incentive, was the main predictor of disorder. Owner-occupied parcels generated less disorder than their renter-occupied neighbors, but both parcel types produced less disorder in a neighborhood with greater homeownership. The results emphasize the need for considering both individual and social incentives for group-beneficial behaviors. (shrink)

In this paper I distinguish between illustrative and performative uses of artworks in the teaching and communication of philosophy, drawing examples from the history of art and my own practice. The former are where works are used merely to illustrate and communicate a philosophical idea or argument, the latter are where the artist or teacher philosophizes through the creation of art. I hope to promote future collaboration between philosophers, art historians and artists, with artworks becoming catalysts for artistic-philosophical investigation, thus (...) revitalizing the idea of universities embodying ongoing and open-ended conversations. (shrink)

This book offers a comprehensive overview of the compatibility of palliative care with the vision of human dignity in the Catholic moral and theological traditions. The unique value of this book is that it presents expert analysis of the major domains of palliative care and how they are compatible with, and enhanced by, the holistic vision of the human person in Catholic health care. This volume will serve as a critically important ethical and theological resource on palliative care, including care (...) at the end of life, for bioethicists, theologians, palliative care specialists, other health care professionals, Catholic health care sponsors, health care administrators and executives, clergy, and students. Patients receiving palliative care and their families will also find this book to be a clarifying and reassuring resource. (shrink)

Testimonial knowledge sometimes depends on internalist epistemic conditions, those that thinkers are able to reflect upon. In the testimony literature the only internalist conditions that are considered are those concerning a hearer's knowledge of a speaker's reliability. I argue, however, that the relevant sense of internal"" should not be seen as referring to just the hearer's point of view, but rather to the points of view of both the hearer and the speaker. There are certain cases of testimonial knowledge transmission (...) that depend on the speaker's knowledge of his audience. These include cases of ""engineered knowledge"" in which a speaker deviously manipulates a hearer's beliefs. Such knowledge is therefore internalist because it depends on factors that are internal to the point of view of the speaker, and not merely on externalist factors such as the reliability of the speakers' and hearers' beliefs.". (shrink)