Scholars and professional organizations in bioethics describe various approaches to “quality assessment” in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes “quality” in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, in that they represent (...) evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, in this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring disparate, isolated work activities; then, we describe quality assessment in terms of tracking interconnected work activities holistically, across different levels of assessment. We conclude by inviting future efforts in quality improvement to adopt a comprehensive approach to quality assessment into their improvement practices, and offer recommendations for how the field might move in this direction. (shrink)

In this Matters Arising article, we outline how the recent article “The impact on patients of objections by institutions to assisted dying: a qualitative study of family caregivers’ perceptions” (White et al., 2023 Mar 13;24(1):22) informed Voluntary Assisted Dying (VAD) implementation in our large Australian public health setting, where objections do not emanate from, but within, the institution. In reporting the harms to patients and caregivers created by institutional objection, White et al. provide an evidenced-based road map for potential potholes (...) or risks associated with VAD implementation. We discuss the complexities emerging from the diverse views of health professionals and the ethical tensions arising from such, especially within certain specialties, and how we developed systemic strategies that support patients, caregivers and staff alike. We highlighted the need to shift from “Do you support VAD?“ to “How can we support you as healthcare professionals to integrate VAD into your practice, in a way that complies with the legislation, meets the needs of patients and caregivers, and feels safe and does not compromise your moral stance?“. (shrink)

© 2015 Elsevier Inc.Postnatal organogenesis occurs in an immune competent environment and is tightly controlled by interplay between positive and negative regulators. Innate immune cells have beneficial roles in postnatal tissue remodeling, but roles for the adaptive immune system are currently unexplored. Here we show that adaptive immune responses participate in the normal postnatal development of a non-lymphoid epithelial tissue. Since the mammary gland is the only organ developing predominantly after birth, we utilized it as a powerful system to study (...) adaptive immune regulation of organogenesis. We found that antigen-mediated interactions between mammary antigen-presenting cells and interferon-γ -producing CD4+ T helper 1 cells participate in MG postnatal organogenesis as negative regulators, locally orchestrating epithelial rearrangement. IFNγ then affects luminal lineage differentiation. This function of adaptive immune responses, regulating normal development, changes the paradigm for studying players of postnatal organogenesis and provides insights into immune surveillance and cancer transformation. Plaks et al. (shrink)

Ecclesiazusae, the first surviving work of Aristophanes from the fourth centuryb.c.e., has often been dismissed as an example of Aristophanes’ declining powers and categorized as being less directly rooted in politics than its fifth-century predecessors owing to the after-effects of Athens’ defeat in the Peloponnesian War. Arguing against this perception, which was largely based on the absence of ad hominem attacks characterizing Aristophanes’ earlier works, this paper explores howEcclesiazusaeengages with contemporary post-war Athenian politics in a manner which, while different to (...) his earlier comedies, remained closely rooted in the political and cultural concerns of the 390s. By examining the figure of Praxagora, I will first consider recent suggestions thatEcclesiazusaehints at the possibility of an anti-democratic coup. I will then examine how contemporary discussions of constitutional and legal reforms (including the invocation of ‘founding fathers’ such as Solon and Lycurgus) are incorporated into both Praxagora's language and the scenes featuring the Selfish Man and Hags that follow the establishment of Praxagora's regime. Examining these final scenes, I conclude thatEcclesiasuzaedoes not suggest that the idea of democratic equality itself is fundamentally flawed, but instead argues that Athens needs a suitable leader, well suited to the rough and tumble of assembly rhetoric, in order to successfully function. In the world ofEcclesiazusae,the men of Athens have failed too often to inspire any hope, putting their own interest above the state, and the new leader must be someone different. Thus Aristophanes sets up Praxagora as a female Solon to remake the state and lead the democracy. The second half of the play demonstrates this need for a strong leader, as problems arise both from the quarter of critical bystanders (the Selfish Man and Epigenes, the Young Man in the ‘hag scene’) and from over-zealous enforcers (the Old Women). (shrink)

In this article, the authors highlight connections between research on Two Spirit Native Americans and standard social studies curriculum. Two Spirit is a Pan-Indian term describing Native Americans who believe they embody both masculine and feminine characteristics/traits in one physical body. Findingsfrom this research expand the field's conception of multiple perspectives and diversity, while creating opportunities for nuanced understandings of genderexpression and gender that go beyond the male/female dichotomy currently accepted as the norm. The authors utilize historical research and a (...) semi-structured,in-depth interview with a current Ojibwe leader to better understand and theorize Native Americans' acceptance of diverse ways of being. The authors conclude that modern-day social studies teachers and students have much to learn from this traditional Native worldview. Specifically, the authors believe that encouraging students to adopt more inclusive perspectives on gender expression and to recognize the plausibility of multiple genders may lead to more advanced, social learning. Combined with reinforcement from responsible adults at school, this recognition would lessen a variety of present-day social ills, including the incidence of teen suicide caused by homophobia. (shrink)

Why do people read novels, go to the theater, or listen to beautiful music? Do we seek out aesthetic experiences simply because we enjoy them--or is there another, deeper, reason we spend our leisure time viewing or experiencing works of art? Aesthetics, the first short introduction to the contemporary philosophy of aesthetics, examines not just the nature of the aesthetic experience, but the definition of art, and its moral and intrinsic value in our lives. Anne Sheppard divides her work (...) into two parts: In the first, she summarizes the major theories defining art and beauty; in the second, she explores the nature of aesthetic evaluation and appreciation. As Sheppard explains, there are three main approaches to defining art, all focused on what art objects share. One proposes that all art imitates something in life, another that it expresses something (such as anger or ecstasy), still another suggests that all art has formal qualities. There is also a fourth which offers that all art shares the quality of beauty. In the second part, which concentrates on literary art, Sheppard explores such philosophic topics as critical judgment, meaning and truth in literature, and the relationship between art and morals. She raises such questions as whether there is one correct interpretation of a work of art and whether art has a moral effect on its audience and, citing specific examples, explores the views that have been put forth. A wide-ranging, intriguing book, which assumes no formal knowledge on the part of its readers, Aesthetics opens the door to a greater understanding and appreciation of art. (shrink)

This book draws on transpersonal anthropology and psychology in order to explore mild altered states of consciousness (ASCs) experienced in everyday life. While research into consciousness and particularly ASCs is growing, this book focuses on a neglected area: ‘everyday’ experiences of ASCs. Opening with an up-to-date overview of the development of the study of ASCs, the author presents an in-depth empirical exploration and mapping of mild ASCs. Dr Sheppard examines original research conducted in a range of religious and secular (...) contexts with participants who were engaged in activities including prayer, sport, nature conservation, music and musical instrument making, and TV viewing. The author takes a novel phenomenological approach to the analysis of ASCs, emphasising the subjective experience. The book explores the healing potential of such mild ASCs; the everyday fantasy reality of the interior landscape; and discusses the problem of validity, and belief in the study of ASCs. It will appeal to students and scholars of transpersonal psychology, consciousness studies, social anthropology, and the philosophy of mind. (shrink)

Interviewed by Christian Sheppard about Richard Kearney’s book The God Who May Be (2001), and speaking also of Kearney’s On Stories (2002) and Strangers, Gods and Monsters (2002), David Tracy remarks on Kearney’s development of the possible as a major philosophical and theological category. Showing the importance of the idea of the infinite, he speaks of the need for a hermeneutical moment to follow the initial encounter, and of a call for general criteria of judgment of the Other. He (...) discusses, too, the dangers and the rewards of doing both theology and philosophy at the same time. To him the category of the Impossible enters into the possible and is not only positive but desired. In a conversation that ranges widely - Derrida and Levinas, Jean-Luc Marion, Angelus Silesius, Kierkegaard, Nicholas of Cusa, Heidegger and Ricoeur, and, in the call for plurality, William James - the two speakers discuss both poetic sensibility and the call for justice. Reflecting on fragmentation, Tracy speaks of the need to focus on suffering and the importance of attaining a sense of ‘the entire story, all of the metaphors’. (shrink)

D.J. Sheppard reflects on Carey's controversial What Good are the Arts?

This anthology of philosophical texts by Greek and Roman authors brings together works from the late fifth century BC to the sixth century AD that comment on major aesthetic issues such as the perception of beauty and harmony in music and the visual arts, structure and style in literature, and aesthetic judgement. It includes important texts by Plato and Aristotle on the status and the role of the arts in society and in education, and Longinus' reflections on the sublime in (...) literature, in addition to less well-known writings by Philodemus, Cicero, Seneca, Plotinus, Augustine and Proclus. Most of the texts have been newly translated for this volume, and some are available in English for the first time. A detailed introduction traces the development of classical aesthetics from its roots in Platonism and Aristotelianism to its ultimate form in late Antiquity. (shrink)

Carceral spaces such as prisons are designed to restrict freedoms and keep inhabitants confined and under surveillance through various mechanisms. As a result, prisons are spaces where movement is restricted through confinement, while prisoners’ ability to move is conflated with freedom. We aim to move beyond this dichotomy and consider a complex rethinking of the body in criminological theory and practice through dance in carceral space. In doing so, we explore under what conditions movement represents agentic practices. Understanding these nuances (...) requires an interrogation of prisoner agency, including prisoners’ subtle maneuverability of power dynamics within the prison. We explore these dynamics using feminist and arts-based methods, specifically dance workshops delivered to twenty participants incarcerated in a Canadian provincial women’s prison. We find that movement and expression in prison may create moments of agentic freedom for incarcerated women under certain conditions. We argue that more nuanced understandings of incarcerated women’s agency can be found in their daily negotiations of time and space, and movement can provide numerous meanings. Our findings suggest arts-based approaches within prison environments create opportunities for women to express their identity and sexuality through movement in ways otherwise not permitted in prison. For many incarcerated women in this study, this sense of freedom may be associated with the ability to focus and take care of themselves while confined. (shrink)

Games may seem like a waste of time, where we struggle under artificial rules for arbitrary goals. The author suggests that the rules and goals of games are not arbitrary at all. They are a way of specifying particular modes of agency. This is what make games a distinctive art form. Game designers designate goals and abilities for the player; they shape the agential skeleton which the player will inhabit during the game. Game designers work in the medium of agency. (...) Game-playing, then, illuminates a distinctive human capacity. We can take on ends temporarily for the sake of the experience of pursuing them. Game play shows that our agency is significantly more modular and more fluid than we might have thought. It also demonstrates our capacity to take on an inverted motivational structure. Sometimes we can take on an end for the sake of the activity of pursuing that end. (shrink)

[This book] develops an account of rationality and justice that is tradition specific.-http://undpress.nd.edu.

There seems to be a deep tension between two aspects of aesthetic appreciation. On the one hand, we care about getting things right. On the other hand, we demand autonomy. We want appreciators to arrive at their aesthetic judgments through their own cognitive efforts, rather than deferring to experts. These two demands seem to be in tension; after all, if we want to get the right judgments, we should defer to the judgments of experts. The best explanation, I suggest, is (...) that aesthetic appreciation is something like a game. When we play a game, we try to win. But often, winning isn’t the point; playing is. Aesthetic appreciation involves the same flipped motivational structure: we aim at the goal of correctness, but having correct judgments isn’t the point. The point is the engaged process of interpreting, investigating, and exploring the aesthetic object. Deferring to aesthetic testimony, then, makes the same mistake as looking up the answer to a puzzle, rather than solving it for oneself. The shortcut defeats the whole point. This suggests a new account of aesthetic value: the engagement account. The primary value of the activity of aesthetic appreciation lies in the process of trying to generate correct judgments, and not in having correct judgments. -/- *There is an audio version available: look for the Soundcloud link, below.*. (shrink)

I propose to study one problem for epistemic dependence on experts: how to locate experts on what I will call cognitive islands. Cognitive islands are those domains for knowledge in which expertise is required to evaluate other experts. They exist under two conditions: first, that there is no test for expertise available to the inexpert; and second, that the domain is not linked to another domain with such a test. Cognitive islands are the places where we have the fewest resources (...) for evaluating experts, which makes our expert dependences particularly risky. -/- Some have argued that cognitive islands lead to the complete unusability of expert testimony: that anybody who needs expert advice on a cognitive island will be entirely unable to find it. I argue against this radical form of pessimism, but propose a more moderate alternative. I demonstrate that we have some resources for finding experts on cognitive islands, but that cognitive islands leave us vulnerable to an epistemic trap which I will call runaway echo chambers. In a runaway echo chamber, our inexpertise may lead us to pick out bad experts, which will simply reinforce our mistaken beliefs and sensibilities. (shrink)

Artificial intelligence (AI) and robotics are digital technologies that will have significant impact on the development of humanity in the near future. They have raised fundamental questions about what we should do with these systems, what the systems themselves should do, what risks they involve, and how we can control these. - After the Introduction to the field (§1), the main themes (§2) of this article are: Ethical issues that arise with AI systems as objects, i.e., tools made and used (...) by humans. This includes issues of privacy (§2.1) and manipulation (§2.2), opacity (§2.3) and bias (§2.4), human-robot interaction (§2.5), employment (§2.6), and the effects of autonomy (§2.7). Then AI systems as subjects, i.e., ethics for the AI systems themselves in machine ethics (§2.8) and artificial moral agency (§2.9). Finally, the problem of a possible future AI superintelligence leading to a “singularity” (§2.10). We close with a remark on the vision of AI (§3). - For each section within these themes, we provide a general explanation of the ethical issues, outline existing positions and arguments, then analyse how these play out with current technologies and finally, what policy consequences may be drawn. (shrink)

An adequate theory of rights ought to forbid the harming of animals to promote trivial interests of humans, as is often done in the animal-user industries. But what should the rights view say about situations in which harming some animals is necessary to prevent intolerable injustices to other animals? I develop an account of respectful treatment on which, under certain conditions, it’s justified to intentionally harm some individuals to prevent serious harm to others. This can be compatible with recognizing the (...) inherent value of the ones who are harmed. My theory has important implications for contemporary moral issues in nonhuman animal ethics, such as the development of cultured meat and animal research. (shrink)

Value capture occurs when an agent’s values are rich and subtle; they enter a social environment that presents simplified — typically quantified — versions of those values; and those simplified articulations come to dominate their practical reasoning. Examples include becoming motivated by FitBit’s step counts, Twitter Likes and Re-tweets, citation rates, ranked lists of best schools, and Grade Point Averages. We are vulnerable to value capture because of the competitive advantage that such crisp and clear expressions of value have in (...) our private reasoning and our public justification. There is, however, a price. In value capture, we take a central component of our autonomy — our ongoing deliberation over the exact articulation of our values — and we outsource it. And the metrics to which we outsource usually engineered for the interests of some external force, like a large-scale institution’s interest in cross-contextual comprehensibility and quick aggregability. That outsourcing cuts off one of the key benefits to personal deliberation. In value capture, we no longer adjust our values and their articulations in light of own rich experience of the world. Our values should often be carefully tailored to our particular selves or our small-scale communities, but in value capture, we buy our values off the rack. In some cases – like decreasing CO2 emissions – the costs of non-tailored values are outweighed by the benefit of precise collective coordination. In other cases, like in our aesthetic lives, they are not. This suggests that we should want different values suited to different scales. We should want value federalism. Some values are perhaps best pursued at the largest-scale level, others at smaller scales. The problem occurs when we exhibit an excess preference for the largest-scale values – when we consistently let the universal metrics swamp our quieter interests. (shrink)

We offer an account of the generic use of the term “porn”, as seen in recent usages such as “food porn” and “real estate porn”. We offer a definition adapted from earlier accounts of sexual pornography. On our account, a representation is used as generic porn when it is engaged with primarily for the sake of a gratifying reaction, freed from the usual costs and consequences of engaging with the represented content. We demonstrate the usefulness of the concept of generic (...) porn by using it to isolate a new type of such porn: moral outrage porn. Moral outrage porn is representations of moral outrage, engaged with primarily for the sake of the resulting gratification, freed from the usual costs and consequences of engaging with morally outrageous content. Moral outrage porn is dangerous because it encourages the instrumentalization of one’s empirical and moral beliefs, manipulating their content for the sake of gratification. Finally, we suggest that when using porn is wrong, it is often wrong because it instrumentalizes what ought not to be instrumentalized. (shrink)

The ninth edition of Media Ethics: Issues and Cases has been updated to reflect the most pressing ethical issues in media. Featuring 25 new cases on hot topic issues from fake news to drones and a new chapter on social justice, this authoritative case book gives students the tools to make ethical decisions in an increasingly complex environment.

Recent conversation has blurred two very different social epistemic phenomena: echo chambers and epistemic bubbles. Members of epistemic bubbles merely lack exposure to relevant information and arguments. Members of echo chambers, on the other hand, have been brought to systematically distrust all outside sources. In epistemic bubbles, other voices are not heard; in echo chambers, other voices are actively undermined. It is crucial to keep these phenomena distinct. First, echo chambers can explain the post-truth phenomena in a way that epistemic (...) bubbles cannot. Second, each type of structure requires a distinct intervention. Mere exposure to evidence can shatter an epistemic bubble, but may actually reinforce an echo chamber. Finally, echo chambers are much harder to escape. Once in their grip, an agent may act with epistemic virtue, but social context will pervert those actions. Escape from an echo chamber may require a radical rebooting of one's belief system. (shrink)

In The Case for Animal Rights, Tom Regan argues that although all subjects-of-a-life have equal inherent value, there are often differences in the value of lives. According to Regan, lives that have the highest value are lives which have more possible sources of satisfaction. Regan claims that the highest source of satisfaction, which is available to only rational beings, is the satisfaction associated with thinking impartially about moral choices. Since rational beings can bring impartial reasons to bear on decision making, (...) Regan maintains that they have an additional possible source of satisfaction that nonrational beings do not have and, consequently, the lives of rational beings turn out to have greater value.. (shrink)

What is a game? What are we doing when we play a game? What is the value of playing games? Several different philosophical subdisciplines have attempted to answer these questions using very distinctive frameworks. Some have approached games as something like a text, deploying theoretical frameworks from the study of narrative, fiction, and rhetoric to interrogate games for their representational content. Others have approached games as artworks and asked questions about the authorship of games, about the ontology of the work (...) and its performance. Yet others, from the philosophy of sport, have focused on normative issues of fairness, rule application, and competition. The primary purpose of this article is to provide an overview of several different philosophical approaches to games and, hopefully, demonstrate the relevance and value of the different approaches to each other. Early academic attempts to cope with games tried to treat games as a subtype of narrative and to interpret games exactly as one might interpret a static, linear narrative. A faction of game studies, self-described as “ludologists,” argued that games were a substantially novel form and could not be treated with traditional tools for narrative analysis. In traditional narrative, an audience is told and interprets the story, where in a game, the player enacts and creates the story. Since that early debate, theorists have attempted to offer more nuanced accounts of how games might achieve similar ends to more traditional texts. For example, games might be seen as a novel type of fiction, which uses interactive techniques to achieve immersion in a fictional world. Alternately, games might be seen as a new way to represent causal systems, and so a new way to criticize social and political entities. Work from contemporary analytic philosophy of art has, on the other hand, asked questions whether games could be artworks and, if so, what kind. Much of this debate has concerned the precise nature of the artwork, and the relationship between the artist and the audience. Some have claimed that the audience is a cocreator of the artwork, and so games are a uniquely unfinished and cooperative art form. Others have claimed that, instead, the audience does not help create the artwork; rather, interacting with the artwork is how an audience member appreciates the artist's finished production. Other streams of work have focused less on the game as a text or work, and more on game play as a kind of activity. One common view is that game play occurs in a “magic circle.” Inside the magic circle, players take on new roles, follow different rules, and actions have different meanings. Actions inside the magic circle do not have their usual consequences for the rest of life. Enemies of the magic circle view have claimed that the view ignores the deep integration of game life from ordinary life and point to gambling, gold farming, and the status effects of sports. Philosophers of sport, on the other hand, have approached games with an entirely different framework. This has lead into investigations about the normative nature of games—what guides the applications of rules and how those rules might be applied, interpreted, or even changed. Furthermore, they have investigated games as social practices and as forms of life. (shrink)

Анотація. У статті проаналізовані досягнення Соціального Вчительства Католицької Церкви, репрезентовані працями Лева ХІІІ, Пія ХІ, Пія ХІІ, Івана Павла ІІ, що розкривають змістовні характеристики поняття «принцип субсидіарності», його роль і значення в системі християнських цінностей. Принцип субсидіарності робить можливими такі взаємовідносини в соціальному житті, коли спільнота вищого порядку не втручається у внутрішнє життя спільноти нижчого порядку, перебираючи на себе належні тій функції; заради спільного добра, спільного блага вона надає їй у разі потреби підтримку й допомогу, узгоджуючи у такий спосіб її (...) взаємодію з іншими соціальними структурами. Принцип субсидіарності скеровує соціальну практику на утвердження спільного блага в людському співтоваристві. Поширення і застосування принципу субсидіарності протистоїть небезпеці «одержавлення» суспільства та найзагрозливіших проявів колективізму, обмежує абсолютизацію влади, бюрократизацію державних і соціокультурних структур, стає одним із гарантів дотримання прав і свобод громадян своєї країни. (shrink)