The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit (...) for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received. (shrink)

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and (...) made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Jonathan Berg argues for the Theory of Direct Belief, which treats having a belief about an individual as an unmediated relation between the believer and the individual the belief is about. After a critical review of alternative positions, Berg uses Grice's theory of conversational implicature to provide a detailed pragmatic account of substitution failure in belief ascriptions and goes on to defend this view against objections, including those based on an unwarranted "Inner Speech" Picture of Thought. The work serves as (...) a case study in pragmatic explanation, dealing also with methodological issues about context-sensitivity in language and the relation between semantics and pragmatics. (shrink)

The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit (...) for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received. (shrink)

The computer revolution has had an enormous effect on all aspects of the practice of medicine, yet little thought has been given to the role of social media in identifying treatment choices for incompetent patients. We are currently living in the ?Internet age? and many people have integrated social media into all aspects of their lives. As use becomes more prevalent, and as users age, social media are more likely to be viewed as a source of information regarding medical care (...) preferences. This article explores the ethical and legal issues raised by the use of social media in surrogate decision making. (shrink)

This volume addresses the intriguing issue of indirect reports from an interdisciplinary perspective. The contributors include philosophers, theoretical linguists, socio-pragmaticians, and cognitive scientists. The book is divided into four sections following the provenance of the authors. Combining the voices from leading and emerging authors in the field, it offers a detailed picture of indirect reports in the world’s languages and their significance for theoretical linguistics. Building on the previous book on indirect reports in this series, this volume adds an empirical (...) and cross-linguistic approach that covers an impressive range of languages, such as Cantonese, Japanese, Hebrew, Persian, Dutch, Spanish, Catalan, Armenian, Italian, English, Hungarian, German, Rumanian, and Basque. (shrink)

The protection of human subjects in biomedical research relies on two principal mechanisms: assessing and comparing the risks and potential benefits of proposed research, and obtaining potential subjects' informed consent. While these have been discussed extensively in the literature, no attention has been paid to whether the processes should be different when the objective of an experimental biomedical intervention is to improve individual appearance, performance, or capability rather than to prevent, cure, or mitigate disease . This essay examines this question (...) in order to ensure that subjects in biomedical enhancement research receive adequate protection. (shrink)

There are two critical steps in determining whether a medical experiment involving human subjects can be conducted in an ethical manner: assessing risks and potential benefits and obtaining potential subjects’ informed consent. Although an extensive literature on both of these aspects exists, virtually nothing has been written about human experimentation for which the objective is not to prevent, cure, or mitigate a disease or condition, but to enhance human capabilities. One exception is a 2004 article by Rebecca Dresser on preimplantation (...) genetic modification — one of the most controversial enhancement technologies — in which she states, “Under existing research ethics principles, it would be unethical for investigators to perform modifications exposing embryos expected to develop into healthy children to significant risk in exchange for a possible physical or mental enhancement.” But Dresser does not explain why such an experiment would be unethical under existing principles, and her conclusion is not self-evident. (shrink)

We hypothesize that heritable epigenetic changes can affect rates of fitness increase as well as patterns of genotypic and phenotypic change during adaptation. In particular, we suggest that when natural selection acts on pure epigenetic variation in addition to genetic variation, populations adapt faster, and adaptive phenotypes can arise before any genetic changes. This may make it difficult to reconcile the timing of adaptive events detected using conventional population genetics tools based on DNA sequence data with environmental drivers of adaptation, (...) such as changes in climate. Epigenetic modifications are frequently associated with somatic cell differentiation, but recently epigenetic changes have been found that can be transmitted over many generations. Here, we show how the interplay of these heritable epigenetic changes with genetic changes can affect adaptive evolution, and how epigenetic changes affect the signature of selection in the genetic record. (shrink)

The United States, along with other nations and international organizations, has developed an elaborate system of ethical norms and legal rules to govern biomedical research using human subjects. These policies govern research that might provide direct health benefits to participants and research in which there is no prospect for participant health benefits. There has been little discussion, however, about how well these rules would apply to research designed to improve participants’ capabilities or characteristics beyond the goal of good health. When (...) mentioned at all in the literature, this so-called enhancement research, as opposed to research aimed at diagnosing, preventing, curing, or treating illnesses or medical conditions, is usually dismissed without explanation. (shrink)

When science takes man as its subject, tensions arise between two values basic to Western society: freedom of scientific inquiry and protection of individual inviolability.... At the heart of this conflict lies an age-old question: When may a society, actively or by acquiescence, expose some of its members to harm in order to seek benefits for them, for others, or for society as a whole?

When science takes man as its subject, tensions arise between two values basic to Western society: freedom of scientific inquiry and protection of individual inviolability.... At the heart of this conflict lies an age-old question: When may a society, actively or by acquiescence, expose some of its members to harm in order to seek benefits for them, for others, or for society as a whole?

It is shown how the discussion of the semantics of sentences attributing belief, central to the philosophy of language since Frege, may benefit from consideration of pragmatic features of the context of utterance. ;The dissertation begins with a historical introduction to the problem of substitutivity in belief contexts. Traditional solutions advanced by Frege, Russell, and Carnap are reviewed, along with traditional objections to such solutions. It is then suggested that the traditional Quinian approach of declaring belief ascriptions semantically ambiguous might (...) be avoided by appeal to pragmatic considerations. ;Radically divergent appeals to pragmatics are discussed. It is suggested, on one hand, how theories of reference associated with philosophers such as Kripke and Kaplan can benefit from pragmatic analysis, as it is demonstrated that substitution failure in belief ascriptions may be due to pragmatic rather than semantical factors. This is argued for in three ways: it is shown how the result of unacceptable substitution may be pragmatically ambiguous, insufficiently informative, or simply misleading. ;It is also suggested, on the other hand, how some followers of Frege may similarly argue that substitution success may be due to pragmatic rather than semantical factors. That is, it is shown how those who maintain that substitution in belief contexts is not truth-preserving and, roughly, that a sentence attributing a belief to someone is true only if the person would assent to it, can argue that our occasional inclination to accept a belief report to which the believer would not assent may be due to features of the sentence's utterance, rather than its truth conditions. ;After brief speculation on the ramifications of these pragmatic analyses for the semantics of belief, there is a discussion of the principle methodological issues raised by pragmatic analyses, with special attention to the distinction between pragmatic import and semantical meaning. Further discussion of pragmatics comes in the appendix, containing a critical review of various conceptions of pragmatics and of Grice's theory of conversation. (shrink)

Jerry Fodor and Ernie LePore argue against inferential role semantics on the grounds that either it relies on an analytic/synthetic distinction vulnerable to Quinean objections, or else it leads to a variety of meaning holism frought with absurd consequences. However, the slide from semantic atomism to meaning holism might be prevented by distinctions not affected by Quine's arguments against analyticity; and the absurd consequences Fodor and LePore attribute to meaning holism obtain only on an implausible construal of inferential roles.

The application of semantical concepts such as synonymy and interpretation to actual situations of usage gives rise to perplexing problems. One of the few attempts to tackle these problems has been carried out by Arne Naess. Further advances along this line may become possible after a clarification of the basic concepts employed. The discussion centers around empirical synonymy and certain other notions built on this concept by Naess. Possible ways of making the system coherent are indicated.

SummaryThe apparent conflict between first person authority and externalism arises only from needlessly thinking of first person authority in terms of “knowing what.”.

This is a presentation of Bolzano's ideas on logic, logical semantics, ontology, proof theory, the foundations of mathematics, and certain aspects of the philosophy of nature. Bolzano's world view was a universal one in the sense that philosophy, mathematics, physics, and metaphysics should build upon the same logical foundation. In the pursuit of this encyclopaedic point of view he already recognized many of the essential things to come in logic and the foundations of mathematics.

Jerry Fodor and Ernie LePore argue against inferential role semantics on the grounds that either it relies on an analytic/synthetic distinction vulnerable to Quinean objections, or else it leads to a variety of meaning holism frought with absurd consequences. However, the slide from semantic atomism to meaning holism might be prevented by distinctions not affected by Quine's arguments against analyticity; and the absurd consequences Fodor and LePore attribute to meaning holism obtain only on an implausible construal of inferential roles.

Jerry Fodor and Ernie LePore argue against inferential role semantics on the grounds that either it relies on an analytic/synthetic distinction vulnerable to Quinean objections, or else it leads to a variety of meaning holism frought with absurd consequences. However, the slide from semantic atomism to meaning holism might be prevented by distinctions not affected by Quine's arguments against analyticity; and the absurd consequences Fodor and LePore attribute to meaning holism obtain only on an implausible construal of inferential roles.

Advocates for the professionalization of clinical bioethics argue that bioethics professionals play an important role in contemporary medicine and patient care, especially when addressing complex ethical questions that arise in the delivery of reproductive medicine. For bioethics consultants to serve effectively, they need adequate training in the medical and ethical issues that patients and clinicians will face, and they need skills to facilitate effective dialog among all parties. Because clinical ethics consultation is a “high‐stakes endeavor” that can acutely affect patient (...) care, efforts are under way to ensure that bioethics consultants have the competence to provide such guidance. Yet to date, no studies have examined whether the training of bioethics consultants meets the needs of health care professionals who are on the front lines of such issues. In fact, limited information is available on the reproductive health issues that bioethics training programs address or the degree to which these programs meet the needs of patients confronting reproductive health decisions and their clinicians. It is therefore important to answer this key question: What are the primary ethical issues encountered in reproductive medicine that currently affect patient care? Equally important, are bioethics training programs prepared to address those issues?To begin to answer these questions, we conducted parallel surveys of directors of graduate bioethics training programs and obstetrician‐gynecologists. The goal of this project is to lay the groundwork to establish a working partnership between bioethics educators and reproductive medicine practitioners to address the often troubling and frequently complex ethical issues in reproductive medicine. (shrink)

The American Journal of Bioethics, Volume 12, Issue 10, Page W1-W2, October 2012.

In the third chapter of LOT 2—"LOT Meets Frege's Problem "—Jerry Fodor argues that LOT provides a solution to "Frege's Problem," as well as to Kripke's Paderewski puzzle . I argue that most of what Fodor says in his discussion of Frege's problem is mistaken.