Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

High-spin states have been studied in Pr-135(59), populated through the Cd-116(Na-23,4n) reaction at 115 MeV, using the Gammasphere gamma-ray spectrometer. The negative-parity yrast band has been significantly extended to spin similar to 45 (h) over bar and excitation energy 21.5 MeV, showing evidence for several rotational alignments. The positive-parity yrast band of Ce-135(58), populated through the p4n channel of this reaction, was also populated to spin similar to 38 (h) over bar and excitation energy 18 MeV. Cranking calculations indicate that (...) these nuclei are soft with respect to the triaxiality parameter gamma and that several competing nuclear shapes occur at high spin. (shrink)

When a wrongdoing occurs, victims, barring special circumstance, can aptly forgive their wrongdoers, receive apologies, and be paid reparations. It is also uncontroversial, in the usual circumstances, that wronged parties can aptly blame their wrongdoer. But controversy arises when we consider blame from third-parties after the victim has forgiven. At times it seems that wronged parties can make blame inapt through forgiveness. If third parties blame anyway, it often appears the victim is justified in protesting. “But I forgave him!” In (...) other cases, however, forgiveness seems irrelevant: B can forgive A, but it can still seem that third parties can aptly blame A for the wrong against B. This perplexity adds a dimension to ongoing discussion regarding criteria for apt blame and the related issues of standing and fittingness. This paper explores the status of third party blame after forgiveness. I argue that while post forgiveness blame is often inapt, in many other cases forgiveness is irrelevant. This difference is explained by appeal to the various relationships third parties might have to wronged parties, and how these differences affect the ways we blame and thereby blame’s aptness. (shrink)

Literature in the epistemology of disagreement has focused on peer disagreement: disagreement between those with shared evidence and equal cognitive abilities. Additional literature focuses on the perspective of amateurs who disagree with experts. However, the appropriate epistemic reaction from superiors who disagree with inferiors remains underexplored. Prima facie, this may seem an uninteresting set of affairs. If A is B’s superior, and A has good reason to believe she is B’s superior, A appears free to dismiss B’s disagreement. However, a (...) closer look will show otherwise. I first distinguish competent from incompetent inferiors and then argue that disagreement from the former often gives superiors reason to adjust credence and reevaluate belief. In other words, epistemic inferiority alone is insufficient grounds for dismissing opinion. More nuanced difficulties arise with incompetent inferiors. When superiors disagree with incompetents, this might provide evidence to bolster belief credence; however, agreement from incompetents can defeat justification. In either instance, inferior opinion carries epistemic weight. Yet, this fails to cover all ground; at times, superiors learn nothing from inferior disagreement. I finish by exploring these uninformative disagreements, how to distinguish them from the informative cases, and the proper epistemic reactions thereof. (shrink)

What is the connection between valid inference and true conditionals? Many conditional logics require that when A is a logical consequence of B, "if B then A" is true. Taking counterlogical conditionals seriously leads to systems that permit counterexamples to that general rule. However, this leaves those of us who endorse non-trivial accounts of counterpossible conditionals to explain what the connection between conditionals and consequence is. The explanation of the connection also answers a common line of objection to non-trivial counterpossibles, (...) which is based on a transition from valid arguments to the corresponding conditionals. It also contributes to the wider project of illuminating the connections between contexts of utterance, on the one hand, and the truth-conditions of conditionals uttered in those contexts, on the other. (shrink)

Christopher Nolan is the writer and director of Hollywood blockbusters like The Dark Knight and The Dark Knight Rises, and also of arthouse films like Memento and Inception. Underlying his staggering commercial success however, is a darker sensibility that questions the veracity of human knowledge, the allure of appearance over reality and the latent disorder in contemporary society. This appreciation of the sinister owes a huge debt to philosophy and especially modern thinkers like Friedrich Nietzsche, Sigmund Freud and Jacques (...) Derrida. Taking a thematic approach to Nolan's oeuvre, Robbie Goh examines how the director's postmodern inclinations manifest themselves in non-linearity, causal agnosticism, the threat of social anarchy and the frequent use of the mise en abyme, while running counter to these are narratives of heroism, moral responsibility and the dignity of human choice. For Goh, Nolan is a 'reluctant postmodernist'. His films reflect the cynicism of the modern world, but with their representation of heroic moral triumphs, they also resist it. (shrink)

In the long aftermath of such modernist suspicions about the still dominant "official" Enlightenment culture, the very title of the recently translated book by Hans Blumenberg is a bluntly direct invitation to controversy--The Legitimacy of the Modern Age. For Blumenberg, when Giordano Bruno, condemned to burn at the stake in 1600, defiantly turned his face from a crucifix offered him as a last chance at redemption, the heroic gesture should be seen as just that, heroic and historically decisive, a rejection (...) of the reality of the Incarnation, and the expression of a decisively new form of thought. "The Nolan" did cross a real threshold that separates modernity from pre-modernity. The new, for Blumenberg is new, not belated, and what's more heretical still in our post-Nietzschean, post-Heideggerean world, better than the old. The "self-assertion" of modernity is, in a simple word, "legitimate.". (shrink)

Reasoning about situations we take to be impossible is useful for a variety of theoretical purposes. Furthermore, using a device of impossible worlds when reasoning about the impossible is useful in the same sorts of ways that the device of possible worlds is useful when reasoning about the possible. This paper discusses some of the uses of impossible worlds and argues that commitment to them can and should be had without great metaphysical or logical cost. The paper then provides an (...) account of reasoning with impossible worlds, by treating such reasoning as reasoning employing counterpossible conditionals, and provides a semantics for the proposed treatment. (shrink)

Fourteen newly commissioned essays trace the historical development of the distinction between primary and secondary qualities, which lies at the intersection of issues in metaphysics, epistemology, and philosophy of perception. 'Primary and Secondary Qualities' focuses on the age of the Scientific Revolution, the 'locus classicus' of the distinction, but begins with chapters on ancient Greek and Scholastic accounts of qualities in an effort to identify its origins. The remainder of the volume is devoted to philosophical reflections on qualities from the (...) seventeenth century to the present day. Virtualliy every major figure is represented from Gassendi to Kant, and special attention is paid to Locke, Descartes, and Hume. The essays collected here cover a wide range of topics, including the foundation for the distinction, the question of whether it is lmetaphysical or merely epistemic, the status of secondary qualities, the nature of sensoriy representation, the relation between philosophy and science, the status of dispositions, and the semantics of sensible-quality terms"--Publisher's description, p. [4] of dust jacket. (shrink)

It is almost universally believed that some infinite regresses are vicious, and also almost universally believed that some are benign. In this paper I argue that regresses can be vicious for several different sorts of reasons. Furthermore, I claim that some intuitively vicious regresses do not suffer from any of the particular aetiologies that guarantee viciousness to regresses, but are nevertheless so on the basis of considerations of parsimony. The difference between some apparently benign and some apparently vicious regresses, then, (...) turns out to be a matter of a more general assessment of costs and benefits, making viciousness of regresses in some cases less of a local matter than is usually thought. (shrink)

Possible worlds have found many applications in contemporary philosophy: from theories of possibility and necessity, to accounts of conditionals, to theories of mental and linguistic content, to understanding supervenience relationships, to theories of properties and propositions, among many other applications. Almost as soon as possible worlds started to be used in formal theories in logic, philosophy of language, philosophy of mind, metaphysics, and elsewhere, theorists started to wonder whether impossible worlds should be postulated as well. In many applications, possible worlds (...) face limitations that can be dealt with through postulating impossible worlds as well. This chapter examines some of the uses of impossible worlds, and philosophical challenges theories of impossible worlds face. (shrink)

Published in the American Journal of Bioethics.

Après le 11 septembre 2001, un ressort essentiel des politiques américaines de renforcement de la « sécurité nationale » a pris la forme d’une insistance quasi paranoïaque sur les menaces potentiellement catastrophiques constituées par le cyber-terrorisme. Un grand nombre de commentateurs politiques, militaires ou économiques, ainsi que d’universitaires et de journalistes, ont envahi..

What political problem can autobiography solve? This article examines the politics of Frederick Douglass’s antebellum personal narratives: his 1845 slave narrative, the Narrative of the Life of Frederick Douglass, an American Slave, and his 1855 autobiography, My Bondage and My Freedom, written at the opposite ends of Douglass’s transition from the abolitionist politics of William Lloyd Garrison and Wendell Phillips to Douglass’s defense of political action and the Constitution as anti-slavery. Placing the two texts alongside Douglass’s distinction “to narrate wrongs” (...) and “denouncing them,” I argue that Douglass writes My Bondage and My Freedom as a mode of denunciation: an autobiographical critique of injustice that balances analysis of collective oppression with advocacy for communal emancipation. Whereas to narrate wrongs encouraged readers to judge Douglass’s story alongside popular criteria of justice, to denounce wrongs is to implicate readers within the structures that create antebellum subjects on and off the plantation, by revealing the coercions and conditionings of society that make not simply slaves but slaveowners, sympathizers, and abolitionists. This article claims that autobiography is a distinct genre of political theory, one that challenges present relations between the individual and the collective by representing not simply its author but an expanded view of “the people.”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Christ's Human Nature and the Cry from the Cross:St. Thomas Aquinas on Psalm 22:2Philip Nolan O.P.Christ's cry from the Cross quoting Psalm 22 (Mark 15:34; Matt 27:46) has become a central focus for contemporary Christological debates.1 A number of modern thinkers have read this verse as expressing in Christ an experience of dereliction incompatible with traditional positions concerning divine impassibility Christ's beatific knowledge, and Trinitarian relations.2 Thomas Joseph (...) White has recently offered an insightful Thomistic critique of these interpretations: [End Page 1219]The final cry of Christ on the cross cannot be interpreted as a cry of either despair or of spiritual separation from God. By contrast, it must be understood theologically as a prayer of desire related to Christ's abandonment to the Father and his hope to introduce humanity into the eschatological gift of redemption.3In his work, White is concerned to engage with modern Christological themes using principles derived from the Thomistic tradition. For this reason, he articulates a rather original alternative to modern theologies of dereliction—especially those marked by divine kenoticism and Luther's theology of the Cross. In offering a view inspired by Thomistic principles, White presents his own creative retrieval of Aquinas's ideas concerning the cry from the Cross.At times, however, White's argument leaves somewhat obscure the literal meaning of the words of that cry: "My God, my God, why have you abandoned me?"4 For example, in pushing back against radical interpretations [End Page 1220] of dereliction, he shifts the language of "abandonment" from God's abandonment of Christ to Christ's abandonment to the Father. My argument in this article is that the textual commentaries on Psalm 225 by Augustine and Aquinas—material that White does not consider specifically—can provide an alternate and somewhat complementary Thomistic approach to the one White proposes, and one more soundly based on Aquinas's texts themselves.6 Christ's cry is a quote from this psalm, and Aquinas's commentary on Ps 22:27 develops the Augustinian interpretation of this verse in order to give greater emphasis to Christ's human nature. This emphasis helps to explain, in a classical way, what it can mean that Christ is abandoned. Thus, Aquinas's exegesis bolsters the orthodox response to contemporary revisionist theologians by providing a clear literal understanding of this contested biblical passage without applying an experience of damnation to Christ or denying classical positions concerning divine impassibility, Christ's beatific knowledge, and the nature of Trinitarian relations.To make this argument, I will first look at the rich tradition of reflection on the Christological meaning of the Psalms, and Psalm 22 in particular, inherited by Thomas. This tradition includes a series of psalm commentaries, conciliar documents, and a variety of other theological works. In this tradition, I argue, we see two primary interpretative approaches. The first is what I will call the Augustinian approach, which insists that Christ is speaking on the Cross for sinners and in the voice of sinners. The second interpretation places more weight on Christ's own voice and insists that he is speaking in a real way for himself—Christ in some way truly is abandoned by God. These interpretations need not and should not be read as contradictory. In fact, all the authorities I examine insist on the first approach. Differences emerge, however, in how they coordinate the latter interpretation with the former. I will discuss Thomas's synthesis of these interpretations, a synthesis that he grounds in the reality of Christ's human nature. Finally, I will suggest [End Page 1221] how a close reading of Thomas's mature treatment of Ps 22:2 supplements contemporary Thomist responses to modern Christological concerns and misguided interpretations of Christ's cry on the Cross.Thomas's Sources for Reading Psalm 22:2Thomas's primary source for understanding Ps 22:2 is Scripture itself Both Mark and Matthew report that Christ spoke the words of this psalm from the Cross, a fact which necessitates for Thomas a Christological interpretation of the psalm.8 Augustine links Ps 22:2 with passages in... (shrink)

This encylopedia entry describes the "Canberra Plan" approach to conceptual analysis, a method closely related to the Ramsey-Carnap-Lewis approach to analysing the meaning of theoretical terms.

Current art world statistics demonstrate that the fight for gender and race equality in the art world is far from over: only sixteen percent of this year's Venice Biennale artists were female; only fourteen percent of the work displayed at MoMA in 2016 was by nonwhite artists; only a third of artists represented by U.S. galleries are female, but over two-thirds of students enrolled in art and art-history programs are young women. Arranged in thematic sections focusing on feminism, race, and (...) sexuality, Curatorial Activism examines and illustrates pioneering examples of exhibitions that have broken down boundaries and demonstrated that new approaches are possible, from Linda Nochlin's 'Women Artists' at LACMA in the mid-1970s to Jean-Hubert Martin's 'Carambolages' in 2016 at the Grand Palais in Paris. Including interviews with pioneering curators such as Okwui Enwezor, Linda Nochlin, Jean-Hubert Martin, and Nan Goldin, this volume is both an invaluable source of practical information for those who understand that institutions must be a driving force in this area and a vital source of inspiration for today's expanding new generation of curators. Preface by Lucy R. Lippard. (shrink)

Despite its growing use over past decades, there has been relatively little public or scholarly discussion of life sentences that deny the possibility of parole. This essay outlines the labyrinthine legal and political developments that have rendered life imprisonment difficult to address—including the intertwined histories of the death penalty and civil death—and draws upon the life writing of those serving life to theorize a more distinct understanding of this punishment. Witnesses reveal how the possibility of life despite the impossibility of (...) parole punishes by subverting the goals of human growth and development. The potentiality of what can be done in the present grinds up against the futility of what could have been done and what could be done were release an option. Considered alongside the laws and court opinions and claims that characterize its convoluted development, these testimonies reveal this punishment’s role in the American imagination. Life without the possibility of parole reinforces and relies upon a vision that not simply some people are unable to change, but that anyone in a democracy—no matter their position—is some steps away from irretrievable exclusion. Permanent confinement denies a restorative vision of democracy: any effort to abolish or amend it must include the voices of those imprisoned. (shrink)

Bortolotti argues that the irrationality of many delusions is no different in kind from the irrationality that marks many non-pathological states typically treated as beliefs. She takes this to secure the doxastic status of those delusions. Bortolotti’s approach has many benefits. For example, it accounts for the fact that we can often make some sense of what deluded subjects are up to, and helps explain why some deluded subjects are helped by cognitive behavioral therapy. But there is an alternative approach (...) that secures the same benefits as Bortolotti’s account while bringing additional benefits. The alternative approach treats both many delusions and many of the non-pathological states to which Bortolotti compares them as in-between states. Subjects in in-between states don’t fully believe the beliefs which it is sometimes convenient to ascribe to them. This alternative approach to belief and belief-ascription fits well with an independently attractive account of the varied purposes of our ordinary attitude ascriptions. It also makes it easier to make fine-grained distinctions between intentional attitudes of different kinds. (shrink)

Conversations with patients and families about the allow-natural-death (AND) order, along with the standard do-not-resuscitate (DNR) order during end-of-life (EOL) decision-making, may create engagement and understanding while promoting care that can be defended using enduring notions of autonomy, beneficence, and professional duty. Ethical, legal, and pragmatic issues surrounding EOL care decision-making seem to suggest discussion of AND orders as one strategy clinicians could consider at the individual practice level and at institutional levels. A discussion of AND orders, along with traditional (...) DNR orders is presented. This is followed by argument and counter-argument focused on ethical, legal, and practical issues germane to EOL care decision-making associated with use of AND orders. (shrink)

In this chapter I argue that Alexis de Tocqueville describes the virtue of citizenship in a way that is relevant to contemporary virtue ethics. He explains how a group can possess a virtue that is distinct from the virtue of individual members of the group. (this is an unofficial draft).

In this paper, I aim to demonstrate that the consequences of the current United States health insurance scheme on both physician and patient autonomy is dire. So dire, in fact, that the only moral solution is something other than what we have now. The United States healthcare system faces much criticism at present. But my focus is particular: I am interested in the ways in which insurance interferes with physician and patient autonomy. I will argue in favor of an expansion (...) of the traditional conception of what I call “medical autonomy” or “healthcare autonomy” and the usual role it plays in bioethical discussions. More generally, I show that in morally designing or evaluating any healthcare system, serious attention should be paid to how this system helps foster what I call active autonomy. (shrink)

There are few, if any, other educational philosophers that have left their mark internationally as John Dewey has. Author of 40 books and no less than 700 articles that appeared in over 140 journals, Dewey's work has been translated into at least 35 languages. His landmark Democracy and Education - published over a century ago in 1916 - is one of the most cited educational texts ever. Dewey has inspired educators and provoked controversies in his day, and still does so (...) today. This volume sets out to engage with Dewey's educational thought, especially as it relates to its circulation in the countries bordering on the Mediterranean. Authors consider his enduring influence, and reflect on the 'push' and 'pull' forces that served to anchor progressivism, in its multiple manifestations, in the region. The notion of a unidirectional force - personified by Dewey - that is somehow absorbed by the 'receiving' country is problematised by most if not all chapters in this volume. Rather, contributors carefully show how context affects a process marked by active appropriation, re-interpretation, adaptation, as well as resistance. (shrink)