This paper presents a clinically orientated illustration of the doctrine of double effect. The case of an elderly gentleman with advanced cancer is discussed, with particular emphasis on two dilemmas encountered during the terminal phase of his illness. The author describes how the doctrine of double effect was applied to help the team make some complex management decisions.

Image-making is a nearly universal human behavior, yet the visual strategies and conventions to represent things in pictures vary greatly over time and space. In particular, pictorial styles can differ in their degree of figurativeness, varying from intersubjectively recognizable representations of things to very stylized and abstract forms. Are there any patterns to this variability, and what might its ecological causes be? Experimental studies have shown that demography and the structure of interaction of cultural groups can play a key role: (...) the greater the degree of contact with other groups, the more recognizable and less abstract are the representations. Here we test this hypothesis on a real-world dataset for the first time. We constructed a balanced database of Indigenous Australian rock art motifs from both isolated and contact Aboriginal groups (those often in contact with other groups). We then ran a survey asking participants to judge the recognizability of the motifs and to provide interpretations. Results show that motifs from contact Aboriginal groups were more likely to be judged as inter-subjectively recognizable and also elicited more convergent descriptions than motifs from isolated groups. This is consistent with the idea that intergroup contact is likely to be an important factor in the cultural evolution of pictorial representation. We discuss the implications of these findings for the archaeology and anthropology of art, and the parallels with language evolution. (shrink)

Knowledge of the ethical and legal basis of medicine is as essential to clinical practice as an understanding of basic medical sciences. In the UK, the General Medical Council requires that medical graduates behave according to ethical and legal principles and must know about and comply with the GMC’s ethical guidance and standards. We suggest that these standards can only be achieved when the teaching and learning of medical ethics, law and professionalism are fundamental to, and thoroughly integrated both vertically (...) and horizontally throughout, the curricula of all medical schools as a shared obligation of all teachers. The GMC also requires that each medical school provides adequate teaching time and resources to achieve the above. We reiterate that the adequate provision and coordination of teaching and learning of ethics and law requires at least one full-time senior academic in ethics and law with relevant professional and academic expertise. In this paper we set out an updated indicative core content of learning for medical ethics and law in UK medical schools and describe its origins and the consultative process by which it was achieved. (shrink)

This article examines why an organization might wish to manage workplace romance, and describes a number of alternative approaches to managing dating. At first sight the ethics of dating bans balances the need to protect female employees from harassment against employee rights to privacy and freedom of association — a rights versus rights issue. However, dating bans seem not to be directed at protecting female employees from harm, but rather protect employers from sexual harassment liability claims -an employer self-interest versus (...) employee rights issue. This article advocates a consequentialist approach to the problem, via the factoring in of other harms caused by prohibiting workplace romance. Given that most workplace romances end up in marriage or long-term partnerships, a ban on workplace romance is argued to be antisocial. The incidence of sexual harassment is very low in comparison to the number of longterm relationships initiated in the workplace. This article concludes by citing examples of firms that encourage romance, showing that is feasible to manage any resulting problems within these firms' existing conflict of interest and sexual harassment rules. (shrink)

The Edinburgh Medical Group Research Project is unique in Britain. Part of its function is to experiment with teaching medical ethics both inside and outside of the Medical School. The papers which follow have been written by two full-time reseach fellows working with the Project and two of the professional advisers, one nursing and one medical. Together they give a picture of the wide scope of exerimental teaching taking place in Edinburgh and present some preliminary results from these experiments.

This article addresses ethical issues in conducting randomized clinical trials with youth. Ethical considerations that occur prior to treatment, during treatment, and following treatment are reviewed. Recommendations, based on empirical evidence and clinical experience, are offered for conducting ethical treatment research with youth and future directions for carrying out research on the ethics of conducting RCTs with youth are offered.

Historically, entities with a vested interest in a product that critics have suggested is harmful have consistently used research to back their claims that the product is safe. Prominent examples are: tobacco, lead, bisphenol A, and atrazine. Research literature indicates that about 80–90% of studies with industry affiliation found no harm from the product, while only about 10–20% of studies without industry affiliation found no harm. In parallel to other historical debates, recent studies examining a possible relationship between mercury exposure (...) and autism spectrum disorder show a similar dichotomy. Studies sponsored and supported by industry or entities with an apparent conflict of interest have most often shown no evidence of harm or no “consistent” evidence of harm, while studies without such affiliations report positive evidence of a Hg/autism association. The potentially causal relationship between Hg exposure and ASD differs from other toxic products since there is a broad coalition of entities for whom a conflict of interest arises. These include influential governmental public health entities, the pharmaceutical industry, and even the coal burning industry. This review includes a systematic literature search of original studies on the potential relationship between Hg and ASD from 1999 to August 2015, finding that of the studies with public health and/or industry affiliation, 86% reported no relationship between Hg and ASD. However, among studies without public health and/or industry affiliation, only 21% find no relationship between Hg and ASD. The discrepancy in these results suggests a bias indicative of a conflict of interest. (shrink)

The case recounts an incident of theft at a CEOs home during a company party. The rogue may well be an employee, and the CEO considers his options: should he let the matter pass and preserve the good will generated by the party, or should he stand on principle and engage the issue frontally? Three commentators provide perspective on an optimal response. They consider whether the CEOs true intent is to show appreciation or showcase opulence. In addition, the aberrant behavior (...) at this celebratory event suggests some measures that management might take in the workplace. (shrink)

The Many Faces of Patriotism debate the consequences of the 21st century's patriotic resurgence, examining it both in theoretical and comparative terms that draw on examples of patriotism from ancient Greece to post-apartheid South Africa.

Background: Treatment of psychotic disorders in pregnancy is often ethically and clinically challenging, especially when psychotic symptoms impair decision-making capacity. There are several competing ethical obligations to consider: the ethical obligation to maternal autonomy, the maternal and fetal beneficence-based obligations to treat peripartum psychosis, and the fetal beneficence-based obligation to minimize teratogenic exposure. Objective: This article outlines an ethical framework for clinical decision-making for the management of chronic psychosis in pregnancy, with an emphasis on special considerations in the previable and (...) periviable period. Case Presentation: A 31-year-old gravida 2, para 1 with intrauterine pregnancy at 12 weeks and 4 days gestation was brought to the emergency department by her husband seven months after delivering her first child, due to sudden onset of behavioral changes that included self-isolation, not eating, and not taking care of her child. Her past medical history included hypothyroidism and inflammatory bowel disease, but no prior psychiatric illness. After being admitted to the psychiatric hospital, she continued to have poor oral intake and weight loss despite initial inpatient treatment with antipsychotics, levothyroxine, and discontinuation of corticosteroids. Her pregnancy was also complicated by the diagnosis of multiple fetal anomalies at 20 weeks gestation, when the fetus was periviable. Conclusions: For previable or periviable pregnancies, the patient and/or surrogate should decide whether to pursue prenatal genetic screening and invasive diagnostic testing, as well as whether to continue or terminate the pregnancy. When the choice is made to continue the pregnancy, initiation of long-term psychiatric treatment (including medications with potential adverse fetal effects) should be based on shared decision-making between the physician and the patient and/or surrogate. Although some pharmacologic interventions may have potential adverse effects on the developing fetus, the use of psychotropic medications can be ethically justified, even if the patient herself does not have the capacity to consent and requires a surrogate, when the goal is to restore maternal autonomy and minimize the risks of maternal and fetal harm from untreated psychiatric illness. (shrink)

Sustained attention, a key cognitive skill that improves during childhood and adolescence, tends to be worse in some emotional and behavioural disorders. Sustained attention is typically studied in non-affective task contexts; here, we used a novel task to index performance in affective versus neutral contexts across adolescence (N = 465; ages 11–18). We asked whether: (i) performance would be worse in negative versus neutral task contexts; (ii) performance would improve with age; (iii) affective interference would be greater in younger adolescents; (...) (iv) adolescents at risk for depression and higher in anxiety would show overall worse performance; and (v) would show differential performance in negative contexts. Results indicated that participants performed more poorly in negative contexts and showed age-related performance improvements. Those at risk of depression performed more poorly than those at lower risk. However, there was no difference between groups as a result of affective context. For anxiety there was no difference in performance as a function of severity. However, those with higher anxiety showed less variance in their reaction times to negative stimuli than those with lower anxiety. One interpretation is that moderate levels of emotional arousal associated with anxiety make individuals less susceptible to the distracting effects of negative stimuli. (shrink)

Historically, entities with a vested interest in a product that critics have suggested is harmful have consistently used research to back their claims that the product is safe. Prominent examples are: tobacco, lead, bisphenol A, and atrazine. Research literature indicates that about 80–90 % of studies with industry affiliation found no harm from the product, while only about 10–20 % of studies without industry affiliation found no harm. In parallel to other historical debates, recent studies examining a possible relationship between (...) mercury exposure and autism spectrum disorder show a similar dichotomy. Studies sponsored and supported by industry or entities with an apparent conflict of interest have most often shown no evidence of harm or no “consistent” evidence of harm, while studies without such affiliations report positive evidence of a Hg/autism association. The potentially causal relationship between Hg exposure and ASD differs from other toxic products since there is a broad coalition of entities for whom a conflict of interest arises. These include influential governmental public health entities, the pharmaceutical industry, and even the coal burning industry. This review includes a systematic literature search of original studies on the potential relationship between Hg and ASD from 1999 to date, finding that of the studies with public health and/or industry affiliation, 86 % reported no relationship between Hg and ASD. However, among studies without public health and/or industry affiliation, only 19 % find no relationship between Hg and ASD. The discrepancy in these results suggests a bias indicative of a conflict of interest. (shrink)

Variant Creutzfeldt–Jakob disease is a fatal, transmissible, neurodegenerative disorder for which there is currently no effective treatment. vCJD arose from the zoonotic spread of bovine spongiform encephalopathy. There is now compelling evidence for human to human transmission through blood transfusions from presymptomatic carriers and experts are warning that the real epidemic may be yet to come. Imperatives exist for the development of reliable, non-invasive presymptomatic diagnostic tests. Research into such tests is well advanced. In this article the ethical implications of (...) the availability of these tests are elaborated and comparisons drawn with predictive genetic testing for Huntington’s disease and screening for HIV. Paramount to considerations is the issue of whom to test, weighing up respect for personal autonomy against obligations to benefit and protect society. A paradigm is proposed similar to that used for HIV screening but with unique features: compulsory testing of all blood/organ donors and individuals undergoing surgery or invasive procedures who have a significant risk of disease transmission. (shrink)

Historically, entities with a vested interest in a product that critics have suggested is harmful have consistently used research to back their claims that the product is safe. Prominent examples are: tobacco, lead, bisphenol A, and atrazine. Research literature indicates that about 80–90% of studies with industry affiliation found no harm from the product, while only about 10–20% of studies without industry affiliation found no harm. In parallel to other historical debates, recent studies examining a possible relationship between mercury exposure (...) and autism spectrum disorder show a similar dichotomy. Studies sponsored and supported by industry or entities with an apparent conflict of interest have most often shown no evidence of harm or no “consistent” evidence of harm, while studies without such affiliations report positive evidence of a Hg/autism association. The potentially causal relationship between Hg exposure and ASD differs from other toxic products since there is a broad coalition of entities for whom a conflict of interest arises. These include influential governmental public health entities, the pharmaceutical industry, and even the coal burning industry. This review includes a systematic literature search of original studies on the potential relationship between Hg and ASD from 1999 to August 2015, finding that of the studies with public health and/or industry affiliation, 86% reported no relationship between Hg and ASD. However, among studies without public health and/or industry affiliation, only 21% find no relationship between Hg and ASD. The discrepancy in these results suggests a bias indicative of a conflict of interest. (shrink)

In this essay I respond to three of the most forceful objections to the open view of the future. It is argued that a) open view advocates must deny bivalence; b) the open view offers no theodicy advantages over classical theism; and c) the open view can’t assure believers that God can work all things to the better. I argue that the first objection is premised on an inadequate assessment of future tensed propositions, the second is rooted in an inadequate (...) assessment of free will, and the third is grounded in an inadequate assessment of God’s intelligence. (shrink)

This volume consists of autobiographical by the following scholars, together with pictures and autographs: Raven I. McDavid, Jr., Henry M. Hoenigswald, John B. Carroll, William G. Moulton, Archibald A. Hill, Yakov Malkiel, Charles F. Hockett, Harold B. Allen, William Bright, Einar Haugen, George S. Lane, Frederic G. Cassidy, James B. McMillan, Winfred P. Lehmann, Fred W. Householder, and Dell Hymes. A master list of references, and an index of persons conclude the volume.

Si on veut penser le pouvoir à partir de l'exclusion des femmes, à partir de leur situation dans le politique, l'examen des images dont elles font l'objet en tant que groupe dominé offre, semble-t-il une perspective intéressante. Penser le pouvoir à partir des images de femmes (dans les films, les romans, les journaux, mais aussi les discours), c'est tenter de voir ce qu'elles disent de la conception et de la représentation traditionnelles du pouvoir, puisqu'elles aboutissent, permette...

Si on veut penser le pouvoir à partir de l'exclusion des femmes, à partir de leur situation dans le politique, l'examen des images dont elles font l'objet en tant que groupe dominé offre, semble-t-il une perspective intéressante. Penser le pouvoir à partir des images de femmes (dans les films, les romans, les journaux, mais aussi les discours), c'est tenter de voir ce qu'elles disent de la conception et de la représentation traditionnelles du pouvoir, puisqu'elles aboutissent, permette...

C.S. Peirce held what is nowadays called a “commitment view” of assertion. According to this type of view, assertion is a kind of act that is determined by its “normative effects”: by asserting a proposition one undertakes certain commitments, typically to be able to provide reason to believe what one is asserting, or, in Peirce’s words, one “takes responsibility” for the truth of the proposition one asserts. Despite being an early adopter of the view, if Peirce’s commitment view of assertion (...) is mentioned at all in contemporary discussions it is only in passing. His view is, however, far more complex and nuanced than he has been given credit for. My primary goal here, then, is to get a better understanding of Peirce’s version of a commitment view of assertion. I also argue that figuring out the details of Peirce’s theory of assertion can also provide us with a viable way to respond to problems that contemporary commitment views of assertion face. (shrink)

Over the last decade, legal recognition of same-sex relationships in Canada has accelerated. By and large, same-sex cohabitants are now recognised in the same manner as opposite-sex cohabitants, and same-sex marriage was legalised in 2005. Without diminishing the struggle that lesbians and gay men have endured to secure this somewhat revolutionary legal recognition, this article troubles its narrative of progress. In particular, we investigate the terms on which recent legal struggles have advanced, as well as the ways in which resistance (...) to the legal recognition has been expressed and dealt with. We argue that to the extent that feminist critiques of marriage, familial ideology, and the privatisation of economic responsibility are marginalised, conservative and heteronormative discourses on marriage and family are reinforced. Our case studies include two pivotal moments in the quest for legislative recognition of same-sex relationships: the Hearings of the Canadian House of Commons Standing Committee on Justice and Human Rights on Bill C-23, The Modernization of Benefits and Obligations Act, in 2000 and the hearings on Same-Sex Marriage in 2003. We find that the debates operated within a narrow paradigm that bolstered many existing hierarchies and exacerbated conditions for those who are economically disadvantaged. (shrink)

While the topic of assertion has recently received a fresh wave of interest from Peirce scholars, to this point no systematic account of Peirce’s view of assertion has been attempted. We think that this is a lacuna that ought to be filled. Doing so will help make better sense of Peirce’s pragmatism; further, what is hidden amongst various fragments is a robust pragmatist theory of assertion with unique characteristics that may have significant contemporary value. Here we aim to uncover this (...) theory, and to show that assertion for Peirce is not a mere corollary of pragmatic conceptions of truth, judgement, and belief, but is rather a central aspect of his philosophy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Brian Boyd responds:In responding to my critical discussion, Lisa Zunshine restates the argument of Why We Read Fiction at some length but replies to none of my specific criticisms. These criticisms are all based on the evidence of the texts that she offers as case studies, especially Mrs Dalloway and Lolita. Although I—and the textual evidence—contradict her claims, she provides no answers to the criticisms.Let me respond to (...) two restatements. First: "Fictional narratives endlessly experiment with rather than automatically execute our evolved cognitive adaptations" (p. 190). This is often, but almost tautologically, true in the case of experimental fiction, as the work of Richardson, Woolf, and Nabokov (to cite Zunshine's key examples) was in their time. It is not necessarily true in the sense Zunshine especially means it—that authors give us a demanding cognitive workout of our capacity for Theory of Mind by incorporating multiple embedding, A's thoughts of B's thoughts of C's thoughts of D's thoughts of E—even in the case of fictional experimenters like Defoe, Tolstoy, or Joyce, and it is not true of the vast bulk of fiction, from folk tale or jokes to soap operas or pulp [End Page 196] novels, and it cannot therefore be an explanation for "why we read fiction," though it may explain why some of us read some fiction. And to identify overloaded embedding when it is not present, as Zunshine does in discussing Mrs Dalloway, constitutes a simple misreading.Second: "Our Theory of Mind makes literature as we know it possible" (p. 191). Granted, without Theory of Mind we would not have fiction. But nor would we have fiction without many other features of human nature: without sociality, episodic memory, language, childhood pretend play, empathy, the brain's inhibitory mechanisms, folk physics, our mental databases for individuals, and much, much more. An evolutionary and cognitive understanding of fiction needs to take into account many aspects of our capacity for understanding events and stories, not just one.Apart from one three-word phrase, Zunshine's sole quotation from my review is this: "To what extent has Zunshine benefited from the methodology, rather than results, of science?" (I refer to "the results of science" here because I note that although, for instance, she relies most heavily on Simon Baron-Cohen among Theory of Mind researchers, while ignoring major figures in the field like Janet Astington or Josef Perner, she does not even cite the book or any of the more than twenty papers of which Baron-Cohen has been primary author since his 1995 Mindblindness.) Her quotation from my review continues: "Alas, she appears to have learned less than one would have hoped.... Her formulations are often weak and indecisive, hedgings, rather than strong testable hypotheses. Rather than apply scientific stringency to her literary analysis, she seems more interested in exploiting than testing what she can find." She confesses herself puzzled by this charge. Let me explain one simple point.Science's core methodological principle is that claims should be subjected to the test of evidence, and accepted or rejected on the basis of their compatibility with the relevant evidence. Leo Spitzer long ago pointed out that good reading follows scientific method: we read, we make hypotheses about the text, and we either confirm or disconfirm the hypotheses according to what we find in the text, and search for ampler hypotheses when previous ones have been discredited.1 Literary scholarship has long been vitiated by a far flabbier methodology, by the naïve assumption that evidence for a proposition suffices: "I see a and b in the text, therefore my claim C is a valid interpretation." But if reading or interpretation C is incompatible with counter-evidence d and e in the text, it is a falsified hypothesis and needs to yield to a better [End Page 197] reading, an interpretation that can incorporate this counter-evidence. I showed that Zunshine's claims about her prime examples were not compatible with evidence in the texts. She does not challenge the textual counter-evidence I provide, but just ignores it. That is where literary criticism most urgently needs to learn from scientific... (shrink)

ABSTRACT Although in recent years Christine Ladd-Franklin has received recognition for her contributions to logic and psychology, her role in late nineteenth- and early twentieth-century philosophy, as well as her relationship with American pragmatism, has yet to be fully appreciated. My goal here is to attempt to better understand Ladd-Franklin’s place in the pragmatist tradition by drawing attention to her work on the nature and unity of the proposition. The question concerning the unity of the proposition – namely, the problem (...) of how to determine what differentiates a mere collection of terms from a unified and meaningful proposition – received substantial attention in Ladd-Franklin’s time, and would continue to interest analytic philosophers well into the twentieth century. I argue that Ladd-Franklin had a distinct theory of the proposition and solution to the problem of the unity of the proposition that she developed over the course of her writings on logic and philosophy. In spelling out her views, I will also show her work interacted with and influenced that of the pragmatist who was her greatest influence, C.S. Peirce. (shrink)

Isaac Levi targets an implicit tension in C.S. Peirce’s epistemology, one that exists between the need to always be open-minded and aware of our propensity to make mistakes so that we do not “block the road of inquiry,” and the need to treat certain beliefs as infallible and to doubt only in a genuine way so that inquiry can proceed in the first place. Attempts at alleviating this tension have typically involved interpreting Peirce as ascribing different normative standards to different (...) areas of inquiry. I argue here that such “double-standard” interpretations face significant problems. I offer instead an interpretation of Peirce on which the differences between different areas of inquiry are descriptive rather than normative. Such a view resolves Levi’s tension while interpreting Peirce as consistently subscribing to one normative standard for all inquiry. (shrink)

In their responses to my article “Epistemically Pernicious Groups and the Groupstrapping Problem” (Boyd, 2018), Bert Baumgaertner (“Groupstrapping, Boostrapping, and Oops-strapping: A Reply to Boyd”) and C. Thi Nguyen (“Group-strapping, Bubble, or Echo Chamber?”) have raised interesting questions and opened lines of inquiry regarding my discussion of what I hope to be a way to help make sense of how members of groups can continue to hold beliefs that are greatly outweighed by countervailing evidence (e.g. antivaxxers, climate-change deniers, (...) etc.). Here I respond to these arguments and suggestions by providing three new reasons to believe that groupstrapping as I describe it occurs in epistemically pernicious groups. (shrink)

This online appendix has five main sections. 1) Simulation 2) Derivation of model a. Success biases b. Migration c. Five equilibrium solutions d. Why economic interactions () between groups is likely not near zero e. Derivation of total payoffs 3) Discussion of the limitation of time-scales 4) An ethnographic example of occupational specialization, Swat Valley. 5) The evolution of the division of labor in other species..

This paper investigates whether it is fruitful to describe the role culture began to play at some point in the Hominin lineage as pointing to a transition in individuality, by reference to the works of Buss, Maynard-Smith and Szathmáry, Michod and Godfrey-Smith. The chief question addressed is whether a population of groups having different cultural phenotypes is either paradigmatically Darwinian or marginal, by using Godfrey-Smith's representation of such transitions in a multi-dimensional space. Richerson and Boyd's «dual inheritance» theory, and (...) the explanation it provides of the evolution of cooperation in the Hominin lineage, is taken into account to shed light on the way Godfrey-Smith deals with cultural evolution, especially concerning the amount of variation in a population of groups with various cultural phenotypes, the role played by multi-level selection in the evolutionary dynamics of such a population and the adequacy of different modalities of group- reproduction. (shrink)

In his recent paper about understanding ethical issues, Boyd suggests that traditional approaches based on principles or people are understood better in terms of perspectives, especially the perspective-based approach of hermeneutics, which he uses for conversation rather than controversy. However, we find that Boyd’s undefined contrast between conversation and controversy does not point to any improvement in communication: disputes occur during conversation and controversy may be conducted in gentle tones. We agree with Boyd, that being prepared to (...) listen and learn are excellent attitudes, but his vague attempts to establish these and similar virtues in hermeneutic theory are not plausible. Additionally, the current controversy about the use of human embryos in stem cell therapy research shows Boyd missing the opportunity to illustrate how conversation would improve understanding. (shrink)