The Consequence Argument has elicited various responses, ranging from acceptance as obviously right to rejection as obviously problematic in one way or another. Here we wish to focus on one specific response, according to which the Consequence Argument begs the question. This is a serious accusation that has not yet been adequately rebutted, and we aim to remedy that in what follows. We begin by giving a formulation of the Consequence Argument. We also offer some tentative proposals about the nature (...) of begging the question. Although the charge of begging the question is frequently made in philosophy, it is surprisingly difficult to pin down the precise nature of this dialectical infelicity (or family of such infelicities). Thus we offer some new proposals about the nature of begging the question with an eye to understanding what is going on in central cases in which the charge is legitimately made. We then defend the Consequence Argument against the charge that it begs the question, so construed. We contend that, whatever the other liabilities of the argument may be, it does not beg the question against the compatibilist. (shrink)

Paternalism in the medical care of children is appropriate and ethically justifiable. However, dilemmatic disagreement by paternalistic agents as to which clinical choice is in the child's best interest may occur because of the underlying conflict between two rival standards for the moral value of life: longevity versus quality. Neither standard is unreasonable. Either could be the basis for choice of medical care by the parents or by the pediatrician. Having the child choose between options disputed by his parents and (...) the pediatrician is unlikely to resolve their conflict. Exercise of informed consent by the adolescent requires agreement by his parents to relinquish their paternalistic veto. The probable best-interest choice by the child when he has matured could be reasonably made from either standard. Therefore, the longevity/quality of life question ought not ordinarily to be foreclosed by paternalistic authority which opts for one standard to the exclusion of the other. Medical interventions, paternalistically determined, are justified in the face of deteriorating quality, but only as long as the interventions themselves do not cause deterioration. Application of this limitation of paternalism to the zone of agreement between the rival life standards is made to clinical case examples. Multiple extrinsic criteria may measure the quality of life. Three quality factors, sensation of pain, capacity to communicate and physical functioning are considered. The extent of the zone of agreement between the two life standards varies because quality of life is a relative good, contingent both upon which extrinsic criteria are selected to assess it and upon the priorities which are set among these criteria. (shrink)

Decision-making capacity (DMC) is, in many ways, a central organizing concept of modern health care ethics. Patients with DMC have the moral—if not always the legal—authority to make all manner of...

In most children’s hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians (...) about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children’s hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are ethics committee meetings, Nursing Ethics Forum, ethics Brown Bag workshops, PICU ethics rounds, Grand Rounds, NICU Comprehensive Care Rounds, Palliative Care Team case conferences, multidisciplinary consults in Fetal Health Center, and ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of “core competencies” than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple “moral spaces” in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set out to do than in the role of the typical hospital ethics consultant today. (shrink)

Recent reports of the discovery of a “God module” in the human brain derive from the fact that epileptic seizures in the left temporal lobe are associated with ecstatic feelings sometimes described as an experience of the presence of God. The brain area involved has been described as either (a) the seat of an innate human faculty for experiencing the divine or (b) the seat of religious delusions.In fact, religious experience is extremely various and involves many parts of the brain, (...) including some that are prehuman in their evolutionary history and some that are characteristically human. In the continuing integration of such experiences, spiritual formation takes place. Thus the entire human brain might be described as a “God module.”Such a process is only possible because of the brain's complexity. The human brain is the most complex entity for its size that we know of. As used here, complexity is a specialized term denoting the presence of a web of interlinked and significant connections—the more intricate the web, the more complex the entity. Complex systems develop only in a milieu that provides both lawfulness and freedom, and they tend to be self‐organizing, becoming more complex and more effective as a result of both inward and outward experience. The evidence suggests that both personal growth and spiritual growth are processes of complexification of character, and of the brain itself. This thesis is tested in light of the work of William James and James W. Fowler. (shrink)

The pandemic creates unprecedented challenges to society and to health care systems around the world. Like all crises, these provide a unique opportunity to rethink the fundamental limiting assumptions and institutional inertia of our established systems. These inertial assumptions have obscured deeply rooted problems in health care and deflected attempts to address them. As hospitals begin to welcome all patients back, they should resist the temptation to go back to business as usual. Instead, they should retain the more deliberative, explicit, (...) and transparent ways of thinking that have informed the development of crisis standards of care. The key lesson to be learned from those exercises in rational deliberation is that justice must be the ethical foundation of all standards of care. Justice demands that hospitals take a safety‐net approach to providing services that prioritizes the most vulnerable segments of society, continue to expand telemedicine in ways that improve access without exacerbating disparities, invest in community‐based care, and fully staff hospitals and clinics on nights and weekends. (shrink)

The publication of 'Animal Rights and Souls in the 18th Century' will be welcomed by everyone interested in the development of the modern animal liberation movement, as well as by those who simply want to savour the work of enlightenment thinkers pushing back the boundaries of both science and ethics. At last these long out-of-print texts are again available to be read and enjoyed - and what texts they are! Gems like Bougeant's witty reductio of the Christian view of animals (...) are included together with path-breaking works of ethics such as Primatt's A Dissertation on the Duty of Mercy and Sin of Cruelty to Brute Animals . There are works I have never seen before, including the remarkable Cry of Nature by the Scottish revolutionary Jacobin, John Oswald. In this set, everyone will find something novel, delightful and truly enlightening. - Peter Singer The discussion of animal rights and the moral status of animals, so prevalent in the late twentieth century, has its roots in the mid to late eighteenth century. Some of the themes we consider of recent invention - the legal standing of animals, the ethical status of vegetarians, cruelty towards animals, ultimately resulting in cruelty to humans - are of long standing. But in the eighteenth-century literature they are interconnected with theological issues surrounding animal souls, the birth of the life sciences, the great chain of being and other peculiarly eighteenth-century problems. This collection explores the exciting early discussions of moral theories concerning animals, placing them within their historical and social context. It reveals that issues such as vivisection, animal souls and vegetarianism were very much live philosophical subjects 200 years ago. The six volumes reprinted here includes complete works and edited extracts from such key eighteenth-century thinkers as Oswald, Primatt, Smellie, Monboddo and Jenyns. Many of the materials are extremely rare and never previously reprinted. The collection, edited with a new introduction and bio-bibliography by Aaron V. Garrett provides valuable original source material to supplement contemporary discussions of animal rights. --18th-century material on the theme of animal rights and practical ethics --an important supplement to contemporary animal rights discussions --provides a broader account of early discussions of the 'science of human nature' through animals --widens our understanding of 18th-century ethics through an important area of practical ethics --includes many scarce texts, most of which have never been reprinted before. (shrink)

In this issue of the Report, Daniel Groll suggests new ways to understand old tensions between autonomy and paternalism. He categorizes disagreements between doctors and patients in four ways. Some are about the ends or goals of medical treatment. For these, he claims, patient choices are based upon patient values, and physicians should neither challenge nor assess them. More common are disagreements about the appropriate means to achieve an agreed-upon goal. These subdivide into two distinct categories—those in which the relative (...) efficacy of possible means is “medically assessable” and those in which it is not. When disagreements are medically assessable, Groll argues, doctors can legitimately challenge patient .. (shrink)

Much more than just an anthology, this survey of humanity's search for the meaning of life includes the latest contributions to the debate, a judicious selection of key canonical essays, and insightful commentary by internationally respected philosophers.

Bioethical decision‐making in pediatrics diverges from similar decisions in other medical domains because the young child is not an autonomous decision‐maker, while the teen is developing—and should be encouraged to develop—autonomy and decisional capacity. Thus the balance between autonomy and beneficence is fundamentally different in pediatrics than in adult medicine. While ethical dilemmas that reflect these fundamental issues are common, many pediatric physician and nursing training programs do not delve into the issues or offer specific training about how to deal (...) with borderline cases.To meet this need, the Children's Mercy Bioethics Center in Kansas City, Missouri, created a program specifically dedicated to serving practicing, experienced pediatric health professionals. Our students come from various professional disciplines: they are doctors, nurses, social workers, chaplains, lawyers, psychologists, counselors, and hospital administrators practicing in pediatrics. (shrink)

Journal editorials, career features, and the popular press commonly talk of a graduate student mental health crisis. To date, studies on graduate student mental health have employed cross-sectional designs, limiting any causal conclusions regarding the relationship between entry into graduate study and mental health. Here, we draw on data from a longitudinal study of undergraduate students in Aotearoa New Zealand, allowing us to compare participants who did, and did not, transition into PhD study following the completion of their undergraduate degree. (...) Using multilevel Bayesian regression, we identified a difference in mental wellbeing between those who entered PhD study and those who did not. This difference, however, was largely due to those not entering PhD study displaying an increase in mental wellbeing. Participants that entered PhD study displayed a small decrease in mental wellbeing, with the posterior distribution of the simple effect heavily overlapping zero. This latter finding was orders of magnitude smaller than one might expect based on previous cross-sectional research and provides an important message; that a marked drop in mental health is not an inevitable consequence of entering graduate study. (shrink)

The Library of Scottish Philosophy: Volumes 1 – 6, Exeter: Imprint Academic, 2004 James Otteson , ed. Adam Smith: Selected Philosophical Writings, 247pp. Paperback £12.95. ISBN 184540-001-1 James Harris , ed. James Beattie: Selected Philosophical Writings, 204pp. Paperback £12.95. ISBN 0907845-711 David Boucher , ed. The Scottish Idealists: Selected Philosophical Writings, 201pp. Paperback £12.95. ISBN 0907845-72X Jonathan Friday , ed. Art and Enlightenment: Scottish Aesthetics in the 18th century, 212pp. Paperback £12.95. ISBN 0907845-762 Gordon Graham , ed. Scottish Philosophy: Selected (...) Writings 1690–1960, 253pp. Paperback £12.95. ISBN 0907845-746 Esther McIntosh , ed. John Macmurray: Selected Philosophical Writings, 198pp. Paperback £12.95. ISBN 0907845-738. (shrink)

This critical study of John Broome’s Rationality Through Reasoning raises some questions about the various requirements of rationality Broome formulates, pointing out some apparent gaps and counterexamples; proposes a general description of rationality that is broadly consistent with Broome’s requirements while providing them with a unifying justification, filling the gaps, and removing the counterexamples; and presents two objections to the book’s broader argument concerning the nature and importance of reasoning.

Edwards’s views on the nature of the human will demonstrate his unique ability to unite philosophical rigor and theological fervor. Edwards was a staunch defender of the Reformed doctrines of absolute divine sovereignty and meticulous providence, but he was also a proponent of the intellectual tools and methods of early modern philosophy (and of John Locke in particular). His ultimate statement of his doctrinal position, Freedom of the Will, is the masterful result of these dual commitments.

Physical activity, and likely the motivation for it, varies throughout the day. The aim of this investigation was to create a short assessment (CRAVE: Cravings for Rest and Volitional Energy Expenditure) to measure motivation states (wants, desires, urges) for physical activity and sedentary behaviors. Five studies were conducted to develop and evaluate the construct validity and reliability of the scale, with 1,035 participants completing the scale a total of 1,697 times. In Study 1, 402 university students completed a questionnaire inquiring (...) about the want or desire to perform behaviors “at the present moment (right now).” Items related to physical activity (e.g., “move my body”) and sedentary behaviors (e.g., “do nothing active”). An exploratory structural equation model (ESEM) revealed that 10 items should be retained, loading onto two factors (5 each for Move and Rest). In Study 2, an independent sample (n= 444) confirmed these results and found that Move and Rest desires were associated with stage-of-change for exercise behavior. In Study 3, 127 community-residing participants completed the CRAVE at 6-month intervals over two years- two times each session. Across-session interclass correlations (ICC) for Move (ICC = 0.72–0.95) and Rest (ICC = 0.69–0.88) were higher than when they were measured across 24-months (Move: ICC = 0.53; Rest: ICC = 0.49), indicating wants/desires have state-like qualities. In Study 4, a maximal treadmill test was completed by 21 university students. The CRAVE was completed immediately pre and post. Move desires decreased 26% and Rest increased 74%. Changes in Move and Rest desires were moderately associated with changes in perceived physical fatigue and energy. In Study 5, 41 university students sat quietly during a 50-min lecture. They completed the CRAVE at 3 time points. Move increased 19.6% and Rest decreased 16.7%. Small correlations were detected between move and both perceived energy and tiredness, but not calmness or tension. In conclusion, the CRAVE scale has good psychometric properties. These data also support tenets of the WANT model of motivation states for movement and rest (Stults-Kolehmainen et al., 2020a). Future studies need to explore how desires to move/rest relate to dynamic changes in physical activity and sedentarism. (shrink)

It is widely believed today that John Duns Scotus’s doctrine of the univocity of being ushered in various deleterious philosophical and theological consequences that resulted in the negative features of modernity. Included in this common opinion, but not examined, is the belief that by affirming univocity Scotus thereby also denied the analogy of being. The present essay challenges this belief by recovering Scotus’s true position on analogy, namely that it obtains in the order of the real, and that complex (...) concepts of creatures are analogically related to complex concepts of God. Scotus’s doctrine is then compared to the later Scotist tradition. The common opinion of the Scotist school from the fourteenth century onward followed Scotus’s position on analogy and considerably expanded upon his scattered remarks. (shrink)

John Foxal was an English Franciscan active primarily in Italy in the latter half of the fifteenth century. His philosophical and theological positions were Scotist, and in his works he comments upon various texts of John Duns Scotus with reference to the Scotist school of thought active in the early fourteenth century. In this article we supplement the list of extant manuscripts, provide a revised list of Foxal’s treatises and offer an edition of one of these, the Tractatus (...) de propositione per se nota. (shrink)

Proper interpretations of symbols of authority are important for navigating both our cultural settings and the contours of Scripture. This paper looks at the ways the Book of Revelation contrasts images of competing authoritative kings, asking the question, who is worthy of worship, Caesar or Christ? In the African Folk-Islamic context of the Makua-Metto people of Mozambique, familiar national and traditional symbols of authority provide a framework for a robust reading of John’s Apocalypse.