The ethics of involving persons with cognitive impairments and/or mental illness in research continues to gain academic and public attention. Concerns about the ability of such persons to provide ethically and legally valid consent and about the appropriateness of their research involvement in certain categories of studies have resulted in publication of guidelines, position papers, standards, and court decisions. These analyses address not only when and from whom informed consent may be obtained but also under what conditions it is ethically (...) permissible to involve persons in research who are too decisionally impaired to provide their own consent.It is an advance in research ethics that there is heightened appreciation of the need for greater protections for, and possibly research participation limitations on, persons unable to give their own consent. In our zeal to protect potentially vulnerable subjects, however, we must craft new protections carefully. Prudence is required in shaping and implementing any new protections. (shrink)

The ethics of involving persons with cognitive impairments and/or mental illness in research continues to gain academic and public attention. Concerns about the ability of such persons to provide ethically and legally valid consent and about the appropriateness of their research involvement in certain categories of studies have resulted in publication of guidelines, position papers, standards, and court decisions. These analyses address not only when and from whom informed consent may be obtained but also under what conditions it is ethically (...) permissible to involve persons in research who are too decisionally impaired to provide their own consent.It is an advance in research ethics that there is heightened appreciation of the need for greater protections for, and possibly research participation limitations on, persons unable to give their own consent. In our zeal to protect potentially vulnerable subjects, however, we must craft new protections carefully. Prudence is required in shaping and implementing any new protections. (shrink)

Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that (...) any guidance offered by the ethics consultant will privilege and empower one party’s viewpoint over—and to the exclusion of—other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new “spaces” for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for “clinical ethics conflict coaching” can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes. (shrink)

This paper presents the behavioral interview model that we developed to formalize our hiring practices when we, most recently, needed to hire a new clinical ethicist to join our staff at the Center for Ethics at Washington Hospital Center.

The role of clinical ethics consultant in hospitals was created about 30 years ago. Since that time, two very different models for clinical ethics consultation, and who should perform it, have arisen: clinician ethicists and nonclinician ethicists, or bioethicists. Neither model provides everything that hospitals might need, and both include perspectives that are not ideal for hospital practice. It’s time for a new model, one designed specifically to meet the needs of hospital patients, one we might call the hospital model (...) of clinical ethics (HMCE). (shrink)

Ethical Considerations When Preparing a Clinical Research Protocol, Second Edition, provides a foundation for improving skills in the understanding of ethical requirements in the design and conduct of clinical research. It includes practical information on ethical principles in clinical research, how to design appropriate research studies, how to consent and assent documents, how to get protocols approved, special populations, confidentiality issues, and the reporting of adverse events. The book's valuable appendix includes a listing of web resources about research ethics, along (...) with a glossary, making it an invaluable resource for scientists collaborating in clinical trials, physician investigators, clinical research fellows, and more. Walks investigators and trainees through the identification of the ethical aspects of each section of a clinical research protocol Includes case histories that illustrate key points Contains information on conducting clinical research within the pharmaceutical industry Includes internet resources and worldwide web addresses for important research ethics documents and regulations Contains a chapter on Study Design and Methodology that is purposely expanded to explicitly address biostatistical considerations. (shrink)

As the field of clinical bioethics has moved from its pioneers, who turned their attention to ethics problems in clinical medicine and clinical and animal research, to today’s ubiquity of university degrees and fellowships in bioethics, there has been a steady drumbeat to professionalize the field. The problem has been that the necessary next steps—to specify the skills, knowledge, and personal and professional attributes of a clinical bioethicist, and to have a method to train and evaluate mastery of these standards—are (...) lacking.Ordinarily, the path to professionalism in medicine starts with the intellectual pioneers. Then come those who develop early experience in clinical settings. Then comes the specification of the skills, knowledge, and personal and professional attributes needed to perform the activities of the new specialty or subspecialty. And only then, after a method to train and evaluate levels of mastery from novice to advanced practitioner has been developed, comes credible credentialing and certification/licensing.Unfortunately, the field of clinical bioethics has skipped these steps. Rather, a credential, that is, the Healthcare Ethics Consultant (HEC) certification, was created by a small group within the bioethics professional association, the American Society of Bioethics and Humanities (ASBH), without community agreement or necessary input. Further, the testing of processes to train HECs and to evaluate their levels of mastery of competencies was prematurely forwarded as sufficient evidence of competence in clinical ethics. That is, the credential, offered by the ASBH for a fee, upon passing an exam based on how many hours one has been involved in clinical consultation, about which there is no field agreement on how such consultations ought to be conducted and for which only controversial standards have been set, is being touted as evidence of competence in clinical bioethics. In their article, “Competencies and Milestones for Bioethics Trainees,” Sawyer and colleagues identify the central weakness of these claims to professionalization and provide the field the first substantive assessment tool and method to train and evaluate competencies. The tool these authors present is the real next step forward for true professionalization of the field of clinical bioethics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 15.2 (2005) 199-210 [Access article in PDF] Conflict-of-Interest Policy at the National Institutes of Health: The Pendulum Swings Wildly* Evan G. DeRenzo **This article addresses the National Institutes of Health (NIH) employee conflict-of-interest (COI) policy that went into effect February 2005. It is not, however, merely an account of another poorly crafted government policy that cries out for revision. Instead, it is (...) also a story about one of our nation's most important and prestigious institutions and its struggles to navigate the crosscurrents of scientific aspirations, power politics, public ambivalence toward capitalist economics in the biosciences, and the media's inclination to exaggerate problems and under report complicated facts. It is also a tale of greed, politics, purgatory, and redemption. The dramatic and abrupt change in the NIH COI policy demonstrates the difficulty of balancing the production of cutting-edge science with the demands for transparency resulting from work performed in the public interest on the public tab. It is an unhappy chapter in the life of a government agency that is also a national treasure. And, one hopes, it will be an example of how harmful and ill-conceived law can be revised and amended to advance national health and well-being. What is the New NIH COI Policy? The new NIH COI employee policy, more accurately referred to as the Interim Final Rule (Federal Register 2005), is a sweeping set of prohibitions on activities and holdings to reduce the possibility that NIH employees will have any actual [End Page 199] or apparent conflicts of interest. For the most part, the prohibitions are applied across-the-board—i.e., without distinction to employee category or function. The new policy includes prohibitions on outside activities, stock holdings, and awards. It prohibits all NIH employees from engaging in any compensated or uncompensated employment, including consulting, serving on advisory or other such boards, and compensated teaching, speaking, writing, or editing with certain kinds of entities. The first class of such entities is referred to as substantially affected organizations, defined as biotechnology, pharmaceutical, medical device companies, and others with similar interests. But these are not the only entities included in the prohibitions. Other organizations from which NIH employees now are cut off are hospitals, clinics, and other health care institutions; health, science, or health research-related professional associations and consumer and advocacy groups. Included also are educational institutions and not-for-profit independent research institutes that are, or were, recent NIH funding applicants, grantees, contractors, or cooperative research and development agreement (CRADA) partners. The only exemptions appear to be for health care institutions at which NIH employees provide clinical care and some forms of writing—e.g., an NIH physician who moonlights at her/his local hospital's emergency room or submits a manuscript to a peer-reviewed journal that receives only unrestricted funding from a prohibited entity. Prohibited and/or restricted holdings include stock in biotechnology, pharmaceutical, and medical device companies and others in research, development, or manufacture of medical devices, equipment, preparations, treatments, or products. The prohibitions apply to senior NIH employees; restrictions in the amount of such holdings apply to all remaining employees. Both apply to the spouses and minor children of NIH employees. If an NIH employee wins an award, the monetary allowance in most cases is limited to $200. In sum, the scope of this policy is vast, too vast to be reasonable. Too many employees are restricted in too many ways. Where appropriate restrictions have been placed on senior NIH employees, even these constructive aspects of the policy are overshadowed by the unfairness and destructiveness of other aspects. This policy far exceeds anything that could be considered sound. Fortunately, the policy has a built-in assessment process to begin at the end of the policy's first year of implementation. One can only hope that a fair and open evaluation will be conducted, the results of which surely must result in major revisions to what is now bad regulation. Why the Policy... (shrink)

Excellence in the care of hospital patients, particularly those in an intensive care unit, reflects esprit de corps among the care team. Esprit de corps depends on a delicate balance; each clinician must preserve a sense of personal responsibility for “my” patient and yet participate in the collaborative work essential to the care of “our” patient. A harmful imbalance occurs when a physician demands total control of the decision-making process, especially concerning end-of-life treatment options. Although emotional factors may push a (...) physician to claim decision-making exclusivity, compounded by a legal framework that overemphasizes individual responsibility, esprit de corps can be preserved through timely communication among clinicians and a recognition that optimal care for “my” patient requires effective team practice. (shrink)

A commentary on “Must We Be Courageous?,” by Ann Hamric, John Arras, and Margaret Mohrmann, in the May-June 2015 issue.

In May 2011, the clinical ethics group of the Center for Ethics at Washington Hospital Center launched a 40-hour, three and one-half day Clinical Ethics Immersion Course. Created to address gaps in training in the practice of clinical ethics, the course is for those who now practice clinical ethics and for those who teach bioethics but who do not, or who rarely, have the opportunity to be in a clinical setting. “Immersion” refers to a high-intensity clinical ethics experience in a (...) busy, urban, acute care hospital. During the Immersion Course, participants join clinical ethicists on working rounds in intensive care units and trauma service. Participants engage in a videotaped role-play conversation with an actor. Each simulated session reflects a practical, realistic clinical ethics case consultation scenario. Participants also review patients’ charts, and have small group discussions on selected clinical ethics topics. As ethics consultation requests come into the center, Immersion Course participants accompany clinical ethicists on consultations.Specific to this pilot, because participants’ evaluations and course faculty impressions were positive, the Center for Ethics will conduct the course twice each year. We look forward to improving the pilot and establishing the Immersion Course as one step towards addressing the gap in training opportunities in clinical ethics. (shrink)

Ethics rounds in clinical ethics have already taken hold in multiple venues. There are “sit-down rounds,” which usually consist of a bioethicist setting a specific, prescheduled time aside for residents and/or others to bring a case or two for discussion with the bioethicist. Another kind of rounds that occurs on an ad hoc or infrequent basis is to have either a staff or outside bioethicist give hospital-wide and/or departmental “grand rounds.” Grand rounds is a traditional educational format in medicine and (...) adding bioethics to the topics covered in grand rounds is an important means of elevating ethical awareness within a department or throughout a healthcare organization. Newer is the rounding practice of adding a bioethicist to other established rounding processes, such as case management and utilization review rounds. All of these kinds of ethics rounds are important opportunities to elevate the level of moral discourse within a healthcare setting and are becoming part and parcel of any full-service hospital bioethics program. (shrink)

As research into Alzheimer's disease and other dementing disorders becomes more complex, risky, invasive, and commonplace, the need intensifies for discussion of the ethics of involving persons with dementia in research, specifically research of greater than minimal risk and of no expected direct benefit to the subject. Reviewing such studies pushes our traditional analysis tools to their limits. Simply balancing and prioritizing the basic ethical principles of respect for persons, beneficence, and justice that serves us well in reviewing the vast (...) majority of studies is inadequate when reviewing research of such ethical complexities as studies with marked risks and no expectation of direct benefit to subjects unable to consent or withdraw. Moving up to the level of theory, placing these principles within the commonly applied frameworks of consequentialism, deontology, or virtue ethics bring us no closer to reducing the tensions such research creates between upholding individual autonomy and advancing society's need to learn how to treat and cure these devastating diseases. What is needed is the introduction of more contemporary moral analyses. Specifically, we need to become more inclusive of the diversity of values perspectives of our general citizenry. In more theoretical terms, we ought to elevate to a more central role a communitarian perspective and a feminist ethics emphasis on relationships and context as we rush to keep in step, ethically, with this rapidly expanding area of medical inquiry. (shrink)

Scholars and professional organizations in bioethics describe various approaches to “quality assessment” in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes “quality” in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, in that they represent (...) evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, in this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring disparate, isolated work activities; then, we describe quality assessment in terms of tracking interconnected work activities holistically, across different levels of assessment. We conclude by inviting future efforts in quality improvement to adopt a comprehensive approach to quality assessment into their improvement practices, and offer recommendations for how the field might move in this direction. (shrink)

Communication and Conflict Management Training for Clinical Bioethics Committees Content Type Journal Article Pages 341-349 DOI 10.1007/s10730-009-9116-7 Authors Lauren M. Edelstein, Johns Hopkins Medicine’s Howard County General Hospital 5755 Cedar Lane Columbia MD 21044 USA Evan G. DeRenzo, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Elizabeth Waetzig, Change Matrix Inc. 485 Maylin St. Pasadena CA 91105 USA Craig Zelizer, Georgetown University Department of Government 3240 Prospect St. Washington, D.C. NW 20057 USA (...) Nneka O. Mokwunye, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume 21, Number 4. (shrink)

Throughout the world, research ethics committees are relied on to prevent unethical research and protect research subjects. Given that reliance, the composition of committees and the manner in which decisions are arrived at by committee members is of critical importance. There have been Instances in which an inadequate review process has resulted in serious harm to research subjects. Deficient committee review was identified as one of the factors In a study in New Zealand which resulted in the suffering and death (...) of many women diagnosed with carcinoma in situ. (shrink)

Organizational ethics programs often are created to address tensions in organizational values that have been identified through repeated clinical ethics consultation requests. Clinical ethicists possess some core competencies that are suitable for the leadership of high-quality organizational ethics programs, but they may need to develop new skills to build these programs, such as familiarity with healthcare delivery science, healthcare financing, and quality improvement methodology. To this end, we suggest that clinical ethicists build organizational ethics programs incrementally and via quality improvement (...) projects undertaken in collaboration with senior clinical leaders. Organizational ethics programs often differ from clinical ethics programs in their membership and processes, and likely will require ethicists to forge new partnerships with a wide array of organizational leaders. With attention to the ways that organizational ethics programs differ from clinical ethics programs, and investment in quality improvement methodology and formal institutional needs assessments, clinical ethics leaders can position an organizational ethics program to advocate effectively for visible and compelling alignment of leadership decision making with the values of the organization. (shrink)

This paper presents the behavioral interview model that we developed to formalize our hiring practices when we, most recently, needed to hire a new clinical ethicist to join our staff at the Center for Ethics at Washington Hospital Center.

Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that (...) any guidance offered by the ethics consultant will privilege and empower one party’s viewpoint over—and to the exclusion of—other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new spaces for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for clinical ethics conflict coaching can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes. (shrink)

Nativists about theory of mind have typically explained why children below the age of four fail the false belief task by appealing to the demands that these tasks place on children’s developing executive abilities. However, this appeal to executive functioning cannot explain a wide range of evidence showing that social and linguistic factors also affect when children pass this task. In this paper, I present a revised nativist proposal about theory of mind development that is able to accommodate these findings, (...) which I call the pragmatic development account. According to this proposal, we can gain a better understanding of the shift in children’s performance on standard false-belief tasks around four years of age by considering how children’s experiences with the pragmatics of belief discourse affect the way they interpret the task. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On Scheeben's Place in Nineteenth-Century Catholic Theology and the Question of His Theological MethodEvan S. KoopMatthias Joseph Scheeben (1835–1888) is enjoying a moment in English-speaking Catholic theological circles. In recent years his thought has attracted increasing interest from scholars who view him as an important forerunner to some of the central currents of Catholic theology in the twentieth century,1 a trend that promises only to accelerate with the recent (...) publication of the initial volumes of the first complete translation of his monumental Handbuch der katholischen Dogmatik into English.2 The much-debated question of Scheeben's proper place in the history of Catholic theology in the nineteenth century therefore, has gained a new relevance. While the present study of course, cannot and does not claim to bring this dispute to a definitive resolution, nevertheless it is hoped that it may at least help to clarify some common misunderstandings that can arise from hasty generalizations, and offer a few insights—which are not in fact new, but which are too often ignored by English-speaking scholars today—into the way in which the thought of the Jesuit theologians of the so-called "Roman School" may have served to influence Scheeben's unique theological method.In the past, numerous attempts have been made to situate Scheeben's thought within a particular theological school, and members of rival schools, in turn, have sought to claim him (or indeed repudiate him) as one of their [End Page 471] own.3 Amid the flood of divergent assessments of Scheeben's theological affinities, there at least exists some scholarly consensus about his greatness as a theologian. In 1935, during the centenary celebrations of Scheeben's birth, Pope Pius XI lauded him as a "man of genius" and proposed his thought to the students of the Germanicum as a model of the proper unity of theology's ascetical and dogmatic elements.4 In a Festschrift dedicated to Scheeben's theology published in the same year, Martin Grabmann judged that Scheeben was "the greatest dogmatic theologian of the nineteenth century,"5 and Carl Feckes, Scheeben's successor at the Cologne seminary, named him "the greatest Mariologist of our time."6 On the eve of the Second Vatican Council, no less an authority than Hans Urs von Balthasar could proclaim that Scheeben was "the greatest German theologian to-date [1961] since the time of Romanticism."7Nearly all, likewise, acknowledge the great difficulty of comprehending Scheeben's theology: even a German theologian of the stature of Joseph Ratzinger laments that Scheeben "has not made it easy, either as a professor for his hearers or as a writer for his readers. His language is rigorous, marked by the laborious travail of thought." The fact that he draws abundantly from such sources as Aquinas and the Greek Fathers "lends to his work [End Page 472] breadth and depth, but does not necessarily facilitate easy access."8 Similarly, the ultramontane Cardinal Henry Edward Manning, in his preface to an English abridgment of Scheeben's Dogmatik, warned that Scheeben's greatest work "requires not only reading but study; and study with patient care and conscientious desire to understand."9 Perhaps it is for this reason that it has become almost proverbial to observe that Scheeben's works are much praised, but seldom read.10Far less agreement, however, exists when it comes to the question of what kind of theologian Scheeben was, or to what theological school he belonged. Was he, asks the great Scheeben scholar Eugen Paul, "the prototype of those theologians who represent (if not establish) the infamous 'two-storey theory [Stockwerkstheorie] with respect to nature and grace—or does he rather belong to those who insist precisely on the transcendental unity of nature and grace?"11 Is Scheeben, in other words, a Neo-Scholastic, even "the most precious flower ever granted to the spring of Neo-Scholasticism,"12 as he was called in the first major study of his theology produced in the twentieth century? Or is he, instead, to be classed with the theologians of the Tübingen School who, under the influence of Romantic Idealism, sought to renew Catholic theology through... (shrink)

Establishing trust among individual agents has defined a central issue of practical reasoning since the dawning of liberal individualism. Hobbes was convinced that foolish self-interest always threatens to defeat uncompelled cooperation when one can gain by abandoning a joint effort. Against this philosophical background, scientific studies of human beings display a surprisingly cooperative species. It would seem to follow that biologically inherited characteristics impair our reason. The response proposed here distinguishes rationality and reasonableness as two forms of good reasoning. One (...) is consistent with the model of strategic rationality, the other with a model of emotional relationship. From the Hobbesian perspective trusting agents are not rational if their makeup discourages advantageous defection even when one knows it will not be detected or punished. The point is indecisive because reasonable trust insulates cooperative action from the factors that have appeared to make it chancy or unstable without some enforcing power. A critical theme is that trust does not simply rest upon a biological disposition to conform to norms. That would explain but not justify aversion to defection. In fact, trust can survive reasoned challenges to norm-conforming dispositions, displaying the responsible social animal living along with the rational individual. (shrink)

Philosophers have long been concerned about what we know and how we know it. Increasingly, however, a related question has gained prominence in philosophical discussion: what should we believe and why? This volume brings together twelve new essays that address different aspects of this question. The essays examine foundational questions about reasons for belief, and use new research on reasons for belief to address traditional epistemological concerns such as knowledge, justification and perceptually acquired beliefs. This book will be of interest (...) to philosophers working on epistemology, theoretical reason, rationality, perception and ethics. It will also be of interest to cognitive scientists and psychologists who wish to gain deeper insight into normative questions about belief and knowledge. (shrink)

Theoretical simplicity is difficult to characterize, and evidently can depend upon a number of distinct factors. One such desirable characteristic is that the laws of a theory have relatively few "counterinstances" whose accommodation requires the invocation of a ceteris paribus condition and ancillary explanation. It is argued that, when one theory is reduced to another, such that the laws of the second govern the behavior of the parts of the entities in the domain of the first, there is a characteristic (...) gain in simplicity of the sort mentioned: while I see no way of quantitatively measuring the "amount" of defeasibility of the laws of a theory, microreduction can be shown to decrease that "amount.". (shrink)

Emotion experience has failed to date to gain a central place in the study of consciousness. This special issue of the _Journal of Consciousness Studies_ presents the most recent views on the matter, with discussions of several aspects of emotion experience. Contributors from different disciplines address links between feelings, brain, body and world. What happens in the brain and in the body when we have feelings? How do feelings relate to our understanding of the world? The contributors also analyse emotion (...) experience per se — the character of moods, the role of emotion experience in demarcating the class of emotion, the alleged positive and negative character of affect, its embodied feel and its relation to action. (shrink)

Mestre, MacCann, Guil, and Roberts propose a model that suggests emotion regulation provides the mechanism through which ability emotional intelligence influences important outcomes. We argue that important nuance in our understanding of people’s choice of emotion regulation strategy can be gained by incorporating personality constructs such as trait emotional intelligence within this model.

To gain insight into human nature philosophers often discuss the inferior performance that results from deficits such as blindsight or amnesia. Less often do they look at superior abilities. A notable exception is Herbert Dreyfus who has developed a theory of expertise according to which expert action generally proceeds automatically and unreflectively. We address one of Dreyfus’s primary examples of expertise: chess. At first glance, chess would seem an obvious counterexample to Dreyfus’s view since, clearly, chess experts are engaged in (...) deep strategic thought. However, Dreyfus’s argument is subtle. He accepts that analysis and deliberation play a role in chess, yet he thinks that all such thought is predicated on intuitive, arational expert perception, and action. We argue that even the so-called intuitive aspect of chess is rational through and through. (shrink)

Is there such a thing as natural knowledge of God? C. Stephen Evans presents the case for understanding theistic arguments as expressions of natural signs in order to gain a new perspective both on their strengths and weaknesses. Three classical, much-discussed theistic arguments - cosmological, teleological, and moral - are examined for the natural signs they embody. At the heart of this book lie several relatively simple ideas. One is that if there is a God of the kind accepted by (...) Christians, Jews, and Muslims, then it is likely that a 'natural' knowledge of God is possible. Another is that this knowledge will have two characteristics: it will be both widely available to humans and yet easy to resist. If these principles are right, a new perspective on many of the classical arguments for God's existence becomes possible. We understand why these arguments have for many people a continued appeal but also why they do not constitute conclusive 'proofs' that settle the debate once and for all. Touching on the interplay between these ideas and contemporary scientific theories about the origins of religious belief, particularly the role of natural selection in predisposing humans to form beliefs in God or gods, Evans concludes that these scientific accounts of religious belief are fully consistent, even supportive, of the truth of religious convictions. (shrink)