The HOD Dichotomy Theorem states that if there is an extendible cardinal, δ, then either HOD is “close” to V or HOD is “far” from V. The question is whether the future will lead to the first or the second side of the dichotomy. Is HOD “close” to V, or “far” from V? There is a program aimed at establishing the first alternative—the “close” side of the HOD Dichotomy. This is the program of inner model theory. In recent years the (...) third author has provided evidence that there is an ultimate inner model—Ultimate-L—and he has isolated a natural conjecture associated with the model—the Ultimate-L Conjecture. This conjecture implies that that the first alternative holds—HOD is “close” to V. This is the future in which pattern prevails. In this paper we introduce a very different program, one aimed at establishing the second alternative—the “far” side of the HOD Dichotomy. This is the program of large cardinals beyond choice. Kunen famously showed that if AC holds then there cannot be a Reinhardt cardinal. It has remained open whether Reinhardt cardinals are consistent in ZF alone. It turns out that there is an entire hierarchy of choiceless large cardinals of which Reinhardt cardinals are only the beginning, and, surprisingly, this hierarchy appears to be highly ordered and amenable to systematic investigation, as we shall show in this paper. The point is that if these choiceless large cardinals are consistent then the Ultimate-L Conjecture must fail. This is the future where chaos prevails. (shrink)

A growing interest in and concern about the adequacy and fairness of modern peer-review practices in publication and funding are apparent across a wide range of scientific disciplines. Although questions about reliability, accountability, reviewer bias, and competence have been raised, there has been very little direct research on these variables.The present investigation was an attempt to study the peer-review process directly, in the natural setting of actual journal referee evaluations of submitted manuscripts. As test materials we selected 12 already published (...) research articles by investigators from prestigious and highly productive American psychology departments, one article from each of 12 highly regarded and widely read American psychology journals with high rejection rates (80%) and nonblind refereeing practices.With fictitious names and institutions substituted for the original ones (e.g., Tri-Valley Center for Human Potential), the altered manuscripts were formally resubmitted to the journals that had originally refereed and published them 18 to 32 months earlier. Of the sample of 38 editors and reviewers, only three (8%) detected the resubmissions. This result allowed nine of the 12 articles to continue through the review process to receive an actual evaluation: eight of the nine were rejected. Sixteen of the 18 referees (89%) recommended against publication and the editors concurred. The grounds for rejection were in many cases described as “serious methodological flaws.” A number of possible interpretations of these data are reviewed and evaluated. (shrink)

With each novel infectious disease outbreak, there is scholarly attention to healthcare providers’ obligation to assume personal risk while they care for infected patients. While most agree that healthcare providers have a duty to assume some degree of risk, the extent of this obligation remains uncertain. Furthermore, these analyses rarely examine healthcare institutions’ obligations during these outbreaks. As a result, there is little practical guidance for healthcare institutions that are forced to weigh whether or when to exclude healthcare providers from (...) providing care or allow them to opt out from providing care to protect themselves. This article uses the COVID-19 pandemic to examine the concept of risk and the professional duties of both healthcare providers and healthcare institutions, and proposes a framework that can be used to make concrete institutional policy choices. This framework should be a useful tool for any hospital, clinic, or health agency that must make these choices during the current pandemic and beyond. (shrink)

The partial ordering of Medvedev reducibility restricted to the family of Π0 1 classes is shown to be dense. For two disjoint computably enumerable sets, the class of separating sets is an important example of a Π0 1 class, which we call a ``c.e. separating class''. We show that there are no non-trivial meets for c.e. separating classes, but that the density theorem holds in the sublattice generated by the c.e. separating classes.

It may be the case that the most challenging moral problem of the twenty‐first century will be the relationship between the individual moral agent and the practices and institutions in which the moral agent is embedded. In this paper, we continue the efforts that one of us, Joan Liaschenko, first called for in 1993, that of using feminist ethics as a lens for viewing the relationship between individual nurses as moral agents and the highly complex institutions in which they (...) do the work of nursing. Feminist ethics, with its emphasis on the inextricable relationship between ethics and politics, provides a useful lens to understand the work of nurses in context. Using Margaret Urban Walker's and Hilde Lindemann's concepts of identity, relationships, values, and moral agency, we argue that health care institutions can be moral communities and profoundly affect the work and identity and, therefore, the moral agency of all who work within those structures, including nurses. Nurses are not only shaped by these organizations but also have the power to shape them. Because moral agency is intimately connected to one's identity, moral identity work is essential for nurses to exercise their moral agency and to foster moral community in health care organizations. We first provide a brief history of nursing's morally problematic relationship with institutions and examine the impact institutional master narratives and corporatism exert today on nurses’ moral identities and agency. We close by emphasizing the significance of ongoing dialogue in creating and sustaining moral communities, repairing moral identities, and strengthening moral agency. (shrink)

Abstract.The partial ordering of Medvedev reducibility restricted to the family of Π01 classes is shown to be dense. For two disjoint computably enumerable sets, the class of separating sets is an important example of a Π01 class, which we call a ``c.e. separating class''. We show that there are no non-trivial meets for c.e. separating classes, but that the density theorem holds in the sublattice generated by the c.e. separating classes.

The prospect of using genome technologies to modify the human germline has raised profound moral disagreement but also emphasizes the need for wide-ranging discussion and a well-informed policy response. The Hinxton Group brought together scientists, ethicists, policymakers, and journal editors for an international, interdisciplinary meeting on this subject. This consensus statement formulated by the group calls for support of genome editing research and the development of a scientific roadmap for safety and efficacy; recognizes the ethical challenges involved in clinical reproductive (...) applications of genome editing but, importantly, rejects the idea that human reproductive germline modification is necessarily morally unacceptable; and highlights the importance of meaningful engagement in discussions of genome editing and the development of regulation and oversight mechanisms to govern future uses of such technologies. (shrink)

Gottlob Frege (1848–1925) was unquestionably one of the most important philosophers of all time. He trained as a mathematician, and his work in philosophy started as an attempt to provide an explanation of the truths of arithmetic, but in the course of this attempt he not only founded modern logic but also had to address fundamental questions in the philosophy of language and philosophical logic. Frege is generally seen (along with Russell and Wittgenstein) as one of the fathers of the (...) analytic method, which dominated philosophy in English-speaking countries for most of the twentieth century. His work is studied today not just for its historical importance but also because many of his ideas are still seen as relevant to current debates in the philosophies of logic, language, mathematics and the mind. The Cambridge Companion to Frege provides a route into this lively area of research. (shrink)

A growing interest in and concern about the adequacy and fairness of modern peer-review practices in publication and funding are apparent across a wide range of scientific disciplines. Although questions about reliability, accountability, reviewer bias, and competence have been raised, there has been very little direct research on these variables.

The ethical theories employed in health care today assume, in the main, a modern Western philosophical framework. Yet the diversity of cultural and religious assumptions regarding human nature, health and illness, life and death, and the status of the individual suggest that a cross-cultural study of health care ethics is needed. A Cross-Cultural Dialogue on Health Care Ethics provides this study. It shows that ethical questions can be resolved by examining the ethical principles present in each culture, critically assessing each (...) value, and identifying common values found within all traditions, It encourages the development of global awareness and sensitivity to and respect for the diversity of peoples and their values and will advance understanding as well as help to foster a greater balance and a fuller truth in consideration of the human condition and what makes for health and wholeness. (shrink)

Uniform sequential continuity, a property classically equivalent to sequential continuity on compact sets, is shown, constructively, to be a consequence of strong continuity on a metric space. It is then shown that in the case of a separable metric space, uniform sequential continuity implies strong continuity if and only if one adopts a certain boundedness principle that, although valid in the classical, recursive and intuitionistic setting, is independent of Heyting arithmetic.

Important examples of $\Pi^0_1$ classes of functions $f \in {}^\omega\omega$ are the classes of sets (elements of ω 2) which separate a given pair of disjoint r.e. sets: ${\mathsf S}_2(A_0, A_1) := \{f \in{}^\omega2 : (\forall i < 2)(\forall x \in A_i)f(x) \neq i\}$ . A wider class consists of the classes of functions f ∈ ω k which in a generalized sense separate a k-tuple of r.e. sets (not necessarily pairwise disjoint) for each k ∈ ω: ${\mathsf S}_k(A_0,\ldots,A_k-1) := (...) \{f \in {}^\omega k : (\forall i < k) (\forall x \in A_i) f(x) \neq i\}$ . We study the structure of the Medvedev degrees of such classes and show that the set of degrees realized depends strongly on both k and the extent to which the r.e. sets intersect. Let ${\mathcal S}^m_k$ denote the Medvedev degrees of those ${\mathsf S}_k(A_0,\ldots,A_{k-1})$ such that no m + 1 sets among A 0,...,A k-1 have a nonempty intersection. It is shown that each ${\mathcal S}^m_k$ is an upper semi-lattice but not a lattice. The degree of the set of k-ary diagonally nonrecursive functions $\mathsf{DNR}_k$ is the greatest element of ${\mathcal S}^1_k$ . If 2 ≤ l < k, then 0 M is the only degree in ${\mathcal S}^1_l$ which is below a member of ${\mathcal S}^1_k$ . Each ${\mathcal S}^m_k$ is densely ordered and has the splitting property and the same holds for the lattice ${\mathcal L}^m_k$ it generates. The elements of ${\mathcal S}^m_k$ are exactly the joins of elements of ${\mathcal S}^1_i$ for $\lceil{k \over m}\rceil \leq i \leq k$. (shrink)

One of the most significant changes in modern healthcare delivery has been the evolution of the paper record to the electronic health record (EHR). In this paper we argue that the primary change has been a shift in the focus of documentation from monitoring individual patient progress to recording data pertinent to Institutional Priorities (IPs). The specific IPs to which we refer include: finance/reimbursement; risk management/legal considerations; quality improvement/safety initiatives; meeting regulatory and accreditation standards; and patient care delivery/evidence based practice. (...) Following a brief history of the transition from the paper record to the EHR, the authors discuss unintended or contested consequences resulting from this change. These changes primarily reflect changes in the organization and amount of clinician work and clinician‐patient relationships. The paper is not a research report but was informed by an institutional ethnography the aim of which was to understand how the EHR impacted clinicians and administrators in a large, urban hospital in the United States. The paper was also informed by other sources, including the philosophies of Jacques Ellul, Don Idhe, and Langdon Winner. (shrink)

The notions of linear and metric independence are investigated in relation to the property: if U is a set of n+1 independent vectors, and X is a set of n independent vectors, then adjoining some vector in U to X results in a set of n+1 independent vectors. It is shown that this property holds in any normed linear space. A related property – that finite-dimensional subspaces are proximinal – is established for strictly convex normed spaces over the real or (...) complex numbers. It follows that metric independence and linear independence are equivalent in such spaces. Proofs are carried out in the context of intuitionistic logic without the axiom of countable choice. (shrink)

In his article, ‘Recovering Humanity: Movement, Sport, and Nature’, Doug Anderson addresses the place of endurance sport, or more generally sport at large, as a potential catalyst for the good life. Anderson contrasts transcendental themes of Henry David Thoreau and Ralph Waldo Emerson with the pragmatic claims of William James and John Dewey, who focus on human possibility and growth. Our aim is to pursue the pragmatic line of thought championed by James and Dewey as a contrasting but not mutually (...) exclusive motive to Anderson’s analysis. We contend that movement can provide humanizing possibilities even more pronounced for those subscribing to pragmatic themes (i.e., growth and the strenuous mood). We will use running and cycling to demonstrate how the strenuous mood enhances the possibility for this humanizing condition. Specifically, we argue that moving in a committed fashion allows us to deepen our relationship with the respective practice and thus opens the possibilities for ‘recovering our humanity’. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values and (...) responsibilities in situations of moral distress. We also discuss the importance of nurses creating “counterstories” of their work as knowledgeable and trustworthy professionals to repair their damaged moral identities, and, finally, we recommend that efforts toward shifting the goal of health care away from the prolongation of life at all costs to the relief of suffering to diminish the moral distress that is a common response to aggressive care at end-of-life. (shrink)

This collection of essays explore the long-standing,intricate relationship between law and faith. Faith in this context is to be read in the broadest sense, as extending beyond religion to embrace the knowledge, beliefs, understandings and practices which are at work alongside the familiar and seemingly more reliable, trusted and relatively certain content and conventionally accepted methods of law and legal reasoning. The essays deal with three broad themes. The first concerns the extent to which faith should be involved in legal (...) decision making. Ought decisions to aspire simply to right reason or ought faith-based models of decision-making to be incorporated into the legal system? If the latter, how is this best done? Ought faith to operate simply as a reason itself or ought it to help to structure the method by which legal decisions are reached? The second, and perhaps most familiar theme, stemming in part from rights discourse, is the extent to which law does, and ought to, respect the rights of those whose religious beliefs conflict with the dominant social norms and practices. Liberal democratic constitutions typically provide protection for religion and religious beliefs. Are these justified, and if so how? Can such protection as exists suffice from the perspective of the faithful, or does law's otherwise pervasive agnosticism make this impossible or illusory? Thirdly, questions of identity and difference arise. Assuming that most societies remain a mix of many faiths (religious and secular) and no faith, how should law and legal theory understand the varying and, it must be said, conflicting claims for recognition. Should we encourage conformity in the hope of reducing friction, or should we preserve and promote difference, seeking to understand others, whether groups or individuals, without removing that which makes them distinct? More radically and controversially, should we be more sceptical of individual and group claims to authenticity and see them rather as strategies in an ongoing power game? Faith after all, like reason and law, has never been far from politics and intrigue, especially in its institutional representation. Contributors: Zenon Bankowski, Anthony Bradney, Claire Davis, John Gardner, Adam Gearey, Tim Macklem, Maleiha Malik, Victor Tadros. (shrink)

This distinctive collection by scholars from around the world focuses upon the cultural, educational, and political significance of Richard Rorty's thought. The nine essays which comprise the collection examine a variety of related themes: Rorty's neopragmatism, his view of philosophy, his philosophy of education and culture, Rorty's comparison between Dewey and Foucault, his relation to postmodern theory, and, also his form of political liberalism.

The theory of apartness spaces, and their relation to topological spaces (in the point–set case) and uniform spaces (in the set–set case), is sketched. New notions of local decomposability and regularity are investigated, and the latter is used to produce an example of a classically metrisable apartness on R that cannot be induced constructively by a uniform structure.

Endurance athletes work at creating habits and lifestyles which correspond to Aristotle’s notion of eudomania. They spend time and energy dedicating themselves to their craft. They relinquish other interests in pursuit of excellence. They fully accept William James’ notion of precipitousness as they create goals and work toward achievement. In this paper, we examine normative issues related to endurance sport participation, the potential dark side of this pursuit of excellence. Our overriding concern is how best to work toward and experience (...) human flourishing while simultaneously remaining attentive to relationships and responsibilities. In terms of potential perils associated with endurance sport, we address questions of autonomy, authenticity and identification. We contend that endurance athletes concerned with these questions benefit from transcendental and pragmatic notions of the good life. (shrink)

This book explores the intimate connections, conflicts and discontinuities between religion and philosophy in the Platonic and Neoplatonic traditions from Antiquity to the early Medieval period. It presents a broader comparative view of Platonism by examining the strong Platonist resonances among different philosophical/religious traditions, primarily Jewish, Christian, Islamic and Hindu, and suggests many new ways of thinking about the relation between these two fields or disciplines that have in modern times become such distinct and, at times, entirely separate domains.

The Institute of Medicine's report, the American Medical Association's project, the Open Society Institute's and the initiative sponsored by the Robert Wood Johnson Foundation have focused attention on improving the care of dying patients. These efforts include advance care planning and the use of written advance directives. Although previous studies have provided quantitative descriptions of patient preferences for life-sustaining treatment, including those documented in written ADs, to our knowledge open-ended written preferences have not been studied. Studies of these open-ended preferences (...) could highlight issues with respect to quality end-of-life care. The purpose of this study was to explore the open-ended proxy, health, and personal care preferences of people with HIV as expressed in a written AD form. (shrink)

Does tenure serve its original purpose of promoting freedom of inquiry for academics in teaching and research? It seems not. Of concern is the finding that achieving tenure does not translate into a significant increase in exercise of freedom of inquiry either in teaching or research. Why? Promotion evaluation for associate professors by their senior colleagues has a continued inhibiting effect. (Published Online February 8 2007).