Offering intensive care to neonates who have conditions that carry extremely poor prognoses is a source of great contention amongst neonatologists. The concept of best interests is commonly used as a rationale for refusing such care, despite the fact that parents of these infants often have a different view of what best interests means. This article takes up the question of what best interests should incorporate for infants with lethal conditions not curable with intensive care, and how and who should (...) decide which treatment options should be implemented. Based on our recommendation that parents be apprised of the basis upon which physicians are evaluating treatment options, we offer a framework that allows all relevant parties to approach the issue of what is appropriate treatment from a similar place. We maintain that this approach will increase transparency, dialogue, understanding, and trust, which, in turn, may result in greater consensus. (shrink)

Although it is well known that intimacy and sexual expression are an important part of being human and of healthy living, facilities such as nursing homes, adult group homes, or assisted living residences commonly struggle with knowing how to balance supporting residents who are incapable to have sexual lives with their duty to protect them from foreseeable harm. This article presents a challenging case and uses the British Columbia Supporting Sexual Health and Intimacy in Care Facility Guidelines to determine what (...) should be done. (shrink)

Gini coefficients, which measure gross inequalities rather than their unfair components, are often used as proxy measures of absolute or relative distributive injustice in Western societies. This presupposes that the fair inequalities in these societies are small and stable enough to be ignored. This article presents a model for a series of ideal, perfectly just societies, where comfortable lives are equally available to everyone, and calculates the Gini coefficients for each. According to this model, inequalities produced by age and other (...) demographic factors, together with reasonable choices under equal opportunity, can raise the Gini coefficients for perfectly just societies to levels at least as high as those of any current Western country, and can as easily account for differences in Gini coefficients between such societies or within one such society over time. If Gini coefficients at these levels are possible for ideal societies without distributive injustice, then they should not be used as proxy measures of distributive injustice in real societies. (shrink)

Although nurses in almost every long-term care facility face daily challenges involving issues related to residents' sexual lives, guidelines for ethically supporting sexual activity are rare and inadequate. A decision-making framework was developed to guide care providers in responding to the sexual expression of residents in long-term care. The framework recommends that nurses should weigh the documented substantial benefits of having a sexual life against harm to the resident and others, and against offence to others. This article illustrates the use (...) of this ethical decision-making framework by using the example of nurses supporting a resident's expression of his sexuality. It is suggested that nurses use this framework to guide their practice when related ethical issues arise. (shrink)

Everett J. Nelson; XVI—Causal Necessity and Induction, Proceedings of the Aristotelian Society, Volume 64, Issue 1, 1 June 1964, Pages 289–300, https://doi.org/.

This paper aims to determine whether we can locate temporal passage in a non-dynamical (block universe) world. In particular, we seek to determine both whether temporal passage can be located somewhere in our world if it is non-dynamical, and also to home in on where in such a world temporal passage can be located, if it can be located anywhere. We investigate this question by seeking to determine, across three experiments, whether the folk concept of temporal passage can be satisfied (...) in our world if it is non-dynamical, and, if it can, what sort of thing in our world satisfies that concept. In particular, we focus on the question of whether that concept (if satisfied) is satisfied by something mind-dependent or something mind-independent. In other words, we ask, is temporal passage something that is at least partially in the mind, or is it entirely external to the mind? We find, contrary to what is often assumed by dynamists and non-dynamists alike, that the folk concept of temporal passage is satisfied in our world conditional on it being non-dynamical, and that the concept is satisfied by something mind-independent. This provides further ammunition for recent deflationary accounts of temporal passage that attempt to locate passage somewhere in our non-dynamical world. (shrink)

The problem of induction is to validate inferences from some experiences or data to others. By experiences or data I mean such things as red patches, sounds, tastes, pains. Distinctions between private and public data, between internal and external impressions, between data and objects, are not epistemologically primitive or given but are modes of categorizing the given. The application of categories and the construction of objects are cases of, and so presuppose the validity of, induction.To hypostatize a construction, or a (...) system of constructions, is in fact to generate what may be called an external world. Examples are physical objects, and scientific objects. And when analysis proceeds, as it often does, by replacing the original subject by constructs, a hierarchy of external systems is generated. Thus, physical objects—e.g., our bodies—are external to data, and scientific objects are external to physical objects. (shrink)

In this paper I wish to offer a suggestion in support of the thesis that if a given set of facts is explained by two rival explanations A and B, where A consists of a single hypothesis H1, and B consists of at least two independent hypotheses H2 and H3, then, other things being equal, A is more probable than B. That this view is true is seldom questioned, though I have never seen any reason given for it, which would (...) justify the methodological value so many philosophers attribute to it. It is not my purpose to discuss simplicity of explanation in general, but simply to point out that the Multiplicative Axiom of the calculus of probabilities justifies the above thesis. I shall call this thesis the Principle of Parsimony. (shrink)

Metaphysical problems may be solved by the methods of inference employed in the empirical sciences. So we are told by many realists and pragmatists, among whom may be mentioned Professors J. B. Pratt, William Savery, and Donald Williams. Mr. Williams and Mr. Pratt have argued for the use of inductive methods in establishing the existence of an external world. Mr. Savery has asserted that all philosophical inference as to matter of fact is inductive. This naturalistic attitude is by no means (...) unusual—in fact it is so common in this age in which the speculations of scientists as well as their achievements have captivated the popular imagination, that even philosophers have for the most part failed to examine its validity and presuppositions. It is the purpose of this paper to present such an examination, not of the philosophic employment of inductive methods in general, but in regard to one specific problem; namely, that of the existence of an external world. What I purpose then is to present and evaluate the view that the existence of an external world may be established by inductive methods as employed in the empirical sciences. (shrink)

This paper presents a new solution to the problem of peer disagreement that distinguishes two principles of rational belief, here called probability and autonomy. When we discover that we disagree with peers, there is one sense in which we rationally ought to suspend belief, and another in which we rationally ought to retain our original belief. In the first sense, we aim to believe what is most probably true according to our total evidence, including testimony from peers and authorities. In (...) the second, we aim to base our beliefs only on objective evidence and argumentation, even if that lowers the probability of their being true. The first principle of rational belief tends to serve the short-term epistemic interests of individuals, while the second tends to serve the long-term epistemic interests of both individuals and groups. The best way to reconcile these principles in cases of peer disagreement is to associate them with two corresponding species of belief, here called perception and opinion. (shrink)

Solipsism can be refuted along fairly traditional, internalist lines, by means of a second-order induction. We are justified in believing in other minds, because other people tell us that they have minds, and we have good inductive reason to believe that whatever certain others say is likely to be true. This simple argument is sound, the author argues, even though we are in no prior position to believe that other thinking people exist as such, or that the sounds they make (...) have any meaning. The mere phenomenal surfaces of others' statements form sufficient grounds for the induction that the argument requires. (shrink)

Recent research has relied on trolley-type sacrificial moral dilemmas to study utilitarian versus nonutili- tarian modes of moral decision-making. This research has generated important insights into people’s attitudes toward instrumental harm—that is, the sacrifice of an individual to save a greater number. But this approach also has serious limitations. Most notably, it ignores the positive, altruistic core of utilitarianism, which is characterized by impartial concern for the well-being of everyone, whether near or far. Here, we develop, refine, and validate a (...) new scale—the Oxford Utilitarianism Scale—to dissociate individual differences in the ‘negative’ (permissive attitude toward instrumental harm) and ‘positive’ (impartial concern for the greater good) dimensions of utilitarian thinking as manifested in the general population. We show that these are two independent dimensions of proto-utilitarian tendencies in the lay population, each exhibiting a distinct psychological profile. Empathic concern, identification with the whole of humanity, and concern for future generations were positively associated with impartial beneficence but negatively associated with instrumental harm; and although instrumental harm was associated with subclinical psychopathy, impartial beneficence was associated with higher religiosity. Importantly, although these two dimensions were independent in the lay population, they were closely associated in a sample of moral philosophers. Acknowledging this dissociation between the instrumental harm and impartial beneficence components of utilitarian thinking in ordinary people can clarify existing debates about the nature of moral psychology and its relation to moral philosophy as well as generate fruitful avenues for further research. (shrink)