Cognitive psychologists have recently identified alterations in perception and reasoning that contribute to the formation and maintenance of beliefs that happen to be delusional. Clinically significant delusions, however, are often deeply unusual. An account of their formation and maintenance must explain not merely how someone can come to hold false or uncommon beliefs, but also how someone can arrive at beliefs that seem profoundly improbable and even bizarre. This paper uses the philosophical concepts of the Bedrock and the Background to (...) provide an account of that foundational, nonrepresentational, non–rule-governed, dispositional structure of everyday understanding that underpins both our perception and our reasoning. The central claim is that the formation and maintenance of delusions becomes intelligible once they are seen to reflect disturbances to this foundational dispositional structure. Different dimensions of the Background are described along with the delusions that might follow from distortions to these dimensions. We challenge the assumption of much recent cognitive psychological theorizing that delusions can be understood as explanations of unusual experiences or as the product of hasty reasoning. Finally, the implications of the theory for the therapy of the delusional patient are briefly discussed. (shrink)

Over the past 15 years, medical schools have paid some attention to the importance of developing students' communication skills as part of their medical education. Over the past decade, medical ethics has been added to the curriculum of most U.S. medical schools, at least on paper. More recently, there has been growing discussion of the importance of professionalism in medical education. Yet, the nature and content of these fields and their relationship to one another remains confused and vague, and that (...) lack of clarity, in turn, impairs the effectiveness of medical education. This ambiguity invites serious contention over who should design and teach the curriculum as well as when, where, and how it should be taught. (shrink)

Medicine needs our trust. We need to be able to rely on individual clinicians and researchers, and we need to be able to have confidence in hospitals and clinics. Yet the organization of our healthcare institutions is not designed to promote that trust. In fact, the structure of our medical institutions seems to undermine our faith.

Because the process of moving from moral principles and facts to action-guiding moral conclusions has not been articulated clearly enough to be useful in a practical way, we designed a systematic approach to aid learners and clinicians in their application of ethical principles to the resolution of clinical dilemmas. Our model for clinical moral reasoning is intended to provide a clear and replicable structure that makes the thought process involved in reasoning about clinical cases explicit. In this paper we present (...) the model and demonstrate how it can be used in three clinical cases. (shrink)

Traditional moral theories of rights and principles have dominated medical ethics discussions for decades. Appeals to utilitarian consequences, as well as the principles of respect for autonomy, beneficence, and justice, have provided the standard vocabulary and filled the literature of the field.Recently on the bioethics scene, however, there has been some discussion of virtue, and, particularly within the nursing ethics literature, appeals are being made to the feminist ethics of care. This intimation of a shift in the wind may have (...) to do with postmodern doubt, or it may be attributable to the claim that virtue theory and the ethics of care are more appropriate to private interaction; theories of rights and justice are best applied to the political domain of public policy. (shrink)

Although medical centres have established boards, special committees, and offices for the review and redress of breaches in ethical behaviour, these mechanisms repeatedly prove themselves ineffective in addressing research misconduct within the institutions of academic medicine. As the authors see it, institutional design: systematically ignores serious ethical problems, makes whistleblowers into institutional enemies and punishes them, and thereby fails to provide an ethical environment.The authors present and discuss cases of academic medicine failing to address unethical behaviour in academic science and, (...) thereby, illustrate the scope and seriousness of the problem. The Olivieri/Apotex affair is just another instance of academic medicine’s dereliction in a case of scientific fraud and misconduct. Instead of vigorously supporting their faculty member in her efforts to honestly communicate her findings and to protect patients from the risks associated with the use of the study drug, the University of Toronto collaborated with the Apotex company’s “stalling tactics,” closed down Dr Olivieri’s laboratory, harassed her, and ultimately dismissed her.The authors argue that the incentives for addressing problematic behaviour have to be revised in order to effect a change in the current pattern of response that occurs in academic medicine. An externally imposed realignment of incentives could convert the perception of the whistleblower, from their present caste as the enemy within, into a new position, as valued friend of the institution. The authors explain how such a correction could encourage appropriate reactions to scientific misconduct from academic medicine. (shrink)

Through a number of studies recently published in the psychology literature, T.D. Wilson, D.T. Gilbert, and others have demonstrated that our judgments about what our future mental states will be are contaminated by various distortions. Their studies distinguish a variety of different distortions, but they refer to them all with the generic term “affective forecasting.” The findings of their studies on normal volunteers are remarkably robust and, therefore, demonstrate that we are all vulnerable to the distortions of affective forecasting. a.

Those who read only the introductory section of “Physician Obligation in Disaster Preparedness and Response,” the statement from the AMA's Council on Ethical and Judicial Affairs, apparently an elaboration on CEJA Opinion 3-I-04, E-9.067, will find an expression of laudable professional responsibility in the face of a disaster. There the AMA authors explicitly acknowledge “that unique responsibilities beyond planning rest on the shoulders of the medical profession”. They also declare that, “physicians are needed to care for victims. In some instances, (...) this will require individual physicians to place their health or their lives at risk”. As the AMA authors note, these responsibilities have been accepted at least since the writing of Thomas Percival in 1803 and endorsed by the AMA in posting their 1847 code. The commitments are also asserted in the preamble of the AMA's most current Principles of Medical Ethics, which states that “a physician must recognize responsibility to patients, first and foremost,” and again in Principle VIII, which states that “[a] physician shall, when caring for a patient, regard responsibility to the patient as paramount”. (shrink)

a This paper is a revised and shortened version of my chapter, “Justice in Allocations for Terrorism, Biological Warfare, and Public Health” in Public Health Ethics, edited by Michael Boylan, Kluwer; 2004. Portions of this material were presented at the International Bioethics Retreat, Pavia, Italy, June 2003, and at the meetings of the Association for Politics and the Life Sciences, Philadelphia, September 2003.

The essay is an analysis of John of Damascus’ justification for venerating the icons. Under the subtitle ‘reasoning for venerating the icons’ the essay conducts the analysis in three parts. First, John's definition of ‘veneration’ is presented and examined. Second, the OT ‘veneration’ passages he cites are critically evaluated. Third, the apparent incoherence of John's case is demonstrated from the Eastern Orthodox notion of scripture. This is a follow-up study to a previous essay (i.e., ‘Handmade: a critical analysis of John (...) of Damascus’ reasoning for making icons’) which analyzes a problem in Orthodox aesthetics closely related to the one I examine here. (shrink)

As the possibility of cloning humans emerges on the horizon people are worrying about the morality of using the new technology. They are anxious about the ethical borders that might be crossed when duplicate humans can be produced by separating the cells of a newly fertilized human egg or, in the more distant future, by creating a zygote from an existing person's genetic material. They are apprehensive about eugenics, concerned about creating humans as sources of spare parts for others, uneasy (...) about producing humans without intending to allow them to live and develop, and uncomfortable about using duplicate humans as business ventures. (shrink)

Neither Peirce’s thought in general nor his semeiotic in particular would appear to be concerned with ‘society’ as it is generally conceived today. Moreover, Peirce rarely mentions ‘society’, preferring the term ‘community’, which his readers have often interpreted restrictively.There are two essential points to be borne in mind. In the first place, the epithet ‘social’ refers here not to the object of thought, but to its production, its mode of action and its transmission and conservation. In the second place, the (...) term ‘community’ is not restricted to the scientific community, as is sometimes supposed. On the contrary, it refers to the ideal form of a society, which he calls ‘the unlimited community’, i. e. a group of people striving towards a common goal.Furthermore, Peirce’s semeiotic has been put in doubt as capable of providing a model for communication, the basis of social, dialogic, thought and action. The aim of the present article is to show that semeiotic, funded as it is on Peirce’s three categories, which define and delimit the ways in which man perceives and represents the phenomena, can provide a comprehensive model for the analysis of all types of communication in all social contexts.Finally, in this domain, as in others, Peirce was a forerunner, with the result that his thought has often been misunderstood or forgotten. In addition, he was pre-eminently a philosopher, thus his work has been neglected in other disciplines. The elaboration of other triadic systems, such as, notably, that of Rossi-Landi, shows that the tendency of semiotics in general is to move away from the former static, dyadic model towards that involving a triadic process. This trend, with which Peircean theory is in harmony, has been sharply accentuated in recent years, but often lacks a philosophical justification for its assumptions, which Peirce provides. (shrink)

Neither Peirce’s thought in general nor his semeiotic in particular would appear to be concerned with ‘society’ as it is generally conceived today. Moreover, Peirce rarely mentions ‘society’, preferring the term ‘community’, which his readers have often interpreted restrictively.There are two essential points to be borne in mind. In the first place, the epithet ‘social’ refers here not to the object of thought, but to its production, its mode of action and its transmission and conservation. In the second place, the (...) term ‘community’ is not restricted to the scientific community, as is sometimes supposed. On the contrary, it refers to the ideal form of a society, which he calls ‘the unlimited community’, i. e. a group of people striving towards a common goal.Furthermore, Peirce’s semeiotic has been put in doubt as capable of providing a model for communication, the basis of social, dialogic, thought and action. The aim of the present article is to show that semeiotic, funded as it is on Peirce’s three categories, which define and delimit the ways in which man perceives and represents the phenomena, can provide a comprehensive model for the analysis of all types of communication in all social contexts.Finally, in this domain, as in others, Peirce was a forerunner, with the result that his thought has often been misunderstood or forgotten. In addition, he was pre-eminently a philosopher, thus his work has been neglected in other disciplines. The elaboration of other triadic systems, such as, notably, that of Rossi-Landi, shows that the tendency of semiotics in general is to move away from the former static, dyadic model towards that involving a triadic process. This trend, with which Peircean theory is in harmony, has been sharply accentuated in recent years, but often lacks a philosophical justification for its assumptions, which Peirce provides. (shrink)

_ Source: _Volume 63, Issue 1, pp 1 - 24 This article examines Diogenes of Apollonia’s doctrines of intellection and soul in relation to his material principle, air. It argues that for Diogenes both intellection and soul are not, as commonly thought, some sort of air, even though both intellection and soul are to be understood in terms of air and the system of τρόποι of air that he has set up. These new interpretations of intellection and soul yield insight (...) into Diogenes’ claims about the ordering activity of air as intellection and a renewed appreciation for his material monism. (shrink)

This unfortunately titled volume offers a collection of fourteen essays and two introductions, many of which stem from a 2014 conference, Aristotle and His Predecessors on Heat, Pneuma, and Soul, which is a more honest reflection of the contents, given its exclusion of the Stoics. Of the essays, eight are devoted to Aristotle, four to Presocratic natural philosophy, one to Plato, and one to the De Spiritu. The poor titling and somewhat oddly circumscribed selection of who and what receives attention, (...) however, do not detract from the quality of the contributions themselves, which is largely excellent.One highlight is Simon Trépanier's account of soul in Empedocles, the... (shrink)

Name der Zeitschrift: Apeiron Jahrgang: 50 Heft: 4 Seiten: 483-510.

Professor Rhodes, with Professor Lewis, has collected the evidence for decrees through which the states of the ancient Greek world were governed, and uses the evidence to study the decision-making procedures and the extent to which the citizens were actively involved.

It is widely assumed that there exist certain objects which can in no way be distinguished from each other, unless by their location in space or other reference-system. Some of these are, in a broad sense, 'empirical objects', such as electrons. Their case would seem to be similar to that of certain mathematical 'objects', such as the minimum set of manifolds defining the dimensionality of an R -space. It is therefore at first sight surprising that there exists no branch of (...) mathematics, in which a third parity-relation, besides equality and inequality, is admitted; for this would seem to furnish an appropriate model for application to such instances as these. I hope, in this work, to show that such a mathematics in feasible, and could have useful applications if only in a limited field. The concept of what I here call 'indistinguishability' is not unknown in logic, albeit much neglected. It is mentioned, for example, by F. P. Ramsey [1] who criticizes Whitehead and Russell [2] for defining 'identity' in such a way as to make indistinguishables identical. But, so far as I can discover, no one has made any systematic attempt to open up the territory which lies behind these ideas. What we find, on doing so, is a body of mathematics, offering only a limited prospect of practical usefulness, but which on the theoretical side presents a strong challenge to conventional ideas. (shrink)

Volumes have been written arguing the morality of abortion. A crucial premise in many of these arguments concerns the status of the fetus; specifically, that the fetus has or does not have a right to life. Opponents of abortion typically argue that fetuses are persons and hence have an inviolable right to life. Advocates of the right to abortion typically maintain that fetuses are not persons and hence have no right to life.

In the past thirty years, face perception has become an area of major interest within psychology. The Oxford Handbook of Face Perception is the most comprehensive and commanding review of the field ever published.For anyone looking for the definitive review of this burgeoning field, this is the essential book.

This paper articulates a conception of organizational justice based on the promise of a mode of organizing that does not violate the particularity of each and every other person. It argues that the decisive condition for such a form of justice resides in the realities of the cultural practices of an organization as they are apparent in the conduct of people in relation to multiple others. These are practices that can only seek justification in the primary right of each person (...) to be regarded with absolute alterity. It also argues that a degree of violence is unavoidable within any practical ordering of justice and that any consideration of ethics and justice in organizations must account for such violence and seek to negotiate its existence on ethical terms. The organizational justice that is referred to is one sensitive to the exercise of its own power and authority in the context of its unavoidable violation of its basis in ethics. This is a justice that is ethically necessary, but is never sure of itself. (shrink)

This paper articulates a conception of organizational justice based on the promise of a mode of organizing that does not violate the particularity of each and every other person. It argues that the decisive condition for such a form of justice resides in the realities of the cultural practices of an organization as they are apparent in the conduct of people in relation to multiple others. These are practices that can only seek justification in the primary right of each person (...) to be regarded with absolute alterity. It also argues that a degree of violence is unavoidable within any practical ordering of justice and that any consideration of ethics and justice in organizations must account for such violence and seek to negotiate its existence on ethical terms. The organizational justice that is referred to is one sensitive to the exercise of its own power and authority in the context of its unavoidable violation of its basis in ethics. This is a justice that is ethically necessary, but is never sure of itself. (shrink)

This tragic case raises two important ethical issues. One is the obvious problem of just allocation of scarce transplant organs. The other is the less obvious problem of the healthcare team's feelings of commitment to their patient. Together they present an unusual conflict for bioethics.

Fecal microbiota transplantation has demonstrated efficacy and is increasingly being used in the treatment of patients with recurrent Clostridium difficile infection. Despite a lack of high-quality trials to provide more information on the long-term effects of FMT, there has been great enthusiasm about the potential for expanding its applications. However, FMT presents many serious ethical and social challenges that must be addressed as part of a successful regulatory policy response. In this article, we draw on a sample of the scientific (...) and bioethics literatures to examine clusters of ethical and social issues arising in five main areas: informed consent and the vulnerability of patients; determining what a “suitable healthy donor” is; safety and risk; commercialization and potential exploitation of vulnerable patients; and public health implications. We find that these issues are complex and worthy of careful consideration by health care professionals. Desperation of a patient should not be the basis for selecting treatment with FMT, and the patient's interests should always be of paramount concern. Authorities must prioritize development of appropriate and effective regulation of FMT to safeguard patients and donors, promote further research into safety and efficacy, and avoid abuse of the treatment. (shrink)

The human microbiome is the bacteria, viruses, and fungi that cover our skin, line our intestines, and flourish in our body cavities. Work on the human microbiome is new, but it is quickly becoming a leading area of biomedical research. What scientists are learning about humans and our microbiomes could change medical practice by introducing new treatment modalities. This new knowledge redefines us as superorganisms comprised of the human body and the collection of microbes that inhabit it and reveals how (...) much we are a part of our environment. The understanding that microbes are not only beneficial but sometimes necessary for survival recasts our interaction with microbes from adversarial to neighborly. This volume explores some of the science that makes human microbiome research possible. It then considers ethical, legal, and social concerns raised by microbiome research. Chapters explore issues related to personal identity, property rights, and privacy. The authors reflect on how human microbiome research challenges reigning views on public health and research ethics. They also address the need for thoughtful policies and procedures to guide the use of the biobanked human samples required for advancing this new domain of research. In the course of these explorations, they introduce examples from the history of biomedical science and recent legal cases that shed light on the issues and inform the policy recommendations they offer at the end of each topic's discussion.This volume is the product of an NIH Human Microbiome Project grant. It represents three years of conversations focused on consensus formation by the twenty-seven members of the interdisciplinary Microbiome Working Group. (shrink)

The need for organs to transplant is clear. Due to the lack of transplants, people suffer, they die, and the cost of taking care of them until they die is huge. There is general agreement that it would be good to increase the supply of organs in order to meet the demand for organ transplantation.

Although rapidity of fading has been long identified as one of the crucial design features of language, little is known about its effects on the design of communication systems. To investigate such effects, we performed an experiment in which pairs of participants developed novel communication systems using media that had different degrees of rapidity of fading. The results of the experiment suggest that rapidity of fading does not affect the pace with which communication systems emerge or the communicative effi cacy (...) of the emerged systems. However, rapidity of fading seems to affect the design of these systems. In particular, communication systems implemented in the more rapidly fading medium exhibited a higher degree of combinatorial reuse of their forms than systems implemented in the medium that faded more slowly. These results suggest that the design of language might be constrained by subtle relations the presence of which can be ascertained only through direct experimental manipulation. Human communication systems crafted today in the laboratory can provide new insights into the design of natural languages. (shrink)

Although rapidity of fading has been long identified as one of the crucial design features of language, little is known about its effects on the design of communication systems. To investigate such effects, we performed an experiment in which pairs of participants developed novel communication systems using media that had different degrees of rapidity of fading. The results of the experiment suggest that rapidity of fading does not affect the pace with which communication systems emerge or the communicative effi cacy (...) of the emerged systems. However, rapidity of fading seems to affect the design of these systems. In particular, communication systems implemented in the more rapidly fading medium exhibited a higher degree of combinatorial reuse of their forms than systems implemented in the medium that faded more slowly. These results suggest that the design of language might be constrained by subtle relations the presence of which can be ascertained only through direct experimental manipulation. Human communication systems crafted today in the laboratory can provide new insights into the design of natural languages. (shrink)

We whole-heartedly support Andrew Garland, Stephanie Morain, and Jeremy Sugarman’s claim that clinicians have a duty to participate in pragmatic clinical trials (Garland, Morain, and Sugarman 2023)...