Purpose: to characterize ethics course content, structure, resources, pedagogic methods, and opinions among academic administrators and course directors at U.S. medical schools. Method: An online questionnaire addressed to academic deans and ethics course directors identified by medical school websites was emailed to 157 Association of American Medical Colleges member medical schools in two successive waves in early 2022. Descriptive statistics were utilized to summarize responses. Results: Representatives from 61 (39%) schools responded. Thirty-two (52%) respondents were course directors; 26 (43%) were (...) deans of academic affairs, medical education, or curriculum; and 3 with other roles also completed the survey (5%). All 61 schools reported some form of formal ethics education during the first year of medical school, with most (n = 54, 89%) reporting a formal mandatory introductory course during preclinical education. Schools primarily utilized lecture and small-group teaching methods. Knowledge-based examinations, attendance, and participation were most commonly used for assessment. A large majority regarded ethics as equally or more important than other foundational courses, but fewer (n = 37, 60%) provided faculty training for teaching ethics. Conclusions: Despite a response rate of 39 percent, the authors conclude that medical schools include ethics in their curricula in small-group and lecture formats with heterogeneity regarding content taught. Preclinical curricular redesigns must innovate and implement best practices for ensuring sound delivery of ethics content in future curricula. Additional large-scale research is necessary to determine said best practices. (shrink)

Howard J. Curzer presents a fresh new reading of Aristotle's Nicomachean Ethics, which brings each of the virtues alive. He argues that justice and friendship are symbiotic in Aristotle's view; reveals how virtue ethics is not only about being good, but about becoming good; and describes Aristotle's ultimate quest to determine happiness.

Recent studies indicate that the processing of an unexpected word is costly when the initial, disconfirmed prediction was strong. This penalty was suggested to stem from commitment to the strongly predicted word, requiring its inhibition when disconfirmed. Additional studies show that comprehenders rationally adapt their predictions in different situations. In the current study, we hypothesized that since the disconfirmation of strong predictions incurs costs, it would also trigger adaptation mechanisms influencing the processing of subsequent strong predictions. In two experiments, participants (...) made speeded congruency judgments on two-word phrases in which the first word was either highly constraining or not. We manipulated the proportion of disconfirmed predictions in highly constraining contexts between participants. The results provide additional evidence of the costs associated with the disconfirmation of strong predictions. Moreover, they show a reduction in these costs when participants experience a high proportion of disconfirmed strong predictions throughout the experiment, indicating that participants adjust the strength of their predictions when strong prediction is discouraged. We formulate a Bayesian adaptation model whereby prediction failure cost is weighted by the participant’s belief about the likelihood of encountering the expected word, and show that it accounts for the trial-by-trial data. (shrink)

Clinical red blood cell transfusion guidelines have been widely adopted in clinical practice, resulting in standardized transfusion practices in hospitalized patients with anemia. Standardization of transfusion practice has been welcomed by clinicians and health systems as a mechanism for reducing unnecessary, harmful, and costly practice variation that results in healthcare disparities. However, overzealously applied guidelines can have deleterious consequences for individual patients, ultimately resulting in and/or exacerbating healthcare disparities, rather than resolving them. This article provides empirical examples of the adverse (...) consequences from the well-meaning attempt to standardize transfusion practice based on clinical practice guidelines and discusses the ethical implications of standardized transfusion practice. (shrink)

This book explores the controversial relationship between physicians and the pharmaceutical industry, identifies the ethical tensions and controversies, and proposes numerous reforms both for medicine's own professional integrity and for effective public regulation of the industry.

In this new lexical survey of Kant's works, Howard Caygill presents Kantian concepts and terminology in terms that will introduce and clarify his ideas for students and general readers alike.

Howard Caygill systematically explores for the first time the relationship between Levinas' thought and the political. From Levinas' early writings in the face of National Socialism to controversial political statements on Israeli and French politics, Caygill analyses themes such as the deconstruction of metaphysics, embodiment, the face and alterity. He also examines Levinas' engagement with his contemporaries Heidegger and Bataille, and the implications of his rethinking of the political for an understanding of the Holocaust.

This book attempts to synthesize two apparently contradictory views of psychology: as the science of internal mental mechanisms and as the science of complex external behavior. Most books in the psychology and philosophy of mind reject one approach while championing the other, but Rachlin argues that the two approaches are complementary rather than contradictory. Rejection of either involves disregarding vast sources of information vital to solving pressing human problems--in the areas of addiction, mental illness, education, crime, and decision-making, to name (...) but a few. Where previous books have focused either on psychology as an abstract science of the mind or as a strictly empirical approach to behavioral problems, this is the only book that attempts to show how the best modern theoretical work on mental mechanisms relates to the best modern empirical work on complex behavioral problems. It will be of considerable interest to psychologists and philosophers across many disciplines and perspectives. (shrink)

There seem to be two kinds of pain: fundamental pain, the intensity of which is a direct function of the intensity of various pain stimuli, and pain, the intensity of which is highly modifiable by such factors as hypnotism, placebos, and the sociocultural setting in which the stimulus occurs.

Moderate physiological or emotional arousal induced after learning modulates memory consolidation, helping to distinguish important memories from trivial ones. Yet, the contribution of subjective awareness or interpretation of arousal to this effect is uncertain. Alexithymia, which is an inability to describe or identify one’s emotional and arousal states even though physiological responses to arousal are intact, provides a tool to evaluate the role of arousal interpretation. Participants scoring high and low on alexithymia learned a list of 30 words, followed by (...) immediate recall. Participants then saw either an arousing or neutral video . Memory was tested 24-h later. Physiological response to arousal was comparable between groups, but subjective response to arousal was impaired in high alexithymia. Yet, delayed word recognition was enhanced by arousal regardless of alexithymia status. Thus, subjective response to arousal, i.e., cognitive appraisal, was not necessary for memory modulation to occur. (shrink)

The loss of the federally protected constitutional right to an abortion is a threat to the already tenuous autonomy of pregnant people, and may augur future challenges to their right to refuse unwanted obstetric interventions. Even before Roe’s demise, pregnancy led to constraints on autonomy evidenced by clinician-led legal incursions against patients who refused obstetric interventions. In Dobbs v. Jackson Women’s Health Organization, the Supreme Court found that the right to liberty espoused in the Constitution does not extend to a (...) pregnant person’s right to an abortion. With Roe’s demise, the right to request specific types of care has been vitiated. The same argument underpinning that holding may now become ballast for attacks on the traditionally more robust right, the right to refuse. Here we discuss how the elevation of fetal and embryonic rights may lead to a cascade of medical intrusions and deprivations of liberty against pregnant persons, and offer an argument opposing these improprieties. (shrink)

In challenging the prevailing paradigm for understanding how the human mind works, Patterns, Thinking, and Cognition is certain to stimulate fruitful debate.

The terms complexity, complex adaptive systems, and sciences of complexity are found often in recent scientific literature, reflecting the remarkable growth in collaborative academic research focused on complexity from the origin and dynamics of organisms to the largest social and political organizations. One of the great challenges in this field of research is to discover which features are essential and shared by all of the seemingly disparate systems that are described as complex. Is there sufficient synthesis to suggest the possibility (...) of an overarching science of complexity? This report describes current views on this subject held by various eminent scholars associated with the Santa Fe Institute.The physical sciences have traditionally been concerned with “simple” systems whose dynamics can be described in mathematical terms with precision and certainty. In contrast, the biological and social sciences are inevitably concerned with self-organized or social “complex” systems whose detailed behaviors appear to be unpredictable. The two categories differ greatly in size and diversity, prompting the late mathematician Stanislaus Ulam to remark that research on complex systems might be compared to the study of non-elephants. Nevertheless, certain integrative themes have begun to emerge.Rising activity in this field of research runs completely counter to the trend toward increasing fragmentation and specialization in the sciences. It has stimulated a resurgence of interest in a broad synthesis involving mathematics, computational science, physics, chemistry, biology, neuroscience, and the social sciences. The growth of effort in this very extended field has been greatly stimulated by the development of new computational tools that are capable of dealing with vast, interrelated databases. Many of the participants in complexity research feel that it is now time to reintegrate the fragmented interests of much of the academic community. The reader is encouraged to consider whether such views are sparking a historic renaissance of scholarship or represent a passing scientific diversion. (shrink)

In this major reinterpretation, Howard Caygill argues that all of Benjamin's work is characterized by its focus on a concept of experience derived from Kant but applied by Benjamin to objects as diverse as urban experience, visual art, literature and philosophy. The book analyzes the development of Benjamin's concept of experience in his early writings showing that it emerges from an engagement with visual experience, and in particular the experience of colour. By representing Benjamin as primarily a thinker of (...) the visual field, Caygill is able to bring forward previously neglected texts on inscription and the visual field and to cast many of his more familiar texts, for instance the Work of Art in an Age of Mechanical Reproduction in a new light. (shrink)

Self-control, so important in the theory and practice of psychology, has usually been understood introspectively. This target article adopts a behavioral view of the self (as an abstract class of behavioral actions) and of self-control (as an abstract behavioral pattern dominating a particular act) according to which the development of self-control is a molar/molecular conflict in the development of behavioral patterns. This subsumes the more typical view of self-control as a now/later conflict in which an act of self-control is a (...) choice of a larger but later reinforcer over a smaller but sooner reinforcer. If at some future time the smaller-sooner reinforcer will be more valuable than the larger-later reinforcer, self-control may be achieved through a commitment to the largerlater reinforcer prior to that point. According to some, there is a progressive internalization of commitment in the development of self-control. This presents theoretical and empirical problems. In two experiments temporal patterning of choices increased self-control. (shrink)

An exploration of Immanuel Kant's account of war and the controversies that have arisen from its interpretation. This book brings the ideas of Kant's critical philosophy to bear on one of the leading political and legal questions of our age: under what circumstances, if any, is recourse to war legally and morally justifiable?

[This book offers] compilation of examples from TV, newspapers, magazines, advertisements, and our nation's political dialogue.

Infallibilism is the view that a belief cannot be at once warranted and false. In this essay we assess three nonpartisan arguments for infallibilism, arguments that do not depend on a prior commitment to some substantive theory of warrant. Three premises, one from each argument, are most significant: if a belief can be at once warranted and false, then the Gettier Problem cannot be solved; if a belief can be at once warranted and false, then its warrant can be transferred (...) to an accidentally true belief; if a belief can be at once warranted and false, then it can be warranted and accidentally true. We argue that each of these is either false or no more plausible than its denial. Along the way, we offer a solution to the Gettier Problem that is compatible with fallibilism. (shrink)

Our aim is to shed light on the relationships between research, knowledge, and policy in the case of goitre and the use of iodine as a preventive measure against it in Norway from the 1850s onward. Goitre was previously widespread in certain areas of Norway, but disappeared around 1950. After many decades of silence about goitre and iodine, an expert report in 2016 argued that action should be taken to prevent iodine deficiency. Already in 1927, an international conference on goitre (...) led to the agreement that the best preventive measure against goitre was to fortify table salt with iodine. The conference had Norwegian participants, but Norwegian health authorities did not follow the recommendations from the conference. To understand why new knowledge and recommendations did not result in new policy, we explore the history of Norwegian research on goitre and iodine, and Norwegian contributions to and the inspiration from international research in the field. Furthermore, we analyse the measures for the prevention and curing of goitre that have been implemented by authorities over time. The preventive measures introduced in Norway from the 1930s were very modest and differed from those in other countries. We argue for the importance of analysing the political context to understand the success or failure of advice given by researchers to policymakers. (shrink)

Although the physician’s use and misuse of power have been discussed in the social sciences and in literature, they have never been explored in medical ethics until now. In this book, Dr. Howard Brody argues that the central task is not to reduce the physician’s power, as others have suggested, but to develop guidelines for its use, so that the doctor shares with the patient both information and the responsibility for deciding on appropriate treatment. Dr. Brody first reviews literary (...) works dealing with medical power, from Dostoevsky’s “The Grand Inquisitor” to stories by William Carlos Williams, Vonda McIntyre, and Richard Selzer. These works, he shows, reveal the healers’ ambivalence over their own powers and patients’ fears of the abuse of power. Dr. Brody then points out important but neglected ethical issues that emerge from an analysis of power, such as the tension between care of individual patients and the pressures of the doctor’s workload; the rescue fantasy that impels some physicians to extraordinary lengths to save a life; and the economic system, which rewards surgeons and other specialists more than it does physicians who spend time talking with patients about their problems. He also shows how the perspective of shared power can shed new light on standard topics in medical ethics—from informed consent and confidentiality to resource allocation and cost containment. (shrink)

Anyone seeking a readable and relatively brief guide to logic can do no better than this classic introduction. A treat for both the intellect and the imagination, it profiles the development of logic from ancient to modern times and compellingly examines the nature of logic and its philosophical implications. No prior knowledge of logic is necessary; readers need only an acquaintance with high school mathematics. The author emphasizes understanding, rather than technique, and focuses on such topics as the historical reasons (...) for the formation of Aristotelian logic, the rise of mathematical logic after more than 2,000 years of traditional logic, the nature of the formal axiomatic method and the reasons for its use, and the main results of metatheory and their philosophic import. The treatment of the Gödel metatheorems is especially detailed and clear, and answers to the problems appear at the end. (shrink)

In any probabilistic theory, we say that a bipartite state ω on a composite system AB steers its marginal state ω B if, for any decomposition of ω B as a mixture ω B =∑ i p i β i of states β i on B, there exists an observable {a i } on A such that the conditional states $\omega_{B|a_{i}}$ are exactly the states β i . This is always so for pure bipartite states in quantum mechanics, a fact (...) first observed by Schrödinger in 1935. Here, we show that, for weakly self-dual state spaces (those isomorphic, but perhaps not canonically isomorphic, to their dual spaces), the assumption that every state of a system A is steered by some bipartite state of a composite AA consisting of two copies of A, amounts to the homogeneity of the state cone. If the state space is actually self-dual, and not just weakly so, this implies (via the Koecher-Vinberg Theorem) that it is the self-adjoint part of a formally real Jordan algebra, and hence, quite close to being quantum mechanical. (shrink)

The article is a detailed case study of theft and fraud by an employee in an organization. The analysis suggests that in the process of dealing with the employee, the issue was notprimarily one of ethics, but of two moral principles in conflict, compassion and concern for a fellow human being and the morality governing responses to betrayal. The latter governed the results because that morality was congruent with the predominant ethics of the organization concerned with preserving the authority structure (...) and integrity of the organization rather than the personal welfare of the individual in the organization. In sum, the paper argues that, based on this case, organizational behavior towards individual employees may be determined by individual morality that is reinforced by organizational ethical principles more concerned with the self interest of the organization than ethics per se. (shrink)

Oxford Scholarly Classics is a new series that makes available again great academic works from the archives of Oxford University Press. Reissued in uniform series design, the reissues will enable libraries, scholars, and students to gain fresh access to some of the finest scholarship of the last century.