From the back cover: "Ever since Plato, philosophers have faced one central question: What is the scope and nature of human knowledge? In this volume the distinguished philosopher Ernest Sosa has collected his essays on this subject written over a period of twenty-five years. All the major topics of contemporary epistemology are covered: the nature of propositional knowledge, externalism versus internalism, foundationalism versus coherentism, and the problem of the criterion. The resulting book is a valuable resource for scholars and (...) can serve as a textbook for graduate seminars in epistemology.". (shrink)

A Virtue Epistemology presents a new approach to some of the oldest and most gripping problems of philosophy, those of knowledge and scepticism. Ernest Sosa argues for two levels of knowledge, the animal and the reflective, each viewed as a distinctive human accomplishment. By adopting a kind of virtue epistemology in line with the tradition found in Aristotle, Aquinas, Reid, and especially Descartes, he presents an account of knowledge which can be used to shed light on different varieties of (...) scepticism, the nature and status of intuitions, and epistemic normativity. (shrink)

Dealing with situations where parents’ views about treatment for their child are strongly opposed to doctors’ views is one major area of ethical challenge in paediatric health care. The traditional approach focuses on the child’s best interests, but this is problematic for a number of reasons. The Harm Principle test is regarded by many ethicists as more appropriate than the best interests test. Despite this, use of the best interests test for intervening in parental decisions is still very common in (...) clinical settings and can lead to confusion. In this paper, I propose the Zone of Parental Discretion as a means of putting into practice the key ideas of the Harm Principle, in a clear, step-by-step process. The Zone of Parental Discretion provides a tool for ethical deliberation by clinicians and ethicists about all situations in which parents and doctors disagree about treatment of a child, whether parents are refusing medically recommended treatment, or requesting non-recommended treatment. (shrink)

In this concise book, one of the world's leading epistemologists provides a sophisticated, revisionist introduction to the problem of knowledge in Western philosophy. Modern and contemporary accounts of epistemology tend to focus on limited questions of knowledge and skepticism, such as how we can know the external world, other minds, the past through memory, the future through induction, or the world’s depth and structure through inference. This book steps back for a better view of the more general issues posed by (...) the ancient Greek Pyrrhonists. Returning to and illuminating this older, broader epistemological tradition, Ernest Sosa develops an original account of the subject, giving it substance not with Cartesian theology but with science and common sense. -/- Descartes is a part of this ancient tradition, but he goes beyond it by considering not just whether knowledge is possible at all but also how we can properly attain it. In Cartesian epistemology, Sosa finds a virtue-theoretic account, one that he extends beyond the Cartesian context. Once epistemology is viewed in this light, many of its problems can be solved or fall away. -/- The result is an important reevaluation of epistemology that will be essential reading for students and teachers. (shrink)

INTRODUCTION Reopening a Discussion The empiricist-derived epistemology that has directed most social and natural scientific inquiry for the last three ...

We study the fine structure of the core model for one Woodin cardinal, building of the work of Mitchell and Steel on inner models of the form . We generalize to some combinatorial principles that were shown by Jensen to hold in L. We show that satisfies the statement: “□κ holds whenever κ the least measurable cardinal λ of order λ++”. We introduce a hierarchy of combinatorial principles □κ, λ for 1 λ κ such that □κ□κ, 1 □κ, λ □κ, (...) κ□κ*. We prove that if holds in V. As an application, we show that ZFC + PFA Con. We also obtain one Woodin cardinal as a lower bound on the consistency strength of stationary reflection at κ+ for a singular, countably closed limit cardinal κ such that # exists; likewise for the failure of □κ* at such a κ. (shrink)

Common sense and philosophical tradition agree that mind makes a difference. What we do depends not only on how our bodies are put together, but also on what we think. Explaining how mind can make a difference has proved challenging, however. Some have urged that the project faces an insurmountable dilemma: either we concede that mentalistic explanations of behavior have only a pragmatic standing or we abandon our conception of the physical domain as causally autonomous. Although each option has its (...) advocates, most theorists have sought a middle way that accommodates both the common-sense view of mind and the metaphysical conviction about the physical world. This volume presents a collection of new, specially written essays by a diverse group of philosophers, each of whom is widely known for defending a particular conception of minds and their place in nature. Contributors include Robert Audi, Lynne Rudder Baker, Tyler Burge, Donald Davidson, Fred Dretske, Ted Honderich, Jennifer Hornsby, Frank Jackson, Jaegwon Kim, Brian P. McLaughlin, Ruth Garrett Millikan, H. W. Noonan, Philip Pettit, Ernest Sosa, and Robert Van Gulick. (shrink)

I argue that Nelson's feminist transformation of empiricism provides the basis of a dialogue across three currently competing feminist epistemologies: feminist empiricism, feminist standpoint theories, and postmodern feminism, a dialogue that will result in a dissolution of the apparent tensions between these epistemologies and provide an epistemology with the openness and fluidity needed to embrace the concerns of feminists.

Common sense and philosophical tradition agree that mind makes a difference. What we do depends not only on how our bodies are put together, but also on what we think. Explaining how mind can make a difference has proved challenging, however. Some have urged that the project faces an insurmountable dilemma: either we concede that mentalistic explanations of behavior have only a pragmatic standing or we abandon our conception of the physical domain as causally autonomous. Although each option has its (...) advocates, most theorists have sought a middle way that accommodates both the common-sense view of mind and the metaphysical conviction about the physical world. This volume presents a collection of new, specially written essays by a diverse group of philosophers, each of whom is widely known for defending a particular conception of minds and their place in nature. Contributors include Robert Audi, Lynne Rudder Baker, Tyler Burge, Donald Davidson, Fred Dretske, Ted Honderich, Jennifer Hornsby, Frank Jackson, Jaegwon Kim, Brian P. McLaughlin, Ruth Garrett Millikan, H. W. Noonan, Philip Pettit, Ernest Sosa, and Robert Van Gulick. (shrink)

In this paper, we put forward the view that emotions have a legitimate and important role in health professional ethics education. This paper draws upon our experience of running a narrative ethics education programme for ethics educators from a range of healthcare disciplines. It describes the way in which emotions may be elicited in narrative ethics teaching and considers the appropriate role of emotions in ethics education for health professionals. We argue there is a need for a pedagogical framework to (...) productively incorporate the role of emotions in health professional ethics teaching. We suggest a theoretical basis for an ethics pedagogy that integrates health professional emotions in both the experience and the analysis of ethical practice, and identify a range of strategies to support the educator to incorporate emotion within their ethics teaching. (shrink)

Ernest Gellner's final book, first published in 1998, is a synoptic interpretation of the thought of Wittgenstein and Malinowski.

In “Tracking, Competence, and Knowledge,” Ernest Sosa notes that in attempting to account for the conditions for knowledge, externalists have proposed that the justification condition be replaced or supplemented by the requirement that a certain modal relation be obtained between a fact and a subject's belief concerning that fact. While assessing attempts to identify such a relation, he focuses on an account labeled “Cartesian‐tracking”, which accounts for the relation in the form of two conditionals. If a person S believes (...) a proposition P → P P → S believes P. Sosa suggests that be abandoned as a requirement, and that, equipped with his modifications, can offer promising results in connection with skepticism. He argues that modified coupled with the requirement that S's belief be “virtuous” can illuminate the nature of propositional knowledge. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Reflective Knowledge draws together ground-breaking work in epistemology by Ernest Sosa. He argues for a reflective virtue epistemology based on virtuous circularity, shows how this idea may be found explicitly or just below the surface in such illustrious predecessors as Descartes and Moore, and defends the view against its rivals.

We present a general construction of a □κ-sequence in Jensen's fine structural extender models. This construction yields a local definition of a canonical □κ-sequence as well as a characterization of those cardinals κ, for which the principle □κ fails. Such cardinals are called subcompact and can be described in terms of elementary embeddings. Our construction is carried out abstractly, making use only of a few fine structural properties of levels of the model, such as solidity and condensation.

We have conducted a retrospective study of deaths on a paediatric medical intensive care unit over a two-year period and reviewed similar series from outside the UK. There were 89 deaths out of 651 admission (13.7% mortality). In almost two-thirds of the cases death occurred with a decision to limit medical treatment or withdraw mechanical ventilation, implying that additional or further therapy was considered futile. We highlight this as a crucially important issue in the practice of intensive care. More comprehensive (...) studies are needed to help clinicians derive consensus on what constitutes a futile intervention, and therefore when such an intervention should be withheld. This will help families and society better understand the limitations of intensive care. (shrink)

This volume presents a selection of the most influential recent discussions of the crucial metaphysical question: What is it for one event to cause another? The subject of causation bears on many topics, such as time, explanation, mental states, the laws of nature, and the philosophy of science. Contributors include J.L Mackie, Michael Scriven, Jaegwon Kim, G.E.M. Anscombe, G.H. von Wright, C.J. Ducasse, Wesley C. Salmon, David Lewis, Paul Horwich, Jonathan Bennett, Ernest Sosa, and Michael Tooley.

Unrealistic optimism is a bias that leads people to believe, with respect to a specific event or hazard, that they are more likely to experience positive outcomes and/or less likely to experience negative outcomes than similar others. The phenomenon has been seen in a range of health-related contexts—including when prospective participants are presented with the risks and benefits of participating in a clinical trial. In order to test for the prevalence of unrealistic optimism among participants of early-phase oncology trials, we (...) conducted a survey with patients over 18 years of age who were enrolled in a phase I, phase I/II, or phase II clinical cancer trial in the New York City area between August 2008 and October 2009. Participants in our study were asked to compare their own chances of experiencing a range of risks and benefits related to the trial they were enrolled in with the chances of the other trial participants. We found a significant optimistic bias in their responses. Respondents tended to overestimate the benefits of the trial they were enrolled in and underestimate its risks. In addition, we found no significant relationship between respondents’ understanding of the trial’s purpose and how susceptible they were to unrealistic optimism. Our findings suggest that improving the consent process for oncology studies requires more than addressing deficits in understanding. (shrink)

Drawing the line on physician assistance in physician-assisted death continues to be a contentious issue in many legal jurisdictions across the USA, Canada and Europe. PAD is a medical practice that occurs when physicians either prescribe or administer lethal medication to their patients. As more legal jurisdictions establish PAD for at least some class of patients, the question of the proper scope of this practice has become pressing. This paper presents an argument for restricting PAD to the terminally ill that (...) can be accepted by defenders as well as critics of PAD for the terminally ill. The argument appeals to fairness-based paternalism and the social meaning of medical practice. These two considerations interact in various ways, as the paper explains. The right way to think about the social meaning of medical practice bears on fair paternalism as it relates to PAD and vice versa. The paper contends that these considerations have substantial force when directed against proposals to extend PAD to non-terminally ill patients, but considerably less force when directed against PAD for the terminally ill. The paper pays special attention to the case of non-terminally ill patients who suffer from treatment-resistant depression, as these patients present a potentially strong case for extending PAD beyond the terminally ill. (shrink)

Feminism, Science, and the Philosophy of Science brings together original essays by both feminist and mainstream philosophers of science that examine issues at the intersections of feminism, science, and the philosophy of science. Contributors explore parallels and tensions between feminist approaches to science and other approaches in the philosophy of science and more general science studies. In so doing, they explore notions at the heart of the philosophy of science, including the nature of objectivity, truth, evidence, cognitive agency, scientific method, (...) and the relationship between science and values. (shrink)

BackgroundFor children with life-limiting conditions who are unable to participate in decision-making, decisions are made for them by their parents and paediatricians. Shared decision-making is widely recommended in paediatric clinical care, with parents preferring a collaborative approach in the care of their child. Despite the increasing emphasis to adopt this approach, little is known about the roles and responsibilities taken by parents and paediatricians in this process. In this study, we describe how paediatricians approach decision-making for a child with a (...) life-limiting condition who is unable to participate in decision-making for his/herself.MethodsThis qualitative phenomenological study involved 25 purposively sampled paediatricians. Verbatim transcripts from individual semi-structured interviews, conducted between mid-2019 and mid-2020, underwent thematic analysis. Interviews were based around a case vignette matched to the clinical experience of each paediatrician.ResultsTwo key themes were identified in the exploration of paediatricians' approach to decision-making for children with life-limiting conditions: there is a spectrum of paediatricians’ roles and responsibilities in decision-making, and the specific influences on paediatricians’ choice of approach for end-of-life decisions. In relation to, analysis showed four distinct approaches: non-directed, joint, interpretative, and directed. In relation to, the common factors were: harm to the child, possible psychological harm to parents, parental preferences in decision-making, and resource allocation.ConclusionsDespite self-reporting shared decision-making practices, what paediatricians often described were physician-led decision-making approaches. Adopting these approaches was predominantly justified by paediatricians’ considerations of harm to the child and parents. Further research is needed to elucidate the issues identified in this study, particularly the communication within and parental responses to physician-led approaches. We also need to further study how parental needs are identified in family-led decision-making approaches. These nuances and complexities are needed for future practice guidance and training around paediatric decision-making.Trial registration: Not applicable. (shrink)

Bioethics, Volume 36, Issue 7, Page 765-773, September 2022.

The idea of “postponed withholding,” proposed by Syltern et al. (2022), is a provocative one, and like all good provocative ideas, provokes deeper thinking from fresh perspectives. Our attention wa...

If people sometimes participate in research because of altruism—because they want to help in the search for treatments—should we revise our views about what kinds of experiments are ethical? If participants act out of altruism, we might let them accept greater risks than we would if they are motivated only by a desire for personal gain. But how can we know when participants are genuinely altruistic?

In theory, HREC members should use the ethical guidelines in the National Statement on the Ethical Conduct of Research Involving Humans as the basis for their decisions, and researchers should design their research in accordance with these guidelines However, very little is known about what researchers and HREC members actually do in practice. In this paper, we report some of the key findings of the study “Human Research Ethics in Practice”, a qualitative interview-based study of health researchers and HREC members (...) in Victoria. The findings shed light on how researchers and HREC members conceptualise ethics, how they use the National Statement, and what deliberative strategies they employ to assess the ethical appropriateness of research studies. The findings also reveal differences and similarities between health researchers’ and HREC members’ perceptions of the roles of HRECs, and point to some sources of misunderstanding and tension. We examine the implications of some of these findings for the ways in which HRECs carry out their task, and research institutions support and promote ethical conduct in research amongst their staff and students. The focus of this study is on health research, but we suggest that the findings are highly relevant to all other research areas where human participants are involved. (shrink)

Usage-based linguistics postulates that multi-word expressions constitute a substantial part of language structure and use, and are formed through repeated chunking and stored as exemplar wholes. They are also re-used to produce new sequences by means of schematization. While there is extensive research on multi-word expressions in many spoken languages, little is known about the status of multi-word expressions in the mainstream U.S. variety of American Sign Language. This paper investigates recurring multi-word expressions, or sequences of multiple signs, that involve (...) a high-frequency sign of visual perception glossed as look and the family of ‘look’ signs. The look sign exhibits two broad functions: look/‘vision’ references literal or metaphorical vision and look/‘reaction’ signals a person’s reaction to a visual stimulus. Data analysis reveals that there are recurring sequences in distinct syntactic environments associated with the two functions of look, suggesting that look is in the process of grammaticalization from a verb of visual perception to a stance verb. The sequences demonstrate the emergence of linguistic structure from repeated use through the domain-general cognitive process of chunking in ASL. (shrink)

Recent years have witnessed a growing concern that terminally illpatients are needlessly suffering in the dying process. This has ledto demands that physicians become more attentive in the assessment ofsuffering and that they treat their patients as `whole persons.'' Forthe most part, these demands have not fallen on deaf ears. It is nowwidely accepted that the relief of suffering is one of the fundamentalgoals of medicine. Without question this is a positive development.However, while the importance of treating suffering has generally (...) beenacknowledged, insufficient attention has been paid to the question ofwhether different types of terminal suffering require differnt responsesfrom health care professionals. In this paper we introduce a distinctionbetween two types of suffering likely to be present at the end of life,and we argue that physicians must distinguish between these types if theyare to respond appropriately to the suffering of their terminally illpatients. After introducing this distinction and explaining its basis,we further argue that the distinction informs a (novel) principle ofproportionality, one that should guide physicians in balancing theircompeting obligations in responding to terminal suffering. As weexplain, this principle is justified by reference to the intereststerminally ill patients have in restoration, as well as in therelief of suffering, at the end of life. (shrink)

In this paper, we defend the ethics of clinical research against the charge of paternalism. We do so not by denying that the ethics of clinical research is paternalistic, but rather by defending the legitimacy of paternalism in this context. Our aim is not to defend any particular set of paternalistic restrictions, but rather to make a general case for the permissibility of paternalistic restrictions in this context. Specifically, we argue that there is no basic liberty-right to participate in clinical (...) research and that considerations of distributive fairness justify some paternalistic protections of research subjects. (shrink)

The allocation of vaccines and therapeutics for Covid‐19 obviously raises ethical questions, and physicians and ethicists have begun to address them. Writers have identified various criteria that should guide allocation decisions, but the criteria often conflict and need to be balanced against one another. This article proposes a model for thinking about how different considerations that are relevant to the distribution of vaccines and scarce treatments for Covid‐19 could be integrated into an allocation procedure. The model employs the construct of (...) a weighted lottery, which is a construct that has been employed in other contexts that involve the distribution of scarce resources. The article highlights the advantages of applying a weighted lottery to the Covid‐19 context and offers an illustration for how it might work in practice. The primary aim of the article is to articulate the structural features of a weighted lottery for this context and to bring out its advantages over other methods for allocating Covid‐19 medications. (shrink)

Scotland is usually portrayed as being a country that had weak and terrible queens, like Margaret Tudor and Mary Queen of Scots. Saint Margaret is the only queen who is constantly portrayed positively. However, that is not because of her actions as queen consort, but because she was a devote Christian. Scotland is also portrayed for not producing well known or strong female rulers. This essay will examine two contemporary female rulers from the mid-fifteenth century, one from Scotland, Eleanor of (...) Scotland, and one imported to Scotland, Mary of Gueldres. Using these case studies it will be demonstrated that Scotland did produce strong female rulers along with acquiring them. (shrink)

: "Clinical pragmatism" is an important new method of moral problem solving in clinical practice. This method draws on the pragmatic philosophy of John Dewey and recommends an experimental approach to solving moral problems in clinical practice. Although the method may shed some light on how clinicians and their patients ought to interact when moral problems are at hand, it nonetheless is deficient in a number of respects. Clinical pragmatism fails to explain adequately how moral problems can be solved experimentally, (...) it underestimates the relevance and importance of judgment in clinical ethics, and it presents a questionable account of the role that moral principles should play in moral problem solving. (shrink)