In this review article we describe the current scope, methods, and contents of medical ethics education in medical schools in Western English speaking countries (mainly the United Kingdom, the United States, and Australia). We assess the strengths and weaknesses of current medical ethics curricula, and students’ levels of satisfaction with different teaching approaches and their reported difficulties in learning medical ethics concepts and applying them in clinical practice. We identify three main challenges for medical ethics education: counteracting the bad effects (...) of the “hidden curriculum,” teaching students how to apply ethical knowledge and critical thinking to real cases in clinical practice, and shaping future doctors’ right character through ethics education. We suggest ways in which these challenges could be addressed. On the basis of this analysis, we propose practical guidelines for designing, implementing, teaching, and assessing a medical ethics program within a four-year medical course. (shrink)

Feminist theorists have shown that knowledge is embodied in ways that make a difference in science. Intemann properly endorses feminist standpoint theory over Longino’s empiricism, insofar as the former better addresses embodiment. I argue that a pragmatist analysis further improves standpoint theory: Pragmatism avoids the radical subjectivity that otherwise leaves us unable to account for our ability to share scientific knowledge across bodies of different kinds; and it allows us to argue for the inclusion, not just of the knowledge produced (...) from marginalised bodies, but of the marginalised themselves. (shrink)

In natural deduction classical logic is commonly formulated by adding a rule such as Double Negation Elimination (DNE) or Classical Reductio ad Absurdum (CRA) to a set of introduction and elimination rules sufficient for intuitionist first-order logic with conjunction, disjunction, implication, negation and the universal and existential quantifiers all taken as primitive. The natural deduction formulation of intuitionist logic, coming from Gentzen, has nice properties:— (i) the separation property: an intuitionistically valid inference is derivable using only the introduction and elimination (...) rules governing the connectives and/or quantifiers that occur in the premises (if any) and conclusion; (ii) the (strict) subformula property: more narrowly, there is a derivation of any intuitionistically valid inference that employs only subformulas of the formulas occurring in premises (if any) and conclusion. (Every formula is, of course, a subformula of itself.). (shrink)

While feminist epistemologists have made important contributions to the deconstruction of the traditional representationalist model, some elements of the Cartesian legacy remain. For example, relativism continues to play a role in the underdetermination thesis used by Longino and Keller. Both argue that because scientific theories are underdetermined by evidence, theory choice must be relative to interpretive frameworks. Utilizing Davidson's philosophy of language, I offer a nonrepresentationalist alternative to suggest how relativism can be more fully avoided.

In lieu of an abstract, here is a brief excerpt of the content:Moral Distress for the Physician AssistantSharyn L. KurtzMy morning rounds as an inpatient medical oncology physician assistant began as usual. I arrived at the hospital early to receive 7 a.m. sign out from the covering resident. The overnight report began favorably. All patients remained stable. Even my patient, whom I will call Mrs. Walker,* had a quiet night. However, given her tenuous admission presentation, including altered mental status, hypercalcemia (...) (high levels of calcium in the blood), atrial fibrillation with rapid ventricular response (irregular, rapid heart function), widespread metastatic lung cancer, and recent neurosurgery to stabilize her spine, I decided to prioritize Mrs. Walker’s morning evaluation.Examining her medical chart proved reassuring. Her tachycardia (rapid heart rate) had been better controlled over the past two days. Her hypercalcemia had been treated, such that she was no longer somnolent. In fact, she was now arousable, conversant, and able to offer some input regarding her healthcare wishes. However, because she was experiencing intermittent delirium, her husband continued to act as her primary medical decision–maker.As her health care proxy, Mr. Walker had experienced conflict with the medical team during his wife’s prior hospital admission. However, even though Mr. Walker lived greater than 45 minutes from the hospital and was not able to visit regularly, he and I spoke daily by phone, which allowed me the opportunity to offer regular medical updates. Mr. Walker felt overwhelmed with his wife’s condition, but he was comfortable with the care the medical team had provided thus far. He was encouraged by the small improvements we had noted since her hospital admission five days prior.Mr. Walker stated on hospital admission that he wished for DNR/I orders to be placed, since this cohered with his wife’s previously stated wishes. However, he still wanted “everything else done” in terms of treating his wife’s medical conditions, including treatment of her atrial fibrillation, pain, and electrolyte anomalies. Most of all, he hoped Mrs. Walker would soon have increased mobility, which he felt would grant his wife the best quality of life possible. He was adamant that “being active” was what Mrs. Walker wished for, and that she had never wanted to be confined to bed.Mr. Walker’s requests seemed reasonable. Although Mrs. Walker’s lung cancer was widespread, and although many on the medical team felt she would not improve to the point where palliative chemotherapy could be considered, [End Page E13] she had stabilized. Her recent spine surgery had been successful, and she was healing adequately. The neurosurgeons had cleared Mrs. Walker for increased activity out of bed as soon as she could be fitted with a lumbar brace. The pain and palliative care specialists felt that Mrs. Walker’s residual back pain and delirium could be well managed with oral medications.Prior to my entering Mrs. Walker’s room to begin her physical evaluation, I was met by her seasoned nurse, whom I will call Amy. “Sharyn,” Amy warned, “Mrs. Walker’s heart rate is 150 and she is complaining of chest pain.” I entered Mrs. Walker’s room, and she was notably uncomfortable, grasping her chest. The monitor showed that Mrs. Walker’s heart rate was in fact in the 150’s. She was pale, short of breath, and wheezing. “Mrs. Walker,” I asked, “how severe is your chest pain on a scale from 1 to 10?” Mrs. Walker replied, “Nine.” I asked Amy to obtain an EKG, to provide oxygen, and to administer an IV medication that would slow Mrs. Walker’s heart rate. I stepped out of the room to place the computer orders, and I paged my attending physician to let him know about Mrs. Walker’s change in status. After hearing the update, my attending physician, whom I will call Dr. Clark, stated that he agreed with all of my treatment decisions thus far. He was on his way into the hospital. I planned out my next steps with him on the phone and returned to the patient’s room.The monitor gave evidence that Mrs. Walker’s heart rate was improving. Mrs. Walker reported that her pain was now “4 out of... (shrink)

Fact/value holism has become commonplace in philosophy of science, especially in feminist literature. However, that facts are bearers of empirical content, while values are not, remains a firmly-held distinction. I support a more thorough-going holism: both facts and values can function as empirical claims, related in a seamless, semantic web. I address a counterexample from Kourany where facts and values seem importantly discontinuous, namely, the simultaneous support by the Nazis of scientifically sound cancer research and morally unsound political policies. I (...) conclude that even by the criteria available at the time, Nazi cancer research was empirically weak, and the weaknesses in their research are continuous with their moral failures in just the ways predicted by the holism I support. (shrink)

In a recent essay — “How Can Feminist Theories of Evidence Assist Clinical Reasoning and Decision-making?” — Maya Goldenberg discusses criticisms of evidence-based medicine (or EBM) (Goldenberg 2013). She is particularly interested in those criticisms that make use of an epistemic appeal to the underdetermination of theory by evidence...

Clough shows how inadequate empirical philosophy is in creating real change in the sciences. Instead, she supports a more pragmatic approach based on the work of Richard Rorty and Donald Davidson. This work encourages Clough's fellow feminists to refocus their critiques and discard their philosophical debates about epistemology.

This paper offers a critique of sustainability reporting and, in particular, a critique of the modern disconnect between the practice of sustainability reporting and what we consider to be the urgent issue of our era: sustaining the life-supporting ecological systems on which humanity and other species depend. Tracing the history of such reporting developments, we identify and isolate the concept of the ‘triple bottom line’ (TBL) as a core and dominant idea that continues to pervade business reporting, and business engagement (...) with sustainability. Incorporating an entity’s economic, environmental and social performance indicators into its management and reporting processes, we argue, has become synonymous with corporate sustainability; in the process, concern for ecology has become sidelined. Moreover, this process has become reinforced and institutionalised through SustainAbility’s biennial benchmarking reports, KPMG’s triennial surveys of practice, initiatives by the accountancy profession and, particularly, the Global Reporting Initiative (GRI)’s sustainability reporting guidelines. We argue that the TBL and the GRI are insufficient conditions for organizations contributing to the sustaining of the Earth’s ecology. Paradoxically, they may reinforce business-as-usual and greater levels of un-sustainability. (shrink)

Desert theories of distributive justice have been attacked on the grounds that they attempt to found large inequalities on morally arbitrary features of individuals: desert is usually classified as a meritocratic principle in contrast to the egalitarian principle that goods should be distributed according to need. I argue that there is an egalitarian version of desert theory, which focuses on effort rather than success, and which aims at equal levels of well‐being; I call it a ‘well‐being desert’ theory. It is (...) argued that this egalitarian conception of desert is preferable to a meritocratic conception, and that its adoption would encourage greater clarity in arguments over wage differentials and in debates about criteria for job and educational competitions. (shrink)

Molecular motor proteins, fueled by energy from ATP hydrolysis, move along actin filaments or microtubules, performing work in the cell. The kinesin microtubule motors transport vesicles or organelles, assemble bipolar spindles or depolymerize microtubules, functioning in basic cellular processes. The mechanism by which motor proteins convert energy from ATP hydrolysis into work is likely to differ in basic ways from man‐made machines. Several mechanical elements of the kinesin motors have now been tentatively identified, permitting researchers to begin to decipher the (...) mechanism of motor function. The force‐producing conformational changes of the motor and the means by which they are amplified are probably different for the plus‐ and minus‐end kinesin motors. BioEssays 25:1212–1219, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

Within the New Zealand curriculum, hauora has been co-opted as an underlying and interdependent concept at the heart of the learning area of health and physical education. Hauora is identified as a Māori philosophy of well-being, advocating a Māori world view of hauora. Contemporary understandings of hauora as a Māori philosophy of health are constructed within dominant English-medium curriculum discourses. At first glance the juxtaposition of ‘hauora’ with ‘well-being’, and hauora being defined as ‘a Māori philosophy of health’ seems like (...) an opportunity to promote an indigenous perspective of health into English-medium curriculum, but the philosophical questions of what knowledge is valued, why we should teach it, and its worth of what is taught for human well-being, remain fraught. The notion of hauora is much richer than the word ‘health’ allows. I explore some issues associated with the equivalence between hauora and health, and some of the potential nuances of hauora in light of a counter-colonial Māori philosophy of holism. I invite the reader to consider the terms ‘whakapapa’ and ‘wairua’ in light of a proposed metaphysics. I show that the terms—and the objects they point to—share a relationship with each other and that recognition of that interdependence are necessary to their well-being. (shrink)

Within the New Zealand curriculum, hauora has been co-opted as an underlying and interdependent concept at the heart of the learning area of health and physical education. Hauora is identified as a Māori philosophy of well-being, advocating a Māori world view of hauora. Contemporary understandings of hauora as a Māori philosophy of health are constructed within dominant English-medium curriculum discourses. At first glance the juxtaposition of ‘hauora’ with ‘well-being’, and hauora being defined as ‘a Māori philosophy of health’ seems like (...) an opportunity to promote an indigenous perspective of health into English-medium curriculum, but the philosophical questions of what knowledge is valued, why we should teach it, and its worth of what is taught for human well-being, remain fraught. The notion of hauora is much richer than the word ‘health’ allows. I explore some issues associated with the equivalence between hauora and health, and some of the potential nuances of hauora in light of a counter-colonial Māori philosophy of holism. I invite the reader to consider the terms ‘whakapapa’ and ‘wairua’ in light of a proposed metaphysics. I show that the terms—and the objects they point to—share a relationship with each other and that recognition of that interdependence are necessary to their well-being. (shrink)

In lieu of an abstract here is the first paragraph: -/- I mean the subtitle of my essay both as praise for the clarity with which Elizabeth Anderson writes about what is at stake in debates about values in science, and as a promise to outline an even more direct route to the heart of the matter. I begin with a quick review of the steps in Anderson’s argument that seem necessary and, indeed, laudable, followed by a brief discussion of (...) those steps in her argument that we might fruitfully skip. The hope is that we will arrive at roughly the same location but with a firmer foothold. (shrink)

Racist beliefs express value judgments. According to an influential view, value judgments are subjective, and not amenable to rational adjudication. In contrast, we argue that the value judgments expressed in, for example, racist beliefs, are false and objectively so. Our account combines a naturalized, philosophical account of meaning inspired by Donald Davidson, with a prominent social-psychological theory of values pioneered by the social-psychologist Milton Rokeach. We use this interdisciplinary approach to show that, just as with beliefs expressing descriptive judgments, beliefs (...) expressing value judgments have empirical content, or can be inferentially linked to beliefs that do; the truth or falsity of that content can be objectively assigned; and that assignment is amenable to rational assessment. While versions of this objective view of value judgments have been defended by moral realists of various metaphysical stripes, our argument has the virtue of appealing, instead, to accounts that are as naturalistically informed as possible. And, unlike the influential subjective view of value judgments, and racist beliefs more particularly, our arguments are better able to account for instances where rational, persuasive strategies have been effective in reducing the ubiquity of racism in American culture. (shrink)

Recent results in kinematics, obtained by myself and those working with me, have convinced me that the philosophical status of physics, as it has come down to us from Renaissance days, requires reconsideration. The reason can be stated in a couple of sentences: it has been found possible to establish certain laws of physics—laws of motion, the law of gravitation, the laws known under the name of the Lorentz transformation, and some others—purely deductively, without specific assumptions, and without empirical appeals (...) save only to the empirical awareness of something we call “the passage of time.” Yet physicists have claimed ad nauseam that the ultimate sanction for “laws of nature” is observation and experiment, that this is what distinguishes physics from other branches of exact inquiry. The contrast in these two conceptions of natural law needs no emphasis. It is the purpose of this article to attempt to clarify this confused situation. (shrink)

In assessing the appropriateness of a scientific community's research effort, Solomon considers a number of "decision vectors," divided into the empirical and non-empirical. Value judgments get sorted as non-empirical vectors. By way of contrast, I introduce Anderson's discussion of the evidential role of value judgments. Like Anderson, I argue that value judgments are empirical in the relevant sense. I argue further that Solomon's decision matrix needs to be reconceptualized: the distinction should not be between the empirical vs. non-empirical, but between (...) the relevant vs. irrelevant. Whether particular value judgments are relevant or not is an empirical question, to be decided on a case-by-case basis. (shrink)

본고는 반성에 대한 리오타르의 후기 저작 두 가지를 논한다. 리오타르는 그의 칸트 독해에서 반성 개념에 대해 논한 바 있다. 본고는 그 중 칸트의 숭고미에 대하여 를 리오타르의 보다 이전의 저술인 비인간 에 포함된 에세이, “Si l’on peut penser sans corps” 와 관련하여 논한다. 이는 칸트의 반성에 대한 리오타르의 보다 자세한 논의인 칸트의 숭고미에 대하여 를 보다 넓은 차원에서 이해하고자 하는 시도이다. 이를 위해 본고는 후기 리오타르 사상에서 주요하게 등장하는, 사유와 신체 모두와 연관을 맺는 정념 개념에 주목한다.

Despite increasing numbers of women lawyers, gender segregation within the legal profession in the United States continues. The present article examines interorganizational differences in the employment of 34 men and 34 women lawyers in 12 in-house legal departments that varied by size and industry in corporations located in the northeast United States. There were differences among the firms with respect to the number, position, and salary of men and women lawyers. The findings suggest that women in-house counsel do not enter (...) the same type of practice or organizations, obtain the same positions, or earn the same salaries as men. The differential employment patterns, the article concludes, stem largely from organizational contingencies, such as a firm's market position, perceived needs, the kinds of rewards and training offered, and recruitment strategies. It also suggests that men's and women's differential location in the labor pool results not from their own career choices but from employer's hiring and work-allocation decisions that provide them with different experiences and expertise, which in turn constrain future employment options. (shrink)

: The relationship between facts and values—in particular, naturalism and normativity—poses an ongoing challenge for feminist science studies. Some have argued that the fact/value holism of W.V. Quine's naturalized epistemology holds promise. I argue that Quinean epistemology, while appropriately naturalized, might weaken the normative force of feminist claims. I then show that Quinean epistemic themes are unnecessary for feminist science studies. The empirical nature of our work provides us with all the naturalized normativity we need.

I think that to Lord Kelvin is attributed the saying that the scientific attitude to a thing, if you can't do anything else with it, is to measure it. This is the attitude I propose to adopt towards Time . The situation is to some extent analogous to the situation with regard to electricity . Science is unable to say what electricity is, and so it almost denies the word any entrance into a treatise on the subject. It replaces it (...) by the word charge , which is something that can be measured. It is important to avoid hypostatizing time into a thing-in-itself. Instead of trying to say what time is we try to find a way of measuring it. (shrink)

First paragraph: Truthmaker theory maintains that for every truth there is something, some thing, some entity, that makes it true. Balking at the prospect that logical truths are made true by any particular thing, a consequence that may in fact be hard to avoid (see Restall 1996, Read 2000), this principle of truthmaking is sometimes restricted to (logically) contingent truths. I aim to show that even in its restricted form, the principle is provably false.

This article begins by outlining some of the history—beginning with brief remarks of Quine's—of work on conditional assertions and conditional events. The upshot of the historical narrative is that diverse works from various starting points have circled around a nexus of ideas without convincingly tying them together. Section 3 shows how ideas contained in a neglected article of de Finetti's lead to a unified treatment of the topics based on the identification of conditional events as the objects of conditional bets. (...) The penultimate section explores some of the consequences of the resulting logic of conditional events while the last defends it. (shrink)

The majority of formal accounts attribute to Stoic logicians the classical truth-functional understanding of the material conditional and exclusive disjunction.These interpretations were disputed,...

This chapter’s main topic revolves around Davidson’s account of radical interpretation and the concept of triangulation as a necessary feature of communication and the formation of beliefs. There are two important implications of this model of belief formation for feminists studying the effects of social location on knowledge production generally, and the production of scientific knowledge in particular. The first is Davidson’s argument that whatever there is to the meaning of any of our beliefs must be available from the radical (...) interpreter’s external, third-person perspective. The second important implication of triangulation is that Davidson’s model is a holistic one that shows that there is no substantive difference in the triangulation process by which we form beliefs concerning basic descriptive features of the world and beliefs concerning evaluative features of the world. (shrink)

I have argued that political values are beliefs informed, more or less well, by the evidence of experience and that, where relevant and well-supported by evidence, the inclusion of political values in scientific theorizing can increase the objectivity of research. The position I endorse has been called the “values-as-evidence” approach. In this essay I respond to three kinds of resistance to this approach, using examples of feminist political values. Solomon questions whether values are beliefs that can be tested, Alcoff argues (...) that even if our values are beliefs that can be tested, testing them might not be desirable because doing so assigns these important values a contingency that weakens their normative force, and Yap argues that the approach is too idealistic in its articulation of the role of evidence in our political deliberations. In response, I discuss the ways that values can be tested, I analyze the evidential strength of feminist values in science, and I argue that the evidence-based nature of these values is neither a weakness nor an idealization. Problems with political values affecting science properly concern the dogmatic ways that evaluative beliefs are sometimes held—a problem that arises with dogmatism toward descriptive beliefs as well. I conclude that scientists, as with the rest of us, ought to adopt a pragmatically-inclined appreciation of the fallible, inductive process by which we gather evidence in support of any of our beliefs, whether they are described as evaluative or descriptive. (shrink)

Recent cases in the United States and Australia have catapulted surrogacy into the forefront of debates and public policy regarding new procreative technologies, even though gestating and birthing a baby for another woman does not necessarily involve artificial insemination or in vitro fertilization. Feminists have condemned commercial surrogacy because it borders on baby selling and exploits women. Similar criticism has appeared in the mass media, but these forums, as well as the medical profession, have considered noncommercial surrogacy as more acceptable (...) because of the absence of monetary exchange. Using two cases of surrogacy, this article argues that the distinction between commercial and altruistic surrogacy is socially constructed rather than based on self-evident or intrinsic differences. Both types of surrogacy involve the application of pervasive gender norms specifying that women's motivations to have children should be based on emotion, selflessness, and caring, not on self-interest, financial incentives, or pragmatism. Applying these norms renders commercial surrogacy deviant, but altruistic arrangements more acceptable. However, the article's central argument is that both types of agreement can entail exploitation, the denial of the birth mother's rights, and the severe reduction of her autonomy. (shrink)

This book is an attempt to make sense of the tension in Nietzsche’s work between the unashamedly egocentric and the apparently mystical. While scholars have tended to downplay one or other of these aspects, this book shows that the two are not only compatible but mutually illuminating. Supporting both of these aspects of Nietzsche’s philosophy is a conception of the one and the many that develops from the thought of Goethe. Goethe is not typically given a lot of attention in (...) Anglophone philosophy, and this is the case even in Nietzsche studies. This is a severe limitation as Goethe had an immense influence on many subsequent thinkers, and this is especially true of Nietzsche. Goethe’s conception of the relationship of the one to the many is unique - as Cassirer wrote, such a view “can hardly be found elsewhere in the history of philosophy or of natural science”. Nietzsche as Egoist and Mystic shows how this “Goethean” conception of the one and the many was further developed by Nietzsche, and how it helps to illuminate Nietzsche’s complex and much disputed religious thought. This book is a mediation between Nietzsche and major currents in mystical thought both East and West which shows how previous interpretations fail to adequately account for crucial aspects of Nietzsche’s thought, including his egoism. (shrink)

Originally published in 1962, this book is a critical study of certain aspects of the work of four Idealist philosophers. It is the thesis of this book that there is a valid and significant form of Idealism to be found in the work of these philosophers, but that they did not succeed in developing it fully and consistently.

The thesis that, in a system of natural deduction, the meaning of a logical constant is given by some or all of its introduction and elimination rules has been developed recently in the work of Dummett, Prawitz, Tennant, and others, by the addition of harmony constraints. Introduction and elimination rules for a logical constant must be in harmony. By deploying harmony constraints, these authors have arrived at logics no stronger than intuitionist propositional logic. Classical logic, they maintain, cannot be justified (...) from this proof-theoretic perspective. This paper argues that, while classical logic can be formulated so as to satisfy a number of harmony constraints, the meanings of the standard logical constants cannot all be given by their introduction and/or elimination rules; negation, in particular, comes under close scrutiny. (shrink)

The hygiene hypothesis offers an explanation for the correlation, well-established in the industrialized nations of North and West, between increased hygiene and sanitation, and increased rates of asthma and allergies. Recent studies have added to the scope of the hypothesis, showing a link between decreased exposure to certain bacteria and parasitic worms, and increased rates of depression and intestinal auto- immune disorders, respectively. What remains less often discussed in the research on these links is that women have higher rates than (...) men of asthma and allergies, as well as many auto-immune disorders, and also depression. The current paper introduces a feminist understanding of gender socialization to the epidemiological and immunological picture. That standards of cleanliness are generally higher for girls than boys, especially under the age of five when children are more likely to be under close adult supervision, is a robust phenomenon in industrialized nations, and some research points to a cross- cultural pattern. I conclude that, insofar as the hygiene hypothesis successfully identifies standards of hygiene and sanitation as mediators of immune health, then attention to the relevant patterns of gender socialization is important. The review also makes clear that adding a feminist analysis of gender socialization to the hygiene hypothesis helps explain variation in morbidity rates not addressed by other sources and responds to a number of outstanding puzzles in current research. Alternative explanations for the sex differences in the relevant morbidity rates are also discussed (e.g., the effects of estrogens). Finally, new sources of evidence for the hygiene hypothesis are suggested in the form of cross-cultural and other natural experiments. (shrink)

According to the axiologist the value concepts are basic and the deontic concepts are derivative. This paper addresses two fundamental problems that arise for the axiologist. Firstly, what ought the axiologist o understand by the value of an act? Second, what are the prospects in principle for an axiological representation of moral theories. Can the deontic concepts of any coherent moral theory be represented by an agent-netural axiology: (1) whatever structure those concepts have and (2) whatever the causal structure of (...) the world happens to be. We show that the answer is "almost always". The only substantive constraint is that autonomous moral agents cannot have the power to simultaneously block the options open to other autonomous moral agents. But this seems to be part and parcel of the notion of an autonomous moral agent. (shrink)

Proofs of Gödel's First Incompleteness Theorem are often accompanied by claims such as that the gödel sentence constructed in the course of the proof says of itself that it is unprovable and that it is true. The validity of such claims depends closely on how the sentence is constructed. Only by tightly constraining the means of construction can one obtain gödel sentences of which it is correct, without further ado, to say that they say of themselves that they are unprovable (...) and that they are true; otherwise a false theory can yield false gödel sentences. (shrink)