When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

Although the philosophical systems of G. W. Leibniz and David Lewis both feature possible worlds, the ways in which their systems are similar and dissimilar are ultimately surprising. At first glance, Leibniz’s modal metaphysics might strike us as one of the most contemporarily relevant aspects of his system. But I clarify in this paper major interpretive problems that result from understanding Leibniz’s system in terms of contemporary views (like Lewis’s, for instance). Specifically, I argue that Leibniz rejects the inference (...) that if something is possible, it therefore occurs in some possible world. This discussion highlights how Leibniz’s account of individual substance (with his strict notion of identity) constrains his modal theorizing and produces fatalistic threats. I then make an unexpected connection between Leibniz’s and Lewis’s systems by showing that Leibniz’s treatment of fatalism bears similarities to the response Lewis gives to the fatalist when considering the paradoxes of time travel. (shrink)

by D. M. Armstrong In the history of the discussion of the problem of universals, G. F. Stout has an honoured, and special. place. For the Nominalist, meaning by that term a philosopher who holds that existence of repeatables - kinds, sorts, type- and the indubitable existence of general terms, is a problem. The Nominalist's opponent, the Realist, escapes the Nominalist's difficulty by postulating universals. He then faces difficulties of his own. Is he to place these universals in a (...) special realm? Or is he to bring them down to earth: perhaps turning them into repeatable properties of particulars, and repeatable relations between universals? Whichever solution he opts for, there are well-known difficulties about how particulars stand to these universals. Under these circumstances the Nominalist may make an important con cession to the Realist, a concession which he can make without abandoning his Nominalism. He may concede that metaphysics ought to recognize that particulars have properties and are related by relations. But, he can maintain, these properties and relations are particulars, not universals. Nor, indeed, is such a position entirely closed to the Realist. A Realist about universals may, and some Realists do, accept particularized properties and relations in addition to universals. As Dr. Seargent shows at the beginning of his book. a doctrine of part icularized properties and relations has led at least a submerged existence from Plato onwards. The special, classical. (shrink)

This paper uses a semiotic, performative theory of language and post-colonial theory to argue that nursing's representations of ‘multiculturalism’ need to be grounded in a theory of whiteness, an historicized understanding of how ethnic/cultural differences come to be represented in the ways they are and informed by Foucault's notions of power/knowledge. Using nursing education and ‘cultural compentency’ as examples, the paper draws on a range of literatures to suggest more critical and politically productive ways of approaching difference from within nursing's (...) largely white interpretive framework. (shrink)

Drawing on ten years of research on the unpublished Wittgenstein papers, Stern investigates what motivated Wittgenstein's philosophical writing and casts new light on the Tractatus and Philosophical Investigations. The book is an exposition of Wittgenstein's early conception of the nature of representation and how his later revision and criticism of that work led to a radically different way of looking at mind and language. It also explains how the unpublished manuscripts and typescripts were put together and why they often provide (...) better evidence of the development of his ideas than can be found in his published writing. In doing so, the book traces the development of a number of central themes in Wittgenstein's philosophy, including his conception of philosophical method, the picture theory of meaning, the limits of language, the application of language to experience, his treatment of private language, and what he called the "flow of life." Arguing that Wittgenstein's views are often much more simple (and more radical) than we have been led to believe, Wittgenstein on Mind and Language provides an overview of the development of Wittgenstein's philosophy and brings to light aspects of his philosophy that have been almost universally neglected. (shrink)

Semiotic objections to markets urge us not to place a good on the market because of the message that doing so would send. Brennan and Jaworski reject them on the grounds that either the contingent semiotics of a market can be changed or the weakness of semiotic reasons allows them to be ignored. The scope of their argument neglects the impure semiotic objections that claim that the message a market sends causes, constitutes, or involves a nonsemiotic wrong. These are the (...) most compelling class of semiotic objections and are the kind actually advanced in the literature. Rather than focusing on the necessity or contingency of a market's semiotics, we should instead attend to a semiotic objection's most important feature: its purity or impurity. (shrink)

In this new introduction to a classic philosophical text, David Stern examines Wittgenstein's Philosophical Investigations. He gives particular attention to both the arguments of the Investigations and the way in which the work is written, and especially to the role of dialogue in the book. While he concentrates on helping the reader to arrive at his or her own interpretation of the primary text, he also provides guidance to the unusually wide range of existing interpretations, and to the reasons (...) why the Investigations have inspired such a diversity of readings. Following closely the text of the Investigations and meant to be read alongside it, this survey is accessible to readers with no previous background in philosophy. It is well-suited to university-level courses on Wittgenstein, but can also be read with profit by students in other disciplines. (shrink)

Philosophical analysis of ecological theories has lagged behind the study of evolutionary theory. The semantic conception of scientific theories, which has been employed successfully in the analysis of evolutionary theory, is adopted here to analyse ecological theory. Two general problems in ecology are discussed. One arises from the continued use of covering law models in ecology, and the other concerns the applicability of ecological theory in conservation biology. The semantic conception of ecological theories is used to resolve these problems.

There are some things money literally cannot buy. Invariably transformable goods are such things because when they are exchanged for money, they become something else. These goods are destroyed rather than transferred in monetary exchanges. They mark out an impassable limit beyond which money and the market cannot reach. They cannot be for sale, in the strongest and most literal sense. Variably transformable goods are similar. They can be destroyed when offered or exchanged for money, but they differ in their (...) ability to sometimes emerge from financial transactions intact. -/- Analyzing transformable goods reveals informative and surprising results. Like other goods and commodities, they are agent relative, defined by the way particular agents value them. Inside the same transaction, a good could be transformable for one agent and not another, depending on how and what these agents value in the transaction. Applying this conceptual framework can reveal otherwise obscure facets of existing and future debates about the ethics and limits of markets. To demonstrate this, the framework is here applied to Richard Titmuss’s arguments about markets in blood, clarifying and illuminating some of his most confusing claims. Applying this framework to other debates may reveal even more striking results. (shrink)

Identity, Morality, and Threat offers a critical examination of the social psychological processes that generate outgroup devaluation and ingroup glorification as the source of conflict. Daniel Rothbart and Karyna Korostelina bring together essays analyzing the causal relationship between escalating violence and opposing images of the Self and Other.

Understanding biological systems in terms of scientific materialism has arguably reached a frontier, leaving fundamental questions about their complexity unanswered. In 1998, Friedrich Cramer proposed a general resonance theory as a way forward. His theory builds on the extension of the quantum physical duality of matter and wave to the macroscopic world. According to Cramer’ theory, agents constituting biological systems oscillate, akin to musical soundwaves, at specific eigenfrequencies. Biological system dynamics can be described as “Symphonies of Life” emerging from the (...) resonance (and dissonance) of eigenfrequencies within the interacting collective. His theory has potential for studying biological problems of increasing complexity in a fast‐changing Anthropocene from a new and transdisciplinary angle. Despite data becoming increasingly available for analyses, Cramer's theory remains ignored and therefore untested a quarter century after its publication. This paper discusses how the theory can move to quantitative assessments and application. Cramer's general resonance theory deserves revival. (shrink)

Although the importance of spirituality is increasingly recognized in clinical medicine, spirituality is rarely mentioned in the practice, literature, or training programs of global health. To understand the role of spirituality in global health practice and identify factors that influence and limit its expression, I initiated conversations and informal interviews with more than 300 global health leaders, students, and practitioners during 2010-2014. Four spiritual themes or challenges emerged: compassion at a distance; dichotomous thinking; conspiracy of silence; and compulsion to save (...) the world. Practitioners expressed strong interest in bringing spirituality more fully into global health discourse, which could help the field realize its potential. (shrink)

Originally conceived as a forty-page conclusion to Hacker’s twenty years of work on the monumental four-volume Analytical Commentary on the Philosophical Investigations, this book “rapidly assumed a life of its own”. A major contribution to the history of analytic philosophy, this substantial volume delivers even more than the title promises. The eight chapters are best approached as a six-chapter book, itself some 220 pages long, on Wittgenstein’s contribution to twentieth-century philosophy, followed by a two-chapter, 120-page epilogue about how and why (...) his influence has waned. The first six chapters provide an encyclopedic summary of the fruits of Hacker’s research on Wittgenstein’s writing, an immensely learned account of British philosophy from the turn of the century to the 1970s, and a detailed account of Wittgenstein’s reception by Oxford, Cambridge, and the Vienna Circle. The book’s closing chapters, “Post-positivism in the United States and Quine’s Apostasy” and “The Decline of Analytic Philosophy,” polemically argue that Quine’s philosophy, and the post-Quinean naturalism prevalent in Anglo-American philosophy today, amount to such a decisive break with the analytic tradition, as Hacker conceives of it, that they should not be counted as “analytic.”. (shrink)

The Late Hellenistic Jewish philosopher Philo of Alexandria has been neglected in studies of theories of mind and language in Post-Aristotelian Philosophy. Philo's dualism distinguishes immateriality and materiality in our language (logos). His arguments about the nature of mind and his explanations of the relation of speech to the mind, divine or human, draw heavily from Stoics and Platonists. Philo appears to present contemporary Platonist, anti-Stoic arguments that mind is of a different nature than body. Also, Philo deserves credit as (...) our first detailed, surviving expositor of the view that meanings are thoughts, presented to the world in speech. (shrink)

Locke’s property rights are now usually understood to be both fundamental and strictly negative. Fundamental because they are thought to be basic constraints on what we may do, unconstrained by anything deeper. Negative because they are thought to only protect a property holder against the claims of others. Here, I argue that this widespread interpretation is mistaken. For Locke, property rights are constrained by the deeper ‘fundamental law of nature,’ which involves positive obligations to those in need and confines the (...) right to excess property within circumstances where it is not needed to preserve human life. (shrink)

Jerome Wakefield has argued that a disorder is a harmful dysfunction. This paper develops how Wakefield should construe harmful in his harmful dysfunction analysis. Recently, Neil Feit has argued that classic puzzles involved in analyzing harm render Wakefield’s HDA better off without harm as a necessary condition. Whether or not one conceives of harm as comparative or non-comparative, the concern is that the HDA forces people to classify as mere dysfunction what they know to be a disorder. For instance, one (...) can conceive of cases where simultaneous disorders prevent each other from being, in any traditional sense, actually harmful; in such cases, according to the HDA, neither would be a disorder. I argue that the sense of harm that Wakefield should employ in the HDA is dispositional, similar to the sense of harm used when describing a vile of poison: “Be careful! That’s poison. It’s harmful.” I call this harm in the damage sense. Using this sense of harm enables the HDA to avoid Feit’s arguments, and thus it should be preferred to other senses when analyzing harmful dysfunction. (shrink)

Preaching should be a speaking of Scripture and not about Scripture.

In the debates concerning the ethics of human enhancement through biological or technological modifications, there have been several appeals to the concept of human dignity, both by those favouring such enhancement and by those opposing it. The result is the phenomenon of ‘dignity talk', where opposing sides both appeal to the concept of human dignity to ground their arguments resulting in a moral impasse. This article examines the use of the concept of human dignity in the enhancement debates and reveals (...) that the problem of dignity talk arises because proponents of various positions tend to ground human dignity in different features of the human individual. These features include species-membership, possession of a particular capacity, a sense of self-worth, and moral behaviour. The article proposes a solution to this problem by appealing to another feature of human beings, namely their being-in-relationship-over-time. Doing so enables us to understand dignity as a concept that affirms the worth of human individuals as complex, multidimensional wholes, rather than as isolated features. Consequently, the concept of human dignity can serve both a descriptive and a normative function in the enhancement debates. At a descriptive level, asking what advocates of a position mean when they refer to human dignity will reveal what aspects of being human they deem to be most valuable. The debate can then focus on these values. The normative function, although it cannot proscribe or prescribe all enhancement, approves only those enhancements that contribute to the flourishing of human individuals as multidimensional wholes. (shrink)

This book is based on papers presented at Wake Forest University, where three forums co-sponsored by the Center for Creative Leadership were held to address the ...

This book updates and adds to the classic Social Movements of the Sixties and Seventies, showing how social movement theory has grown and changed.

Examining the significance of Kant's account of "rational faith," this study argues that he profoundly revises his account of the human will and the moral philosophy of it in his later religious writings.

This edition of G. E. Moore's notes taken at Wittgenstein's seminal Cambridge lectures in the early 1930s provides, for the first time, an almost verbatim record of those classes. The presentation of the notes is both accessible and faithful to their original manuscripts, and a comprehensive introduction and synoptic table of contents provide the reader with essential contextual information and summaries of the topics in each lecture. The lectures form an excellent introduction to Wittgenstein's middle-period thought, covering a broad range (...) of philosophical topics, ranging from core questions in the philosophy of language, mind, logic, and mathematics, to illuminating discussions of subjects on which Wittgenstein says very little elsewhere, including ethics, religion, aesthetics, psychoanalysis, and anthropology. The volume also includes a 1932 essay by Moore critiquing Wittgenstein's conception of grammar, together with Wittgenstein's response. A companion website offers access to images of the entire set of source manuscripts. (shrink)

This paper derives a mathematical expression giving the development of the probability of a scientific hypothesis with the number of confirming tests, as determined by Bayes's theorem, in a special case in which all the tests are "independent" of one another. The simple expression obtained shows clearly how the various factors influence the growth of the probability. The result is used to set a numerical lower bound on the probabilities representing the a priori beliefs of humans in generalizations that become (...) accepted. By making a comparison with the predictions of a "logical atomic" model in the case of physical laws, it is argued that humans have significant a priori "knowledge" in a weak sense. (shrink)

The scientific work of Gianfranco Miglio must be placed in the cleavage of ''political realism'', and it must be seen together with the attempt to study political phenomena applying the same methodology of natural science (this is the meaning of the Miglian ''positivism''). What kind of role did he therefore appointed to political thought? To Miglio, the political class – in the way in which Mosca conceived it – needed ideologies to concretely exercise power: in particular, the class of ''helpers'' (...) had the duty to release technical assignments but also to think forms of legitimation of the authority. Persuaded that the end of Cold War meant also the end of an era, started four centuries before with the birth of modern State, Miglio devoted the last years of his life to think new political models, and with them new forms of legitimation of power. Beyond the specific contents of his constitutional proposals and rather than fulfilling a political role strictu sensu, the ''militant'' commitment of Miglio answered to his theoretical need to think post-State political thought and institutions, once perceived the first signs of the «autumn» of the modern State. (shrink)

The issue of identity cards is hotly debated in many countries, but it often seems to be an oddly backward-looking debate that presumes outdated “Orwellian” architectures. In the modern world, surely we should be debating the requirements for national identity management schemes, in which identity cards may or may not be a useful implementation, before we move on to architecture. If so, then, what should a U.K. national identity management scheme for the 21st century look like? Can we assemble a (...) set of requirements understandable to politicians, professionals and the public? We’ve certainly had some difficulty to date. One reason might be that we lack a compelling, narrative vision. As a result, we’re constructing a legacy system that will subvert the rational goals of worthwhile scheme. We’re not aiming high enough. The technology, I will argue, can deliver far more than the politicians, professionals and public imagine: In particular, it can deliver the apparently paradoxical result of more security and more privacy by exploiting smart cards, biometrics and cryptography. In this paper, I will set out a high-level vision of what a forward-looking national identity management and identity “card” scheme should look like: Dr. Who’s psychic paper. Not only is this a simple, clear vision that is familiar to the expert and layperson alike, but it’s a very useful artistic representation of the capabilities of the technology. I will further suggest that a utility implementation of identity infrastructure can deliver the on this vision in a practical way, and that all of the technology needed to create an ID scheme for the future already exists. (shrink)

What if individual psychology took another path than the one guided by the idea of the “Sturm und Drang” of adolescence? What if this path less-traveled led to community-oriented rites of passage that satisfied youth's deep craving for the ancestral wisdom of the Universe … and simultaneously affirmed that parents, too, would continue to grow and contribute as they transited mid-life? This article brings the reader down the path less-traveled to explore navigational aids for future travelers and provides an example (...) of the explosion of community engagement and creativity that can occur when the transitions of adolescence and mid-life, traditionally viewed as crises, become opportunities and assets for fostering individual health and community resiliency, adaptation, and well-being through community-oriented rites of passage. (shrink)