This chapter contains sections titled: What is a Father? Fatherly Mercy as Attitude Mercy Enables Connection with Children Mercy Strengthens Relationships What Does Fatherly Mercy Look Like? Notes.

Editors' introduction to 3rd thematic issue on philosophy of medicine.

Last year saw the 20th anniversary edition of JECP, and in the introduction to the philosophy section of that landmark edition, we posed the question: apart from ethics, what is the role of philosophy ‘at the bedside’? The purpose of this question was not to downplay the significance of ethics to clinical practice. Rather, we raised it as part of a broader argument to the effect that ethical questions – about what we should do in any given situation – are (...) embedded within whole understandings of the situation, inseparable from our beliefs about what is the case, what it is that we feel we can claim to know, as well as the meaning we ascribe to different aspects of the situation or to our perception of it. Philosophy concerns fundamental questions: it is a discipline requiring us to examine the underlying assumptions we bring with us to our thinking about practical problems. Traditional academic philosophers divide their discipline into distinct areas that typically include logic: questions about meaning, truth and validity; ontology: questions about the nature of reality, what exists; epistemology: concerning knowledge; and ethics: how we should live and practice, the nature of value. Any credible attempt to analyse clinical reasoning will require us to think carefully about these types of question and the relationships between them, as they influence our thinking about specific situations and problems. So, the answers to the question we posed, about the role of philosophy at the bedside, are numerous and diverse, and that diversity is illustrated in the contributions to this thematic edition. (shrink)

It is widely assumed that disability is typically a bad thing for those who are disabled. Our purpose in this essay is to critique this view and defend a more nuanced picture of the relationship between disability and well-being. We first examine four interpretations of the above view and argue that it is false on each interpretation. We then ask whether disability is thereby a neutral trait. Our view is that most disabilities are neutral in one sense, though we cannot (...) make simple generalizations about disability's relationship to well-being in other important senses. After defending this view, we discuss its practical implications for selective abortion for disability, nondisabled people's interactions with disabled people, and the use of QALYs in health policy. (shrink)

It is commonly thought that disability is a harm or “bad difference” because having a disability restricts valuable options in life. In his recent essay “Disability, Options and Well-Being,” Thomas Crawley offers a novel defense of this style of reasoning and argues that we and like-minded critics of this brand of argument are guilty of an inconsistency. Our aim in this article is to explain why our view avoids inconsistency, to challenge Crawley's positive defense of the Options Argument, and to (...) suggest that this general line of reasoning employs a double standard. (shrink)

It may seem obvious that causing disability in another person is morally problematic in a way that removing or preventing a disability is not. This suggests that there is a moral asymmetry between causing disability and causing non-disability. This chapter investigates whether there are any differences between these two types of actions that might explain the existence of a general moral asymmetry. After setting aside the possibility that having a disability is almost always bad or harmful for a person (a (...) view that we have critiqued at length elsewhere), seven putative differences are considered. Ultimately, it is concluded that none of these seven factors can ground a general moral asymmetry between causing disability and causing non-disability, though each factor can provide some moral reason to avoid causing disability in certain particular cases. (shrink)

What makes some human rights campaigns for the physical integrity rights of prisoners more effective than others? Despite various normative arguments condemning these practices, only limited systematic analysis documents the relative effectiveness of different arguments on individuals. This is surprising, because the success of human rights campaigns depends on getting individuals to care about and support policy positions that protect human rights. We constructed an experiment to compare the effects of six different arguments against prisoner abuse and torture. We found (...) that an argument which emphasized the suffering of the prisoner had a consistently positive and significant effect on opposition to torture and prisoner abuse. However, this effect was largely contingent on subjects’ political ideology. Political conservatives actually became less opposed to torture, on average, after reading the same argument emphasizing the prisoners’ suffering or the sacredness of human beings. (shrink)

How does the visual system recognize images of a novel object after a single observation despite possible variations in the viewpoint of that object relative to the observer? One possibility is comparing the image with a prototype for invariance over a relevant transformation set. However, invariance over rotations has proven difficult to analyze, because it applies to some objects but not others. We propose that the invariant transformations of an object are learned by incorporating prior expectations with real-world evidence. We (...) test this proposal by developing an ideal learner model for learning invariance that predicts better learning of orientation dependence when prior expectations about orientation are weak. This prediction was supported in two behavioral experiments, where participants learned the orientation dependence of novel images using feedback from solving arithmetic problems. (shrink)

With increased frequency, reproductive technologies are placing prospective parents in the position of choosing whether to bring a disabled child into the world. The most well-known objection to the act of “selecting against disability” is known as the Expressivist Argument. The argument claims that such acts express a negative or disrespectful message about disabled people and that one has a moral reason to avoid sending such messages. We have two primary aims in this essay. The first is to critically examine (...) the standard Expressivist Argument, which we analyze in terms of the expression of ableist attitudes. We distinguish three interpretations of the argument and argue that each version faces serious objections. Our second aim is to articulate two closely related arguments that also pertain to expressed ableist attitudes. The Expressive Harms Argument maintains that there is a moral reason to avoid actions that give rise to the perception of ableist attitudes in cases where this is likely to have negative consequences for disabled people. The Ableist Motivation Argument speaks against selecting against disability in cases where one would be motivated by ableist attitudes. While these two arguments face various objections, we seek to establish that they are more promising than the most natural interpretations of the Expressivist Argument. (shrink)

That people do wrong would appear to be a moral datum: a moral realm without wrongdoing may not be coherent. Thus, an adequate philosophic theory of morality ought to allow for it. But such a theory ought also to explain wrongdoing, both axiologically and causally. This is so if we take such a theory to have practical significance. Indeed, insofar as moral philosophy and its cognate areas have practical significance, explaining wrongdoing is arguably the most pressing practical issue for theory (...) construction in this domain. For a philosophical theory of morality to have practical significance, and, further, to have influence on behavior, it must be psychologically relevant to the organisms that it ranges over. That is, the concepts that the theory purports to explain must be plausibly realized within the psychology of the creatures for which the theory is intended. Any theory satisfying this constraint would then be in a position to illuminate those psychological features that are explanatory of blameworthy behavior. The argument presented here is that moral realism and its underlying moral psychology, cognitivism, face serious difficulties allowing for and explaining, both metaphysically and psychologically, such behavior. Moral cognitivism and realism fail to adequately account for this most fundamental of moral phenomena. Hence, a comprehensive understanding of moral experience is impossible within the cognitivist/realist perspective. (shrink)

This paper describes the design of a control and management network (orderwire) for a mobile wireless Asynchronous Transfer Mode (ATM) network. This mobile wireless ATM network is part of the Rapidly Deployable Radio Network (RDRN). The orderwire system consists of a packet radio network which overlays the mobile wireless ATM network, each network element in this network uses Global Positioning System (GPS) information to control a beamforming antenna subsystem which provides for spatial reuse. This paper also proposes a novel Virtual (...) Network Configuration (VNC) algorithm for predictive network configuration. A mobile ATM Private Network-Network Interface (PNNI) based on VNC is also discussed. Finally, as a prelude to the system implementation, results of a Maisie simulation of the orderwire system are discussed. (shrink)

This paper extends a stochastic theory for buffer fill distribution for multiple “on‘ and “off‘ sources to a mobile environment. Queue fill distribution is described by a set of differential equations assuming sources alternate asynchronously between exponentially distributed periods in “on‘ and “off‘ states. This paper includes the probabilities that mobile sources have links to a given queue. The sources represent mobile user nodes, and the queue represents the capacity of a switch. This paper presents a method of analysis which (...) uses mobile parameters such as speed, call rates per unit area, cell area, and call duration and determines queue fill distribution at the ATM cell level. The analytic results are compared with simulation results. (shrink)

There is a trend toward the use of predictive systems in communications networks. At the systems and network management level predictive capabilities are focused on anticipating network faults and performance degradation. Simultaneously, mobile communication networks are being developed with predictive location and tracking mechanisms. The interactions and synergies between these systems present a new set of problems. A new predictive network management framework is developed and examined. The interaction between a predictive mobile network and the proposed network management system is (...) discussed. The Rapidly Deployable Radio Network is used as a specific example to illustrate these interactions. (shrink)

The Free Discussion between Richard Price and Joseph Priestley (1778) originated as a correspondence between the two after the publication of Priestley's Disquisitions on Matter and Spirit, his most important philosophical work (1777). At the time it was thought remarkable that a controversey such as this could be conducted so amicably, but then the two were close friends. Nevertheless their philosophical, as opposed to their oft mentioned political views, were at opposite ends of a spectrum.

Screening for asymptomatic disease is a routine aspect of contemporary public health practice. However, it is also controversial, because it leads to overdiagnosis and overtreatment, with many arguing that programmes are “ineffective,” i.e., the “costs” outweigh the “benefits.” This paper explores a more fundamental objection to screening programmes: that, even if they are effective, they are ethically impermissible because they breach the principle of non-maleficence. In so doing, it suggests a new approach to the ethics of risk, justifying a concern (...) with how policies affect individuals’ absolute ex-ante prospects. Part 1 sets up the tension between screening and non-maleficence. Part 2 introduces and motivates a novel interpretation of the non-maleficence principle, “ex-ante Do No Harm,” which resolves this tension. Part 3 defends and clarifies this principle by discussing its relationship to the ex-ante Pareto principle. Part 4 discusses the worry that risk estimates are too “subjective.”. (shrink)

Diseases causing inherited retinal degeneration in humans, such as retinitis pigmentosa and macular dystrophy, are genetically heterogeneous and clinically diverse. More than 40 genes causing retinal degeneration have been mapped to specific chromosomal sites; of these, at least 10 have been cloned and characterized. Mutations in two proteins, rhodopsin and peripherin/RDS, account for approximately 35% of all cases of autosomal dominant retinitis pigmentosa and a lesser fraction of other retinal conditions. This target article reviews the genes and mutations causing retinal (...) degeneration and proposes mechanisms whereby specific mutations lead to particular clinical consequences, that is, the relationship between genotype and phenotype. Retinitis pigmentosa and macular dystrophy are genetically heterogeneous diseases that cause retinal degeneration in humans and often result in severe visual impairment or blindness. Although many of the genes causing these diseases have not been identified, three photoreceptor-specific proteins have been implicated: rhodopsin, peripherin/RDS, and the P-subunit of rod phosphodiesterase. Mutations in the genes for these three proteins can cause either dominant retinitis pigmentosa, recessive retinitis pigmentosa, dominant congenital stationary night blindness, or dominant macular degeneration. Why this multiplicity of clinical phenotypes? Our target article summarizes the genetic and biochemical background to this question and proposes a number of possible explanations. Discussion focuses mainly on 73 distinct disease-causing mutations of rhodopsin. We feel that rhodopsin and other photoreceptor proteins can serve as model systems for unraveling the connection between genotype and phenotype, not only for inherited retinal diseases but for other degenerative disorders as well. (shrink)

Recent findings emphasize the complexity, both genetic and functional, of the manifold genes and mutations causing inherited retinal degeneration in humans. Knowledge of the genetic bases of these diseases can contribute to design of rational therapy, as well as elucidating the function of each gene product in normal visual processes.

Dimensions of character are often overlooked in professional practice at the expense of the development of technical competence and operational efficiency. Drawing on philosophical accounts of virtue ethics and positive psychology, the present work attempts to elevate the role of ‘good’ character in the professional domain. A ‘good’ professional is ideally one that exemplifies dimensions of character informed by sound judgement. A total of 2340 professionals, from five discrete professions, were profiled based on their valuation of qualities pertaining to character (...) and judgement. Profile differences were subsequently examined in the self-reported experience of professional purpose towards a wider societal ‘good’. Analysis of covariance, controlling for stage of career, revealed that professionals valuing character reported higher professional purpose than those overweighting the importance of judgement or valuing neither character nor judgement, F = 7.92, p <.001. No differences were found between the two groups valuing character, irrespective of whether judgement was valued simultaneously. This profiling analysis of entry-level and in-service professionals, based on their holistic character composition, paves the way for fresh philosophical discussion regarding what constitutes a ‘good’ professional and the interplay between character and judgement. The empirical findings may be of substantive value in helping to recognise how the dimensions of character and judgement may impact upon practitioners’ professional purpose. (shrink)

Over the past decade or so within this journal, there have been critical debates concerning the role of mindfulness within education, the influence of neoliberalism on education in general and well-being interventions specifically, and the relevance of the philosophy of Martin Heidegger for critiquing modernity including the nature and purpose afforded education. In this article, we propose that these debates are sufficiently interrelated to develop a more unified argument. We will show how a Heideggerian perspective is conceptually rich, in both (...) its heritage, as it draws upon both East-Asian wisdom and western thinking, and its engagement, as it confronts the implications of what Heidegger called a ‘technical-era’, for offering such a unified critique. The focus of this critique is on instrumental forms of mindfulness (mindfulness ‘in’ education), which when framed by neoliberalism has rather narrow goals concerning individual well-being and performance. In contrast, more critical and integral forms of mindfulness (mindfulness ‘as’ education) offer the potential for more holistic and authentic learning. Throughout the article, we discuss how Heideggerian philosophy offers a number of useful concepts (e.g., enframing, Dasein, authenticity, meditative thinking), which are able to both critique the instrumentalisation of approaches like mindfulness by neoliberalism and speak to more holistic education oriented toward more authentic being in the world. (shrink)

Given the importance of cross-disciplinary research, facilitating CDR effectiveness is a priority for many institutions and funding agencies. There are a number of CDR types, however, and the effectiveness of facilitation efforts will require sensitivity to that diversity. This article presents a method characterizing a spectrum of CDR designed to inform facilitation efforts that relies on bibliometric techniques and citation data. We illustrate its use by the Toolbox Project, an ongoing effort to enhance cross-disciplinary communication in CDR teams through structured, (...) philosophical dialogue about research assumptions in a workshop setting. Toolbox Project workshops have been conducted with more than 85 research teams, but the project's extensibility to an objectively characterized range of CDR collaborations has not been examined. To guide wider application of the Toolbox Project, we have developed a method that uses multivariate statistical analyses of transformed citation proportions from published manuscripts to identify candidate areas of CDR, and then overlays information from previous Toolbox participant groups on these areas to determine candidate areas for future application. The approach supplies 3 results of general interest: A way to employ small data sets and familiar statistical techniques to characterize CDR spectra as a guide to scholarship on CDR patterns and trends. A model for using bibliometric techniques to guide broadly applicable interventions similar to the Toolbox. A method for identifying the location of collaborative CDR teams on a map of scientific activity, of use to research administrators, research teams, and other efforts to enhance CDR projects. (shrink)

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Prolonged survival after the declaration of death by neurologic criteria creates ambiguity regarding the validity of this methodology. This ambiguity has perpetuated the debate among secular and nondissenting Catholic authors who question whether the neurologic standards are sufficient for the declaration of death of organ donors. Cardiopulmonary criteria are being increasingly used for organ donors who do not meet brain death standards. However, cardiopulmonary criteria are plagued by conflict of interest issues, arbitrary standards for candidacy, and the lack of standardized (...) protocols for organ procurement. Combining the neurological and cardiopulmonary standards into a single protocol would mitigate the weaknesses of both and provide greater biologic and moral certainty that a donor of unpaired vital organs is indeed dead. (shrink)

In recent years, the opioid crisis in the United States has sparked significant discussion on doctor–patient interactions concerning chronic pain treatments, but little to no attention has been given to investigating the vocal aspects of patient talk. This exploratory sociolinguistic study intends to fill this knowledge gap by employing prosodic discourse analysis to examine context-specific linguistic features used by the interlocutors of two distinct medical interactions. We found that patients employed both low pitch and creak as linguistic resources when describing (...) chronic pain, narrating symptoms and requesting opioids. The situational use of both features informs us about the linguistic ways in which patients frame fraught issues like chronic pain in light of the current opioid crisis. This study expands the breadth of phonetic analysis within the domain of discourse analysis, serving to illuminate discussions surrounding the illocutionary role of the lower vocal tract in expressing emotions. (shrink)

"The premise of this collection is that despite this perceptual sharing, "sublime economy" has yet to be investigated in a purely cross-disciplinary way.