We read Marshall et al.’s paper with great interest but were left with many questions and concerns (Marshall et al., in press). As a group of public health researchers and practitioners (nursing, s...

Communication and cultivation accounts of responsibility argue that blaming has an important communicative and agency-cultivating function when addressed at someone we consider to be deserving of blame. On these accounts, responsible agents are agents who can understand negative reactive attitudes and are sensitive to their moral-agency cultivating function. In this paper I examine our reproachful engagements with agents whose moral agency is underdeveloped or compromised. I discuss how these engagements compare to blaming on CC accounts and argue reproachful engagements can (...) have an important communicative and agency-cultivating pointe. I then go on to propose an addition to CC-accounts that explains how underdeveloped and compromised agents can be held responsible. I will show how this addition resolves ambiguities in accounts from McKenna, Vargas and McGeer. I conclude the paper by anticipating an objection CC accounts could raise: that reproach and blame are co-extensive. (shrink)

Stoffregen & Bardy's primary motivation for rejecting current views on specification in favor of the global array is that current forms of specification in single-energy arrays allow the ambiguous or inadequate specification of reality. I show that this motivation is not justified, and that the global array concept still falls prey to inadequate specification.

We have studied ethical considerations of care among health professionals when treating and setting priorities for elderly patients in Norway. The views of medical doctors and nurses were analysed using qualitative methods. We conducted 21 in depth interviews and 3 focus group interviews in hospitals and general practices. Both doctors and nurses said they treated elderly patients different from younger patients, and often they were given lower priorities. Too little or too much treatment, in the sense of too many interventions (...) and too much drugs, combined with too little care and comfort, was admitted as a relatively frequent yet unwanted consequence of the way clinical priorities were set for elderly patients. This was explained in terms of elderly patients not tolerating the same treatment as younger patients, and questions were raised about the quality of life of many elderly patients after treatment. These explanations were frequently referred to as medically sound decision making. Other explanations had little to do with medically sound decisions. These often included deep frustration with executive guidelines and budget constraints. (shrink)

Adequate and inadequate ideas play a central role in Spinoza’s system. A number of recent commentators have suggested that the internality or externality of an idea’s immediate cause is a necessary and sufficient condition of the idea’s adequacy or inadequacy, respectively. I show that this thesis is subject to counterexample and briefly explore the significance of this critique for recent interpretations. I offer an alternative interpretation on which adequate and inadequate ideas are characterized by the manner in which (...) they grasp their objects. Adequate ideas conceive of their objects as following from God. Inadequate ideas conceive of their objects as affecting the body at a time and place. (shrink)

There is widespread agreement among philosophers and legal scholars that the distribution of educational resources in the US is unjust, but little agreement about why. An increasingly prominent view posits a sufficientarian standard based on the requirements of democratic citizenship. This view, which I refer to as democratic sufficientarianism, argues that inequalities in educational resources or opportunities above the threshold required for democratic citizenship are morally unobjectionable if and only if all children are provided with an education sufficient to meet (...) those demands. In the article, I argue that democratic sufficientarianism faces a democratic education dilemma. Either the philosopher specifies a precise and demanding threshold with antidemocratic implications, or she insists upon democratic equality irrespective of educational achievements, thereby undercutting the search for anything but a minimal educational threshold. As an alternative, I defend a new sufficientarian standard that is reflexive, education-specific, and democracy-compatible. This reflexive sufficientarian standard can act as a guide to democratic deliberation about education policy. The article also sketches possibilities for litigation on behalf of children who have received insufficient primary education. (shrink)

According to situationism in psychology, behavior is primarily influenced by external situational factors rather than internal traits or motivations such as virtues. Environmental ethicists wish to promote pro-environmental behaviors capable of providing adequate protection for the environment, but situationist critiques suggest that character traits, and environmental virtues, are not as behaviorally robust as is typically supposed. Their views present a dilemma. Because ethicists cannot rely on virtues to produce pro-environmental behaviors, the only real way of salvaging environmental virtue theory is (...) to reject or at least minimize the requirement that environmental ethics must provide protection and assistance to the environment. Virtue theory is often favored by environmentalists precisely because it does matter what one's reasons are for acting, even if one's actions are ineffective at producing positive results. However, because endorsing behaviorally ineffective virtues, for whatever reason, entails that environmental ethicists are abandoning the goal of helping and protecting the environment, environmental ethicists should consider looking elsewhere than virtues and focus instead on the role of situations. (shrink)

Name der Zeitschrift: Millennium Jahrgang: 11 Heft: 1 Seiten: 69-100.

One key difference between perceptual experience and thought is the distinctly sensory way perception presents things to us. Some philosophers nevertheless suggest this sensory phenomenal character does not exhaust the way things are made manifest to us in perceptual experience. Edmund Husserl maintains that there is also a significant non‐sensory side to perception's phenomenal character. We may experience, for instance, an object's facing surface in a sensory mode and, as part of the same perceptual experience, also that object's out‐of‐view surface (...) in a non‐sensory mode. To the extent that perceptual experience makes things available to us in a non‐sensory mode, Husserl calls it inadequate. Here, I reconstruct four arguments for the conclusion that perceptual experience is inadequately found in various of Husserl's writings and critically evaluated them. My aim is both to showcase the variety and sophistication of Husserl's reasons for thinking perceptual experience is inadequate and to problematize that idea. (shrink)

In the context of calls to decolonise education in European contexts, this paper draws on coloniality-based critiques of Eurocentric modernity to take up the links between democracy, slavery, and colonialism in education. Starting from the position that modernity requires epistemological support to sustain racism and white supremacy in European democracies, we read coloniality-based critiques of democracy with empirical literature about the teaching of slavery. We consider possibilities for revised critical engagements with democracy and with the history of European colonialism and (...) slavery. The paper builds on and contributes to recent decolonial critiques of democracy in education by explicitly engaging a tension raised around the possibility of disentangling democracy from its colonial roots. (shrink)

Developmentally, adolescence sits in transition between childhood and adulthood. Involving adolescents in their medical decision-making prompts important and complex ethical questions. Originating in the UK, the concept of Gillick competence is a dominant framework for navigating adolescent medical decision-making from legal, ethical and clinical perspectives and is commonly treated as comprehensive. In this paper, we argue that its utility is far more limited, and hence over-reliance on Gillick risks undermining rather than promoting ethically appropriate adolescent involvement. We demonstrate that Gillick (...) only provides guidance in the limited range of cases where legal decisional authority needs to be clarified. The range of cases where use of Gillick actually promotes adolescent involvement is narrower still, because several features must be present for Gillick to be enacted. Each of these features can, and do, act as barriers to adolescent involvement. Within these limited situations, we argue that Gillick is not specific or strong enough and is reliant on ethically contestable principles. Moreover, in most situations in adolescent healthcare, Gillick is silent on the ethical questions around involving adolescents. This is because it focuses on decisional authority—having the final say in decision-making—which is one small subset of the many ways adolescents could be involved in decision-making. The implication of our analysis is that use of Gillick competence tends to limit or undermine adolescent involvement opportunities. We propose that those working with adolescents should be judicious in seeking Gillick’s guidance, instead drawing on and developing alternative frameworks that provide a comprehensive model for adolescent involvement. (shrink)

It has been claimed that ceteris paribus laws, rather than strict laws are the proper aim of the special sciences. This is so because the causal regularities found in these domains are exception-ridden, being contingent on the presence of the appropriate conditions and the absence of interfering factors. I argue that the ceteris paribus strategy obscures rather than illuminates the important similarities and differences between representations of causal regularities in the exact and inexact sciences. In particular, a detailed account of (...) the types and degrees of contingency found in the domain of biology permits a more adequate understanding of the relations among the sciences. (shrink)

Spinoza shared with his contemporaries the conviction that the passions are, on the whole, unruly and destructive. A life of virtue requires that the passions be controlled, if not entirely vanquished, and the preferred means of imposing this control over the passions is via the power of reason. But there was little agreement in the seventeenth century about just what gives reason its strength and how its power can be brought to bear upon the wayward passions.

The importance of philosophy in understanding madness is promoted, and the importance of the patient’s existential philosophical stance in creating and overcoming the psychotic experience is particularly emphasised. In contrast to the factographic approaches characteristic of the empirical knowledge of the relevant special sciences, the spiritual meta-instance of selfovercoming is clarified by developing the thesis of the irreducibility and irreplaceability of human self-consciousness in both the deterioration and improvement of mental health. The meaning of the right attitude towards transcendence is (...) explained, which implies the awareness of the limited knowledge of absolute reality, but not the loss of hope in its sanative manifestations. The main criteria for inadequate self-awareness of madness are the lack of a harmonised autobiographical narrative and incompatibility with the transcendent and universal order of values. (shrink)

European Journal of Philosophy, Volume 30, Issue 2, Page 755-777, June 2022.

Disclosure is a common response to conflicts of interest; it is intended to expose the conflict to scrutiny and enable it to be appropriately managed. For disclosure to be effective the receiver of the disclosure needs to be able to use the information to assess how the conflict may impact on their interests and then implement a suitable response. The act of disclosure also creates an expectation of self-regulation, as the person with the conflicting interests will be mindful of their (...) own potential biases and aware that their decisions may be monitored. This article discusses some of the problems of relying on disclosure as a solution to address conflicts of interest in research, including the added complexities around institutional conflicts of interest. The case of Dan Markingson illustrates these issues and highlights the vulnerable position relying on disclosure as a solution leaves research participants in. (shrink)

This paper is aimed at a critical assessment of the moral framework of the current Chinese health system from a Confucian perspective, by focusing on the debate between the individual directed approach and the family-oriented approach to a health care system. Concerned with the nature and status of the family in communal life, the paper deals with the following questions: to cope with the frailties of material life (including susceptibility to disease), what good is presupposed by human existence and flourishing; (...) why it is the family that serves as the primary locus of bearing and realizing this unique good; and what kind of society might possess the structures necessary to achieve the good thus conceived. All these questions lead to a revision of the theory of justice required in health care, in favor of family health saving accounts as an important institutional guarantee. (shrink)

In this essay, we explore consequences of the systemic failure to track and to publicize the prevalence of patient‐safety threats in American medicine. Tens of millions of Americans lose trust in medical care every year due to safety shortfalls. Because this loss of trust is long‐lasting, the corrosive effects build up over time, yielding a collective maelstrom of mistrust among the American public. Yet no one seems to notice that patient safety is a root cause, because no one is counting. (...) In addition to identifying the origins of this purblindness, we offer an alternative policy approach. This would call for government to transparently track safety threats through the systematic collection and reporting of patients’ experiences. This alternative strategy offers real promise for stemming the erosion of trust that currently accompanies patient‐safety shortfalls while staying consistent with Americans’ preferences for a constrained government role with respect to medical care. (shrink)

This article is currently available as a free download on ingentaconnect.

I discuss a proposal by Jim Higginbotham for distinguishing mastery of a concept and knowing a conception.

L'article cherche ä demontrer que le relativisme ne constitue pas une base viable pour les reflexions sur les relations interculturelles. Contrairement ä ce que beaucoup d'intellectuels croient actuellement, le relativisme ne s'avere pas plus difficile ä defaire qu'une pensee recherchant une assise universelle pour penser les relations entre cultures. Trois points de vue importants sont abordes pour etayer la these de l'article. II y a d'abord le concept de matrice interculturelle developpee par le sociologue quebecois Jean-Jacques Simard. Selon cet auteur, (...) les valeurs de la modernite, comme la liberte et l'egalite des personnes, sont des valeurs universelles et non propres ä la culture occidentals La modernite est en effet une matrice culturelle qui ne se cantonne pas ä une culture particuliere. Ensuite, une analyse du relativisme present chez Levi-Strauss est faite afm de montrer l'incoherence de cette approche. Pour terminer, on aborde quelques points interessants sur le relativisme apportes par Raymond Boudon, dont le concept d'axiologie est rationaliste et non consequentialiste, et qui affaiblissent le relativisme des valeurs. (shrink)

In November 2018 the American Society for Bioethics and Humanities (ASBH) administered the first Healthcare Ethics Consultant Certification examination to 138 candidates, 136 of whom (98.5 percent) passed and were “certified” as “healthcare ethics consultants.” I believe this certification process is both premature and inadequate.Certification for ethics consultants is premature because, as Kornfeld and Prager state repeatedly in their article in this issue of The Journal of Clinical Ethics, “The Clinician as Clinical Ethics Consultant: An Empirical Method of Study,” (...) there is a lack of “empirical data on the nature of the problems that prompt ethics consultation requests and on the functions required to address them.” These authors proceed to provide a model for the kind of empirical data collection that is needed.Even more relevant, the ASBH model that certifies clinical ethics consultants is inadequate. First, it is inappropriate for a nonclinical organization such as the ASBH to claim the right to certify a clinical process, ethics consultation, involving patients and health professionals. Second, the current certification process requires only a written examination in contrast to the two-step quality attestation process proposed in 2013 by Eric Kodish, MD, and 11 other senior members of the ASBH, including its then president.Third and most importantly, the eligibility criteria for being certified to work on hospital units and to make clinical recommendations for patients and families are minimal and insufficient. The only stated requirements are a bachelor’s degree and 400 hours of healthcare ethics consulting experience. By contrast, practicing physicians and nurses train for many years to gain clinical experience that enables them to apply clinical ethical standards in the care and management of all inpatients and outpatients, not just the small percent for whom an ethics consultation is requested. (shrink)

Kuhn made two attempts at providing an evolutionary analogy for scientific change. The first attempt, in The Structure of Scientific Revolutions , is very brief and unstructured; in this article I discuss some of its weaknesses. Alexander Bird takes this attempt more seriously and provides a criticism based on oversimplified evolutionary assumptions. These assumptions prove to be inadequate for the second, more articulate, evolutionary analogy suggested by Kuhn in “The Road since Structure.” I argue, however, that this second Kuhnian (...) attempt is undermined by his inadequate view of biological progress and by his misunderstanding of the concept of ecological niche. *Received April 2008. †To contact the author, please write to: School of Politics, International Studies, and Philosophy, Queen’s University Belfast, 21 University Square, Belfast, BT7 1PA Northern Ireland; e‐mail: [email protected]. (shrink)

Counterpart theorists need not posit the counterpart relation in addition to the identity relations as an Additional relation relating objects across possible worlds. Identity can be viewed as a relation applicable to individuals within possible worlds, while the counterpart relation replaces identity in translations of ordinary utterances which correlate individuals in different possible worlds and, hence, in all modal utterances. CT is, in other words, a theory of modal discourse — it proposes a way of understanding all modal predications. As (...) such, it is not to be seen as providing a second ‘looser’ sense of identity across worlds, in addition to the ‘narrow’ sense. Perhaps Lewis' original formulation encourages this misunderstanding insofar as it (see, especially, P2) denies strict identity across possible worlds. Accordingly, I have suggested a modification of CT whereby syntactic restrictions upon variables eliminates any temptation to posit two parallel relations applicable to entities existing in different possible worlds. (shrink)

Roughly, the Central Dogma of molecular biology states that DNA codes for protein, not the other way around. This principle, which is still heralded as an important element of contemporary biological theory, has received much critical attention since its original formulation by Francis Crick in 1958. Some have argued that the principle should be rejected, on the grounds that it fails to fully capture the ins-and-outs of protein synthesis, while others have argued that the Dogma is predicated on notions of (...) information that are simply implausible. Yet, despite all this criticism, there is much about the Dogma that has not been said. Existing discussions, for example, gloss over the many distinct, logically independent readings of the Central Dogma that have been defended in the philosophical and biological literature, making it difficult to see which dogma is being criticized. Additionally, this oversight makes it unclear what the overall upshot of these discussions should be taken to be. My aim in this paper is to fix this. (shrink)