Background: Demand for organisational ethics capacity is growing in health organisations, particularly among managers. The role of clinical ethicists in, and perspective on, organisational ethics has not been well described or documented in the literature. Objective: To describe clinical ethicists’ perspectives on organisational ethics issues in their hospitals, their institutional role in relation to organisational ethics, and their perceived effectiveness in helping to address organisational ethics issues. Design and Setting: Qualitative case study involving semi-structured interviews with 18 clinical ethicists across (...) 13 health organisations in Toronto, Canada. Results: From the clinical ethicists’ perspective, the most pressing organisational ethics issues in their organisations are: resource allocation, staff moral distress linked to the organisation’s moral climate, conflicts of interest, and clinical issues with a significant organisational dimension. Clinical ethicists were consulted in particular on issues related to staff moral distress and clinical issues with an organisational dimension. Some ethicists described being increasingly consulted on resource allocation, conflicts of interest, and other corporate decisions. Many clinical ethicists felt they lacked sufficient knowledge and understanding of organisational decision-making processes, training in organisational ethics, and access to organisational ethics tools to deal effectively with the increasing demand for organisational ethics support. Conclusion: Growing demand for organisational ethics expertise in healthcare institutions is reshaping the role of clinical ethicists. Effectiveness in organisational ethics entails a re-evaluation of clinical ethics training to include capacity building in organisational ethics and organisational decision-making processes as a complement to traditional clinical ethics education. (shrink)
The Ontology for Biomedical Investigations (OBI) is an ontology that provides terms with precisely defined meanings to describe all aspects of how investigations in the biological and medical domains are conducted. OBI re-uses ontologies that provide a representation of biomedical knowledge from the Open Biological and Biomedical Ontologies (OBO) project and adds the ability to describe how this knowledge was derived. We here describe the state of OBI and several applications that are using it, such as adding semantic expressivity to (...) existing databases, building data entry forms, and enabling interoperability between knowledge resources. OBI covers all phases of the investigation process, such as planning, execution and reporting. It represents information and material entities that participate in these processes, as well as roles and functions. Prior to OBI, it was not possible to use a single internally consistent resource that could be applied to multiple types of experiments for these applications. OBI has made this possible by creating terms for entities involved in biological and medical investigations and by importing parts of other biomedical ontologies such as GO, Chemical Entities of Biological Interest (ChEBI) and Phenotype Attribute and Trait Ontology (PATO) without altering their meaning. OBI is being used in a wide range of projects covering genomics, multi-omics, immunology, and catalogs of services. OBI has also spawned other ontologies (Information Artifact Ontology) and methods for importing parts of ontologies (Minimum information to reference an external ontology term (MIREOT)). The OBI project is an open cross-disciplinary collaborative effort, encompassing multiple research communities from around the globe. To date, OBI has created 2366 classes and 40 relations along with textual and formal definitions. The OBI Consortium maintains a web resource providing details on the people, policies, and issues being addressed in association with OBI. (shrink)
Introduction: Variation across research ethics boards in conditions placed on access to medical records for research purposes raises concerns around negative impacts on research quality and on human subject protection, including privacy.Aim: To study variation in REB consent requirements for retrospective chart review and who may have access to the medical record for data abstraction.Methods: Thirty 90-min face-to-face interviews were conducted with REB chairs and administrators affiliated with faculties of medicine in Canadian universities, using structured questions around a case study (...) with open-ended responses. Interviews were recorded, transcribed and coded manually.Results: Fourteen sites required individual patient consent for the study to proceed as proposed. Three indicated that their response would depend on how potentially identifying variables would be managed. Eleven sites did not require consent. Two suggested a notification and opt-out process. Most stated that consent would be required if identifiable information was being abstracted from the record. Among those not requiring consent, there was substantial variation in recognising that the abstracted information could potentially indirectly re-identify individuals. Concern over access to medical records by an outside individual was also associated with requirement for consent. Eighteen sites required full committee review. Sixteen allowed an external research assistant to abstract information from the health record.Conclusions: Large variation was found across sites in the requirement for consent for research involving access to medical records. REBs need training in best practices for protecting privacy and confidentiality in health research. A forum for REB chairs to confidentially share concerns and decisions about specific studies could also reduce variation in decisions. (shrink)
A collection of personal narratives and essays, Living Professionalism is designed to help medical students and residents understand and internalize various aspects of professionalism. These essays are meant for personal reflection and above all, for thoughtful discussion with mentors, with peers, with others throughout the health care provider community who care about acting professionally.
Chris Tucker's paper on the hiddenness argument seeks to turn aside a way of defending the latter which he calls the value argument. But the value argument can withstand Tucker's criticisms. In any case, an alternative argument capable of doing the same job is suggested by his own emphasis on free will.
Mark McCreary has argued that I cannot consistently advance both the hiddenness argument and certain arguments for religious scepticism found in my book The Wisdom to Doubt . This reaction was expected, and in WD I explained its shortsightedness in that context. First, I noted how in Part III of WD , where theism is addressed, my principal aim is not to prove atheism but to show theists that they are not immune from the scepticism defended in Parts I and (...) II. To the success of this aim, McCreary's arguments are not so much as relevant, for a thoroughgoing scepticism embracing even the hiddenness argument is quite compatible with its success. But I also explained how someone convinced that the hiddenness argument does prove atheism escapes the grip of religious scepticism because of that argument's reliance on apparent conceptual truths. McCreary's critique obscures this point but does not defuse it. (shrink)
Amongst Kant's lesser known early writings is a short treatise with the curious title Dreams of a Spirit-Seer Explained by Dreams of Metaphysics , in which, with considerable acumen and brilliance, and not a little irony, Kant exposes the empty pretensions of his contemporary, the Swedish visionary and Biblical exegete, Emanuel Swedenborg, to have access to a spirit world, denied other mortals. Despite his efforts, it must be feared, however, that Kant did not, alas, succeed in laying the spirit of (...) Swedenborg himself to rest once and for all, for there has arisen in our own day, and within philosophy itself, a movement of thought, if such it can be called, which, like that of Swedenborg, is founded upon an unbridled and unhealthy exercise of the imagination, and apparently believes that philosophical problems can be discussed and resolved by the elaboration of fantastical, and at times repulsive, examples; if we require a name for this contemporary pretence at philosophy, we could take as our model the Italian word for science fiction, fantascienza , and call it ‘fantaphilosophy’: it is my aim to show that this fantaphilosophy is a phantom philosophy. (shrink)
Analytical philosophers, if they are true to their training, never forget the first lesson of analytical philosophy: philosophers have no moral authority. In so far as analytical philosophers believe this, they find it easy to live with. For them even to assert, let alone successfully lay claim to, moral authority would require, first, hard work of some non-analytical and probably mistaken kind and, secondly, personality traits of leadership or confidence or even charisma, which philosophers may accidentally have but which they (...) are certainly not trained to have and had better not rely upon, while they live by analytical standards. Yet a further reason why analytical philosophers find the denial of their moral authority easy to accept is that they never forget the second lesson of analytical philosophy, either: nobody else has any moral authority. (shrink)
The influence of J. L. Austin on contemporary philosophy was substantial during his lifetime, and has grown greatly since his death, at the height of his powers, in 1960. Philosophical Papers, first published in 1961, was the first of three volumes of Austin's work to be edited by J. O. Urmson and G. J. Warnock. Together with Sense and Sensibilia and How to do things with Words, it has extended Austin's influence far beyond the circle who knew him or read (...) the handful of papers he published in journals. (shrink)
William Alston's Perceiving God: The Epistemology of Religious Experience is a most significant contribution to the philosophy of religion. The product of 50 years' reflection on its topic , this work provides a very thorough explication and defence of what Alston calls the ‘mystical perceptual practice’ – the practice of forming beliefs about the Ultimate on the basis of putative ‘direct experiential awareness’ thereof . Alston argues, in particular, for the rationality of engaging in the Christian form of MP . (...) On his view, those who participate in CMP are justified in forming beliefs as they do because their practice is ‘socially established’, has a ‘functioning overrider system’ and a ‘significant degree of self-support’; and because of the ‘lack of sufficient reasons to take the practice as unreliable’. (shrink)
This book is the one to put into the hands of those who have been over-impressed by Austin 's critics....[Warnock's] brilliant editing puts everybody who is concerned with philosophical problems in his debt.
There are doubtless many with personal experience of suffering, or of comforting others in distress, who would agree with Milton thus far that philosophic argument is powerless to satisfy those who in their anguish ask the question ‘Why did it happen to me?’ Yet to think so is to underestimate both the necessity and the power of reason: clarity of mind and the disposition to argue are commonly enhanced rather than diminished by suffering; and if reason is an essential part (...) of man's nature, it should serve him, if anywhere, in the trials of life. We have every justification, therefore, despite common opinion, for seeking a rational answer to the question proposed. It must, however, be admitted at the outset that there is no direct answer to the question which can both withstand critical scrutiny and bring genuine comfort to the afflicted, an answer, that is, which accepts the question as it stands with its attendant presuppositions; but there is an indirect answer, which, precisely by rejecting one or more of these presuppositions and restating the question, can indeed satisfy these two requirements. Before such an answer can be outlined, however, the question in its traditional form must be examined and the traditional answers to it critically reviewed. (shrink)
Common sense is on the one hand a certain set of processes of natural cognition – of speaking, reasoning, seeing, and so on. On the other hand common sense is a system of beliefs (of folk physics, folk psychology and so on). Over against both of these is the world of common sense, the world of objects to which the processes of natural cognition and the corresponding belief-contents standardly relate. What are the structures of this world? How does the scientific (...) treatment of this world relate to traditional and contemporary metaphysics and formal ontology? Can we embrace a thesis of common-sense realism to the effect that the world of common sense exists uniquely? Or must we adopt instead a position of cultural relativism which would assign distinct worlds of common sense to each group and epoch? The present paper draws on recent work in computer science (especially in the fields of naive and qualitative physics), in perceptual and developmental psychology, and in cognitive anthropology, in order to consider in a new light these and related questions and to draw conclusions for the methodology and philosophical foundations of the cognitive sciences. (shrink)
In many places and times, and for many people, God's existence has been rather less than a clear fact. According to the hiddenness argument, this is actually a reason to suppose that it is not a fact at all. The hiddenness argument is a new argument for atheism that has come to prominence in philosophy over the past two decades. J. L. Schellenberg first developed the argument in 1993, and this book offers a short and vigorous statement of its central (...) claims and ideas. Logically sharp but so clear that anyone can understand, the book addresses little-discussed issues such as why it took so long for hiddenness reasoning to emerge in philosophy, and how the hiddenness problem is distinct from the problem of evil. It concludes with the fascinating thought that retiring the last of the personal gods might leave us nearer the beginning of religion than the end. (shrink)
Aristotle is widely regarded as the greatest of all philosophers; indeed, he is traditionally referred to simply as `the philosopher'. Today, after more than two millennia, his arguments and ideas continue to stimulate philosophers and provoke them to controversy. In this book J.L. Ackrill conveys the force and excitement of Aristotle's philosophical investigations, thereby showing why contemporary philosophers still draw from him and return to him. He quotes extensively from Aristotle's works in his own notably clear English translation, and a (...) picture emerges of a lucid, lively, subtle and tough-minded thinker of astonishing range and penetration. Professor Ackrill identifies many striking connections between Aristotle's ideas and ideas in recent philosophy; he also raises philosophical questions of his own, and exemplifies the way in which Aristotle can still be argued with and learned from. (shrink)
J.L. Ackrill's work on Plato and Aristotle has had a considerable influence upon ancient philosophical studies in the late twentieth century. This volume collects the best of Ackrill's essays on the two greatest philosophers of antiquity. With philosophical acuity and philological expertise he examines a wide range of texts and topics--from ethics and logic to epistemology and metaphysics--that continue to be in the focus of debate.