In this study we relate four different measures: the theodicy models proposed by van der Ven, the coping strategies proposed by Pargament, a measure of positive or negative self-image and the post critical belief scales we ourselves have developed. We analysed the data of 251 Dutch-speaking Belgians. In the analysis we focus on the relation of the different measures with the post critical belief scales. Different types of believers are using different theodicy models, somewhat different coping strategies and we observe (...) some differences in self-image, where believers have a more positive self-image than non-believers. We could suggest that there is a specific theodicy model used by symbolic believers and another theodicy model used by more literal believers. The former could be interpreted as more developed and perhaps more religiously mature. (shrink)

Although considerable attention has been devoted to the concepts of “visible” and “invisible” victims in general medical practice, especially in relation to resource allocation, far less consideration has been devoted to these concepts in behavioral health. Distinctive features of mental health care in the United States help explain this gap. This essay explores three specific ways in which the American mental health care system protects potentially “visible” individuals at the expense of “invisible victims” and otherwise fails to meet the needs (...) of great numbers of people with serious psychiatric conditions: prioritization of the wrong patients, incentivization of excessive caution among providers, and a narrow definition of psychiatry's purview. While each of these practices has been discussed elsewhere in the literature, they are rarely considered as part of an interrelated and systemic problem. Reconceptualizing these three issues as aspects of the larger conflict between the interests of “visible” and “invisible” victims may prove a path toward reform. (shrink)

An applicant to our graduate program in philosophy, accepted as well by one (but only one) other graduate program, wrestles with his decision. Finally he decides to attend the other program, but he thanks me for our offer, telling me, "I'm glad that at least I had a choice." I want to focus a bit on these two stories, for while the central conclusion in each -- something turning on the importance of choice -- is initially compelling, it is also, (...) on reflection, philosophically puzzling. It is compelling, because many of us in similar positions would share this response; phenomenologically, it feels right to us. We want to believe that the central facts of our lives -- whether or not we have children, where we are educated, what career we follow, with 1 whom we join as partners -- contain in them some fundamental element of our own selection and decision. We will be exploring below exactly what will turn out to be important here, and why, but for now, in our pre-reflective grasp of this phenomenon, we can say that it seems to have something to do with the value we place on autonomy, self-governance, self-authorship. We want, metaphorically speaking, to write the story of our own lives. But let me now begin to draw out why I find this insistence on the importance of choice, which so many of us would share, to be so puzzling. Both individuals, in both stories, want to be offered a certain additional option in order to have -- or at least to feel that they have? -- a choice about what they are going to do next. But, on the one hand, we could argue that, even with this added option, they still don't have a "real" choice -- they don't have the choice of doing what they most want to do; and on the other hand, one could argue that even without the added option, they always had some choice. Let me explain. In the first story, my friend certainly doesn't have open to her the option that would have been her first choice (and, in our society, what we might call the standard choice, the most frequently chosen option): to produce a biological child with her partner in a happy marriage.. (shrink)

Ethical behavior — the conscious attempt to act in accordance with an individually-owned morality — is the product of an advanced stage of the maturing process. Three models of ethical growth derived from research in human development are applied to issues of business ethics.

The purpose of this paper is to point out that some mathematical doctrines attributed by Aristotle to Plato find their origin in a threefold order of problems: first, in some allusions contained in the dialogues, which might create ambiguities within the so-called standard model of ideas; second, in the Aristotelian interpretation of ideal entities as universals or predicates, an interpretation in turn partly authorized by Plato himself; third, in the tendency not to emphasize the possibility of understanding participation and the (...) whole-part relationship from a non-quantitative point of view. In this paper I will disregard the complex debate about whether or not to attribute the unwritten doctrines of the Aristotelian account to Plato, but I will appraise in what sense some Aristotelian objections to participation may arise from the fact of conceiving of numbers and magnitudes as ideas. (shrink)

Neurocognitive enhancement, or cosmetic neurology, offers the prospect of improving the learning, memory and attention skills of healthy individuals well beyond the normal human range. Much has been written about the ethics of such enhancement, but policy-makers in the USA, the UK and Europe have been reluctant to legislate in this rapidly developing field. However, the possibility of discrimination by employers and insurers against individuals who choose not to engage in such enhancement is a serious threat worthy of legislative intervention. (...) While lawmakers should not prevent individuals from freely pursuing neurocognitive enhancement, they should act to ensure that such enhancement is not coerced. This paper offers one model for such legislation, based upon a proposed US law, the Genetic Information Nondiscrimination Act of 2008, to address precisely this particular pitfall of the impending neuroscience revolution. (shrink)

Apolitical, amoral, an aesthete whose writings point toward some form of liberation: this is the figure who emerges from most recent scholarship on Friedrich ...

Exploring the ethical questions posed by, in, and about children’s literature, this collection examines the way texts intended for children raise questions of value, depict the moral development of their characters, and call into attention shared moral presuppositions. Even as children’s literature has evolved in opposition to its origins in didactic Sunday school tracts and moralizing fables, authors, parents, librarians, and scholars remain sensitive to the values conveyed to children through the texts they choose to share with them.

The purpose of this article is to address the complex relationships within the geography of virtues. Based on the recent prototypical theories of concepts as idealized cognitive models arising from abstraction, the article argues that the relations between virtues are asymmetrical, with a prototypical virtue characterizing the whole category and specific virtues being character traits or skills derived from the prototypical virtue. It also argues that the most promising candidates for the role of prototypical virtue are phronesis (practical wisdom) and (...) the virtue of care, for their ability to represent and elicit any virtuous behavior when the situation calls for them. It therefore confronts the two options, which embody competing perspectives. In the concluding section, it proposes two possible directions for further research to settle in favor of one of the candidates. The article can be taken as an illustration of the potential of prototype theory for analyzing ethical concepts. (shrink)

The health and fitness of United States presidents has been a matter of concern since the Constitutional Convention. Several United States presidents, including James Madison, James Garfield, and Woodrow Wilson, were significantly impaired during portions of their tenure. Yet how to address this issue has proved both ethically and politically challenging, increasingly so during our nation's current period of elevated polarization. This essay reviews the history of presidential impairment and the range of proposals that have been offered to address it. (...) Ultimately, the essay argues that any effort to require the release of medical records or to evaluate the president while in office is likely to prove ineffective and politically unworkable, but also that providing the public with more medical information about candidates and presidents is unlikely to prove useful to voters in rendering their decisions. (shrink)

ABSTRACT The EU’s activation of Article 7 procedures against Hungary and Poland signals that it is beginning to take seriously the illiberal turn in Central Europe. However, the likelihood that the EU can restrain populist and illiberal tendencies in Hungary and Poland in the near future is slim. Despite the efficacy of the EU and other international organizations in promoting liberalism in these countries in the past, similar efforts are hobbled by a lack of political will and by significant bureaucratic (...) hurdles. The impetus to protect the liberal institutions and practices developed after the collapse of communism must come from the combined efforts of additional external actors and, most of all, by strong pressure from below. (shrink)

The removal of controversial names and monuments from the public sphere in the United States has gained traction in the context of efforts to achieve social justice for historically mistreated and marginalized communities. Such debates are increasingly raising issues in the healthcare setting as hospitals and medical schools grapple with the legacies of figures whose scientific contributions are clouded with ethical transgressions. Present efforts to address these challenges have largely occurred at the institutional level. The results have been guidelines that (...) are complex, highly inconsistent across institutions, and largely downplay the symbolic importance of such historical redress. This paper proposes a simpler three-part test for name and monument removal in the medical and hospital settings that places greater weight on the symbolic importance of the renaming process itself instead of only considering the outcomes. (shrink)

Clinical Ethics Consultation (CEC) has grown significantly in the last decade, and efforts are being made to professionalize the practice. The American Society for Bioethics and Humanities (ASBH) has been instrumental in this process, having published the _Code of Ethics and Professional Responsibilities for Healthcare Ethics Consultants_ and founded and endorsed the creation of the _Healthcare Ethics Consultant Certified (HCEC) Certification Commission._ The ASBH also published “core competencies” for healthcare ethics consultants and has delineated a clear identity and role of (...) such consultants distinct from that other healthcare professionals. In addition, more enter the field armed with advanced degrees (MA and PhD) or certification in clinical ethics consultation. While some have questioned the trend toward professionalization, the momentum is clearly in its favor. This paper explores three questions: Does the professionalization of healthcare ethics consultation expose those engaged in the field to the types of liability claims faced by professionals in other fields? What specific liabilities could affect a healthcare ethics consultant? And finally, what should healthcare ethics consultants do to protect themselves against liability claims? We conclude that while the risk of liability remains low, those engaged in the field should accept that risk just as part of their status as professionals and, like those in allied professions, seek appropriate protection in the form of liability insurance. (shrink)

One of the criteria used by many transplant centers in assessing psychosocial eligibility for solid organ transplantation is social support. Yet, social support is a highly controversial requirement that has generated ongoing debate between ethicists and clinicians who favor its consideration (i.e., utility maximizers) and those who object to its use on equity grounds (i.e., equity maximizers). The assumption underlying both of these approaches is that social support is not a commodity that can be purchased in the marketplace. This essay (...) argues for the reconceptualization of social support as a product that can—and should—be purchased for transplant candidates to render them eligible for transplant. (shrink)

This article is concerned with the dynamic of social change in the domain of food consumption and seeks to understand the role played by social representations in the transformation of daily food practices. It rests on a model of change that hinges on the processes of cultivation and naturalization of new components of practices. Social representation theory is used to enhance the understanding of the ways that representations contribute to these processes of cultivation and naturalization. Using a visual and multimodal (...) framework for analyzing online environments, the research looked at 984 Instagram posts published by 34 actors who have an interest in promoting alternative proteins in the Canadian context. Results show an emergent subfield of food consumption defined by representations of alternative proteins actively and fluidly intertwined with those of their meat and dairy counterparts. This interplay emerges as being confrontational in the cultivation phase of the model for changing practices –where alternative proteins are presented as being better than meat and dairy – but becomes much more conciliatory during its naturalization phase, in which alternative proteins are presented as being as good as meat and dairy. (shrink)

Die Arbeit setzt sich mit der neuzeitlichen Theodizeefrage auseinander. In einem ersten Schritt wird versucht, den genuinen Gehalt der Philosophie von Leibniz darzustellen, dessen Werk für die weitere Diskussion dieser Thematik maßgeblich wurde. Dabei wird aufgewiesen, dass die Argumente von Leibniz empiristischen und fideistischen Bestreitungen einer Theodizee standzuhalten und den Glauben an den allmächtigen und gütigen Gott mit dem Phänomen menschlicher Freiheit in Verbindung zu bringen vermögen. In einem zweiten Schritt werden die Positionen von Kant und Leibniz konfrontiert. Dabei zeigt (...) sich, dass Kant den von Leibniz bezeichneten Weg nicht verwirft, sondern weiterführt und die Theodizeefrage konsequent in der Praxis menschlichen Weltumgangs zu verorten vermag. (shrink)

Evidence‐based medicine has become both the mantra of clinical practice and the dominant contemporary approach to patient care. Gordon Guyatt et al. first proposed applying the concept to medical education in the early 1990s, arguing for training that “de‐emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale” in favor of “examination of evidence from clinical research”; over the following twenty‐five years, nearly every medical school and residency program in the United States incorporated these methods into its training. During this same period, (...) admissions requirements and protocols have continued to rely on subjective, non‐evidence‐based ideals largely developed a century earlier. In light of the continued underrepresentation of certain demographic groups among matriculants, as well as the national controversy surrounding admissions standards at undergraduate institutions—most notably embodied in the lawsuit by Students for Fair Admissions against Harvard University—the moment may be ripe for a radical reexamination of those requirements. (shrink)

Clinicians are often called upon to assess the capacity of a patient to appoint a healthcare agent. Although a consensus has emerged that the standard for such assessment should differ from that for capacity to render specific healthcare decisions, exactly what standard should be employed remains unsettled and differs by jurisdiction. The current models in use draw heavily upon analogous methods used in clinical assessment, such as the “four skills” approach. This essay proposes an alternative model that relies upon categorization (...) and sliding scale risk assessment that can be used to determine to how much scrutiny the proxy appointment should be subjected and how much certainty of accuracy should be required in order to maximize the patient’s autonomy and ensure that her underlying wishes are met. (shrink)

Rather than being a neutral phenomenon, the authors propose that medical school donations should be viewed as a social good for advancing education and improving healthcare. Seen in this light, they aim to offer a framework for analysis that will be useful to medical institutions and their stakeholders in addressing proposed donations from contentious or divisive sources, and in managing those donations that subsequently appear controversial.

"What do grown children owe their parents?" Over two decades ago philosopher Jane English asked this question and came up with the startling answer: nothing (English 1979). English joins many contemporary philosophers in rejecting the once-traditional view that grown children owe their parents some kind of fitting repayment for past services rendered. The problem with the traditional view, as argued by many, is, first, that parents have duties to provide fairly significant services to their growing children, and persons do not (...) owe repayment for others' mere performance of duty; second, even where parents go above and beyond duty in their loving and generous rearing of their children, the benefits are bestowed, at least on young children, without their voluntary acceptance and consent, and so, again, fail to generate any obligation of subsequent repayment on their part (see Blustein 1982: 182-3). Moreover, the entire idiom of obligation and repayment, in English's 1 words, "tends to obscure, or even to undermine, the love that is the correct ground of filial obligation" (352). English's alternative, however -- that children strictly "owe" their parents nothing except what flows naturally from whatever love and affection exist between them -- also strikes many as problematic. Christina Hoff Sommers offers examples of what seem to be clearly delinquent adult children, who simply don't "feel" like sharing their lives with their aging parents, or providing any emotional or financial support to them, and so don't (Sommers 1986: 440-41). Sommers points out that we need some talk of obligations in order to fill in the cracks in human relationships where love and affection fail: "The ideal relationship cannot be 'duty-free,' if only because sentimental ties may come unraveled, often leaving one of the parties at a material disadvantage'" (450-51). Sommers proposes as her alternative to English that legitimate duties arise out of special relationships defined by social roles: being a father or mother, a son or a daughter, "is socially as well as biologically prescriptive; it not only defines what one is; it also defines who one is and what one owes" (447).. (shrink)

Limitations on reproductive decision making, including forced sterilization and involuntary birth control, raise significant ethical challenges. In the United States, these issues are further complicated by a disturbing history of the abuse and victimization of vulnerable populations. One particularly fraught challenge is the risk of teratogenicity posed by moodstabilizing psychiatric medications in patients who are incapable of appreciating such dangers. Long-acting reversible contraception (LARC) offers an intervention to prevent pregnancy among individuals who receive such treatments, but at a cost to (...) their reproductive autonomy. This article examines the ethical issues involved in the use of involuntary LARC for patients on teratogenic psychiatric medications (TPMs) and argues that such an approach can only be justified as a last resort after a careful consideration of the alternatives and an assessment of potential risks and benefits. (shrink)

In this paper, we argue that to reverse the excess of specialization and to create room for interdisciplinary cross-fertilization, it seems necessary to move the existing epistemic plurality towards a collaborative process of social cognition. In order to achieve this, we propose to extend the psychological notion of joint attention towards what we call joint intellectual attention. This special kind of joint attention involves a shared awareness of sharing the cognitive process of knowledge. We claim that if an interdisciplinary research (...) team aspires to work collaboratively, it is essential for the researchers to jointly focus their attention towards a common object and establish a second-person relatedness among them. We consider some of the intellectual dispositions or virtues fostered by joint intellectual attention that facilitate interdisciplinary exchange, and explore some of the practical consequences of this cognitive approach to interdisciplinarity for education and research. (shrink)

Jacob Böhme (1575-1624) is one of the most important German thinkers. His writings have influenced literature, philosophy, religion and art beyond national borders from his time up to the present. One hundred years after the beginning of the Protestant Reformation - on the eve of the Thirty Years' War - Böhme wanted to give voice to the need for a deep spiritual and philosophical renewal. In a series of exhibitions - in Dresden, Coventry, Amsterdam, and Wrocław - the Dresden State (...) Art Collections recall this unconventional thinker, whose ideas about the relationship between science and belief, humanity and nature, woman and man are today more current than ever. Exhibition: Coventry Cathedral, UK (30.04. - 05.07.2019)"-- Back cover. (shrink)

The most widely accepted model of decisional capacity assessment requires that a patient communicate a clear and consistent choice to the evaluator. This approach works effectively when patients prove unable to express a choice owing to physical, psychological, or cognitive limitations. In contrast, the approach raises ethics concerns when applied to patients who volitionally refuse to communicate a choice. This article examines the ethical issues that arise in such cases and offers a rubric for addressing decisional capacity under such circumstances.

The model for capacity assessment in the United States and much of the Western world relies upon the demonstration of four skills including the ability to communicate a clear, consistent choice. Yet such assessments often occur at only one moment in time, which may result in the patient expressing a choice to the evaluator that is highly inconsistent with the patient’s underlying values and goals, especially if a short-term factor (such as frustration with the hospital staff) distorts the patient’s preferences (...) momentarily. These challenges are particularly concerning in cases, which arise frequently in hospital settings, in which patients demand immediate self-discharge, often during off-hours, while faced with life-threatening risks. This paper examines the distinctive elements that shape such cases and explores their ethical implications, ultimately offering a model for such situations that can be operationalized. (shrink)

The COVID-19 pandemic has focused considerable attention on crisis standards of care (CSCs). Most public CSCs at present are effective tools for allocating scarce but not uncommon resources (like ventilators and dialysis machines). However, a different set of challenges arise with regard to extremely scarce resources (ESRs), where the number of patients in need may exceed the availability of the intervention by magnitudes of hundreds or thousands. Using the allocation of extracorporeal membrane oxygenation machines as a case study, this paper (...) argues for a different set of CSCs specifically for ESRs and explores four principles (transparency, uniformity, equity and impact) that should shape such guidelines. (shrink)

Nature experiences usually lead to restorative effects, such as positive affective states and reduced stress. Even watching nature compared to urban images, which are known to differ in several image properties that are processed at early stages, can lead to such effects. One potential pathway explaining how the visual input alone evokes restoration is that image properties processed at early stages in the visual system evoke positive associations. To study these automatic bottom-up processes and the role of lower-level visual processing (...) involved in the restoring effects of nature, we conducted two studies. First, we analyzed nature and urban stimuli for a comprehensive set of image properties. Second, we investigated implicit associations in a dichotomous set of nature and urban images in three domains, namely, valence, mood, and stress restoration. To examine the role of lower-level processing in these associations, we also used stimuli that lacked the spatial information but retained certain image properties of the original photographs. While original nature images were associated with “good,” “positive mood,” and “restoration,” urban images were associated with “bad” and “stress.” The results also showed that image properties differ between our nature and urban images and that they contribute to the implicit associations with valence, although spatial information and therefore recognition of the environment remained necessary for positive associations. Moreover, lower-level processed image properties seem to play no or only minor roles for associations with mood and stress restoration. (shrink)