Too many patients are injured in the course of care. Clinicians may mistakenly cause new harm to a patient or fail to take established steps to improve the presenting condition. Medical institutions within which they work may lack mechanisms to reduce errors or prevent them from harming patients. Many, perhaps even most, injuries are preventable, probably numbering in the hundreds of thousands a year for hospital care alone. Long ignored by medical practitioners and health-care payers and little appreciated by the (...) public, the problem of medical injury is finally receiving high-level policy attention. Much credit goes to the Institute of Medicine for its landmark report of November 1999, which marshaled the evidence about medical injuries and highlighted new approaches to systematic improvement of safety within systems of care. (shrink)

Too many patients are injured in the course of care. Clinicians may mistakenly cause new harm to a patient or fail to take established steps to improve the presenting condition. Medical institutions within which they work may lack mechanisms to reduce errors or prevent them from harming patients. Many, perhaps even most, injuries are preventable, probably numbering in the hundreds of thousands a year for hospital care alone. Long ignored by medical practitioners and health-care payers and little appreciated by the (...) public, the problem of medical injury is finally receiving high-level policy attention. Much credit goes to the Institute of Medicine for its landmark report of November 1999, which marshaled the evidence about medical injuries and highlighted new approaches to systematic improvement of safety within systems of care. (shrink)

This study examined the relationship between individual differences in executive functions (EF; assessed by measures of working memory, Stroop, trail making, and verbal fluency) and ability to down-regulate and up-regulate responses to emotionally evocative film clips. To ensure a wide range of EF, 48 participants with diverse neurodegenerative disorders and 21 older neurologically normal ageing participants were included. Participants were exposed to three different movie clips that were designed to elicit a mix of disgust and amusement. While watching the films (...) they were either instructed to watch, down-regulate, and up-regulate their visible emotional responses. Heart rate and facial behaviours were monitored throughout. Emotion regulatory ability was operationalised as changes in heart rate and facial behaviour in the down- and up-regulation conditions, controlling for responses in the watch condition. Results indicated that higher verbal fluency scores were related to greater ability to regulate emotion in both the down-regulation and up-regulation conditions. This finding remained significant even after controlling for age and general cognitive functioning. No relationships were found between emotion regulation and the other EF measures. We believe these results derive from differences among EF measures, with verbal-fluency performance best capturing the complex sequence of controlled planning, activation, and monitoring required for successful emotion regulation. These findings contribute to our understanding of emotion–cognition interaction, suggesting a link between emotion-regulatory abilities and individual differences in complex executive functions. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Despite the supreme political and economic significance of boundaries--and ongoing challenges to existing national boundaries--scant attention has been paid to their ethics. This volume explores how diverse ethical traditions understand the political and property rights reflected in territorial and jurisdictional boundaries. It is the first book to bring together thinkers from a range of traditions, both religious and secular, to discuss the ethics of boundaries. Each contributor represents a tradition's views on questions surrounding the use of boundaries to delimit property (...) and political rights. What does it mean to own something? What resources should not be privately owned? What justifies the erection of political boundaries between one people and another? How ''hard'' should such boundaries be? What rights extend to minorities within a state? Should territorial boundaries coincide with social ones? Does national autonomy have an ethical basis, or is it an aspect of modern power politics? Should we aim for a more inclusive community than that afforded by modern nation-states? Cross-chapter dialogue and a substantive conclusion draw out similarities and differences among the traditions represented, traditions that include Christianity, classical liberalism, Confucianism, international law, Islam, Judaism, liberal egalitarianism, and natural law. In addition to the editors, the contributors are Nigel Biggar, Joseph Boyle, Joseph Chan, Russell Hardin, Will Kymlicka, Loren Lomasky, Robert McCorquodale, Richard B. Miller, David Novak, Sulayman Nyang, Michael Nylan, Raul C. Pangalangan, Daniel Philpott, Jeremy Rabkin, Hillel Steiner, M. Raquibuz Zaman, and Noam J. Zohar. (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

The essays in this book engage the original and controversial claims from Michael Boylan's A Just Society. Each essay discusses Boylan's claims from a particular chapter and offers a critical analysis of these claims. Boylan responds to the essays in his lengthy and philosophically rich reply.

Bioethicists function in an environment in which their peers - healthcare executives, lawyers, nurses, physicians - assert the integrity of their fields through codes of professional ethics. Is it time for bioethics to assert its integrity by developing a code of ethics? Answering in the affirmative, this paper lays out a case by reviewing the historical nature and function of professional codes of ethics. Arguing that professional codes are aggregative enterprises growing in response to a field's historical experiences, it asserts (...) that bioethics now needs to assert its integrity and independence and has already developed a body of formal statements that could be aggregated to create a comprehensive code of ethics for bioethics. A Draft Model Aggregated Code of Ethics for Bioethicists is offered in the hope that analysis and criticism of this draft code will promote further discussion of the nature and content of a code of ethics for bioethicists. (shrink)

“April is the cruelest month, breeding Lilacs out of the dead land, mixing memory and desire… ” So, begins T.S. Eliot’s iconic poem, “The Wasteland,” challenging the memory of Chaucer’s April from Canterbury Tales, as being a delightful month to go on pilgrimage. Platonic teachings emphasize that you don’t create, you just remember. Might the inverse might also be true, “You don’t remember, you just create.” As the oneirocritic, Robert Bosnak, contends, you do not actually remember your dreams. You (...) remember your memory you recreate the dream in this time. Since the challenges of post-modernism, this is no longer a far-fetched idea. The eminent historian of immigration, Deborah Dash Moore, defines history in this regard, as “a search for a plausible narrative.” “History” is not a record of what happened, but rather, is a record of what we believe happened, or what we want to believe happened. This brings to the fore Foucault’s documenting the relationship of knowledge to power, as well as Freud’s assertion that material which is unacceptable to the ego, is disguised, in order to make them palatable. This places the notion of memory in a different light. There are incidents that occurred fifty years ago that seem as if they occurred five minutes ago. The depth psychologist and champion of the imagination, James Hillman, referred to this process as “soul-making.” Back to T.S. Eliot: when he studied Sanskrit at Harvard, he was certainly aware that the Sanskrit word for memory, smara (from which smrti “that which is remembered,” is derived) is also an epithet for Kama Deva, the Indian Cupid. Hence, the mixing of memory and desire. Perhaps, in this light, the study of history, which is a form of collective memory, is also a form of mass therapy, an effort to process the collective past. Hegel and Marx both believed classical India to be an inferior civilization because it had “no history,” but collections of mythologies. Maybe classical India, however, held an awareness that all memory is myth, a word which in its early Greek form literally translates as “plot.” Jesus declares (in the Gospel story) “Let the dead bury the dead.” As the Jesus narrative exemplifies, however, burying the dead is no easy task. Perhaps our ongoing, ever-morphing narratives, allow us an oblique opportunity to connect with and process our pain. And in this theatre of memory, the goal may not be to accumulate or catalogue what has been spoken (itihasa), but look a good miller, to process the grain into its essence: from what has passed, and is passing, and is to come, into what always is. Perhaps, the pilgrimage of the mind, on its endless perigination of story, is meant to ultimately take us to love, but that may be unspeakable. Keywords: memory, desire, narrative, history, myth, power. (shrink)

In this book, I make use of an idea from economics to suggest how noble human tendencies might not only have survived the ruthless pressures of the material world, but actually have been nurtured by them.

How important is luck in economic success? No question more reliably divides conservatives from liberals. As conservatives correctly observe, people who amass great fortunes are almost always talented and hardworking. But liberals are also correct to note that countless others have those same qualities yet never earn much. In recent years, social scientists have discovered that chance plays a much larger role in important life outcomes than most people imagine. In Success and Luck, bestselling author and New York Times economics (...) columnist Robert Frank explores the surprising implications of those findings to show why the rich underestimate the importance of luck in success--and why that hurts everyone, even the wealthy. Frank describes how, in a world increasingly dominated by winner-take-all markets, chance opportunities and trivial initial advantages often translate into much larger ones--and enormous income differences--over time; how false beliefs about luck persist, despite compelling evidence against them; and how myths about personal success and luck shape individual and political choices in harmful ways. But, Frank argues, we could decrease the inequality driven by sheer luck by adopting simple, unintrusive policies that would free up trillions of dollars each year--more than enough to fix our crumbling infrastructure, expand healthcare coverage, fight global warming, and reduce poverty, all without requiring painful sacrifices from anyone. If this sounds implausible, you'll be surprised to discover that the solution requires only a few, uncontroversial steps. Compellingly readable, Success and Luck shows how a more accurate understanding of the role of chance in life could lead to better, richer, and fairer economies and societies. (shrink)

A common compatibilist view says that we are free and morally responsible in virtue of the ability to respond aptly to reasons. Many hold a version of this view despite disagreement about whether free will requires the ability to do otherwise. The canonical version of this view is reductive. It reduces the pertinent ability to a set of modal properties that are more obviously compatible with determinism, like dispositions. I argue that this and any reductive view of abilities faces a (...) significant challenge: it cannot adequately explain the freedom-grounding element of this ability. The problem has the form of a dilemma. This leaves reasons-responsive compatibilists with two options: abandon theories of free will grounded in abilities or abandon reductive theories of abilities. (shrink)

(Part of a symposium on an OUP collection of Paul Russell's papers on free will and moral responsibility). Paul Russell’s The Limits of Free Will is more than the sum of its parts. Among other things, Limits offers readers a comprehensive look at Russell’s attack on the problematically idealized assumptions of the contemporary free will debate. This idealization, he argues, distorts the reality of our human predicament. Herein I pose a dilemma for Russell’s position, critical compatibilism. The dilemma illuminates the (...) tension between Russell’s critical and compatibilist commitments. The problem is not obviously insurmountable, and as a compatibilist who is sympathetic to the view, my aim is to spark further discussion. (shrink)

P.F. Strawson’s account of moral responsibility in “Freedom and Resentment” has been widely influential. In both that paper and in the contemporary literature, much attention has been paid to Strawson’s account of blame in terms of reactive attitudes like resentment and indignation. The Strawsonian view of praise in terms of gratitude has received comparatively little attention. Some, however, have noticed something puzzling about gratitude and accountability. We typically understand accountability in terms of moral demands and expectations. Yet gratitude does not (...) express or enforce moral demands or expectations. So, how is it a way to hold an agent accountable? In a more general manner, we might ask if there is even sense to be made of the idea that agents can be accountable—i.e., “on the hook”—in a positive way. In this paper, I clarify the relationship between gratitude and moral accountability. I suggest that accountability is a matter of engaging with others in a way that is basically concerned with their feelings and attitudes rather than solely a matter of moral demands. Expressions of gratitude are a paradigmatic form of this concerned engagement. I conclude by defending my view from the objection that it leads to an overly generous conception of holding accountable and suggest in reply that moral responsibility skeptics may not help themselves to as many moral emotions as they might have thought. (shrink)

And I find myself knowing the things that I knew Which is all that you can know on this side of the blueIs there such a thing as direct, non-conceptual experience, or is all experience, by its very nature, conceptually mediated? Is some notion of non-conceptual sensory awareness required to account for our ability to represent and negotiate our physical environment, or is it merely an artifact of deep-seated but ultimately misguided Cartesian metaphysical assumptions? Perhaps conscious experience in humans is (...) inextricably tied to the representational or self-reflexive capacities of language; if so, does it necessarily follow that newborn infants and animals are not conscious? Is the very notion of non-conceptual... (shrink)

P.F. Strawson’s compatibilism has had considerable influence. However, as Watson has argued in “Responsibility and the Limits of Evil”, his view appears to have a disturbing consequence: extreme evil exempts an agent from moral responsibility. This is a reductio of the view. Moreover, in some cases our emotional reaction to an evildoer’s history clashes with our emotional expressions of blame. Anyone’s actions can be explained by his or her history, however, and thereby can conflict with our present blame. Additionally, we (...) too might have been evil if our history had been like the unlucky evildoer’s. Thus, our emotional responses to the evildoer compromise our standing to blame them. Since Strawson’s view demarcates moral responsibility by moral emotional responses, his view appears to be self-defeating. In this paper, I defend the Strawsonian view from the reductio and self-defeat problems. I argue that two emotions, disgust and elevation, can be moral reactive attitudes in Strawson’s sense. First, moral disgust expresses neither blame nor exemption from responsibility. Instead, moral disgust presupposes blameworthiness but is instead a distinct response to the extreme wrongdoer. Secondly, moral disgust involves self-directed attitudes that explain away our apparent lack of standing to blame the evil agent. The structure of disgust as a reactive attitude is mirrored along the positive dimension by the emotion that Haidt has called “elevation”, a feeling of moral inspiration. I conclude by defending my view from objections about the moral appropriateness of disgust. (shrink)

This paper accepts as given that business students want to get ahead. It criticizes business schools for their failure to reduce the incongruence between doing what is right and doing what it takes to get ahead. Because of this failure business school graduates carry negative ideas, attitudes and behaviors vis-à-vis social responsibility from business schools into the business world. Recommendations are made for increasing the social responsibility of business schools.

We seek to change the conversation about brain death by highlighting the distinction between brain death as a biological concept versus brain death as a legal status. The fact that brain death does not cohere with any biologically plausible definition of death has been known for decades. Nevertheless, this fact has not threatened the acceptance of brain death as a legal status that permits individuals to be treated as if they are dead. The similarities between “legally dead” and “legally blind” (...) demonstrate how we may legitimately choose bright-line legal definitions that do not cohere with biological reality. Not only does this distinction bring conceptual coherence to the conversation about brain death, but it has practical implications as well. Once brain death is recognized as a social construction not grounded in biological reality, we create the possibility of changing the social construction in ways that may better serve both organ donors and recipients alike. (shrink)

According to many commentators, Davidson’s earlier work on philosophy of action and truth-theoretic semantics is the basis for his reputation, and his later forays into broader metaphysical and epistemological issues, and eventually into what became known as the triangulation argument, are much less successful. This book by two of his former students aims to change that perception. In Part One, Verheggen begins by providing an explanation and defense of the triangulation argument, then explores its implications for questions concerning semantic normativity (...) and reductionism, the social character of language and thought, and skepticism about the external world. In Part Two, Myers considers what the argument can tell us about reasons for action, and whether it can overcome skeptical worries based on claims about the nature of motivation, the sources of normativity and the demands of morality. The book reveals Davidson’s later writings to be full of innovative and important ideas that deserve much more attention than they are currently receiving. (shrink)

Vulnerabilities often characterize the availability of immigrant populations of interest in social behavioral science, public health, and medical research. Refugees, asylum seekers, and undocumented immigrants present unique vulnerabilities relevant to protocol development as well as ethics review procedures and criteria. This paper describes vulnerable populations in relation to the Belmont Report and US federal regulations for the protection of human subjects, both of which are commonly used in international research contexts. It argues for safeguards for immigrants comparable to protections for (...) such populations as pregnant women, prisoners, and children. The paper further presents a two-part model for the review of protocols that involve immigrants. The model is intended to help identify the risks to immigrants associated with participation in research, and to suggest how researchers can responsibly frame studies and access to research participant immigrants through community-based, and/or non-governmental organizations that serve immigrants and immigrant communities. (shrink)

The representation of physics problems in relation to the organization of physics knowledge is investigated in experts and novices. Four experiments examine the existence of problem categories as a basis for representation; differences in the categories used by experts and novices; differences in the knowledge associated with the categories; and features in the problems that contribute to problem categorization and representation. Results from sorting tasks and protocols reveal that experts and novices begin their problem representations with specifiably different problem categories, (...) and completion of the representations depends on the knowledge associated with the categories. For, the experts initially abstract physics principles to approach and solve a problem representation, whereas novices base their representation and approaches on the problem's literal features. (shrink)

Five symposia from the 25th annual Oberlin Colloquium in Philosophy focus on cognitive suicide, the explanatory role of content, Cartesian error and the objectivity of perception, social content and psychological content, and belief attribution and context.

The standard event-causal theory of action says that an intentional action is caused in the right way by the right mental states. This view requires reductionism about agency. The causal role of the agent must be nothing over and above the causal contribution of the relevant mental event-causal processes. But commonsense finds this reductive solution to the “agent-mind problem”, the problem of explaining the relationship between agents and the mind, incredible. Where did the agent go? This paper suggests that this (...) challenge against event-causal reductionism is importantly related to debates about fundamentality. It also suggests that extant event-causal answers to the agent-mind problem, ones that suggest that part of an agent’s mind can stand proxy for the agent herself, fail against the challenge. It sketches an alternative reductive view that appeals to entity grounding. This view resolves the commonsense challenge and promises to be theoretically fruitful with respect to other longstanding problems with the event-casual view. The paper concludes with a burden-shifting argument against emergentist agent-causal theories and non-reductive event-causal theories of agency. (shrink)

Tocqueville pessimistically predicted that liberty and equality would be incompatible ideas. Robert Dahl, author of the classic _A Preface to Democratic Theory,_ explores this alleged conflict, particularly in modern American society where differences in ownership and control of corporate enterprises create inequalities in resources among Americans that in turn generate inequality among them as citizens. Arguing that Americans have misconceived the relation between democracy, private property, and the economic order, the author contends that we can achieve a society of (...) real democracy and political equality without sacrificing liberty by extending democratic principles into the economic order. Although enterprise control by workers violates many conventional political and ideological assumptions of corporate capitalism as well as of state socialism. Dahl presents an empirically informed and philosophically acute defense of "workplace democracy." He argues, in the light of experiences here and abroad, that an economic system of worker-owned and worker-controlled enterprises could provide a much better foundation for democracy, political equality, and liberty than does our present system of corporate capitalism. (shrink)

Children’s early science interest begins well before middle school, and parents can be important in generating and sustaining such interest. This qualitative study addresses how parental occupations shape physical scientists’ early science interest. Our framework uses Social Cognitive Career Theory, and our research question is, “How do parental occupations create learning opportunities for children and motivate them to pursue physical science?” We examine interviews from 17 physical scientists in Project Crossover, a sequential mixed-methods study that broadly examines factors influencing entry (...) into physics and chemistry doctoral programs. Parental occupations can create learning opportunities through role modeling, encouragement, exposure, familiarity, and bonding. Thus, parents can be valuable in creating learning opportunities for children outside classrooms. Study limitations include a small sample and lack of information about familial structure. Our research contributes to the emergent understanding of the role of parental occupations in science interest, which further influences individual career trajectories. (shrink)

In a well-known apocryphal story, Theresa of Avila falls off the donkey she was riding, straight into mud, and injures herself. In response, she seems to blame God for her fall. A playful if indignant back and forth ensues. But this is puzzling. Theresa should never think that God is blameworthy. Why? Apparently, one cannot blame what one worships. For to worship something is to show it a kind of reverence, respect, or adoration. To worship is, at least in part, (...) to praise. You cannot praise and blame simultaneously. Indeed, Paul counsels against “back-talk” against God, suggesting we lack the standing to blame our creator (Romans 9:20). Drawing on Strawsonian theorizing about praise and blame, this paper argues that, surprisingly, a person can both blame and worship God. Although blameful worship is possibly epistemically akratic, it may sometimes be acceptable given our nature as finite, emotional beings. In fact, blaming God might on occasion be the only way we have to stand with God’s goodness despite apparent evidence of evil in the world. This suggestion, I’ll argue, should change the way we think about the problem of evil. The problem has interpersonal and moral psychological dimensions that merit serious attention. (shrink)

Can an effective argument against scepticism about objective values be modelled on Donald Davidson’s familiar argument against scepticism about external things?

As is evident from the other articles in this special issue, end-of-life treatment has engendered a vigorous dialogue in the United States over the past few decades because decision making at the end of life raises broad and difficult ethical issues that touch on health professionals, patients, and their families. This concern is exacerbated by the high cost related to the end of life in the U.S. Moreover, in light of demographic patterns, progressively scarce health care resources, and an expanding (...) array of life-saving technologies, decisions at the end of life are becoming problematic matters of public and, thus, scholarly concern in most countries. Issues at the end of life are central not only to bioethics but also raise important ancillary policy dimensions. (shrink)

This paper articulates and responds to a challenge to contemporary compatibilist views of free will. Despite the popularity and appeal of compatibilist theories, many are left with lingering doubts about compatibilism. This paper explains this doubt in terms of the absurdity challenge: because a compatibilist accepts that they do not have causal access to all the actual sufficient causal sources of their own agency, the compatibilist can find their own agency absurd. By taking a cue from political philosophy, this paper (...) argues that a non-ideal construction of the problem of free will allows compatibilists to overcome this existential-metaphysical challenge, and by doing so, perhaps adopt a metaphysically progressive picture of human agency. (shrink)