Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians is a concise and practical guide to ethical decision-making in medicine. The text is aimed at second- and third-year one-semester ethics courses offered in medical schools, health sciences departments, and nursing programs. By taking an applied approach rather than a theoretical approach, this text serves the needs of medical and nursing students, residents, and practicing physicians by sorting through questions of moral principles relevant to the diverse and growing (...) number of healthcare professionals. The many topics covered include truth telling, refusal of treatment, assisted suicide, managing error, and reproductive choice. (shrink)

The central view of this dissertation is that a more comprehensive theory of scientific learning must incorporate insights from the disciplines of methodology and sociology. The standards of methodology play an indispensible role in learning by providing some of the principles necessary for theoretical evaluation. But such principles are not sufficient for socially embedded learning and they do not exclude the operation of social interests within science. It is the institutional structure of science that helps make up what abstract standards (...) alone lack: the material means with which to affect the advancement of learning. Institutions add something of their own dynamic to learning by helping to realize the abstract principles of methodology--they are never simply neutral husks. ;The views of a number of methodologists and sociologists are examined to demonstrate that this view of learning has not always been appreciated. Some methodologists have thought that by developing a theory of scientific method they were ensuring science's insulation from society at large. Such projects expect too much of methodology and the best methodology we have--fallibilism--leaves science open to social influence. Some sociologists have seen the role of a social theory as cutting across that of methodology--as if a social account of learning could only be at the expense of methodology. This had led some to deny methodology any explanatory power and others to limit sociology to accounting for merely the external aspects of scientific development. ;I throughout try to suggest how learning may be best accounted for by a fallibilist methodology combined with an institutional social theory. Such a dual view of learning is helpful because the advancement of learning is at times as dependent on its material constraints as on its intellectual ones. Thus, a comprehensive theory of learning can help science be a more critical enterprise and so contribute to its advancement. (shrink)

BackgroundPatient autonomy is a fundamental, yet challenging, principle of professional medical ethics. The idea that individual patients should have the freedom to make choices about their lives, including medical matters, has become increasingly prominent in current literature. However, this has not always been the case, especially in communist countries where paternalistic attitudes have been interwoven into all relationships including medical ones. Patients’ expectations and the role of the doctor in the patient-physician relationship are changing. Croatia, as a transitional country, is (...) currently undergoing this particular process.MethodsQualitative research was conducted by means of six focus group discussions held in the years 2012 and 2013 in Croatia. Focus groups were held separately with each of the following: first year and final year medical students, physicians engaged in medical ethics education, physicians practicing in a clinical hospital, family medicine residents and individuals representing patients with chronic disease. This research specifically addresses issues related to patient autonomy, in particular, the principles of truth telling, confidentiality, and informed consent. All focus group discussions were audio taped and then transcribed verbatim and systematized according to acknowledged qualitative analysis methods.Results and discussionPatient autonomy is much more than a simple notion defined as the patient’s right to make treatment decisions independently. It has to be understood in context of the broader socio-cultural setting. At present, both patients and medical doctors in Croatia are increasingly appreciating the importance of promoting the principle of autonomy in medical decision-making. However, the current views of medical students, physicians and patients reveal inconsistencies.Conclusions Knowing how to respect the various facets of patients’ autonomy should be part of physician’s professional duties, and also be reflected in his or her core clinical competencies. For this reason greater importance should be dedicated to patient autonomy issues in medical education in Croatia. (shrink)

Institutional review boards are almost universally considered to be overworked and understaffed. They also require substantial commitments of time and resources from their members. Although some surveys report average IRB memberships of 15 people or more, federal regulations require only five. We present data on IRB meetings at eight of the top 25 academic medical centers in the United States funded by the National Institutes of Health. These data indicate substantial contributions from primary reviewers and chairs during protocol discussions but (...) little from other members, which implies that it may be possible for smaller IRBs to accomplish the same tasks with no reduction in the quality of review. (shrink)

In 85 new and updated essays, this comprehensive volume provides an authoritative guide to the philosophy of religion. Includes contributions from established philosophers and rising stars 22 new entries have now been added, and all material from the previous edition has been updated and reorganized Broad coverage spans the areas of world religions, theism, atheism,, the problem of evil, science and religion, and ethics.

Integrating large language models (LLMs) like GPT-4 into medical ethics is a novel concept, and understanding the effectiveness of these models in aiding ethicists with decision-making can have significant implications for the healthcare sector. Thus, the objective of this study was to evaluate the performance of GPT-4 in responding to complex medical ethical vignettes and to gauge its utility and limitations for aiding medical ethicists. Using a mixed-methods, cross-sectional survey approach, a panel of six ethicists assessed LLM-generated responses to eight (...) ethical vignettes. The main outcomes measured were relevance, reasoning, depth, technical and non-technical clarity, as well as acceptability of GPT-4’s responses. The readability of the responses was also assessed. Of the six metrics evaluating the effectiveness of GPT-4’s responses, the overall mean score was 4.1/5. GPT-4 was rated highest in providing technical (4.7/5) and non-technical clarity (4.4/5), whereas the lowest rated metrics were depth (3.8/5) and acceptability (3.8/5). There was poor-to-moderate inter-rater reliability characterised by an intraclass coefficient of 0.54 (95% CI: 0.30 to 0.71). Based on panellist feedback, GPT-4 was able to identify and articulate key ethical issues but struggled to appreciate the nuanced aspects of ethical dilemmas and misapplied certain moral principles. This study reveals limitations in the ability of GPT-4 to appreciate the depth and nuanced acceptability of real-world ethical dilemmas, particularly those that require a thorough understanding of relational complexities and context-specific values. Ongoing evaluation of LLM capabilities within medical ethics remains paramount, and further refinement is needed before it can be used effectively in clinical settings. (shrink)

This book says Prior claims: (1) that a sentence never names; (2) what a sentence says cannot be otherwise signified; and (3) that a sentence says what it says whatever the type of its occurrence; (4) and that quantifications binding sentential variables are neither eliminable, substitutional, nor referential. The book develops and defends (1)-(3). It also defends (4) against the sorts of strictures on quantification of such philosophers as Quine and Davidson.

In 85 new and updated essays, this comprehensive volume provides an authoritative guide to the philosophy of religion. Includes contributions from established philosophers and rising stars 22 new entries have now been added, and all material from the previous edition has been updated and reorganized Broad coverage spans the areas of world religions, theism, atheism,, the problem of evil, science and religion, and ethics.

The purpose of this paper is to uncover and correct several confusions about expressions, tokens and the relations between them that crop up in even highly sophisticated writing about language and logic.

Conversational implicatures are easy to grasp for the most part. But it is another matter to give a rational reconstruction of how they are grasped. We argue that Grice's attempt to do this fails. We distinguish two sorts of cases: (1) those in which we grasp the implicature by asking ourselves what would the speaker have to believe given that what he said is such as is required by the talk exchange; (2) those in which we grasp the implicature by (...) asking ourselves why it is that what the speaker said is so obviously not such as is required by the talk exchange. We argue that Grice's account does not fit those cases falling under (2). (shrink)

The significance of the semantical paradoxes for natural languages is examined. If Tarski’s reflections on the issue are correct, English is inconsistent. Paul Ziff responds to Tarskian reflections by arguing to the conclusion that no natural language is or can be inconsistent. The authors reject Ziff’s argument, but they defend something similar to its conclusion: no language, natural or otherwise, is or can be inconsistent in the way that Tarski holds languages capable of formulating the Epimenides are inconsistent.

Human allografts for life-threatening organ failure have been demonstrated to be lifesaving and are now considered to be standard of care for many conditions. Transplantation of non-vital anatomic body parts has also been accomplished. Hand transplantation after limb loss in adults has been shown to offer some promising benefits in both functional and psychological measures in preliminary studies. It has been suggested to expand eligibility criteria to include minors, with one such operation having already been performed. With this in mind, (...) we examine the current state of hand transplantation research in the context of available alternatives. We examine the ethics of carrying out these operations in minors, including under the protections of clinical research. We argue that children should not be considered for this surgery due to the substantial risks of immunosuppressive medication, the likelihood that the graft will need to be replaced during the patient’s lifetime and the lack of significant compensatory advantages over modern prosthetics. (shrink)

In Tractatus, Wittgenstein held that there are null sentences – prominently including logical truths and the truths of mathematics. He says that such sentences are without sense (sinnlos), that they say nothing; he also denies that they are nonsensical (unsinning). Surely it is what a sentence says which is true or false. So if a sentence says nothing, how can it be true or false? The paper discusses the issue.

For Rudolf Carnap the question ‘Do numbers exist?’ does not have just one sense. Asked from within mathematics, it has a trivial answer that could not possibly divide philosophers of mathematics. Asked from outside of mathematics, it lacks meaning. This paper discusses Carnap ’s distinction and defends much of what he has to say.

Fundamental to Quine’s philosophy of logic is the thesis that substitutional quantification does not express existence. This paper considers the content of this claim and the reasons for thinking it is true.

We give a semantical account of propositional identity which is stronger than mutual entailment. That is, according to our account: (1) if A = B is true in a model, so are A 'validates' B and B 'validates' A. (2) There exist models m such that A 'validates' B and B 'validates' A are true in m but A = B is not true in m. According to our account the following rule is sound: (3) from (.. A..) = (.. (...) B..) infer A = B. The paper respondes to a criticism of an earlier paper by James Freeman . (shrink)

Individuals differ in their support for social change. We argue that examinations of inequality and change would benefit from consideration of underlying personality processes. New data suggest that Right-Wing Authoritarianism and Social Dominance Orientation, indicators of support for inequality, may be motivated by biologically driven personality processes, particularly those related to positive-approach motivation.

The paper asks: are all tautologies true in a language with truth-value gaps? It answers that they are not. No tautology is false, of course, but not all are true. It also contends that not all contradictions are false in a language with truth-value gaps, though none are true.

Suppose there is a domain of discourse of English, then everything of which any predicate is true is a member of that domain. If English has a domain of discourse, then, since ‘is a domain of discourse of English’ is itself a predicate of English and true of that domain, that domain is a member of itself. But nothing is a member of itself. Thus English has no domain of discourse. We defend this argument and go on to argue to (...) the same conclusion without relying on the supposition that English is a language which contains the predicate ‘is a domain of discourse of English’. (shrink)

The paper purports to show, against Quine, that one can construct a language , which results from the extension of the theory of truth functions by introducing sentence letter quantification. Next a semantics is provided for this language. It is argued that the quantification is neither substitutional nor requires one to consider the sentence letters as taking entities as values.

This paper is a discussion of Frege's maxim that it is only in the context of a sentence that a word has a meaning. Quine reads the maxim as saying that the sentence is the fundamental unit of significance. Dummett rejects this as a truism. But it is not a truism since it stands in opposition to a conception of meaning held by John Locke and others. The maxim denies that a word has a sense independently of any sentence in (...) which it occurs. Dummett says this denial is inconsistent with the fact that people understand sentences they have never heard before. The maxim is defended against this attack. (shrink)

Peter Geach proposed a substitutional construal of quantification over thirty years ago. It is not standardly substitutional since it is not tied to those substitution instances currently available to us; rather, it is pegged to possible substitution instances. We argue that (i) quantification over the real numbers can be construed substitutionally following Geach's idea; (ii) a price to be paid, if it is that, is intuitionism; (iii) quantification, thus conceived, does not in itself relieve us of ontological commitment to real (...) numbers. (shrink)

Let C1 and C2 be distinct moral codes formulated in English. Let C1 contain a norm N and C2 its negation. The paper construes the moral relativist as saying that if both codes are consistent, then, in the strongest sense of correctness applicable to moral norms, they are also both correct in the sense that they contain only correct moral norms. If we believe that the physical statements of English are true (false) in English, we will reject an analogous statement (...) made of physical theories. We will hold that the strongest sense of correctness applicable to physical statements is not system-relative. The moral relativist denies that there is any corresponding sense of correctness applicable to moral norms. That is, there is no notion of moral correctness that is not system-dependent. It is argued that, while the position may not be true, there is not a strictly logical basis for refuting it. (shrink)

Pavel Tichy presents an interpretation of Anselm’s Proslogion III argument. Tichy presents an interpretation of this argument and raises doubts about one of the premises. The authors contend that Tichy’s interpretation of Anselm is wrong. The argument Tichy comes to raise doubts about is not Anselm’s.

In this paper the authors argue that if Tarski’s definition of truth for the calculus of classes is correct, then set theories which assert the existence of proper classes (classes which are not the member of anything) are incorrect.

Whereas arithmetical quantification is substitutional in the sense that a some-quantification is true only if some instance of it is true, it does not follow (and, in fact, is not true) that an account of the truth-conditions of the sentences of the language of arithmetic can be given by a substitutional semantics. A substitutional semantics fails in a most fundamental fashion: it fails to articulate the truth-conditions of the quantifications with which it is concerned. This is what is defended in (...) the paper. In particular, it is defended against remarks to the contrary in a well known paper on the subject. (shrink)

In this book a non-realist philosophy of mathematics is presented. Two ideas are essential to its conception. These ideas are (i) that pure mathematics--taken in isolation from the use of mathematical signs in empirical judgement--is an activity for which a formalist account is roughly correct, and (ii) that mathematical signs nonetheless have a sense, but only in and through belonging to a system of signs with empirical application. This conception is argued by the two authors and is critically discussed by (...) three philosophers of mathematics. (shrink)

Frege held that the result of applying a predicate to names lacks reference if any of the names lack reference. We defend the principle against a number of plausible objections. We put forth an account of consequence for a first-order language with identity in which the principle holds.