Abstract Context: Established in 1997, Summa Health System’s Medical Ethics Committee (EC) serves as an educational, supportive, and consultative resource to patients/families and providers, and serves to analyze, clarify, and ameliorate dilemmas in clinical care. In 2009 the EC conducted its 100th consult. In 2002 a Palliative Care Consult Service (PCCS) was established to provide supportive services for patients/families facing advanced illness; enhance clinical decision-making during crisis; and improve pain/symptom management. How these services affect one another has thus far been (...) unclear. Objectives: This study describes EC consults: types, reasons, recommendations and utilization, and investigates the impact the PCCS may have on EC consult requests or recommendations. Methods: Retrospective reviews of 100 EC records explored trends and changes in types of consults, reasons for consults, and EC recommendations and utilization. Results: There were 50 EC consults each in the 6 years pre- and post-PCCS. Differences found include: (1) a decrease in number of reasons for consult requests (133–62); (2) changes in top two reasons for EC consult requests from ‘Family opposed to withdrawing life-sustaining treatment (LST)’ and ‘Patient capacity in question’ to ‘Futility’ and ‘Physician opposed to providing LST’; (3) changes in top two recommendations given by the EC from ‘Emotional Support for Patient/Family’ and ‘Initiate DNR Order’ to ‘Comfort Care’ and ‘Withdraw Treatment.’ Overall, 88% of recommendations were followed. Conclusion: PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined. Content Type Journal Article Pages 1-16 DOI 10.1007/s10730-011-9170-9 Authors Jessica Richmond Moeller, Department of Psychiatry and Behavioral Sciences, Akron General Medical Center, 400 Wabash Ave, Akron, OH 44307, USA Teresa H. Albanese, Health Services Research and Education Institute, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Kimberly Garchar, Kent State University, 6000 Frank Ave., N.W, North Canton, OH 44720, USA Julie M. Aultman, Department of Family and Community Medicine, Northeast Ohio Medical University, P.O. Box 95, Rootstown, OH 44272, USA Steven Radwany, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Dean Frate, Internal Medicine, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737. (shrink)

Failure is a central notion both in ethics of engineering and in engineering practice. Engineers devote considerable resources to assure their products will not fail and considerable progress has been made in the development of tools and methods for understanding and avoiding failure. Engineering ethics, on the other hand, is concerned with the moral and social aspects related to the causes and consequences of technological failures. But what is meant by failure, and what does it mean that a failure has (...) occurred? The subject of this paper is how engineers use and define this notion. Although a traditional definition of failure can be identified that is shared by a large part of the engineering community, the literature shows that engineers are willing to consider as failures also events and circumstance that are at odds with this traditional definition. These cases violate one or more of three assumptions made by the traditional approach to failure. An alternative approach, inspired by the notion of product life cycle, is proposed which dispenses with these assumptions. Besides being able to address the traditional cases of failure, it can deal successfully with the problematic cases. The adoption of a life cycle perspective allows the introduction of a clearer notion of failure and allows a classification of failure phenomena that takes into account the roles of stakeholders involved in the various stages of a product life cycle. (shrink)

‘Molinism’, in contemporary usage, is the name for a theory about the workings of divine providence. Its defenders include some of the most prominent contemporary Protestant and Catholic philosophical theologians.¹ Molinism is often said to be the only way to steer a middle..

Background independence is generally considered to be ‘the mark of distinction’ of general relativity. However, there is still confusion over exactly what background independence is and how, if at all, it serves to distinguish general relativity from other theories. There is also some confusion over the philosophical implications of background independence, stemming in part from the definitional problems. In this paper I attempt to make some headway on both issues. In each case I argue that a proper account of the (...) observables of such theories goes a long way in clarifying matters. Further, I argue, against common claims to the contrary, that the fact that these observables are relational has no bearing on the debate between substantivalists and relationalists, though I do think it recommends a structuralist ontology, as I shall endeavour to explain. (shrink)

This study provides an evaluation of ethical business perception of busIness students from three countries: Australia, Taiwan and the United States. Although statistically significant differences do exist there is significant agreement with the way students perceive ethical/unethical practices in business. The findings of this paper indicate a universality of business ethical perceptions.

We focus here on some familiar kinds of cases of conflict between friendship and morality, and, on the basis of our account of the nature of friendship, argue for the following two claims: first, that in some cases where we are led morally astray by virtue of a relationship that makes its own demands on us, the relationship in question is properly called a friendship; second, that relationships of this kind are valuable in their own right.

Property dualism is enjoying a slight resurgence in popularity, these days; substance dualism, not so much. But it is not as easy as one might think to be a property dualist and a substance materialist. The reasons for being a property dualist support the idea that some phenomenal properties (or qualia) are as fundamental as the most basic physical properties; but what material objects could be the bearers of the qualia? If even some qualia require an adverbial construal (if they (...) are modifications of the thing that is conscious because of them, not properties of something else to which the subject of consciousness is related), then the property dualist can be driven to speculative forms of materialism none of which, at this point, looks more likely to be true than the more modest versions of emergent dualism defended by contemporary substance dualists. (shrink)

"I am delighted to offer my highest praise to Dean Cocking and Jeroen van den Hoven's brilliant new book, Evil Online. The confrontation between good and evil occupies a central place in the challenges facing our human nature, and this creative investigation into the spread of evil by means of all-powerful new technologies raises fundamental questions about our morality and values. Cocking and Van den Hoven's account of the moral fog of evil forces us to face both the demons (...) within each of us as well as the demons all around us. In the end, we are all enriched by their perceptive analyses." —Phil Zimbardo, Professor Emeritus of Psychology, Stanford University Principal Investigator, Stanford Prison Experiment "The internet offers new and deeply concerning opportunities for immorality, much of it shocking and extreme. This volume explains with great insight and clarity the corrupting nature of the internet and the moral confusion it has produced. It will play a vital role in the growing debate about how to balance the benefits of the internet against the risks it poses to all of us. Evil Online is an excellent book." —Roger Crisp, Professor of Moral Philosophy, University of Oxford We now live in an era defined by the ubiquity of the internet. From our everyday engagement with social media to trolls on forums and the emergence of the dark web, the internet is a space characterized by unreality, isolation, anonymity, objectification, and rampant self-obsession—the perfect breeding ground for new, unprecedented manifestations of evil. Evil Online is the first comprehensive analysis of evil and moral character in relation to our increasingly online lives. Chapters consider traditional ideas around the phenomenon of evil in moral philosophy and explore how the dawn of the internet has presented unprecedented challenges to older theoretical approaches. Cocking and Van den Hoven propose that a growing sense of moral confusion—moral fog—pushes otherwise ordinary, normal people toward evildoing, and that values basic to moral life such as autonomy, intimacy, trust, and privacy are put at risk by online platforms and new technologies. This new theory of evildoing offers fresh insight into the moral character of the individual, and opens the way for a burgeoning new area of social thought. A comprehensive analysis of an emerging and disturbing social phenomenon, Evil Online examines the morally troubling aspects of the internet in our society. Written not only for academics in the fields of philosophy, psychology, information science, and social science, Evil Online is accessible and compelling reading for anyone interested in understanding the emergence of evil in our digitally-dominated world. (shrink)

The Oxford Handbook of Metaphysics offers the most authoritative and compelling guide to this diverse and fertile field of philosophy. Twenty-four of the world's most distinguished specialists provide brand-new essays about 'what there is': what kinds of things there are, and what relations hold among entities falling under various categories. They give the latest word on such topics as identity, modality, time, causation, persons and minds, freedom, and vagueness. The Handbook's unrivaled breadth and depth make it the definitive reference work (...) for students and academics across the philosophical spectrum. (shrink)

His attempt to answer that question had been anticipated in the eighteenth century by writers as varied as Swift, Diderot and Hume; and was addressed again, under Burke's influence, in the nineteenth century by some who are often regarded as exemplars of liberalism, such as Tocqueville and Lord Acton, or as enemies to it, such as John Henry Newman."--Jacket.

It has become quite common for people to develop `personal'' relationships nowadays, exclusively via extensive correspondence across the Net. Friendships, even romantic love relationships, are apparently, flourishing. But what kind of relations really are possible in this way? In this paper, we focus on the case of close friendship. There are various important markers that identify a relationship as one of close friendship. One will have, for instance, strong affection for the other, a disposition to act for their well-being and (...) a desire for shared experiences. Now obviously, while all these features of friendship can gain some expression through extensive correspondence on the Net, such expression is necessarily limited –you cannot, e.g., physically embrace the other, or go on a picnic together. The issue we want to address here however, is whether there might be distinctive and important influences on the structure of interaction undertaken on the Net, that affect the kind of identity ``Net-friends'''' can develop in relation to one another. In the normal case, one develops a close friendship, and in doing so, one''s identity, in part, is shaped by the friendship. To some extent, through extensive shared experience, one comes to see aspects of the world (and of oneself) through the eyes of one''s friend and so, in part, one''s identity develops in an importantly relational way, i.e., as the product of one''s relation with the close friend. In our view, however, on account of the limits of, and/or the kind of, shared contact and experience one can have with another via correspondence on the Net, there are significant structural barriers to developing the sort of relational identity that is a feature of close friendship. In arguing our case here, and by using the case of Net ``friendship'''' as our foil, we aim to shed light on the nature and importance of certain sorts of self-expression and relational interaction found in close friendship. (shrink)

Selective scientific realists disagree on which theoretical posits should be regarded as essential to the empirical success of a scientific theory. A satisfactory account of essentialness will show that the (approximate) truth of the selected posits adequately explains the success of the theory. Therefore, (a) the essential elements must be discernible prospectively; (b) there cannot be a priori criteria regarding which type of posit is essential; and (c) the overall success of a theory, or ‘cluster’ of propositions, not only individual (...) derivations, should be explicable. Given these desiderata, I propose a “unification criterion” for identifying essential elements. (shrink)

We argue that companion friendship is not importantly marked by self-disclosure as understood in either of these two ways. One's close friends need not be markedly similar to oneself, as is claimed by the mirror account, nor is the role of private information in establishing and maintaining intimacy important in the way claimed by the secrets view. Our claim will be that the mirror and secrets views not only fail to identify features that are in part constitutive of close or (...) companion friendship, but that they miss the mark quite broadly and fail to capture anything significant and distinctive about the ways in which friendship has an impact on the self. The article will proceed as follows. In the first section we outline our account of the self in friendship. In the next two sections we examine the mirror and secrets views and develop our own view in counterpoint to these. In the final section we defend our own account by showing how it provides the governing conditions which do distinguish friendship from other kinds of relations between persons. (shrink)

A critical essay on St. Augustine's social and political thought. In describing Augustine, the author captures the essence of the man in these words: "Genius he had in full measure... he is the master of the phrase or the sentence that embodies a penetrating insight, a flash of lightning that illuminates the entire sky; he is the rhetorician, the epigrammist, the polemicist, but not the patient, logical systematic philosopher.".

This paper argues that the language of rights cannot express distinctively ecofeminist insights into the treatment of nonhuman animals and the environment. An alternative is proposed in the form of a politicized ecological ethic of care which can express ecofeminist insights. The paper concludes with consideration of an ecofeminist moral issue: how we choose to understand ourselves morally in relation to what we are willing to count as food. "Contextual moral vegetarianism" represents a response to a politicized ecological ethic of (...) care. (shrink)

In this classic analysis of travel and sightseeing, author Dean MacCannell brings social scientific understandings to bear on tourism in the postindustrial age, during which the middle class has acquired leisure time for international travel. In _The Tourist_—now with a new introduction framing it as part of a broader contemporary social and cultural analysis—the author examines notions of authenticity, high and low culture, and the construction of social reality around tourism.

While there are no serious arguments in favor of there being no state control whatsoever over the private ownership and employment of firearms, there are significant arguments on the other extreme of the ‘gun control debate’ which contend for bans on the private ownership of firearms or some subset thereof. In this paper I argue that gun ban proponents like Jeff McMahan and Nicholas Dixon confuse the risk or likelihood of being confronted by an attacker intent on serious or lethal (...) harm with the right to defend oneself when faced by such an attacker. When this distinction is properly understood it becomes clear that arguments for the banning of all privately owned guns, or particular classes of guns, cannot stand so long as the firearms in question can be reasonably considered to be an effective means for individuals to defend themselves against attackers intent on serious or lethal harm. (shrink)

This book debates competing approaches to ethical decision-making for members of the armed forces of liberal-democratic states. In this volume, four prominent thinkers propose and debate competing approaches to ethical decision-making for military personnel. Deane-Peter Baker presents and expounds the 'Ethical Triangulation' model, an ethical decision-making method he has employed through much of his career as an applied military ethicist. Rufus Black advocates for a natural law-based approach, one which has heavily influenced the framework formally adopted by the Australian Defence (...) Force. Roger Herbert outlines the 'Moral Deliberation Roadmap', the moral reasoning framework recently adopted by the US Naval Academy. Iain King then sets out a model of quasi-utilitarian decision-making developed in several post-conflict settings and refined at the UK's Royal College of Defence Studies. After the opening chapters in which each author outlines their favoured decision-making approach, the four contributors then evaluate each other's proposals, often critically. Philosopher David Whetham offers some concluding thoughts in which he summarises areas of agreement between the authors, identifies key areas of difference, and suggests directions for future research. This book will be of great interest to students of military ethics, the ethics of war, moral philosophy, and International Relations, as well as military professionals. (shrink)

Just as tariffs lead to economic distortions and provide incentives for corruption, so do patent monopolies on prescription drugs, except the impact is often an order of magnitude larger.

It is a natural thought that understanding language consists in possessing knowledge—to understand a word is to know what it means. It is also natural to suppose that this knowledge is propositional knowledge—to know what a word means is to know that it means such-and-such. Thus it is prima facie plausible to suppose that understanding a bit of language consists in possessing propositional knowledge of its meaning. I refer to this as the epistemic view of understanding language. The theoretical appeal (...) of this view for the philosophy of language is that it provides for an attractive account of the project of the theory of meaning. If understanding language consists in possessing propositional knowledge of the meanings of expressions, then a meaning theory amounts to a theory of what speakers know in virtue of understanding language. In this paper I argue that, despite its intuitive and theoretical appeal, the epistemic view is false. Propositional knowledge is not necessary for understanding language, not even tacit knowledge. Unlike knowledge, I argue, linguistic understanding does not fail in Gettier cases, does not require epistemic warrant and does not even require belief. The intuitions about knowledge that have been central to epistemology do not seem to hold for linguistic understanding. So unless epistemologists have been radically mistaken about what knowledge requires, knowledge is unnecessary for understanding language. (shrink)

In this paper I draw on Thaddeus Metz’s pioneering work in African ethics, and particularly his account of the concept described by the terms ubuntu, botho, hunhu or utu, to sketch an African normative understanding of the act of rebellion against the authority of the state. Most commonly articulated in the phrase “a person is a person through other persons”, ubuntu is interpreted by Metz as a unique communitarian moral principle which can be described in its essence as the claim (...) that “actions are right, or confer ubuntu on a person, insofar as they prize communal relationships, ones in which people identify with each other, or share a way of life, and exhibit solidarity toward one another, or care about each other’s quality of life”. On the face of it, this principle appears at odds with rebellions against state authority. Following Metz, I argue, however, that a deeper grasp of this principle does, in fact, provide a justification for instances of civilian rebellion against state authority, under appropriate circumstances. (shrink)

This book offers the first introduction to a major Japanese philosophical movement through the interests and arguments of its founder, Nishida Kitaro (1870-1945), his successor, Tanabe Hajime (1885-1962), and student-turned-critic, Tosaka Jun (1900-1945). Focusing on their contributions to thinking about place, space, and dialectics, this concise introduction brings these influential thinkers to life by connecting their work to issues still debated in the philosophy of science and physics today. Beginning with an overview of the reception of quantum physics and relativity (...) theory in Japan and concluding with an account of the direct relevance of the Kyoto School to the development of world philosophy in a posthuman age, each clearly-written chapter engages historical contexts and includes: · Carefully-chosen excerpts and original translations of Nishida, Tanabe, and Tosaka · Focus boxes explaining complex concepts and problems of contextualization. A timeline, glossary and index. Further reading lists featuring relevant and significant articles and books in English. This introduction is an ideal starting point for students and lecturers looking to become better acquainted with three central Japanese philosophers and learn why their work impacts our current thinking about science. (shrink)

Shows that the very same asymmetries that arise for intentionally also arise from deciding, desiring, in favor of, opposed to, and advocating. It seems that the phenomenon is not due to anything about the concept of intentional action in particular. Rather, the effects observed for the concept of intentional action should be regarded as just one manifestation of the pervasive impact of moral judgment.

How do we know what other speakers say? Perhaps the most natural view is that we hear a speaker's utterance and infer what was said, drawing on our competence in the syntax and semantics of the language. An alternative view that has emerged in the literature is that native speakers have a non-inferential capacity to perceive the content of speech. Call this the perceptual view. The disagreement here is best understood as an epistemological one about whether our knowledge of what (...) speakers say is epistemically mediated by our linguistic competence. The present paper takes up the question of how we should go about settling this issue. Arguments for the perceptual view generally appeal to the phenomenology of speech comprehension. The present paper develops a line of argument for the perceptual view that draws on evidence from empirical psychology. The evidence suggests that a speaker's core syntactic and semantic competence is typically deployed sub-personally. The point is not just that the competence is tacit or unconscious, but that the person is not the locus of the competence. I argue that standing competence can enter into the grounds for knowledge only if it is subject to a certain sort of epistemic assessment, an assessment that is appropriate only if the person is the locus of that competence. If the person is not the locus of a speaker's core linguistic competence, as the psychological evidence suggests, then that competence does not enter into the grounds for our knowledge of what speakers say. If this line of argument is right, it has implications for the epistemology of perception and for our understanding of how empirical psychology bears on epistemology generally. (shrink)

Recent publications by several leading philosophers of chemistry have focused on the definition, scope, utility, and nomenclature of issues dealing with acidity and basicity. In this paper, molecular orbital theory is used to explain all acid–base reactions, concluding that the interaction of the highest occupied molecular orbital (HOMO) of one substrate, “the base,” with the lowest unoccupied molecular orbital (LUMO) of a second substrate, “the acid,” determines the reactivity of such systems. This paradigm provides an understanding of all acid–base reactions (...) as well as other reactions which, on the surface, may not seem like acid–base reactions but which have fundamental underpinnings of that kind of chemistry. Rather than being unable to determine a unified understanding of acidity and basicity as suggested in the philosophy of chemistry literature, we propose that acidity and basicity fit securely in a classification of many other reactions that, using classical chemistry knowledge, pre-quantum chemistry, would not be possible. We strongly support the use of all scientific knowledge and experience in the development of the ideas in the philosophy science. We further suggest increased interactions between philosophers of science and scientists, so that all scholars benefit from the values, knowledge, and perspectives of other disciplines. (shrink)

The JSTOR Archive is a trusted digital repository providing for long-term preservation and access to leading academic journals and scholarly literature from around the world. The Archive is supported by libraries, scholarly societies, publishers, and foundations. It is an initiative of JSTOR, a not-for-profit organization with a mission to help the scholarly community take advantage of advances in technology. For more information regarding JSTOR, please contact [email protected].

Reports of ethical violations by upper level managers continue to multiply despite increasing attention being given to ethics by firms and business schools. Much of the analysis of these violations focuses on either these managers'lack of operational principles or their willingness to abandon principles in the face ofcompetitive pressures. Much of the attention by firms and business schools focuses either on the articulation of operational principles (a deontological approach) or on the training of managers to sort their way through subtle (...) ethical dilemmas in the face of competitive pressure (a utilitarian approach). While valuable, these approaches alone are incomplete.This paper suggests that many ethical violations by upper managers are the by-product ofsuccess — not of competitive pressures. Our research suggests that many managers are poorly prepared to deal with success. First, success often allows managers to becomecomplacent and to lose focus, diverting attention to things other than the management of their business. Second, success, whether personal or organizational, often leads toprivileged access to information, people or objects. Third, with success usually comes increasinglyunrestrained control of organizational resources. And fourth, success can inflate a manager's belief in his or her personalability to manipulate outcomes. Even individuals with a highly developed moral sense can be challenged (tempted?) by the opportunities resulting from the convergence of these dynamics. We label the inability to cope with and respond to the by-products of success the Bathsheba Syndrome, based on the account of the good King David (a story familiar in a variety of traditions). Recognition of this phenomenon implies that we change or broaden our approach to the teaching of business ethics. It also implies that organizations must re-evaluate and change structures, procedures, and practices which enhance the likelihood of managers falling victim to the Bathsheba Syndrome. (shrink)

Non-invasive prenatal testing is an emerging form of prenatal genetic testing that provides information about the genetic constitution of a foetus without the risk of pregnancy loss as a direct result of the test procedure. As with other prenatal tests, information from NIPT can help to make a decision about termination of pregnancy, plan contingencies for birth or prepare parents to raise a child with a genetic condition. NIPT can also be used by women and couples to test purely ‘for (...) information’. Here, no particular action is envisaged following the test; it is motivated entirely by an interest in the result. The fact that NIPT can be performed without posing a risk to the pregnancy could give rise to an increase in such requests. In this paper, we examine the ethical aspects of using NIPT ‘purely for information’, including the competing interests of the prospective parents and the future child, and the acceptability of testing for ‘frivolous’ reasons. Drawing on several clinical scenarios, we claim that arguments about testing children for genetic conditions are relevant to this debate. In addition, we raise ethical concerns over the potential for objectification of the child. We conclude that, in most cases, using NIPT to test for adult-onset conditions, carrier status or non-serious traits presenting in childhood would be unacceptable. (shrink)

Uncorrected Proof; please cite published version.

This book is an exploration of the content and dimensions of contemporary Continental philosophy of religion. It is also a showcase of the work of some of the philosophers who are, by their scholarship, filling out the meaning of the term Continental philosophy of religion.

Violence can be physical and psychological. It can characterize personal actions, forms of group activity, and abiding social and political policy. This book includes all of these aspects within its focus on institutional forms of violence. Institution is also a broad category, ranging from formal arrangements such as the military, the criminal code, the death penalty and prison system, to more amorphous but systemic situations indicated by parenting, poverty, sexism, work, and racism. Violence is as complex as the human beings (...) who resort to it; its institutional forms pervade our relational lives. We are all participants in it as victims and perpetrators. The chapters in this book were written in the hope that violence can be explicated, even if not fully understood, and that such clarification can help us in devising less violent forms of living, even if it does not lead to its total abolition. The studies bring new aspects of violence to light and offer a number of suggestions for its remedy. (shrink)