Charles Chihara's new book develops and defends a structural view of the nature of mathematics, and uses it to explain a number of striking features of mathematics that have puzzled philosophers for centuries. The view is used to show that, in order to understand how mathematical systems are applied in science and everyday life, it is not necessary to assume that its theorems either presuppose mathematical objects or are even true. Chihara builds upon his previous work, in which he (...) presented a new system of mathematics, the constructibility theory, which did not make reference to, or presuppose, mathematical objects. Now he develops the project further by analysing mathematical systems currently used by scientists to show how such systems are compatible with this nominalistic outlook. He advances several new ways of undermining the heavily discussed indispensability argument for the existence of mathematical objects made famous by Willard Quine and Hilary Putnam. And Chihara presents a rationale for the nominalistic outlook that is quite different from those generally put forward, which he maintains have led to serious misunderstandings.A Structural Account of Mathematics will be required reading for anyone working in this field. (shrink)

Voluntariness of consent to research has not been sufficiently explored through empirical research. The aims of this study were to develop a more comprehensive approach to assessing voluntariness and to generate preliminary data on the extent and correlates of limitations on voluntariness. We developed a questionnaire to evaluate subjects’ reported motivations and constraints on voluntariness. 88 subjects in five different areas of clinical research—substance abuse, cancer, HIV, interventional cardiology, and depression—were assessed. Subjects reported a variety of motivations for participation. Offers (...) of financial incentives were common but not influential, pressures from others were rare, and no threats were reported. However, certain financial incentives and—paradoxically—altruistic motivations led some subjects to feel more constrained. Consistent with previous studies, no one pattern of motivation was common to all research subjects. There was little evidence of constrained voluntariness, but some suggestion of areas of concern. Voluntariness appears to be susceptible to systematic empirical investigation. (shrink)

: Responding to the paper by Miller and Joffe, we review the development of the concept of therapeutic misconception (TM). Our concerns about TM's impact on informed consent do not derive from the belief that research subjects have poorer outcomes than persons receiving ordinary clinical care. Rather, we believe that subjects with TM cannot give an adequate informed consent to research participation, which harms their dignitary interests and their abilities to make meaningful decisions. Ironically, Miller and Joffe's approach ends up (...) largely embracing the very position that they inaccurately attribute to us: the belief that, with some exceptions, it is only the prospect of poorer outcomes that should motivate efforts to dispel TM. In the absence of empirical studies on the steps required to dispel TM and the impact of such procedures on subject recruitment, it is premature to surrender to the belief that TM must be widely tolerated in clinical research. (shrink)

Charles Chihara gives a thorough critical exposition of modal realism, the philosophical doctrine that there exist many possible worlds of which the actual world--the universe in which we live--is just one. The striking success of possible-worlds semantics in modal logic has made this ontological doctrine attractive. Modal realists maintain that philosophers must accept the existence of possible worlds if they wish to have the benefit of using possible-worlds semantics to assess modal arguments and explain modal principles. Chihara challenges this (...) claim, and argues instead for modality without worlds; he offers a new account of the role of interpretations or structures of the formal languages of logic. (shrink)

Buddhist Ethics and Modern Society: An International Symposium. Ed. Charles Wei-hsun Fu and Sandra A. Wawrytko. Greenwood Press, Connecticut 1991. 442 pp. n.p.

Charles Chihara gives a thorough critical exposition of modal realism, the philosophical doctrine that there exist many possible worlds of which the actual world--the universe in which we live--is just one. The striking success of possible-worlds semantics in modal logic has made thisontological doctrine attractive. Modal realists maintain that philosophers must accept the existence of possible worlds if they wish to have the benefit of using possible-worlds semantics to assess modal arguments and explain modal principles. Chihara challenges this claim, (...) and argues instead formodality without worlds; he offers a new account of the role of interpretations or structures of the formal languages of logic. (shrink)

Inner Peace, World Peace: Essays on Buddhism and Nonviolence. Ed. Kenneth Kraft. SUNY Series in Buddhist Studies. State University of New York Press, Albany, NY 1992. 148 pp. n.p.

Many parents cite intimacy as one of their reasons for deciding to educate at home. It seems intuitively obvious that home education is conducive to intimacy because of the increased time families spend together. Yet what is not clear is whether intimacy can provide justification for one’s decision to home educate. To see whether this is so, we introduce the concept of ‘attentive parenting’, which encompasses a set of family characteristics, and we examine whether and under what conditions attentive parents (...) risk loss of intimacy by sending their children to school; or, alternatively, whether they can avoid this risk by educating children at home. What we will determine is whether families who exhibit the specified characteristics are prima facie justified in educating their children at home under the conditions of interest. We argue that, for attentive parents, home education not only promotes greater intimacy, but also provides insurance against the loss of intimacy that may occur under certain conditions when children attend schools. (shrink)

Depression is often diagnosed in patients nearing the end of their lives and medication or psychotherapy is prescribed. In many cases this is appropriate. However, it is widely agreed that a health care professional should treat sick persons so as to improve their condition as they define improvement. This raises questions about the contexts in which treatment of depression in late life is appropriate. This article reviews a problematic case concerning the appropriateness of treatment in light of the literature in (...) bioethics. Specific attention is paid to the concept of authenticity and the role of suffering. Suffering is often the result of a situation in which one's self is damaged. In some circumstances, this suffering should not be seen as a symptom of illness but as a reflection, in a difficult life context, of the individual's authentic nature. Assessment of depression in the elderly must go beyond a symptom list and must consider both the context of the individual's situation and his or her authentic self. When the symptoms reflect the individual's assessment of the situation in the context of the authentic self, they may be "appropriate." However, even when the symptoms are appropriate, if they interfere with life assessment and adjustment, treatment should be considered. (shrink)

In El Salvador from 1978 to 1988, contraceptive use among married women 15–44 years of age increased from 34% to 47%, and the total fertility rate declined from 6·3 to 4·6 children per woman. Most of this change took place from 1978 to 1985. Sterilization is the most prevalent method used, but nearly one-half of the women who are sterilized did not use any contraception before their operation. Few young couples use reversible methods of contraception to space births or delay (...) the start of childbearing. On average, women wait 8 years after marriage and have nearly three children before they use contraception. (shrink)

Employing the National Institute of Mental Health-funded Prevention of Suicide in Primary Care Elderly Collaborative Trial as a case study, we discuss 2 sets of ethical issues: obtaining informed consent for a clinic-based intervention study and using treatment as usual (TAU) as the control condition. We then address these ethical issues in the context of the debate about the quality improvement efforts of health care organizations. Our analysis reveals the tension between ethics and scientific integrity involved with using TAU as (...) a control condition and the difficulty in designing high-quality research in a community-based setting. (shrink)

This book presents a thorough overview of a model of human functioning based on the idea that behavior is goal-directed and regulated by feedback control processes. It describes feedback processes and their application to behavior, considers goals and the idea that goals are organized hierarchically, examines affect as deriving from a different kind of feedback process, and analyzes how success expectancies influence whether people keep trying to attain goals or disengage. Later sections consider a series of emerging themes, including dynamic (...) systems as a model for shifting among goals, catastrophe theory as a model for persistence, and the question of whether behavior is controlled or instead 'emerges'. Three chapters consider the implications of these various ideas for understanding maladaptive behavior, and the closing chapter asks whether goals are a necessity of life. Throughout, theory is presented in the context of diverse issues that link the theory to other literatures. (shrink)

This ethnographic study introduces the term “distressed work” to describe the emergence of chronic frictions between moral imperatives for health care workers to keep working and the dramatic increase in distress during the Covid‐19 pandemic. Interviews and observant participation conducted in a hospital intensive care unit during the Covid‐19 pandemic reveal how health care workers connected job duties with extraordinary emotional, physical, and moral burdens. We explore tensions between perceived obligations of health care professionals and the structural contexts of work. (...) Key findings cluster around the moral imperatives of health care work and the distress that work engendered as work spaces, senses of vocation, patient and family interactions, and end‐of‐life care shifted. While the danger of working beyond limits has long been an ordinary feature of health care work, it has now become a chronic crisis. Assessing this problem in terms of distressed work and its structural contexts can better address effective, worker‐informed responses to current health care labor dilemmas. (shrink)

This book is concerned with `the problem of existence in mathematics'. It develops a mathematical system in which there are no existence assertions but only assertions of the constructibility of certain sorts of things. It explores the philosophical implications of such an approach through an examination of the writings of Field, Burgess, Maddy, Kitcher, and others.

Learning disabilities are highly prevalent on college campuses, yet students with learning disabilities graduate at lower rates than those without disabilities. Academic and psychosocial supports are essential for overcoming challenges and for improving postsecondary educational opportunities for students with learning disabilities. A holistic, multi-level model of campus-based supports was established to facilitate culture and practice changes at the institutional level, while concurrently bolstering mentors’ abilities to provide learning disability-knowledgeable support, and simultaneously creating opportunities for students’ personal and interpersonal development. Mixed (...) methods were used to investigate implementation of coordinated personal, interpersonal, and institutional level supports for undergraduate science, technology, engineering, and math (STEM) students with learning disabilities. A one-group pre-test post-test strategy was used to examine undergraduate outcomes. Participants included 52 STEM undergraduates with learning disabilities, 57 STEM graduate student mentors, 34 STEM faculty mentors, and 34 university administrators and personnel as members of a university-wide council. Enrolled for two years, undergraduates were engaged in group meetings involving psychoeducation and reflective discussions, development of self-advocacy projects, and individual mentorship. Undergraduates reported improved self efficacy (p =.001), campus connection (p <.001), professional development (p ≤.002), and self advocacy (p <.001) after two academic years. Graduate student mentors increased their understanding about learning disabilities and used their understanding to support both their mentees and other students they worked with. Council members identified and created opportunities for delivering learning disability-related trainings to faculty, mentors and advisors on campus, and for enhancing coordination of student services related to learning and related disorders. Disability-focused activities became integrated in broader campus activities regarding diversity. This research explicates a role that college campuses can play in fostering the wellbeing and the academic and career development of its students with developmental learning and related disorders. It offers an empirically tested campus-based model that is multilevel, holistic, and strengths-based for supporting positive outcomes of young people with learning disabilities in STEM. Moreover, findings advance the knowledge of supports and skills that are important for self-regulating and navigating complex and multi-faceted disability-related challenges within both the post-secondary educational environment and the young adults’ sociocultural context. (shrink)

This paper explores some lines of argument in wittgenstein's post-Tractatus writings in order to indicate the relations between wittgenstein's philosophical psychology, On the one hand, And his philosophy of language, His epistemology, And his doctrines about the nature of philosophical analysis on the other. The authors maintain that the later writings of wittgenstein express a coherent doctrine in which an operationalistic analysis of confirmation and language supports a philosophical psychology of a type the authors call "logical behaviorism." they also maintain (...) that there are good grounds for rejecting the philosophical theory implicit in wittgenstein's later works. In particular, They first argue that wittgenstein's position leads to some implausible conclusions concerning the nature of language and psychology; second, They maintain that the arguments wittgenstein provides are inconclusive; and third, They sketch an alternative position which they believe avoids many of the difficulties implicit in wittgenstein's philosophy. (shrink)