Severe staffing shortages have emerged as a prominent threat to maintaining usual standards of care during the COVID-2019 pandemic. In dire settings of crisis capacity, healthcare systems assume the ethical duty to maximise aggregate population-level benefit of existing resources. To this end, existing plans for rationing mechanical ventilators and intensive care unit beds in crisis capacity focus on selecting individual patients who are most likely to survive and prioritising these patients to receive scarce resources. However, staffing capacity is conceptually different (...) from availability of these types of discrete resources, and the existing strategy of identifying and prioritising patients with the best prognosis cannot be readily adapted to fit this real-world scenario. We propose that two alternative approaches to staffing resource allocation offer a better conceptual fit: prioritise the worst off: restrict access to acute care services and hospital admission for patients at relatively low clinical risk and prioritise staff interventions with high near-term value: universally restrict selected interventions and treatments that require substantial staff time and/or energy but offer minimal near-term patient benefit. These strategies—while potentially resulting in care that deviates from usual standards–support the goal of maximising the aggregate benefit of scarce resources in crisis capacity settings triggered by staffing shortages. This ethical framework offers a foundation to support institutional leaders in developing operationalisable crisis capacity policies that promote fairness and support healthcare workers. (shrink)

Patient outcome after serious brain injury is highly variable. Following a period of coma, some patients recover while others progress into a vegetative state (unresponsive wakefulness syndrome) or minimally conscious state. In both cases, assessment is difficult and misdiagnosis may be as high as 43%. Recent advances in neuroimaging suggest a solution. Both functional magnetic resonance imaging and electroencephalography have been used to detect residual cognitive function in vegetative and minimally conscious patients. Neuroimaging may improve diagnosis and prognostication. These techniques (...) are beginning to be applied to comatose patients soon after injury. Evidence of preserved cognitive function may predict recovery, and this information would help families and health providers. Complex ethical issues arise due to the vulnerability of patients and families, difficulties interpreting negative results, restriction of communication to “yes” or “no” answers, and cost. We seek to investigate ethical issues in the use of neuroimaging in behaviorally nonresponsive patients who have suffered serious brain injury. The objectives of this research are to: (1) create an approach to capacity assessment using neuroimaging; (2) develop an ethics of welfare framework to guide considerations of quality of life; (3) explore the impact of neuroimaging on families; and, (4) analyze the ethics of the use of neuroimaging in comatose patients. (shrink)

BackgroundSevere brain injury is a leading cause of death and disability. Diagnosis and prognostication are difficult, and errors occur often. Novel neuroimaging methods can improve diagnostic and prognostic accuracy, especially in patients with prolonged disorders of consciousness (PDoC). Yet it is currently unknown how family caregivers understand this information, raising ethical concerns that disclosure of neuroimaging results could result in therapeutic misconception or false hope.MethodsTo examine these ethical concerns, we conducted semi-structured interviews with caregivers of patients with PDoC who were (...) enrolled in a concurrent neuroimaging research program designed to detect covert consciousness following severe brain injury. Caregivers held surrogate decision-making status for a patient. Interviews were conducted at two time points for each caregiver. The first interview occurred before the disclosure of neuroimaging results. The second occurred after disclosure. Descriptive analysis was applied to the data of four interview topics: (1) expectations for neuroimaging; (2) reactions to evidence of preserved cognition; (3) reactions to null results; and (4) understanding of the results and study.ResultsTwelve caregivers participated in the study; two caregivers shared surrogate decision-making status for one patient with PDoC. Twenty-one interviews were completed; one caregiver declined to participate in the post-disclosure interview. Three patients with PDoC associated with the study displayed evidence of covert consciousness. Overall, caregivers understood the neuroimaging research and results. Caregivers who received results of covert consciousness were generally pleased. However, there was some variation in expectations and reactions to these data and null results.ConclusionThis study, for the first time, reveals caregiver expectations for and reactions to neuroimaging evidence of covert consciousness in patients with PDoC. Caregivers understood the neuroimaging research and results, casting doubt on speculative ethical concerns regarding therapeutic misconception and false hope. However, disclosure of neuroimaging result could be improved. Pre-disclosure consultations might assist professionals in shaping caregiver expectations. Standardization of disclosure might also improve comprehension of the results. (shrink)

Although there is wide agreement that ethics consults are at risk for conflicts of interest, ethics consultants have limited guidance with regard to how to identify and approach COIs. We aim to address these concerns and provide practical guidance. We will define and consider four categories of COIs: consult type, team composition, dual clinical roles and other concerns. We will define and consider six actions available for ECs to take in response to COIs: no action, disclosure only, obtaining a second (...) opinion, referring to another EC, referring to an institutional ethics committee or seeking an outside consult. We will then propose a points-based algorithm for ECs to use to determine the appropriate response to COI. Finally, we will discuss the strengths and limitations of our proposed algorithm. (shrink)

Setting the scene -- Sentience and the sentient mind -- Special senses and their interpretation Survival strategies -- Social strategies -- Animals of the waters -- Animals of the air -- Animals of the savannah and plains -- Animals of the forests -- Close neighbours -- Our duty of care.

Western societies today are coming unmoored in the face of an earth-shaking ethical and cultural paradigm shift. At its core is the question of what it means to be human and how we are meant to live. The old answers are no longer accepted; a dizzying array of options are offered in their stead. Underpinning this smorgasbord of lifestyles is a thicket of unquestioned assumptions, such as the separation of gender from biological sex, which not so long ago would have (...) been universally rejected as radical notions. In the spring of 2019, a group of Orthodox Christian scholars drawn from a wide variety of academic disciplines met together to offer responses to the moral crisis our generation faces, elaborating upon its various forms and facilitating a fuller understanding of some of its theological and philosophical foundations. In doing so they offer support to all those who question the claims that are so forcefully insisted upon today--a clarity that will aid them in standing up and resisting trends that have already shown to be the cause of great suffering and unhappiness. (shrink)

Bernard Williams’ Shame and Necessity (1993) was an influential early contribution to what has become a broader movement to rehabilitate shame as a moral emotion. But there is a tension in Williams’ discussion that presents an under-appreciated difficulty for efforts to rehabilitate shame. The tension arises between what Williams takes shame in its essence to be and what shame can do—the role that shame can be expected to play in ethical life. Williams can—and we argue, should—be read as avoiding the (...) difficulties stemming from this tension, but this requires a reevaluation of several of his central claims about shame’s role in ethical thought and experience. For instance, his broad claims that the “structures of shame” can “give a conception of one’s ethical identity” (93), and that shame “mediates … between ethical demands and the rest of life” (102), cannot be taken at face value. What emerges is a view that is in a sense less ambitious, but also more in tune with the spirit of Williams’ larger project. There may also, we suggest, be a more general lesson: We should be suspicious of the temptation to seek some special affinity between shame and ethical life, lest we distort our understanding of both. (shrink)

Scientists typically use a variety of representations, including different kinds of figures, to present and defend hypotheses. In order to understand the justification of scientific hypotheses, it is essential to understand how visual representations contribute to scientific arguments. Since the logical understanding of arguments involves the truth or falsity of the representations involved, visual representations must have the capacity to bear truth in order to be genuine components of arguments. By drawing on Goodman's analysis of symbol systems, and on Tarski's (...) work on truth, I show that the figures used in science meet this criterion. (shrink)

According to Weyl, “‘inexhaustibility’ is essential to the infinite”. However, he distinguishes two kinds of inexhaustible, or merely potential, domains: those that are “extensionally determinate” and those that are not. This article clarifies Weyl's distinction and explains its enduring logical and philosophical significance. The distinction sheds lights on the contemporary debate about potentialism, which in turn affords a deeper understanding of Weyl.

Philosophers of perception have a notoriously difficult time trying to account for hallucinatory experiences. One surprisingly quite popular move, and one that cross-cuts the representationalism/relationalism divide, is to say that hallucinations involve an awareness of uninstantiated properties. In this paper, I provide a new argument against this view. Not only are its proponents forced to classify many hallucinations as veridical, such experiences turn out to be necessarily veridical. In addition, I show that representationalists who endorse the uninstantiated property view must (...) reject the common fundamental kind claim and adopt disjunctivism, and naïve realists/relationalists must radically modify their disjunctivism: The distinction between ‘veridical’ and ‘hallucinatory’ will no longer track a metaphysical distinction between the relevant experiences. (shrink)

Religion within the Boundaries of Mere Reason remains one of the most opaque of Kant's published writings. Though this opacity belongs, partly, to the text itself, a key claim of this article is that this opacity stems also from the narrow lenses through which his readers view this text. Often read as part of Kant's moral philosophy or his universal history, the literature has thus far neglected a different vantage point on the Religion, one that does not refute the utility (...) of these lenses but complements them. This paper places the Religion alongside parts of Kant's corpus that it is less typically paired with, namely his natural history writings—in particular, his writings on the concept of race and the development of the human races. I argue that by doing so, we can shed much light on Kant's infamous claim that there is a radical evil in the human species. More precisely, we will come to appreciate that this evil is not, as it is usually understood, a static property or fixed characteristic of human beings. Instead, radical evil concerns a dynamic, changing defect in human nature that increasingly threatens our aspirations to collective moral perfection. (shrink)

Welches Verhältnis besteht zwischen „Bild" und menschlichem Denken? Welche Rolle spielt das Konzept der „Form" im menschlichen Wissen? Forscher aus Philosophie, Kulturwissenschaften, Wissenschaftsgeschichte, Ästhetik, Literatur, Anthropologie, Mathematik und Biologie untersuchen aus historischer und theoretischer Perspektive den Zusammenhang zwischen der Aktivität des Denkens und den Konzepten von Bild und Form.

The Fold is a book of practical philosophy that takes a radical new approach to aesthetics. Laura U. Marks calls this philosophy "enfolding-unfolding aesthetics," based in ideas derived from Gilles Deleuze and others (G.F.W. Leibniz, David Bohm, and Édouard Glissant) that the universe is folded in on itself. She proposes a theory of mediation as contact and connection across the folds and a set of embodied methods for detecting such cosmic connections. In drawing out this aesthetics, Marks considers the (...) embodied and sensuous dimensions of engaging with audiovisual works and works of art-dimensions that Marks suggests are composed of the very folds that compose everything and everyone: all living beings, from humans to particles, sandwiches to stars, technologies, thoughts and images, in the present, the past, and the future. Making use of art and film, with a focus on African diaspora and Arab cinema, Marks opens ways to strengthen connections to the cosmos and to better trace processes of becoming that are immanent within the fold. (shrink)

Examines the nature of life from physical life and nutrition, to behavior and sentient life, to conscious life and mind, to values and spirituality.

The volume provides a thorough look into Marina Sbisà’s distinctive, Austinian-inspired approach to speech acts. By gathering original essays from a world-class lineup of philosophers of language, linguists, social epistemologists, action theorists, and communication scholars, the collection provides the first comprehensive critical treatment of Sbisa’s outstanding contribution to speech act theory.

Narratives of hope are omnipresent in democratic life, but what can they tell us about the structure and orientation of politics? While common, they are often reduced to an all-compassing understanding that overlooks hope's various forms and implications. Democratic theory, however, lacks the theoretical language to attend to these distinctions. The aim of this essay is thus to define a collective and political account of hope and recover the normative basis of a democratic theory of hope. Drawing on the literature (...) on hope and juxtaposing it with extracts from Harvey Milk's ‘The Hope Speech,’ I first distinguish its collective experience before turning to Hannah Arendt. While Arendt rejects a politics of hope that turns away from the world, exploring how she thinks with and against hope provides a theoretically fruitful approach that elevates the in-betweenness of its worldly expression. From that standpoint, I relate the work and experience of hoping with others to her notions of natality, action and promises. These three conceptual touchstones provide the normative basis of a democratic theory of hope and help situate a collective sense of possibility inherent in democratic politics. (shrink)

Predicativity is a notable example of fruitful interaction between philosophy and mathematical logic. It originated at the beginning of the 20th century from methodological and philosophical reflections on a changing concept of set. A clarification of this notion has prompted the development of fundamental new technical instruments, from Russell's type theory to an important chapter in proof theory, which saw the decisive involvement of Kreisel, Feferman and Schütte. The technical outcomes of predica-tivity have since taken a life of their own, (...) but have also produced a deeper understanding of the notion of predicativity, therefore witnessing the " light logic throws on problems in the foundations of mathematics. " (Feferman 1998, p. vii) Predicativity has been at the center of a considerable part of Feferman's work: over the years he has explored alternative ways of explicating and analyzing this notion and has shown that predicative mathematics extends much further than expected within ordinary mathematics. The aim of this note is to outline the principal features of predicativity, from its original motivations at the start of the past century to its logical analysis in the 1950-60's. The hope is to convey why predicativity is a fascinating subject, which has attracted Feferman's attention over the years. (shrink)

Laura Nader is a towering figure as anthropologist, teacher, and public intellectual. Her letters give a glimpse of academic life mostly unseen by academics and by the general public. The collection includes letters from academic colleagues, but it also contains correspondence from lawyers, politicians, citizens, people on death row, Peace Corps workers, members of the military, scientists, and more.

Insights into the intelligence throughout the natural and technical environment, in the fabric of our devices and dwellings, in our clothes, and under our skin. Is there a way to understand the materials that surround us not as passive objects, but as other intelligences interacting with our own? In Parallel Minds, expert in materials science and nanotechnology Laura Tripaldi delivers not only detailed insights into the properties and emergent behaviors of matter as revealed by state-of-the-art chemistry, synthetic biology, and (...) nanotech, but also a rich philosophical reflection that crosses the frontier between nature and culture, where the most cutting-edge scientific syntheses resonate with ancient myth. The result is a technomaterial bestiary full of unexpected encounters with “strange minds”—from cobwebs to kevlar and carbon fibre, from centaurs to amoebas to arachnids, from polycephalic slime to resonating plasmons, from viruses to golems. Parallel Minds reveals the intelligence at large throughout the natural and technical environment, in the fabric of our devices and dwellings, in our clothes, and even under our skin. Full of lateral ideas and unexpected images, Tripaldi’s book imbues the study and synthesis of materials with a new urgency. For not only do the materials that surround us participate actively in the construction of the world in which we live, but harnessing their ability to interact intelligently with their environment could be the key to the future of our species. (shrink)

The separating and isolating tendencies of measuring practices can lead educators to lose sight of the aims and purposes of education. These end purposes can be used to guide and ensure that the activities of educators are educational, and therefore, Biesta recommends there is a need for educators to reconnect with them. This article. explores this notion of a ‘reconnection’ and argues that if educators are to challenge any potentially miseducative measuring practices, then this reconnection must require educators to value (...) and desire particular end purposes. Desires are recognised to be existential in character and are identified as being necessary for initiating actions. It is argued here that this aspect of desires is important for understanding the significance of a ‘reconnection’ because without it the purposes of education may remain only as abstract philosophical ideals. To make a difference and to challenge the isolating and miseducative tendencies of some measuring practices, educators must come to value particular purposes of education, and in addition, they must exercise the courage to enact them. This can be made possible because educators strongly care for and desire the actualisation of the purposes to which they are connected. (shrink)

This article pursues a Whiteheadian association of meals and cooking with an orienting concern for ecological well-being and planetary health. Process thought helps those who eat to recognize the real influences that our meals have upon the emerging world.

Neoliberal Techniques of Social Suffering: Political Resistance and Critical Theory from Latin America and Spain is the result of the critical and political commitment of various Latin American and Spanish philosophers who share a critical approach to the global “stealth revolution” in recent decades, where neoliberalism has forced the well-being and reproduction of life to adapt to a system devastating for both humans and non-humans. The authors voice the shared concern of contemporary Spanish and Latin American societies to build new (...) conceptions of the public and the common through mobilizing affects usually disavowed in political theory. If, in Ancient Greece, the idea of strengthening the most vulnerable and weakest was deplored as the art of sophists, this collection edited by Laura Quintana and Nuria Sánchez Madrid explores the other side of our social world to revive grassroots strategies of resistance and emancipation, which are able to bring about new distributions of power, welfare, and discursive legitimation and to extend our goal of creating a radically democratic world. (shrink)

This paper offers a novel solution to the Wrong Kind of Reason problem that afflicts Fitting-Attitude analyses of value. I argue that we can distinguish reasons of the right kind from reasons of the wrong kind by being clear about what our reasons are for. In Wrong Kind of Reason cases, our reason to have a certain affective attitude is a reason for an action, and it is this category-mistake that is the source of the problem.

While various definitions of moral distress have been proposed, some agreement exists that it results from illegitimate constraints in clinical practice affecting healthcare professionals’ moral agency. If we are to reduce moral distress, instruments measuring it should provide relevant information about such illegitimate constraints. Unfortunately, existing instruments fail to do so. We discuss here several shortcomings of major instruments in use: their inability to determine whether reports of moral distress involve an accurate assessment of the requisite clinical and logistical facts (...) in play, whether the distress in question is aptly characterized as moral, and whether the moral distress reported is an appropriate target of elimination. Such failures seriously limit the ability of empirical work on moral distress to foster appropriate change. (shrink)

The so-called bottoming-out problem is considered one of the most serious problems in Stuart Glennan's mechanistic theory of causality. It is usually argued that such a problem cannot be overcome with the acknowledgement of the non-causal character of fundamental phenomena. According to such a widespread view, in the mechanistic account causation must go all the way down to the bottom level; a solution to the bottoming-out problem, therefore, requires an appeal to an ancillary account of causation that covers fundamental phenomena. (...) In this paper I reconsider the arguments that led to this conclusion and criticize them. I argue that the no-causality-at-the-fundamental-level solution is in harmony with the causal anti-fundamentalism that characterizes the mechanistic theory. Moreover, contrarily to the dualistic solution put forward by Glennan, the no-causality-at-the-fundamental-level is not an ad-hoc solution.Finally, I provide the sketch for an account of the existence of an order in nature at the fundamental level that is consistent with the singularist and ontologically parsimonious spirit of the mechanistic account. (shrink)

Despite the centrality of the term within the title, the meaning of ?care? in residential child care remains largely unexplored. Shifting discourses of residential child care have taken it from the private into the public domain. Using a care ethics perspective, we argue that public care needs to move beyond its current instrumental focus to articulate a broader ontological purpose, informed by what is required to promote children's growth and flourishing. This depends upon the establishment of caring relationships enacted within (...) the lifespaces shared by children and those caring for them. We explore some of the central features of caring in the lifespace and conclude that residential child care is best considered to be a practical/moral endeavour rather than the technical/rational one it has become. It requires morally active, reflexive practitioners and containing environments. (shrink)

We began writing the first edition of this textbook in 2006, soon after a wave of major corporate scandals had shaken the financial world. Headlines made the companies involved in these ethical scandals household names: Enron, WorldCom, Arthur Andersen, KPMG, J.P. Morgan, Merrill Lynch, Morgan Stanley, Citigroup, Salomon Smith Barney. At that time, we suggested that, in light of such significant cases of financial fraud, mismanagement, criminality, and deceit, the relevance of business ethics could no longer be questioned.

Philosophy and Phenomenological Research, EarlyView.

This chapter contains sections titled: Notes.

The price for morality as the meaning of existence is the entrance of another kind of absurdity, a moral absurdity. Clearly, there is something absurd about life on The Good Place. Moral worth, both on The Good Place and in our real‐life existence, comes in degrees. Deontological views, most famously associated with Immanuel Kant, hold that the morality of an action is determined based on whether or not it adheres to a moral rule. Care requires being flexible in different situations (...) so as to best foster caring relationships with others. A care ethics approach would give some support to Eleanor's claims in The Good Place, insofar as a caring home life is essential to the development of the child in a variety of ways. The power of caring relationships is perhaps nowhere more salient than in the show's final few episodes. (shrink)

Il n'est pas fruit du hasard cette rencontre qui a précédé l'édition de ce livre. Les rapports entre philosophes français et catalans viennent de loin. Le XIXe était modèle des "voyages philosophiques". Est parmi les plus connus celui de Cousin en Allemagne. Moins connus, mais également fructifères étaient ceux des philosophes exilés qui partirent sous les régimes de persécutions pour trouver en France non seulement un lieu d'accueil, mais également l'opportunité de confrontation de leurs idées avec celles des philosophes français. (...) De la même manière, certains exilés de la commune avaient trouvé un lieu d'accueil dans la Barcelone révolutionnaire des années républicaines. Ces rencontres n'ont jamais totalement fini de se produire au long du XXe siècle, période au cours de laquelle l'exil avait constitué la manière d'échapper à une morte sûre dans l'Espagne de la guerre civile. La période actuelle vit une nouvelle revitalisation des échanges, et ce livre en est un exemple."--Page 4 of cover. (shrink)

Notre défi consiste à penser avec les lèvres, à faire sentir la portée de certaines philosophies contemporaines qui font jouer l'exigence d'avoir la bouche bien ouverte et des lèvres qui montrent les dents. Comment faire de la philosophie, non pas avec le langage, mais avec la langue, autrement dit avec sa matérialité et sa singularité? Ce livre ne traite pas du langage, de l'identité ou du sujet, ou peut-être que si, mais à partir des lèvres : il questionne la frontière, (...) l'altérité, le pouvoir, la jouissance, la littérature et ses politiques. Bref, il recherche le plaisir de faire de la philosophie en langues. (shrink)