The United States health care industry is the second largest in the world, expending an estimated 479 million metric tons (MMT) of carbon dioxide per year, nearly 8 percent of the country's total emissions. The importance of carbon reduction in health care is slowly being accepted. However, efforts to “green” health care are incomplete since they generally focus on buildings and structures. Yet hospital care and clinical service sectors contribute the most carbon dioxide within the U.S. health care industry, with (...) structures/equipment and pharmaceuticals ranking as the third and fourth highest emitters in the industry. Given the magnitude of health care carbon emissions—and the paucity of attention to the carbon of hospital care and clinical services—this essay identifies overuse of health care as a health threat with serious ethical implications, offers a data‐driven action plan for carbon reduction in health care, and provides practical suggestions for more sustainable health care delivery in the United States. (shrink)

In this paper we argue the need to reimagine research ethics frameworks to include notions of environmental sustainability. While there have long been calls for healthcareethics frameworks and decision-making to include aspects of sustainability, less attention has focused on howresearchethics frameworks could address this. To do this, we first describe the traditional approach to research ethics, which often relies on individualised notions of risk. We argue that we need to broaden this notion of individual risk to consider issues associated with (...) environmental sustainability. This is because research is associated with carbon emissions and other environmental impacts, both of which cause climate change health hazards. We introduce how bioethics frameworks have considered notions of environmental sustainability and draw on these to help develop a framework suitable for researchers. We provide a case study of data-driven health research to apply our framework. (shrink)

Our century has witnessed violence on an unprecedented scale, in wars that have torn deep into the fabric of national and international life. And as we can see in the recent strife in Bosnia, genocide in Rwanda, and the ongoing struggle to control nuclear weaponry, ancient enmities continue to threaten the lives of masses of human beings. As never before, the question is urgent and practical: How can nations--or ethnic groups, or races--after long, bitter struggles, learn to live side by (...) side in peace? In An Ethic for Enemies, Donald W. Shriver, Jr., President Emeritus of Union Theological Seminary, argues that the solution lies in our capacity to forgive. Taking forgiveness out of its traditional exclusive association with personal religion and morality, Shriver urges us to recognize its importance in the secular political arena. The heart of the book examines three powerful and moving cases from recent American history--our postwar dealings with Germany, with Japan, and our continuing domestic problem with race relations--cases in which acts of forgiveness have had important political consequences. Shriver traces how postwar Germany, in its struggle to break with its political past, progressed from denial of a Nazi past, to a formal acknowledgement of the crimes of Nazi Germany, to providing material compensation for survivors of the Holocaust. He also examines the efforts of Japan and the United States, over time and across boundaries of race and culture, to forgive the wrongs committed by both peoples during the Pacific War. And finally he offers a fascinating discussion of the role of forgiveness in the American civil rights movement. He shows, for instance, that even Malcolm X recognized the need to move from contempt for the integrationist ideal to a more conciliatory, repentant stance toward Civil Rights leaders. Malcolm came to see that only through forgiveness could the separate voices of the African-American movement work together to achieve their goals. If mutual forgiveness was a radical thought in 1964, Shriver reminds us that it has yet to be realized in 1994. "We are a long way from ceasing to hold the sins of the ancestors against their living children," he writes. Yet in this poignant volume, we discover how, by forgiving, enemies can progress and have progressed toward peace. A timely antidote to today's political conflicts, An Ethic for Enemies challenges to us to confront the hatreds that cripple society and threaten to destroy the global village. (shrink)

What is the relation between a reason and an action when the reason explains the action by giving the agent's reason for doing what he did? We may call such explanations rationalizations, and say that the reason rationalizes the action. In this paper I want to defend the ancient - and common-sense - position that rationalization is a species of ordinary causal explanation. The defense no doubt requires some redeployment, but not more or less complete abandonment of the position, as (...) urged by many recent writers. (shrink)

The US healthcare industry emits an estimated 479 million tonnes of carbon dioxide each year; nearly 8% of the country’s total emissions. When assessed by sector, hospital care, clinical services, medical structures, and pharmaceuticals are the top emitters. For 15 years, research has been dedicated to the medical structures and equipment that contribute to carbon emissions. More recently, hospital care and clinical services have been examined. However, the carbon of pharmaceuticals is understudied. This article will focus on the carbon emissions (...) of pharmaceuticals since they are consistently calculated to be among the top contributors to healthcare carbon and assess the factors that contribute to pharmaceutical carbon emissions. Specifically, overprescription, pharmaceutical waste, antibiotic resistance, routine prescriptions, non-adherence, drug dependency, lifestyle prescriptions, and drugs given due to a lack of preventive healthcare will be identified. Prescribing practices have environmental ramifications. Carbon reduction, when focused on pharmaceuticals, can lead to cleaner, more sustainable healthcare. (shrink)

There is more than one way to say that composition is identity. Yi has distinguished the Weak Composition thesis from the Strong Composition thesis and attributed the former to David Lewis while noting that Lewis associates something like the latter with me. Weak Composition is the thesis that the relation between the parts collectively and their whole is closely analogous to identity. Strong Composition is the thesis that the relation between the parts collectively and their whole is identity. Yi is (...) right that Strong Composition does not fully reflect my view. We must recognize further what, borrowing Lewis's characterization, could be called the "stronger, and stranger" Composition thesis, or what I'll call the Stronger Composition thesis for short. On Strong Composition, it is only collectively that the parts are identical with the whole. On Stronger Composition, they are individually identical with it as well. I will explain and motivate this thesis. (shrink)

The carbon emissions of global health care activities make up 4–5% of total world emissions, placing it on par with the food sector. Carbon emissions are particularly relevant for health care because of climate change health hazards. Doctors and health care professionals must connect their health care delivery with carbon emissions and minimize resource use when possible as a part of their obligation to do no harm. Given that reducing carbon is a global ethical priority, the informed consent process in (...) health care delivery must change. I argue that the expanded role of bioethicists in this climate crisis is to promote and support “green informed consent:” the sharing of climate information with patients, offering options for lower-carbon health care, and accepting the patient’s right to decline treatments which are deemed too carbon intensive for their values. (shrink)

Bioethics, Volume 36, Issue 5, Page 547-555, June 2022.

Bioethics, Volume 36, Issue 5, Page 547-555, June 2022.

Approximately 47 percent of women ages fifteen to forty‐four are currently without children, and slightly more than 20 percent of white women in America will never bear children, the highest percentage in modern history. Many fertile women who are childless are voluntarily so. Although any competent person twenty‐one years or older is legally eligible for voluntary sterilization, many doctors refuse to sterilize childfree women. This essay explores various reasons a woman would want to continue in her childfree lifestyle, evaluates the (...) accessibility of sterilization for women who are childfree by examining the reported reasons for denial of sterilization—both from the woman's and the physician's perspective—and assesses the legal status of voluntary sterilization for nonparous women. The essay also urges physicians to follow recommended guidelines for counseling women who, regardless of parity, desire sterilization and to provide this contraception if, after careful consideration, there are no outstanding health or other reasons that the procedure should not be performed. (shrink)

How is it possible for David Hume to be both withering skeptic and constructive theorist? I recommend an answer like the Pyrrhonian answer to the question how it is possible to suspend all judgment yet engage in active daily life. Sextus Empiricus distinguishes two kinds of assent: one suspended across the board and one involved with daily living. The first is an act of will based on appreciation of reasons; the second is a causal effect of appearances. Hume makes the (...) same distinction, only he extends the sort of assent involved in daily life to theoretical matters as well. He is a skeptic both in finding no reason to grant the first sort of assent and in being subject to the second. (shrink)

This textbook is a flexible and affordable collection of classic and contemporary primary sources in philosophy. The readings cover seven basic topics of Western Philosophy. The selections are long enough to present a self-contained argument but not so lengthy that students lose track of the main point. Each reading has an outline with study questions, questions for reflection and discussion, and an annotated bibliography. The book includes a glossary and an appendix on logic and argumentation.

In this volume--the first, focused study of Hume on time and identity--Baxter focuses on Hume’s treatment of the concept of numerical identity, which is central to Hume's famous discussions of the external world and personal identity. Hume raises a long unappreciated, and still unresolved, difficulty with the concept of identity: how to represent something as "a medium betwixt unity and number." Superficial resemblance to Frege’s famous puzzle has kept the difficulty in the shadows. Hume’s way of addressing it makes sense (...) only in the context of his unorthodox theory of time. Baxter shows the defensibility of that theory against past dismissive interpretations, especially of Hume’s stance on infinite divisibility. Later the author shows how the difficulty underlies Hume’s later worries about his theory of personal identity, in a new reading motivated by Hume’s important appeals to consciousness. Baxter casts Hume throughout as an acute metaphysician, and reconciles this side of Hume with his overarching Pyrrhonian skepticism. (shrink)

It is largely acknowledged that natural languages emerge not just from human brains but also from rich communities of interacting human brains (Senghas, ). Yet the precise role of such communities and such interaction in the emergence of core properties of language has largely gone uninvestigated in naturally emerging systems, leaving the few existing computational investigations of this issue at an artificial setting. Here, we take a step toward investigating the precise role of community structure in the emergence of linguistic (...) conventions with both naturalistic empirical data and computational modeling. We first show conventionalization of lexicons in two different classes of naturally emerging signed systems: (a) protolinguistic “homesigns” invented by linguistically isolated Deaf individuals, and (b) a natural sign language emerging in a recently formed rich Deaf community. We find that the latter conventionalized faster than the former. Second, we model conventionalization as a population of interacting individuals who adjust their probability of sign use in response to other individuals' actual sign use, following an independently motivated model of language learning (Yang, , ). Simulations suggest that a richer social network, like that of natural (signed) languages, conventionalizes faster than a sparser social network, like that of homesign systems. We discuss our behavioral and computational results in light of other work on language emergence, and other work of behavior on complex networks. (shrink)

In 2014, the United States health care industry produced an estimated 480 million metric tons of carbon dioxide ; nearly 8% of the country's total emissions. The importance of sustainability in health care — as a business reliant on fossil fuels for transportation, energy, and operational functioning — is slowly being recognized. These efforts to green health care are incomplete, since they only focus on health care structures. The therapeutic relationship is the essence of health care — not the buildings (...) that contain the practice. As such, this article will first postulate reasons for a lack of environmental sustainability in US health care. Second, the article will focus on current green health care initiatives in the United States in which patients and physicians participate. Third, the rationale for participation in green initiatives will be explained. Fourth, the article will propose that, based on the environmental values of patients and physicians, health care insurance plans and health care insurance companies can be targeted for green health care reform, thereby closing the loop of sustainable health care delivery. (shrink)

Similarity is one of the most important relations humans perceive, arguably subserving category learning and categorization, generalization and discrimination, judgment and decision making, and other cognitive functions. Researchers have proposed a wide range of representations and metrics that could be at play in similarity judgment, yet have not comprehensively compared the power of these representations and metrics for predicting similarity within and across different semantic categories. We performed such a comparison by pairing nine prominent vector semantic representations with seven established (...) similarity metrics that could operate on these representations, as well as supervised methods for dimensional weighting in the similarity function. This approach yields a factorial model structure with 126 distinct representation‐metric pairs, which we tested on a novel dataset of similarity judgments between pairs of cohyponymic words in eight categories. We found that cosine similarity and Pearson correlation were the overall best performing unweighted similarity functions, and that word vectors derived from free association norms often outperformed word vectors derived from text (including those specialized for similarity). Importantly, models that used human similarity judgments to learn category‐specific weights on dimensions yielded substantially better predictions than all unweighted approaches across all types of similarity functions and representations, although dimension weights did not generalize well across semantic categories, suggesting strong category context effects in similarity judgment. We discuss implications of these results for cognitive modeling and natural language processing, as well as for theories of the representations and metrics involved in similarity. (shrink)

Background:Since 2010, the United States has experienced 228 disasters, affecting over 86 million people. Because of population shifts, the growing number of people living with chronic conditions or disabilities, and the growing number of older citizens living independently, access and service gaps often exist for those without money or other transferable resources. There is a lack of evidence regarding individual community members’ capacity to prepare for emergencies.Research objective:The purpose of this study is to highlight participant experiences in becoming better prepared (...) for emergencies and provide insight from a social justice perspective.Research design:This is a descriptive qualitative study, staying very close to the data as an end product rather than a beginning for interpretation.Participants and research context:A total of 13 low-income, uninsured, or under-insured attendees at a medical outreach clinic were interviewed.Ethical considerations:Institutional Review Board approval was obtained from the University of Texas at Tyler.Findings:Four themes emerged from the interview data: (a) evaluation of the emergency-preparedness education, (b) making emergency plans, (c) challenges in preparing for emergencies, and (d) facilitators of emergency preparedness.Discussion:Identifying the potential challenges to individual emergency preparedness among vulnerable populations is the first step in overcoming them. The capacity to comply with such measures, especially the ability of those with limited incomes and other vulnerable populations, must be considered.Conclusion:Synchronized, well-ordered assistance will close gaps in recovery and enhance efficiency in pre- and post-event aid. Theoretically, doing so will promote engaged and resilient members of society who are better able to withstand adverse events. The importance of the relationship between individual preparedness levels and the resiliency of nations supports the social justice imperative to address the needs of vulnerable populations in the mitigation and planning phase of the emergency management cycle. (shrink)

I argue that an individual has aspects numerically identical with it and each other that nonetheless qualitatively differ from it and each other. This discernibility of identicals does not violate Leibniz's Law, however, which concerns only individuals and is silent about their aspects. They are not in its domain of quantification. To argue that there are aspects I will appeal to the internal conflicts of conscious beings. I do not mean to imply that aspects are confined to such cases, but (...) the best way to start is to recognize them experientially. We can feel the conflicts within ourselves. In doing so we can feel some of our aspects. I will try to enhance our understanding of the concept of aspect by listing and formalizing some principles for its use. After that I will argue that all sorts of individual things have aspects, not just people who are conflicted. (shrink)

In the Treatise of Human Nature , Hume argues that, because we have adequate ideas of the smallest parts of space, we can infer that space itself must conform to our representations of it. The paper examines two challenges to this argument based on Descartes's and Locke's treatments of adequate ideas, ideas that fully capture the objects they represent. The first challenge, posed by Arnauld in his Objections to the Meditations , asks how we can know that an idea is (...) adequate. The second challenge, implicit in Locke's Essay , asks how an empiricist can characterize an idea as inadequate, as both picking out an object and yet failing to capture it fully. In showing how Hume responds to these challenges, his theory of perceptual representation is explained and his treatment of space is related to his scepticism. His conclusion is shown not to be a characterization of space as it exists wholly apart from our powers of conception. Instead, in an adumbration of Kant, his claim is restricted to space as it appears to us. (shrink)

The concept of metaphor as primarily a vehicle for conveying ideas, even if unusual ones, seems to me as wrong as the parent idea that a metaphor has a special meaning. I agree with the view that metaphors cannot be paraphrased, but I think this is not because metaphors say something too novel for literal expression but because there is nothing there to paraphrase. Paraphrase, whether possible or not, inappropriate to what is said: we try, in paraphrase, to say it (...) another way. But if I am right, a metaphor doesn't say anything beyond its literal meaning . This is not, of course, to deny that a metaphor has a point, nor that that point can be brought out by using further words. . . . My disagreement is with the explanation of how metaphor works its wonders. To anticipate: I depend on the distinction between what words mean and what they are used to do. I think metaphor belongs exclusively to the domain of use. It is something brought off by the imaginative employment of words and sentences and depends entirely on the ordinary meanings of those words and hence on the ordinary meanings of the sentences they comprise. Donald Davidson is University Professor of philosophy at the University of Chicago. He is the author of many important essays, including "Actions, Reasons and Causes," "Causal Relations," and "Truth and Meaning," coauthor of Decision-Making: An Experimental Approach, and coeditor of Words and Objections, Semantics of Natural Language, and The Logic of Grammar. (shrink)

Problems of Rationality is the eagerly awaited fourth volume of Donald Davidson 's philosophical writings. From the 1960s until his death in August 2003 Davidson was perhaps the most influential figure in English-language philosophy, and his work has had a profound effect upon the discipline. His unified theory of the interpretation of thought, meaning, and action holds that rationality is a necessary condition for both mind and interpretation. Davidson here develops this theory to illuminate value judgements and how we (...) understand them; to investigate what the conditions are for attributing mental states to an object or creature; and to grapple with the problems presented by thoughts and actions which seem to be irrational. Anyone working on knowledge, mind, and language will find these essays essential reading. (shrink)

El artículo presenta algunos resultados del estudio de la participación de Karol Wojtyła, obispo auxiliar y, sucesivamente, arzobispo de Cracovia, en el Concilio Vaticano II, así como de la recepción del mismo durante su ministerio pastoral en la archidiócesis polaca y al servicio de la Iglesia universal antes de su elección como sucesor de Pedro. Es posible hablar del “estilo conciliar” de Wojtyła: lo que la Iglesia ha enseñado sobre la gloria de Dios en el Vaticano II y sobre el (...) modo en el que dicha gloria debe acontecer en la vida de los fieles de nuestro tiempo encuentra en Wojtyła una concreta e iluminadora expresión histórica. (shrink)

Metaphysics and the Modern World makes the abiding questions of the nature of the self, world, and God available for the modern reader. Donald Phillip Verene presents these questions in both their systematic and historical dimensions, beginning with Aristotle's claim in his Metaphysics that philosophy begins in wonder. The first three chapters concern the origin of metaphysics as the transformation of the conception of reality in ancient Greek mythology, the ontological argument as the basis of Christian metaphysics, and the (...) Renaissance cosmology of infinite worlds and the coincidence of contraries. The final four chapters present the central issues of the metaphysics of history through the New Science of Vico, the principle of true infinity of Hegel's Logic, the dialectic of spirit and life in Cassirer's Metaphysics of Symbolic Forms, and the conception of actual entities and God in Whitehead's Process and Reality. In these discussions, the reader will find a lively and learned account of a field of philosophy that is often thought difficult to access, but in this work becomes most accessible and a pleasure to read. -- back cover. (shrink)

The concept of metaphor as primarily a vehicle for conveying ideas, even if unusual ones, seems to me as wrong as the parent idea that a metaphor has a special meaning. I agree with the view that metaphors cannot be paraphrased, but I think this is not because metaphors say something too novel for literal expression but because there is nothing there to paraphrase. Paraphrase, whether possible or not, inappropriate to what is said: we try, in paraphrase, to say it (...) another way. But if I am right, a metaphor doesn't say anything beyond its literal meaning. This is not, of course, to deny that a metaphor has a point, nor that that point can be brought out by using further words.... My disagreement is with the explanation of how metaphor works its wonders. To anticipate: I depend on the distinction between what words mean and what they are used to do. I think metaphor belongs exclusively to the domain of use. It is something brought off by the imaginative employment of words and sentences and depends entirely on the ordinary meanings of those words and hence on the ordinary meanings of the sentences they comprise. Donald Davidson is University Professor of philosophy at the University of Chicago. He is the author of many important essays, including "Actions, Reasons and Causes," "Causal Relations," and "Truth and Meaning," coauthor of Decision-Making: An Experimental Approach, and coeditor of Words and Objections, Semantics of Natural Language, and The Logic of Grammar. (shrink)

‘Bioethics still has important work to do in helping to secure status equality for LGBT people’ writes Timothy F. Murphy in a recent Bioethics editorial. The focus of his piece, however, is much narrower than human rights, medical care for LGBT people, or ending the HIV/AIDS pandemic. Rather, he is primarily concerned with sexuality and gender identity, and the medical intersections thereof. It is the objective of this response to provide an alternate account of bioethics from a Queer perspective. I (...) will situate Queer bioethics within Queer studies, and offer three ‘lessons’ that bioethics can derive from this perspective. These are not definitive rules for Queer bioethics, since it is a field which fundamentally opposes categorizations, favoring pastiche over principles. These lessons are exploratory examples, which both complement and contradict LGBT bioethics. My latter two lessons – on environmental bioethics and disability – overlap with some of Murphy's concerns, as well as other conceptions of LGBT bioethics. However, the first lesson takes an antithetical stance to Murphy's primary focus by resisting all forms of heteroconformity and disavowing reproduction as consonant with Queer objectives and theory. The first lesson, which doubles as a primer in Queer theory, does heavy philosophical lifting for the remainder of the essay. This response to Timothy F. Murphy, whose work is certainly a legacy in bioethics, reveals the multiplicity of discourses in LGBT/Queer studies, many of which are advantageous – even essential – to other disciplines like bioethics. (shrink)