In this essay, we defend the design of the Salk polio vaccine trial and try to put some limits on the role schemata should play in designing clinical research studies. Our presentation is structured as a response to de Freitas and Pietrobon who identified the CONSORT statement as a schema that would have, had it existed at the time, ruled out the design of the Salk polio vaccine trial of 1954 in favor of a completely randomized controlled clinical trial. We (...) argue that large-scale public health interventions often require evidence beyond simple efficacy, the limit of what an RCT can provide, and that the design actually adopted for the Salk trial represented a reasonable—albeit imperfect—compromise. This is of more than historical interest in that many contemporary studies are of the scale and scope to require a more pragmatic, rather than explanatory, approach to study design. (shrink)

The land ethic of Aldo Leopold has increasingly received attention as an example of an environmental virtue ethic. However, an important remaining question is how to cultivate and transmit environmental virtues. The answer to this question can be found in the pursuit of wild leisure. The classical view of leisure primarily as articulated in Aristotle’s Politics provides a good starting point for an examination of wild leisure. Leopold thought wild leisure was important and associated it with his land ethic. Leopold’s (...) view of wild leisure focused on the role of perception in ecological education and the habituation of virtue. The classical virtue of moderation when habituated by wild leisure becomes the central virtue required by an ecological conscience. Wild leisure educates just those intellectual and scientific virtues necessary for refined perception and prudence. These virtues provide connections between good citizenship and land citizenship. (shrink)

The first part of the paper sketches the rationale for the classical theistic thesis that, though God is not really related to the world, the world is really related to God. Part II delineates four sets of recent criticisms ofthis thesis: (a) an objection which assesses it as conflating transparent and opaque construals of intentional propositions, (b) a dilemma which regards it as undermining either free divine creativity or God’s knowledge of the contingent, (c) arguments which view its adherence to (...) an absolute divine immutability and independence as in conflict both with God’s knowledge of a changing creation and with human knowledge of God, and (d) two religiously inspired objections which contend that the thesis is contradictory to the biblical claim that God is personally related to the world. Part III develops the linguistic essence of the classical thesis through the syntactical insights of Sommers’ logic and defends it against the objections posed. (shrink)

The purpose of this paper is to review the rising influence of commercialism in American medicine and to examine some of the consequences of this trend. Increased competition subverts physician collegiality, draws hospitals into for-profit ownership and behavior, and leads clinical investigators into secrecy and possibly into bias and abuse. Medicine faces a deprofessionalization evidenced in loss of control over the clinical setting and over self-regulation. Health care becomes a commodity relying on cultivation of desires instead of satisfaction of needs, (...) even as many basic needs go unmet. Patients become consumers empowered with lawsuits and the connection of medicine to the relief of suffering is attenuated. Medical encounters are increasingly impersonal, dominated by specialization, technology, and bureaucracy. Patients are losing their physician-advocates to new conflicts of interests, physicians are losing their impulse to charity, and trust in the doctor-patient relationship and in medicine generally is eroding. (shrink)

This article presents the rationale of a new approach to the debate between sociobiology and religion. In it, I outline a sociobiology that may generate alternative and competing hypotheses about the existence of gods as beings (theisms) and the nature of their participation in the universe. I examine the central theoretical issues of this sociobiology and discuss the strengths and weaknesses of a sociobiological approach to theological issues, including problems pertinent to nontheistic theologies. A concluding case is made for an (...) enriched and revitalized agenda in the dialogue between sociobiology and religion. While consistent with current research on gene‐culture coevolution, the article's treatment expands on earlier work to begin incorporating theoretical terms that carry a more direct theological impact. (shrink)

That dichotomization is, at least under certain circumstances, a bad idea is not news. A well-known, early example is the biblical story of King Solomon, who used the absurdity of the procedure to help adjudicate a dispute between two women who each claimed to be the mother of a contested child. Solomon reasoned that his proposal to split the child into two, giving half to each woman, would be abhorrent to the real mother, and when one of the women objected (...) while the other thought the proposal was "only fair," the choice between the women was made obvious.Things, however, are not always so clear-cut, and it is not difficult to find arguments that point to the advantages that accrue to those that simplify matters.... (shrink)

Man has the urge to thrust against the limits of language. Think for instance about one's astonishment that anything exists. This astonishment cannot be expressed in the form of a question and there is no answer to it. Anything we can say must, a priori, be nonsense.

I present an argument which is related to the ontological argument which has a more plausible premise and a weaker conclusion. I assume two postulates concerning the meaning of ‘x creates y’. I then prove that the proposition possibly, something (non-vacuously) creates everything entails, in quantified S5, that there is a necessarily existing object with creative power - an object which creates all (and some) contingently existing objects in some possible world.

Pressures to contain budgets and provide cost‐effective care are widespread in the American health care system, no less in psychiatry than elsewhere. The ethical implications of such economically motivated trends, however, become even more important in the area of psychiatric medicine.

Heidegger understands technology as an act of revealing rather than merely a human achievement. Within the modern era, technology represents the manner in which humans stand within and make manifest the open interplay and inter-relatedness that is world. The danger of this era is the extent to which everything has become available, accessible, and disposable to human manipulation, practically without limit. However, the very totalizing extent to which this is happening, and the forgetfullness that takes it all for granted, can (...) also make us suddenly aware that everything, including world itself, is at risk; that we ourselves are at risk; that we are the danger. He calls for an attitude of releasement that handles world with a sense of receiving, and not just taking, a sense of thankfulness. Such a change could directly impact how we see ourselves and our responsibilities as we go about developing and using technologies. (shrink)

Research shows that the physician’s personal attributes and social characteristics have a strong association with their end-of-life decision making. Despite efforts to increase patient, family and surrogate input into EOL decision making, research shows the physician’s input to be dominant. Our research finds that physician’s social values, independent of religiosity, have a significant association with physician’s tendency to withhold or withdraw life sustaining, EOL treatments. It is suggested that physicians employ personal social values in their EOL medical coping, because they (...) have to cope with existential dilemmas posed by the mystery of death, and left unresolved by medical decision making mechanisms such as advanced directives and hospital ethics committees. (shrink)

It is well known that Augustine, Boethius, Anselm and Aquinas participated in a tradition of philosophical theology which determined God to be simple, perfect, immutable and timelessly eternal. Within the parameters of such an Hellenic understanding of the divine nature, they sought a clarification of one of the fundamental teachings of their Christian faith, the doctrine of the Trinity. These classical theists were not dogmatists, naively unreflective about the very possibility of their project. Aquinas, for instance, explicitly worried about and (...) fought to dispel the seeming contradiction between the philosophical requirement of divine simplicity and the creedal insistence on a threefold personhood in God. 1 Nevertheless, doubts abound. Philosophers otherwise friendly to Classical Theism still remain unsure about the coherence of affirming a God that is at once absolutely simple and triune. 2 A less friendly critic has even suggested that the theory of divine simplicity pressured Augustine and his medieval followers away from recognizing that real complexity within the life of God which Trinitarianism expresses. 3. (shrink)