Of Goals and Goods and Floundering About: A Dissensus Report on Clinical Ethics Consultation Content Type Journal Article Pages 275-291 DOI 10.1007/s10730-009-9101-1 Authors Jeffrey P. Bishop, Vanderbilt University Center for Biomedical Ethics and Society 2525 West End Avenue, Suite 400 Nashville Tennessee 37203 USA Joseph B. Fanning, Vanderbilt University Center for Biomedical Ethics and Society 2525 West End Avenue, Suite 400 Nashville Tennessee 37203 USA Mark J. Bliton, Vanderbilt University Center for Biomedical Ethics and Society 2525 West End Avenue, (...) Suite 400 Nashville Tennessee 37203 USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume 21, Number 3. (shrink)

Erratum to: Echo Calling Narcissus: What Exceeds the Gaze of Clinical Ethics Consultation? Content Type Journal Article Pages 171-171 DOI 10.1007/s10730-010-9132-7 Authors Jeffrey P. Bishop, Saint Louis University Tenet Chair of Health Care Ethics, Albert Gnaegi Center for Health Care Ethics Salus Center, Room 527, 3545 Lafayette Ave St. Louis MO 63104-1314 USA Joseph B. Fanning, Vanderbilt University Center for Biomedical Ethics and Society 2525 West End Ave., 4th Floor, Suite 400 Nashville TN 37203 USA Mark J. Bliton, Vanderbilt (...) University Center for Biomedical Ethics and Society 2525 West End Ave., 4th Floor, Suite 400 Nashville TN 37203 USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 22 Journal Issue Volume 22, Number 2. (shrink)

Voluntary active euthanasia and physician assisted suicide should not be legalised because too much that is important about living and dying will be lostIn the first of this two part series, I unpack the historical philosophical distinction between killing and allowing a patient to die in order to clear up the confusion that exists. Historically speaking the two kinds of actions are morally distinct because of older notions of causality and human agency. We no longer understand that distinction primarily because (...) we have shifted our notions of causality from a traditional formulation to a modern formulation of causality and thus of moral assessment that focuses on the effects of an action. In this essay, I prepare the ground for a companion essay by showing that the traditional formulation allows us to maintain notions of meaning and purpose to human living and dying that are precluded in the efficiency paradigm of modernity. Taken together with the companion essay, I am claiming that voluntary active euthanasia and physician assisted suicide should not be legalised because too much that is important about dying and living will be lost.TWO LIESIt would be naïve to think that euthanasia, in either the VAE sense, or in the more passive sense of PAS, does not happen. It would even be naïve to think that it does not occur in a non-voluntary form. It would be equally naïve, however, to think it could be controlled through governmental regulation. The real question with regard to PAS/VAE, put so eloquently by Martha Minow, is which lie do you countenance: the lie that euthanasia does not already happen, or the lie that it can be controlled without having repercussions well beyond the limits of procedural mastery?1 With this two part paper series, I will argue that the …. (shrink)

Bishop and Trout here present a unique and provocative new approach to epistemology. Their approach aims to liberate epistemology from the scholastic debates of standard analytic epistemology, and treat it as a branch of the philosophy of science. The approach is novel in its use of cost-benefit analysis to guide people facing real reasoning problems and in its framework for resolving normative disputes in psychology. Based on empirical data, Bishop and Trout show how people can improve their reasoning (...) by relying on Statistical Prediction Rules. They then develop and articulate the positive core of the book. Their view, Strategic Reliabilism, claims that epistemic excellence consists in the efficient allocation of cognitive resources to reliable reasoning strategies, applied to significant problems. The last third of the book develops the implications of this view for standard analytic epistemology; for resolving normative disputes in psychology; and for offering practical, concrete advice on how this theory can improve real people's reasoning. This is a truly distinctive and controversial work that spans many disciplines and will speak to an unusually diverse group, including people in epistemology, philosophy of science, decision theory, cognitive and clinical psychology, and ethics and public policy. (shrink)

Artificial Neural Networks have reached “grandmaster” and even “super-human” performance across a variety of games, from those involving perfect information, such as Go, to those involving imperfect information, such as “Starcraft”. Such technological developments from artificial intelligence (AI) labs have ushered concomitant applications across the world of business, where an “AI” brand-tag is quickly becoming ubiquitous. A corollary of such widespread commercial deployment is that when AI gets things wrong—an autonomous vehicle crashes, a chatbot exhibits “racist” behavior, automated credit-scoring processes (...) “discriminate” on gender, etc.—there are often significant financial, legal, and brand consequences, and the incident becomes major news. As Judea Pearl sees it, the underlying reason for such mistakes is that “... all the impressive achievements of deep learning amount to just curve fitting.” The key, as Pearl suggests, is to replace “reasoning by association” with “causal reasoning” —the ability to infer causes from observed phenomena. It is a point that was echoed by Gary Marcus and Ernest Davis in a recent piece for theNew York Times: “we need to stop building computer systems that merely get better and better at detecting statistical patterns in data sets—often using an approach known as ‘Deep Learning’—and start building computer systems that from the moment of their assembly innately grasp three basic concepts: time, space, and causality.” In this paper, foregrounding what in 1949 Gilbert Ryle termed “a category mistake”, I will offer an alternative explanation for AI errors; it is not so much that AI machinery cannot “grasp” causality, but that AI machinery (qua computation) cannot understand anything at all. (shrink)

Death cannot be mastered through a metaphysics of efficiency that interprets all actions in terms only of cause and effect, but it can be transcended if we leave the frame open to death’s ambiguityIn the second of this two part series, I describe how in shifting our frames from one of human purpose and meaning to one of efficiency, we shift the possible answers we get to our questions about voluntary active euthanasia and physician assisted suicide . Thus, by placing (...) VAE/PAS within the frame of efficiency, we narrow our focus to the final effect in the world of cause and effect—namely death. Thus, in ensconcing euthanasia within a legal framework meant to instrumentally and efficiently control euthanasia, we are in fact narrowing our focus on death. Thus, in legalising VAE/PAS we are not just adding one choice to a panoply of other choices, we are in fact changing the nature of all choices, for each choice conditions all others. We should therefore live with the lie that VAE/PAS do not happen as opposed to living with the lie that through efficient legal control we protect patients from medical dominance.AN ANECDOTESeveral years ago an acquaintance told me about a terrible situation in which he found himself during the Vietnam war. He was Green Beret—one of the elite special forces corps of the US army. He was in an area that was officially off limits to the US. His unit came under heavy fire and a buddy was shot in several places but was still alive. His comrade was in serious pain, but what scared him the most was that he might die in the jungle, be eaten by a wild animal, or be captured by the enemy. There was no way to get him out. The wounded soldier …. (shrink)

This piece presents the work of academics and architects in a collaborative venture. It provides an architectural design and a series of statements towards the hypothetical creation of an unconventional city centre in the Chinese city of Shenzhen. The idea is to create a linear university that would run the 20-kilometer length of the Shenzhen Strip: the 20K university. The contributors outline, in the diversity of their idioms, a complex spatial condition fundamental to life, and demonstrate new relationships between knowledge (...) and the city. The design of the proposed ‘open university space’ responds to two simultaneous and interrelated challenges: that posed to architecture, and that posed to science. The university would embody the meeting of these at the intersection of the urban infrastructure and the knowledge infrastructure. The purpose is thus also to develop the notion of knowledge, embodied in institutions, as urban infrastructure. (shrink)

In cognitive neuroscience and in philosophy of mind, causation is a notion that is immensely important but usually not defined precisely enough to afford careful application. A widespread basic flaw is the confusion of causation with correlation. All empirical knowledge in the sciences is based on observing correlations; assigning causal relations to them or interpreting them causally always requires a theoretical background that is implicitly or (better) explicitly stated. This entails that differing theoretical approaches might lead to different interpretations of (...) correlations. In this special volume we attempt to contribute to an improved understanding of causation, in general, and its relationship to consciousness studies, specifically. (shrink)

Book Information Faith with Reason. By Paul Helm. Clarendon Press. Oxford. 2000. Pp. xvi + 185.

The Heythrop Journal, Volume 63, Issue 3, Page 333-348, May 2022.

Standard Analytic Epistemology (SAE) names a contingently clustered class of methods and theses that have dominated English-speaking epistemology for about the past half-century. The major contemporary theories of SAE include versions of foundationalism, coherentism, reliabilism, and contextualism. While proponents of SAE don’t agree about how to define naturalized epistemology, most agree that a thoroughgoing naturalism in epistemology can’t work. For the purposes of this paper, we will suppose that a naturalistic theory of epistemology takes as its core, as its starting-point, (...) an empirical theory. The standard argument against naturalistic approaches to epistemology is that empirical theories are essentially descriptive, while epistemology is essentially prescriptive, and a descriptive theory cannot yield normative, evaluative prescriptions. In short, naturalistic theories cannot overcome the is-ought divide. Our main goal in this paper is to show that the standard argument against naturalized epistemology has it almost exactly backwards. (shrink)

After describing Heidegger's critique of metaphysics as ontotheology, I unpack the metaphysical assumptions of several transhumanist philosophers. I claim that they deploy an ontology of power and that they also deploy a kind of theology, as Heidegger meant it. I also describe the way in which this metaphysics begets its own politics and ethics. In order to transcend the human condition, they must transgress the human.

Our aim in this paper is to bring the woefully neglected literature on predictive modeling to bear on some central questions in the philosophy of science. The lesson of this literature is straightforward: For a very wide range of prediction problems, statistical prediction rules (SPRs), often rules that are very easy to implement, make predictions than are as reliable as, and typically more reliable than, human experts. We will argue that the success of SPRs forces us to reconsider our views (...) about what is involved in understanding, explanation, good reasoning, and about how we ought to do philosophy of science. (shrink)

This essay places Foucault's work into a philosophical context, recognizing that Foucault is difficult to place and demonstrates that Foucault remains in the Kantian tradition of philosophy, even if he sits at the margins of that tradition. For Kant, the forms of intuition—space and time—are the a priori conditions of the possibility of human experience and knowledge. For Foucault, the a priori conditions are political space and historical time. Foucault sees political space as central to understanding both the subject and (...) objects of medicine, psychiatry, and the social sciences. Through this analysis one can see that medicine's metaphysics is a metaphysics of efficient causation, where medicine's objects are subjected to mechanisms of efficient control. (shrink)

Guiding our response in this essay is our view that current efforts to demarcate the role of the clinical ethicist risk reducing its complex network of authorizations to sites of power and payment. In turn, the role becomes susceptible to various ideologies—individualisms, proceduralisms, secularisms—that further divide the body from the web of significances that matter to that body, where only she, the patient, is located. The security of policy, standards, and employment will pull against and eventually sever the authorization secured (...) by authentic moral inquiry. Instead of asking “What do I need to know?”, the question animating the drive to standardize will be “What is the policy or standard?” The claims of the authors in this issue of HEC Forum confirm these suspicions. (shrink)

In the mid-1970s, the biomedical model of medicine gave way to the biopsychosocial model of medicine; it was billed as a more comprehensive and compassionate model of medicine. After more than a century of disentangling medicine from religion, the medicine and spirituality movement is attempting to bring religion and spirituality back into medicine. It is doing so under a biopsychosociospiritual model. I unpack one model for allowing religion back into medicine called the RCOPE. RCOPE is an instrument designed to categorize (...) religion and spirituality as psychological coping mechanisms. I explore how such instruments are related to the history of statistical measurement and demonstrate the political impetus that governs such enterprises. The biopsychosociospiritual medicine is billed as a more holistic and comprehensive model. This new model of medicine offers total care. However, I demonstrate how this total care becomes totalizing, indeed totalitarian, admitting religion and spirituality back into the fold of medicine under a new secularized medical control. (shrink)

Humanity does not gradually progress from combat to combat until it arrives at universal reciprocity, where the rule of law finally replaces warfare; humanity installs each of its violences in a system of rules and thus proceeds from domination to domination. (Foucault, 1984, 85)In this essay, I take a note from Michel Foucault regarding the notion of biopolitics. For Foucault, biopolitics has both repressive and constitutive properties. Foucault's claim is that with the rise of modern government, the state became exceedingly (...) concerned about the body politic, the bodies that make up the polis, including the health of those bodies. However, Giorgio Agamben claims that Foucault and all western political philosophy misses the relationship between power and Sovereignty, with disastrous results and totalizing tendencies. I explore the case of Terri Schiavo claiming that the social conservatives have attempted to politicize bare life in its legal maneuverings, but I also show how the social liberals open an uncontrollable space between life and death. Both the left and the right miss the aporia at the heart of western political philosophy, and bioethics is complicit in the totalizing effects of contemporary medicine. (shrink)

Strategic Reliabilism is a framework that yields relative epistemic evaluations of belief-producing cognitive processes. It is a theory of cognitive excellence, or more colloquially, a theory of reasoning excellence (where 'reasoning' is understood very broadly as any sort of cognitive process for coming to judgments or beliefs). First introduced in our book, Epistemology and the Psychology of Human Judgment (henceforth EPHJ), the basic idea behind SR is that epistemically excellent reasoning is efficient reasoning that leads in a robustly reliable fashion (...) to significant, true beliefs. It differs from most contemporary epistemological theories in two ways. First, it is not a theory of justification or knowledge – a theory of epistemically worthy belief. Strategic Reliabilism is a theory of epistemically worthy ways of forming beliefs. And second, Strategic Reliabilism does not attempt to account for an epistemological property that is assumed to be faithfully reflected in the epistemic judgments and intuitions of philosophers. If SR makes recommendations that accord with our reflective epistemic judgments and intuitions, great. If not, then so much the worse for our reflective epistemic judgments and intuitions. (shrink)

This article commemorates Jean Baudrillard’s career with an account of the consistency of his interventionist logic, the subtlety of his styles of argument and the prescience of his observations. It provides an account of Baudrillard’s sustained engagement with the intensification of simulation that has increasingly codified trends in communications, technology politics, the social, the psychological and economics in the name of functionality. The consistency of Baudrillard’s arguments belies the many superficial judgements made about them, which were anyway often knowingly encouraged (...) by Baudrillard’s rhetorical strategies. (shrink)

In the fourteenth chapter of The Philosophy of Information, Luciano Floridi puts forth a criticism of ‘digital ontology’ as a step toward the articulation of an ‘informational structural realism’. Based on the claims made in the chapter, the present paper seeks to evaluate the distinctly Kantian scope of the chapter from a rather unconventional viewpoint: while in sympathy with the author’s doubts ‘against’ digital philosophy, we follow a different route. We turn our attention to the concept of construction as used (...) in the book with the hope of raising some additional questions that might contribute to a better understanding of what is at stake in Floridi’s experimental epistemological response to digital ontology. (shrink)

In this article we outline the ways in which questions of language have both revealed problems with conceptions of knowledge and suggested constructive ways of addressing those problems. Having examined the limitations of instrumental notions of language, we outline some alternatives, especially those developed from the middle of the 19th and throughout the 20th century. We locate forceful and influential philosophical interventions in the writings of Nietzsche and Heidegger and foundational revisions in the linguistics of Ferdinand de Saussure and his (...) structuralist inheritors. We also chart the parallel path of literary theory from Mallarmé through Blanchot and poststructuralism to deconstruction. We conclude, after making some observations about the politicization of language in the works of feminist and postcolonial theorists, with some remarks about how the question of language helps to problematize global knowledge. (shrink)

Recognition that it is both possible and important to teach secondary school students about bioethics issues and theory has grown slowly within the field of bioethics. In the late 1970s and 1980s, a few first-generation pioneers recognized the teaching and learning opportunities inherent in bioethics and obtained pilot grants to educate high school teachers about bioethics issues. In the 1990s and 2000s, second-generation efforts explored the possibilities of bioethics in secondary schools using a range of approaches, models, and funding sources. (...) A third generation of programs that are now emerging benefits from more stable funding and offers materials that may be accessed by teachers across a country or around the world; a number of these programs are endorsed by national entities. An historical overview of these efforts to teach bioethics in high schools highlights some essential steps that must be taken to meet the challenge of teaching bioethics in pre-college settings. (shrink)

Violence is spoken of in several senses but its most basic definition, as a force exerted by one thing on another, harbors serious problems, especially when it comes to a consideration of its source or cause. We begin this article by identifying some of the aporias of violence with reference to philosophical and religious discourses and then we go on to analyze how violence problematizes concepts of law and justice in world historical contexts. We examine several traditions including Indo-European mythology, (...) as well as Hindu, Taoist, and ancient Greek philosophy, before addressing the concept of violence in modern thought, as a revision of Christianity. We conclude with some discussion of epistemological violence and its critics. (shrink)

The purpose of this note is to redirect attention to some of the literary evidence that concerns the site of Apollo's temple on the Palatine. For this evidence has an irritating habit of refusing to confirm what would otherwise be irrefutable archaeological proof of the temple's site. It is now fashionable to identify the site of the temple with that occupied by the temple-core that was originally assigned to Iuppiter Victor on the south-west angle of the Palatine in the region (...) of the Scalae Caci, the Temple of Magna Mater, the Casa Romuli, and the so-called House of Liuia. This was, in the view of most scholars, Euander's citadel that Virgil calls Pallanteum and this must be the site of the Augustan buildings. Now the House of Liuia has been identified with apparent probability as the House of Augustus, and we know from literary evidence that the temple of Apollo, Augustus' private house, and the house decreed to him by the senate must have been in close proximity to each other. The temple-core on the south-west of the Palatine is of Augustan date and is built over the remains of houses of the late republic1 which appear to have been demolished for the purpose. If Liuia's House was the house of Augustus then Iuppiter Victor's temple must be assigned to Apollo. (shrink)

Summary Coursework is an integral part of the GCSE framework, valued for its motivational qualities and its curricular validity. It is a common perception, widely reported in the national press and educational media, that coursework can be held at least partly accountable for differential performances at GCSE; coursework, it is argued, advantages girls. This article reports on an analysis of data arising from a project which offered an opportunity to study current and post-GCSE students’ perceptions of coursework. The outcomes indicate (...) that, when categorised by their relative levels of attainment, girls’ and boys’ perceptions show limited evidence of homogeneity. In other words, to suggest that girls’ and boys’ perceptions of coursework are a function of gender is a gross over-simplification. Other factors are at play and further, more specific and tailored research is essential if we are to understand how best to optimise the benefits that are claimed for coursework. (shrink)

Compelled by recent public and politicized cases in which withdrawal of nutrition and hydration were at issue, this essay examines recent Church statements and argues that the distinction between private and public forms of human life is being lost. Effacing the distinction between the sphere of the home (oikos), where the maintenance of life (zoē) occurs, and the city (polis), where political and public life (bios) occurs, may have unforeseen and unwanted consequences. Through their well-intentioned efforts to preserve the sanctity (...) of life, certain bishops and the Congregation for the Doctrine of the Faith have unfortunately brought political considerations into the home, taking decision-making authority away from those most intimately related to the patient. Thus, the question of removing nutrition and hydration in the case of patients such as Schiavo and Englaro becomes politicized and abstract, in contrast with the Church's previous positions on the importance of proportionate means in the maintenance of life, local decision making, and its recognition of life as a penultimate end. (shrink)

Health Savings Accounts have been marginalized in the West. In Singapore, however, they are foundational to the financing of health care. In this brief essay, I shall begin to sketch a justification for Health Savings Accounts. The family has always been thought of as a mere prolegomena to the polis and to be primarily about securing the goods of material life: food, shelter, intimacy. I shall first explore the recent scientific literature on the communal nature of human thriving and follow (...) it with a phenomenological account of human dependency. I shall claim that in securing the material means to sustain life, the family is also involved in the creation of the life-world of the child. That means that the bare necessities of life met in families are not merely about sustaining bodily life but are also part of the meaning-making aspects of life. The family then should have recourse to the material means of life-and-death decisions, because it is in these life-and-death decisions that the families’ life-world of values is to be deployed. (shrink)

A person making normative judgments can do so from the perspective of a Judge or a Coach. If you're a Judge, you seek to assign responsibility. If you're a Coach, you seek to improve an agent's performance. While there is a place for being sometimes a Judge and sometimes a Coach, no one should always be a Judge. It is a small and mean person who only wags a finger and never lends a hand. The same is true for a (...) normative discipline like epistemology. A good coach gives useful advice. Advice is useful when it suggests that you modify something you can directly control. And because we are typically unable to directly control our beliefs, a good epistemological coach will have no use for a theory that tells us what an epistemologically good belief is, such as a theory of knowledge or justification. But we are capable of changing many of the ways we reason about the world. Otherwise, what's an education good for? And so a good epistemological coach needs a theory of what makes reasoning epistemically good. What sort of theory of good reasoning would a good epistemological coach employ in order to provide useful guidance for real people? We argue for a middle path between a pure reliablist theory of good reasoning and a pure pragmatic theory of good reasoning. The best theory for an epistemological coach, the theory that will yield the most effective advice, is a mongrel theory that identifies good reasoning with reasoning that achieves an adroit combination of reliabilist accuracy and pragmatic efficiency. (shrink)

(No abstract is available for this citation).

The article examines the distinction between the state of emergency and the normal state and an inherent undecidability at the base of the distinction. We argue that states of emergency arise from strategic sovereign decisions to divide visible from invisible, enemy from ally, underground economy from above-ground, illegitimate war from legitimate war. The capacity to so divide is manifested, for instance, in the technology of air raid sirens in a way that indicates the momentum of the technicity that covertly underlies (...) sovereign power. The article, furthermore, shows how the distinction between the visible and the invisible can serve as a mystification, perpetuating the state of emergency by disguising the intrinsic connection between the two domains. (shrink)

The purpose of this note is to redirect attention to some of the literary evidence that concerns the site of Apollo's temple on the Palatine. For this evidence has an irritating habit of refusing to confirm what would otherwise be irrefutable archaeological proof of the temple's site. It is now fashionable to identify the site of the temple with that occupied by the temple-core that was originally assigned to Iuppiter Victor on the south-west angle of the Palatine in the region (...) of the Scalae Caci, the Temple of Magna Mater, the Casa Romuli, and the so-called House of Liuia. This was, in the view of most scholars, Euander's citadel that Virgil calls Pallanteum and this must be the site of the Augustan buildings. Now the House of Liuia has been identified with apparent probability as the House of Augustus, and we know from literary evidence that the temple of Apollo, Augustus' private house, and the house decreed to him by the senate must have been in close proximity to each other. The temple-core on the south-west of the Palatine is of Augustan date and is built over the remains of houses of the late republic1 which appear to have been demolished for the purpose. If Liuia's House was the house of Augustus then Iuppiter Victor's temple must be assigned to Apollo. (shrink)

Professor Richmond's reply t o m y article on Palatine Apollo is argued with his usual enthusiasm and cogency. This reply to him, which has been delayed by my departure for Australia, must begin with an expression of the respect that I feel for an antagonist far more able and experienced than I can claim to be. Indeed, it was while lecturing on Ovid, Tristia 3 that I first met Professor Richmond's masterly article on the Augustan Palatium . From this (...) article my enthusiasm for the subject began, and I know that Professor Richmond has always welcomed discussion and argument about the famous Augustan temple of Apollo on the Palatine. I can but join him in urging any who may have been interested by our discussion to study his original article which contains much more besides a discussion of the site of Apollo's temple. (shrink)

Professor Richmond's reply t o m y article on Palatine Apollo is argued with his usual enthusiasm and cogency. This reply to him, which has been delayed by my departure for Australia, must begin with an expression of the respect that I feel for an antagonist far more able and experienced than I can claim to be. Indeed, it was while lecturing on Ovid, Tristia 3 that I first met Professor Richmond's masterly article on the Augustan Palatium. From this article (...) my enthusiasm for the subject began, and I know that Professor Richmond has always welcomed discussion and argument about the famous Augustan temple of Apollo on the Palatine. I can but join him in urging any who may have been interested by our discussion to study his original article which contains much more besides a discussion of the site of Apollo's temple. (shrink)