Background 300 million operations and procedures are performed annually across the world, all of which require a patient’s informed consent. No standardised measure of the consent process exists in current clinical practice. We aimed to define a core outcome set for informed consent for therapy. Methods The core outcome set was developed in accordance with a predefined research protocol and the Core OutcoMes in Effectiveness Trials methodology comprising systematic review, qualitative semi structured interviews, a modified Delphi process and consensus webinars (...) to ratify outcomes for inclusion in the final core outcome set.. Participants from all key stakeholder groups took part in the process, including patients and the public, healthcare practitioners and consent researchers. Results 36 outcome domains were synthesised through systematic review and organised into a consent taxonomy. 41 semi-structured interviews were performed with all consent stakeholders groups. 164 participants from all stakeholder groups across 8 countries completed Delphi Round 1 and 125 completed Round 2. 11 outcomes met the ‘consensus in’ criteria. 6 met ‘consensus in’ all stakeholder groups and were included directly in the final core outcome set. 5 remaining outcomes meeting ‘consensus in’ were ratified over two consensus webinars. 9 core outcomes were included in the final core outcome set: Satisfaction with the quality and amount of information, Patient feeling that there was a choice, Patient feeling that the decision to consent was their own, Confidence in the decision made, Satisfaction with communication, Trust in the clinician, Patient satisfaction with the consent process, Patient rated adequacy of time and opportunity to ask questions. Conclusion This international mixed-methods qualitative study is the first of its kind to define a core outcome set for informed consent for intervention. It defines what outcomes are of importance to key stakeholders in the consent process and is a forward step towards standardising future consent research. (shrink)

Language is coordination. Pursuing this, the present Special Issue of Pragmatics & Cognition challenges two widely held positions. First, the papers reject the claim that language is essentially ‘symbolic’. Second, they deny that minds represent verbal patterns. Rather, language is social, individual, and contributes the feeling of thinking. Simply, it is distributed. Elucidating this claim, the opening papers report empirically-based work on the anticipatory dynamics of reading, their cognitive consequences, Shakespearean theatre, what images evoke, and insight problem-solving. Having given reasons (...) for rejecting linguistic autonomy, the papers turn to theory building. Initially, attention is given to a possible origin for semiotic cognition. Then, it is claimed that language functions by realizing values. Next, it is argued that human dynamics are co-regulated by cultural and biological symbols. Finally, in a review article, the distributed view of language is used to contrast Clark’s organism-centered cognition with what is here called ecologically extended cognition. (shrink)

Book Reviews STEPHEN R. L. CLARK, Religious Studies, FirstView Article.

Patient-centered care is now recognized as a clinical method and ideal model for patient – health professional relationships, and many definitions have influenced its evolution. Overall the patient-centered care literature has provided relatively little to define patient-centered care at the level of the patient-professional relationship. Additionally, patient-centered care lacks grounding in ethical theory. This thesis asserts that theoretical concepts from the ethics of care can provide a stronger conceptual basis for patient-centered care.This thesis begins with a critical interpretive review of (...) the patient-centered care literature, yielding 12 articles that previously introduced new theoretical and definitional work on patient-centered care and patient-centered communication. Six common themes and ideas were discovered, and include Engaging the Patient as a Whole Person, Recognizing and Responding to Emotions, Fostering a Therapeutic Alliance, Promoting an Exchange of Information, Sharing Decision Making, and Enabling Self-Management and Patient Navigation. These elements were then compared to key elements of the ethics of care. This thesis argues that feminists have good reason to consider care as a type of moral duty, and it describes how this duty functions. This thesis also argues that a duty to care is triggered when caregivers are presented with particular substantive forms of vulnerability. Specifically, this thesis argues that vulnerable subjects whose constitutive needs are at risk require particular moral obligations. The links between the ethics of care and patient-centered care are discussed, including how an ethics of care response ought to function in the health care context. Finally, the cases of J.J. and Makayla Sault, two aboriginal girls who refused chemotherapy in favour of traditional aboriginal healing practices, are analyzed. This thesis offers a short scoping review of the bioethics discourse surrounding these cases. A review of this discourse revealed several common themes, which included the peripheral importance of culture and history, the equating of best interests with survival, the supremacy of science-based medicine, and the impartial application of ethical principles. This thesis recommends that health care professionals apply an ethics of care approach to similar ethical dilemmas in the future, which involves shifting one's ethical focus to the central relationships of the case, understanding the unique perspective of the patient's narrative, and promoting a care-based rather than a justice-based approach to problem-solving. (shrink)

This paper proposes to reorient the philosophical debate about peer disagreement. The problem of peer disagreement is normally seen as a problem about the extent to which disagreement provides one with evidence against one's own conclusions. It is thus regarded as a problem for individual inquiry. But things look different in more collaborative contexts. Ethical norms relevant to those contexts make a difference to the epistemology. In particular, we argue that a norm of mutual answerability applies to us when we (...) engage in shared inquiry with others, and precludes us from treating one another's conflicting judgments as evidence relevant to the dispute. From this it follows that standard philosophical accounts of peer disagreement—e.g., the Equal Weight View and the Total Evidence View—presuppose that the disagreeing parties are in a sense alienated from one another. It's doubtful that such forms of alienated disagreement should be treated as the central case. (shrink)

The Ethics of Human Enhancement: Understanding the Debate has two chief aims. These aims are to help readers understand the existing debate and to move the debate forward. The book consists of an introductory chapter by Alberto Giubilini and Sagar Sanyal (which lays out some prominent bioconservative objections to enhancement), eight essays grouped under the theme of "Understanding the Debate" (Section I), and eight devoted to "Advancing the Debate" (Section II). In this review, we offer brief summaries of each essay (...) and ask whether the book successfully advances the debate. (shrink)

The field of neuroimaging has reached a watershed. Brain imaging research has been the source of many advances in cognitive neuroscience and cognitive science over the last decade, but recent critiques and emerging trends are raising foundational issues of methodology, measurement, and theory. Indeed, concerns over interpretation of brain maps have created serious controversies in social neuroscience, and, more important, point to a larger set of issues that lie at the heart of the entire brain mapping enterprise. In this volume, (...) leading scholars -- neuroimagers and philosophers of mind -- reexamine these central issues and explore current controversies that have arisen in cognitive science, cognitive neuroscience, computer science, and signal processing. The contributors address both statistical and dynamical analysis and modeling of neuroimaging data and interpretation, discussing localization, modularity, and neuroimagers' tacit assumptions about how these two phenomena are related; controversies over correlation of fMRI data and social attributions ; and the standard inferential design approach in neuroimaging. Finally, the contributors take a more philosophical perspective, considering the nature of measurement in brain imaging, and offer a framework for novel neuroimaging data structures. Contributors: William Bechtel, Bharat Biswal, Matthew Brett, Martin Bunzl, Max Coltheart, Karl J. Friston, Joy J. Geng, Clark Glymour, Kalanit Grill-Spector, Stephen José Hanson, Trevor Harley, Gilbert Harman, James V. Haxby, Rik N. Henson, Nancy Kanwisher, Colin Klein, Richard Loosemore, Sébastien Meriaux, Chris Mole, Jeanette A. Mumford, Russell A. Poldrack, Jean-Baptiste Poline, Richard C. Richardson, Alexis Roche, Adina L. Roskies, Pia Rotshtein, Rebecca Saxe, Philipp Sterzer, Bertrand Thirion, Edward Vul The hardcover edition does not include a dust jacket. (shrink)

From the moment of discovery, the Piltdown "fossils" were the center of controversy. Piltdown apparently provided a human fossil on English soil, a maker for the eoliths, and proof that the brain came first in human evolution and that an anatomically modern braincase was present at the beginning of the Ice Age. Every conclusion was important and controversial, and for many years it was not possible to discuss human evolution without considering Piltdown. Hundreds of papers were written about the discoveries, (...) but the problem remained. Anatomically it seemed impossible to associate the skull and jaw, but the chance association of an ape's jaw and a human skull in England seemed at least as improbable. The solution came when J.S. Weiner, Kenneth Oakley, and W.L. le Cros Clark showed that everything was fake–the bones had been stained, ape's teeth filed down, and fossils added to the assemblage to determine the antiquity. The whole matter is carefully reviewed in Weiner's The Piltdown Forgery ( 1955). (shrink)

In May 2010, philosophers, family and friends gathered at the University of Notre Dame to celebrate the career and retirement of Alvin Plantinga, widely recognized as one of the world's leading figures in metaphysics, epistemology, and the philosophy of religion. Plantinga has earned particular respect within the community of Christian philosophers for the pivotal role that he played in the recent renewal and development of philosophy of religion and philosophical theology. Each of the essays in this volume engages with some (...) particular aspect of Plantinga's views on metaphysics, epistemology, or philosophy of religion. Contributors include Michael Bergman, Ernest Sosa, Trenton Merricks, Richard Otte, Peter VanInwagen, Thomas P. Flint, Eleonore Stump, Dean Zimmerman and Nicholas Wolterstorff. The volume also includes responses to each essay by Bas van Fraassen, Stephen Wykstra, David VanderLaan, Robin Collins, Raymond VanArragon, E. J. Coffman, Thomas Crisp, and Donald Smith. (shrink)

According to a natural view of instrumental normativity, if you ought to do φ, and doing ψ is a necessary means for you to do φ, then you ought to do ψ. In “Instrumental Normativity: In Defense of the Transmission Principle,” Benjamin Kiesewetter defends this principle against certain actualist-inspired counterexamples. In this article I argue that Kiesewetter’s defense of the transmission principle fails. His arguments rely on certain principles—Joint Satisfiability and Reason Transmission—which we should not accept in the unqualified forms (...) needed to establish his conclusion. (shrink)

SummaryKekulé first suggested a hexagonal structure for benzene in 1865. For over a half-century after, chemists struggled to reconcile proposed structures for benzene and other aromatic compounds with their resistance to chemical transformation and tendency to maintain the type during reaction. The combined structural and reactivity features of these compounds were eventually covered by the term ‘aromaticity’. Kekulé, Bamberger and Thiele had each proposed a criterion for aromaticity; all were either empirically contradicted or incapable of evaluation. In the 1930s, two (...) rival quantum mechanical methods succeeded in establishing a physical basis for aromaticity. Using valence bond theory, Pauling attributed benzene's stability to its being a resonance hybrid of several Lewis structures. Calculating resonance energies was challenging but manipulating Lewis structures was not; that procedure provided qualitative insights into aromatic structure and reactivity. Resonance theory appealed especially to organic chemists and eclipsed Hückel's contemporaneous molecular orbital approach, which remained relatively inaccessible. In the 1950s, however, simple rules derived from Hückel's mathematics, combined with proton NMR data, provided seemingly universal criteria for aromaticity. In the event, post-1950 discoveries of non-organic, three-dimensional compounds such as ferrocene and the fullerenes that exhibit aromatic properties led chemists to doubt the utility and universality of ‘aromaticity’ as a concept. A recent consensus maintains that aromaticity is a multi-variable phenomenon that cannot be reduced to a strict definition, a property it shares with other core chemical concepts such as ‘acidity’ and ‘reactivity’. (shrink)

Rather than ask if expertise is under threat, this paper uses case studies to show how expertise is enabled. Its appearance can be traced to how the already known evokes sensibility, judging, thinking and languaging. As defined below, it draws on epistemic cycles. Using Secchi and Cowley’s (2021) 3M model, this posits a second cut between the micro and the macro. In the mesosphere, people create temporary domains or what William James (1991) calls ‘little worlds’. Within these corpora popularia, the (...) new is made possible – expertise sets off unimagined outcomes. Thus, many concerns cannot be solved by scientific correlates of a natural ontological attitude: indeed, the truism clarifies many social challenges. We lack social institutions that dedicate expertise to goals like ecosocial justice and life-sustaining relations. Once the necessary expertise is traced to epistemic cycles, we can demand of institutions that they create bodies that seek to bring a rich future to evolution. (shrink)

Stephen Ward argues that present media practices are narrowly based within the borders of single country and thus unable to successfully inform the public about a globalized world. Presenting an ethical framework for work in multimedia, the author extends John Rawl’s theories of justice and the human good to redefine the aims for which journalism should strive and then applies this new foundation to issues such as the roles of patriotism and objectivity in journalism. An innovative argument that presents (...) a necessary corrective to contemporary media practices, Global Journalism Ethics is a theoretically rich study for journalists on the air, in print, and on the internet. (shrink)

How, if at all, does one's intention to realize an end bear on the justification for taking the means to that end? Theories that allow that intending an end directly provides a reason to take the means are subject to a well-known "bootstrapping" objection. On the other hand, "anti-psychologistic" accounts—which seek to derive instrumental reasons directly from the reasons that support adopting the end itself—have unacceptable implications where an agent faces multiple rationally permissible options. An alternative, predictive, role for intention (...) in means-end reasoning is considered and rejected. A new proposal is then developed, according to which instrumental reasons are not merely reasons to perform an act necessary for a given end, but to perform the act for the sake of that end. (shrink)

Atheist philosophers Jean-Paul Sartre and Kurt Baier, though from different philosophical traditions, shared a common concern about the traditional Judeo-Christian-Muslim doctrine that human beings are the creations of a Supreme Being. For Sartre, in “Existentialism is a Humanism” (1946), a God who designed us would thereby detract from our freedom and dignity. For Baier, in “The Meaning of Life” (1957), the idea that God designs us to serve his own purposes was deeply offensive in treating us as artifacts, domestic animals, (...) or slaves. Indeed, Baier said explicitly what was implicit in Sartre: that the divine creation of humans as would violate Immanuel Kant’s respect for persons principle. But this Kantian objection is badly flawed in ignoring the crucial role of human free will in traditional Abrahamic theism. Still, if we focus not on the divine-creation doctrine but on the doctrine of eternal torment for non-worshippers of God, then traditional Abrahamic theism does arguably undermine human freedom and dignity. For the threat of eternal torment is extraordinarily coercive. Keywords: theism, artifacts, free will, eternal torment, coercion. (shrink)

This book is a comprehensive introduction to media ethics and an exploration of how it must change to adapt to today's media revolution. Using an ethical framework for the new 'mixed media' ethics – taking in the global, interactive media produced by both citizens and professionals – Stephen J. A. Ward discusses the ethical issues which occur in both mainstream and non-mainstream media, from newspapers and broadcast to social media users and bloggers. He re-defines traditional conceptions of journalistic truth-seeking, (...) objectivity and minimizing harm, and examines the responsible use of images in an image-saturated public sphere. He also draws the contours of a future media ethics for the 'new mainstream media' and puts forward cosmopolitan principles for a global media ethics. His book will be invaluable for all students of media and for others who are interested in media ethics. (shrink)

Is it a good objection to a moral theory that it demands a great deal of individual agents? I argue that if we interpret the question to be about the potential welfare costs associated with our moral obligations, the answer must be “no.” However, the demands a moral theory makes can also be measured in terms of what it requires us to take responsibility for. I argue that this is distinct from what we may be required to do or give (...) up, and that it provides a conception of demandingness that makes better sense of our intuitive reactions. (shrink)

According to the view Rik Peels defends in Responsible Belief, one is responsible for believing something only if that belief was the result of choices one made voluntarily, and for which one may be held responsible. Here, I argue against this voluntarist account of doxastic responsibility and in favor of the rationalist position that a person is responsible for her beliefs insofar as they are under the influence of her reason. In particular, I argue that the latter yields a more (...) plausible account of the conditions under which ignorance may serve as an excuse for wrongdoing. (shrink)

Environmental concerns and the complex issues and dilemmas raised by animal rights pose fundamental questions for philosophers. The essays in this welcome collection put environmental thinking into the broader context of philosophical thought. Distinguished contributions from key thinkers, including Mary Midgley, Stephen Clark, J.Baird Callicott, Holmes Rolston, Dale Jamieson and John Haldane, focus on our attitudes to animals and the environment as critically determined by deeper philosophical concerns. Timothy Chappell's useful introduction provides a guide to the issues and (...) dilemmas and links the diverse arguments and themes. Examining whaling, animal captivity, and specicism amongst other topics, this book adds substantially to the contemporary debate in environmental philosophy. (shrink)

Does objectivity exist in the news media? In The Invention of Journalism Ethics, Stephen Ward argues that given the current emphasis on interpretation, analysis, and perspective, journalists and the public need a new theory of objectivity. He explores the varied ethical assertions of journalists over the past few centuries, focusing on the changing relationship between journalist and audience. This historical analysis leads to an innovative theory of pragmatic objectivity that enables journalists and the public to recognize and avoid biased (...) and unbalanced reporting. Ward convincingly demonstrates that journalistic objectivity is not a set of absolute standards but the same fallible but reasonable objectivity used for making decisions in other professions and public institutions. Considered a classic in the field since its first publication in 2004, this second edition includes new chapters that bring the book up to speed with journalism ethics in the twenty-first century by focusing on the growing dominance of online journalism and calling for a radical approach to journalism ethics reform. Ward also addresses important developments that have occurred in the last decade, including the emergence of digital journalism ethics and global journalism ethics. (shrink)

The experience of having to suffer debilitating pain is far too common in the United States, and many patients continue to be inadequately treated by their doctors. Although many physicians freely admit that their pain management practices may have been somewhat lacking, many more express concern that the prescribing of heightened levels of opioid analgesics may result in closer regulatory scrutiny, criminal investigation, or even criminal prosecution.Although several researchers have examined the regulatory environment and the threat of sanction or harm (...) it poses to physicians and patients, few have examined the likelihood of investigation or prosecution stemming from the aggressive use of opioids in physician-directed pain management. Accordingly, in an effort to assess whether the fear of prosecution is realistic and, if so, what factors contribute to its likelihood, we surveyed chief prosecutors in four states about their knowledge, opinions, and attitudes concerning opioids and the prosecution of physicians stemming from the treatment of patients who were either terminally ill or suffering from chronic noncancer pain. (shrink)

In China creativity is construed as an ethico‐aesthetic practice in which signifying acts of self‐presentation (yi) are evaluated as to their efficacy in fostering harmonious relations of social exchange within specific historical occasions. To say this is to call attention to the performative dimension of aesthetic creativity; to recognize, beyond its constative meaning, the force of an expressive act to produce effects that profoundly affect its recipients.

A timely call for a new ethic of journalism engagement for today's troubled media sphere, Objectively Engaged Journalism argues that media should be neither neutral nor partisan but engaged in protecting egalitarian democracy. It shows how journalists, professional or citizen, can be both objective in method and dedicated to improving a global public sphere toxic with disinformation, fake news, and extremism. Drawing from history, ethics, and current media issues, Stephen Ward rejects the ideals of neutrality and "just the facts" (...) objectivity, showing how they are based on invalid dualistic thinking with deep roots in Western culture. He presents a theory of pragmatic objectivity and applies it to journalism. Journalism's role in interpreting culture, he argues, needs a form of objectivity that embraces human strengths and limitations. Defining responsible journalism as situated, imperfect inquiry, Objectively Engaged Journalism is one of the first systematic studies of the ethical foundations of engaged journalism for a media that is increasingly perspectival and embedded in society. (shrink)

Medicalized Death and the Right to Die Movement Prior to the 20th Century, most Americans died at home, surrounded by family, friends, and neighbors. Religion, not medicine, governed the death bed for there was little physicians could do for the dying. Eventually, however, advances in medicine and technology would lead to dramatic changes in the timing and location of death: patients not only began living longer, they were also dying longer, and unlike their predecessors, were more likely to die alone, (...) in institutions, and among strangers. Modern medicine, in its zeal to conquer death, had become obsessed with its curative function and ability to extend the lives of the dying. To many in the medical community, death represented failure and was something to be avoided at all costs, and like many other social problems in the United States, had become medicalized. (shrink)

This essay review addresses the central responsibility thesis of David Brink's "Fair. Opportunity and Responsibility" and then considers two applications of the central. Thesis: legal insanity and diminished capacity.

This chapter addresses the potential contributions of neuroscience to criminal justice decision-making and policy, with special emphasis on criminal responsibility. The central question is whether neuroscience is relevant to criminal justice. The general conclusion is that it is scarcely useful at present but may become more relevant as the science progresses. After explaining the meaning of criminal responsibility in use, the chapter speculates about the source of claims for the positive influence of neuroscience. The scientific status of behavioral neuroscience and (...) two radical challenges to responsibility neuroscience allegedly raises, determinism and the death of agency, are discussed next. Then, the specific relevance of neuroscience to criminal law and the use of neuroscience in criminal cases in the United States and abroad are addressed. The penultimate section points to some areas warranting modest optimism for the use of neuroscience in criminal justice. A brief conclusion follows. (shrink)

This chapter attempts to improve our conception of objectivity in general, especially in journalism and other media work. It defends the twin theses that: Global news media needs a new conception of objectivity and the conception of pragmatic objectivity is a viable candidate, and pragmatic objectivity is part of a radical rethinking of journalism and media ethics. It is an alternative to the professional objective model, a still-influential traditional idea of the objective journalist as a neutral stenographer of fact. Journalists (...) need to disrupt this model of good journalism. The chapter reconstructs objectivity as a natural evaluative capacity of humans that is situated and holistic. Then, it uses this naturalistic perspective to articulate pragmatic objectivity and apply it to journalism. (shrink)

This handbook is one of the first comprehensive research and teaching tools for the developing area of global media ethics. The advent of new media that is global in reach and impact has created the need for a journalism ethics that is global in principles and aims. For many scholars, teachers and journalists, the existing journalism ethics, e.g. existing codes of ethics, is too parochial and national. It fails to provide adequate normative guidance for a media that is digital, global (...) and practiced by professional and citizen. A global media ethics is being constructed to define what responsible public journalism means for a new global media era. Currently, scholars write texts and codes for global media, teach global media ethics, analyse how global issues should be covered, and gather together at conferences, round tables and meetings. However, the field lacks an authoritative handbook that presents the views of leading thinkers on the most important issues for global media ethics. This handbook is a milestone in the field, and a major contribution to media ethics. (shrink)

This chapter defends the project of global media ethics against the skeptics. The overall question for this chapter can be stated as follows: Is the creation of global media ethics as a whole a realistic and desirable goal? The chapter proceeds by exploring, and responding to, the major criticisms of the project and its idea of moral globalism. It then presents a realistic conception of what can be achieved by global media ethics. The chapter concludes that it is both rational (...) and practically worthwhile to support the project of global media ethics. (shrink)

This chapter explores the future of global media ethics by focusing on a question that is a cause of misunderstanding and, perhaps, its greatest conceptual challenge: What is the goal of global media ethics? The chapter argues that the image of global media ethics has been distorted by the view that a global ethic must consist of one, uniquely correct set of principles affirmed by a large majority of journalists around the world. Instead, the chapter proposes the idea of global (...) media ethics as plural in structure and method, as different discourses across different cultures. The future of global media ethics is participation in webs of de-centered discourse about the changing world of global media. (shrink)

While commentators have long decried managerial short-termism, the deleterious effects of managerial short-termism on corporate social performance (CSP), and how to ameliorate those negative effects, remain underexplored. Specifically, due to the difficulty of unobtrusively measuring what is fundamentally a cognition in managers, empirical evidence at the organizational level of managerial short-termism’s effect on CSP is relatively sparse. Here, we measure managerial short-termism by content analyzing firms’ publicly filed annual reports (10-Ks). Using a combined dataset for 1,665 U.S. firms for the (...) period 2000–2012, we show that managerial short-termism is negatively associated with CSP. However, we also show that this effect can be reduced through increased external monitoring by important stakeholders who value CSP. Specifically, we show that increasing dedicated institutional ownership and increasing analyst coverage both decrease the negative effect of managerial short-termism on CSP. We contribute to theory by predicting and showing the negative effect of managerial short-termism on CSP, and how external monitoring can reduce its deleterious effects. We contribute to practice by showing how this managerial cognition can be identified, and how its negative effects can be ameliorated, at the organizational level. (shrink)

The legalization of physician-assisted suicide remains a hotly debated issue throughout the United States, and continues to capture the attention of government officials at both the state and federal levels. While the practice is currently legal in Oregon, some federal lawmakers and officials from the U.S. Department of Justice have attempted to outlaw that state's practice through legislation, or through a strained interpretation of the federal Controlled Substances Act. And while several citizen groups throughout the United States have attempted but (...) failed to legalize PAS through popular initiative, several state lawmakers have succeeded in specifically outlawing the practice. Yet even though physician-assisted suicide remains unlawful in every state except Oregon, there is ample evidence that American physicians throughout the United States have participated in PAS by providing their terminally ill patients with lethal prescriptions. (shrink)