Donation after circulatory determination of death (DCDD) is an accepted practice in the United States, but heart procurement under these circumstances has been debated. Although the practice is experiencing a resurgence due to the recently completed trials using ex vivo perfusion systems, interest in thoracoabdominal normothermic regional perfusion (TA-NRP), wherein the organs are reanimated in situ prior to procurement, has raised many ethical questions. We outline practical, ethical, and equity considerations to ensure transplant programs make well-informed decisions about TA-NRP. We (...) present a multidisciplinary analysis of the relevant ethical issues arising from DCDD-NRP heart procurement, including application of the Dead Donor Rule and the Uniform Definition of Death Act, and provide recommendations to facilitate ethical analysis and input from all interested parties. We also recommend informed consent, as distinct from typical “authorization,” for cadaveric organ donation using TA-NRP. (shrink)

The purpose of this article is to investigate how cultural meanings associated with the left ventricular assist device inform acceptance and experience of this innovative technology when it is used as a destination therapy. We conducted open-ended, semistructured interviews with family caregivers and patients who had undergone LVAD-DT procedures at six U.S. hospitals. A grounded theory approach was used for the analysis. Thirty-nine patients and 42 caregivers participated. Participants described a sense of obligation to undergo the procedure because of its (...) promise for salvation. However, once the device was implanted, patients described being placed into a liminal state of being neither sick nor healthy, with no culturally scripted role. Consideration of end-of-life decisions was complicated by the uncertainties about how patients with LVADs die. Pre-implantation communications among patient, family, and clinicians should take into account the impact of the technology on meaning, identity, and patient experience. (shrink)

Generic sentences involving phrasal conjunctions present a prima facie problem for the standard theory of generics according to which they express quasi-universal generalisations about what is characteristic for members of a particular kind. For example, the sentence ‘Elephants live in Africa and Asia’ is true, even though it is uncharacteristic for an elephant to live in both Africa and Asia. In response to this problem, theorists have recently proposed radical departures from the standard view. This paper argues that such departures (...) are unwarranted: not only do they fail to fully accommodate the data involving generic conjunctions, their scope is overly narrow, since the phenomena in question also arise in non-generic contexts. I propose a new theory of generics that aims to account for generic conjunctions in a principled manner and which sheds new light on the mereological commitments of natural language. (shrink)

ABSTRACTThis article explores the relationship between the operation of combat drones and the martial virtue courage. The article proceeds in three parts. Part one develops a brief account of virtue generally, and the martial virtue courage in particular. Part two discusses why critics suggest that drone operation does not fit the orthodox conceptualization of courage and, in some instances, even erodes the virtue. Part three explores how these criticisms are flawed. This section of the paper goes on to argue that (...) the criticisms are predicated on a twofold misunderstanding. The first involves improperly truncated conceptualizations of courage, which are, in part, predicated upon a narrow definition of risk. From this narrow definition of risk springs the conclusion that drone operation must be riskless. The second misunderstanding follows from the first and involves the failure to grasp properly how courage can be cultivated and required in drone operation. The paper concludes with a discussion of how, pr.. (shrink)

There is a standard quantificational view of generic sentences according to which they have a tripartite logical form involving a phonologically null generic operator called 'Gen'. Recently, a number of theorists have questioned the standard view and revived a competing proposal according to which generics involve the predication of properties to kinds. This paper offers a novel argument against the kind-predication approach on the basis of the invalidity of Generic Excluded Middle, a principle according to which any sentence of the (...) form ⌜Either Fs are G or Fs are not G⌝ is true. I argue that the kind-predication approach erroneously predicts that GEM is valid, and that it can only avoid this conclusion by either collapsing into a form of the quantificational analysis or otherwise garnering unpalatable metaphysical commitments. I also show that, while the quantificational approach does not validate GEM as a matter of logical form, the principle may be validated on certain semantic analyses of the generic operator, and so, such theories should be rejected. (shrink)

John Broome argues that fairness requires that claims are satisfied in proportion to their strength. Broome holds that, when distributing indivisible goods, fairness requires the use of weighted lotteries as a surrogate to satisfy proportionally each candidate's claims. In this article, we present two arguments against Broome's account of fairness. First, we argue that it is almost impossible to calculate the weights of the lotteries in accordance with the requirements of fairness. Second, we argue that Broome rules out those methods (...) whose use might provide some resolution to this problem. From these arguments, we conclude that, contra Broome, fairness does not require the proportional satisfaction of claims. (shrink)

Kevin Dorst has recently pointed out an apparently puzzling consequence of denying epistemic luminosity: given some natural-sounding bridging principles between knowledge, credence, and indicative conditionals, the denial of epistemic luminosity licenses the knowledge and assertability of abominable-sounding conditionals of the form ⌜If I don’t know that ϕ, then ϕ⌝. We provide a general and systematic examination of this datum by testing Dorst’s claim against various semantics for the indicative conditional in the setting of epistemic logic. Our conclusion is that, regardless (...) of whether knowledge is luminous, the knowability of these conditionals is highly sensitive to the correct semantic analysis of the indicative conditional. Moreover, standard pragmatic resources can explain away the infelicity of such assertions. As it stands, the datum does not tell against epistemic non-luminosity. (shrink)

It is a familiar point that we can use generic sentences to express generalisations that are tolerant to exceptions and then go on to state those exceptions explicitly. It is a less familiar point that switching the order of the generics has deleterious effects on their felicity. For example, the sequences ‘Ravens are black, but albino ravens aren’t’ is perfectly felicitous and judged to be true, whereas its reverse ‘Albino ravens aren’t black, but ravens are’ is infelicitous and contradictory-sounding. This (...) paper argues that such sequences pose a problem for extant theories of generics: while they have no trouble predicting the felicity of the first sequence of generics, they are unable to explain why reversing the order results in infelicity. I propose to account for these observations by adopting a dynamic semantic theory of generic sentences. (shrink)

Several recent works in political theory argue that exit, rather than being a coward’s choice, is a potent mode of resistance that is particularly well suited to the current political era. These works reclaim exit, seeing it as a method of political opposition. While innovative and illuminating, these accounts are limited because they tend to treat all exits as resistance, regardless of context or content, and they are inclined to over-saturate exit with oppositional political meaning. I argue that resistant exit (...) should be more narrowly defined. By examining a range of empirical cases, I identify and explore three distinctive characteristics of this particular type of opposition. In addition to clarifying a recently developed idea in current scholarship, this article provides a systematic way for scholars to understand and interpret the intersection between resistance and exit. (shrink)

The ethical obligation to provide a reasonably safe discharge option from the inpatient setting is often confounded by the context of homelessness. Living without the security of stable housing is a known determinant of poor health, often complicating the safety of discharge and causing unnecessary readmission. But clinicians do not have significant control over unjust distributions of resources or inadequate societal investment in social services. While physicians may stretch inpatient stays beyond acute care need in the interest of their patients (...) who are experiencing homelessness, they must also consider the implications of using an inpatient hospital bed for someone without the attendant level of medical need. Caring for patients in an inpatient setting when they no longer require acute care means fewer beds for acute care patients. And when a patient who is experiencing homelessness declines a medically safer option such as a skilled nursing facility, then clinicians may be faced with the sole option of discharge to the street, which raises troubling questions of nonmaleficence and social justice. Here we investigate the different forms of injustice that play out when patients are discharged to the street, and offer a map of the interwoven ethical responsibilities of clinicians, hospitals, and skilled nursing facilities. (shrink)

Of late, resistance has become a central notion in political theory, standing at the heart of attempts to respond to the dilemmas of contemporary times. However, many accounts tend to ascribe to an idealised, heroic view. In this view, resistance represents a clearcut action against injustice and stems from individuals’ conscious choice and their unwavering ethical commitment to the cause. Some liberal scholars, most notably Candice Delmas and Jason Brennan, have argued that citizens of democratic societies have a moral duty (...) to resist state-sanctioned injustice. This resistance occurs either through ‘principled – civil or uncivil – disobedience’ or through ‘defensive actions’. While acknowledging that pervasive injustice can compromise our cognitive and moral capacities, however, their articulation of our political obligation to resist refrains from a sustained examination of the moral dilemmas, uncertainties and risks that arise when fighting systemic oppression. (shrink)

It has been argued that the primary acquisition of genericity in early child speech poses a problem for standard quantificational approaches to generics and instead motivates the claim that generics give voice to an innate, default mode of generalising. This article argues that analogous puzzles involving the acquisition of A‐quantifiers undermine the empirical support for a purely cognition‐based approach to generics. Instead, these acquisition puzzles should be solved by generalising the core insight of the cognitive defaults theory to these expressions, (...) reconciling formal semantic approaches with the role that cognitive development plays on lexical competence. (shrink)

It is said there are only two things in life that are certain: death and taxes … maybe only taxes.

A prevailing theme of the scholarship on Plato’s Crito has been civil disobedience, with many scholars agreeing that the Athenian Laws do not demand a slavish, authoritarian kind of obedience. While this focus on civil disobedience has yielded consensus, it has left another issue in the text relatively unexplored—that is, the challenges and attractions of leaving one’s homeland or of “exit.” Reading for exit reveals two fundamental, yet contradictory, desires in the Crito: a yearning to escape the injustice of the (...) homeland for self-preservation and freedom and a deep-seated need to honor one’s obligations and attachments to the homeland. By exposing the conflicted nature of leaving one’s native land, Plato’s Crito enriches an understanding of the meaning and consequences of an exit for the individual. (shrink)

The purpose of this paper is to present the essence of Ayn Rand's theory of rational egoism and to indicate how it is the only ethical theory that can provide a foundation for ethics in business. Justice, however, cannot be done to the breadth and depth of Rand's theory in so short a space as this article; consequently, I have provided the reader with a large number of references for further study. At minimum, Ayn Rand's theory, because of its originality (...) and challenge to establishment theories, should be included in all business ethics courses and discussions of business ethics. (shrink)

Though many argue over root causes, few dispute the existence of gender disparities across our societal landscape. Patriarchal norms consistently obstruct the flourishing of those who identify themselves as women, those who are identified by others as women, and generally those who gender-identify in ways that challenge the norms of heterosexual cis-gender male privilege. Acknowledging the limits of our analysis, here we focus on some of the disparities faced by women in particular.1 From the persistent wage gap despite women's steadily (...) increasing participation in the workforce, to the perplexing paucity of women occupying C-suite positions in business or tenured professorships in academia despite efforts to... (shrink)

This paper reevaluates Kaplan’s (Themes from Kaplan, Oxford University Press, Oxford, pp 481–563, 1989b) infamous ‘compulsive talker’ objection to Reichenbach’s (Elements of symbolic logic, AQ1 Macmillan, New York, 1947 ) token-reflexive theory of indexicals. It argues that Kaplan’s objection depends on the modal status of Reichenbachian tokens. On one interpretation, Kaplan’s objection stands. But on another, equally plausible interpretation, the following points hold: (i) Reichenbach’s theory effectively preempts contemporary discussion of rigid definite descriptions, (ii) Kaplan’s own analysis of indexicals in (...) terms of _dthat_-terms comes extremely close to Reichenbach’s own analysis, and (iii) Kaplan’s ‘compulsive talker’ objection should be rejected. (shrink)

As part of the roundtable, “Moral Injury, Trauma, and War,” this essay explores the relationship between revisionist just war theory and moral injury. It proceeds in four sections. First, it offers a brief overview of the just war tradition, focusing on traditionalist and revisionist accounts, respectively. Next, it explores the relationship between moral injury and armed conflict. Then, it explores the links between moral injury and revisionist accounts of just war theory. Finally, by way of conclusion, the essay signals two (...) potential complementary paths forward that future research could use to clarify the revisionist position and its link with moral injury. (shrink)

Philosophical Perspectives, Volume 35, Issue 1, Page 320-339, December 2021.

Sheldon S. Wolin's theory of fugitive democracy has been both lauded and criticized for its radical departure from the mainstays of democratic theory: formal institutions, political offices and constitutional arrangements of power. For Wolin, democracy is correctly understood as an ephemeral event that appears unexpectedly when ordinary citizens, united by a shared grievance, collectively interrupt normal political proceedings and reject constitutionalism. This article critically analyzes Wolin's theory in light of a historical phenomenon in which citizens collectively interrupted politics: frontier vigilantism (...) in the American West from 1850 to 1900. Critical of Wolin's wholesale rejection of constitutionalism, the article reveals the potentially legalistic patterns of extra-legal collective action, and it argues for de-fetishizing democratic practice that occurs outside of institutional channels. (shrink)

During the coronavirus disease 2019 (COVID‐19) pandemic, bioethical analyses often emphasized population health and societal benefit. Hospital policies frequently focused on reducing risk of transmitting SARS‐CoV‐2 by restricting visitors; requiring protective equipment; and screening staff, patients and visitors. While restrictions can be burdensome, they are often justified as essential measures to protect the whole population against a virus with high rates of transmission, morbidity and mortality. Yet communities are not monolithic, and the impacts of these restrictions affect different groups differently. (...) An ophthalmological unit outreach program in Ethiopia serves to illustrate. Pre‐operative screening policies were designed to protect as many patients as possible but had adverse impacts on underserved communities. As this case study demonstrates, creating hospital policies that truly serve the good of the society may require a more holistic review of impacts on inequitably positioned communities. (shrink)

Heart disease is the leading cause of death amongst adult Americans and has recently become a top killer worldwide. The direct costs of cardiovascular disease are projected to triple in the next 20 years, from $272.5 billion to $818.1 billion (Heidenreich et al. 2011). Although there has been a decreased incidence and prevalence of ischemic heart disease over the past several decades in the United States, heart failure remains a major cause of morbidity and mortality. In the United States, approximately (...) 500,000 to 700,000 new cases are identified each year (Lloyd-Jones et al. 2009). Heart failure is now the number one diagnosis leading to hospitalization. As such, it is an increasingly heavy economic burden on .. (shrink)

A retrospective essay on John MacCunn’s “Cosmopolitan Duties,” International Journal of Ethics, 1899.