Background: Despite the expansion of ethics consultation services, questions remain about the aims of clinical ethics consultation, its methods and the expertise of those who provide such services.Objective: To describe physicians’ expectations regarding the training and skills necessary for ethics consultants to contribute effectively to the care of patients in intensive care unit .Design: Mailed survey.Participants: Physicians responsible for the care of at least 10 patients in ICU over a 6-month period at a 921-bed private teaching hospital with an established (...) ethics consultation service. 69 of 92 eligible physicians responded.Measurements: Importance of specialised knowledge and skills for ethics consultants contributing to the care of patients in ICU; need for advanced disciplinary training; expectations regarding formal-training programmes for ethics consultants.Results: Expertise in ethics was described most often as important for ethics consultants taking part in the care of patients in ICU, compared with expertise in law , religious traditions , medicine and conflict-mediation techniques . When asked about the formal training consultants should possess, however, physicians involved in the care of patients in ICU most often identified advanced medical training as important.Conclusions: Although many physicians caring for patients in ICU believe ethics consultants must possess non-medical expertise in ethics and law if they are to contribute effectively to patient care, these physicians place a very high value on medical training as well, suggesting a “medicine plus one” view of the training of an ideal ethics consultant. As ethics consultation services expand, clear expectations regarding the training of ethics consultants should be established. (shrink)

In this article I will argue first that if ignorance poses a problem for valid consent in medical contexts then framing effects do too, and second that the problem posed by framing effects can be solved by eliminating those effects. My position is thus a mean between two mistaken extremes. At one mistaken extreme, framing effects are so trivial that they never impinge on the moral force of consent. This is as mistaken as thinking that ignorance is so trivial that (...) it never impinges on the moral force of consent. At the other mistaken extreme, framing effects are so serious that their existence shows that consent has no independent moral force. This is as mistaken as the idea that ignorance is so serious that its existence shows that consent has no independent moral force. I will argue that, instead of endorsing either of these mistaken extreme views, we should instead endorse a moderate view according to which framing effects sometimes pose a serious challenge for the validity of consent, just as ignorance does, but one which we can solve by eliminating the effect, just as we can solve the problem of ignorance by eliminating it. (shrink)

The U.S. Code of Federal Regulations governing federally funded research on human subjects assumes that harmful research is sometimes morally justifiable because the beneficiaries of that research share a particular vulnerability with its subjects. In this article, I argue against this assumption, which occurs in every subpart of the Code of Federal Regulations that deals with specific vulnerable populations . I argue that shared vulnerability is no exception to the general principle that harming one person in order to benefit another (...) is no more justifiable if the two people have traits in common. Further, shared vulnerability is not a reasonable proxy for any morally relevant desideratum of research, in particular the desire to benefit the worst off, the desire to avoid exploitation, and the desire to use vulnerable populations in research only when necessary. (shrink)

Subsequent consent can be morally efficacious. First, it licenses nostalgia and dismissiveness no more than its prior cousin does. Second, it's coherent because linked to the mental state of not minding. Third, it's just as vulnerable to bilking as prior consent is, as is clear once we distinguish between basing moral assessments on expectations versus on actual outcomes. Fourth, mind control is illegitimate because it short circuits the subject's will, not because its consent is subsequent. Finally, our intuitions about rape (...) show that dissent sometimes outweighs consent in matters of sex, not that subsequent consent is always inefficacious. (shrink)

In this paper I argue, against the current consensus, that the right to withdraw from research is sometimes alienable. In other words, research subjects are sometimes morally permitted to waive their right to withdraw. The argument proceeds in three major steps. In the first step, I argue that rights typically should be presumed alienable, both because that is not illegitimately coercive and because the general paternalistic motivation for keeping them inalienable is untenable. In the second step of the argument, I (...) consider three special characteristics of the right to withdraw, first that its waiver might be exploitative, second that research involves intimate bodily access, and third that it is irreversible. I argue that none of these characteristics justify an inalienable right to withdraw. In the third step, I examine four considerations often taken to justify various other allegedly inalienable rights: concerns about treating yourself merely as a means as might be the case in suicide, concerns about revoking all your future freedoms in slavery contracts, the resolution of coordination problems, and public interest. I argue that the motivations involved in these four types of situations do not apply to the right to withdraw from research. (shrink)

So long as a ban is enforceable, large private athletic institutions—such as Major League Baseball and the National Collegiate Athletic Association—should not allow their athletes to take performance-enhancing drugs. The argument I present is game-theoretic: though each athlete prefers unilateral permission to dope over a universal ban, he also prefers a universal ban over universal permission to dope. That is because, while doping improves absolute measures of performance, it does not improve relative performance if many athletes dope. Large private athletic (...) institutions should honour their athletes' preferences and should not enact any policy that gives only some athletes but not others permission to dope. Thus, they should ban doping. My paper examines and defends this game-theoretic argument. After explaining the argument, I compare it to other arguments for the same conclusion. I then discuss whether the game-theoretic argument counterintuitively fails to justify banning some forms of doping, and whether it counterintuitively justifies banning things other than doping. After arguing that a doping ban on game-theoretic grounds is neither wrongly paternalistic or nor wrongfully coercive, I end by discussing some limitations of the argument. (shrink)

In this paper, I will examine a puzzling discrepancy between the way clinicians are allowed to treat their patients and the way researchers are allowed to treat their subjects: in certain cases, researchers are legally required to disclose quite a bit more information when obtaining consent from prospective subjects than clinicians are when obtaining consent from prospective patients. I will argue that the proper resolution of this puzzling discrepancy must appeal to a pragmatic criterion of disclosure for informed consent: that (...) what needs to be disclosed in order for consent to be valid depends on what the patient/subject needs to know in order to make a decision. I will then use this pragmatic criterion of disclosure to argue that when obtaining consent researchers should be permitted to omit the same information clinicians are, given certain qualifications. I will also examine how this puzzle forces us to confront some perhaps surprising truths about valid consent. My broader aim in this paper is to examine, not so much the puzzle itself, but rather what this particular puzzle can teach us about more theoretical issues surrounding informed consent. (shrink)

Futility is easily defined as uselessness. The mistaken appearance that it cannot be defined is explained by difficulties applying it to particular cases. This latter problem is a major goal of clinical training and cannot be solved in a pithy statement.

The Code of Federal Regulations permits harmful research on children who have not agreed to participate, but I will argue that it should be no more permissive of harmful research on such children than of harmful research on adults who have not agreed to participate. Of course, the Code permits harmful research on adults. Such research is not morally problematic, however, because adults must agree to participate. And, of course, the Code also permits beneficial research on children without needing their (...) explicit agreement. This sort of research is also not problematic, this time because paternalism towards children may be justifiable. The moral problem at the center of this paper arises from the combination of two potential properties of pediatric research, first that it might be harmful and second that its subjects might not agree to participate. In Section 2 of this article I explain how the Code permits harmful research on non-agreeing children. Section 3 contains my argument that we should no more permit harmful research on non-agreeing children than on non-agreeing adults. In Section 4, I argue that my thesis does not presuppose that pediatric assent has the same moral force that adult consent does. In Section 5, I argue that the distinction between non-voluntary and involuntary research is irrelevant to my thesis. In Section 6, I rebut an objection based on the power of parental permission. In Section 7 I suggest how the Code of Federal Regulations might be changed. (shrink)

ABSTRACT The 2006 Institute of Medicine (IOM) report, ‘Ethical Considerations for Research Involving Prisoners’, recommended five main changes to current US Common Rule regulations on prisoner research. Their third recommendation was to shift from a category‐based to a risk‐benefit approach to research review, similar to current guidelines on pediatric research. However, prisoners are not children, so risk‐benefit constraints on prisoner research must be justified in a different way from those on pediatric research. In this paper I argue that additional risk‐benefit (...) constraints on prisoner research are unnecessary: the current Common Rule regulations, omitting category‐based restrictions but conjoined with the IOM report's other four main recommendations, ensure that prisoner research is as ethical as non‐prisoner research is. I explain why four problems which which may be more prevalent in prisons and which risk‐benefit constraints may seem to address – coercion, undue inducements, exploitation, and protection from harm – are in fact not solved by adding further risk‐benefit constraints on prisoner research. (shrink)

In this paper, I will argue that, while the ethical issues raised by cluster randomization can be challenging, they are not new. My thesis divides neatly into two parts. In the first, easier part I argue that many of the ethical challenges posed by cluster randomized human subjects research are clearly present in other types of human subjects research, and so are not novel. In the second, more difficult part I discuss the thorniest ethical challenge for cluster randomized research – (...) cases where consent is genuinely impractical to obtain. I argue that once again these cases require no new analytic insight; instead, we should look to political philosophy for guidance. In other words, the most serious ethical problem that arises in cluster randomized research also arises in political philosophy. (shrink)

This theory accords to volitions the status of basic mental actions, maintaining that these are spontaneous exercises of the will--a "two-way" power which ...

Durkheim écrit ce livre avec un but double : d'abord il voulait expliquer ce qui crée une société, ce qui la tient ensemble ; ensuite il voulait éclaircir l'influence qu'a la société sur la pensée logique. Pour Durkheim, la religion est la clé utilisée pour déverrouiller ces deux problématiques.Dans ce livre, Durkheim argumente que les représentations religieuses sont en fait des représentations collectives : l'essence du religieux ne peut être que le sacré. Il est une caractéristique qui se trouve universellement (...) dans toutes les religions. Le sacré, être collectif et impersonnel, représente ainsi la société elle-même. Ensuite il argumente que la société a un impact majeur dans la genèse de la pensée logique. C'est la société qui fournit à l'individu les catégories (le temps, l'espace, le nombre etc.) et les concepts nécessaires pour la pensée logique. (shrink)

There is a long tradition in philosophy and literary theory defending the view that engagement with literature promotes readers’ empathy. Until the last century, few of the empirical claims adduced in that tradition were investigated experimentally. Recent work in psychology and neuropsychology has now shed new light on the interplay of empathy and literature. This article surveys the experimental findings, addressing three central questions: What is it to read empathically? Does reading make us more empathic? What characteristics of literature, if (...) any, affect readers’ empathy? While experimental studies have delivered no conclusive answers to these questions, it has exposed their psychological complexity and constructed a more nuanced picture of the diverse ways in which literature interacts with our empathic capacities. (shrink)

With special emphasis on Foucault's many recently published lecture series this book provides an updated, comprehensive presentation of his most important diagnoses, his many ground-breaking analytical concepts as well as a systematic account of his unique conception of philosophy.

When we perceive an object, we perceive the object from a perspective. As a consequence of the perspectival nature of perception, when we perceive, say, a circular coin from different angles, there is a respect in which the coin looks circular throughout, but also a respect in which the coin's appearance changes. More generally, perception of shape and size properties has both a constant aspect—an aspect that remains stable across changes in perspective—and a perspectival aspect—an aspect that changes depending on (...) one's perspective on the object. How should we account for the perspectival aspect of spatial perception? We present a framework within which to discuss the perspectival aspect of perception and put forward three desiderata that any account of the perspectival aspect of perception should satisfy. We discuss views on which the perspectival aspect of perception is analyzed in terms of constitutively mind-dependent appearance properties as well as views on which the perspectival aspect of perception is analyzed in terms of representations of mind-independent perspectival properties. (shrink)

Two experiments examine the effects of unreportable hints on anagram solving performance and on solvers' subjective experience of insight. In Experiment 1, after seeing a hint presented too briefly to identify, participants solved anagrams preceded by the solution fastest and solved anagrams preceded by unrelated hints slowest. Participants' “warmth” ratings for solution hints were more insight-like than those for unrelated hints. In Experiment 2 a hint, or no hint, was presented at one of three different exposure durations . Participants benefited (...) from solution-relevant hints that were either unreportable or reportable, but showed a cost only for unrelated hints that were reportable. Participants' ratings of their insight experiences showed that unreportable solution and semantically related hints produced more insight-like experiences than did unrelated hints. The results suggest that unreportable processing of solution-related information is important for the insight experience. (shrink)

First published in 1818, The World as Will and Representation contains Schopenhauer's entire philosophy, ranging through epistemology, metaphysics, philosophy of mind and action, aesthetics and philosophy of art, to ethics, the meaning of life and the philosophy of religion, in an attempt to account for the world in all its significant aspects. It gives a unique and influential account of what is and is not of value in existence, the striving and pain of the human condition and the possibility of (...) deliverance from it. This new translation of the first volume of what later became a two-volume work reflects the eloquence and power of Schopenhauer's prose and renders philosophical terms accurately and consistently. It offers an introduction, glossary of names and bibliography, and succinct editorial notes, including notes on the revisions of the text which Schopenhauer made in 1844 and 1859. (shrink)

We argue that the trend toward providing users with feasible and actionable explanations of AI decisions—known as recourse explanations—comes with ethical downsides. Specifically, we argue that recourse explanations face several conceptual pitfalls and can lead to problematic explanation hacking, which undermines their ethical status. As an alternative, we advocate that explanations of AI decisions should aim at understanding.

This is the first comprehensive translation of the expanded French version of E.F.F. Chladni's Traité d'Acoustique, using Chladni's 1802 Die Akustik for reference and clarification. Chladni's experiments and observations with sound and vibrations profoundly influenced the development of the field of Acoustics. The famous Chladni diagrams along with other observations are contained in Die Akustik, published in German in 1802 and Traité d'Acoustique, a greatly expanded version, published in French in 1809. The present translation was undertaken by Robert T. Beyer, (...) PhD (1920-2008), noted acoustician, Professor of Physics at Brown University, and Gold Medal recipient of the Acoustical Society of America. Along with many other projects completed over the course of his career, Dr. Beyer translated Von Neumann's seminal work, Mathematical Foundations of Quantum Mechanics from the original German, spent 30 years translating Russian physics treatises and journals, served as editor of the English translation of the Soviet Journal of Experimental and Theoretical Physics, and also authored Sounds of our Times: Two Hundred Years of Acoustics. Represents the first comprehensive English translation of a seminal work in acoustics Translated by a prominent acoustician, and former Gold Medal recipient of the Acoustical Society of America In addition to the classic experiments with glass plates and violin bows, covers topics in music, architecture, and anatomy of human and animal hearing Appeals to a wide audience in physics, acoustics, and history of science. (shrink)

In his Treatise, Hume confronted the tensions between his project of uncovering the causal operations of the human mind and the extreme skeptical tendencies of his system. Louis Loeb argues that Hume overreaches, and he advances a controversial interpretation of Hume's epistemological framework that shows how Hume could have avoided the more destructive positions in his work.

Hume's claim that a state is a belief is often intertwined—though without his remarking on this fact—with epistemic approval of the state. This requires explanation. Beliefs, in Hume's view, are steady dispositions (not lively ideas), nature's provision for a steady influence on the will and action. Hume's epistemic distinctions call attention to circumstances in which the presence of conflicting beliefs undermine a belief's influence and thereby its natural function. On one version of this interpretation, to say that a belief is (...) justified, ceteris paribus, is to say that for all that has been shown the belief would be steady in its influence under suitable reflection. On a second version, it is to say that prima facie justification is an intrinsic property of the state, in virtue of its steadiness. These versions generate different understandings of the relationship between Parts iii and iv of Book I of the Treatise. (shrink)

A dialogue between a foreign philosopher and a powerful statesman outline Plato's reflections on the family, the status of women, property rights, and criminal law.

The Anthropocene is heralded as a new epoch distinguishing itself from all foregoing eons in the history of the Earth. It is characterized by the overarching importance of the human species in a number of respects, but also by the recognition of human dependence and precariousness. A critical human turn affecting the human condition is still in the process of arriving in the wake of an initial Copernican Revolution and Kant's ensuing second Copernican Counter-revolution. Within this landscape, issues concerning the (...) human - its finitude, responsiveness, responsibility, maturity, auto-affection and relationship to itself - appear rephrased and re-accentuated as decisive probing questions. In this book Sverre Raffnsøe explores how the change has ramifications for the kinds of knowledge that can be acquired concerning human beings and for the human sciences as a study of human existential beings in the world. (shrink)

Criticism on Bhagavadgītā, Hindu sacred work.

This article critically reflects on the research portfolio by the ecological economist Clive Spash who has helped pinpoint specific and systemic blindspots in a political-economic system that prioritises myopic development trajectories divorced from ecological reality. Drawing on his published work and collaborations it seeks to make sense of the slow, or absent, progress in averting global warming and ecological destruction. Three strands of key concern and influence are identified and discussed with reference to their orientation and explicit expression regarding Ontology, (...) Epistemology and Axiology. Some complementary points about indeterminacy and holism are presented to further strengthen the arguments for a transition towards a social-ecological economic system that puts values and principles back into focus. While Clive Spash's work has made a strong case within the economic community and appealing to ecology professionals, the value-myopia or value-vacuum has to be tackled across all disciplines, politics and society for a meaningful and urgently required transformation in decision making. Hence, the article finishes with some suggestions for the (higher) education system, and highlights the importance of simplicity and sufficiency, as well as strong sustainability-driven citizen and community action as necessary catalysts of change in this social-ecological transformation. (shrink)