The main thesis of this excellent little book is that "contrary to widespread misapprehensions, two formally different kinds of utilitarianism, simple and general, and along with the latter one kind of rule-utilitarianism, are extensionally equivalent; that is, analogous principles of the various kinds necessarily yield equivalent judgments in all cases; or, in other words, it makes no difference in theory whether the simple or generalization test is applied to acts or—within limits—whether an appeal is made to rules grounded in utility." (...) The "misapprehension" is dispelled in the particularly valuable third chapter, "Extensional Equivalence," by means of an a priori causal analysis of action situations and an exacting consideration of action descriptions. Furthermore, Lyons argues that other rule-utilitarian theories not extensionally equivalent to the simple utilitarianism of tradition differ from it in the wrong ways. As a result of these two findings the author holds that "any appeal to generalization or to rules consequently fails to escape the force of traditional arguments against utilitarianism." Utilitarian readers who accept Lyons' argument and particularly his interspersed but incisive criticisms of the works of Broad, Harrison, Singer, Harrod, Brandt, and Rawls, are likely to feel that it is best to go back to Mill! But in his final chapter Lyons' analysis of promising and fairness throws doubt on the adequacy of any purely utilitarian moral theory. However this may be, to read Lyons' book is to follow a precise and rigorous intellect, free of current dogmas about value statements, while it threads its way through a maze of conceptual complexities toward substantive philosophic conclusions.—R. B. C. (shrink)

This study explored drug users’ attitudes toward and understanding of randomized controlled trials testing addiction therapies. A video portraying a fictional consent conference for a randomized controlled trial with placebo arm was shown to poor male and female drug users of diverse ethnic status and sexual orientation. The video stimulated focus group discussion in which participants’ comments often reflected “experimental realism”—a realistic view of the trial—and adequate understanding of the uncertain efficacy of the treatment being tested, as well as the (...) concepts of randomization and placebo control. However, participants’ comprehension of the nature of placebos was compromised by the widespread view that placebos are a way of testing a subject’s willpower and personal control over his or her addiction. Comments also showed a mistrust of the video investigator’s integrity and competence and signs of therapeutic misconception and misestimation. The study’s findings underscore the importance of tailoring informed consent encounters to the personal and sociohistorical context of participants’ lived experiences. (shrink)

This manual presents a carefully researched, detailed psychodynamic treatment program for the alleviation of a transdiagnostic range of primary Axis I anxiety disorders, including panic disorder, generalized anxiety disorder, social anxiety disorder, post-traumatic stress disorder, and related psychological problems. First exploring the principles of psychodynamic theory and formulation, the authors then present a three-phased process of Panic Focused Psychodynamic Psychotherapy-Extended Range : initial evaluation, interpretation of central conflicts and defense mechanisms, and termination. Each phase is discussed in depth and relies (...) on central case illustrations to demonstrate techniques and results. A subsequent chapter explores how to address complex issues that may arise during the course of treatment. Altogether, this manual not only provides a demonstrated, adaptable approach for anxiety disorders, but also clearly embodies a spirit of research and empiricism heretofore rare in psychodynamic psychotherapies, with an eye toward future development. (shrink)

In dealing with an objection to the view of abortion presented in Chapter 6, we have already looked beyond abortion to infanticide. In so doing we will have confirmed the suspicion of supporters of the sanctity of human life that once abortion is accepted, euthanasia lurks around the next comer - and for them, euthanasia is an unequivocal evil. It has, they point out, been rejected by doctors since the fifth century B.C., when physicians first took the Oath of Hippocrates (...) and swore 'to give no deadly medicine to anyone if asked, nor suggest any such counsel'. Moreover, they argue, the Nazi extermination programme is a recent and terrible example of what can happen once we give the state the power to MI innocent human beings. (shrink)

OBJECTIVE: To describe the issues faced, and how they were addressed, by the University of Toronto Critical Care Medicine Program/Joint Centre for Bioethics Task Force on Appropriate Use of Life-Sustaining Treatment. The clinical problem addressed by the Task Force was dealing with requests by patients or substitute decision makers for life-sustaining treatment that their healthcare providers believe is inappropriate. DESIGN: Case study. SETTING: The University of Toronto Joint Centre for Bioethics/Critical Care Medicine Program Task Force on Appropriate Use of Life-Sustaining (...) Treatment. PARTICIPANTS: The 24-member Task Force included physician and nursing leaders from five critical care units, bioethicists, a legal scholar, a health administration expert, a social worker, and a hospital public relations professional. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Our specific lessons learned include a) a policy focus on process; b) use of a negotiation and mediation model, rather than a hospital ethics committee model, for this process; and c) the policy development process is itself a negotiation, so we recommend equal involvement of interested groups including patients, families, and the public. CONCLUSIONS: This article describes the key issues faced by the Task Force while developing its policy. It will provide a useful starting point for other groups developing policy on appropriate use of life-sustaining treatment. (shrink)

This volume brings together 14 classic papers by interpersonal pioneers. Collectively, these papers not only demonstrate the coherence and explanatory richness of interpersonal psychoanalysis; they anticipate the emphasis on relational patterns and analyst-analysand interaction that typifies much recent theorizing. Each paper receives a substantial introduction from a leading contemporary interpersonalist. The pioneers of interpersonal psychoanalysis are: H. Sullivan, F. Fromm-Reichmann, J. Rioch, C. Thompson, R. Crowley, E. Schachtel, E. Tauber, E. Fromm, H. Bone, E. Singer, D. Schecter, J. Barnett, (...) S. Arieti, and J.Schimel. (shrink)

B C Hurst; Means, Ends, Content and Objectives in Curriculum Planning: a critique of Sockett and Hirst, Journal of Philosophy of Education, Volume 18, Issue 1.

B C Hurst; Cooper on Equality and Excellence in Education, Journal of Philosophy of Education, Volume 15, Issue 1, 30 May 2006, Pages 119–124, https://doi.org/1.

The United Nations Convention on the Rights of the Child risks harm to adolescents insofar as it encourages not only poor decision making by adolescents but also parenting styles that will have an adverse impact on the development of mature decision-making capacities in them. The empirical psychological and neurophysiological data weigh against augmenting and expression of the rights of children. Indeed, the data suggest grounds for expanding parental authority, not limiting its scope. At the very least, any adequate appreciation of (...) the moral claims regarding the authority of parents with respect to the decision-making capacity of adolescents needs to be set within an understanding of the psychological and neurophysiological facts regarding the development of adolescent decision-making capacity. (shrink)

I give the label “ethical pluralism” to the meta-ethical view that competing moral views are valid. I assume that validity is conferred on a moral view by its satisfying the relevant meta-ethical criteria in a maximally satisfactory way. If the relevant meta-ethical criteria are based on something roughly like the wide reflective equilibrium model, then ethical pluralism is likely to be correct. Traditional moral views do not grant exemptions from their own binding rules or principles to agents – should any (...) exist – who adhere to a competing valid moral view. Given the usual conception of accepting a moral view, an ethical pluralist cannot honestly accept a traditional moral view. Consequently, I argue, an ethical pluralist is committed to the view that all traditional moral views are invalid. Given the likelihood of ethical pluralism, this conclusion is alarming. I set forth a weak conception of accepting a moral view that is designed to allow an ethical pluralist honestly to accept a traditional moral view. In particular, my conception is designed to explain how someone can (a) be guided by the view that she accepts; (b) accept her own moral view while rationally not accepting competing views that she thinks are equally valid; and (c) not be prepared to prescribe morally to those who are following other valid views. Central to my formulation are what I call a stance of modest respectful disapproval toward other people’s wrong behavior, together with acceptance of decisive moral reasons for oneself that are generated by the valid moral view that one accepts. (shrink)

Bradford C Bemiss, Chad A WittDepartment of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO, USA: Chronic rejection is a major cause of death after the first year following lung transplantation. Bronchiolitis obliterans is the most common pathologic finding on biopsy, characterized by fibrous granulation tissue, which obliterates the lumen of the bronchiole. Clinically, in the absence of tissue for pathology, BO syndrome refers to a progressive irreversible drop in the forced (...) expiratory volume in 1 second. Recently, a broader definition of chronic rejection, termed "chronic lung allograft dysfunction", has been used to encompass a more inclusive definition of posttransplant dysfunction. Recently, the lung transplant community has come to realize that chronic rejection may be the final common result after repetitive epithelial insults. Acute rejection, infection, and alloreactivity to mismatched HLA antigens are a few of these insults that damage the surface of the bronchioles. Recent evidence of autoimmunity to the normally hidden structural proteins collagen V and K-α1 tubulin have been correlated with a BO phenotype as well, perhaps correlating the epithelial damage with a mechanism for developing BO lesions. Many immunomodulatory medications and treatments have been studied for effectiveness for the treatment of chronic lung allograft dysfunction. New drugs, which more precisely target the immune system, are being developed and tested. Further study is required, but recent advances have improved our understanding of the pathogenesis and potential intervention for this common and deadly complication of lung transplantation.Keywords: lung transplant, bronchiolitis obliterans syndrome, rejection. (shrink)

What criteria shall we use to evaluate normative theories of practical rationality? one answer is provided by a version of the wide reflective equilibrium model (wre). What criteria shall we use to evaluate models on the level of wre? one answer is provided by a variant of the historical philosophy of science model. The latter answer may support the former.

An attempt is made here to examine the analysis three political thinkers - Thomas Paine, William Godwin, and Jeremy Bentham have offered of the idea of equality. The inquiry underrtaken is philosophical and not historical in character, since no attempt is made either at tracing the influence ht the biographical-cum-intellectual level of one of them upon the other or at treating their ideas on equality as born out of their preoccupation with the same problem to which they give various answers (...) and which can therefore be considered within a single overall framework. Instead, each thinker is considered independently. And a study is undertaken of the way he understands equality, the way he justifies it, the sort of equality he considers most important and his reasons for this, the area of life he takes the idea of equality to illuminate, the manner in which he relates it to other ideas, etc.. In each case, a fairly coherent philosophy of equality is sought to be constructed out of their respective writings. These three thinkers are selected for two reasons. The idea of equality looms quite large in their thought; as such, it was felt that looking at their writings from the standpoint of equality may illuminate their certain features that may otherwise remain obscure or relatively underemphasized. Further, as they consider equality from different philosophical positions it was believed that a critical examination of their writings could, perhaps, point to the general merits and limitations of their respective positions in terms of equality. in chapter I, it is argued that there are distinct views of God discernible in Paine's writings, and that corresponding to them are three distinct views of equality, though only two of them are discussed by Paine at any length. in chapter II, it is argued that, though Godwin begins as a thoroughgoing rationalist, three are shifts in his general philosophical position, and that, with each shift, his ideas on truth, rationality and equality undergo important changes. Finally, in chapter III, it is argued that there are two distinct theories of equality in Bentham and that tension between them remains unresolved. (shrink)

Aims: To review the literature on perceptions of nursing students and/or educators on the contribution of ethics education to ethical competence in nursing students. Background: Nurses do not always demonstrate the competencies necessary to engage in ethical practice. Educators continue to debate about the best ways to teach ethics to nurses so that they can develop ethical competencies. Data sources: MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science. Review methods: A total of 15 articles with a quantitative, qualitative, or mixed-methods (...) design published between January 1992 and March 2012 were analyzed. Results: According to students and educators, ethics education increases ethical perception of nursing students and the development of reflective and analytical skills. However, its contribution to the development of ethical behavior was barely mentioned. The accounts of students and educators revealed essential features of effective ethics education: active involvement of students in case study discussions and use of ethical frameworks. The use of activating educational strategies requires a safe learning environment where students can openly reflect on values at stake in their care practice. Conclusion: A better understanding of how students learn to develop ethical skills and of influencing factors can guide educators to develop ethics courses for nursing curriculum. Future research needs to focus on the methodological accuracy of sampling and measuring instruments. (shrink)

Rule utilitarianism as commonly formulated has the undesired implication that in case wrong has been done, Any act whatsoever is right. This is due to the fact that in setting the criterion for a set of rules which confers rightness, Rule utilitarians fail to require that obedience to the rules in situations of less than universal obedience must result in the most good attainable in those situations. I suggest a rule-Utilitarian criterion which remedies this defect and which, Borrowing from brandt, (...) Also guarantees that the public acknowledgement of the rules would be desirable. (shrink)

Climo and Howells argue that a comparison of counterfactual statements is the best approach to causation in historical analysis. In historical explanation, it is often difficult to distinguish causes from effects, real causes from potential ones, and epiphenomena from either causes or effects. The symbolic statement "A causes B" describes the actual world. Two statements using the parameters A and B may be formed which do not describe the actual world. By determining which of the statements, "If not-A then B" (...) and "If not-A then not-B," is closer to the actual world, one can conclude whether A is a cause of B. Despite their claims, however, Climo and Howells do not prove that their method is superior to others in dealing with effects and preemption. Their method also has internal difficulties when dealing with epiphenomena and relations to the actual world. (shrink)