This article considers the ethical implications of prospective payment from the perspective of physicians and other health care practitioners. It focuses on the argument that prospective payment creates ethical conflict by giving physicians an economic incentive to do less for their patients. This argument is criticized in two respects. First, available evidence is reviewed which suggests that the incentives actually created by different prospective payment schemes and their effect on "optimal" patterns of practice is uncertain. Further, it is pointed out (...) that ethical conflict originates in the dual role of physicians as agents and suppliers of service. Recognizing that such conflict exists under any payment mechanism, a better focus for the ethical evaluation of prospective payment is suggested that considers whether the incentive to do less is likely to have adverse effects on physician decisions, relative to decisions made under other payment mechanisms. Keywords: incentives, utilization, conflict of interest, efficiency, justice, agent CiteULike Connotea Del.icio.us What's this? (shrink)

The phenomenon of ‘plant sleep’ – whereby vegetables rhythmically open and close their leaves or petals in daily cycles – has been a continual source of fascination for those with botanical interests, from the Portuguese physician Cristóbal Acosta and the Italian naturalist Prospero Alpini in the sixteenth century to Percy Bysshe Shelley and Charles Darwin in the nineteenth. But it was in 1757 that the topic received its earliest systemic treatment on English shores with the prodigious author, botanist, actor, (...) and Royal Society critic John Hill’s The Sleep of Plants, and Cause of Motion in the Sensitive Plant. As the present article aims to illustrate, Hill and his respondents used this remarkable behaviour, exhibited by certain plants, as a lens through which to reassess the nature of vegetables, and to address pressing questions of wider natural philosophical import, particularly the degree of continuity between the structures and functions of plants and animals and whether similar mechanisms necessarily account for related movements in different life forms. These disputes, this paper contends, also had profound methodological implications regarding the proper way to conduct experiments, the extent to which it was acceptable to extrapolate from observations, and the status of causal explanations. (shrink)

In The Origin of Species (1859) Darwin challenged many of the most deeply-held beliefs of the Western world. Arguing for a material, not divine, origin of species, he showed that new species are achieved by "natural selection." The Origin communicates the enthusiasm of original thinking in an open, descriptive style, and Darwin's emphasis on the value of diversity speaks more strongly now than ever. As well as a stimulating introduction and detailed notes, this edition offers a register of the many (...) writers referred to by Darwin in the text. (shrink)

Charles Crittenden here offers an original solution to one of the traditional dilemmas of philosophy—whether there can be any thing not existing, since to say that some thing does not exist seems to presuppose its existence. Drawing on the tools of Wittgensteinian philosophy and speech act theory, Crittenden argues that we can and often do make reference to unreal objects such as fictional characters, though they do not exist in any sense at all.

"... stimulating and insightful... a thoroughly researched and timely contribution to the secondary literature of ethics... " —Library Journal "His important new work establishes Scott... as one of the foremost interpreters of the Continental philosophical tradition of the US.... Necessary for anyone working in ethics or the Continental tradition." —Choice "... a provocative discourse on the consequences of the ethical in the thought of Nietzsche, Foucault, and Heidegger." —The Journal of Religion Charles E. Scott's challenging book advances the broad (...) claim that ethics as a way of judging and thinking has come into question as philosophers have confronted suffering and conflicts that arise from our traditional systems of value. (shrink)

By mass-energy equivalence, the gravitational field has a relativistic mass density proportional to its energy density. I seek to better understand this mass of the gravitational field by asking whether it plays three traditional roles of mass: the role in conservation of mass, the inertial role, and the role as source for gravitation. The difficult case of general relativity is compared to the more straightforward cases of Newtonian gravity and electromagnetism by way of gravitoelectromagnetism, an intermediate theory of gravity that (...) resembles electromagnetism. (shrink)

An examination of split-brain syndrome, and whether split-brain patients have two minds.

It may seem odd to review a New York social club's yearbook, with its list of members’ addresses and series of committee reports. But such books sometimes contain material of more general interest. The latest one from the Century Association, for example, devotes 250 of its 685 pages to “Century Memorials”—that is, biographical sketches of recently deceased members, written by other members. Among the well-known figures taken up in these eighty-three sketches are the artists Richard Anuszkiewicz and Robert Motherwell; the (...) architects Henry N. Cobb and Charles A. Platt; the newspaper editors Harold Evans and Whitelaw Reid; the historians Henry F. Graff and William McFeely; the translator and literary scholar Donald Keene; the collector of literary and musical manuscripts Frederick Koch; the popular writer on Russian history Robert K. Massie; the clergyman James Parks Morton; the financier Felix G. Rohatyn; the lawyers Whitney North Seymour Jr. and Isaac N. Phelps Stokes; the literary editor Elisabeth Sifton; the university president Michael Sovern; the museum director Evan H. Turner; and the broadcast journalist Sander Vanocur. The sketches are generally well written and often richly evocative: the writers include Louis Begley, Kenneth T. Jackson, D. T. Max, and Honor Moore.The long shelf of Century volumes like this one clearly constitutes a valuable contribution to prosopographical literature. And the Century is not the only institution with such a tradition (other examples are the British Academy and the American Philosophical Society); but their publications are a frequently overlooked source, one not always available in research libraries. Unfortunately, it is also a source that seems to be diminishing: the American Antiquarian Society and the John Simon Guggenheim Memorial Foundation are examples of organizations, each with a history of providing biographical information, that are no longer doing so. Of course, the great previous runs of the former's Proceedings and the latter's Reports remain (one hopes) on the shelves for those who know to look for them. A step in the opposite direction has recently been taken by the Grolier Club, which has not had such a tradition (except for two biographical volumes in 1959 and 2000): its Gazette now includes a section of memorials in each issue. This is a welcome move, but one has to regret that so little scholarly use is made of this whole body of biographical detail and reminiscence. (shrink)

This paper describes one style of functional analysis commonly used in the neurosciences called task-bound functional analysis. The concept of function invoked by this style of analysis is distinctive in virtue of the dependence relations it bears to transient environmental properties. It is argued that task-bound functional analysis cannot explain the presence of structural properties in nervous systems. An alternative concept of neural function is introduced that draws on the theoretical neuroscience literature, and an argument is given to show that (...) this alternative concept of may help to overcome the explanatory limitations of task-bound functional analysis. (shrink)

Science, material, idealism, pragmaticism, history of scientific thought.

There has been much debate regarding the 'double-effect' of sedatives and analgesics administered at the end-of-life, and the possibility that health professionals using these drugs are performing 'slow euthanasia.' On the one hand analgesics and sedatives can do much to relieve suffering in the terminally ill. On the other hand, they can hasten death. According to a standard view, the administration of analgesics and sedatives amounts to euthanasia when the drugs are given with an intention to hasten death. In this (...) paper we report a small qualitative study based on interviews with 8 Australian general physicians regarding their understanding of intention in the context of questions about voluntary euthanasia, assisted suicide and particularly the use of analgesic and sedative infusions (including the possibility of voluntary or non-voluntary 'slow euthanasia'). We found a striking ambiguity and uncertainty regarding intentions amongst doctors interviewed. Some were explicit in describing a 'grey' area between palliation and euthanasia, or a continuum between the two. Not one of the respondents was consistent in distinguishing between a foreseen death and an intended death. A major theme was that 'slow euthanasia' may be more psychologically acceptable to doctors than active voluntary euthanasia by bolus injection, partly because the former would usually only result in a small loss of 'time' for patients already very close to death, but also because of the desirable ambiguities surrounding causation and intention when an infusion of analgesics and sedatives is used. The empirical and philosophical implications of these findings are discussed. (shrink)

Intercultural Digital Ethics faces the central challenge of how to develop a global IDE that can endorse and defend some set of universal ethical norms, principles, frameworks, etc. alongside sustaining local, culturally variable identities, traditions, practices, norms, and so on. I explicate interpretive pros hen ethical pluralism ) emerging in the late 1990s and into the twenty-first century in response to this general problem and its correlates, including conflicts generated by “computer-mediated colonization” that imposed homogenous values, communication styles, and so (...) on upon “target” peoples and cultures via ICTs as embedding these values in their very design. I contrast different kinds of ethical pluralisms as structural apparatus for understanding what differences may mean and allow for, as these emerged in the 1990s forwards with EP. As interwoven with phronēsis, a form of reflective judgment and virtue, EP more radically preserves irreducible differences and so fosters positive engagements across deep cultural differences. I show how EP emerged in the context of empirical research on “Cultural Attitudes towards Technology and Communication” beginning in 1998, and then in specific applications within Internet Research Ethics beginning in 2000. I summarize its main characteristics and trace how it has further been taken up in ICE, IRE, Intercultural Information Ethics, and virtue ethics more broadly. I respond to important criticisms and objections, arguing that EP thus stands as an important component for a contemporary IDE that seeks an ethical cosmopolitanism in place of computer-mediated colonization. (shrink)

ABSTRACTMaterialism is the view that everything that is real is material or is the product of material processes. It tends to take either a ‘cosmological’ form, as a claim about the ultimate nature of the world, or a more specific ‘psychological’ form, detailing how mental processes are brain processes. I focus on the second, psychological or cerebral form of materialism. In the mid-to-late eighteenth century, the French materialist philosopher Denis Diderot was one of the first to notice that any self-respecting (...) materialist had to address the question of the status and functional role of the brain, and its relation to our mental life. After this the topic grew stale, with knee-jerk reiterations of ‘psychophysical identity’ in the nineteenth-century, and equally rigid assertions of anti-materialism. In 1960s philosophy of mind, brain–mind materialism reemerged as ‘identity theory’, focusing on the identity between mental processes and cerebral processes. In contrast, Diderot’s cerebral materialism allows for a more culturally sedimented sense of the brain, which he described in his late Elements of Physiology as a ‘book – except it is a book which reads itself’. Diderot thus provides a lesson for materialism as it reflects on the status of the brain, science and culture. (shrink)

This article defends the thesis that in theorizing about the mind we need to accord first-person (“introspective” or “reflective”) judgments about experience a “selective provisional trust.” Such an approach can form part of a descriptive psychology. It is here so employed to evaluate some influential interpretations of research on attention to conclude that—despite what conventional wisdom suggests—an “introspection-positive” policy actually offers us a better critical perspective than its contrary. What supposedly teaches us the worthlessness of introspection actually shows us why (...) we need to take it seriously. (shrink)

‘Racial justice’ is a term widely used in everyday discourse, but little explored in philosophy. In this essay, I look at racial justice as a concept, trying to bring out its complexities, and urging a greater engagement by mainstream political philosophers with the issues that it raises. After comparing it to other varieties of group justice and injustice, I periodize racial injustice, relate it to European expansionism and argue that a modified Rawlsianism relying on a different version of the thought (...) experiment could come up with suitable principles of corrective racial justice. (shrink)

Numbers are symbols manipulated in accord with the axioms of arithmetic. They sometimes represent discrete and continuous quantities, but they are often simply names. Brains, including insect brains, represent the rational numbers with a fixed-point data type, consisting of a significand and an exponent, thereby conveying both magnitude and precision.

Philosophy confronts two existential crises: the threats to its existence from scientists like Stephen Hawking who claim that philosophy is dead; and the threat to life itself from catastrophic climate change. The essay’s first theoretical part critiques Nietzsche’s claim that philosophy’s primary function is to guarantee the future of life. The essay’s second practical part claims that philosophy must meet the challenge of life’s extinction through a revised model for ethics in education. Taking its start from recent conceptualizations of philosophy (...) as a ‘field discipline,’ this part considers African American models for delivering ethics in education to under-resourced communities. The third part shows how these theoretical models may be actualized in the practice of an African field philosopher. (shrink)

Yang returns to the problem of referential ambiguity, addressed in the opening paper by Gleitman and Trueswell. Using a computational approach, he argues that “big data” approaches to resolving referential ambiguity are destined to fail, because of the inevitable computational explosion needed to keep track of contextual associations present when a word is uttered. Yang tests several computational models, two of which depend on one‐trial learning, as described in Gleitman and Trueswell’s paper. He concludes that such models outperform cross‐situational learning (...) models, thereby formalizing, reinforcing, and advancing the conclusions offered by Gleitman and Trueswell. (shrink)

Charles Groulier | : La question de savoir si la signification est normative et comment préciser l’idée de normativité sémantique fait l’objet de nombreux débats actuels. Nous proposons de partir de l’hypothèse qu’un langage est un système de règles, et qu’apprendre un langage c’est apprendre à obéir à des règles qui régissent l’usage de ses expressions. Nous distinguons d’abord entre différentes notions de signification et de normativité. Puis nous examinons de façon critique deux objections à l’idée d’une normativité sémantique (...) : la première réduit la normativité sémantique au « doit » instrumental, l’autre à la normativité épistémique. Nous proposons ensuite une conception alternative de la normativité sémantique fondée sur le concept d’acte locutionnaire. | : There are many ongoing debates over whether meaning is normative or about how the idea of semantic normativity is to be fleshed out. We suggest to start from the assumption that language is a system of rules, and learning a language is learning to obey the rules for the use of its expressions. We first distinguish between different notions of meaning and of normativity. Then we critically examine and reject two objections to the idea of semantic normativity : one reducing semantic normativity to instrumental “ought”, the other to epistemic normativity. We then propose an alternative conception of semantic normativity based on the speech-acts theorists’ concept of locutionary act. (shrink)

When philosophers undertake to say what it is that makes life worth living, they generally display a procrustean habit of thought which the practice of philosophy itself does much to encourage. As a result, they arrive at an image of the human good that is far more controversial than they suspect. The canonical view among philosophers ancient and modern has been, in essence, that the life lived well is the life lived in accord with a rational plan. To me this (...) conception of the human good seems manifestly wrong. The idea that life should be the object of a plan is false to the human condition. It misses the important truth which Proust, by contrast, discerned and made into one of the organizing themes of his great meditation on disappointment and revelation, A la recherche du temps perdu : The happiness that life affords is less often the good we have reason to pursue than the good that befalls us unexpectedly. (shrink)

Population ethics contains several principles that avoid the repugnant conclusion. These rules rank all possible alternatives, leaving no room for moral ambiguity. Building on a suggestion of Parfit, this paper characterizes principles that provide incomplete but ethically attractive rankings of alternatives with different population sizes. All of them rank same-number alternatives with generalized utilitarianism.

Grice and Strawson's 'In Defense of a Dogma is admired even by revisionist Quineans such as Putnam (1962) who should know better. The analytic/synthetic distinction they defend is distinct from that which Putnam successfully rehabilitates. Theirs is the post-positivist distinction bounding a grossly enlarged analytic. It is not, as they claim, the sanctified product of a long philosophic tradition, but the cast-off of a defunct philosophy - logical positivism. The fact that the distinction can be communally drawn does not show (...) that it is based on a real difference. Subcategories that can be grouped together by enumeration will do the trick. Quine's polemical tactic (against which Grice and Strawson protest) of questioning the intelligibility of the distinction is indeed objectionable, but his argument can be revived once it is realized that 'analytic' et al. are theoretic terms, and there is no extant theory to make sense of them. Grice and Strawson's paradigm of logical impossibility is, in fact, possible. Their attempt to define synonymy in Quinean terms is a failure, nor can they retain analyticity along with the Quinean thesis of universal revisability. The dogma, in short, is indefensible. (shrink)

English translation, with Chinese source text, of a seminal Chinese classic.

ABSTRACT Thaddeus Metz is probably the leading expert on the meaning of life. His latest book admirably displays his intellectual agility and fairness: arguments, counter-arguments, examples and counter-examples come in wave after wave that may compel most of us to slow down the pace of reading. If you have ever had the delight of interacting with Professor Metz at a conference, you know his irrepressible energy and love for debate. In this brief essay, I challenge some of Metz’s terminology, raise (...) a worry about the role of metaphysics in the meaning of life literature, suggest a reply to the religious relational account of meaning, and firm up the intuition that meaning is enhanced in a theistic cosmos. (shrink)

In his Philosophical Inquiry concerning Human Liberty (1717), the English deist Anthony Collins proposed a complete determinist account of the human mind and action, partly inspired by his mentor Locke, but also by elements from Bayle, Leibniz and other Continental sources. It is a determinism which does not neglect the question of the specific status of the mind but rather seeks to provide a causal account of mental activity and volition in particular; it is a ‘volitional determinism’. Some decades later, (...) Diderot articulates a very similar determinism, which seeks to recognize the existence of “causes proper to man” (as he says in the Réfutation d’Helvétius). The difference with Collins is that now biological factors are being taken into account. Obviously both the ‘volitional’ and the ‘biological’ forms of determinism are noteworthy inasmuch as they change our picture of the nature of determinism itself, but my interest here is to compare these two determinist arguments, both of which are broadly Spinozist in nature – and as such belong to what Jonathan Israel called in his recent book “the radical Enlightenment,” i.e. a kind of underground Enlightenment constituted by Spinozism – and to see how Collins’ specifically psychological vision and Diderot’s specifically biological vision correspond to their two separate national contexts: determinism in France in the mid-1750s was a much more medico-biological affair than English determinism, which appears to be on a ‘path’ leading to Mill and associationist psychology. (shrink)

BackgroundEarly in the COVID-19 pandemic, the urgent need to discover effective therapies for COVID-19 prompted questions about the ethical problem of randomization along with its widely accepted solution: equipoise. In this scoping review, uses of equipoise in discussions of randomized controlled trials of COVID-19 therapies are evaluated to answer three questions. First, how has equipoise been applied to COVID-19 research? Second, has equipoise been employed accurately? And third, do concerns about equipoise pose a barrier to the ethical conduct of COVID-19 (...) RCTs?MethodsGoogle Scholar and Pubmed were searched for articles containing substantial discussion about equipoise and COVID-19 RCTs. 347 article titles were screened, 91 full text articles were assessed, and 48 articles were included. Uses of equipoise were analyzed and abstracted into seven categories.Results and discussionApproximately two-thirds of articles used equipoise in a way that is consistent with the concept. They invoked equipoise to support RCTs of specific therapies, RCTs in general, and the early termination of RCTs after achieving the primary outcome. Approximately one-third of articles used equipoise in a manner that is inconsistent with the concept. These articles argued that physician preference, widespread use of unproven therapies, patient preference, or expectation of therapeutic benefit may undermine equipoise and render RCTs unethical. In each case, the purported ethical problem can be resolved by correcting the use of equipoise.ConclusionsOur findings highlight the continued relevance of equipoise as it supports the conduct of well-conceived RCTs and provides moral guidance to physicians and researchers as they search for effective therapies for COVID-19. (shrink)

Seneca’s Letters sketch a theory of attentive action according to which distraction is caused by inconsistent beliefs about values, such that the degree of an agent’s attention to an endorsed action is proportionate to the consistency of her beliefs about value, i. e. her proximity to virtue. The agent’s activity of attentive action is co-ordinated with a state of alertness to her interests, which accordingly triggers switches in attention that sustain the endorsed action in single-minded agents or cause distraction if (...) the new interest is irrelevant to it. Seneca’s theory reflects the older Stoic conception of the tensional mental strength of the virtuous agent, which Chrysippus identified as the causal factor over and above virtue that ensures her successful performance of right action. (shrink)

Charles Baudouin was a French psychoanalyst. Born in Nancy, a town that played a significant role in the history of psychoanalysis, he was a contemporary of Freud, Jung and Adler. After receiving his degree in philosophy, he moved to Geneva where his early work and first book focused on suggestion and hypnosis, later becoming interested in literature and the relation between psychoanalysis and education. Largely forgotten, Charles Baudouin' s work warrants greater attention from both psychoanalysts and historians alike. (...) He was a prolific... (shrink)

The psycho-social day-to-day experience of COVID-19 pandemic has shone some light on the wider scope of health vulnerability and has correspondingly enlarged the ethical debate surrounding the social implications of health and healthcare. This emerging paradigm is neither a single-handed problem of biomedical scientists nor of social analysts. It instead needs a strategically oriented collaborative and interdisciplinary preventive effort. To that effect, this article presents some socio-ethical reflections underscoring the judicious use of the insight from care ethics as an asset (...) in minimizing the possible propagation of the COVID-19 virus and the escalation of its vulnerability in the day-to-day human interaction. It further emphasizes that if this insight is overlooked, the effects of the diverse facets of the “shadow pandemics” of COVID-19—fallouts on both the affected and the infected—may equally be deadly. (shrink)

Little is known about how ethical organizational contexts influence employees’ perceived stress levels and well-being. This study used two theoretical lenses, ethical impact theory (Promislo et al. in Handbook of Unethical Work Behavior, M.E. Sharpe, Armonk, 2013) and ethical decision-making theory (Schwartz in J Bus Ethics 139(4): 755–776, 2016), to investigate the relationships among perceived organizational ethics (comprised of ethical climate, leader/manager ethics, and corporate social responsibility), work-related stress, and employee well-being (comprised of vitality, life satisfaction, personal growth initiative, flourishing, (...) positive mental health, and self-actualization). Findings across two studies indicated that organizational ethics was negatively related to work-related stress, and that work-related stress was negatively related to employee well-being. Perceived organizational ethics is positively related to employee well-being, with post hoc mediation tests indicating that work-related stress partially mediates this relationship. Our findings suggest that organizations should be proactive in improving their ethical climate, such as choosing ethical leaders, developing a robust and well-communicated code of ethics, and actively practicing CSR. These measures should reduce excessive work-related stress and improve employee well-being. (shrink)

Hervaeus Natalis distinguishes two types of items that can have esse obiective in the intellect: objects of acts of intellection (man, this cat, etc.) and properties unapprehended by these acts, or background properties (being a species, being a particular, etc.), that are beings of reason. Yet, his conception of the esse obiective of objects evolved. First, he had a neutral conception of esse obiective: items presenting themselves to the intellect are cognized, transparently, without being altered in the process. Later, he (...) developed an ontologically committing conception of the objective being of objects: items presenting themselves to the intellect take on rational being (esse rationis) as such. This evolution transpires because Hervaeus introduces intentional relations as what makes the cognized item be objectively in the intellect and includes them within the class of background properties (being of reason). Both these conceptions manage to account for our access to extra-mental things. -/- . (shrink)

The origins of this book go back to I956 when it was suggested to me that a study on the philosophy of Gianfrancesco Pico della Mirandola would furnish an important addition to our knowledge of the philoso phy of the Italian Renaissance. It was not, however, until I960 that I could devote a significant portion of my time to a realization of this goal. My work was essentially completed in 1963, at which time it was presented in its original form (...) as a doctoral dissertation in the Phi losophy Department of Columbia University. Since then I have made many minor improvements and several chapters have been extensively reworked. This study represents the first attempt in fifty years to give a detailed account of even a portion of Gianfrancesco Pico's life and thought. The most comprehensive previous study, Gertrude Bramlette Richards, "Gianfrancesco Pico della lv1irandola" (Cornell University Dissertation, I 9 I 5), which I have found very useful in preparing my own book, is largely based on secondary literature and is mistaken in a number of details. Furthermore, Miss Richards' treatment of Gian francesco Pico as a thinker is very sketchy and is not an exhaustive study of his own writings. It is hoped that my present study, built in part on her extensive bibliographical indications, brings forth a certain amount of new information which will be of value for further research. (shrink)

The sixteen chapters, commissioned specially for this volume, are written by an internationally recognized team of scholars and examine topics such as the Trinity, God's necessary existence, simplicity, omnipotence, omniscience, ...

The investigation of probabilistic causality has been plagued by a variety of misconceptions and misunderstandings. One has been the thought that the aim of the probabilistic account of causality is the reduction of causal claims to probabilistic claims. Nancy Cartwright (1979) has clearly rebutted that idea. Another ill-conceived idea continues to haunt the debate, namely the idea that contextual unanimity can do the work of objective homogeneity. It cannot. We argue that only objective homogeneity in combination with a causal interpretation (...) of Bayesian networks can provide the desired criterion of probabilistic causality. (shrink)

Stone & Wang collate the nascent research examining the mnemonic consequences associated with social media use. In particular, they highlight two important factors in understanding how social media use shapes the way individuals and groups remember the past: the type of information (personal vs. public) and the role (producer vs. consumer) individuals undertake when engaging with social media. Stone and Wang investigate those two features in relation to induced forgetting for personal information and false memories/truthiness for public information.