Purpose Although surrogate decision-making is prevalent in intensive care units and concerns with decision quality are well documented, little is known about how clinicians help family members understand the surrogate role. We investigated whether and how clinicians provide normative guidance to families regarding how to function as a surrogate. Subjects and methods We audiorecorded and transcribed 73 ICU family conferences in which clinicians anticipated discussing goals of care for incapacitated patients at high risk of death. We developed and applied a (...) coding framework to identify normative statements by clinicians regarding what considerations should guide surrogates’ decisions, including whether clinicians explained one or more of Buchanan and Brock’s three standard principles of SDM to family members. Results Clinicians made at least one statement about how to perform the surrogate role in 24 conferences ). We observed three general types of normative guidance provided to surrogates, with some conferences containing more than one type of guidance: counselling about one or more standard principles of SDM ; counselling surrogates to make decisions centred on the patient as a person, without specifying how to accomplish that ; and counselling surrogates to make decisions based on the family’s values. Conclusions Clinicians did not provide normative guidance about the surrogate role in two-thirds of family conferences for incapacitated patients at high risk for death. When they did, clinicians’ guidance was often incomplete and sometimes conflicted with standard principles of SDM. Future work is needed to understand whether providing explicit guidance on how to perform the surrogate role improves decision-making or mitigates surrogates’ psychological distress. (shrink)

Three studies were conducted to explore the psychological determinants of COVID-deterrent behaviors. In Study 1, using data collected and analyzed both before and after the release of COVID-19 vaccines, mask-wearing, other preventative behaviors like social distancing, and vaccination intentions were positively related to assessments of the Coronavirus Behavioral Health Mindset ; belief in the credibility of science; progressive political orientation; less use of repressive and more use of sensitization coping; and the attribution of COVID-19 safety to effort rather than ability, (...) powerful forces, fate, or luck. In Study 2, favorable COVID-19 vaccination intentions were related to greater willingness to work, lower emotional distress, and greater customer experience mindset. Study 3 examined the personality and motives of individuals who volunteered to help deliver COVID-19 inoculations to the local community. The vaccine-giving volunteers, especially those with prosocial motives, had high CVBHM scores, belief in the credibility of science, low use of repressive coping, greater attribution of COVID-19 protection to effort, low likelihood of voting conservative, were older, and had more education than others. The majority of public health volunteers expressed prosocial motives to help people or join a cause, but many expressed the personal motives of getting the COVID-19 vaccination for themselves, conveying a public image of compassion, or structuring time. Based on the three research studies, a COVID-19 Mindset Hierarchy model is proposed to integrate the results. (shrink)

This understanding of dirty hands should dispell the air of paradox so often associated with it. Dirty hands is a genuine moral problem, but not a conceptual one. The temptation to see it as a conceptual one arises from a hasty acceptance of these assumptions:Moral criticism is appropriate if and only if we can always do what is right. If we cannot do X or avoid doing Y, we cannot be criticized for failing to do X or for doing Y.We (...) are always free to avoid moral compromise since goodness is a matter of having the will to do what is right.We are morally compromised if and only if we either intentionally do what is wrong, or if we do what is right for the wrong reasons.As a general description of conscientiousness, these conditions are uncontroversial. However, conscientiousness does not exhaust the moral realm. The problem with the individuals in the cases above is not that they are guilty of being unconscientious. They are conscientious and still cannot avoid dirtying themselves.The Kantian aspiration to render ourselves invulnerable to moral compromise is well-intentioned and deserves our respect insofar as it alerts us to the importance of struggling with courage and imagination against evil. But to the extent that it rejects or ignores the possibility of moral tragedy, the Kantian conception paints too optimistic and artificial a picture of the human condition. We are complicated creatures with diverse and often conflicting ethical loves. Rigging our ethical theories to eliminate such conflicts does nothing to change life as real-life moral agents experience it. As with any kind of theory, we need to be careful about unwittingly deforming the world in order to make it conform to the beloved castles we so often build in the air. (shrink)

© 2014 Taylor Francis. The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus testing of every client presenting for services in venues where HIV prevalence is high. Because older adults have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent and ever HIV testing in a probability sample of at-risk (...) adults seeking services in needle exchange sites, sexually transmitted disease clinics, and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months or ever. Aging-related disparities in HIV testing exist among clients of these high HIV prevalence venues and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis. (shrink)

It cannot be denied that a correct notion of justice is very relevant to the solution of most modern problems. The constant appeal to the rights of individuals and groups of individuals and the widespread practice of injustice bear witness to this. Yet the very frequency with which the terms justice and injustice are used has, one fears, reduced those words to mere labels for whatever claim it is desired to make or deny, without regard for the existence of an (...) objectively just order in public and private life. There is need then of a reaffirmation of the idea of justice and an application of its principles, in terms suitable to our modern modes of thought, to current problems of human relationships. (shrink)

Here is a surprisingly neglected question in contemporary epistemology: what is it for an agent to believe that p in response to a normative reason for them to believe that p? On one style of answer, believing for the normative reason that q factors into believing that p in the light of the apparent reason that q, where one can be in that kind of state even if q is false, in conjunction with further independent conditions such as q’s being (...) a normative reason to believe that p. The primary objective of this paper is to demonstrate that that style of answer cannot be right, because we must conceive of believing for a normative reason as constitutively involving a kind of rationality-involving relation that can be instantiated at all only if there is a known fact on the scene, which the agent treats as a normative reason. A secondary objective, achieved along the way, is to demonstrate that in their Prime Time Errol Lord and Kurt Sylvan do not succeed in undermining the factoring picture in general, only a simple-minded version of it. (shrink)

We can contrast rationalising explanations of the form S φs because p with those of the form S φs because S believes that p. According the Common Kind View, the two sorts of explanation are the same. The Disjunctive View denies this. This paper sets out to elucidate the sense in which the Common Kind Theorist asserts, but the Disjunctivist denies, that the two explanations are the same. I suggest that, in the light of the distinction between kinds of explanation (...) and particular explanations, the relevant sameness thesis is ambiguous, thus giving us two distinct versions of the Common Kind View. I then argue that the only direct arguments for Disjunctivism available in the literature fail because they only succeed in undermining one version of the Common Kind View. I finish, however, by providing a fresh argument for the Disjunctive View which aims to undermine both versions of its competitor. (shrink)

According to the ideological surround model of research, a more “objective” psychology of religion requires efforts to bring etic social scientific and emic religious perspectives into formal dialog. This study of 245 Iranian university students illustrated how the dialogical validity of widely used etic measures of religion can be assessed by examining an emic religious perspective on psychology. Integrative Self-Knowledge and Self-Control Scales recorded two aspects of the “Perfect Man” as described by the Iranian Muslim philosopher Mortazā Motahharī. Use of (...) these instruments in correlation and multiple regression procedures identified Intrinsic, Extrinsic Personal, Religious Interpretation, Extrovertive Mysticism, Prayer Fulfillment, Universality, Connectedness, and Religiosity Scales as adaptive in their implications for a Muslim psychology of religion. Religious Crisis had maladaptive and Extrinsic Social, Introvertive Mysticism, and Quest Scales had ambiguous implications. These data illustrated how etic forms of understanding can clarify and can be clarified by emic insights. (shrink)

The current work builds a definition of irritability from both academic definitions and lay perspectives. In Study 1, a quantitative content analysis of academic definitions resulted in eight main content categories (i.e., behaviour, emotion or affect, cognition, physiological, qualifiers, irritant, stability or endurance, and other). In Study 2, a community sample of 39 adults participated in qualitative interviews. A deductive thematic analysis resulted in two main themes. The first main theme dealt with how participants positioned irritability in relation to other (...) negative states. The second dealt with how participants constructed irritability as both a loss of control and as an experience that should be controlled. The discussion integrates the findings of both studies and provides a concise, but comprehensive definition. (shrink)

We show, using the fine structure of K, that the theory ZF + AD + X R[X K] implies the existence of an inner model of ZF + AD + DC containing a measurable cardinal above its Θ, the supremum of the ordinals which are the surjective image of R. As a corollary, we show that HODK = K for some P K where K is the Dodd-Jensen Core Model relative to P. In conclusion, we show that the theory ZF (...) + AD + ¬DCR implies that R† exists. (shrink)

Jennifer Hornsby has defended the Reasons-Knowledge Thesis : the claim that \-ing because p requires knowing that p, where the ‘because’ at issue is a rationalising ‘because’. She defends by appeal to the thought that it provides the best explanation of why the subject in a certain sort of Gettier case fails to be in a position to \ because p. Dustin Locke and, separately, Nick Hughes, present some modified barn-façade cases which seem to constitute counterexamples to and undermine Hornsby’s (...) way of motivating it by rendering their alternative Reasons-Explanation Thesis a better explanation of Hornsby’s datum. This paper defends and Hornsby’s argument for it against those objections. First, I point out that their supposedly intuitive verdict about the relevant barn-façade cases is not as intuitive as they think. Second, I point out that even if we share the intuition: we have strong reason to doubt the verdict anyway. And finally, I point out that since is independently implausible, the two problems can be tackled anyway. (shrink)

It is now standard in the literature on reasons and rationality to distinguish normative reasons from motivating reasons. Two issues have dominated philosophical theorising concerning the latter: (i) whether we should think of them as certain (non-factive) psychological states of the agent – the dispute over Psychologism; and (ii) whether we should say that the agent can Φ for the reason that p only if p – the dispute over Factivism. This paper first introduces a puzzle: these disputes look very (...) much like merely verbal disputes about the meaning of phrases like `S’s reason’ in motivating reasons ascriptions, and yet charity requires us to think that something substantive is afoot. But what? The second aim of the paper is to extract substantive theses from certain natural arguments for Psychologism and Anti-Factivism – theses which are versions of a controversial view of the nature and normative structure of rationality. The paper ends by arguing against these substantive theses on phenomenological and ethical grounds. The upshot is that proponents of Psychologism and Anti-Factivism are either engaged in the project of defending merely verbal theses or they’re engaged in the project of defending false substantive ones. (shrink)

The primary focus of Susanne Mantel’s excellent 'Determined by Reasons' is to develop a distinctive abilities-based account of acting in response to normative reasons, one which is clearly modelled on extant ability-theoretic accounts of knowledge. This review sketches Mantel’s account and raises a worry: that the account fails to characterise the sort of abilities constitutively involved in responding to reasons because it allows that agents can act for the reason that p even if their belief that p is not accessible (...) to conscious reasoning. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 353 proportionalism that Finnis's theological argument exploits. In this regard, there is no moral theory, good or bad, which overreaches so far as proportionalism does. Princeton University Princeton, New Jersey ROBERT P. GEORGE Faithful Persuasion: In Aid of a Rhetoric of Christian Theology. By DAVID S. CUNNINGHAM. Notre Dame: University of Notre Dame Press, 1991. Pp. xvii + 312. $29.95 (cloth) ; $16.95 (paper). The relation (...) between words and the Word has always been of in· terest in Christian theology. Earlier in this century a school of writers approached " the Bible as literature " with a view to bringing Scripture into a more persuasive relation with literature at large, but their insistence on the rigorous exclusion of dogmatic elements from literary scrutiny impoverished their work. A later set of procedures and perspectives on rhetoric and language in their relation to reality was bet· ter able to allow the utterances of a text's speakers their own integrity, whether sacred or secular. In any case, a thematic interpretation of the founding texts of Christianity, influenced by Aristotle's Rhetoricwhere form is a means for persuasively communicating an idea-content -had long predominated in ecclesial usage, germane as it was to the didactic concerns of the Church. An alternative tradition, more indebted to Aristotle's Poetics, where form, content, and functions are treated as factors making for the indissoluble whole which is the literary work, has been less conspicuous-though its offer of initiation into the " world " of the sacred writers gives it great exegetical potential. The text's "word " should be encountered at the level of its own patterned imagery and wrought design. In the appreciation of the Gospels this has become in recent decades a commonplace. However, as the T. S. Eliot scholar Helen Gardner warned, one should not so react against the older approach as to treat the biblical text as the product of a disembodied imagination, rather than a human being writing a work that might make his readers "wise unto salvation." David S. Cunningham's Faithful Persuasion extends this discussion of the propriety or impropriety of a rhetorical approach to Scripture to the discourse of Christian theology as a whole. The intent is a laudable one but its execution vitiated, to my mind, by the excessive concessions to scepticism from which the author sets out. Because his theological epistemology, aware of the limitations of the propositions in which we assert the truths of faith, will grant those assertions no more than a 354 BOOK REVIEWS (continuously) revisable character, he falls back on an account of theology as rhetoric so as to make the best of a bad job. For persuasion is what we use when we know demonstration is hopeless. As a result, Professor Cunningham's study, which could most usefully have "placed" a variety of theologies of past, present, and, prospectively, future on the spectrum of (onto-) logic, poetic, and rhetoric, concludes instead that theology must regard itself as rhetorical or perish! This inevitably narrows the several services theologies of different kinds can perform for the Church. Imagine how biblical studies would be reduced were the exegete only to treat his text as paraenesis, and never as history or as a symbolic world. Nonetheless, on the way from its (as I find) unsatisfactory startingpoint and to its depressing conclusion, Faithful Persuasion has worthwhile points to make about a number of authors (of various periods) and topics, though it might have made them more persuasively (its author's key term) had the intended audience (middle-brow or academic?) been more clearly viewed in advance. AIDAN NICHOLS, O.P. Blackfriars Cambridge, England Church and Culture: German Catholic Theology, 1860-1914. By THOMAS FRANKLIN O'MEARA, O.P. Notre Dame/London: University of Notre Dame Press, 1991. Pp. x + 260. $35.95 (cloth). " In 1925, Baden's Kultusminister, a Protestant, began an address to the Gorresgesellschaft in Heidelberg by describing this era: ' Brave men like Hertling, Schell, Julius Bachem, and Carl Muth, shook the German Catholic world in order to lead it out of its fortress, to lead it again into the midst of the life and activity of the entire people, even when this seemed at... (shrink)

In 1998, Clark and Chalmers articulated and defended the extended mind hypothesis. They argued, against the backdrop of functionalism about the mind, and for the specific case of the mental state type belief, that it is possible for a person's mind to extend out-side the boundary of their body. Departing from the framework of Indo-analytic comparative philosophy, we show that the Advaita Vedanta School of classical Indian philosophy, against the backdrop of a specific form of panpsychism, defended an account on (...) which a person's conscious experience, during an act of perceptual knowledge, is located outside the boundary of their body. Using the work of Adams and Maher on how to respond to Adams and Aizawa's coupling-constitution fallacy, we argue that the Advaita Vedanta account of mind can be taken to generate what we call the mind extension hypothesis -- the view that consciousness can extend outside of the body in perception. Recognizing the problematic nature of panpsychism as a metaphysical view about consciousness, we close by following work by Itay Shani on the real combination problem. We argue that the Advaita Vedanta account of panpsychism, as a kind of cosmopsychism, allows for a response to the so-called real combination problem proposed by Coleman. (shrink)

We apply an online optimization process based on machine learning to the production of Bose-Einstein condensates. BEC is typically created with an exponential evaporation ramp that is optimal for ergodic dynamics with two-body s-wave interactions and no other loss rates, but likely sub-optimal for real experiments. Through repeated machine-controlled scientific experimentation and observations our ’learner’ discovers an optimal evaporation ramp for BEC production. In contrast to previous work, our learner uses a Gaussian process to develop a statistical model of the (...) relationship between the parameters it controls and the quality of the BEC produced. We demonstrate that the Gaussian process machine learner is able to discover a ramp that produces high quality BECs in 10 times fewer iterations than a previously used online optimization technique. Furthermore, we show the internal model developed can be used to determine which parameters are essential in BEC creation and which are unimportant, providing insight into the optimization process of the system. (shrink)

A project of the Gandhi Centennial Committee of Southern Illinois University, the book outlines the basic tenets of Gandhian philosophy as interpreted by Western thinkers, deals with problems of American education, and offers some reflec­tions on what kinds of solutions may be posed by educators, primarily at the university level. The Foreword and Epilogue are by two distinguished Indian educators, _K. L. Shrimali_, Vice-chancellor, and _N. A. Nikam_, former Vice-chancellor, University of Mysore.

Textes de philosophes français et britanniques issus du colloque tenu à l'Université de Nantes en 1998. Ils sont consacrés à la philosophie analytique de la religion et abordent des sujets tels que la nature et la justification des croyances religieuses, la question du mal, celles des preuves de l'existence de Dieu, de la théodicée, du langage religieux, du miracle, de la prière, etc.

Compromise as a notion is frequently met in discussion and debate regarding many everyday decisions, including health care. It therefore seems that it may be of interest and value to try to give this some careful consideration. In the following pages, an attempt is made to discuss what one might mean when one uses this concept. Consideration is then given to some possible uses of compromise in health care. Having suggested that in certain situations compromise is a morally valuable process, (...) the author also considers some of the possible limits of compromise. (shrink)

В работе рассматриваются некоторые актуальные аспекты творчества великих философов, писателей и поэтов - тех мыслителей, которые наиболее убедительно продемонстрировали генетическую связь философии и литературы.

Evolutionary developmental biology (evo-devo) has undergone dramatic transformations since its emergence as a distinct discipline. This paper aims to highlight the scope, power, and future promise of evo-devo to transform and unify diverse aspects of biology. We articulate key questions at the core of eleven biological disciplines—from Evolution, Development, Paleontology, and Neurobiology to Cellular and Molecular Biology, Quantitative Genetics, Human Diseases, Ecology, Agriculture and Science Education, and lastly, Evolutionary Developmental Biology itself—and discuss why evo-devo is uniquely situated to substantially improve (...) our ability to find meaningful answers to these fundamental questions. We posit that the tools, concepts, and ways of thinking developed by evo-devo have profound potential to advance, integrate, and unify biological sciences as well as inform policy decisions and illuminate science education. We look to the next generation of evolutionary developmental biologists to help shape this process as we confront the scientific challenges of the 21st century. (shrink)

In recent years a large component of my reading has involved difficult texts on theological method, epistemology, and neuro-psychology. What I present in this article in significant respects is a simplified conflation of this reading that contributes some original elements in a paradigmatic approach to 'doing theology'. For this reason, I generally do not engage in specific citations within my text, and instead include at the end of the article some remarks on some of my reading. My main purpose is (...) to use a manner of speaking or writing - using extended metaphors - to make it more accessible to readers who want to 'do theology' in their own lives and in their ministries, rather than grapple with more formal presentations of what is treated. (shrink)

We used computer simulations to study the possible role of the dispersion of cellular coupling, refractoriness or both, in the mechanisms underlying cardiac arrhythmias. Local ischemia was first assumed to induce cell to cell dispersion of the coupling resistance (Case 1), refractory period (Case 2), or both of them (Case 3). Our numerical experiments based on the van Capelle and Durrer model showed that vortices could not be induced by cell to cell variations. With cellular properties dispersed in a patchy (...) way within the ischemic zone, a single activation wave could give rise to abnormal activities. This demonstrates the stability of the wave front under small inhomogeneities. Probabilities of reentry, estimated for the three cases cited above showed that a severe alteration of the coupling resistance may be an important factor in the genesis of reentry. Moreover, use of isochronal maps revealed that vortices were both stable and sustained with an alteration of the coupling alone or combined with a reduction of the action potential duration. Conversely, simulations with reduction of the refractoriness alone, inducing only transient patterns, could exhibit functionally determined reentries. (shrink)

In this paper, the empirical performance of several preference functionals is assessed using individual and group experimental data. We investigate if there is a risky choice theory that fits group decisions better than alternative theories, and if there are significant differences between individual and group choices. Experimental findings reported in this paper provide answers to both of those questions showing that expected utility gains a “winning” position over higher-level functionals when risky choices are undertaken by individuals as well as by (...) small groups. However, in the group experiment, alternatives improve their relative performance, a fact that hints at the existence of differences between individual and group choices. We interpreted this result as evidence that feelings-like disappointment aversion become stronger in group decision. (shrink)

Positive public perceptions of academic quality and professional ethics are critical to the long-term legitimacy of American colleges and universities. Faculty codes of conduct are one mechanism whereby the professoriate can define acceptable practice, exercise social control, and maintain public confidence in higher education, yet the drivers of their adoption are not well understood. Building upon previous research into such organizational behavior by institutional type, this study examined the prevalence and content of publicly posted faculty codes of conduct within an (...) organizational field of institutions that share a common religious identity but differ in their institutional types and employment structures. Faculty handbooks from American member institutions of the Council for Christian Colleges & Universities, an international association of faith-based institutions, were gathered and analyzed. Although only 27% of CCCU member institutions in the U.S. publicly posted faculty codes of conduct, the average number of tenets present in each code was higher than suggested by previous research. Study findings also revealed that membership category, institutional type, and employment structures influence the content of faculty codes of conduct, indicating that isomorphic pressures operate within this particular organizational field. The piece concludes by commending publicly posted codes of conduct as an affirmation of the personal responsibility, fairness, and care exercised by ethical professionals in the academy. (shrink)

The criminal law presently distinguishes between actions and omissions, and only rarely proscribes failures to avert consequences that it would be an offense to bring about. Why? In recent years it has been persuasively argued by both Glover and Bennett that, celeris paribus, omissions to prevent a harm are just as culpable as are actions which bring that harm about. On the other hand, and acknowledging that hitherto “lawyers have not been very successful in finding a rationale for it,” Tony (...) Honoré has sought to defend the law's differential treatment. He proposes a “distinct-duties theory” that in addition to the general duties we owe to everyone, we also owe distinct duties to a more limited collection of people and associations, specified by features of our relationship with them. Where a distinct duty holds, breach by omission may well be no better than breach by positive action. But absent a distinct duty, omissions, per Honoré, are less culpable. They are mere failures to intervene and improve or rectify things, whereas actions are positive interventions which make things worse. And, thus, the law has good reason to differentiate between them. (shrink)