BackgroundElectronic patient record (EPR) technology is a key enabler for improvements to healthcare service and management. To ensure these improvements and the means to achieve them are socially and ethically desirable, careful consideration of the ethical implications of EPRs is indicated. The purpose of this scoping review was to map the literature related to the ethics of EPR technology. The literature review was conducted to catalogue the prevalent ethical terms, to describe the associated ethical challenges and opportunities, and to identify (...) the actors involved. By doing so, it aimed to support the future development of ethics guidance in the EPR domain.MethodsTo identify journal articles debating the ethics of EPRs, Scopus, Web of Science, and PubMed academic databases were queried and yielded 123 eligible articles. The following inclusion criteria were applied: articles need to be in the English language; present normative arguments and not solely empirical research; include an abstract for software analysis; and discuss EPR technology.ResultsThe medical specialty, type of information captured and stored in EPRs, their use and functionality varied widely across the included articles. Ethical terms extracted were categorised into clusters ‘privacy’, ‘autonomy’, ‘risk/benefit’, ‘human relationships’, and ‘responsibility’. The literature shows that EPR-related ethical concerns can have both positive and negative implications, and that a wide variety of actors with rights and/or responsibilities regarding the safe and ethical adoption of the technology are involved.ConclusionsWhile there is considerable consensus in the literature regarding EPR-related ethical principles, some of the associated challenges and opportunities remain underdiscussed. For example, much of the debate is presented in a manner more in keeping with a traditional model of healthcare and fails to take account of the multidimensional ensemble of factors at play in the EPR era and the consequent need to redefine/modify ethical norms to align with a digitally-enabled health service. Similarly, the academic discussion focuses predominantly on bioethical values. However, approaches from digital ethics may also be helpful to identify and deliberate about current and emerging EPR-related ethical concerns. (shrink)

ABSTRACTThe idea of “church autonomy” has risen to prominence in law and religion discourse in recent years. Defenders argue that church autonomy is essential to protecting religious freedom, while critics argue that it permits great harm. This heated dispute often obscures the fact that religious group autonomy is not all-or-nothing. Religious organizations can enjoy some autonomy without being free from all legal oversight. This article thus seeks to make progress in the debate by providing a taxonomy of kinds of judicial (...) examination of religious organizations’ decisions—focusing on employment decisions—and normatively assessing each kind. I argue that religious groups should enjoy protection from certain kinds of examination, but other kinds are justifiable, and even required. My argument supports an approach similar to that seen in some recent European Court of Human Rights decisions, rather than the less discriminating approach of U.S. courts. (shrink)

In this paper, I examine P. F. Strawson's "Freedom and Resentment" [6] in an effort to clarify the essential features of attitudes that Strawson believes may be understood as reactive. I propose a definition of the reactive attitudes that outlines the various conditions that must be met in order to give rise to a given reactive attitude. I then expand upon Strawson's work by introducing two additional categories of reactive attitudes: self-reflexive reactive attitudes and second-personal reflexive reactive attitudes. In addition (...) to explaining the new categories of reactive attitudes that I seek to introduce, I also set forth reasons that lead me to accept such attitudes as reactive. Finally, I outline why I believe the self-reflexive reactive attitudes provide the foundation upon which all the other reactive attitudes rest. (shrink)

In this paper, I examine P. F. Strawson's "Freedom and Resentment" [6] in an effort to clarify the essential features of attitudes that Strawson believes may be understood as reactive. I propose a definition of the reactive attitudes that outlines the various conditions that must be met in order to give rise to a given reactive attitude. I then expand upon Strawson's work (as captured in my definition of reactive attitudes) by introducing two additional categories of reactive attitudes: self-reflexive reactive (...) attitudes and second-personal reflexive reactive attitudes. In addition to explaining the new categories of reactive attitudes that I seek to introduce, I also set forth reasons that lead me to accept such attitudes as reactive. Finally, I outline why I believe the self-reflexive reactive attitudes provide the foundation upon which all the other reactive attitudes rest. (shrink)

In this article, we explore the concept of a “right not to know” on a population rather than individual level. We argue that a population level “right not to know” is a useful concept for helping to define the appropriate boundaries of public engagement initiatives in the emerging public health genomics context.

While the realm of bioethics has traditionally focused on the rights of the individual and held autonomy as a defining principle, public health ethics has at its core a commitment to the promotion of the common good. While these two domains may at times conflict, concepts arising in one may also be informative for concepts arising in the other. One example of this is the concept of a “right not to know.” Recent debate suggests that just as there is a (...) “right to know” information about one's genetic status, there is a parallel “right not to know” when it comes to genetic information that if communicated, could be detrimental to an individual's social or psychological well-being. As new genetic technologies continue to change the nature of genetic testing and screening, it is crucial that normative frameworks to guide and assess genetic public health initiatives be developed. In this context, the question of whether a “right not to know” may also be said to exist for populations on a public health level merits attention. (shrink)

This article provides an analysis of theories of metaphor, tracing how far those which have dominated Western thought until the past few decades are reflective of the definitions within which writers from Classical Greece were working. It is shown how, during the Middle Ages and beyond, in particular since the seventeenth century, definitions of metaphor which emphasised ‘literal’ and ‘figurative’ levels of meaning have led to serious misconceptions concerning its nature and function in the attempts of human beings to conceptualise (...) and make sense of their experiences. A discussion of these misconceptions is provided in some detail and traditional definitions are shown to have distorted the deeper insights held by classical writers, such as Aristotle, Demetrius and Longinus. The article continues with descriptive analyses of the mistaken nature of definitions of metaphor which confine it to creative, poetic forms of discussion. It is shown that conventional speech utterances comprise simple metaphors to a large extent and how these provide an immensely important base from which education could help pupils extend and enrich both their thought and language. This could be done by teaching them ways of interpreting the novel, poetic metaphors of others and how to create their own. (shrink)

This chapter examines an evidentialist ethics of belief, and W. K. Clifford’s proposal in particular. It argues that regardless of how one understands the notion of evidence, it is implausible that we could have a moral obligation to refrain from believing something whenever we lack sufficient evidence. Alternatively, this chapter argues that there are wide-scope conditional requirements on beliefs but that these requirements can be met without having sufficient evidence for the belief in question. It then argues that we (...) are epistemically, though not morally, required to form epistemically valuable beliefs. However, these beliefs, too, need not be beliefs for which we have sufficient evidence—epistemically good beliefs need not be based on sufficient evidence. (shrink)

Background: Ethical frameworks for organ donation following circulatory death (DCD) were established >20 years ago. However, considerable variation exists among these, indicating consensus has not been reached on all issues. Additionally, advances such as cardiac DCD transplants and normothermic regional perfusion (NRP) may have reignited old debates.Methods: We reviewed the English-language literature addressing ethical issues in DCD from 1993 to 2022, examining changes in frequency with which ethical principles and their sub-themes identified within each, were addressed.Results: Non-maleficence was the most (...) frequently addressed principle (192 of 199 articles), as well as the most varied, with 9 subthemes (versus 2-4 within each of the other bioethical principles).Conclusions: There were several changes in the terminology used to refer to DCD over time, and substantial interest in cardiac DCD and NRP in recent publications, arising in 11 and 19 of the 30 publications from 2018 to 2022. (shrink)

The notion of scope as it relates to a model of logical form is discussed. The inability of the accepted definition of scope to account for the contrast between priority scope - the logical priority of different quantifiers & other logical notions via rule ordering - & binding scope - the identification of the connection between variables of quantification & a particular quantifier - is demonstrated. The semantic ambiguity of this dichotomy of scope is explored (...) via examination of donkey sentences. A formal representation of this dichotomy is suggested. The government-binding approach & principle of compositionality that handle scope relations via the logical form is rejected due to the complexity of the mechanism by which syntactic form results in logical forms. A discourse representational approach is also rejected. It is concluded that the interaction of syntax & semantics is instead better represented by a game-theoretical treatment of scope & anaphora. 26 References. T. Rosenberg. (shrink)

The focus of this paper is the syntax of inverse scope in Hungarian, a language that largely disambiguates quantifier scope at spell-out. Inverse scope is attributed to alternate orderings of potentially large chunks of structure, but with appeal to base-generation, as opposed to nonfeature-driven movement as in Kayne 1998. The proposal is developed within mirror theory and conforms to the assumption that structures are antisymmetrical. The paper also develops a matching notion of scope in terms of (...) featural domination, as opposed to c-command, and applies it to otherwise problematic cases of pied piping. Finally, the interaction of different quantifier types is examined and the patterns are explained invoking morphological considerations on one hand and A-bar reconstruction on the other. (shrink)

The demand in the workplace is rapidly changing brought about by the educational reforms and the emergence of disruptive technology. The changes increase the importance of employability skills and literacy that would ensure career success and degree program relevance. On this premise, a study was carried out using a scoping review to examine the existing literature that published information related to employability skills of Teacher Education graduates in the Philippines. The review covered fifteen published articles that qualified in inclusion and (...) exclusion criteria. Results revealed the top employable skills which include communication; information and communication technology; problem-solving and critical thinking; collaboration, cooperation, and teamwork; research; and leadership. This study offers these skills as a framework in the curriculum enhancement of teacher education programs. It was recommended to Teacher Education Institutions to revisit their curriculum and find out if these competencies were given considerable emphasis in instruction. The partially employable skills of graduates from teacher education programs imply the furtherance of the inquiry to confirm if these skills are employable or not. Future tracer studies may take the lens of the framework in evaluating the responsiveness of the curriculum. (shrink)

Having been neglected or maligned for most of this century, Newton's method of 'deduction from the phenomena' has recently attracted renewed attention and support. John Norton, for example, has argued that this method has been applied with notable success in a variety of cases in the history of physics and that this explains why the massive underdetermination of theory by evidence, seemingly entailed by hypothetico-deductive methods, is invisible to working physicists. This paper, through a detailed analysis of Newton's deduction of (...) one particular 'proposition' in optics 'from the phenomena', gives a clearer account than hitherto of the method - highlighting the fact that it is really one of deduction from the phenomena plus 'background knowledge'. It argues, that, although the method has certain heuristic virtues, examination of its putative accreditational strengths reveals a range of important problems that its defenders have yet adequately to address. (shrink)

Background The COVID-19 pandemic forced governments, multilateral public health organisations and research institutions to undertake research quickly to inform their responses to the pandemic. Most COVID-19-related studies required swift approval, creating ethical and practical challenges for regulatory authorities and researchers. In this paper, we examine the landscape of ethics review processes in Africa during public health emergencies (PHEs). Methods We searched four electronic databases (Web of Science, PUBMED, MEDLINE Complete, and CINAHL) to identify articles describing ethics review processes during public (...) health emergencies and/or pandemics. We selected and reviewed those articles that were focused on Africa. We charted the data from the retrieved articles including the authors and year of publication, title, country and disease(s) reference, broad areas of (ethical) consideration, paper type, and approach. Results Of an initial 4536 records retrieved, we screened the titles and abstracts of 1491 articles, and identified 72 articles for full review. Nine articles were selected for inclusion. Of these nine articles, five referenced West African countries including Liberia, Guinea and Sierra Leone, and experiences linked to the Ebola virus disease. Two articles focused on South Africa and Kenya, while the other two articles discussed more general experiences and pitfalls of ethics review during PHEs in Africa more broadly. We found no articles published on ethics review processes in Africa before the 2014 Ebola outbreak, and only a few before the COVID-19 outbreak. Although guidelines on protocol review and approval processes for PHEs were more frequently discussed after the 2014 Ebola outbreak, these did not focus on Africa specifically. Conclusions There is a gap in the literature about ethics review processes and preparedness within Africa during PHEs. This paper underscores the importance of these processes to inform practices that facilitate timely, context-relevant research that adequately recognises and reinforces human dignity within the quest to advance scientific knowledge about diseases. This is important to improve fast responses to PHEs, reduce mortality and morbidity, and enhance the quality of care before, during, and after pandemics. (shrink)

This article examines the changing scope and method of ecumenical public theology from the World Missionary Conference of 1910 until the present. Most changes were made in response to the changing ideological and political contexts. The collapse of liberalism and the social gospel was followed by a type of confessional ethics which arose directly out of the German Church Struggle. In opposition to this there emerged a realist ecumenical social ethics, much indebted to Reinhold Niebuhr, and of Ronald Preston. (...) This type of public theology and its distinctive ‘middle axiom’ method are examined and contrasted with the more recent public theologies which were influenced by liberation theology and grassroots movements. It is suggested that the ending of the Cold War and the fundamental changes that have taken place since September 11 2001 present a radically new kind of challenge to public theology. (shrink)

The philosophical conception of mechanistic explanation is grounded on a limited number of canonical examples. These examples provide an overly narrow view of contemporary scientific practice, because they do not reflect the extent to which the heuristic strategies and descriptive practices that contribute to mechanistic explanation have evolved beyond the well-known methods of decomposition, localization, and pictorial representation. Recent examples from evolutionary robotics and network approaches to biology and neuroscience demonstrate the increasingly important role played by computer simulations and mathematical (...) representations in the epistemic practices of mechanism discovery and mechanism description. These examples also indicate that the scope of mechanistic explanation must be re-examined: With new and increasingly powerful methods of discovery and description comes the possibility of describing mechanisms far more complex than traditionally assumed. (shrink)

BackgroundSocio-cultural perceptions surrounding death have profoundly changed since the 1950s with development of modern intensive care and progress in solid organ transplantation. Despite broad support for organ transplantation, many fundamental concepts and practices including brain death, organ donation after circulatory death, and some antemortem interventions to prepare for transplantation continue to be challenged. Attitudes toward the ethical issues surrounding death and organ donation may influence support for and participation in organ donation but differences between and among diverse populations have not (...) been studied.ObjectivesIn order to clarify attitudes toward brain death, organ donation after circulatory death and antemortem interventions in the context of organ donation, we conducted a scoping review of international English-language quantitative surveys in various populations.Study appraisalA search of literature up to October 2020 was performed, using multiple databases. After screening, 45 studies were found to meet pre-specified inclusion criteria.Results32 studies examined attitudes to brain death, predominantly in healthcare professionals. In most, around 75% of respondents accepted brain death as equivalent to death of the person. Less common perspectives included equating death with irreversible coma and willingness to undertake organ donation even if it caused death. 14 studies examined attitudes to organ donation following circulatory death. Around half of respondents in most studies accepted that death could be confidently diagnosed after only 5 min of cardiorespiratory arrest. The predominant reason was lack of confidence in doctors or diagnostic procedures. Only 6 studies examined attitudes towards antemortem interventions in prospective organ donors. Most respondents supported minimally invasive procedures and only where specific consent was obtained.ConclusionsOur review suggests a considerable proportion of people, including healthcare professionals, have doubts about the medical and ethical validity of modern determinations of death. The prognosis of brain injury was a more common concern in the context of organ donation decision-making than certainty of death. (shrink)

This chapter provides a critical overview of ten central arguments that philosophers have given in support of a distinction between the conceptual and the nonconceptual. We use these arguments to examine the question of whether (and in what sense) perceptual states might be deemed nonconceptual and also whether (and in what sense) animals and infants might be deemed to lack concepts. We argue that philosophers have implicitly relied on a wide variety of different ways to draw the conceptual/nonconceptual distinction and (...) that all ten of the arguments we discuss face considerable difficulties. (shrink)

Entry into the practice of medicine is heavily regulated through scope of practice and licensing laws that make it illegal for nonlicensed individuals to perform many medical services. As institutions are structured at the beginning of the twenty-first century, most regulation takes place at the state level, through state departments of health that establish criteria for performing different types of medical activities, and that restrict allowable activities for various types of health care professionals. The regulations over the activities of (...) physicians are more uniform across states than for other health care professionals because, although the regulation is done by individual state governments, the standards for physicians are set by the National Board of Medical Examiners, a group controlled by physicians themselves. The justification for this regulation is that it produces higher quality health care. Some would make an even stronger argument that regulation is necessary because patients do not have sufficient knowledge to distinguish effective practitioners from ineffective ones. (shrink)

Entry into the practice of medicine is heavily regulated through scope of practice and licensing laws that make it illegal for nonlicensed individuals to perform many medical services. As institutions are structured at the beginning of the twenty-first century, most regulation takes place at the state level, through state departments of health that establish criteria for performing different types of medical activities, and that restrict allowable activities for various types of health care professionals. The regulations over the activities of (...) physicians are more uniform across states than for other health care professionals because, although the regulation is done by individual state governments, the standards for physicians are set by the National Board of Medical Examiners, a group controlled by physicians themselves. The justification for this regulation is that it produces higher quality health care. Some would make an even stronger argument that regulation is necessary because patients do not have sufficient knowledge to distinguish effective practitioners from ineffective ones. (shrink)

Substance use disorders (SUDs) constitute a growing global health crisis, yet many limitations and challenges exist in SUD treatment research, including the lack of objective brain-based markers for tracking treatment outcomes. Electroencephalography (EEG) is a neurophysiological technique for measuring brain activity, and although much is known about EEG activity in acute and chronic substance use, knowledge regarding EEG in relation to abstinence and treatment outcomes is sparse. We performed a scoping review of longitudinal and pre-post treatment EEG studies that explored (...) putative changes in brain function associated with abstinence and/or treatment in individuals with SUD. Following PRISMA guidelines, we identified studies published between January 2000 and March 2022 from online databases. Search keywords included EEG, addictive substances (e.g., alcohol, cocaine, methamphetamine), and treatment related terms (e.g., abstinence, relapse). Selected studies used EEG at least at one time point as a predictor of abstinence or other treatment-related outcomes; or examined pre- vs. post-SUD intervention (brain stimulation, pharmacological, behavioral) EEG effects. Studies were also rated on the risk of bias and quality using validated instruments. Forty-four studies met the inclusion criteria. More consistent findings included lower oddball P3 and higher resting beta at baseline predicting negative outcomes, and abstinence-mediated longitudinal decrease in cue-elicited P3 amplitude and resting beta power. Other findings included abstinence or treatment-related changes in late positive potential (LPP) and N2 amplitudes, as well as in delta and theta power. Existing studies were heterogeneous and limited in terms of specific substances of interest, brief times for follow-ups, and inconsistent or sparse results. Encouragingly, in this limited but maturing literature, many studies demonstrated partial associations of EEG markers with abstinence, treatment outcomes, or pre-post treatment-effects. Studies were generally of good quality in terms of risk of bias. More EEG studies are warranted to better understand abstinence- or treatment-mediated neural changes or to predict SUD treatment outcomes. Future research can benefit from prospective large-sample cohorts and the use of standardized methods such as task batteries. EEG markers elucidating the temporal dynamics of changes in brain function related to abstinence and/or treatment may enable evidence-based planning for more effective and targeted treatments, potentially pre-empting relapse or minimizing negative lifespan effects of SUD. (shrink)

Ways of Scope Taking is concerned with syntactic, semantic and computational aspects of scope. Its starting point is the well-known but often neglected fact that different types of quantifiers interact differently with each other and other operators. The theoretical examination of significant bodies of data, both old and novel, leads to two central claims. (1) Scope is a by-product of a set of distinct Logical Form processes; each quantifier participates in those that suit its particular features. (2) (...) Scope interaction is further constrained by the semantics of the interacting operators. The arguments are developed using Minimalist syntax, Generalized Quantify theory, Discourse Representation Theory, and algebraic semantics. The contributors (Beghelli, Ben-Shalom, Doetjes, Farkas, Gutiérrez Rexach, Honcoop, Stabler, Stowell, Szabolcsi and Zwarts) make tightly related theoretical assumptions and focus on related empirical phenomena, which include the direct and inverse scope of quantifiers, distributivity, negation, modal and intensional contexts, weak islands, event-related readings, interrogatives, wh/quantifier interactions, and Hungarian syntax. An introduction to the formal semantics background is provided. Audience: Linguists, philosophers, computational and psycholinguists; advanced undergraduates, graduate students and researchers in these fields. (shrink)

BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

Ockham holds what nowadays would be characterized as a “higher-order perception” theory of consciousness. Among the most common objections to such a theory is the charge that it gives rise to an infinite regress in higher-order states. In this paper, I examine Ockham’s various responses to the regress problem, focusing in particular on his attempts to restrict the scope of consciousness so as to avoid it. In his earlier writings, Ockham holds that we are conscious only of those states (...) to which we explicitly attend. This view, I go on to argue, is inadequate on both phenomenological and philosophical grounds. Interestingly, and perhaps for this very reason, in later works, Ockham goes on to develop an alternative explanation for his account of the limited scope of consciousness. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Just Share: Justice and Fairness in Resource Allocation*Pat Milmoe Mccarrick (bio) and Martina Darragh (bio)Each of us has some basic sense of what the words “fair” or “just” or “fairness” or “justice” mean. Each of us probably also has an idea of what is “fair” in health care. The attempt by the state of Oregon in the mid-1980s to quantify this notion made a previously private exercise a (...) public one. This transition has been chronicled in the bioethics literature that focuses on resource allocation. These works examine both theories of justice and concepts of “health”; the fair distribution of health resources has been of continuing interest since the beginning of bioethics in the 1960s. Early writing on justice includes authors Tom L. Beauchamp, Robert H. Blank, James F. Childress, H. Tristram Engelhardt, Paul T. Menzel, Paul Ramsey, and Robert M. Veatch (VII).During the 1980s, bioethicists such as Daniel Callahan and Norman Daniels proposed thinking of health care decisions not as moments of personal crisis but as choices that span a lifetime, possibly involving tradeoffs in other areas of one’s life, e.g., education. The Oregon experience added another dimension to the discussion. The initial rank-ordering of health services by cost produced a skewed list—for example, surgery for life-threatening conditions ranked below minor, elective procedures. For the project to make sense, the ranking algorithm could not be based on cost alone, but rather on a combination of costs and benefits both to individuals and to the community—“concatenations of individual and group goods” (I, Jecker and Jonsen 1995). Various metaphors have been used in the literature to facilitate discussion of this shift from individual to individual/community trade-offs: medical services as a “commons” (I, Asch 1995, Jecker and Jonsen 1995, Michels 1994); resource allocation as a “lifeboat” (I, Campbell 1995; III, Kaveny 1994); medical care as “shares” in a community health (III, Nelson 1992, Ford and Kissick 1995; II, Anderson 1993); and rationing as traveling through the desert with one jug of water for two people (a story from the Halachah literature) (I, Zoloth-Dorfman 1995). [End Page 81]Such metaphors do not promote any one “theory of justice” but rather draw from the work of a number of bioethicists as well as from theological, sociological, economic, and business literature. The five major conceptions of justice that are referenced most frequently are: “(1) a libertarian conception, which takes liberty to be the ultimate political ideal; (2) a socialist conception, which takes equality to be the ultimate political ideal; (3) a welfare liberal conception, which takes contractual fairness or maximal utility to be the ultimate political ideal; (4) a communitarian conception, which takes the common good to be the ultimate political ideal; and (5) a feminist conception, which takes a gender-free society to be the ultimate political ideal” (I, Sterba 1995).The use of new metaphors also draws on expanded concepts of “health.” “As health care is currently practiced, the most powerful symbols for public and professional alike are those that promise the defeat of time” (I, Campbell 1995). When medical care is perceived as an unrelated series of individual cures, the fact that health care resources are finite cannot be addressed.Reflections concerning the difficulties in limiting the use of health care resources have an ancient lineage and reveal a tight bond with the obsession to postpone death at all costs. Plato in Book 3 of the Republic recognizes the quandary of infinite expectations and finite resources that characterizes the challenge of health care choices. (I, Engelhardt 1996)The proliferation of expensive medical technologies and the loss of autonomy by health care professionals further complicates perceptions of the crucial issues at hand. Some have said that Americans place too much emphasis on individualism to address these issues. Daniels et al. believe that this is too pessimistic a view and that the American commitment to protecting equal opportunity for all provides a firm basis for developing a public consensus on what is fair in health care (III, Daniels, Light, and Caplan 1996). Finally, several authors suggest that the nature of all four principles of medical ethics, not justice alone, must be... (shrink)

The article examines the practice of the applicability of the Article 18 of the International Covenant on Civil and Political Rights (hereinafter—ICCPR) and Article 9 of the European Convention on Human Rights and Fundamental Freedoms (hereinafter—ECHR). Through the case—law of the European Court on Human Rights (hereinafter—ECtHR) and insights of the Human Rights Committee the author is investigating the content and limits of the freedom of religion. The article examines in detail the limiting clauses to the freedom of belief (national (...) security, public order, public health, public morals) and the possibility to apply derogation clause. The author comes to the conclusion that due to the complexity of this right it is difficult to forecast the future developments of this right. The jurisprudence of the ECtHR is numerous as well as the decisions of the Court are often accompanied by dissenting opinions. Moreover, some potential cases related to the freedom of religion are not considered by the ECtHR as the admissibility criteria are not met. Therefore the author looks forward to the forthcoming jurisprudence of both—regional and universal human rights bodies. (shrink)

This article critically examines the proposal that the word "racism" should be restricted to the most egregious of racial ills. It argues that the costs of restricting the scope of the term in this way are too great and that the proposal gives too much weight to white sensitivities.

In his attempt to put forward an empiricist version of structuralism, van Fraassen develops an approach to scientific representation and models which has been the object of several critiques. Here we cover the “Loss of Reality Objection”, namely, that reality itself would play no role in science if science could only refer to mathematical models. We examine and dismiss the solution offered by van Fraassen. Finally, we offer an alternative solution path.

Although there have been several reviews of the The MIT Encyclopedia of the Cognitive Sciences, the six reviews in this issue of Artificial Intelligence represent an unusual opportunity to see in one collection how scholars from a wide range of perspectives evaluate MITECS. I found it very useful to consider the reviews side by side and am grateful to the reviewers for providing a number of new insights into the nature of the cognitive sciences. It is also gratifying to see (...) such generally positive assessments from five of the six reviewers (Carr, Dorr, Husbands, Okamato and Peterson) and it is intriguing to consider the more negative comments by Lakoff. In this essay, rather than consider in detail the many points raised by the reviews, I examine more globally how a project like MITECS might be evaluated and how it seemed to fare in light of these reviews. (shrink)

Research in evolutionary biology and philosophy of biology and cognition strongly suggests that human organisms modify their environment through active processes of niche construction. Recently, proponents of the free-energy principle and variational active inference have argued that their approach can deepen our understanding of the reciprocal causal relationship between organisms and their niche on various scales. This paper examines the feasibility and scope of variational formalisations and conceptualisations of the organism-niche nexus with a particular focus on the extended active (...) inference account. I will draw a conceptual distinction between selective niche construction, developmental niche construction, and organism-niche coordination dynamics and argue that these notions capture different causal patterns, each of which with a distinct scope. Against this background, I will analyse and discuss the extended active inference account and its strategy to integrate variational active inference with work on extended cognition. The proponents of extended active inference assume that their account can provide an explanation of selective niche construction, developmental niche construction, and organism-niche coordination dynamics. However, my key claim will be that this account has the potential to elucidate the workings of organism-niche coordination dynamics, but does not adequately capture the causal patterns of selective niche construction and developmental niche construction. (shrink)

This thesis argues that the strongest account of moral rights entails that animals and other marginal cases hold rights. The thesis contends that mutual advantage social contract theories offer the strongest account of rights from a security perspective, and that such theories entail rights for animals and marginal cases. Both of these claims are widely contested. Chapter 1 examines the fundamental elements of a social contract theory as developed by Hobbes and Hume. Chapter 2 revises the fundamental elements of contract (...) theory to make them more persuasive, and derives from them an account of rights for animals and marginal cases. Chapter 3 examines the most plausible competing accounts of rights for animals and marginal cases: utilitarianism, neo-Kantianism, and capability theory. Chapter 4 argues that the mutual advantage account of rights is better than the leading competitors from a security perspective. (shrink)

This article examines the argument that biodiversity is crucial for well-functioning ecosystems and that such ecosystems provide important goods and services to our human societies, in short the ecosystem services argument (ESA). While the ESA can be a powerful argument for nature preservation, we argue that its dominant functionalist interpretation is confronted with three significant problems. First, the ESA seems unable to preserve the nature it claims to preserve. Second, the ESA cannot explain why those caring about nature want to (...) preserve it. Third, the ESA might undermine its own goal because it potentially decreases environmental motivations. (shrink)

This paper examines whether the prospect of compensation may render otherwise disproportionate harms proportionate. It argues that we should reject this possibility. Instead, it distinguishes duties of compensation as a requirement of rectificatory justice from a harm’s degree of compensability, and argues that only the latter is relevant to proportionality. On this view, failing to compensate constitutes a distinct wrong, while harms that are not adequately compensable carry extra weight in proportionality calculations. This explains how the prospect of compensation affects (...) permissions to harm, without relying on the dubious assumption that disproportionate harms may be rendered proportionate by future compensation. (shrink)

Although the theory of Jean Piaget is correctly characterized as genetic epistemology, its nature and scope remain unclear and controversial. An examination of Piaget's Introduction a l'epistemologie genetique indicates that Piaget relies heavily upon a model of comparative anatomy and, consequently, that genetic epistemology is about both the history of science and individual development. This biological model seems to be the basis for Piaget's view that the history of science can be seen as a (Kantian) history of scientific concepts (...) whereas psychogenetic development is a history of these very same concepts on the individual level. Finally, although there are passages indicating a different interpretation of the scope of genetic epistemology, I give several reasons for preferring the more liberal interpretation. (shrink)

Drawing on feminist labour law and political economy literature, I argue that it is crucial to interrogate the personal and territorial scope of labour. After discussing the “commodification” of care, global care chains, and body work, I claim that the territorial scope of labour law must be expanded beyond that nation state to include transnational processes. I use the idea of social reproduction both to illustrate and to examine some of the recurring regulatory dilemmas that plague labour markets. (...) I argue that unpaid care and domestic work performed in the household, typically by women, troubles the personal scope of labour law. I use the example of this specific type of personal service relation to illustrate my claim that the jurisdiction of labour law is historical and contingent, rather than conceptual and universal. I conclude by identifying some of the implications of redrawing the territorial and personal scope of labour law in light of feminist understandings of social reproduction. (shrink)

This article examines the relationship between artificial general intelligence and the image of God. After identifying various models that Christian theologians use to classify or define the imago Dei, particular attention will be given to the ‘created co-creator’ model. Scholars have interpreted this model in different ways, based on the nature of human creative action. This action is seen as either subordinate to divine creation action or the human creative action is truly cooperative with divine creative action. Whether AGI would (...) be made in the image of God in these models is then explored, highlighting the differences between humans as sub-creators versus humans as cooperative co-creators. If human creative action is cooperative, then the question arises as to whether AGI can be made in ‘the image of humanity’. Some elements of this image are explored, and then the discussion turns to whether AGI would be made in ‘the image of humanity’, and if so, could AGI still be made in the image of God?Contribution: The argument concludes by pointing to future work using the various models of imago Dei to help inform the relationship between humans and AGI by briefly mentioning two examples. (shrink)

While strike action has been common since the industrial revolution, it often invokes a passionate and polarising response, from the strikers themselves, from employers, governments and the general public. Support or lack thereof from health workers and the general public is an important consideration in the justification of strike action. This systematic review sought to examine the impact of strike action on patient and clinician attitudes, specifically to explore (1) patient and health worker support for strike action and (2) the (...) predictors for supporting strike action and the reasons given for engaging in strike action. A systematic scoping review was employed to identify all relevant literature, followed by a textual narrative synthesis. A total of 34 studies met inclusion criteria. Support for strike action was largely context‐dependent. A range of factors impact support for strike action; broader cultural and structural factors, such as unionisation and general acceptance of strike action; systemic factors, such as the nature of the healthcare system, including infrastructure and work conditions; the strike itself and a range of individual factors, the most notable of which was being a student or in an early career stage. There were also some surprising results, for example, during doctors strike, nurses were provided with the opportunity to expand their role, which led to greater professional autonomy and job satisfaction. (shrink)

The teacher’s personality in general plays an important role in the educational process. It is often examined in relation to outcome factors on the teacher or student side, e.g. teaching effectiveness or student motivation. Physical education (PE) with its peculiarities and allocated educational mandate particularly demands the personality of the PE teacher. Research considering this group of teachers is sparse, diverse and hard to capture due to different personality understandings. Our review therefore aims at identifying and analyzing underlying personality (...) understandings, research questions and results of studies considering the personality of the PE teacher. We conducted a scoping review. After the screening and additional analyses process, 23 studies were included. Included references had to be empirical, published in German or English and explicitly examine the PE teacher’s personality as variable or mention it as outcome factor in school context. All studies are cross-sectional, 22 studies quantitative, one qualitative. Regarding personality understandings, 12 studies follow a trait psychological, six studies a vocational, one study an interpersonal personality understanding. Four studies’ personality understanding is not concretely determinable. Considering research questions, three studies aim at identifying the PE teacher’s personality in general and do e.g. not find considerable differences between the PE teacher’s and other teacher’s personality. Nine studies examine the relationship between the PE teacher’s personality and different correlates such as burnout, highlighting e.g. that female PE teachers’ burnout process is less homogeneous than males. Eleven studies examine the PE teacher’s personality from an external view and show e.g. that students of different age groups perceive the PE teacher’s personality differently. Our review offers possible practical implications. By e.g. knowing their personality structure – their inside –, PE teachers can play to their own strengths and make use of their individual personality configuration in order to teach authentically and successfully, i.e. transferring the inside to the outside. Due to partly questionable and fragmentary methodologies of the included studies, results have to be interpreted with caution. More studies considering the PE teacher’s personality following a broad personality understanding are needed to include potentially relevant factors for teaching and by this receive evident insights. (shrink)

Communications and categorizations mark the temporality of the possible sequences of network states, and each event thus produced modifies the space of the network by provoking in individual actors various types of learning that present an extensive and intensive dimension. This chapter examines in detail these types of learning and the mobilizations of the network space involved. Like inter‐individual communication, categorization potentially impacts both dimensions of learning. The chapter first discusses learning from inter‐individual communication, and shows that it is synonymous (...) with bringing innovation in a weak sense to the network. It then discusses learning related to categorization, which we will see is likely to introduce novelty in a strong sense within the network. The increasing efficiency of the individual learning process would thus be tempered by the global cognitive network's degree of redundancy. (shrink)

Summary By means of examples drawn from everyday experience, the author investigates what conditions must be satisfied in order that behaviour may be called rational or irrational. Does the attribution of irrationality apply to means or to ends? Is it based on consideration of the total cost? Is heroism irrational? Cannot what is irrational for one person be rational for another? Finally, the author uses this approach to come to the problem of induction and to that of moral freedom.RésuméL'auteur examine, (...) à l'aide d'exemples divers tiréds de l'expérience quotidienne, quelles sont les conditions qui doivent ětre remplies pour qu'on puisse qualifier une conduite de rationnelle ou d'irrationnelle. L'imputation d'irrationalité concerne‐t‐elle les moyens ou les buts? Se fonde‐t‐elle sur une estimation globale des coǔts? L'héroïsme est‐il irrationnel? Ce qui est irrationnel pour l'un ne peut‐il pas ětre rationnel pour un autre? Enfin, il aborde par ce biais le problème de l'induction et celui de la liberté morale.ZusammenfassungDer Verfasser untersucht aufgrund verschiedener aus dem Alltag gezogenen Beispiele die Frage, welches die Bedingungen sind, die erfüllt sein müssen, damit man ein Verhalten als rational bezeichnen kann. Bezieht sich das Zuschreiben von Irrationalität auf Mittel oder auf Ziele? Ist es auf der Einschätzung des Aufwandes begründet? Ist Heldentum irrational? Kann das, was dem einen als irrational gilt, einem andern nicht als rational gelten? Schliesslich wird über das Induktionsproblem das Problem der moralischen Freiheit angegangen. (shrink)

This paper examines the properties of the validity and scope of arguments as standards for evaluating the epistemic qualities of particular deliberative exchanges within a context of value pluralism where parties can hold differing views of the common good based on incommensurable basic values. In this context, the task of political decisions is to maximise the interests of all, only judging between internally coherent versions of the common good on the basis of their mutual impact. The paper argues open, (...) democratic, deliberation provides the best chance of discovering such a path, through developing mutual understanding across incommensurable positions. Identifying the validity and scope of a deliberative exchange enhances this potential. Any deliberative exchange may be characterised in terms of its validity – the reasons that support its conclusions – and scope – the unquestioned assumptions that mark the boundaries of that reasoning. The paper explains the epistemic role of these two features in developing understanding across plural positions. Clarity about the validity of an exchange reveals positions that can be shared. Acknowledgement of its scope avoids over-extending its conclusions and reveals how positions differ, providing the starting point for further deliberation about their co-ordination. The paper ends by drawing the conclusion that deliberation characterised in this way should be democratic and open. (shrink)

In the past decade, philosopher Bernard Rollin points out, we have "witnessed a major revolution in social concern with animal welfare and the moral status of animals." Adopting the stance of a moderate, Harold Guither attempts to provide an unbiased examination of the paths and goals of the members of the animal rights movement and of its detractors. Given the level of confusion, suspicion, misunderstanding, and mistrust between the two sides, Guither admits the difficulty in locating, much less staying in, (...) the middle of the road. The philosophical conflict, however, is fairly clear: those who resist reform, fearing that radical change in the treatment of animals will infringe on their business and property rights, versus the new activists who espouse a different set of moral and ethical obligations toward animals. From his position as a moderate, Guither presents a brief history of animal protection and the emergence of animal rights, describes the scope of the movement, and identifies major players such as Paul and Linda McCartney and organizations such as People for the Ethical Treatment of Animals that are actively involved in the movement. He concentrates on what is actually happening in the 1990s, discussing in detail the possible consequences of the current debate for those who own, use, or enjoy animals in entertainment and leisure pursuits. A reference work for students in animal sciences and veterinary medicine, the book also poses questions for philosophers, sociologists, and public policymakers as well as animal owners, animal and biomedical researchers, and manufacturers and distributors of animal equipment and supplies. (shrink)

Context In response to outbreaks of vaccine‐preventable disease and increasing rates of vaccine refusal, some political communities have recently implemented coercive childhood immunization programs, or they have made existing childhood immunization programs more coercive. Many other political communities possess coercive vaccination policies, and others are considering developing them. Scholars and policymakers generally refer to coercive immunization policies as “vaccine mandates.” However, mandatory vaccination is not a unitary concept. Rather, coercive childhood immunization policies are complex, context‐specific instruments. Their legally and morally (...) significant features often differ, and they are imposed by political communities in varying circumstances and upon diverse populations. Methods In this paper, we introduce a taxonomy for classifying real‐world and theoretical mandatory childhood vaccination policies, according to their scope (which vaccines to require), sanctions and severity (which kind of penalty to impose on vaccine refusers, and how much of that penalty to impose), and selectivity (how to enforce or exempt people from vaccine mandates). Findings A full understanding of the operation of a vaccine mandate policy (real or potential) requires attention to the separate components of that policy. However, we can synthesize information about a policy's scope, sanctions, severity, and selectivity to identify a further attribute—salience —which identifies the magnitude of the burdens the state imposes on those who are not vaccinated. Conclusion Our taxonomy provides a framework for forensic examination of current and potential mandatory vaccination policies, by focusing attention on those features of vaccine mandates that are most relevant for comparative judgments. (shrink)

Russell's classic examination of the relation between individual experience and the general body of scientific knowledge. It is a rigorous examination of the problems of an empiricist epistemology.

Bourdieu is an important thinker within the sociological tradition and has a philosophically sophisticated approach to theoretical knowledge and research practice. In this paper, we examine the implication of his work for nursing and the health sciences more broadly. We argue that his work is best described as a reflexive realist who provides a space for a nonpositivist approach to knowledge that does not fall into the trap of idealism or relativism. We emphasize that Bourdieu was not an abstract theorist, (...) but only utilized theories to understand and explain the social world in all its empirical complexity. Theory is emphasized over method without denying the importance of method. We then provide a brief overview of some of his key concepts: habitus, field and capital. His work is a scientifically astute practice that has an emancipatory purpose, with particular resonance to the problems of nursing as a social practice. Some have criticized Bourdieu for undermining agency and we briefly address this issue, but argue that his conceptual framework helps us to understand what endures in social practice and why change is often problematic. In short, this paper argues that Bourdieu's work is a fruitful resource for critiquing existing nursing approaches that are preoccupied with agency over structure. (shrink)

This study aims to evaluate the ideas on the scope and method of economics of Joseph Schumpeter who is one of the important economists of the 20th century. The study consists of four sections: In the first section we underline the interesting points of his life to understand the roots, background, or 'vision' of his thought system. In the second section, we will examine his methodological views that he asserted in his first (but translated into English only in 2010) (...) book. Third section will be concerned with his 'analysis of economics' which refers to his critics of Leon Walras's general equilibrium analysis (as static) and his own alternative (dynamics analysis of capitalist economies) about the central subject matter of economics. In the fourth section we will treat his approach about the development/evolution process of economic thought in time. The study concludes with a brief assessment: Schumpeter is one of the rare economists who can build his own thought system in the history of economics, and he embraced a pluralist perspective in the field of the methodology of economics. (shrink)

In this paper, I examine the question of the scope of justice, in a not unusual distributive, egalitarian, and universalistic framework. Part I outlines some central features of the egalitarian theory of justice I am proposing. According to such a conception, justice is – at least prima facie – immediately universal, and therefore global. It does not morally recognize any judicial boundaries or limits. Part II examines whether, even from a universalistic perspective, there are moral or pragmatic grounds for (...) rejecting or limiting the global scope of justice. In particular, I scrutinize five universalistic objections: (1) the principle of “moral division of labor”; (2) the connection between cooperation and distributive justice; (3) the primacy of democracy; (4) the dangers of a world state; and (5) political‐pragmatic reasons. I intend to show that these objections cannot undermine the strong normative claims of global justice. At the most, political‐pragmatic reasons speak in favor of initially striving for somewhat less, in order to receive more general backing. (shrink)

_The Widening Scope of Shame_ is the first collection of papers on shame to appear in a decade and contains contributions from most of the major authors currently writing on this topic. It is not a sourcebook, but a comprehensive introduction to clinical and theoretical perspectives on shame that is intended to be read cover to cover. The panoramic scope of this multidisciplinary volume is evidenced by a variety of clinically and developmentally grounded chapters; by chapters explicating the (...) theories of Silvan Tomkins and Helen Block Lewis; and by chapters examining shame from the viewpoints of philosophy, social theory, and the study of family systems. A final section of brief chapters illuminates shame in relation to specific clinical problems and experiential contexts, including envy, attention deficit disorder, infertility, masochism, the medical setting, and religious experience. This collection will be of special interest to psychoanalytically oriented readers. It begins with a chapter charting the evolution of Freud's thinking on shame, followed by chapters providing contemporary perspectives on the role of shame in development, and the status of shame within the theory of narcissism. Of further psychoanalytic interest are two reprinted classics by Sidney Levin on shame and marital dysfunction. In both depth of clinical coverage and breadth of perspectives, _The Widening Scope of Shame_ is unique in the shame literature. Readable, well organized, and completely up to date, it becomes essential reading for all students of this intriguing and unsettling emotion and of human development more generally. (shrink)

Russell's classic examination of the relation between individual experience and the general body of scientific knowledge. It is a rigorous examination of the problems of an empiricist epistemology.

Objective: The field of clinical ethics is relatively new and expanding. Best practices in clinical ethics against which one can benchmark performance have not been clearly articulated. The first step in developing benchmarks of clinical ethics services is to identify and understand current practices.Design and setting: Using a retrospective case study approach, the structure, activities, and resources of nine clinical ethics services in a large metropolitan centre are described, compared, and contrasted.Results: The data yielded a unique and detailed account of (...) the nature and scope of clinical ethics services across a spectrum of facilities. General themes emerged in four areas—variability, visibility, accountability, and complexity. There was a high degree of variability in the structures, activities, and resources across the clinical ethics services. Increasing visibility was identified as a significant challenge within organisations and externally. Although each service had a formal system for maintaining accountability and measuring performance, differences in the type, frequency, and content of reporting impacted service delivery. One of the most salient findings was the complexity inherent in the provision of clinical ethics services, which requires of clinical ethicists a broad and varied skill set and knowledge base. Benchmarks including the average number of consults/ethicist per year and the hospital beds/ethicist ratio are presented.Conclusion: The findings will be of interest to clinical ethicists locally, nationally, and internationally as they provide a preliminary framework from which further benchmarking measures and best practices in clinical ethics can be identified, developed, and evaluated. (shrink)