This paper describes the first three-year experience of the Consortium Ethics Program (CEP-1) of the University of Pittsburgh Center for Medical Ethics, and also outlines plans for the second three-year phase (CEP-2) of this experiment in continuing ethics education. In existence since 1990, the CEP has the primary goal of creating a cost-effective, permanent ethics resource network, by utilizing the educational resources of a university bioethics center and the practical expertise of a regional hospital council. The CEP's conception and specific (...) components stem from recognition of the need to make each hospital a major focus of educational efforts, and to provide academic support for the in-house activities of the representatives from each institution. (shrink)

This article draws upon affect theory to analyze transformations of garage sale sellers through the exchange of their affectively charged possessions. Garage sales are awash with human emotion; they feature used personal belongings suffused with identities, histories, stories, and memories that are moved along with affect. The objects for sale are “sticky” in that they act as vessels and glue for strands of sentiment to reflexively pass between sellers and buyers, transmitting affective orientations, whether positive or negative. The affective elements (...) of garage sale goods are contagious as they can intersubjectively leap from one body to another. (shrink)

Transactions in the U.S. garage sale range from the commercial to the giftlike, in a Maussian sense. As two-thirds of the participants, women create a sense of community through garage sale exchange. This article explores how women, partly differentiated along lines of race and class, solidify their personal relationships, transmit something of themselves with their possessions, transform their own lives in the process, and contribute to a broader spirit of community through the generalized reciprocity and even moral economy that manifests (...) in giftlike exchange. There is an important link, both material and symbolic, between women's relational skills, their association with the home and the moral, and the creation of community in the garage sale. (shrink)

The critical look at hospice care by Felicia Ackerman in Vol. 6 of the CambridgeQuarterly requires a response, since the author presents her view as having major implications for health policy. As a healthcare executive with over 25 years experience, and as a spokesperson for both my own program and others in the National Hospice Work Group, twelve of the nation's largest nonprofit hospices, I submit that her analysis of hospice care is naive. Ackerman's lack of practical understanding concerning the (...) care of the terminally ill results in a discussion that misses the key policy issues. (shrink)

Today's pre-service teachers grew up attending schools where high stakes testing and teacher accountability were the norm. Despite a substantial body of research focused on the influence high-stakes testing on the practices of novice social studies teachers, a gap exists regarding the accountability movement's influence on novice social studies teachers. This study focused explicitly on the influence high-stakes testing and the culture of accountability had on two pre-service social studies teachers during their student teaching experience. Our findings highlight the ways (...) the accountability culture of public schools served a narrow gatekeeping function, limiting what participants learned during student teaching. Rethinking gatekeeping during student teaching within the current era of accountability and oversight positions teacher educators to confront the constricting nature of student teaching today. Student teachers must learn to recognize the gatekeeping aspects of the accountability culture and to make sense of the contradictions embedded in the student teaching experience. (shrink)

A discussion of ethical decision-making literature is overdue. In this article, we summarize the current literature of ethical decision-making models used in mental health professions. Of 1,520 articles published between 2001 and 2020 that met initial search criteria, 38 articles were included. We report on the status of empirical evidence for the use of these models along with comparisons, limitations, and considerations. Ethical decision-making models were synthesized into eight core procedural components and presented based on the composition of steps present (...) in each model. This taxonomy provides practitioners, trainers, students, and supervisors relevant information regarding ethical decision-making models. (shrink)

This article presents the Pilgrimage Model as a template for educators wishing to lead students on site-specific studies of engaged learning. During the 2015–2016 academic year, a group of Georgeto...

_Humanizing Education_ offers historic examples of humanizing educational spaces, practices, and movements that embody a spirit of hope and change. From Dayton, Ohio, to Barcelona, Spain, this collection of essays from the _Harvard Educational Review_ carries readers to places where people have first imagined—and then organized—their own educational responses to dehumanizing practices and conditions. Contributors include Montse Sánchez Aroca, William Ayers, Kathy Boudin, Fernando Cardenal, Jeffrey M. R. Duncan-Andrade, Marco Garrido, Jay Gillen, Maxine Greene, Kathe Jervis, Nancy Uhlar Murray, Valerie (...) Miller, Wendy Ormiston, Ana Y. Ramos-Zayas, Vanessa Siddle Walker, Arthur E. Thomas, and Travis Wright. (shrink)

Each of these hospice officials makes several criticisms of my paper, Philosophy of Hospice I will treat these criticisms in turn.

The Common Prior Assumption (CPA) plays an important role in game theory and the economics of information. It is the basic assumption behind decision-theoretic justifications of equilibrium reasoning in games (Aumann, 1987, Aumann and Brandenburger, 1995) and no-trade results with asymmetric information (Milgrom and Stokey, 1982). Recently several authors (Dekel and Gul, 1997, Gul, 1996, Lipman, 1995) have questioned whether the CPA is meaningful in situations of incomplete information, where there is no ex ante stage and where the (...) primitives of the model are the individuals' beliefs about the external world (their first-order beliefs), their beliefs about the other individuals' beliefs (second-order beliefs), etc., i.e. their hierarchies of beliefs. In this context, the CPA is a mathematical property whose conceptual content is not clear. The main results of this paper (Theorems 1 and 2) provide a characterization of Harsanyi consistency in terms of properties of the belief hierarchies that are entirely unrelated to the idea of an ex ante stage. (shrink)

In this paper we present a sequent calculus for the multi-agent system S5 m . First, we introduce a particularly simple alternative Kripke semantics for the system S5 m . Then, we construct a hypersequent calculus for S5 m that reflects at the syntactic level this alternative interpretation. We prove that this hypersequent calculus is theoremwise equivalent to the Hilbert-style system S5 m , that it is contraction-free and cut-free, and finally that it is decidable. All results are proved in (...) a purely syntactic way and the cut-elimination procedure yields an upper bound of ip 2 (n, 0) where ip 2 is an hyperexponential function of base 2. (shrink)

Ethics support staff help others to deal with moral challenges. However, they themselves can also experience moral challenges such as issues regarding (breaching) confidentiality when practicing ethics support. Currently there is no insight in these confidentiality issues and also no professional guidance for dealing with them. To gain insight into moral challenges related to Moral Case Deliberation (MCD), we studied a) beliefs and experiences of MCD facilitators regarding breaching confidentiality, b) considerations for (not) breaching confidentiality, and c) needs for an (...) ethics support tool. Data collection consisted of qualitative research methods: six semi-structured interviews; analyses of a) two recorded MCD sessions, and b) a focus group with MCD facilitators. Findings: MCD facilitators mention different conceptions and interpretations of confidentiality and various moral challenges. Questions concerning confidentiality ultimately cause reflections on roles and responsibilities of facilitators. Needs for ethics support vary from seeking advice to procedural and sometimes normative guidance for MCD facilitators. Education for MCD facilitators should focus on developing a concrete tool that stimulates awareness and reflection(skills). (shrink)

Aphantasia is a recently discovered disorder characterised by the total incapacity to generate visual forms of mental imagery. This paper proposes that aphantasia raises important theoretical concerns for the ongoing debate in the philosophy and science of consciousness over the nature of dreams. Recent studies of aphantasia and its neurobehavioral correlates reveal that the majority of aphantasics, whilst unable to produce visual imagery while awake, nevertheless retain the capacity to experience rich visual dreams. This finding constitutes a novel explanandum for (...) theories of dreaming. Specifically, I argue that the recent dream reports of aphantasics constitute an empirical challenge to the emerging family of views which claim that dreams are essentially imaginative experiences, constitutively involving the kinds of mental imagery which aphantasics, ex-hypothesi, lack. After presenting this challenge in the context of Jonathan Ichikawa’s recent arguments for this view, I argue that this empirical challenge may be overcome if the imagination theorist abandons Ichikawa’s account of dreaming in favour of a modified version. This involves the claim that dreams are essentially inactive and constitutively involve non voluntary forms of imagination. I conclude with a suggestion for further research which can test the viability of this alternative hypothesis, and move the debate forward. (shrink)

The publication of Daniel Lehrman’s 1953 paper, “A Critique of Konrad Lorenz’s Theory of Instinctive Behavior,” (_The Quarterly Review of Biology_ 28(4):337–363) exposed a gulf between comparative psychologists and ethologists regarding the concept of instincts. At the center of this debate was a rivalry between T. C. Schneirla—Lehrman’s doctoral advisor—and Konrad Lorenz. While Schneirla maintained that the concept of innate instincts mischaracterized developmental processes, Lorenz maintained that innateness was essential to understand the evolution of behavior. A year after the publication (...) of Lehrman’s paper, the Singer-Polignac Foundation organized a small conference where leaders in evolutionary biology, ethology, behavioral physiology, and comparative psychology met to discuss the concept of instinct and innateness. The result of this meeting was the publication of the book _L’instinct dans le comportement des animaux et de l’homme_ (M. Autuori et al. ( 1956 ) Masson, Paris) in which each conference participant submitted a chapter that was followed by a discussion among the participants. Here I review the historical context surrounding this conference with a republishing of the commentary on Schneirla’s chapter, “Interrelationships of the ‘Innate’ and the ‘Acquired’ in Instinctive Behavior.” Originally published in English, German, and French, the discussion is included here with a new translation into English for the first time. A companion article (this issue; G. M. Kohn (2024) “Revisiting T. C. Schneirla’s ‘Interrelationships of the “Innate” and the “Acquired” in Instinctive Behavior’ (1956)”) discusses and makes available Schneirla’s complete paper. (shrink)

During the postwar period, the concept of instinct came to encapsulate the debate around the importance of nature versus nurture. The fact that animals show highly organized behavior early in development suggested the presence of an underlying fixity where behavior was “inbuilt” into an animal’s biology despite an individual’s experiences. This placed a discrete and exhaustive line between the innate and acquired that became a foundation for the European-dominated field of ethology. Across the Atlantic, a group of comparative psychologists led (...) by the American Museum of Natural History’s T. C. Schneirla contested this approach, proposing that the study of animal behavior should avoid abstract dichotomies with a renewed focus on developmental processes. While Schneirla’s theoretical and empirical work shaped the modern study of animal behavior, his legacy requires revisiting in an era where the nature versus nurture debate is regaining prominence. In this article, I revisit Schneirla’s approach to behavior with a focus on his paper “Interrelationships of the ‘Innate’ and the ‘Acquired’ in Instinctive Behavior” (published in M. Autuori et al. (1956) _L’instinct dans le comportement des animaux et de l’homme_; Masson, Paris, pp. 387–452) for the journal’s “Classics in Biological Theory” collection; the paper is available as supplementary material in the online version of this article. A companion article (this issue; G. M. Kohn (2024) “A Discussion on Instinct, Paris, 1954”) presents the commentary that was published with it. (shrink)

ABSTRACT:Psychedelic substances have great promise for the treatment of many conditions, and they are the subject of intensive research. As with other medical treatments, both research and clinical use of psychedelics depend on our ability to ensure informed consent by patients and research participants. However, some have argued that informed consent for psychedelic use may be impossible, because psychedelic experiences can be transformative in the sense articulated by L. A. Paul (2014). For Paul, transformative experiences involve either the acquisition of (...) knowledge that cannot be obtained in any other way or changes in the self. Either of these characteristics may appear to undermine informed consent. This article argues, however, that there is limited evidence that psychedelic experiences are transformative in Paul's sense, and that they may not differ in their transformative features from other common medical experiences for which informed consent is clearly possible. Further, even if psychedelic experiences can be transformative, informed consent is still possible. Because psychedelic experiences are importantly different in several respects from other medical experiences, this article closes with recommendations for how these differences should be reflected in informed consent processes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Maurice Blondel on the Practice of Supernatural ReligionAnne M. CarpenterIntroductionMaurice Blondel attended daily Mass to the very end of his life.1 This essay is, in a way, a meditation on this fact. But it is more nearly a confrontation with Blondel's philosophical argument in defense of human action's capacity for affirming the infinite, for "containing" the infinite in its affirmation of the infinite, an affirmation achieved in action's finitude. (...) That is, this is an essay on Blondel's argument for a supernatural religion that can be literally practiced. Much like Blondel's larger philosophical works, this essay spends its time exploring the coordinating ground of supernatural religion, which is the natural world split open in two directions: in its very existence, which is a supposition of what absolutely outstrips its power; in its very action, which in ecstasy takes the shape of a desire for a reversal that it cannot offer itself. So the natural world presupposes the supernatural and desires the supernatural while remaining, of its own power, natural. Blondel makes a theoretical distinction in the universe that, concretely, is a natural–supernatural one committed to a single destiny. This theory and this concreteness cohere in order to make the literal practice of religion both possible and necessary, terms that this essay explains. [End Page 1305]Action: The Problem of Theory and PracticeBlondel's later writing in the 1930s expands on an important paradox that appears in the very early L'Action (1893). That paradox has to do with a distinction between theory—that is, the world of ideas and reflection—and practice, by which Blondel means the concrete world of human action, a world that for Blondel is an expansive range or "body" of action. It is true, after all, that an idea is not a deed. And yet no deed is without its idea, without the mediatory power of the act of consciousness, nor without the mediation of this consciousness's rationality—a further synthesizing act within consciousness—even when the deed contradicts reason. "Hence," says Blondel, "it is because we find in our acts a kind of creative sovereignty that we have a consciousness of ourselves and reason; it is because we are reasonable and conscious of ourselves that we judge ourselves capable of voluntary initiative."2 The paradox, at one angle, is this leap or gap, this difference nevertheless sustained by a mediation, where ideas and deeds are non-identical yet inseparable. At another angle, it is a paradox that a "science of practice" has to straddle, since it studies (as science) what it is not: concrete action (practice). Blondel, whether young or of his latter days, is after the possibility of such a science. He is also after the bond between reasoning and acting. In this section, I also seek that bond, and I make use of Blondel's early and later works together to give a sense not of Blondel's development, but of the Gestalt of his life's work with respect to the bond between thought and action.3The bond first requires the rejection of monism. Though Blondel's stance toward theologies of his day tends to be more well-known among theologians, and therefore filtered through questions of nature and grace and carried through to a rejection of a two-tiered conception of the universe, still, his nearer interlocutors are often monists: modern philosophers and the modern sciences, and their strange compatriots in history, the spiritual movements of the fin de siècle, involving spiritualisms of various kinds, recollected in our popular imagination today in visions of crystal balls and séance tables. The positivism of the modern sciences and of modern (French) philosophy poses a totally self-contained "nature" that can be explained [End Page 1306] without religion, in a form of what English speakers might call "secularism," but which is more accurately filtered through French Republican desires for laïcité.4 While Blondel was writing, there were not only these political and scientific and philosophical trends, but also the semi-pantheistic, variously agnostic religious movements that dominated privileged circles in Europe at the time. These are a kind of... (shrink)

An anthropocentric scope for clinical medical ethics (CME) has largely separated this area of bioethics from environmental concerns. In this article, we first identify and reconcile the ethical issues imposed on CME by climate change including the dispersion of related causes and effects, the transdisciplinary and transhuman nature of climate change, and the historic divorce of CME from the environment. We then establish how several moral theories undergirding modern CME, such as virtue ethics, feminist ethics, and several theories of justice, (...) promote both a flourishing of human medical practice and the environment. We conclude by defining an expanded the scope of CME as inclusive of not only patients, families, physicians, and other health professionals but other humans, non-humans, and their shared environment. We then apply this scope and theory to a widely used framework for applying CME, the Four Topics model, to construct a climate conscious approach to CME. (shrink)

Our new issue brings unlikely philosophers into dialogue (for example, Adorno and Krishnamurti) for the first time as well as reconsiders some of the most important figures (for example, Nietzsche...

Some recent uses of artificial intelligence for facial recognition, evaluating resumes, and sorting photographs by subject matter have revealed troubling disparities in performance or impact based on the demographic traits of subject populations. These disparities raise pressing questions about how using artificial intelligence can work to promote justice or entrench injustice. Political theorists and philosophers have developed nuanced vocabularies and theoretical frameworks for understanding and adjudicating disputes about what justice requires and what constitutes injustice. The interdisciplinary community committed to understanding (...) and conscientiously using big data could benefit from this work. Thus, in the spirit of encouraging cross-disciplinary dialogue and collaboration, this piece examines contemporary scholarship in political theory and philosophy to illustrate some of the vocabularies and frameworks political theorists and philosophers have developed for thinking about justice and injustice. It then draws on these frameworks to illuminate how the use of artificial intelligence can implicate questions of justice, with a focus on institutional discrimination, structural injustice, and epistemic injustice. Ultimately, the piece argues that the use of artificial intelligence—far from representing a decision to take power out of human hands—represents a novel way of harnessing human power, making questions of justice central to its conscientious undertaking. (shrink)

The evaluation of the European Moral Case Deliberation Outcomes project (Euro-MCD) has resulted in a revised evaluation instrument, knowledge about the content of MCD (moral case deliberation), and the perspectives of those involved. In this paper, we report on a perspective that has been overlooked, the facilitators’. We aim to describe facilitators’ perceptions of high-quality moral case deliberation and their Euro-MCD sessions. The research took place in Norway, Sweden, and the Netherlands using a survey combined with interviews with 41 facilitators. (...) Facilitators’ perceived that attaining a high-quality MCD implies fostering a safe and respectful atmosphere, creating a wondering mode, being an attentive authority, developing moral reflective skills, reaching a common understanding, and ensuring organisational prerequisites for the MCD sessions. Our central conclusion is that efforts at three levels are required to attain a high-quality MCD: trained and virtuous facilitator; committed, respectful participants; and organizational space. Furthermore, managers have a responsibility to prepare MCD participants for what it means to take part in MCD. (shrink)

A vital step to successfully orienting Deleuze with biosemiotics (and theories of biological complexity overall) is to discover a coherent scientific throughline in his work that also accounts for the aesthetic/creative dimension of his philosophy. This requires the heterodox move (from a Deleuzean point of view) of giving priority to the organism. I argue that Deleuze’s treatment of the organism does more than signal a superficial relation to biological complexity theory that, as a result of his nuanced take on the (...) matter, undermines the value of the organic body to his system. Instead, we can recognize a working theory of autopoiesis in the early Deleuze that scaffolds as well as substantiates his later ethological and biosemiotic observations and reveals a definite, albeit minimal, notion of subjectivity in his work. Most importantly, reorienting his logic of sense as a logic of sense-making, or the context-dependent signification between system and environment (Thompson, 2007), allows us to begin the work of mining a scientific throughline in Deleuze’s work akin to biological complexity theory that is of value to both Deleuze studies and biosemiotics. (shrink)

Much has been made of the so-called “speculative turn” in contemporary philosophy. For some, this turn marks the “end of phenomenology” and the dawn of a new empiricism in European philosophy. For others, it amounts to nothing more than a renewal of the straw-person accusation of psychologism against phenomenology. In truth, it is neither. Instead, this article argues that while at times mutually critical of one another, speculative materialism and phenomenology are best understood as parallel projects with shared trajectories and (...) aims, common concerns, and even comparable methods. The bene????it of reading these two apparently divergent camps as parallel projects is that it allows phenomenology to understand the diversity of its own history anew and, in light of this, to draw from speculative realism as a resource for rethinking its objectives and methods in its pursuit of a robust post-Kantian realism. (shrink)

Supporting children to successfully transition from primary to secondary school is of utmost importance for several reasons, including to prevent future emotional and behavioural problems. Level Up is a novel, UK-based intervention consisting of five online group sessions, straddling the summer holidays, and providing at-risk children and their parents/carers with skills to manage their behaviour, emotions, and relationships to support their transition to secondary school. A prior evaluation of Level Up reported a need to better describe the mechanisms of change. (...) This study therefore evaluated the experiences of children and their parents/carers regarding the facilitators and barriers to engagement and change, and the perceived impact. Fourteen children and 17 parents/carers were interviewed. Identified barriers and facilitators were: (1) Having a safe, supportive, and fun space, (2) Learning through connection, (3) A family approach, (4) Problematic group dynamics, and (5) Connecting through video calls. Perceived impact was described as: (1) Empowering children, (2) Supporting children socially, (3) Supporting parents and carers in their parenting role, and (4) Supporting a successful transition to secondary school. Another theme (5) describes some families’ experiences of limited impact. These findings can be used to better understand how to support children in their school transition. (shrink)

The alienation of labour is both classical and contemporary. In its classical form, it speaks to the potential dehumanisation of workers in capitalist societies. In its contemporary form, it manifests itself in the disenfranchisement of the individual because of changes in organised global workplaces. Over the years, Africa’s labour transition from traditional spirituality to contemporary organised global workplaces has fuelled new forms of public labour alienation. Civil servants, in some African countries, experience labour alienation reminiscent of work under capitalism. This (...) is in contradiction to the pre-colonial and traditional view of work as a vocation. Zimbabwe is undergoing negative economic, social, and political growth that has resulted in the alienation of civil servants. The government reneges on its public role of providing space for individual growth and well-being in preference for ‘public capitalism’ and cultural alienation. The potential for an effective public service lies in changing the work culture. Contribution: This article interrogates the impacts of the work culture within the public service in Zimbabwe in an attempt to proffer a return to the African traditional spirituality of work that was founded on the principles of ubuntu. It recognises the traditional symbiotic relationship between being and doing among the indigenous African communities as the panacea for the continent’s human capital development. (shrink)

In their article “The Bioethics of Environmental Injustice: Ethical, Legal, and Clinical Implications of Unhealthy Environments,” Ray and Cooper (2024) invite us to prioritize environmental health...

This essay argues for two conclusions. First, clinical decision-making is not best thought of as analogous to the purchase of other services, such as car repair. Health-care decision-making is far more difficult, collaborative, emotionally fraught, and subject to cognitive distortions. Second, the provision of health care should not be delegated to unregulated markets. Unlike other markets, there is no reason to expect health-care market outcomes to be efficient or fair or to promote individual freedom, properly conceived. Markets may play an (...) important role in implementing an allocation of healthcare, but they are not an ethically acceptable alternative to determining what that allocation should be. (shrink)