Hospital systems commonly face the challenge of determining just ways to allocate scarce drugs during national shortages. There is no standardised approach of how this should be instituted, but principles of distributive justice are commonly used so that patients who are most likely to benefit from the drug receive it. As a result, clinical indications, in which the evidence for the drug is assumed to be established, are often prioritised over research use. In this manuscript, we present a case of (...) a phase II investigational trial of intravenous thiamine for delirium prevention in patients undergoing haematopoietic stem cell transplantation to emphasise several shortcomings in the overarching prioritisation of clinical over research uses of scarce drugs. Specifically, we present the following considerations: clinical use may not have stronger evidence than research use; a strong scientific rationale for research use may outweigh the claim for clinical indications in which there is weak evidence; treatment within the context of a clinical trial may be the standard of care; and research use may not only benefit patients receiving the treatment but also offers the prospect of improving future clinical care. In summary, we argue against allocation schemes that prohibit all research uses of scarce drugs and instead recommend that allocation schemes include a balanced approach that weighs risks and benefits of access to scarce drugs irrespective of the research versus clinical use designation. (shrink)

The secrets from the inner meaning of Torah form the soul of the Chasidic movement's thought. They inspire, revive, and inflame Jewish souls with a passion to constantly increase observance and devotion. For more than two centuries it has inoculated millions against the ravages of secularism and preserved the spiritual life of the Jewish nation. Chasidus emerged as a protection from the storm winds of modernity. Today's Jewish community might benefit from a new look at the Chasidic movement's beginnings and (...) reflections. Even those Jews who fulfill their religious obligations frequently perform rituals in a lifeless and superficial way. Were we to discover the depth and soulful vitality that fill Chasidic literature, a renewed passion might flame our faltering Jewish experience with the warmth of Torah. Unfortunately, for many of my contemporary American Jews, access to the gem-stones of the Chasidim has been denied. Chasidic works are overwhelmingly in Hebrew, and few good translations exist. This book provides an introduction to the basic terms and ideas of Chasidic texts. It is written for the interested lay reader who may be new to Torah study, as well as the yeshiva student who is knowledgeable about Biblical narratives and Talmudic law but may be new to the world of Chasidus. (shrink)

Using a real-life case involving an accidental discovery of misattributed paternity as a springboard for discussion, I reflect on several practical and theoretical issues surrounding truth-telling in the doctor-patient relationship. I present the moral dilemma and identify arguments in favour of and against disclosure. I then examine the theoretical difficulties in balancing conflicting reasons and in establishing what constitutes the 'truth'. I conclude that withholding the information from the patients would be ethically permissible and, more generally, that honesty is not (...) always the best policy. (shrink)

There is no evidence to suggest that even as late as January 1672, when Newton was elected a Fellow of the Royal Society, anyone had any inkling of his new theory of colours. His name exploded on the scientific scene as the inventor and constructor of a new kind of telescope—what later became known as the reflector . Had the erudition of the London virtuosi been a little broader, they would have known that in fact he was not the inventor (...) of the telescope, even though the precise form he gave it was his. Not only was the idea a hundred years old, during which period it was repeatedly suggested by various writers, but also Newton himself took the idea straight from the most recent of these suggestions, namely that included in James Gregory's Optica promota of 1663. The situation becomes even more ironic when we realize that the new instrument was admired for wrong reasons and on merits that were far from Newton's intentions. Nevertheless, admired it was, and there was a good reason for this: Newton's instrument was in fact the first reflector actually to be constructed and, moreover, for a few weeks it performed quite well. Several astonomers became interested because of the high magnifying power relative to its dimensions. (shrink)

edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.

The primary aim of this paper is to defend the Lockean View—the view that a belief is epistemically justified iff it is highly probable—against a new family of objections. According to these objections, broadly speaking, the Lockean View ought to be abandoned because it is incompatible with, or difficult to square with, our judgments surrounding certain legal cases. I distinguish and explore three different versions of these objections—The Conviction Argument, the Argument from Assertion and Practical Reasoning, and the Comparative Probabilities (...) Argument—but argue that none of them are successful. I also present some very general reasons for being pessimistic about the overall strategy of using legal considerations to evaluate epistemic theories; as we will see, there are good reasons to think that many of the considerations relevant to legal theorizing are ultimately irrelevant to epistemic theorizing. (shrink)

The primary objective of this paper is to introduce a new epistemic paradox that puts pressure on the claim that justification is closed under multi premise deduction. The first part of the paper will consider two well-known paradoxes—the lottery and the preface paradox—and outline two popular strategies for solving the paradoxes without denying closure. The second part will introduce a new, structurally related, paradox that is immune to these closure-preserving solutions. I will call this paradox, The Paradox of the Pill. (...) Seeing that the prominent closure-preserving solutions do not apply to the new paradox, I will argue that it presents a much stronger case against the claim that justification is closed under deduction than its two predecessors. Besides presenting a more robust counterexample to closure, the new paradox also reveals that the strategies that were previously thought to get closure out of trouble are not sufficiently general to achieve this task as they fail to apply to similar closure-threatening paradoxes in the same vicinity. (shrink)

A comparative method of studying the biological bases of personality compares human trait dimensions with likely animal models in terms of genetic determination and common biological correlates. The approach is applied to the trait of sensation seeking, which is defined on the human level by a questionnaire, reports of experience, and observations of behavior, and on the animal level by general activity, behavior in novel situations, and certain types of naturalistic behavior in animal colonies. Moderately high genetic determination has been (...) found for human sensation seeking, and marked strain differences in rodents have been found in open-field behavior that may be related to basic differences in brain neurochemistry. Agonistic and sociable behaviors in both animals and humans and the trait measure of sensation seeking in humans have been related to certain common biological correlates such as gonadal hormones, monoamine oxidase (MAO), and augmenting of the cortical evoked potential.The monoamine systems in the rodent brain are involved in general activity, exploratory behavior, emotionality, socialization, dominance, sexual and consummately behaviors, and intracranial self-stimulation. Preliminary studies have related norepinephrine and enzymes involved in its production and degradation to human sensation seeking. A model is suggested that relates mood, behavioral activity, sociability, and clinical states to activity of the central catecholamine neurotransmitters and to neuroregulators and other transmitters that act in opposite ways on behavior or stabilize activity in the arousal systems. Stimulation and behavioral activity act on the catecholamine systems in a brain–behavior feedback loop. At optimal levels of catecholamine systems activity (CSA) mood is positive and activity and sociability are adaptive. At very low or very high levels of CSA mood is dysphoric, activity is restricted or stereotyped, and the organism is unsocial or aggressively antisocial. Novelty, in the absence of threat, may be rewarding through activation of noradrenergic neurons. (shrink)

Recent years have seen the rise of a new family of non-probabilistic accounts of epistemic justification. According to these views—we may call them Normalcy Views—a belief in P is justified only if, given the evidence, there exists no normal world in which S falsely beliefs that P. This paper aims to raise some trouble for this new approach to justification by arguing that Normalcy Views, while initially attractive, give rise to problematic accounts of epistemic defeat. As we will see, on (...) Normalcy Views seemingly insignificant pieces of evidence turn out to have considerable defeating powers. This problem—I will call it the Easy-Defeat Problem—gives rise to a two-pronged challenge. First, it shows that the Normalcy View has counterintuitive implications and, second, it opens the door to an uncomfortable skeptical threat. (shrink)

Computing Methodologies -- Artificial Intelligence.

The ArgumentThe inclusion of an item within a theory may be essential or accidental, and if the former then the explanation of its meaning and of its inclusion in the theory cannot be by accidental events and circumstances. Since all events and circumstances – be they social, political, religious, psychological, etc. – are accidental vis-à-vis the ideas they occasion, they cannot serve as explanation of these ideas. The only way to explain the ideas is by showing their essentiality to the (...) theory rather than their importance to the people. Thus, the place of spirits and souls within seventeenth-century science is explained by Platonic ideology.This demands a concept of nature which is thoroughly efficient causative, and a concept of explanation which is thoroughly informative. This means that theories must explain any given effect by a cause which is separable from it and is conceptually heterogeneous to it. Such a nature and such an explanation are inherently paradoxical and irrational, which explains the preponderance of these traits in seventeenth-century science as created by Kepler, through Galileo and Descartes to Newton.The primary efficient-causal and explanatory agency is force, which is ontically distinct from matter and from the motion it causes in matter. Soul, spirit and active principle are mere variants of force. Thus, their presence in seventeenth-century science is explained only by their being conceptually essential to any Platonic philosophy of nature. (shrink)

In recent work, Bengson, Cuneo, and Shafer‐Landau (2020) develop a new social version of moral intuitionism that promises to explain why our moral intuitions are trustworthy. In this paper, we raise several worries for their account and present some general challenges for the broader class of views we call Social Moral Intuitionism. We close by reflecting on Bengson, Cuneo, and Shafer‐Landau's comparison between what they call the “perceptual practice” and the “moral intuition practice”, which we take to raise some difficult (...) normative and meta‐normative questions for theorists of all stripes. (shrink)

The medical profession’s role should be limited to advice and informationThe medical establishment’s desire to interfere with the autonomous wishes of boxers seems at odds with the principle of respect for autonomy prevalent in contemporary biomedical practice. I argue that the role of the medical profession in boxing should be solely an advisory and informational one. In addition, the distinctions made between boxing and other high risk sports often rely on an insufficient knowledge of the sport. This leads to misdirected (...) criticisms and excessive emphasis on the colourful discourse of boxing, as opposed to the practice of boxing itself. Dr Herrera’s claim in his article that boxing differs from other sports in the acceptability of its acts outside the realm of sport is refuted.1 The importance of consent as a legitimising factor is highlighted, and a number of possible solutions to improve safety within the sport are tentatively suggested.In the United Kingdom, a competent adult may legally refuse medical treatment, irrespective of the severity of his condition or the validity of his reasons. With the pre-eminence of an autonomy based model of bioethics, respecting a patient’s wishes forms an integral part of acting in his best interests. It is puzzling, then, to find that the Australian Medical Association have called for a ban on boxing on the grounds that the activity is excessively hazardous to the health of boxers. The often mentioned principle of respect for autonomy is abandoned once the person drops the privileged title of “patient”. This suggests that being a patient …. (shrink)

It seems to me that the ingredients of most theories both in Artificial Intelligence and in Psychology have been on the whole too minute, local, and unstructured to account–either practically or phenomenologically–for the effectiveness of common-sense thought. The "chunks" of reasoning, language, memory, and "perception" ought to be larger and more structured; their factual and procedural contents must be more intimately connected in order to explain the apparent power and speed of mental activities.

Glenn Cohen, Holly Fernandez Lynch, and Christopher Deubert are right in their article “A Proposal to Address NFL Club Doctors’ Conflicts of Interest and to Promote Player Trust” that the problem with the medical care rendered to National Football League players is not that the doctors are bad, but that the system in which they provide care is structured badly. We saw some of the problems this system causes last season in what happened to Case Kenum, a quarterback for the (...) Los Angeles Rams who, despite having a possible concussion from a game injury, was allowed to continue to play, with a concussion spotter in the booth and coaches, teammates, seven game officials, and two full training staffs present. From my experience playing in the league from 1989 to 1999, I do not believe that you can eliminate the conflict of interest completely, but I think it can be limited to the point that it does not harm the player. As the structure is now, with the team paying the club doctor, it is impossible to put the players’ health and well-being before the team's on-field priorities. (shrink)

Case 1 reminds us that patients have duties too, while case 2 presents an instance of justified withholding of informationHow refreshing to read these two cases! No conjoined twins, fantastical chimeras, or other incredible scenarios at the fringes of medical reality. Each case highlights the practical and theoretical difficulties that doctors face in their everyday practice.Case 1: In case 1, the patient, who had declined an HIV test, changed his mind and requested an HIV test on the request form without (...) informing the doctor. The pathologist performed the tests and returned the results to the unsuspecting doctor, who duly investigated the matter. The doctor’s anxiety at the situation, as well as the worries of the entire practice and pathology laboratory, must have been deeply unpleasant. Thus the patient, no doubt unintentionally, caused much distress by requesting the HIV test. He was, at the very least, guilty of a lack of foresight and consideration. As a minimum, he should have informed the doctor of his last minute alteration. This would have enabled the doctor to discuss the implications of the test, to organise appropriate counselling, and, most importantly, to receive the results in full knowledge of the situation.As Dr Fraser points out, the experience of case 1 reinforces the importance of taking good medical notes. Even if the patient’s refusal had been documented in the notes, however, this would not have prevented him from requesting the HIV test, and indeed other tests, on the blood form. Pharmacists may still occasionally be faced with situations when they are unsure whether the doctor prescribed 10 capsules of a drug, or 110 capsules, as the patient may have added a “1” in front of the doctor’s original prescription. Similarly, how …. (shrink)

The public revelation in 2003 that medical students perform intimate examinations without patient consent has engendered much debate in the press and scientific journals. Using this case as a springboard for discussion, I will argue that medical schools should encourage students to raise their ethical concerns and call for a change of policy making it easier for students to do so. I will also address the question of medical students’ moral obligations towards their patients, and conclude that medical students ought (...) to express their discontent when faced with unethical practices or attitudes.In early January 2003, a study appeared in the British Medical Journal revealing that nearly a quarter of rectal and vaginal examinations on anaesthetised patients were performed by medical students without patient consent.1 Although the study did not generate the firestorm of controversy many expected, it engendered much discussion on ethical issues surrounding informed consent and patient autonomy, as well as stressing the need for greater ethics training for medical students. As an ethical problem, however, the case of intimate examinations is, to my mind, relatively uninteresting. If we agree that it is wrong for doctors to perform a vaginal examination on a conscious person without their consent, then it follows that it will still be …. (shrink)

Although telephone consultations are widely used in the delivery of healthcare, they are vulnerable to breaches of patient confidentiality. Current guidelines on telephone consultations do not address adequately the issue of confidentiality. In this paper, we propose a solution to the problem: a password system to control access to patient information. Authorised persons will be offered the option of selecting a password which they will use to validate their request for information over the telephone. This simple yet stringent method of (...) access control should improve security while allowing the continuing evolution of telephone consultations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Good Neighbors Make Good Fences: Frost’s “Mending Wall”Zev TrachtenbergDefenders of the institution of private property have considered at length its benefits to individuals: for Aristotle it allows for the practice of certain virtues; for Hegel it allows for the expression of free human personality. 1 Property is also, of course, seen as the foundation of political society: for Locke men form government to enforce their property rights; for Jefferson (...) property enables citizens to participate in their institutions of self-government. 2But there is a level of human experience between simple individuality and the formal rules and rights articulated and enforced by society. I have in mind the more immediate form of human association evoked by the word community. Let me offer a rough-and-ready distinction. The social contract tradition prompts us to think of society in terms of the cooperative human enterprise of protecting individuals’ interests; the concept of society calls to mind formal voluntary agreements and associations, contracts, the economy, ultimately laws and rights. 3 We can think of community, by contrast, in affective terms; it calls to mind the direct human relations of people who share a place and mode of living. 4 A society has laws and a government; a community has customs and a culture.In this essay, then, I want to explore the relationship between property and community. It is, I think, an ambiguous one: property can be accused of corroding the human connections that constitute community life, but the maintenance of a property regime can also be seen as itself a communal enterprise. 5 This ambiguity is displayed vividly in Robert Frost’s “Mending Wall.” 6 Reading the poem can help us see the complex ways in which property and community are intertwined. [End Page 114]I“Mending Wall” has two characters: its narrator and his neighbor, owners of adjacent farms, who meet each Spring to repair the stone wall that stands between their properties. The narrator, at first glance, seems to take a somewhat skeptical attitude toward property. (We shall see that his attitude is in fact more complicated.) The poem opens with his words “Something there is that doesn’t love a wall”—a phrase he repeats later, making it a kind of slogan for the position on property he personifies. That position seems to reject human attempts to inscribe the arbitrary divisions of property holdings on the land. The narrator sees in natural processes an attempt to cast off this artificial imposition: that which doesn’t love a wall “sends the frozen-ground-swell under it, /And spills the upper boulders in the sun.” He recognizes that asserting a separation between the two parcels of property by erecting a wall is futile. For, he recognizes, the two parcels are one, connected underneath the wall by natural forces that work unconsciously but actively against human efforts to divide them.The neighbor, by contrast, speaks for an individualistic belief in the value of marking property holdings. “Good fences make good neighbors” are his only words in the poem, repeated in the last line like a counter-slogan to the narrator’s. The neighbor first offers his slogan in response to the fact that the wall is not needed for the practical purpose of keeping his and the narrator’s goods separate. Their goods do not need a wall to be kept apart: they have no cows to wander back and forth across the line, and the narrator’s “apple trees will never get across/And eat the cones under [the neighbor’s] pines.” For the neighbor, that is, the utility of the wall is not economic. Rather it serves to define the sort of relationship he wishes to have with those who surround him: his slogan expresses an ideology of human separation. In the neighbor’s eyes, apparently, all that makes a neighbor is the mere fact of owning an adjacent farm, hence what makes a good neighbor is his separateness. For what else could characterize the goodness of neighbors who are made good by fences?The neighbor thus personifies a position on property that disvalues community. Property is marked by walls, whose main function in his view... (shrink)

In ordinary discourse we often attribute beliefs not just to individuals but also to groups. But can groups really have genuine beliefs? This paper considers but ultimately rejects one of the main arguments in support of the claim that groups can be genuine believers – the Argument From Interpretationism – and concludes that we have good reasons to be sceptical about the existence of group beliefs. According to the Argument From Interpretationism, roughly speaking, groups qualify as genuine believers because we (...) can interpret their behaviour in much the same way that we can interpret the behaviour of individuals. While this argument may seem initially attractive, I argue that it is ultimately unsuccessful. In particular, I argue that the argument is unsuccessful even if one is generally sympathetic towards interpretationism. The reason for this, as we will see, is that a number of problems arise when we try to apply the interpretationist strategy – originally formulated with individual subjects in mind – to plural subjects or groups. In showing why the Argument From Interpretationism fails, the paper also brings into focus some more general constraints on the scope and applicability of interpretationism. (shrink)

An approach to phenomenology, by D. Cairns.--Husserl's critique of psychologism: its historic roots and contemporary relevance, by J. Wild.--The ideal of a presuppositionless philosophy, by M. Farber.--On the intentionality of consciousness, by A. Gurwitsch.--The "reality-phenomenon" and reality, by H. Spiegelberg.--The phenomenological concept of "horizon", by H. Kuhn.--Phenomenology and logical empiricism, by F. Kaufmann.--Phenomenology and the history of science, by J. Klein.--Phenomenology and the social sciences, by A. Schuetz.--Art and phenomenology, by F. Kaufmann.--The relation of science to philosophy in the light (...) of Husserl's thought, by L. O. Kattsoff.--Husserl and the social structure of immediacy, by C. Hartshorne.--A materialist approach to Husserl's philosophy, by V. J. McGill.--Outline-sketch of a system of metaphysics, by W. E. Hocking.--Men and the law, by G. Husserl.--The ghost of modality, by H. Weyl.--Supplement: Grundlegende untersuchungen zum phänomenologischen ursprung der räumlichkeit der natur, by E. Husserl. (shrink)

Received by the IRE, October 24, 1960. The author's work summarized here—which was done at the MIT Lincoln Laboratory, a center for research operated by MIT at Lexington, Mass., with the joint Support of the U. S. Army, Navy, and Air Force under Air Force Contract AF 19-5200; and at the Res. Lab. of Electronics, MIT, Cambridge, Mass., which is supported in part by the U. S. Army Signal Corps, the Air Force Office of Scientific Research, and the ONR—is based (...) on earlier work done by the author as a Junior Fellow of the Society of Fellows, Harvard University. (shrink)

The English Separatist movement provided the background for which John Smyth and Thomas Helwys emerged to reconstitute a biblical ecclesiology. Through the study of the New Testament, they came to the position that infant baptism and covenantal theology could not be the foundation for the New Testament church. Both men embraced believer’s baptism as the basic foundation in which a recovered church should be built. Unfortunately, Smyth defected to the Mennonites, leaving Thomas Helwys to continue the fledging work known as (...) Baptists. This article will examine the life of Thomas Helwys and his contribution to Baptist ecclesiology; it will also review selected literary works that contributed to the recovery of a New Testament church and the founding of Baptist ecclesiology. (shrink)

This paper investigates the relationship between linguistic expression and human reason in Herder’s Treatise on the Origin of Language. I argue that additive theories of human language, which contend that the linguistic capacity is in principle separable from the other cognitive faculties of the linguistic being, cannot be brought into agreement with Herder’s distinctly transformative account of human language and reason. For Herder, the transformation of our sensible faculties through language is required in order to guarantee the unity of human (...) cognition, and hence reason itself is understood as fundamentally linguistic. This positing of a strong unity between language and reason makes Herder an important, if still under-appreciated, precursor of the twentieth-century linguistic turn. (shrink)

This study was undertaken to investigate whether work variables identified in theory and research as being related to employee experiences/behaviours add to the understanding and explain employees' experiences of workplace harassment. The extent to which social cognitive theory (SCT), specifically moral disengagement, explains the processes by which work characteristics are related to harassment was also examined. The purpose of the study was to identify the presence of relationships among work characteristics, satisfaction, moral disengagement and workplace harassment. According to the results, (...) employees with negative opinions of their work tended to experience negative affect and to believe that it is acceptable to harm others. The results of this study provide evidence of (1) relationships between harassment and several workplace characteristics and (2) the applicability of SCT to the explanation of how work characteristics relate to harassment. (shrink)

What do corporations look like when they have integrity, and how can we move more companies in that direction? Corporate Integrity offers a timely, comprehensive framework- and practical business lessons - bringing together questions of organizational design, communication practices, working relationships, and leadership styles to answer this question. Marvin T. Brown explores the five key challenges facing modern businesses as they try to respond ethically to cultural, interpersonal, organizational, civic and environmental challenges. He demonstrates that if corporations are to (...) meet the needs of civil society, they must facilitate inclusive communication patterns based on mutual recognition and civic cooperation. Corporate Integrity is essential reading for professionals in organizational ethics, business leaders, and graduate students looking for practical and reflective insights into doing business with integrity and purpose. (shrink)

A leading contributor to artificial intelligence offers insight into the numerous ways in which the mind works to demonstrate how emotions and feelings are just ...