The question whether epistemological concepts are closed under deduction is an important one since many skeptical arguments depend on closure. Such skepticism can be avoided if closure is not true of knowledge (or justification). This response to skepticism is rejected by Peter Klein and others. Klein argues that closure is true, and that far from providing the skeptic with a powerful weapon for undermining our knowledge, it provides a tool for attacking the skeptic directly. This paper examines various arguments in (...) favor of closure and Klein's attempted use of closure to refute skepticism. Such a refutation of skepticism is mistaken. But the closure principle is in any case false, so the skepticism that depends on it is undermined. The appeal of the closure principle derives from a failure to recognize an important feature of our epistemological concepts, namely, their context relativity. (shrink)

In another tumultuous term of the United States Supreme Court in 2022-2023 a series of critical cases implicate instant and forthcoming changes in multiple fronts that collectively shift the national public health law and policy environment.

In lieu of an abstract, here is a brief excerpt of the content:The Veterans Affairs National Center for Clinical EthicsJames L. Bernat (bio)The veterans health administration is the largest health care system in the United States and, indeed, is larger that the health care system of many foreign countries. In February 1991 the Department of Veterans Affairs (V.A.) in Washington, D.C. awarded a contract to the clinical ethics group at the Veterans Affairs Medical Center in White River Junction, Vermont (...) to establish the V.A. National Center for Clinical Ethics. In this article I describe the organizational context, mission, operation, and future direction of the Center, which William A. Nelson, Ph.D., and I co-direct.The Veterans Health AdministrationThe Department of Veterans Affairs operates 171 hospitals providing services ranging from primary, secondary, and tertiary medical care to psychiatric hospitals, rehabilitation centers, and nursing homes. The V.A. also provides outpatient services at all hospitals and at dozens of free-standing outpatent clinics. V.A. medical centers employ over 14,000 physicians and serve approximately 4.5 million veteran patients (Hollingsworth and Bondy 1990; Mirvis 1990).The V.A. serves an important educational function, providing training sites for medical students, postgraduate physicians, and trainees in other health-related fields. Approximately 78 percent of V.A. medical centers are affiliated with medical schools. Over one-third of all American medical students and over 40 percent of interns and residents spend a portion of their training in V.A. medical centers. More than 100,000 students in all health-related fields train in V.A. facilities annually (Hollingsworth and Bondy 1990).Research is another mission of the V.A. Many academic physicians and scientists derive their research and salary funding from V.A contracts and awards. The V.A. Research Career Development Program provides the means for many medical school faculty members to achieve successful careers as scientists and clinical investigators. Although research accounts for only slightly more than 1 percent of the V.A. medical budget, two V.A. researchers have been awarded the Nobel Prize (Hollingsworth and Bondy 1990). [End Page 385]In comparison to other medical care settings, the average V.A. patient is likely to be older, poorer, male, less well-educated, more chronically ill, and more expensive to care for. Many patients first patronize the V.A. system after they have been bankrupted by the costs of a major illness. Unlike young, healthy patients ideally favored by health maintenance organizations, these patients immediately require large expenditures for hospitalizations, medications, and other treatments. Additional burdens have been placed on V.A. facilities by a record of chronic federal underfunding over the past decade, despite expanded patient censuses at every facility.Bioethical issues arise in V.A. facilities with great frequency for several reasons. Older and poorer patients are often sicker, have fewer home-support resources, and have completed fewer advance directives for health care. Chronic operational underfunding requires explicit health care rationing systemwide. Academic physicians within the V.A. system have multiple professional duties that have the potential for conflict. Although their primary duty is to their patients, they also must serve the federal government and their medical school academic supervisors. The practice of medical care rationing pits the physician's professional duty to his patient against his duty to the system (Mirvis 1990).The V.A. has responded to these bioethical demands with several initiatives. Hospital ethics advisory committees have been developed in nearly every V.A. medical center. The V.A. National Bioethics Committee has been empaneled to encourage uniform policies across the V.A. system concerning bioethical issues. Most recently, funds were provided for the V.A. National Center for Clinical Ethics.Functions of the National Center for Clinical Ethics (NCCE)The NCCE has a fourfold mission: 1) to enhance the quality of clinical ethics programs at all 171 V.A. medical centers nationwide; 2) to staff the V.A. National Bioethics Committee; 3) to assist administrators and planners in the V.A. Central Office on policy development concerning bioethical issues; and 4) to study, organize, and coordinate clinical, educational, and research bioethics programs throughout the system.Enhancing the quality of clinical ethics programs at V.A. medical centers is largely an... (shrink)

Among the morass of critical issues impacting the results of the midterm elections in 2022 were core public health issues related to health care access, justice, and reforms. Collectively, voters’ communal health and safety concerns dominated outcomes in key races which may shape national, state, and local legal approaches to protecting the public’s health in the modern era.

The dominant paradigm of experiments in the social and behavioral sciences views an experiment as a test of a theory, where the theory is assumed to generalize beyond the experiment's specific conditions. According to this view, which Alan Newell once characterized as “playing twenty questions with nature,” theory is advanced one experiment at a time, and the integration of disparate findings is assumed to happen via the scientific publishing process. In this article, we argue that the process of integration is (...) at best inefficient, and at worst it does not, in fact, occur. We further show that the challenge of integration cannot be adequately addressed by recently proposed reforms that focus on the reliability and replicability of individual findings, nor simply by conducting more or larger experiments. Rather, the problem arises from the imprecise nature of social and behavioral theories and, consequently, a lack of commensurability across experiments conducted under different conditions. Therefore, researchers must fundamentally rethink how they design experiments and how the experiments relate to theory. We specifically describe an alternative framework, integrative experiment design, which intrinsically promotes commensurability and continuous integration of knowledge. In this paradigm, researchers explicitly map the design space of possible experiments associated with a given research question, embracing many potentially relevant theories rather than focusing on just one. Researchers then iteratively generate theories and test them with experiments explicitly sampled from the design space, allowing results to be integrated across experiments. Given recent methodological and technological developments, we conclude that this approach is feasible and would generate more-reliable, more-cumulative empirical and theoretical knowledge than the current paradigm – and with far greater efficiency. (shrink)

As the United States emerges from the worst public health threat it has ever experienced, the Supreme Court is poised to reconsider constitutional principles from bygone eras. Judicial proposals to roll back rights under a federalism infrastructure grounded in states’ interests threaten the nation’s legal fabric at a precarious time. This column explores judicial shifts in 3 key public health contexts — reproductive rights, vaccinations, and national security — and their repercussions.

Commentaries on the target article offer diverse perspectives on integrative experiment design. Our responses engage three themes: (1) Disputes of our characterization of the problem, (2) skepticism toward our proposed solution, and (3) endorsement of the solution, with accompanying discussions of its implementation in existing work and its potential for other domains. Collectively, the commentaries enhance our confidence in the promise and viability of integrative experiment design, while highlighting important considerations about how it is used.

Fully updated and revised by James Penner and Emmanuel Melissaris, McCoubrey & White's Textbook on Jurisprudence clearly breaks down the complexities of this often daunting yet fascinating subject. Sophisticated ideas are explained concisely and with clarity, ensuring the reader is aware of the subtleties of the subject yet not overwhelmed. With chapters dedicated to both key concepts and leading theorists, this text takes a wide-ranging look at jurisprudence and places central ideas in context. In particular this text centres (...) around one of the leading theorists, H.L.A Hart, and considers the landscape of jurisprudence in relation to his seminal The Concept of Law, looking at the key ideas which influenced him and considering the response to his work. Coverage of post-modern and feminist legal theory is also included, alongside discussion of key theorists such as Hobbes, Kant, and Rawls.Logically organised to support the topics commonly taught on jurisprudence and legal theory courses, this text provides an easy-to-follow and digestible account of this wide-ranging subject, making it the ideal companion text for further reading and research throughout your course. (shrink)

Scepticism about ought simpliciter is the view that there is no such thing as what one ought simpliciter to do. Instead, practical deliberation is governed by a plurality of normative standpoints, each authoritative from their own perspective but none authoritative simpliciter. This paper aims to resist such scepticism. After setting out the challenge in general terms, I argue that scepticism can be resisted by rejecting a key assumption in the sceptic’s argument. This is the assumption that standpoint-relative ought judgments bring (...) with them a commitment to act in accordance with those judgments. Instead, I propose an alternative account of our normative concepts according to which only ought simpliciter judgments commit one to acting in accordance with those judgments. In addition to answering the sceptical challenge, the proposal offers an independently motivated account of what makes a concept normatively authoritative. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 63.4 (2002) 639-658 [Access article in PDF] "The whole exercise of reason":Charles Mein's Account of Rationality James G. Buickerood L'Auteur de cet Ouvrage nous paroit meriter un rang distingué parmi les Auteurs Metaphysiques. Il seroit seulement à souhaiter qu'il eût traité ses matiéres avec un peu plus de Methode. Ce n'est pas qu'il ne soit très-intelligible, & que son Stile même ne (...) soit assez pur, mais un Auteur devroit se souvenir que ceux qui liront son ouvrage ne suivront pas ses pensées comme il les suit, & qu'on ne se rapellera pas ce qu'il a dit aussi facilement qu'il se le rapelle lui-même.... Il nous paroit que si l'Auteur veut encore s'exercer sur pareilles matieres il ne fera pas mal de repasser sur ce qui'il vient de publier, de donner des definitions plus intelligibles, & d'éclaircir le reste avec plus d'exactitude. — Bibliothèque raisonnée, June 1729 Two Dissertations concerning Sense, and the Imagination. With an Essay on Consciousness appeared anonymously in mid-summer 1728 over the prestigious imprint of Tonson in the Strand. 1 The "Essay on Consciousness" explicates the nature and functions of consciousness. The two dissertations modestly prepare for an inquiry into human understanding, which [End Page 639] is at present very much wanted; and towards which the removal of those Prejudices arising from Sense, and the Imagination, which hinder Men from discovering the Truth, or discerning it, tho' fairly offered to them, is the first Step to be made; and may be of some use to any one who shall hereafter undertake to explain and set forth, in a clear and perspicuous Light, the native and genuine Operations of the Understanding, as they are in Themselves, without mixing or confounding them with any Others. (1-2) A Bibliothèque raisonnée review twice noted the book's diffusion and inconvenient organization. 2 The book is nonetheless interesting for its clear defense of the cognitive superiority of reason over sense and imagination, its attack on contemporary conflations of human and brutal natures, and its treatment of consciousness, dreams, madness, and the self. In its assay of human understanding Two Dissertations implements Peripatetic, Cartesian, and even Lockean principles. The last notwithstanding, the work is an assault on the Lockean reduction of understanding to passive perception and on Locke's conception of knowledge as the perception of ideas and their relations. It is also an attempt to resuscitate reason in the teeth of nominalist accounts of rationality such as those of John Toland and allied freethinkers. 3 In pursuing these goals, it offers variations on traditional concepts of cognition, such as a conception of notions as acts of intellectual apprehension which an interpreting mind brings to bear on sensory appearances. This understanding of notions as acts falls within the British notional way marked by Digby, White, Sergeant, and especially Burthogge, antedating publication of George Berkeley's explicit distinction between passive ideas and notions owing to reflection. 4 Notions play an important role in Two Dissertations, contrasting the mind's active, rational contribution to knowledge with Lockean ideas. Yet the work's treatment of notions contains intimations of a more elaborate conception of rationality that includes a distinct order of reflective notions not deployed in this book (25-26).Clearly identifying the purposes, doctrine, and authorship of Two Dissertations is worthwhile insofar as its detailed analysis of consciousness is intrinsically interesting and quite possibly historically important, despite its neglect in the past century. For its "Essay on Consciousness" purports to be the "first Attempt that hath been made on the Subject" (sig. A3r ; cf. 141-42). While conventional [End Page 640] interpretations of modern philosophy may have habituated us to be skeptical of such a claim made as late as 1728, it is by no means outlandish, subject to textual and conceptual qualification. This paper concerns primarily just one function of the conscious mind addressed in Two Dissertations: the concept of... (shrink)

This paper examines the general prospects for conceptual role expressivism, expressivist theories that embrace conceptual role semantics. It has two main aims. The first aim is to provide a general characterisation of the view. The second aim is to raise a challenge for the general view. The challenge is to explain why normative concepts are not a species of defective concepts, where defective concepts are those that cannot meaningfully embed and participate in genuine inference. After rejecting existing attempts to answer (...) the challenge, I propose an alternative solution. However, the solution leaves conceptual role expressivism a far less distinctive and interesting position than its proponents claim. I conclude that we should be sceptical about how much expressivists gain by appealing to conceptual role semantics. (shrink)

Critical notice of Guy Fletcher's 'Dear Prudence: The Nature and Normativity of Prudential Discourse' and Dale Dorsey's 'A Theory of Prudence'.

Two dogmas of empiricism, by W. V. Quine.--In defense of a dogma, by H. P. Grice and P. F. Strawson.--The analytic and the synthetic: an untenable dualism, by M. G. White.--Synonymity, by B. Mates.--The meaning of a word, by J. L. Austin.--Meaning and synonymy in natural languages, by R. Carnap.--Analytic-synthetic, by J. Bennett.--On "analytic," by R. M. Martin.--Selected bibliography (p. [188]-196).

In recent years there has been a major revival of interest in the political philosophy of Immanuel Kant. Thinkers have looked to Kant's theories about knowledge, history, the moral self and autonomy, and nature and aesthetics to seek the foundations of their own political philosophy. This volume, written by established authorities on Kant as well as by new scholars in the field, illuminates the ways in which contemporary thinkers differ regarding Kantian philosophy and Kant's legacy to political and ethical theory. (...) The book contains essays by Patrick Riley, Lewis White Beck, Mary Gregor, and Richard L. Velkley that place Kant in the tradition of political philosophy; chapters by Dieter Henrich, Susan Shell, Michael W. Doyle, and Joseph M. Knippenberg that examine Kantian perspectives on history and politics; contributions by William A. Galston, Bernard Yack, William James Booth, and Ronald Beiner that judge the Kantian legacy; and classic discussions by John Rawls, Jürgen Habermas, Charles Taylor, and Hans-Georg Gadamer that present different perspectives on contemporary debates about Kant. (shrink)

Although this book derives its inspiration and model from Descartes' Meditations and Husserl's Cartesian Meditations, it attempts to overcome Cartesianism ...

The introduction by Merold Westphal sets the scene: "Two books, two visions of philosophy, two friends and sometimes colleagues...". Modernity and Its Discontents is a debate between Caputo and Marsh in which each upheld their opposing philosphical positions by critical modernism and post-modernism. The book opens with a critique of each debater of the other's previous work. With its passionate point-counterpoint form, the book recalls the philosphical dialogues of classical times, but the writing style remains lucid and uncluttered. Taking the (...) failure of Englightenment ideals as their common ground, the debaters challenge each other's ideas on the nature of post-foundationalist critique. At the core of the argument lies the timely question of the role that each person can play in creating a truly humane society. (shrink)

The concept of whole‐brain death is under attack again. Scholars are arguing that the concept of brain death per se—regardless of the focus on “higher,” “stem” or “whole”—is fundamentally flawed. These scholars have identified what they believe are serious discrepancies between the definition and criterion of brain death, and have pointed out that medical professionals and lay persons remain confused about its meaning. Yet whole‐brain death remains the standard for determining death in much of the Western world and its defenders (...) believe this concept best maps onto our everyday conception of death. (shrink)

Si l'on a pu dire que la philosophie analytique, sous l'influence du positivisme logique, a longtemps accordé un statut privilégié à la logique et aux sciences de la nature - parfois au point d'y réduire tout ce à quoi la philosophie peut légitimement prétendre -, il semble désormais que cette conception trop étroite doive laisser place à une étude globale des différentes institutions de la culture, étude dont Morton White entreprend ici la justification philosophique. A la lumière du holisme (...) scientifique de Duhem et de Quine, l'auteur renouvelle les approches de James, de Dewey et des autres représentants de cette grande tradition de la pensée américaine qu'est le pragmatisme. Il nous propose ainsi une véritable reconception de la philosophie dans ses rapports aux sciences et à la culture. (shrink)

The distinction between the "permanent" (will not reverse) and "irreversible" (cannot reverse) cessation of functions is critical to understand the meaning of a determination of death using circulatory–respiratory tests. Physicians determining death test only for the permanent cessation of circulation and respiration because they know that irreversible cessation follows rapidly and inevitably once circulation no longer will restore itself spontaneously and will not be restored medically. Although most statutes of death stipulate irreversible cessation of circulatory and respiratory functions, the accepted (...) medical standard is their permanent cessation because permanence is a perfect surrogate indicator for irreversibility, and using it permits a more timely declaration. Therefore, patients properly declared dead in donation after circulatory death (DCD) protocols satisfy the requirements of death statutes and do not violate the dead donor rule. The acronym DCD should represent organ "donation after circulatory death" to clarify that the death standard is the permanent cessation of circulation, not heartbeat. Heart donation in DCD does not retroactively negate the donor's death determination because circulation has ceased permanently. (shrink)

Expressivists about normative thought and discourse traditionally deny that there are nondeflationary normative propositions. However, it has recently been suggested that expressivists might avoid a number of problems by providing a theory of normative propositions compatible with expressivism. This paper explores the prospects for developing an expressivist theory of propositions within the framework of cognitive act theories of propositions. First, I argue that the only extant expressivist theory of cognitive propositions—Michael Ridge's ‘ecumenical expressivist’ theory—fails to explain identity conditions for normative (...) propositions. Second, I argue that this failure motivates a general constraint—the ‘unity requirement’—that any expressivist theory of propositions must provide a unified nonrepresentational explanation of that in virtue of which propositional attitudes have the content that they have. Third, I argue that conceptual role accounts of content provide a promising framework in which to develop an expressivist theory of cognitive propositions. (shrink)

The definition of death is one of the oldest and most enduring problems in biophilosophy and bioethics. Serious controversies over formally defining death began with the invention of the positive-pressure mechanical ventilator in the 1950s. For the first time, physicians could maintain ventilation and, hence, circulation on patients who had sustained what had been previously lethal brain damage. Prior to the development of mechanical ventilators, brain injuries severe enough to induce apnea quickly progressed to cardiac arrest from hypoxemia. Before the (...) 1950s, the loss of spontaneous breathing and heartbeat were perfect predictors of death because the functioning of the brain and of all other organs ceased rapidly and nearly simultaneously thereafter, producing a unitary death phenomenon. In the pretechnological era, physicians and philosophers did not have to consider whether a human being who had lost certain “vital functions” but had retained others was alive, because such cases were technically impossible. (shrink)

Abstract:Disturbing cases continue to be published of patients declared brain dead who later were found to have a few intact brain functions. We address the reasons for the mismatch between the whole-brain criterion and brain death tests, and suggest solutions. Many of the cases result from diagnostic errors in brain death determination. Others probably result from a tiny amount of residual blood flow to the brain despite intracranial circulatory arrest. Strategies to lessen the mismatch include improving brain death determination training (...) for physicians, mandating a test showing complete intracranial circulatory arrest, or revising the whole-brain criterion. (shrink)

The shape of a life hypothesis holds that the temporal sequence of good or bad times in a life can itself be a valuable feature of that life. This is generally thought to be incompatible with additivism about lifetime well-being, which holds that lifetime well-being is fully determined by momentary well-being. This discussion examines Dale Dorsey’s recent argument that these views are in fact compatible. I argue that accepting the conjunction of these views requires stronger commitments than Dorsey recognizes. After (...) arguing that these commitments are problematic, I conclude that we should reject the compatibility claim. (shrink)

A combination of emerging life support technologies and entrenched organ donation practices are complicating the physician's task of determining death. On the one hand, technologies that support or replace ventilation and circulation may render the diagnosis of death ambiguous. On the other, transplantation of vital organs requires timely and accurate declaration of death of the donor to keep the organs as healthy as possible. These two factors have led to disagreements among physicians and scholars on the precise moment of death. (...) In this article, I suggest that the debate about exactly when a person dies can benefit from distinguishing the strict biological concept of death from the medical standards for determining human death, and I show how an appreciation of the difference between the permanent and irreversible cessation of circulation is helpful in understanding the reasons for the two approaches to determining when death should be declared. (shrink)

The publicity surrounding the recent McMath and Muñoz cases has rekindled public interest in brain death: the familiar term for human death determination by showing the irreversible cessation of clinical brain functions. The concept of brain death was developed decades ago to permit withdrawal of therapy in hopeless cases and to permit organ donation. It has become widely established medical practice, and laws permit it in all U.S. jurisdictions. Brain death has a biophilosophical justification as a standard for determining human (...) death but remains poorly understood by the public and by health professionals. The current controversies over brain death are largely restricted to the academy, but some practitioners express ambivalence over whether brain death is equivalent to human death. Brain death remains an accepted and sound concept, but more work is necessary to establish its biophilosophical justification and to educate health professionals and the public. (shrink)

Nair-Collins and Joffe (2023) highlighted the noncongruence between the language of the Uniform Determination of Death Act (UDDA) and the accepted brain death bedside testing standard by showing th...

Among the old and new controversies over brain death, none is more fundamental than whether brain death is equivalent to the biological phenomenon of human death. Here, I defend this equivalency by offering a brief conceptual justification for this view of brain death, a subject that Andrew Huang and I recently analyzed elsewhere in greater detail. My defense of the concept of brain death has evolved since Bernard Gert, Charles Culver, and I first addressed it in 1981, a development that (...) paralleled advances in intensive care unit treatment. The century‐old concept of the organism as a whole provides the fundamental justification for the equivalency of brain death and human death. In our technological age, in which increasing numbers of components and systems of an organism can be kept alive, and for longer intervals, the permanent cessation of functioning of the organism as a whole is the phenomenon that best corresponds to its death. (shrink)

Ariane Lewis provided an insightful review of several controversial cases of death by neurologic criteria (“brain death”) in the UK, focusing on Archie Battersbee, a boy whose tragic illness provok...

Notwithstanding these wise pronouncements, my project here is to characterize the biological phenomenon of death of the higher animal species, such as vertebrates. My claim is that the formulation of “whole- brain death ” provides the most congruent map for our correct understanding of the concept of death. This essay builds upon the foundation my colleagues and I have laid since 1981 to characterize the concept of death and refine when this event occurs. Although our society's well-accepted program of multiple (...) organ procurement for transplantation requires the organ donor first to be dead, the concept of brain death is not merely a social contrivance to permit us to obtain the benefits of organ procurement. Rather, the concept of whole- brain death stands independently as the most accurate biological representation of the demise of the human organism. (shrink)