Letters commenting on Hardwig, J "Is There a Duty to Die?" with a reply to those letters by the author.

The following article is a response to the position paper of the Hastings Center, “Ethical Challenges of Chronic Illness”, a product of their three year project on Ethics and Chronic Care. The authors of this paper, three prominent bioethicists, Daniel Callahan, Arthur Caplan, and Bruce Jennings, argue that there should be a different ethic for acute and chronic care. In pressing this distinction they provide philosophical grounds for limiting medical care for the elderly and chronically ill. We give a (...) critical survey of their position and reject it as well as any attempt to characterize the physician-patient relationship as a commercial contract. We emphasize, as central features of good medical practice, a commitment to be the patient's agent and a determination to acquire and be guided by knowledge. These commitments may sometimes conflict with efforts to have the physician serve as an instrument of social and economic policies limiting medical care. (shrink)

Daniel Callahan has argued that economic and social benefits would result from a policy of withholding medical treatments which prolong life in persons over a certain age. He claims 'the real goal of medicine' is to conquer death and prolong life with the use of technology, regardless of the age and quality of life of the patient, and this has been responsible for the escalation of health care expenditure. Callahan's proposal is based on economic rationalism but there is (...) little evidence to suggest that substantial economic savings could be achieved. Moreover, his argument raises serious moral objections. A policy of withholding treatments from members of a social group involves elements of compulsion and discrimination, both of which would intrude on the doctor-patient relationship, undermine the autonomy of elderly patients, and invoke the slippery slope towards involuntary forms of euthanasia. Life-death decisions should be based on more than the one criterion of age, and take account of more relevant factors such as the patient's usual state of well-being, her/his expressed wishes, informed consent and the type of illness. Any move to the implementation and enforcement of the policy Callahan recommends would be rejected by health professionals and the public. (shrink)

There are important similarities between moral thought and talk and thought and talk about gender: disagreements about gender, like disagreements about morality, seem to be intractable and to outstrip descriptive agreement; and it seems coherent to reject any definition of what it is to be a woman in terms of particular social, biological, or other descriptive features, just as it seems coherent to reject any definition of what it is to be good or right in terms of any set of (...) descriptive properties. These similarities give us reason to investigate the idea that, like moral thought and talk, gender thought and talk is inherently normative. This paper proposes a normative account of gender thought and talk in terms of fitting treatment. On this fitting treatment account, to judge that A is gender G is just to judge that it is fitting to treat A as a G. This account is a descriptive or hermeneutical account of our gender thought and talk rather than an ameliorative account of our gender concepts or a metaphysical account of gender properties in social metaphysics. This paper argues that other descriptive accounts of gender thought and talk face problems that the fitting treatment account overcomes. (shrink)

A US Department of Health and Human Services Final Rule, Protecting Statutory Conscience Rights in Health Care, and a proposed bill in the British House of Lords, the Conscientious Objection Bill, may well warrant a concern that—to borrow a phrase Daniel Callahan applied to self-determination—conscientious objection in health care has “run amok.” Insofar as there are no significant constraints or limitations on accommodation, both rules endorse an approach that is aptly designated “conscience absolutism.” There are two common strategies to (...) counter conscience absolutism and prevent conscientious objection in medicine from running amok. One, non-toleration, is to decline to accommodate physicians who refuse to provide legal, professionally accepted, clinically appropriate medical services within the scope of their clinical competence. The other, compromise or reasonable accommodation, is to impose constraints on accommodation. Several arguments for non-toleration are critically analyzed, and I argue that none warrants its acceptance. I maintain that non-toleration is an excessively blunt instrument to prevent conscientious objection in medicine from running amok. Instead, I defend a more nuanced contextual approach that includes constraints on accommodation. (shrink)

This article focuses on two possible missions for a national bioethics commission. The first is handling differences of worldview, political orientation, and discipline. Recent work in political philosophy emphasizes regard for the dignity of difference manifested in "conversation" that seeks understanding rather than agreement. The President's Council on Bioethics gets a mixed review in this area. The second is experimenting with prophetic bioethics. "Prophetic bioethics" is a term coined by Daniel Callahan to describe an alternative to compromise-seeking "regulatory bioethics." (...) It involves a critique of modern medicine. In the contemporary context, the areas of biotechnology and access to health care cry out for prophetic attention. The Council has addressed biotechnology; unfortunately, that experience suggests that the kind of prophecy that it practices poses risks to conversation. With regard to access issues, the article proposes an effort that unites themes of human dignity, solidarity, and limits in support of reform, while highlighting, rather than papering over, differences. (shrink)

Epistemic decision theorists aim to justify Bayesian norms by arguing that these norms further the goal of epistemic accuracy—having beliefs that are as close as possible to the truth. The standard defense of Probabilism appeals to accuracy dominance: for every belief state that violates the probability calculus, there is some probabilistic belief state that is more accurate, come what may. The standard defense of Conditionalization, on the other hand, appeals to expected accuracy: before the evidence is in, one should expect (...) to do better by conditionalizing than by following any other rule. We present a new argument for Conditionalization that appeals to accuracy‐dominance, rather than expected accuracy. Our argument suggests that Conditionalization is a rule of coherence: plans that conflict with Conditionalization don't just prescribe bad responses to the evidence; they also give rise to inconsistent attitudes. (shrink)

A popular argument is that peer disagreement about controversial moral topics undermines justified moral belief in a way that peer disagreement about non-moral topics does not undermine justified non-moral belief. Call this argument the argument for moral skepticism from peer disagreement. Jason Decker and Daniel Groll have recently made a companions in guilt response to this argument. Decker and Groll argue that if peer disagreement undermines justified moral belief, then peer disagreement undermines much non-moral justified belief; if the argument for (...) moral skepticism from peer disagreement succeeds, then a kind of non-moral skepticism holds too. And we should not hold that the status of such non-moral beliefs are undermined by peer disagreement. In this paper, I shows that Decker and Groll’s companions in guilt argument fails. I then draw out the implications of my argument for the epistemology of disagreement and the epistemology of moral disagreement more generally. For instance, I then argue that peer disagreement about morality does not undermine all justified moral belief but that peer disagreement about morality does preclude most moral beliefs from being justified and constituting knowledge in a way that peer disagreement about non-moral topics does not preclude most non-moral beliefs from being justified and constituting knowledge. (shrink)

The occasion for this collection of four essays—by Vlastos, Ostwald, Callahan, and Solmsen—was Plato’s 2400th birthday in 1974. We note at once the book’s most disappointing and inexplicable flaw: it includes no example of North’s own fine classical scholarship and luminous understanding of the spirit of Platonic thought. Ostwald’s essay, ranging over much of the Platonic corpus, tills the well-plowed field of Plato’s contribution to the nomos-physis problem. His thesis is clear and familiar: Plato introduces new objects, eide, into (...) nature, the knowledge of which objects founds both the techne [[sic]] of the true king and justice. The science of such knowledge is the bulwark against Thrasymachus’s, Callicles', and Glaucon’s arguments concerning ‘natural law'. Ostwald seems unwilling, though, to grapple with the practical details of this techne [[sic]] in the political sphere. Rep. 546b-e and Polit. 310d ff. are programmatic, not substantive, and supply more puzzlement than answer. Callahan takes no smaller a topic than dialectic, myth, and history in Plato. His most interesting claim is that myth provides a setting for dialectic; each dialogue, he argues, is itself a myth, providing a locus wherein mythical topics, historical personages, and records of dialectical examinations can themselves be examined. Solmsen’s quite suggestive essay asks why Plato should investigate the physical world, which is intrinsically less than fully knowable, as well as being an insufficient source of guidance for man on issues of justice, moderation, and conduct. Though pointing out that physical bodies and their science must be of lesser rank than dialectic, Solmsen reminds us that not only did bodies provide a starting-point for mathematical demonstrations, and the incentive for solid geometry, but also that the planetary motions provided a taxis, an order, which was an image of an ordered cosmos, itself an image of an ordered eidetic realm. (shrink)

In this article, we consider two independently appealing theories—the Growing-Block view and Humean Supervenience—and argue that at least one is false. The Growing-Block view is a theory about the nature of time. It says that past and present things exist, while future things do not, and the passage of time consists in new things coming into existence. Humean Supervenience is a theory about the nature of entities like laws, nomological possibility, counterfactuals, dispositions, causation, and chance. It says that none of (...) these entities are fundamental, since if they were, this would entail the existence of irreducible necessary connections between matters of fact. Instead, these entities supervene on a fundamental, non-nomological ‘Humean mosaic’ of property instances at spacetime points. We will further explain and motivate the Growing-Block view and Humean Supervenience in Sects. 2 and 3, but first, we turn to our master argument. (shrink)

I am interested in extending modal calculi by adding propositional quantifiers, given by the rules for quantifier introduction: provided that p does not occur free in A.

The author's motivation for constructing the calculi of this paper\nis so that time and tense can be "discussed together in the same\nlanguage" (p. 282). Two types of enriched propositional caluli for\ntense logic are considered, both containing ordinary propositional\nvariables for which any proposition may be substituted. One type\nalso contains "clock-propositional" variables, a,b,c, etc., for\nwhich only clock-propositional variables may be substituted and that\ncorrespond to instants or moments in the semantics. The other type\nalso contains "history-propositional" variables, u,v,w, etc., for\nwhich only history-propositional variables may (...) be substituted and\nthat correspond to maximally linearly ordered subsets of instants.\nThis second type is for tense logics in which time is not linear\nand where at any moment there may exist alternative future courses\nof events. Quantifiers are included in both types but only for clock-\nand history-propositional variables. However, these quantifiers are\ngiven an essentially substitutional interpretation. In addition,\nbesides each clock-propositional variable being true at exactly one\ninstant, the semantics requires that for each instant there be at\nleast one clock-propositional variable true at that instant, which\nin effect amounts to having each instant of the model "denoted" in\nthe formalism by some clock-propositional variable. Thus it is not\nsurprising that quantification over clock-propositional variables\nturns out to have a "well behaved first-order semantics" (p. 284).\n{One axiom relating history- with clock-propositions seems to need\nrevision: CKTauTbuAUabUba. Since the clock-propositional variables\nmight be true at the same instant the consequent should include an\nalternative, namely, LCab.} Besides the standard truth-functional\nand tense operators G,H,F,P, the author includes L for "it is\nalways the case that". The model-theoretic earlier-than relation\nordering instants and the semantic truth-at (an instant) relation\nare formalized by Uab and Taα (for a wff α) which\nare defined respectively as LCbPa (whenever the clock-proposition\nb is the case the clock-proposition a was the case) and LCaα\n(α is the case whenever the clock-proposition a is the case).\nBecause the future tense operators are definable in terms of U\nand T and the latter are definable in terms of L and P, the\ndual of H, the author notes that his completeness proofs can be\nrestricted to L and H as primitive and with the future tense\noperators used for other interpretations, especially Prior, A.'s\nindeterminist "it will be the case that", where time is not linear.\nThe author concludes with some rather technical observations showing\nthat "in ordinary tense logics the instants are nonstandard elements\nof the models. This provides", according to the author, "a semantic\npressure to build the instants into tense logic, so that they will\nappear as standard elements in the models" (p. 283). (shrink)

We show that five important elements of the ‘nomological package’— laws, counterfactuals, chances, dispositions, and counterfactuals—needn’t be a problem for the Growing-Block view. We begin with the framework given in Briggs and Forbes (in The real truth about the unreal future. Oxford studies in metaphysics. Oxford University Press, Oxford, 2012 ), and, taking laws as primitive, we show that the Growing-Block view has the resources to provide an account of possibility, and a natural semantics for non-backtracking causal counterfactuals. We show (...) how objective chances might ground a more fine-grained concept of feasibility, and furnished a places in the structure where causation and dispositions might fit. The Growing-Block view, thus understood, provides the resources to explain the close link between modality and tense, so that it predicts modal change as time passes. This account lets us capture not only what the future might hold for us, and also what might have been. (shrink)

Sociological and philosophical analysis of the role of will power upon the moral development of individuals.

This book is an attack on the widespread assumption that the mind has parts and that it is the interaction between these parts which accounts for the irrational behaviour displayed un self- deception and weakness of will.

Aim To study the views of people in a largely Muslim country, Kuwait, of the acceptability of a life-ending action such as physician-assisted suicide (PAS). Method 330 Kuwaiti university students judged the acceptability of PAS in 36 scenarios composed of all combinations of four factors: the patient's age (35, 60 or 85 years); the level of incurability of the illness (completely incurable vs extremely difficult to cure); the type of suffering (extreme physical pain or complete dependence) and the extent to (...) which the patient requests a life-ending procedure, euthanasia or PAS (no request, some form of request, repeated requests). In all scenarios, the patients were women who were receiving the best possible care. The ratings were subjected to cluster analysis and analyses of variance. Results Five clusters were found. For 44%, PAS was always very unacceptable, no matter what the circumstances. For 23%, it was unacceptable, but less so if the patient was older or requested it repeatedly. For 16%, it was unacceptable if the patient was young but was acceptable if the patient was elderly. For 5%, it was unacceptable if the patient had extreme pain but was acceptable if completely dependent. For 11%, it was unacceptable if the patient did not request it but acceptable if she did. Conclusion The majority of the Kuwaiti university students opposed PAS either categorically or with a slight variation according to circumstances. Nonetheless, a minority approved of PAS in some cases, particularly when the patient was elderly. (shrink)

Part of the Studies in Crime and Public Policy series, this book, written by one of the top philosophers of punishment, examines the main trends in penal theorizing over the past three decades. Duff asks what can justify criminal punishment, and then explores the legitimacy of actual practices by examining what would count as adequate justification for them. Duff argues that a "communicative conception of punishment," which he presents as a third way between consequentialist and retributive theories, offers the most (...) fruitful way of understanding punishment's meaning and justification. Duff addresses such questions as how much sentences should be constrained by proportionality requirements; what modalities of punishment best communicate their intended meaning; and what decisionmaking procedures he envisions. This book will appeal to criminologists, philosophers, and others interested in theories of punishment. (shrink)

Gender discrimination and sexual harassment of female police officers by their male counterparts remain areas of liability where police departments appeared to have failed to effectively confront the nagging issues. However, the appreciable level of research conducted on these issues in the global North has not been matched by the South, where issues bordering on sexual violence have cultural underpinnings. Drawing from the case of the Nigeria Police Force, feminist analysis was used to explore the lived reality of 43 female (...) officers in a qualitative study. Participants expressed distress in abiding by structural discriminatory regulations against female officers which include non-admittance of married women into the force, forbidding unmarried officers from getting pregnant, and a stipulated minimum of three-year work period before a female officer can marry. Findings also indicated that participants suffer a variety of sexual harassment, intimidation, and, violence from their male colleagues, while they feel constrained in reporting their victimization. Important policy and practical implications requiring the Nigerian police to address hegemonic masculinity and promote gender equality were provided. (shrink)

Marcia Baron has offered an illuminating and fruitful discussion of extra-legal excuses. What is particularly useful, and particularly important, is her focus on our excusatory practices—on the ways and contexts in which we make, offer, accept, bestow and reject excuses: if we are to reach an adequate understanding of excuses, their implications and their grounds, we must attend to the roles that they can play in our human activities and relationships—and to the complexities and particularities of those roles. However, I (...) want to focus my comments less on the details of Baron’s discussions of excuses in extra-legal contexts than on the implications of her discussion for our understanding of excuses in the criminal law. What light (if any, a sceptic might add) can such analyses of our extra-legal concepts and practices throw on legal concepts and doctrines? (shrink)

In [1, §4], my ‘proof’ that GH1 has the finite model property is incorrect; there are considerable obscurities towards the end of §1, particularly on p. 33; and I should have exhibited the finite models for GH1. In §1 of this paper I expand the analysis of the sub-directly irreducible models for GH1 which I give in §1 of [1]. In §2 I give a correct proof that GH1 has the finite model property. In §3 I exhibit these finite models (...) as models on certain ordered sets. (shrink)