Although ethics consultation is offered as a clinical service in most hospitals in the United States, few valid and practical tools are available to evaluate, ensure, and improve ethics consultation quality. The quality of ethics consultation is important because poor quality ethics consultation can result in ethically inappropriate outcomes for patients, other stakeholders, or the health care system. To promote accountability for the quality of ethics consultation, we developed the Ethics Consultation Quality Assessment Tool. ECQAT enables raters to assess the (...) quality of ethics consultations based on the written record. Through rigorous development and preliminary testing, we identified key elements of a quality ethics consultation, established scoring criteria, developed training guidelines, and designed a holistic assessment process. This article describes the development of the ECQAT,.. (shrink)

The Ethics Consultation Quality Assessment Tool (ECQAT) establishes standards by which the quality of ethics consultation records (ECRs) can be assessed. These standards relate to the ethics question, consultation-specific information, ethical analysis, and recommendations and/or conclusions, and result in a score associated with one of four levels of ethics consultation quality. For the ECQAT to be useful in assessing and improving the quality of healthcare ethics consultations, individuals who rate the quality of ECRs need to be able to reliably use (...) the tool.We developed a short course to train ethics consultants in using the ECQAT, and evaluated whether the participants (1) achieved an acceptable level of calibration in matching expert-established quality scores for a set of ethics consultations, and (2) were satisfied with the course. We recruited 28 ethics consultants to participate in a virtual, six-session course. At each session participants and faculty reviewed, rated, and discussed one to two ECRs. The participants’ calibration in matching expert-established quality scores improved with repeated exposure at all levels of ethics consultation quality. Participants were generally more accurate when assessing consultation quality at the dichotomous level of “acceptable” (scores of three or four) versus “unacceptable” (scores of one or two) than they were with a more specific score. Participants had higher rates of accuracy with the extreme ratings of “strong” (level four) or “poor” (level one). Although participants were highly satisfied with the course, only a minority of participants achieved the prespecified acceptable level of calibration (that is, 80 percent or greater accuracy between their score and expert-established scores). These results suggest that ECQAT training may require more sessions or need modification in the protocol to achieve higher reliability in scoring. Such trainings are an important next step in ensuring that the ECQAT is a tool that can be used to promote improvement in ethics consultation quality. (shrink)

Discovering a deep unity in Nietzsche's work by exploring the structure and argumentative movement of a wide range of his books, Berkowitz shows that Nietzsche is a moral and political philosopher in the Socratic sense whose governing question is, "What is the best life?".

The Greek philosopher Aristotle, writing over two thousand years before Wall Street, called people who engaged in activities which did not contribute to society "parasites." In his latest work, renowned scholar Robert C. Solomon asserts that though capitalism may require capital, but it does not require, much less should it be defined by the parasites it inevitably attracts. Capitalism has succeeded not with brute strength or because it has made people rich, but because it has produced responsible citizens and--however (...) unevenly--prosperous communities. It cannot tolerate a conception of business that focuses solely on income and vulgarity while ignoring traditional virtues of responsibility, community, and integrity. Many feel that there is too much lip-service and not enough understanding of the importance of cooperation and integrity in corporate life. This book rejects the myths and metaphors of war-like competition that cloud business thinking and develops an "Aristotelean" theory of business. The author's approach emphasizes several core concepts: the corporation as community, the search for excellence, the importance of integrity and sound judgment, as well as a more cooperative and humane vision of business. Solomon stresses the virtues of honesty, trust, fairness, and compassion in the competitive business world, and confronts the problem of "moral mazes" and what he posits as its solution--moral courage. (shrink)

According to proponents of the extended mind, bio-external resources, such as a notebook or a smartphone, are candidate parts of the cognitive and mental machinery that realises cognitive states and processes. The present chapter discusses three areas of ethical concern associated with the extended mind, namely mental privacy, mental manipulation, and agency. We also examine the ethics of the extended mind from the standpoint of three general normative frameworks, namely, consequentialism, deontology, and virtue ethics.

This important book charts the development of philosophical thinking about history over the past 250 years, combining extracts from key texts with new explanatory and critical discussion. The book is designed to make the work of thinkers such as Hume, Herder, Hegel, Dilthey, Nietzsche, Heidegger and Foucault accessible to students with no prior knowledge of Western philosophy. An introductory section is followed by nine further chapters exploring contrasting schools of thought. The volume reveals the origins of contemporary trends in the (...) discipline and relates wider philosophical reflections to the study of history itself. It also points to connections between philosophy of history and literary and cultural theory which have developed in recent decades. (shrink)

Contemporary philosophers have grown increasingly skeptical toward both morality and moral theory. Some argue that moral theory is a radically misguided enterprise that does not illuminate moral practice, while others simply deny the value of morality in human life. In this important new book, Louden responds to the arguments of both "anti-morality" and "anti-theory" skeptics. In Part One, he develops and defends an alternative conception of morality, which, he argues, captures more of the central features of both Aristotelian and Kantian (...) ethics than do other contemporary models, and enables the central importance of morality to be convincingly reaffirmed. In Louden's model, morality is primarily a matter of what one does to oneself, rather than what one does or does not do to others. This model eliminates the gulf that many anti-morality critics say exists between morality's demands and the personal point of view. Louden further argues that morality's primary focus should be on agents and their lives, rather than on right actions, and that it is always better to be morally better--i.e. it is impossible to be "too moral." Part Two presents Louden's alternative conception of moral theory. Here again he draws on the work of Aristotle and Kant, showing that their moral theories have far more in common than is usually thought, and that those features that they share can be the basis for a viable moral theory that is immune to the standard anti-theory objections. Louden reaffirms the necessity and importance of moral theory in human life, and shows that moral theories fulfill a variety of genuine and indispensable human needs. (shrink)

Beyond geometry : Leibniz and the science of law -- The force of law : will -- Leibniz's systema iuris -- From the gesetzbuch to the landrecht : the ALR and the triumph of legality -- The rule of law : the Crown Prince lectures and the grounding of legality in order and security -- From reason to history : Savigny's system and the rise of social legal science -- The Bürgerliches Gesetzbuch (BGB) of 1900 : positive legal science and (...) the end of justice. (shrink)

Theories of discourse bring to realism new ideas about how knowledge develops and how representations of reality are influenced. We gain an understanding of the conceptual aspect of social life and the processes by which meaning is produced. This collection reflects the growing interest realist critics have shown towards forms of discourse theory and deconstruction. The diverse range of contributions address such issues as the work of Derrida and deconstruction, discourse theory, Eurocentrism and poststructuralism. What unites all of the contributions (...) is a sense that it is essential to provide a realist alternative to the hitherto dominance of social constructionism, hermeneutics and postmodernism, over many of the issues discussed. By developing a realist perspective the different authors attempt to embed discourse within the structured nature of the reality of the world. Realism can situate language, discourse and ideology within context specific, or 'causally efficacious' circumstances. Realism can help to uncover issues of power, representation, and subjectivity and how discursive and other social practices produce real effects. This can help us understand the manner in which social structures are reproduced through various forms of ideology and discourse. And by knowing this, we can start to address questions concerning human emancipation and how the world is to be transformed. (shrink)

Winner of the 1975 National Book Award, this brilliant and widely acclaimed book is a powerful philosophical challenge to the most widely held political and social positions of our age--liberal, socialist, and conservative.

The past decade has witnessed escalating legal and ethical challenges to the diagnosis of death by neurologic criteria. The legal tactic of demanding consent for the apnea test, if successful, can halt the DNC. However, US law is currently unsettled and inconsistent in this matter. Consent has been required in several trial cases in Montana and Kansas but not in Virginia and Nevada. In this paper, we analyze and evaluate the legal and ethical bases for requiring consent before apnea testing (...) and defend such a requirement by appealing to ethical and legal principles of informed consent and battery and the right to refuse medical treatment. We conclude by considering and rebutting two major objections to a consent requirement for apnea testing: a justice-based objection to allocate scarce resources fairly and a social utility objection that halting the diagnosis of brain death will reduce the number of organ donors. (shrink)

Virtue has been rediscovered in the United States as a subject of public debate and of philosophical inquiry. Politicians from both parties, leading intellectuals, and concerned citizens from diverse backgrounds are addressing questions about the content of our character. William Bennett's moral guide for children, A Book of Virtues, was a national bestseller. Yet many continue to associate virtue with a prudish, Victorian morality or with crude attempts by government to legislate morals. Peter Berkowitz clarifies the fundamental issues, arguing (...) that a certain ambivalence toward virtue reflects the liberal spirit at its best. Drawing on recent scholarship as well as classical political philosophy, he makes his case with penetrating analyses of four central figures in the making of modern liberalism: Hobbes, Locke, Kant, and Mill.These thinkers are usually understood to have neglected or disparaged virtue. Yet Berkowitz shows that they all believed that government resting on the fundamental premise of liberalism--the natural freedom and equality of all human beings--could not work unless citizens and officeholders possess particular qualities of mind and character. These virtues, which include reflective judgment, sympathetic imagination, self-restraint, the ability to cooperate, and toleration do not arise spontaneously but must be cultivated. Berkowitz explores the various strategies the thinkers employ as they seek to give virtue its due while respecting individual liberty. Liberals, he argues, must combine energy and forbearance, finding public and private ways to support such nongovernmental institutions as the family and voluntary associations. For these institutions, the liberal tradition powerfully suggests, play an indispensable role not only in forming the virtues on which liberal democracy depends but in overcoming the vices that it tends to engender.Clearly written and vigorously argued, this is a provocative work of political theory that speaks directly to complex issues at the heart of contemporary philosophy and public discussion.New Forum Books makes available to general readers outstanding, original, interdisciplinary scholarship with a special focus on the juncture of culture, law, and politics. New Forum Books is guided by the conviction that law and politics not only reflect culture, but help to shape it. Authors include leading political scientists, sociologists, legal scholars, philosophers, theologians, historians, and economists writing for nonspecialist readers and scholars across a range of fields. Looking at questions such as political equality, the concept of rights, the problem of virtue in liberal politics, crime and punishment, population, poverty, economic development, and the international legal and political order, New Forum Books seeks to explain--not explain away--the difficult issues we face today. (shrink)

This is a paradigmatic work of contemporary philosophy.

In this enduring text, renowned philosopher Robert C. Solomon provides students with a detailed introduction to modern existentialism.

Robert Stern investigates how scepticism can be countered by using transcendental arguments concerning the necessary conditions for the possibility of experience, language, or thought. He shows that the most damaging sceptical questions concern neither the certainty of our beliefs nor the reliability of our belief-forming methods, but rather how we can justify our beliefs.

The ability to improvise represents one of the highest levels of musical achievement. An improviser must master a musical language to such a degree as to be able to spontaneously invent stylistically idiomatic compositions on the spot. This feat is one of the pinnacles of human creativity, and yet its cognitive basis is poorly understood. What musical knowledge is required for improvisation? How does a musician learn to improvise? What are the neural correlates of improvised performance? In 'The Improvising Mind' (...) these questions are explored through an interdisciplinary approach that draws on cognitive neuroscience, study of historical pedagogical treatises on improvisation, interviews with improvisers, and musical analysis of improvised performances. Findings from these treatises and interviews are discussed from the perspective of cognitive psychological theories of learning, memory, and expertise. Musical improvisation has often been compared to 'speaking a musical language.' While past research has focussed on comparisons of music and language perception, few have dealt with this comparison in the performance domain. In this book, learning to improvise is compared with language acquisition, and improvised performance is compared with spontaneous speech from both theoretical and neurobiological perspectives. (shrink)

Charles Bell’s Bridgewater Treatise on the hand should be read as elaborating philosophies of pedagogy and the senses, and as fitting with Bell’s work on the nervous system. In The Hand, Bell argues that sensory reception must be coupled with muscular action to establish true knowledge, elevating the ‘doing’ hand to epistemological parity with the long-superior ‘seeing’ eye. Knowledge in anatomy was typically couched in terms to do with sight and depiction; but according to Bell, anatomy simply could not teach (...) the sort of feeling that one would encounter inside a living body. Instead, anatomy taught students to map the parts so that their fingers, moving through a surgical field, could ‘see’ and therefore could know and could act. This elevation of the status of the hand also had social implications that fit with Bell’s reformist politics. (shrink)

Robert Hanna presents a fresh view of the Kantian and analytic traditions that have dominated continental European and Anglo-American philosophy over the last two centuries, and of the connections between them. But this is not just a study in the history of philosophy, for out of this emerges Hanna's original approach to two much-contested theories that remain at the heart of contemporary philosophy. Hanna puts forward a new 'cognitive-semantic' interpretation of transcendental idealism, and a vigorous defense of Kant's theory (...) of analytic and synthetic necessary truth, making this compelling reading for all who are interested in these fundamental philosophical issues. (shrink)

How are justified belief and rational belief related? Some philosophers think that justified belief and rational belief come to the same thing. Others take it that justification is a matter of how well a particular belief is supported by the evidence, while rational belief is a matter of how well a belief coheres with a person’s other beliefs. In this paper, I defend the view that justification is a dimension of rationality, a view that can make sense of both of (...) these conflicting accounts. When it modifies belief, ‘rational’ is a multidimensional adjective, as there are multiple dimensions along which a belief can be rational. I will argue that one of these dimensions is justification, an account that can not only explain why philosophers give diverging theories of the relationship between justified belief and rational belief, but can also reveal why rational belief and justified belief are closely related despite being distinct. (shrink)

Permissivism says that for some propositions and bodies of evidence, there is more than one rationally permissible doxastic attitude that can be taken towards that proposition given the evidence. Some critics of this view argue that it condones, as rationally acceptable, sets of attitudes that manifest an untenable kind of arbitrariness. I begin by providing a new and more detailed explication of what this alleged arbitrariness consists in. I then explain why Miriam Schoenfield’s prima facie promising attempt to answer the (...) Arbitrariness Objection, by appealing to the role of epistemic standards in rational belief formation, fails to resolve the problem. Schoenfield’s strategy is, however, a useful one, and I go on to explain how an alternative form of the standards-based approach to Permissivism – one that emphasizes the significance of the relationship between people’s cognitive abilities and the epistemic standards that they employ – can respond to the arbitrariness objection. (shrink)

In the article Privacy and Health Practices in the Digital Age, the authors describe current privacy challenges for digital health data and review the theoretical framework on privacy in the contex...

One of our great behavioral scientists, the bestselling author of Behave, plumbs the depths of the science and philosophy of decision-making to mount a devastating case against free will, an argument with profound consequences Robert Sapolsky's Behave, his now classic account of why humans do good and why they do bad, pointed toward an unsettling conclusion: We may not grasp the precise marriage of nature and nurture that creates the physics and chemistry at the base of human behavior, but (...) that doesn't mean it doesn't exist. Now, in Determined, Sapolsky takes his argument all the way, mounting a brilliant (and in his inimitable way, delightful) full-frontal assault on the pleasant fantasy that there is some separate self telling our biology what to do. Determined offers a marvelous synthesis of what we know about how consciousness works-the tight weave between reason and emotion and between stimulus and response in the moment and over a life. One by one, Sapolsky tackles all the major arguments for free will and takes them out, cutting a path through the thickets of chaos and complexity science and quantum physics, as well as touching ground on some of the wilder shores of philosophy. He shows us that the history of medicine is in no small part the history of learning that fewer and fewer things are somebody's "fault"; for example, for centuries we thought seizures were a sign of demonic possession. Yet, as he acknowledges, it's very hard, and at times impossible, to uncouple from our zeal to judge others and to judge ourselves. Sapolsky applies the new understanding of life beyond free will to some of our most essential questions around punishment, morality, and living well together. By the end, Sapolsky argues that while living our daily lives recognizing that we have no free will is going to be monumentally difficult, doing so is not going to result in anarchy, pointlessness, and existential malaise. Instead, it will make for a much more humane world. (shrink)

Despite legislation and public education, racism and sexism are alive and well. Though pre‐conceptive gender selection may enhance procreative liberty, this technology presents two disturbing questions. First, does sex selection represent underlying parental sexism? Second, by performing gender selection, do medical professionals perpetuate sexism? It will be maintained that pre‐conceptive sex selection is sexist as it reflects parental anticipation of stereotypical gender based behavior. Perhaps even more incriminating, sex selection forces parents to prefer one sex over another, to place a (...) value on gender. This emphasis on sex conflicts with societal goals which urge, and often legally require, individuals to ignore gender. We will assert that pre‐conceptive gender selection exemplifies sexism in its purest most blatant form as prior to conception, before parents can possibly know anything about their child, gender dominates the calculus of a child’s worth. We will also emphasize that physicians, by facilitating sex selection, legitimize the motivations of their patients and provide de facto support of sexism. In a similar vein, arguments against pre‐conceptive race selection will be made. (shrink)