ObjectivesThe end of life is an ethically challenging time requiring complex decision-making. This study describes ethical frameworks among physician trainees, explores how these frameworks manifest and relates these frameworks to experiences delivering end-of-life care.DesignWe conducted semistructured in-depth exploratory qualitative interviews with physician trainees about experiences of end-of-life care and moral distress. We analysed the interviews using thematic analysis.SettingAcademic teaching hospitals in the United States and United Kingdom.ParticipantsWe interviewed 30 physician trainees. We purposefully sampled across three domains we expected to be (...) associated with individual ethics in order to elicit a diversity of ethical and experiential perspectives.ResultsSome trainees subscribed to a best interest ethical framework, characterised by offering recommendations consistent with the patient’s goals and values, presenting only medically appropriate choices and supporting shared decision-making between the patient/family and medical team. Others endorsed an autonomy framework, characterised by presenting all technologically feasible choices, refraining from offering recommendations and prioritising the voice of patient/family as the decision-maker.ConclusionsThis study describes how physician trainees conceptualise their roles as being rooted in an autonomy or best interest framework. Physician trainees have limited clinical experience and decision-making autonomy and may have ethical frameworks that are dynamic and potentially highly influenced by experiences providing end-of-life care. A better understanding of how individual physicians’ ethical frameworks influences the care they give provides opportunities to improve patient communication and advance the role of shared decision-making to ensure goal-aligned end-of-life care. (shrink)

Some patients who are dependent on extracorporeal membrane oxygenation (ECMO) are alert and retain capacity to participate in decision-making, including decisions regarding whether to continue life...

:Empirical work has shown that patients and physicians have markedly divergent understandings of treatability statements in the context of serious illness. Patients often understand treatability statements as conveying good news for prognosis and quality of life. In contrast, physicians often do not intend treatability statements to convey improvement in prognosis or quality of life, but merely that a treatment is available. Similarly, patients often understand treatability statements as conveying encouragement to hope and pursue further treatment, though this may not be (...) intended by physicians. This radical divergence in understandings may lead to severe miscommunication. This paper seeks to better understand this divergence through linguistic theory—in particular, H.P. Grice’s notion of conversational implicature. This theoretical approach reveals three levels of meaning of treatability statements: the literal meaning, the physician’s intended meaning, and the patient’s received meaning. The divergence between the physician’s intended meaning and the patient’s received meaning can be understood to arise from the lack of shared experience between physicians and patients, and the differing assumptions that each party makes about conversations. This divergence in meaning raises new and largely unidentified challenges to informed consent and shared decision making in the context of serious illness, which indicates a need for further empirical research in this area. (shrink)

The current issue of the American Journal of Bioethics illustrates the scope of disagreement among professionals about normothermic regional perfusion (NRP). A similar range of opinions has been de...

A key source of support for the view that challenging people’s beliefs about free will may undermine moral behavior is two classic studies by Vohs and Schooler (2008). These authors reported that exposure to certain prompts suggesting that free will is an illusion increased cheating behavior. In the present paper, we report several attempts to replicate this influential and widely cited work. Over a series of five studies (sample sizes of N = 162, N = 283, N = 268, N (...) = 804, N = 982) (four preregistered) we tested the relationship between (1) anti-free-will prompts and free will beliefs and (2) free will beliefs and immoral behavior. Our primary task was to closely replicate the findings from Vohs and Schooler (2008) using the same or highly similar manipulations and measurements as the ones used in their original studies. Our efforts were largely unsuccessful. We suggest that manipulating free will beliefs in a robust way is more difficult than has been implied by prior work, and that the proposed link with immoral behavior may not be as consistent as previous work suggests. (shrink)

Perhaps the central focus of American bioethics has been to push against medical paternalism on the grounds that it impedes the autonomy of patients—that is, their ability to make choices of their...

This chapter shows how The Daily Show targets those political and religious leaders who claim to receive clear revelations from the divine, either by their own particular religious experiences and practices or through sacred texts. It considers some of the ways Stewart calls into question their apparently unquestionable grasp of the mind of God. Philosophers like the famous English thinker John Locke have made their living by carefully examining not only the nature of the world around us, but also the (...) more puzzling aspects of human behavior. For instance, Locke describes and critiques the sort of “enthusiasm” by recognizing that such religiously convicted individuals: “persuade themselves that they are under the peculiar guidance of heaven in their actions and opinions, especially in those of them which they cannot account for by the ordinary methods of knowledge and principles of reason. (shrink)

In their target article, Nielsen Busch and Mjaaland (2023) address a longstanding debate within the bioethics and organ transplantation community regarding whether controlled donation after circula...

In their target article, Millum and Bromwich situate their article against a backdrop of well-documented empirical research demonstrating that many participants have variable and often poor...

The opinion of Mr. Justice Francis of the English High Court which denied the parents of Charlie Gard, who had been born with an extremely rare mutation of a genetic disease, the right to take their child to the United States for a proposed experimental treatment occasioned world wide attention including that of the Pope, President Trump, and the US Congress. The case raise anew a debate as old as the foundation of Western medicine on who should decide and on (...) what standard when there is a conflict between a family and the treating physicians over a possible treatment. This paper will explore the different approaches of the British and American courts on the issue and the various proposals from that of John Rawls in his A Theory of Justice to a processed-based approach for resolving such disputes. As carefully crafted as the opinion of Mr Justice Nicholas Francis in the Gard case proved to be, it left commentators unsatisfied. A widespread criticism, captured in an article by Michael Dougherty in The National Review was for the state to ‘get out of the way of the parents trying to act in the best interests of the child’.1 Although he conceded the parents could be adding to the suffering of the child by taking Charlie to America for an experimental therapy and agreed that such a choice ‘may be the wrong decision,’ in Dougherty’s view, it should still be ‘their decision’. Dougherty’s stand was the popular response to the question of ‘Who should decide?’ It fails, however, to propose any rationale for the decision. It provided no norms, no standards and no guidelines for the parents. Their motive could equally well be indifference to the suffering of the child as concern for his well-being. Furthermore, even good, loving parents may make …. (shrink)

We examined participants' reading and recall of informed consent documents presented via paper or computer. Within each presentation medium, we presented the document as a continuous or paginated document to simulate common computer and paper presentation formats. Participants took slightly longer to read paginated and computer informed consent documents and recalled slightly more information from the paginated documents. We concluded that obtaining informed consent online is not substantially different than obtaining it via paper presentation. We also provide suggestions for improving (...) informed consent-in both face-to-face and online experiments. (shrink)

in Neil Jacobs (ed.), Open Access: Key strategic, technical and economic aspects, Chandos Publishing, 2006.

There is a puzzle about why self-deception, a process that obscures the truth, is so pervasive in human behavior given that tracking the truth seems important for our survival and reproduction. William von Hippel and Robert Trivers argue that, despite appearances, there is good reason to think that self-deception is an adaptation by arguing: self-deception leads to a positive self-perception and a positive self-perception increases an individual’s fitness. D.S. Neil Van Leeuwen, however, gives persuasive arguments against both steps. In (...) response, we will defend both propositions, thereby supporting the conclusion that self-deception indeed has adaptive value. The first premise will be bolstered by a survey of the philosophical literature and empirical work on self-deception, whereas the second will be strengthened by empirical research on a behavioral phenomenon known as the winner effect. (shrink)

While The Daily Show with Jon Stewart is certainly entertaining, it can also deliver a deeper analysis of our contemporary media environment. Stewart's analysis echoes that of the celebrated New York University media theorist Neil Postman, whose discerning insights seem to ground some of The Daily Show's sharpest comic bits. Much of The Daily Show's sharpest comedy requires its audience to grasp a Postman‐like criticism of television news. In addition, Stewart himself seems to offer a more general critique of (...) today's televised public discourse that is reminiscent of Postman's in several significant ways. This isn't to say, however, that Postman and Stewart are in perfect agreement. For one thing, Postman argues that the transformation of serious discussion into entertainment is all but inevitable when this discussion takes place on television. Stewart, on the other hand, seems to believe that television can do better. (shrink)

In this paper we examine the relationship between diligence and ethics and the connection between procrastination and ethical misconduct for lawyers. From there we ask the question of whether legal education does enough to teach law students good habits of time management that might minimize the kind of procrastination that so often goes hand in hand with lawyer malfeasance. Far from concluding that legal education addresses these issues adequately we advance the claim that legal education actually teaches procrastination. Drawing on (...) the work of Neil Fiore and his book: The Now Habit: A Strategic Program for Overcoming Procrastination and Enjoying Guilt-Free Play we argue that law students are often susceptible to the psychological factors that lead to procrastination: fear of failure, fear of success and resentment of authority. From there we outline aspects of legal education that feed into rather than combating these vulnerabilities. Finally we outline recommendations for how legal education could begin to take more seriously the relationship between time management and legal ethics and to model and inculcate good time management skills. (shrink)

Neil Gascoigne and Tim Thornton’s Tacit Knowledge is an attempt to find a place for tacit knowledge as “knowledge” within the limits of analytic epistemology. They do so by reference to Jason Stanley and Timothy Williamson’s analysis of the term “way” and by the McDowell-like claim that reference to the tacitly rooted “way” of doing something exhausts the knowledge aspect of tacit knowledge, which preserves the notion of tacit knowledge, while excluding most of Michael Polanyi’s examples, and rendering (...) Hubert Dreyfus’s and John Searle’s accounts irrelevant. This is more a redefinition of terms than an account of tacit knowledge. (shrink)

Public support for responses to the coronavirus pandemic has sharply diverged on partisan lines in many countries, with conservatives tending to oppose lockdowns, social distancing, mask mandates and vaccines, and liberals far more supportive. This polarization may arise from the way in which the attitudes of each side is echoed back to them, especially on social media. In this paper, I argue that echo chambers are not to blame for this polarization, even if they are causally responsible for it. They (...) are not to blame, because belief calibration in an echo chamber is a rational process; moreover, the epistemically constitutive properties of echo chambers are not optional for epistemically social animals like us. There is no special problem of echo chambers; rather, there is a problem of misleading evidence (especially higher-order evidence). Accordingly, we ought to respond to misinformation about COVID neither by attempting to dismantle echo chambers nor by attempting to make people more rational, but rather by attempting to supplant unreliable higher-order evidence with better evidence. (shrink)

Several noted political theorists have argued that a state can be legitimate even if it does not generate in its citizens an obligation to obey the law. I argue that this claim is false. All plausible analyses of political legitimacy either build in the concept of political obligation, or else incorporate claims that require some account of political obligation. In either case, political legitimacy is possible only when a state successfully generates in its citizens an obligation to obey the law.

Anti-racist education within the Academy holds the potential to truly reflect the cultural hybridity of our diverse, multi-cultural society through the canons of knowledge that educators celebrate, proffer and embody. The centrality of Whiteness as an instrument of power and privilege ensures that particular types of knowledge continue to remain omitted from our curriculums. The monopoly and proliferation of dominant White European canons does comprise much of our existing curriculum; consequently, this does impact on aspects of engagement, inclusivity and belonging (...) particularly for Black, Asian and Minority Ethnic (BAME) learners. This paper explores the impact of a dominant Eurocentric curriculum and the Decolonising the Curriculum agenda within higher education and its influence upon navigating factors such as BAME attainment, engagement and belonging within the Academy. This paper draws on a Critical Race Theory (CRT) theoretical framework to centralize the marginalized voices of fifteen BAME students and three academics of colour regarding this phenomena. Aspects examined consider the impact of a narrow and restrictive curriculum on BAME students and staff and how the omission of diverse histories and multi-cultural knowledge canons facilitates marginalization and discriminatory cultures. (shrink)

In the first part of this chapter, I will focus on two main questions: (1) how Maimonides departs from Aristotle in maintaining a difference of kind rather than degree in identifying prophecy rather than wisdom as the ultimate human perfection; and (2) why Maimonides does not explicitly identify a virtue of practical reasoning that corresponds to Aristotle’s understanding of phronêsis. In the second part of the chapter, I will discuss why Dante, contrary to Maimonides, emphasises the significance of practical judgement (...) in his redeployment of Aristotelian ethical theory. I will also discuss how the didactic and protreptic purposes of his poetic discourse are shaped by the same underlying psychological theory that grounds his emphasis on this intellectual virtue. The modest aim of this chapter is to treat these two engagements with Peripatetic philosophy as case studies that reward attention to the inextricable links between politics/religion and philosophical enquiry, even against the grain of seemingly common lineages sharing similar concerns. Connected with this modest aim, this chapter will also discuss how Maimonides’s and Dante’s attention to didactic and protreptic concerns impacts their treatment of philosophical questions and therefore indicates how attention to the kairos of their writings exposes and helps appreciate their philosophical rigour. (shrink)

This is a study of Aristotle's moral philosophy as it is contained in the Nicomachean Ethics. Hardie examines the difficulties of the text; presents a map of inescapable philosophical questions; and brings out the ambiguities and critical disagreements on some central topics, inclduing happiness, the soul, the ethical mean, and the initiation of action.

There are a plethora of issues within higher education which continually reinforce aspects of inequality and discrimination. These particular issues are aligned to institutionally racist struc...

Our motor system can generate representations which carry information about the goals of another agent's actions. However, it is not known whether motor representations play a deeper role in social understanding, and, in particular, whether they enable tracking others' beliefs. Here we show that, for adult observers, reliably manifesting an ability to track another's false belief critically depends on representing the agent's potential actions motorically. One signature of motor representations is that they can be disrupted by constraints on an observed (...) agent's action capacities. We therefore used a `mummification' technique to manipulate whether the agent in a visual ball-detection task was free to act or whether he was visibly constrained from acting. Adults' reaction times reliably reflected the agent's beliefs only when the agent was free to act on the ball and not when the agent was visibly constrained from acting. Furthermore, it was the agent's constrained action capabilities, rather than any perceptual novelty, that determined whether adult observers' reaction times reliably reflected the agent's beliefs. These findings signal that our motor system may underpin more of social cognition than previously imagined, and, in particular, that motor representations may underpin automatic false-belief tracking. (shrink)

This essay was prompted by the question of how Hathayoga, literally 'the Yoga of force', acquired its name. Many Indian and Western scholars have understood the 'force' of Haṭhayoga to refer to the effort required to practice it. Inherent in this understanding is the assumption that Haṭhayoga techniques such as _praṇayama_ are strenuous and may even cause pain. Others eschew the notion of force altogether and favor the so-called 'esoteric' definition of Haṭhayoga and moon in the body). This essay examines (...) these interpretations in light of definitions of _haṭhayoga_ and the adverbial uses of _haṭha_ in Sanskrit Yoga texts that predate the fifteenth-century _Hathapradipika_. (shrink)

Cognitive Science, Volume 46, Issue 7, July 2022.

In recent years there has been an outpouring of work at the intersection of social movement studies and organizational theory. While we are generally in sympathy with this work, we think it implies a far more radical rethinking of structure and agency in modern society than has been realized to date. In this article, we offer a brief sketch of a general theory of strategic action fields (SAFs). We begin with a discussion of the main elements of the theory, describe (...) the broader environment in which any SAF is embedded, consider the dynamics of stability and change in SAFs, and end with a respectful critique of other contemporary perspectives on social structure and agency. (shrink)

ABSTRACT This module is designed to sensitise you to the special needs of participants who belong to populations that are more vulner.

In 2015, in preparation for implementation of the California End of Life Option Act, the UCLA Workgroup dedicated scores of hours to exploring the ethical underpinnings of aid-in-dying and the guid...

Epistasis plays an important role in the genetic architecture of common human diseases and can be viewed from two perspectives, biological and statistical, each derived from and leading to different assumptions and research strategies. Biological epistasis is the result of physical interactions among biomolecules within gene regulatory networks and biochemical pathways in an individual such that the effect of a gene on a phenotype is dependent on one or more other genes. In contrast, statistical epistasis is defined as deviation from (...) additivity in a mathematical model summarizing the relationship between multilocus genotypes and phenotypic variation in a population. The goal of this essay is to review definitions and examples of biological and statistical epistasis and to explore the relationship between the two. Specifically, we present and discuss the following two questions in the context of human health and disease. First, when does statistical evidence of epistasis in human populations imply underlying biomolecular interactions in the etiology of disease? Second, when do biomolecular interactions produce patterns of statistical epistasis in human populations?Answers to these two reciprocal questions will provide an important framework for using genetic information to improve our ability to diagnose, prevent and treat common human diseases. We propose that systems biology will provide the necessary information for addressing these questions and that model systems such as bacteria, yeast and digital organisms will be a useful place to start. BioEssays 27:637–646, 2005. © 2005 Wiley Periodicals, Inc. (shrink)

_Reconsiders the contemporary relevance of Schelling’s radical philosophical and religious ecology._.

A number of scientists have recently argued that neuroscience provides strong evidence against the requirements of the folk notion of free will. In one such line of argumentation, it is claimed that choice is required for free will, and neuroscience is showing that people do not make choices. In this article, we argue that this no-choice line of argumentation relies on a specific conception of choice. We then provide evidence that people do not share the conception of choice required of (...) the argument, nor do people hold that free will requires the conception of choice on which the argument relies. This leaves the proponents of the no-choice argument with a dilemma: Either they adopt a conception of choice that is not required of the folk concept of free will and thus they cease to be talking about the folk concept of free will, or they adopt a conception of choice that aligns with the folk concept of choice and thus the no-choice argument fails. (shrink)

This special issue has emerged out of the continuing concern for discriminatory tensions situated within the context of race, education, and social mobility. The institutionally racist structures w...

Shows how to program on a computer (in Prolog) the effective skills taught in introductory and intermediate logic courses. The topics include the relevance of relevance, representing formulae and proofs, avoiding loops and blind alleys, and other aspects. Of interest to computational logicians, proof-theorists, cognitive scientists, and workers in artificial intelligence. Distributed by Columbia U. Press. Annotation copyright by Book News, Inc., Portland, OR.

Recently, several philosophers have defended what might be called `neo-essentialism' about natural kinds. Their views purport to improve upon the traditional essentialism of Kripke and Putnam by rejecting the claim that essences must be comprised of intrinsic properties. I argue that this so-called break from traditional essentialism is not a break at all, because the widespread interpretation of Putnam according to which he takes essences to be intrinsic is mistaken. Putnam makes no claim to the effect that essences of natural (...) kinds must be intrinsic, and offers at least one example of a natural kind whose essence is non-intrinsic. I conclude that his traditional essentialism has been misinterpreted, and consequently that neo-essentialism is not so `neo' after all. (shrink)