As the field of clinical ethics consultation sets standards and moves forward with the Quality Attestation process, questions should be raised about what ethical issues really do arise in practice. There is limited data on the type and number of ethics consultations conducted across different settings. At Loyola University Medical Center, we conducted a retrospective review of our ethics consultations from 2008 through 2013. One hundred fifty-six cases met the eligibility criteria. We analyzed demographic data on these patients and conducted (...) a content analysis of the ethics consultation write-ups coding both the frequency of ethical issues and most significant, or key, ethical issue per case. Patients for whom ethics consultation was requested were typically male, white, between 50 and 69 years old, of non-Hispanic origin, and of Roman Catholic faith. Nearly half were in the intensive care unit and 44.2 % died in the hospital. The most frequent broad ethical categories were decision-making, goals of care/treatment, and end-of-life. More specifically, capacity, patient’s wishes/autonomy, and surrogate decision maker were the most frequent particular ethical issues. The most common key ethical issues were withdrawing/withholding treatment, patient wishes/autonomy, and capacity. Our findings provide additional data to inform the training of clinical ethics consultants regarding the ethical issues that arise in practice. A wider research agenda should be formed to collect and compare data across institutions to improve education and training in our field. (shrink)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 RECORDER'S PREFACE . . . . . . . . . . . . . . . . . . (...) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 THE DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.. (shrink)

The stories in this volume shed light on the potential of narrative inquiry to fill gaps in knowledge, particularly given the mixed results of quantitative research on patient views of and experiences with genetic and genomic testing. Published studies investigate predictors of testing (particularly risk perceptions and worry); psychological and behavioral responses to testing; and potential impact on the health care system (e.g., when patients bring DTC genetic test results to their primary care provider). Interestingly, these themes did not dominate (...) the narratives published in this issue. Rather, these narratives included consistent themes of expectations and looking for answers; complex emotions; areas of contradiction and conflict; and family impact. More narrative research on patient experiences with genetic testing may fill gaps in knowledge regarding how patients define the benefits of testing, changes in psychological and emotional reactions to test results over time, and the impact of testing on families. (shrink)

Everyone agrees that testing hypotheses is important, but Bowers et al. provide scant details about where hypotheses about perception and brain function should come from. We suggest that the answer lies in considering how information about the outside world could be acquired – that is, learned – over the course of evolution and development. Deep neural networks (DNNs) provide one tool to address this question.

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious (...) wrongdoing by physicians. (shrink)

Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

This paper argues that in Christian Wolff’s theory of knowledge, logical regimentation does not take the place of experiential justification, but serves to facilitate the application of empirical information and clearly exhibit its warrant. My argument targets rationalistic interpretations such as R. Lanier Anderson’s. It is common ground in this dispute that making concepts “distinct” issues in the premises on which all deductive justification rests. Against the view that concepts are made distinct only by analysis, which is carried out (...) by the understanding independently of experience, I contend that for Wolff some distinct concepts are arrived at through experience. I emphasize that Wolff countenances empirical methods of obtaining distinct concepts even in mathematics. This striking feature of his view indicates how its empiricist elements can be reconciled with his injunction to follow “mathematical” method. (shrink)

Analysis of Emmy Noether's 1918 theorems provides an illuminating method for testing the consequences of coordinate generality, and for exploring what else must be added to this requirement in order to give general covariance its far-reaching physical significance. The discussion takes us through Noether's first and second theorems, and then a third related theorem due originally to F. Klein. Contact will also be made with the contributions of, principally, J.L. Anderson, A. Trautman, P.A.M. Dirac, R. Torretti and the father (...) of the whole business, A. Einstein. (shrink)

_Review of: Anderson, Abraham, _Kant, Hume, and the Interruption of Dogmatic Slumber_, New York, Oxford University Press, 2020, 180+xxii, 978-0-19-009674-8_.

Analysis of Emmy Noether’s 1918 theorems provides an illuminating method for testing the consequences of “coordinate generality”, and for exploring what else must be added to this requirement in order to give general covariance its far-reaching physical significance. The discussion takes us through Noether’s first and second theorems, and then a third related theorem due originally to F. Klein. Contact will also be made with the contributions of, principally, J.L. Anderson, A. Trautman, P.A.M. Dirac, R. Torretti and the father (...) of the whole business, A. Einstein (an apparent shift in Einstein’s thinking on the significance of general covariance between 1916 and 1918 is highlighted). (shrink)

More than forty years have passed since Congress, in response to the Civil Rights Movement, enacted sweeping antidiscrimination laws in the Civil Rights Act of 1964, the Voting Rights Act of 1965, and the Fair Housing Act of 1968. As a signal achievement of that legacy, in 2008, Americans elected their first African American president. Some would argue that we have finally arrived at a postracial America, butThe Imperative of Integration indicates otherwise. Elizabeth Anderson demonstrates that, despite progress toward (...) racial equality, African Americans remain disadvantaged on virtually all measures of well-being. Segregation remains a key cause of these problems, and Anderson skillfully shows why racial integration is needed to address these issues. Weaving together extensive social science findings--in economics, sociology, and psychology--with political theory, this book provides a compelling argument for reviving the ideal of racial integration to overcome injustice and inequality, and to build a better democracy. -/- Considering the effects of segregation and integration across multiple social arenas, Anderson exposes the deficiencies of racial views on both the right and the left. She reveals the limitations of conservative explanations for black disadvantage in terms of cultural pathology within the black community and explains why color blindness is morally misguided. Multicultural celebrations of group differences are also not enough to solve our racial problems. Anderson provides a distinctive rationale for affirmative action as a tool for promoting integration, and explores how integration can be practiced beyond affirmative action. -/- Offering an expansive model for practicing political philosophy in close collaboration with the social sciences, this book is a trenchant examination of how racial integration can lead to a more robust and responsive democracy. (shrink)

Feminist epistemology and philosophy of science studies the ways in which gender does and ought to influence our conceptions of knowledge, the knowing subject, and practices of inquiry and justification. It identifies ways in which dominant conceptions and practices of knowledge attribution, acquisition, and justification systematically disadvantage women and other subordinated groups, and strives to reform these conceptions and practices so that they serve the interests of these groups. Various practitioners of feminist epistemology and philosophy of science argue that dominant (...) knowledge practices disadvantage women by (1) excluding them from inquiry, (2) denying them epistemic authority, (3) denigrating their “feminine” cognitive styles and modes of knowledge, (4) producing theories of women that represent them as inferior, deviant, or significant only in the ways they serve male interests, (5) producing theories of social phenomena that render women's activities and interests, or gendered power relations, invisible, and (6) producing knowledge (science and technology) that is not useful for people in subordinate positions, or that reinforces gender and other social hierarchies. Feminist epistemologists trace these failures to flawed conceptions of knowledge, knowers, objectivity, and scientific methodology. They offer diverse accounts of how to overcome these failures. They also aim to (1) explain why the entry of women and feminist scholars into different academic disciplines, especially in biology and the social sciences, has generated new questions, theories, and methods, (2) show how gender has played a.. (shrink)

We articulate a view of natural kinds as complex universals. We do not attempt to argue for the existence of universals. Instead, we argue that, given the existence of universals, and of natural kinds, the latter can be understood in terms of the former, and that this provides a rich, flexible framework within which to discuss issues of indeterminacy, essentialism, induction, and reduction. Along the way, we develop a 'problem of the many' for universals.

Can human beings be free and responsible if there is an all-powerful God? Anselm of Canterbury offers viable answers to questions which have plagued religious people for at least two thousand years. Katherin Rogers examines Anselm's reconciliation of human free will and divine omnipotence in the context of current philosophical debates.

Introduction -- Anselm's classical theism -- The Augustinian legacy -- The purpose, definition, and structure of free choice -- Alternative possibilities and primary agency -- The causes of sin and the intelligibility problem -- Creaturely freedom and God as Creator Omnium -- Grace and free will -- Foreknowledge, freedom, and eternity : part I, the problem and historical background -- Foreknowledge, freedom, and eternity : part II, Anselm's solution -- The freedom of God.

Abstract In this paper I suggest a way that an already promising view on ethical art criticism can account for the value of mediocre artworks which endorse morally commendable perspectives. In order for the view I call prescriptive ethicism to deal with such cases of critical ambivalence, it must take account of the interaction between moral content and form in art. Such interaction is seen in the way the aesthetic features of an artwork partly determine its moral value, or success (...) in providing ethical insight. I argue that if a work lacks the kind of moral value which is determined by the interaction between form and content, then we have little reason to engage with that work. When a work expresses an otherwise commendable moral attitude in a clumsy or trite manner, while it is clearly compromised aesthetically, it is also compromised ethically. For such a work forfeits the ability to reveal new aspects of ethical life. (shrink)

The trouble with business schools -- The great, but delicate experiment -- A hippocratic oath for business -- Six more arguments for the MBA oath -- The purpose of a manager -- Ethics and integrity -- No man is an island : stakeholders -- Ambition and good faith -- The letter and the spirit : law -- The sunlight of responsibility : transparency -- Personal and professional growth -- Sustainable prosperity : a partnership for living well -- Accountability.

Gatekeeping, or determining membership of your group, is crucial to science: the moniker ‘scientific’ is a stamp of epistemic quality or even authority. But gatekeeping in science is fraught with dangers. Gatekeepers must exclude bad science, science fraud and pseudoscience, while including the disagreeing viewpoints on which science thrives. This is a difficult tightrope, not least because gatekeeping is a human matter and can be influenced by biases such as groupthink. After spelling out these general tensions around gatekeeping in science, (...) we shed light on them with a case study from psychology. This concerns whether academic psychologists rightly or wrongly classify the applied-psychology framework of NLP (‘neuro-linguistic programming’) as unscientific and even pseudoscientific. This example of gatekeeping is particularly instructive because both the NLP community and the psychology community, we argue, make legitimate but also illegitimate moves. This case gives rise to several general insights about gatekeeping in science more generally. (shrink)

This is a very introductory introduction to some ways in which the special and general theories of relativity may bear upon metaphysical questions about the nature of time and space, and the persistence of objects.

Accessible and elegant teachings from a well-loved and revered woman Zen teacher. “The truth and joy of this life is that we cannot change things as they are.” The import of those words can be found beautifully expressed in the work of the woman who spoke them, Katherine Thanas (1927–2012)—in her art, in her writing, and especially in her Zen teaching. Fearlessly direct and endlessly curious, Katherine’s understanding of Zen was inseparable from her affinity for the arts. She (...) was an MFA student studying painting with Richard Diebenkorn, the preeminent Californian abstract painter, when she met Shunryu Suzuki, author of Zen Mind, Beginner’s Mind, in the sixties. Soon thereafter she decided to drop painting to dedicate herself to Zen, which she did for the last forty years of her life. In these essential teachings taken from her dharma talks—which make up her only book—her love of art and literature shine through in her elegant prose and her vast references, from poets William Stafford and Naomi Shihab Nye to the Zen teachings of Dogen and Robert Aitken. Ranging on subjects from the practice of zazen to the meaning of life, Katherine urges us to “develop an insatiable appetite for inner awareness, to become proficient with this mind.” This slim volume is an important contribution by a well-loved and revered teacher. (shrink)

I investigate the consequences of Nietzsche's perspectivism for notions of truth and objectivity, and show how the metaphor of visual perspective motivates an epistemology that avoids self-referential difficulties. Perspectivism's claim that every view is only one view, applied to itself, is often supposed to preclude the perspectivist's ability to offer reasons for her epistemology. Nietzsche's arguments for perspectivism depend on “internal reasons”, which have force not only in their own perspective, but also within the standards of alternative perspectives. Internal reasons (...) allow a perspectivist argument against dogmatism without presupposing aperspectival criteria for theory choice. Nietzsche also offers “internal” conceptions of truth and objectivity which reduce them to a matter of meeting our epistemic standards. This view has pluralistic implications, which conflict with common sense, but it is nevertheless consistent and plausible. Nietzsche's position is similar to Putnam's recent internalism, and this is due to their common Kantian heritage. (shrink)

Learn to be responsible with Grover and your Sesame Street friends! Young readers will discover how to be a good helper to both themselves and those around them. Now in Spanish!

Critical Notice on Organizations as Wrongdoers By Stephanie Collins Oxford University Press, 2023. -/- Extract: What, if any, role does metaphysics have to play in addressing moral questions? When answering questions about moral responsibility, many theories rely on answers to questions about the nature of agency and agents, the persistence of persons and the existence and nature of free will. In recent work in social ontology, philosophers have argued for views of social categories or identities that take ethical and social–political (...) desiderata into consideration in several ways. Some argue for views of gender identities that depend on epistemic and ethical considerations (Bettcher, 2009). Others develop views of gender categories in ways they take to be metaphysically realist, tracking robust explanatory patterns in the world. For instance, Barnes (2017) argues for this interpretation of Haslanger’s views of racial and gender categories. Others argue that injustice and oppression are reflected in the nature of social categories. For instance, while it ought not to be this way, some gender categories are, for instance, trans-exclusionary (Ásta 2018). Indeed, one might even argue that social categories can involve a distinctively metaphysical form of oppression (Jenkins 2020, 2023). It is clear that many philosophers argue in ways that draw close connections between metaphysical and moral theorizing. ... (shrink)

Altruism is a well-studied phenomenon in the social sciences, but online altruism has received relatively little attention. In this article, we examine several cases of online altruism, and analyse the key characteristics of the phenomenon, in particular comparing and contrasting it against models of traditional donor behaviour. We suggest a novel definition of online altruism, and provide an in-depth, mixed-method study of a significant case, represented by the r/Assistance subreddit. We argue that online altruism can be characterized by its differing (...) experiences compared to traditional giving, from a giver’s point of view, and unique mechanisms and actions made possible by the internet. These findings explain why people give to anonymous strangers online and provide a new perspective on altruism that is important in building a more altruistic internet and society. (shrink)

This is a short response to Aaron Cotnoir's 'Composition as General Identity', in which I suggest some further applications of his ideas, and try to press the question of why we should think of his 'general identity relation' as a genuine identity relation.

In this chapter I outline some metaphysical views about time, and about persistence, and discuss how they can help us clarify our thinking about life and death.

The main goal of publicly funded biomedical research is to generate social value through the creation and application of knowledge that can improve the well-being of current and future people. Prioritising research with the greatest potential social value is crucial for good stewardship of limited public resources and ensuring ethical involvement of research participants. At the National Institutes of Health (NIH), peer reviewers hold the expertise and responsibility for social value assessment and resulting prioritisation at the project level. However, previous (...) research has shown that peer reviewers place more emphasis on a study’s methods (‘Approach’) than on its potential social value (best approximated by the criterion of ‘Significance’). Lower weighting of Significance may be due to reviewers’ views on the relative importance of social value, their belief that social value is evaluated at other stages of the research priority-setting process or the lack of guidance on how to approach the challenging task of assessing expected social value. The NIH is currently revising its review criteria and how these criteria contribute to overall scores. To elevate the role of social value in priority setting, the agency should support empirical research on how peer reviewers approach the assessment of social value, provide more specific guidance for reviewing social value and experiment with alternative reviewer assignment strategies. These recommendations would help ensure that funding priorities align with the NIH’s mission and the obligation of taxpayer-funded research to contribute to the public good. (shrink)

Christian ethical imagination was always tempered by various social prejudices prevalent in local contexts. Particularly during modernity and subsequently through colonial expansion, the role of race and caste became central to the expansion of Christianity through missionary activity. A closer scrutiny of colonial missionary Christianity clearly suggests the significance of racialised worldview shaping theological and ethical paradigms. In particular contexts, such racialised imagination underpinned and gave credence to other forms of social prejudices, such as caste in South Asia. Through a (...) post-colonial lens, I examine the role of race and caste in shaping Christian ethical frameworks and articulate the rationale for ‘decolonising’ the modern foundations of Christian ethics in pursuit of racial justice in our contemporary society. (shrink)

Dialogue, as a philosophical form, enables the exploration of the conditions, limits, and consequences of understanding arguments. Two philosophers who undertook to write dialogues—Plato and Heidegger—feature moments in philosophical conversation in which understanding, on its own, fails to convince an interlocutor of an argument. In this article, I examine the philosophical stakes of the collisions which unfold in Plato’s Gorgias, between Socrates and Callicles, and in Heidegger’s “Triadic Conversation,” between the Guide and the Scientist. Plato’s Socrates is ostensibly unsuccessful in (...) persuading Callicles to adopt his position while Heidegger’s Guide is able to support the Scientist in learning a new way of thinking. I argue that it is Heidegger’s attention to feeling as a philosophically significant phenomenon which can overcome trans-rational resistance which may persist even after truth has been determined. (shrink)

The work of Michèle Le Dœuff creatively disrupts established notions of what philosophy might be. Far from being a discipline about the leader and the disciple, a hierarchy of knowledge and paternalism, Le Dœuff proposes a philosophy of dialogue and friendship. The conversations in this book explore how this philosophy can be enacted and explored, and show how openness and generosity can be the starting point of truly rigorous thinking. Introduced and curated by the late philosopher, Pamela Sue Anderson, (...) In Dialogue with Michèle Le Dœuff explores themes like contemporary feminism, joy in philosophy, memory, the significance of friendship to thinking and a key Le Dœuffian concept, the imaginary. Le Dœuff's interlocutors, including Penelope Deutscher, Elizabeth Fallaize and Meenda Dhanda, are some of the most significant thinkers in the fields of feminism and continental thought and provide insights and ways into considering philosophy as a profoundly dialogical exercise. (shrink)

Unlike most fiction writers, Proust was trained in philosophy. In fact, he even considered writing a philosophical treatise instead of the novel we know so well. This hesitation about what form his writing should take still haunts his final choice of a novel, which is both philosophical, and yet, not philosophy. Take your pick of philosophers, from Plato to Nietzsche, and you can easily find an essay or even a book arguing that this particular philosopher most applies to Proust. But (...) as one plunges into the narrative that he finally wrote, one is struck by the fact that In Search of Lost Time feels nothing like what we often call a philosophical novel, or even, a novel of ideas. Instead, philosophical reflection lies in the shadows of his fictional world, a sort of parallel life that can be found in the underweave. (shrink)

The lifeworld of the classroom -- Getting deep : the integrative biology of teaching and learning -- Preparation for teaching : "what can they experience in class?" -- Teaching as improvisational jazz : "to go somewhere to answer a big question" -- Free to learn : a radical aspect of our approach -- Student experiences of other students : "all together in this space" -- Transcending the classroom : student reports of personal and professional change -- Messing up and messing (...) about : student needs and teachers' adaptation of our phenomenological approach -- The contribution of our existential phenomenological approach to higher education pedagogy : implications for theory, research, and practice. (shrink)

Over the past two decades, stories of world-ending catastrophe have featured prominently in film and television. Zombie apocalypses, climate disasters, alien invasions, global pandemics and dystopian world orders fill our screens-typically with a singular figure or tenacious group tasked with saving or salvaging the world. Why are stories of End Times crisis so popular with audiences? And why is the hero so often a white man who overcomes personal struggles and incredible obstacles to lead humanity toward a restored future? This (...) book examines the familiar trope of the hero and the recasting of contemporary anxieties in narratives like The Walking Dead, Snowpiercer and Mad Max: Fury Road. Some have familiar roots in Western cultural traditions yet many question popular assumptions about heroes and heroism to tell new and fascinating stories about race, gender and society and the power of individuals to change the world. (shrink)

How do things persist? Are material objects spread out through time just as they are spread out through space? Or is temporal persistence quite different from spatial extension? This key question lies at the heart of any metaphysical exploration of the material world, and it plays a crucial part in debates about personal identity and survival. This book explores and compares three theories of persistence — endurance, perdurance, and stage theories — investigating the ways in which they attempt to account (...) for the world around us. Having provided valuable clarification of its two main rivals, the book concludes by advocating stage theory. Such a basic issue about the nature of the physical world naturally has close ties with other central philosophical problems. This book includes discussions of change and parthood, of how we refer to material objects at different times, of the doctrine of Humean supervenience, and of the modal features of material things. In particular, it contains new accounts of the nature of worldly vagueness, and of what binds material things together over time, distinguishing the career of a natural object from an arbitrary sequence of events. Each chapter concludes with a reflection about the impact of these metaphysical debates upon questions about our personal identity and survival. (shrink)