Anesthesiology training programs are tasked with equipping trainees with the skills to become medically and ethically competent in the practice of anesthesia and to be prepared to obtain board certification, yet there is currently no standardized ethics curriculum within anesthesia training programs in the United States. To bridge this gap, and to provide a validated ethics curriculum to meet the aforementioned needs, in July 2021, a survey was sent to anesthesia scholars in the field of biomedical ethics to identify key (...) areas that should be included in such an ethics curriculum. The responses were rated on a Likert scale and ranked. This paper identifies the top ten topics identified as high priority for inclusion in an anesthesiology training program and consequently deemed most relevant to meet the educational needs of graduates of an anesthesiology residency: (1) capacity to consent; (2) capacity to refuse elective versus lifesaving treatment; (3) application of surrogate decisionmaking; (4) approach to do not resuscitate (DNR) status in the operating room; (5) patient autonomy and advance directives; (6) navigating patient beliefs that may impair care; (7) “futility” in end-of-life care: when to withdraw life support; (8) disclosure of medical errors; (9) clinical criteria for “brain death” and consequences of this definition; and (10) the impaired anesthesiologist. (shrink)

We examine and reject the claim that the past-directed aspect of mental time travel (episodic memory) is unique to humans. Recent work in our laboratory with rats has demonstrated behaviours that resemble judgements about past occasions. Similar to human episodic memory, we can also demonstrate a dissociation in the neural basis of recollection and familiarity in nonhumans.

The ability to understand the mental states of others has sometimes been attributed to a domain‐specific mechanism which privileges the processing of these states over similar but nonmental representations. If correct, then others’ beliefs should be processed more efficiently than similar information contained within nonmental states. We tested this by examining whether adults would be faster to process others’ false beliefs than equivalent “false” photos. Additionally, we tested whether they would be faster to process others’ true beliefs about something than (...) their own (matched) personal knowledge about the same event. Across four experiments, we found a small but reliable effect in favor of the first prediction, but no evidence for the second. Results are consistent with accounts positing specialized processes for (false) mental states. The size of the effect does, however, suggest that alternative explanations such as practice effects cannot be ruled out. (shrink)

_The third of four volumes in a distinguished series, this volume includes chapters on the nature of the communal bond, marriage and family, welfare, taxation, government, and criminal justice_ The four-volume series on the Jewish political tradition that includes this volume seeks to connect the political thought of ancient Israel and the Diaspora with the emerging traditions of the modern Israeli state. The first two volumes dealt with authority and membership, respectively; this third volume, with Madeline Kochen as coeditor, (...) deals with community, with chapters on the communal bond, marriage and family, welfare, taxation, government, and criminal justice. (shrink)

After a discussion of Bacon's views on the subject, Van Leeuwen examines a different theory of certainty. This is the theory that was elaborated by Chillingworth and Tillotson, two English Protestant clergymen, in the course of a controversy centering upon the problem of deciding with certainty which beliefs constituted a Rule of Faith, i.e., the basic requirements of belief for Salvation. Chillingworth and Tillotson attempted to avoid both dogmatism and total skepticism by insisting on the existence of levels (...) of certainty and maintaining that the criteria of common sense are appropriate for the solution of theoretical religious questions. According to Van Leeuwen, the application of this theory is extended to scientific contexts in the work of Wilkins and Glanvill and is inherent in the scientific work of such members of the Royal Society as Boyle and Newton. The exposition is good; but the author's claim to a rigorous evolutionary line in the development of the doctrine of certainty among the figures he has treated is sometimes overstated.—T. J. C. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume, Tillotson, and Dialogue XIIJeff JordanJeff JordanUniversity of DelawareFootnotes1. 'Natural religion' in the seventeenth and eighteenth centuries denoted knowledge of the divine which could be had via reason or instinct, independent of any purported special revelation.2. Of the two best works on Hume's philosophy of religion, J. C. A. Gaskin, Hume's Philosophy of Religion (Atlantic Highlands, New Jersey, 1988); and K. Yandell, Hume's "Inexplicable Mystery": His Views on (...) Religion (Philadelphia, 1990), only the first examines Hume's critique of the argument from prudence at all (see Hume's Philosophy of Religion, 194-203); but Gaskin's treatment of Hume's critique leaves untouched several important elements of the critique.3. B. Pascal, Pensées, ed. L. Lafuma, trans. J. Warrington (1670; reprint, London, 1960), 92-96.4. On Locke, see Essay Concerning Human Understanding (1690), bk. 2, chap. 21. On Leibniz, see Die Philosophischen Schriften, 3:621. On Craig, see Theologiae Christianae Principia Mathematica (1699), chap. 6. On Paley, see A View of the Evidences of Christianity (1795), pt. 3, chap. 8.5. Tillotson, "The Wisdom of Being Religious," Sermon 1 in Works of Tillotson (London, 1820), 1:317-89 (hereafter cited as W).6. I do not mean to suggest that Hume was aware only of the sermon "The Wisdom of Being Religious," but that Hume was aware of Tillotson's claims and arguments as found in several of his sermons. "The Wisdom of Being Religious" is important because (i) it is explicitly mentioned by Hume in his A Letter From A Gentleman to His Friend in Edinburgh (1745; reprint, Edinburgh, 1967), 23, so we know that Hume had read this sermon; (ii) it was one of the best known of Tillotson's sermons; and (iii) it contains all of the elements of Tillotson's argument from prudence.7. T. Birch, "Life of the Author," in Works of Tillotson, 1:xix-xx. See also L. G. Locke, Tillotson (Copenhagen, 1954).8. Tillotson may have been aware of the Port Royal Logic version of the wager through Locke with whom Tillotson was in correspondence. See Tillotson, 83.9. Tillotson's case for (1) is treated extensively in his sermon, "The Advantage of Religion to Societies," Sermon 3 in Works of Tillotson, 1:409-23.10. In the passage quoted (W 361-62), Tillotson claims that the atheist will naturally dread a superior being who can defeat one's plans and judge one's actions.11. See also "The Efficacy, Usefulness, and Reasonableness Of Divine Faith," Sermon 223 in Works of Tillotson, 9:258-79. The idea of a grand lie is first found in Plato; see Republic 3:389, 414, 5:459.12. "Pascalian Wagering," Canadian Journal of Philosophy 16, no. 3 (1986): 437-54.13. Though Tillotson mentions "odds" and "hazards," he does not incorporate probability values in his version of the wager. His wager is a decision under uncertainty and not a decision under risk: he does not, that is, calculate the expected utility of theistic belief. Pascal was the first to formulate the wager as a decision under risk where the probability-weighted averages of the utility values (the expected utility) determine the right choice.14. Of course, these principles were not stated explicitly until much later. See Ian Hacking, The Emergence of Probability (London, 1975).15. For an example of the many-gods objection, see M. Martin, Atheism: A Philosophical Justification (Philadelphia, 1990), 232-34. For a response to the many-gods objection see my "Pascal's Wager and the Many-Gods Objection," International Philosophical Quarterly 31, no. 3 (1991): 309-17.16. See David Hume, Dialogues Concerning Natural Religion, ed. N. Kemp Smith (1778; reprint, Indianapolis, 1947), 214, 218 (hereafter cited as "D").17. It should be noted that Philo's first point is interrupted by the second and is not completed until after the second is completed.18. I will assume that Philo speaks for Hume in this exchange with Cleanthes (D 219-27). Of the three points asserted by Philo in this exchange all three are asserted elsewhere by Hume. On the first point, see The Natural History of Religion (1757), secs. 9 and... (shrink)

Some philosophers hold that philosophy is what you do to a problem until it’s clear enough to solve it by doing science. Others hold that if a philosophical problem succumbs to empirical methods, that shows it wasn’t really philosophical to begin with. Either way, the facts seem clear enough: questions first mooted by philosophers are sometimes coopted by people who do experiments. This seems to be happening now to the question: “what are propositional attitudes?” and cognitive psychology is the science (...) of note. (shrink)

Several areas of welfare economics seek to evaluate states of affairs as a function of interpersonally comparable individual utilities. The aim is to map each state of affairs onto a vector of individual utilities, and then to produce an ordering of these vectors that can be represented by a mathematical function assigning a real number to each. When this approach is used in intertemporal contexts, a central theoretical question concerns the evaluative weight to be applied to utility coming at different (...) times. This question concerns the rate of pure time preference, which is one key determinant of the social discount rate. This article argues that the standard philosophical account of pure time preference is mistaken, because it ascribes to economists a methodological commitment they need not, and often do not, accept. This in turn undercuts the most common philosophical objection to pure time preference, which traces at least to Rawls’s A Theory of Justice. The article then evaluates three further objections to pure time preference, concluding that it might still be defensible under certain circumstances. The article closes by articulating a final argument that is suggested by the “Social, Economic and Ethical Concepts and Methods” chapter of the most recent Intergovernmental Panel on Climate Change report. If this further argument is sound, it would constitute a decisive objection to pure time preference as it currently figures in much intertemporal welfare economics. (shrink)

Je crois que le secret de la littérature est là, et qu’un livre n’est beau qu’habilement paré de l’indifférence des ruines. Il y a un mystère dans les phrases que chacun retient pour soi, ces phrases qui hantent ou soulèvent ; ces phrases auxquelles on revient ou qui plutôt reviennent, elles, comme reviennent les rêves et les chansons. Qu’elles ne soient pas communes à tous, sauf exceptions, à moins que l’institution ou quelque hasard les aient homologuées, qu’elles restent singulières et (...) bien cachées, devrait convaincre, mais de quoi ? Mon propos, Madeline Chalon, ou ce que je tenterai d’en faire, répondra d’autant mieux à votre invitation, qu’il prendra la forme d’une lettre, d’une réponse, d’un envoi. C’est à la fois naïf et prétentieux, mais depuis le début je ne peux me séparer de ce pari qui est bien plus qu’un désir, et moins qu’une facilité. Si j’en profite pour reprendre un motif – l’incitation – qui m’aura fait pas mal cavaler, c’est aussi pour l’éclaircir, une dernière fois, (...). (shrink)

The idea of a 'logic of quantum mechanics' or quantum logic was originally suggested by Birkhoff and von Neumann in their pioneering paper [1936]. Since that time there has been much argument about whether, or in what sense, quantum 'logic' can be actually considered a true logic (see, e.g. Bell and Hallett [1982], Dummett [1976], Gardner [1971]) and, if so, how it is to be distinguished from classical logic. In this paper I put forward a simple and natural semantical framework (...) for quantum logic which reveals its difference from classical logic in a strikingly intuitive way, viz. through the fact that quantum logic admits (suitably formulated versions of) the characteristic quantum-mechanical notions of superposition and incompatibility of attributes. That is, precisely the features that distinguish quantum from classical physics also serve, within this framework, to distinguish quantum from classical logic. Some light is shed on the question of whether quantum logic is a genuine logical system by introducing a natural entailment relation for quantum-logical formulas with the implication symbol. The novelty is that, although implication behaves as it should (i.e. the 'deduction theorem' holds), the order of introduction of premises is significant. The fact that a reasonable entailment relation can be formulated for quantum logic supports the view that it is a genuine logical system and not merely an algebraic formalism. (shrink)

This paper distinguishes between five different approaches to social discount rates in climate change economics, criticizes two of these, and explains how the other three are to some degree mutually compatible. It aims to shed some new light on a longstanding debate in climate change economics between so-called “descriptivists” and “prescriptivists” about social discounting. The ultimate goal is to offer a sketch of the conceptual landscape that makes visible some important facets of the debate that very often go unacknowledged.

Inference to the best explanation—or, IBE—tells us to infer from the available evidence to the hypothesis which would, if correct, best explain that evidence. As Peter Lipton puts it, the core idea driving IBE is that explanatory considerations are a guide to inference. But what is the epistemic status of IBE, itself? One issue of contemporary interest is whether it is possible to provide a justification for IBE itself which is non- objectionably circular. We aim to carve out some new (...) space in this debate. In particular, we suggest that the matter of whether a given rule-circular argument is objectionably circular itself depends crucially on some subtle distinctions which have been made in the recent literature on perceptual warrant. By bringing these debates together, a principled reason emerges for why some kinds of rule-circular justifications for IBE are considerably less objectionable than others. (shrink)

In recent work, Mark Alfano and Jennifer Saul have put forward a similar kind of provocative sceptical challenge. Both appeal to recent literature in empirical psychology to show that our judgments across a wide range of cases are riddled with unreliable cognitive heuristics and biases. Likewise, they both conclude that we know a lot less than we have hitherto supposed, at least on standard conceptions of what knowledge involves. It is argued that even if one grants the empirical claims that (...) Saul and Alfano make, the sceptical conclusion that they canvass might not be as dramatic as it first appears. It is further argued, however, that one can reinstate a more dramatic sceptical conclusion by targeting their argument not at knowledge but rather at the distinct epistemic standing of understanding. (shrink)

The application of Gödel’s theorem to the problem of minds and machines is difficult. Paul Benacerraf makes the entirely valid ‘Duhemian’ point that the argument is not, and cannot be, a purely mathematical one, but needs some philosophical premisses to be able to yield any philosophical conclusions. Moreover, the philosophical premisses are of very different kinds. Some are concerned with what is essential to being a machine—these are typically intricate, but definite, easily formalised by the mathematician, but unintelligible to the (...) layman: others attempt to capture what is essential to being a mind, a person or a self—these are typically intuitive, but vague; resistant to exact definition by the logician, but, none the less, widely used and well understood. Gödel’s theorem itself, like many other truths, can be taken either way: it can be taken as a formal proof sequence yielding certain syntactical results about a certain class of formal systems, but it can also be taken as giving us a certain type or style of argument, which we can understand, and, once having got the hang of it, adapt and apply in innumerable different circumstances. In my dispute with the mechanist, I take Gödel’s argument both ways: I first take it as an argument which the mechanist, even according to his own mechanist principles, must accept as scoring some point against his favourite machine; and then I hope that the mechanist, as a man, will see that he can do better and that this sort of argument will always apply against any form of mechanism he espouses. (shrink)

Jian Zhou,* Weiqiang Ju,* Xiaopeng Yuan, Xiaofeng Zhu, Dongping Wang, Xiaoshun HeOrgan Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China *These authors contributed equally to this work: Hyperosmolar nonketotic hyperglycemic coma is a serious, rare complication induced by methylprednisolone pulse therapy for acute rejection after orthotopic liver transplantation. Herein, we report an unusual case of a 58-year-old woman who experienced acute rejection at 30 months after OLT, only one case in which HNKHC resulted in MP (...) pulse therapy for acute rejection in all 913 recipients in our center. The general morbidity of HNKHC was 1.09‰ in this study. HNKHC is characterized by rapid onset, rapid progression, and a lack of specific clinical manifestations. High-dose MP management was a clear risk factor. The principle of treatment included rapid rehydration, low-dose insulin infusion, and correcting disorders of electrolytes and acidosis. In conclusion, clinicians considering MP pulse therapy after OLT should be alert to the occurrence of HNKHC. Keywords: liver transplantation, complications, hyperosmolar nonketotic hyperglycemic coma, methylprednisolone pulse therapy, principle of treatment. (shrink)