In lieu of an abstract, here is a brief excerpt of the content:Side Stepping The Issues: Disappointment With An Ethics Consult For A Medically High Risk PatientBrent R. CarrMonths of severe symptoms were a blur—hour after hour of suffering. Sleep is her only respite. Her 5-word diagnosis, “treatment-refractory depression with anxious distress,” seemed too orderly, like a flattened 2-dimensional strip of ribbon that simply ironed out all the chaos and confused distress roiling within her. Anyone entering the psychiatric unit early (...) in the morning could hear her near-breathless sobbing, calling for nursing help, repeatedly pleading to anyone who would listen that she was dying. By afternoon, her wheelchair would be situated off to one side of the milieu to prevent agitation of other [End Page 13] patients. From there, she would summon them with small gestures or brief, incessant outbursts to save her, that her body was decaying, withering before them. Such is the torment of nihilistic delusions. She flailed her arms, rocking back and forth, lamenting that no one would help. Although she possessed full leg strength, she refused to stand from the wheelchair, fearing collapse. These distressed pleas were sustained well past each dinner, the anguish echoing from her room, and during her evening shower. Sometimes a pillow-muffled sigh and silence would disclose when her torments became engulfed in sleep.Two years prior, she had a similar episode that lasted almost 3-years. It had failed to respond to months of psychotherapy and more than 15 medication trials. That time, she had cried with happiness after the mental illness went into full remission after only a three-week course of electroconvulsive therapy (ECT). She described this as her miracle. But as miraculous as the ECT was for her, it was problematic. She is a high-risk patient with ongoing hypertension and Wolff-Parkinson-White Syndrome, a condition that leads to an inappropriately fast pulse from aberrant electrical pathways in the heart. During the final week of ECT, she experienced a marked blood pressure surge that led to severe cardiac pathology—Takatsubo’s cardiomyopathy. This is also known as “stress cardiomyopathy” or “broken heart syndrome,” befitting the vexed emotional state she had been in. The cardiomyopathy resembled a myocardial infarct, and it took several months for her to fully recover. Unfortunately, this prevented the use of ECT as a relapse prevention treatment. By one-year post-ECT, her systolic left ventricular dysfunction had resolved, and her ejection fraction (the heart’s pumping efficiency) had normalized.Now, once again, she was treatment-resistant, and ECT was the treatment of choice. The risk stratification for ECT encompassed her prior Takatsubo’s cardiomyopathy, which has a small but known chance for recurrence. This made her a high-risk patient. This risk was convoluted even more by her depression-induced psychosis, wherein she believed that she was dying, that meds were poisoning her, and that ECT would kill her from a heart attack. Before the psychiatric team consulted the ECT service, a mental health court had already ruled regarding her lack of capacity for her medical decisions. The court had authorized her husband as her proxy with authority to consent for her medical care, including for ECT. My role in this case was as the ECT proceduralist from the neuromodulation service who had been consulted by the primary team. The husband was an informed individual and signed consent for ECT. These events all coincided with the primary attending’s departure on scheduled leave. There was now a new covering attending.The resident psychiatrist was apprehensive about ECT and deliberated that the patient was at least able to identify potential risks of ECT—even if exacerbated by a nihilistic delusion. The resident speculated that perhaps the patient should at least be able to refuse ECT, given her previous cardiomyopathy. The newly arrived attending deferred a response regarding her concern and stated it had already been decided by the “team.” This amplified doubt. The medical students sensed the resident’s apprehension and felt confused about whether the patient should receive ECT or not. This dynamic quickly spilled over into nursing discussions, where some were now hesitating about the decision. The cohesiveness of the psychiatry treatment team was compromised... (shrink)

We introduce a natural two-cardinal version of Bagaria’s sequence of derived topologies on ordinals. We prove that for our sequence of two-cardinal derived topologies, limit points of sets can be characterized in terms of a new iterated form of pairwise simultaneous reflection of certain kinds of stationary sets, the first few instances of which are often equivalent to notions related to strong stationarity, which has been studied previously in the context of strongly normal ideals. The non-discreteness of these two-cardinal derived (...) topologies can be obtained from certain two-cardinal indescribability hypotheses, which follow from local instances of supercompactness. Additionally, we answer several questions posed by the first author, Holy and White on the relationship between Ramseyness and indescribability in both the cardinal context and in the two-cardinal context. (shrink)

This paper investigates the key drivers behind the origins of value-for-money (VFM) audit in Canada and the aims, intents, and logics ascribed by the original proponents. Drawing on insights from governmentality and New Public Management, the paper utilizes analysis methods adapted from case study research to review a wide range of primary documentation (e.g., Hansards from the Public Accounts Committee, House of Commons debates, the so-called Wilson report and the FMCS study) and secondary documentation (newspaper articles, Office of the Auditor (...) General internal publications, journal articles). Major findings indicate a rise of a management consulting culture within the Auditor General’s office following the appointment of James Johnson Macdonell. VFM legislation effectively operationalized practices drawn from management consulting expertise by invitation of the consultant. It was offered as an answer to the growing scope and size of government, which had become problematized by the Auditor General in terms of parliament losing control over the public purse. The Auditor General’s invocation of financial crisis led to a substantial broadening of mandate and increase in resources for that office. (shrink)

In October 2016, the White House, the European Parliament, and the UK House of Commons each issued a report outlining their visions on how to prepare society for the widespread use of artificial intelligence. In this article, we provide a comparative assessment of these three reports in order to facilitate the design of policies favourable to the development of a ‘good AI society’. To do so, we examine how each report addresses the following three topics: the development of a (...) ‘good AI society’; the role and responsibility of the government, the private sector, and the research community in pursuing such a development; and where the recommendations to support such a development may be in need of improvement. Our analysis concludes that the reports address adequately various ethical, social, and economic topics, but come short of providing an overarching political vision and long-term strategy for the development of a ‘good AI society’. In order to contribute to fill this gap, in the conclusion we suggest a two-pronged approach. (shrink)

The articles in this special issue of Environmental Values have a shared significance. In one way or another, all of them reflect contemporary concerns about issues of trust, risk, uncertainty, and the cultural shaping of science.These are matters of mounting significance for the politics of the environment in countries like Britain, and indeed for politics more generally, as we have seen in a succession of recent controversies. The Brent Spar oil platform farrago, the hugely costly BSE-CJD upsets, the continuing (...) uproars around genetically modified plants and foods ­ central in all of these have been challenges to the political authority of official patterns of scientifically-backed reassurance, concerning the impacts of deep and open-ended trajectories of technological transformation.To understand what is likely to be at stake in such matters for the politics of industrial democracies in the 21st century, there is now an urgent need to develop richer pictures than those currently dominant, of the cultural and epistemological architecture on which our regulatory institutions have been coming to rely. The contributions to this special issue can be pictured as building blocks in such a process.The present article offers a complementary perspective ­ one grounded in a degree of more hands-on personal experience of related matters. (shrink)

This paper proposes to reorient the philosophical debate about peer disagreement. The problem of peer disagreement is normally seen as a problem about the extent to which disagreement provides one with evidence against one's own conclusions. It is thus regarded as a problem for individual inquiry. But things look different in more collaborative contexts. Ethical norms relevant to those contexts make a difference to the epistemology. In particular, we argue that a norm of mutual answerability applies to us when we (...) engage in shared inquiry with others, and precludes us from treating one another's conflicting judgments as evidence relevant to the dispute. From this it follows that standard philosophical accounts of peer disagreement—e.g., the Equal Weight View and the Total Evidence View—presuppose that the disagreeing parties are in a sense alienated from one another. It's doubtful that such forms of alienated disagreement should be treated as the central case. (shrink)

Health care is provided in many contexts—not just hospitals, clinics, and community health settings. Different institutional settings may significantly influence the design and delivery of health care and the ethical obligations and practices of health care practitioners working within them. This is particularly true in institutions that are established to constrain freedom, ensure security and authority, and restrict movement and choice. We describe the results of a qualitative study of the experiences of doctors and nurses working within two women’s prisons (...) in the state of New South Wales (NSW), Australia. Their accounts make clear how the provision and ethics of health care may be compromised by the physical design of the prison, the institutional policies and practices restricting movement of prisoners and practitioners, the focus on maintaining control and security, and the very purpose of the prison and prison system itself. The results of this study make clear the impact that context has on professional practice and illustrate the importance of sociology and anthropology to bioethics and to the development of a more nuanced account of professional ethics. (shrink)

Demonstrates the way in which the principles of analytic philosophy can be used in solving problems in contemporary American life.

A critical discussion of R S Peters' account of emotions and their place in education.

A defense of the translation of "bedeutung" by "meaning" in frege's "posthumous writings" (blackwell 1979). Objections made to such renderings as 'denotation' and 'reference'.

-The synoptic method. Reprinted from the Journal of philosophy, v. 36, no. 13, June 22, 1939. --The method of personalism. Reprinted from the Personalist, August, 1939.

Andrew Reid's essay on the value of education in this journal distinguished the intrinsic features of education from what education is for, the latter being ultimately located in the promotion of personal well-being. At a meta-ethical level, this response accepts Reid's claim about ultimate location, but challenges his view that prudential goods are desire- independent, arguing for a desire-dependent conception based on supra-individual, but not always universal-human, preferences. It also questions his claim that the source of educational value lies in (...) the intrinsic features of education, rejecting the suggestion that epistemological rather ethical considerations should be the starting-point. (shrink)

The purpose of this dissertation is to identify some of the most pressing problems in the dominant contemporary approach to research ethics, and to devise an alternative approach that avoids these problems. I contend that the fundamental ethical values invoked in human research are often appealed to in contradictory or ambiguous ways, or in ways that do not adequately capture or do not show an adequate understanding of the specific ethical concerns of human research. One significant problem in this domain (...) is that values for ethical research are often unreflectively imported from medical therapy, producing ill-suited guidelines that cannot capture the different ethical situations that arise in the context of research. Furthermore, ethical guidelines in this area are often not developed with a sufficient understanding of the deep philosophical issues that they invoke. I suggest that we can address these problems through examining the fundamental ethical concerns of research on a philosophical level. This method will reveal severe problems with the approach to two of the ethical values underlying research; beneficence and respect for autonomy (or respect for persons). Once the nature of these problems has been revealed, and with reference to ethical problems that typically arise in the domain of research, I construct a coherent philosophical foundation for research ethics, which both avoids these deep-seated problems and better captures the ethical issues that arise in the domain of human research. I argue that we need to radically depart from the values of beneficence and autonomy/respect for persons as they are currently understood in the guidelines. We need an idea of beneficence that is clearly distinct from that which is used in the therapeutic medical context from which this notion is currently drawn. I also contend that we need to move away from autonomy as a central value in research ethics. I posit an alternative choice-based approach to informed consent which is concerned both with respecting agents’ freedom of choice, and also with their wellbeing, as providing a good means of protecting and promoting the interests of the individual research subject. Although these two imperatives are often thought to clash on a fundamental level, I will show that, in research ethics, they can be reconciled with minimal conflict. Though this represents a departure from the ethics of medical therapy, this approach is far more suited to the context of research. This theoretical basis for informed consent can help to clarify the ethical problems that are specific to this domain and provide us with relevant ethical guidance in research ethics. (shrink)

The ‘humanisation’ of education is one of the three leitmotifs in a recent Soviet planning document A Conception of General Education. It is suggested that Western education systems also need to be humanised, although not so radically as the Soviet, by the removal of obstacles to educating pupils as members of a liberal democratic society. A future joint research agenda between East and West should concentrate on improving mutual understanding of this goal, clarifying conceptual obstacles, and reflecting on means of (...) realising it. Specific proposals are put forward under all three headings. (shrink)

[The Historical Roots of Our Environmental Crisis; ].

I want to begin with the simple and obvious point, supported by common experience, that it is extremely difficult to talk about religion at all, whether we are trying to do so within a discipline, such as law or psychology or anthropology, or in speaking in more informal ways with our friends. There are many reasons for this: it is in the nature of religious experience to be ineffable or mysterious, at least for some people or in some religions; different (...) religions imagine the world and its human inhabitants, and their histories, in ways that are enormously different and plainly unbridgeable; and there is no superlanguage into which all religions can all be translated, for purposes either of comparison or of mutual intelligibility. What is more, it seems to be nearly always the case that one religion's deepest truths and commitments, its fundamental narratives, appear simply irrational, even weird, to those who belong to another tradition; this means that in any attempt to study and talk about a religion other than one's own there is a necessary element of patronization, at least whenever we are studying beliefs we could not imagine ourselves sharing.Yet it is of enormous importance to attempt to learn to talk about religion well, if we possibly can, if only for the obvious political and practical reason that religious divisions, both within nations and among them, are often intractable and bitter, and mutual understanding very difficult to attain. And it is hard even to imagine an intellectually respectable way of doing this. Think of the anthropologist of religion for example: is he or she to assume that there is a cross-cultural phenomenon called `religion', and if so on what basis? `Religion' is our word, and why should we assume that the Samburu of Kenya or the Hindus of the Indian subcontinent have practices or beliefs that parallel what we know in the west? . Or consider the psychologist, say the psychotherapist working on analytic principles: is he or she to regard the religious beliefs and experiences of a patient as fantasies and wishes of a pathological kind, of which the patient should be cured? Or as healthy formations? If the latter, how can that position possibly be explained in the language of psychology?Or think of the historian of the Middle Ages, interested say in architecture or philosophy: how is she to come to understand the world of religious meaning in which the people whose work she is describing lived, and how can she represent it in anything other than reduced terms? Or, to shift to another field, how is the economist to think about the tensions between the premises of his economic thought and those of the religious life of his culture, in which he perhaps participates?My aim here will not be to presume to offer any final answer to the question of my title, How to talk about religion — I think there is none — but rather to explore it in a tentative and inconclusive way, with the hope of complicating our sense of the importance and interest both of the question itself and of our own performed responses to it. (shrink)