How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness. How Doctors Think is divided into four parts. Part one introduces the (...) concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment. (shrink)

Ronald Barnett pursues this quest through an exploration of pairs of contending concepts that speak to the idea of the university such as space and time; being ...

Should we believe our controversial philosophical views? Recently, several authors have argued from broadly conciliationist premises that we should not. If they are right, we philosophers face a dilemma: If we believe our views, we are irrational. If we do not, we are not sincere in holding them. This paper offers a way out, proposing an attitude we can rationally take toward our views that can support sincerity of the appropriate sort. We should arrive at our views via a certain (...) sort of ‘insulated’ reasoning – that is, reasoning that involves setting aside certain higher-order worries, such as those provided by disagreement – when we investigate philosophical questions. (shrink)

Despite both positive and negative perceptions of the current state of higher education, the contemporary debate over what it is to be a university is limited. Most of all, it is limited imaginatively. The range of imagined options is narrow. The imagination has not been given anything even approaching a wide scope. As a result, our sense as to what a university could be and could become in the modern age is itself impoverished. If we are seriously to develop a (...) wide range of ideas of the university that is adequate to the challenges of the modern world, the imagination itself needs to be freed. Imagining the University seeks to address each of these sets of issues and will do so by first, identifying a very wide range of ideas of the university as it is now unfolding and could become; secondly, by evaluating those conceptions of the university with a classification of ideas of the university; and thirdly, by reflecting on the imagination itself, its current impoverishment and its possibilities. Whether studying, researching or deciding policy, this book is vital reading to all those involved in the planning and delivery of higher education. (shrink)

Self-verifying judgments like _I exist_ seem rational, and self-defeating ones like _It will rain, but I don’t believe it will rain_ seem irrational_._ But one’s evidence might support a self-defeating judgment, and fail to support a self-verifying one. This paper explains how it can be rational to defy one’s evidence if judgment is construed as a mental performance or act, akin to inner assertion. The explanation comes at significant cost, however. Instead of causing or constituting beliefs, judgments turn out to (...) be mere epiphenomena, and self-verification and self-defeat lack the broader philosophical import often claimed for them. (shrink)

An internalist slogan says that justification depends on internal factors. But which factors are those? This paper examines some common motivations favoring internalism over externalism, and says they are compatible with including dispositional and even past mental states in the internal.

The “scientific essentialist” doctrine asserts that the following are examples of a posteriori necessary identities: water is H2O; gold is the element with atomic number 79; and heat is the motion of molecules. Evidence in support of this assertion, however, is difficult to find. Both Hilary Putnam and Saul Kripke have argued convincingly for the existence of a posteriori necessities. Furthermore, Kripke has argued for the existence of a posteriori necessary identities in regard to a particular class of statements involving (...) proper names. Neither Kripke nor Putnam, however, has argued convincingly that sentences containing syntactically complex terms or descriptive phrases can express a posteriori necessary identities. I will argue by way of a hypothetical example that ‘water is H2O’ does not express a necessary identity. My argument is unique in that it attacks the relevant sufficiency claim needed to underwrite this putative necessary identity.1 That is, even if we grant that water is necessarily composed of H2O, we should not accept that H2O necessarily forms water. (shrink)

Our experiences with many sorts of evils yield debates about the role of forgiveness as a possible moral response. These debates include (1) the preliminary question whether evils are, by definition, unforgivable, (2) the contention that evils may be forgivable but that forgiveness cannot entail reconciliation with one’s evildoer, (3) the concern that only direct victims of evils are in a position to decide if forgiveness is appropriate, (4) the conceptual worry that forgiveness of evil may not be genuine or (...) complete if hard feelings recur, (5) the interest of many in holding that forgiveness is never required, and (6) the concern that analyses of evil ought to prioritize the suffering, and credit the perspectives, of victims of evils, in tension with the possibility that forgiveness concerns the well-being of offenders. In this paper, I critically evaluate these concerns from the perspective of nonideal theory. I conclude that crediting victims’ perspectives is importantly basic to empirically informed moral theory, and that objections to forgiveness including (1) evil’s unforgivability ignore victims’ differing accounts. When we take actualities and experiences to be informative and central, some of the usual debates become less pressing, perhaps even moot. (shrink)

I. Introduction Two kinds of remedies have traditionally been employed for breach of contract: legal relief and equitable relief. Legal relief normally takes the form of money damages. Equitable relief normally consists either of specific performance or an injunction – that is, the party in breach may be ordered to perform an act or to refrain from performing an act. In this article I will use a “consent theory of contract” to assess the choice between money damages and specific performance. (...) According to such a theory, contractual obligation is dependent on more fundamental entitlements of the parties and arises as a result of the parties' consent to transfer alienable rights. My thesis will be that the normal rule favoring money damages should be replaced with one that presumptively favors specific performance unless the parties have consented to money damages instead. The principal obstacle to such an approach is the reluctance of courts to specifically enforce contracts for personal services. The philosophical distinction between alienable and inalienable rights bolsters this historical reticence, since a right to personal services may be seen as inalienable. I will then explain why, if the subject matter of a contract for personal services is properly confined to an alienable right to money damages for failure to perform, specific enforcement of such contracts is no longer problematic. Finally, I shall consider whether the subject matter of contracts for corporate services is properly confined to money damages like contracts for personal services, or whether performance of corporate services can be made the subject of a valid rights transfer and judicially compelled in the same manner as contracts for external resources. (shrink)

Dimensions of the ethical work climate, as conceptualized by Victor and Cullen (1988), are potentially important influences on individual ethical decision-making in the organizational context. The present study examined the direct and indirect effects of individuals' perceptions of work climate on their ethical judgments and behavioral intentions regarding an ethical dilemma. A national sample of marketers was surveyed in a scenario-based research study. The results indicated that, although perceived climate dimensions did not have a direct effect on behavioral intentions, there (...) were significant moderating effects. Climates perceived as emphasizing social responsibility and rules/codes moderated the individual ethical judgment-behavioral intentions relationship such that individuals were less likely to say that they would engage in a questionable selling practice even when they themselves did not believe the practice to be unethical. Respondents were somewhat more likely to form intentions consistent with their judgment that the questionable practice was morally acceptable when the ethical climate was characterized by an emphasis on team/friendship. (shrink)

In what senses can the academy be said to be a site of culture? Does that very idea bear much weight today? Perhaps the negative proposition has more substance, namely that the academy is no longer (if indeed it ever was) a place of culture. After all, we live in dark times-of unbridled power, tyranny, domination and manipulation. Some say that we have entered an age of the posthuman or even the inhuman. It just may be, however, that in such (...) a world, the academic community is needed more than ever for it offers a culture of justified revelation. It is a culture that reveals the world to us in new ways, but in ways that are attested and contested; its judgements emerge out of a critical and unworldly pedantry. With some hesitancy, we can legitimately therefore speak of not just a culture of the academic community but, indeed, the culture of the academic community. (shrink)

In Moral Passages, Kathryn Pyne Addelson presents an original moral theory suited for contemporary life and its moral problems. Her basic principle is that knowledge and morality are generated in collective action, and she develops it through a critical examination of theories in philosophy, sociology and women's studies, most of which hide the collective nature and as a result hide the lives and knowledge of many people. At issue are the questions of what morality is, and how moral theories (...) (whether traditional or feminist) are implemented. Addelson takes up a large number of historical cases and contemporary social problems, including teen pregnancy, contraception and abortion, and gay rights. These cases allow her to see how the knowledge and lives of some people are declared deviant or immoral, while those of others appear to show the public consensus. One case she uses throughout the book is Margaret Sanger's early work on birth control with the anarcho-syndicalist movement--a revisionist history that reveals rather than hides the collective nature of morality and knowledge. Addelson shows how the usual individualist philosophies promote theories which hide the authority of the professionals who make them. A collectivist approach, she argues, must show the part professionals play in collective action. Her aim is to allow professional knowledge makers to be morally and intellectually responsible. Based on Addelson's twenty years of work in feminist philosophy and interactionist sociology as well as her long-standing involvement in women's community organization, Moral Passages investigates how morality and knowledge are collectively enacted in today's world. (shrink)

Although the condition known as synaesthesia is currently undergoing a scientific resurgence, to date the literature has largely focused on the heterogeneous nature of synaesthesia across individuals. In order to provide a better understanding of synaesthesia, however, general characteristics need to be investigated. Synaesthetic experiences are often described as occurring ‘internally’ or in the ‘mind’s eye’, which is remarkably similar to how we would describe our experience of visual mental imagery. We assessed the role of visual imagery in synaesthesia by (...) sampling a large group of synaesthetes and found that they report experiencing more vivid mental images than controls. These findings have important implications for our general understanding of synaesthesia and, in particular, emphasize the need to control for visual imagery in behavioural and neuroimaging paradigms. (shrink)

On two standard views of vagueness, vagueness as to whether Harry is bald entails that nobody knows whether Harry is bald—either because vagueness is a type of missing truth, and so there is nothing to know, or because vagueness is a type of ignorance, and so even though there is a truth of the matter, nobody can know what that truth is. Vagueness as to whether Harry is bald does entail that nobody clearly knows that Harry is bald and that (...) nobody clearly knows that Harry is not bald. But it does not entail that nobody knows that Harry is bald or that nobody knows that Harry is not bald. Hence, the two standard views of vagueness are mistaken. (shrink)

I am persuaded both by the theory of evil advanced by Claudia Card in The Atrocity Paradigm and by the idea that there are evils done to the environment; however, I argue that the theory of evil she describes has difficulty living up to her claim that it "can make sense of ecological evils the victims of which include trees and even ecosystems" (2002, 16). In this paper, I argue that Card's account of evil does not accommodate the kinds of (...) harms inflicted on ecosystems and such nonhuman individuals as trees. I consider the possibility that Card intends a much broader version of evils than the language of the atrocity paradigm lets on, with its attention to sentience and dignity. I'm so persuaded by the atrocity paradigm, however, that I retain the centrality of suffering and introduce the idea that atrocities are intuitively massive, that is, done to groups or generations and not an individual person, animal or tree, so that the paradigm encourages us to think of evil as it relates to far more holistic entities which include the sentient. Evil may require the sort of suffering that only sentience can give rise to, which is not to say we let out trees but says rather that it is impossible to identify wrongs to ecosystems and groups that are not also intertwined with the fates of their sentient dependents. I conclude that Card is right to emphasize victims' suffering as a chief component of evil, and that the ontology of what constitutes a victim must be interpreted broadly, not the notion of suffering. (shrink)

The article “Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose,” Marshall et al. (2024) highlights the critical issue of care after an opioid overdose. “Revive and Re...

Pretty much everyone knows that our genes have at least something to do with how able or how high achieving we are. Some believe that we should not speak of this common knowledge, nor inquire into how genetic influence works or what it might mean. If we do not keep an open mind to the fact of genetic influence on academic achievement, however, then we cannot explore its possible implications. And if we do not consider the implications, then we cannot, (...) as a society, harness any potential benefits or avoid possible pitfalls. So that's what this essay is about—exploring what behavioral genetics research might be able to offer to educational theory, policy, and practice.We cannot yet use biological information to make accurate predictions for all children. We do know, however, that academic achievement is heritable, which is to say that differences between individuals are influenced by differences in their DNA. If genes are part of the problem for some pupils (to take the negative spin on this), then it seems likely that studying them could be part of a solution. And that's what behavioral geneticists are trying to do—to chart and understand pathways from DNA to behavior and to identify interventions that can maximize outcomes for all. The fact is, though, that we have an awfully long way to go. (shrink)

Counterfactual Entailment is the view that a counterfactual conditional is true just in case its antecedent entails its consequent. I present an argument for Counterfactual Entailment, and I develop a strategy for explaining away apparent counterexamples to the view. The strategy appeals to the suppositional view of counterfactuals, on which a counterfactual is essentially a statement, made relative to the supposition of its antecedent, of its consequent.

Sometimes form-meaning mappings in language are not arbitrary, but iconic: they depict what they represent. Incorporating iconic elements of language into a compositional semantics faces a number of challenges in formal frameworks as evidenced by the lengthy literature in linguistics and philosophy on quotation/direct speech, which iconically portrays the words of another in the form that they were used. This paper compares the well-studied type of iconicity found with verbs of quotation with another form of iconicity common in sign languages: (...) classifier predicates. I argue that these two types of verbal iconicity can, and should, incorporate their iconic elements in the same way using event modification via the notion of a context dependent demonstration. This unified formal account of quotation and classifier predicates predicts that a language might use the same strategy for conveying both, and I argue that this is the case with role shift in American Sign Language. Role shift is used to report others’ language and thoughts as well as their actions, and recently has been argued to provide evidence in favor of Kaplanian “monstrous” indexical expressions. By reimagining role shift as involving either quotation for language demonstrations or “body classifier” predicates for action demonstrations, the proposed account eliminates one major argument for these monsters coming from sign languages. Throughout this paper, sign languages provide a fruitful perspective for studying quotation and other forms of iconicity in natural language due to their lack of a commonly used writing system which is otherwise often mistaken as primary data instead of speech, the rich existing literature on iconicity within sign language linguistics, and the ability of role shift to overtly mark the scope of a language report. In this view, written language is merely a special case of a more general phenomenon of sign and speech demonstration, which accounts more accurately for natural language data by permitting more strict or loose verbatim interpretations of demonstrations through the context dependent pragmatics. (shrink)

The authors examine the nature of the relationship between social science and philosophy and address the sort of work social science should do, and the role and sorts of claims that an accompanying philosophy should engage in. In particular, the authors reintroduce the question of ontology, an area long overlooked by philosophers of social science, and present a cricital engagement with the work of Roy Bhaskar. The book argues against the excesses of philosophising and commits itself to a philosophical approach (...) more deeply grounded in the social sciences. (shrink)

I offer a brief survey of thematic elements in contemporary literature on forgiveness and then an overview of the responses to that literature comprising the contents of this volume. I concentrate on the extent to which work in moral psychology provides a needed corrective to some excesses in philosophical aversion to empirically informed theorizing. I aim to complicate what has been referred to at times as the standard or classic view, by which philosophers often mean the predominant view of forgiveness (...) in the first half of the thirty-year boom in contemporary philosophy of forgiveness. I conclude by enjoining philosophers to further consider psychological contexts in which forgiveness may be seen primarily as a commitment rather than primarily as an emotional state. (shrink)

Roger White (2015) sketches an ingenious new solution to the problem of induction. He argues from the principle of indifference for the conclusion that the world is more likely to be induction- friendly than induction-unfriendly. But there is reason to be skeptical about the proposed indifference-based vindication of induction. It can be shown that, in the crucial test cases White concentrates on, the assumption of indifference renders induction no more accurate than random guessing. After discussing this result, the paper explains (...) why the indifference-based argument seemed so compelling, despite ultimately being unsound. (shrink)

The Catholic Tradition requires the faithful to form and follow their conscience. This is the case even with the recognition that consciences can be malformed and one can make errors in practical judgments. Water Shaping Stone examines various aspects of this tradition regarding conscience by using, among other sources, twentieth-century magisterial documents, theologians' works, and Scripture. Kathryn Lilla Cox argues that while the Magisterium retains teaching authority, and a responsibility to help form consciences through its teaching, focusing only on (...) the Magisterium leads to incomplete formation. A more holistic vision of conscience formation means considering the formation of the moral agent to be a multifaceted process that draws on, for example, teaching, prayer, rituals, Scripture, practices, and virtues, along with relationships with the Triune God and communities of accountability. This vision of conscience formation retains the magisterial teaching authority while acknowledging discipleship as the theological basis for making and assessing practical judgments of conscience. (shrink)

"Change is not merely necessary to life--it is life." That's Alvin Toffler, characteristically stating the profound in a profoundly direct way. And yes, even when we see change coming--as we're about to graduate from school, take a new job, get married--it's still not so easy to accept. And when we don't see it coming--oof, we have an even harder time. Here to help us embrace change and defuse its unsettling power is Change Happens, a full-color illustrated gift book to consult, (...) to share, to give, and to keep on a night table. Curated by Kathryn and Ross Petras, the ultimate connoisseurs of quotes whose books and calendars have over 4.5 million copies in print, these words of wisdom inspire us to be open to change and remind us that nothing positive in life ever happens without it. Arranged alphabetically by subject--including Adapting, Curveballs, Faith, Letting Go, Regrets, Second Chances, Vulnerability--it's a book to turn to in moments of need, when offering advice to a friend or loved one, when urging a child to find the courage to take a step, when marking an important occasion. (shrink)

The author develops her account of Claudia Card's ethical work as nonideal ethical theory (NET). She clarifies Card's role in ethical theorizing of the recent past, partly in order to brief the unfamiliar reader on Card's ethics and nonideal theory, and partly to enter Card's contributions into the story of nonideal theory's emergence in philosophy. She then recommends, to other NET philosophers, the prioritization of (i) Card's rejection of the "administrative point of view", and (ii) Card's focus on "intolerable harms" (...) as critical to excellent ethical theorizing. She ends with the observation that NET may helpfully point toward reasons to take a pessimistic stance toward moral progress as elaborated in some classic texts in political philosophy; her appreciation of Card's insights yields a variety of pessimism that Card herself did not share. (shrink)

Decision theory has had a long-standing history in the behavioural and social sciences as a tool for constructing good approximations of human behaviour. Yet as artificially intelligent systems (AIs) grow in intellectual capacity and eventually outpace humans, decision theory becomes evermore important as a model of AI behaviour. What sort of decision procedure might an AI employ? In this work, I propose that policy-based causal decision theory (PCDT), which places a primacy on the decision-relevance of predictors and simulations of agent (...) behaviour, may be such a procedure. I compare this account to the recently-developed functional decision theory (FDT), which is motivated by similar concerns. I also address potentially counterintuitive features of PCDT, such as its refusal to condition on observations made at certain times. (shrink)

Starting out : ethics issues in beginning a practice -- Clinical practice -- Documentation and record keeping -- Dealing with third parties and protecting confidentiality -- Financial decisions -- Staff training and office policies -- Advertising and marketing -- Continuing professional development -- Leaving a practice -- Closing thoughts.

Marketers use autobiographical advertising as a means to create nostalgia for their products. This research explores whether such referencing can cause people to believe that they had experiences as children that are mentioned in the ads. In Experiment 1, participants viewed an ad for Disney that suggested that they shook hands with Mickey Mouse as a child. Relative to controls, the ad increased their confidence that they personally had shaken hands with Mickey as a child at a Disney resort. The (...) increased confidence could be due to a revival of a true memory or the creation of a new, false one. In Experiment 2, participants viewed an ad for Disney that suggested that they shook hands with an impossible character (e.g., Bugs Bunny). Again, relative to controls, the ad increased confidence that they personally had shaken hands with the impossible character as a child at a Disney resort. The increased confidence is consistent with the notion that autobiographical referencing can lead to the creation of false or distorted memory. ᭧ 2002 John Wiley & Sons, Inc. (shrink)

Suppose you are on a commercial airplane that is flying at 35,000 feet. Next to you sits a man who appears to be sleeping. In fact, this man has been drugged and put upon the plane without his knowledge or consent. He has never flown on a plane before and, indeed, has no idea what an airplane is. Suddenly the man awakes and looks around him. Terrified by the alien environment in which he finds himself, he searches for a door (...) or window from which to make an escape. As luck would have it, he is seated right next to a window exit and he begins to pull the handle that will open the window. You are aware that opening the window exit at this altitude will cause the cabin to quickly depressurize and that this man, you, and probably several other passengers will be sucked out the window to your deaths. You desperately want to stop him from opening the window. Now assume that for some reason it is impossible to prevent him physically from performing the deadly act. Your only option is to rationally persuade him to leave the window exit alone. You cry out to him and, with both hands on the handles, he turns to face you and waits to hear what you have to say. What sort of argument would you make? (shrink)

There is conflicting experimental evidence about whether the “stakes” or importance of being wrong affect judgments about whether a subject knows a proposition. To date, judgments about stakes effects on knowledge have been investigated using binary paradigms: responses to “low” stakes cases are compared with responses to “high stakes” cases. However, stakes or importance are not binary properties—they are scalar: whether a situation is “high” or “low” stakes is a matter of degree. So far, no experimental work has investigated the (...) scalar nature of stakes effects on knowledge: do stakes effects increase as the stakes get higher? Do stakes effects only appear once a certain threshold of stakes has been crossed? Does the effect plateau at a certain point? To address these questions, we conducted experiments that probe for the scalarity of stakes effects using several experimental approaches. We found evidence of scalar stakes effects using an “evidence seeking” experimental design, but no evidence of scalar effects using a traditional “evidence-fixed” experimental design. In addition, using the evidence-seeking design, we uncovered a large, but previously unnoticed framing effect on whether participants are skeptical about whether someone can know something, no matter how much evidence they have. The rate of skeptical responses and the rate at which participants were willing to attribute “lazy knowledge”—that someone can know something without having to check—were themselves subject to a stakes effect: participants were more skeptical when the stakes were higher, and more prone to attribute lazy knowledge when the stakes were lower. We argue that the novel skeptical stakes effect provides resources to respond to criticisms of the evidence-seeking approach that argue that it does not target knowledge. (shrink)

John Kaplan, The Hardest Drug: Heroin and Public Policy Chicago: The University of Chicago Press, 1983, xi + 247 pp.

The nature of moral action versus moral judgment has been extensively debated in numerous disciplines. We introduce Virtual Reality (VR) moral paradigms examining the action individuals take in a high emotionally arousing, direct action-focused, moral scenario. In two studies involving qualitatively different populations, we found a greater endorsement of utilitarian responses–killing one in order to save many others–when action was required in moral virtual dilemmas compared to their judgment counterparts. Heart rate in virtual moral dilemmas was significantly increased when compared (...) to both judgment counterparts and control virtual tasks. Our research suggests that moral action may be viewed as an independent construct to moral judgment, with VR methods delivering new prospects for investigating and assessing moral behaviour. (shrink)

Feminist philosophy is now an established subdiscipline, but it began as an effort to transform the profession. Academics and activists worked together to make the new courses, and feminist theory was tested in the streets. As time passed, the "second wave" receded, but core elements of feminist theory were preserved in the academy. How can feminist philosophers today continue the early efforts of changing profession and the society, hand in hand with women outside the academy.

Nearly $2 trillion is spent annually in the U.S. treating chronic illness — yet accessibility to quality health care services in rural communities for the chronically ill and dying remains problematic. Unique barriers present special challenges to a meaningful discussion of and subsequent strategies for addressing these issues in the context of increasingly scarce resources.